Vascular stenting for aneurysms
Described herein are flexible implantable occluding devices that can, for example, navigate the tortuous vessels of the neurovasculature. The occluding devices can also conform to the shape of the tortuous vessels of the vasculature. In some embodiments, the occluding devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. Some embodiments describe methods and apparatus for adjusting, along a length of the device, the porosity of the occluding device. In some embodiments, the occluding devices allows adequate blood flow to be provided to adjacent structures such that those structures, whether they are branch vessels or oxygen-demanding tissues, are not deprived of the necessary blood flow.
1. A method of treating an aneurysm, the method comprising:
advancing a delivery device within a blood vessel comprising an aneurysm until a distal portion of the device is adjacent the aneurysm;
expanding a first stent within the vessel, the expanded first stent extending from a first side of the aneurysm to a second side of the aneurysm; and
withdrawing the delivery device from the vessel upon determining that between about 30% and about 70% of a fluid in a body of the aneurysm has formed occlusive material, comprising a thrombus.
2. The method of claim 1 , wherein the determining comprises imaging the aneurysm.
3. The method of claim 1 , wherein the withdrawing occurs upon determining that between about 30% and about 50% of the fluid has formed the occlusive material.
4. The method of claim 1 , wherein the withdrawing occurs upon determining that by about 50% of the fluid has formed the occlusive material.
5. The method of claim 1 , wherein the withdrawing occurs upon determining that by not more than about 50% of the fluid has formed the occlusive material.
6. The method of claim 1 , further comprising, when at least about 30% of the fluid has not formed the occlusive material after expanding the first stent, expanding a second stent within the expanded first stent.
7. The method of claim 6 , further comprising determining that at least about 30% of the fluid has formed the occlusive material after expanding the second stent.
8. The method of claim 7 , wherein withdrawing the delivery device occurs after expanding both the first and second stents, and upon determining, after expansion of the second stent, that at least about 30% of the fluid has formed the occlusive material.
9. A method of implanting a stent at an aneurysm in a blood vessel, the method comprising:
providing an elongate body comprising a proximal portion, a distal portion, and a lumen extending between the proximal portion and the distal portion;
inserting the distal portion in a blood vessel comprising an aneurysm;
advancing the distal portion within the blood vessel until the distal portion is proximate to the aneurysm;
advancing, relative to the elongate body and within the lumen of the elongate body, a stent in a compressed configuration;
expanding the stent within the vessel, the expanded stent extending from a first location distal to the aneurysm to a second location proximal to the aneurysm; and
following the expanding the stent and upon confirming that a body of the aneurysm has from about 30% to no more than about 70% occlusion formation, wherein said occlusion formation is indicative of a correlated level of thrombosis, withdrawing the elongate body from the vessel.
10. The method of claim 9 , wherein the withdrawing occurs upon a body of the aneurysm having between about 30% and about 50% occlusion formation.
11. The method of claim 9 , wherein the withdrawing occurs upon a body of the aneurysm having approximately 50% occlusion formation.
12. The method of claim 9 , wherein the withdrawing occurs upon a body of the aneurysm having approximately 30% occlusion formation.
13. The method of claim 9 , further comprising, when the body of the aneurysm has not generated occlusion formation, advancing a second stent in a compressed configuration within the vessel and expanding the second stent within the vessel prior to withdrawing the elongate body, the second stent extending from a third location distal to the aneurysm to a fourth location proximal to the aneurysm.
14. The method of claim 9 , wherein the withdrawing occurs upon a body of the aneurysm having not more than about 50% of the fluid having formed the occlusive material.
15. A method for generating thrombus within an aneurysm, the method comprising:
advancing a delivery device within a blood vessel until a distal portion of the delivery device is adjacent the aneurysm;
expanding a stent across the aneurysm;
imaging the aneurysm;
determining a degree of thrombosis within the aneurysm after expanding the stent; and
after determining that said expanding results in formation of occlusion material, comprising a thrombus, in the aneurysm corresponding to between about 30% and about 70% of a fluid in a body of the aneurysm, withdrawing the delivery device from the vessel.
16. The method of claim 15 , wherein the withdrawing occurs upon formation of the occlusion material corresponding to between about 30% and about 50% of the fluid.
17. The method of claim 15 , wherein the withdrawing occurs upon formation of the occlusion material corresponding to about 50% of the fluid.
18. The method of claim 15 , wherein the withdrawing occurs upon formation of the occlusion material corresponding to about 30% of the fluid.
19. The method of claim 15 , further comprising, when the fluid in the body of the aneurysm has not formed the occlusion material, expanding a second stent across the aneurysm prior to withdrawing the delivery device.
20. The method of claim 15 , wherein the withdrawing occurs upon formation of the occlusion material corresponding to not more than about 50% of the fluid.