Vascular remodeling device
Described herein are flexible implantable devices or stents that can conform to the shape of vessels of the neurovasculature. In some embodiments, the devices can direct blood flow within a vessel away from an aneurysm or limit blood flow to the aneurysm. In some embodiments, a vascular remodeling device includes a first section and a protruding section. During deployment, the device expands from a compressed configuration to an expanded configuration. The first section anchors the device in an afferent vessel and/or in an efferent vessel of a bifurcation and the protruding section is positioned in the junction of the bifurcation having an aneurysm and across the neck of the aneurysm or at least partially within the aneurysm.
1. A method of treating an aneurysm at a junction of a bifurcation having an afferent vessel and first and second efferent vessels, the method comprising:
anchoring, in the first efferent vessel, a distal section of a stent while in an expanded configuration;
anchoring, in the afferent vessel, a proximal section of the stent while in the expanded configuration; and
positioning a protruding section of the stent while in the expanded configuration to abut an ostium of the aneurysm on a side of the aneurysm that is adjacent to the second efferent vessel, wherein, while in the expanded configuration, a maximum cross-sectional dimension of the protruding section is greater than a maximum cross-sectional dimension of the proximal section and a maximum cross-sectional dimension of the distal section,
wherein the stent comprises filaments, and at least a portion of the protruding section has a lower filament density than other portions of the protruding section to allow perfusion to the second efferent vessel.
2. The method of claim 1 , further comprising positioning the protruding section to abut the ostium of the aneurysm on a side of the aneurysm that is adjacent to the first efferent vessel.
3. The method of claim 1 , wherein the aneurysm is located between the first and second efferent vessels.
4. The method of claim 1 , wherein the proximal section defines a proximal lumen, the distal section defines a distal lumen, and the protruding section defines an intermediate lumen, and wherein, after the positioning, the proximal, intermediate, and distal lumens provide a substantially unobstructed path for fluid flow from the afferent vessel to the first efferent vessel and a strut pattern of the protruding section permits fluid flow to the second efferent vessel.
5. The method of claim 1 , wherein at least one of the proximal, distal, and protruding sections is self-expanding.
6. The method of claim 1 , further comprising inserting embolic material into the aneurysm.
7. The method of claim 1 , wherein, while in the expanded configuration, first cells of the proximal section and/or the distal section have a first cell size that is substantially equal to a second expanded cell size of the second cells of the protruding section.
8. The method of claim 1 , wherein the protruding section has a strut pattern that is substantially the same as a strut pattern of the proximal section and/or the distal section.
9. The method of claim 1 wherein the protruding section extends around only a portion of the circumference of the stent.
10. A method of treating an aneurysm at a junction of a bifurcation having an afferent vessel and first and second efferent vessels, the method comprising:
providing a stent in a compressed configuration within a catheter, the stent comprising (i) a proximal section, (ii) a distal section; and (iii) a protruding section, between the proximal and distal sections, and wherein the stent comprises filaments, and at least a portion of the protruding section has a lower filament density than other portions of the protruding section to allow perfusion to the second efferent vessel;
expanding the stent from the compressed configuration to an expanded configuration out of the catheter, the expanding comprising:
anchoring, in the first efferent vessel, the distal section;
anchoring, in the afferent vessel, the proximal section; and
positioning the protruding section to abut an ostium of the aneurysm on a side of the aneurysm that is adjacent to the second efferent vessel, wherein, while in the expanded configuration, a maximum cross-sectional dimension of the protruding section is greater than a maximum cross-sectional dimension of the proximal section and a maximum cross-sectional dimension of the distal section.
11. The method of claim 10 , wherein the expanding further comprises positioning the protruding section to abut the ostium of the aneurysm on a side of the aneurysm that is adjacent to the first efferent vessel.
12. The method of claim 10 , wherein the aneurysm is located between the first and second efferent vessels.
13. The method of claim 10 , wherein the proximal section defines a proximal lumen, the distal section defines a distal lumen, and the protruding section defines an intermediate lumen, and wherein, after the expanding, the proximal, intermediate, and distal lumens provide a substantially unobstructed path for fluid flow from the afferent vessel to the first efferent vessel and a strut pattern of the protruding section permits fluid flow to the second efferent vessel.
14. The method of claim 10 , wherein at least one of the proximal, distal, and protruding sections self-expands during the expanding.
15. The method of claim 10 , further comprising inserting embolic material into the aneurysm.
16. The method of claim 10 , wherein the protruding section has a strut pattern that is substantially the same as a strut pattern of the proximal section and/or the distal section.
17. The method of claim 10 wherein the protruding section extends around only a portion of the circumference of the stent.
18. A method of treating an aneurysm at a junction of a bifurcation having an afferent vessel and first and second efferent vessels, the method comprising:
providing a stent in a compressed configuration within a catheter, the stent comprising (i) a proximal section, (ii) a distal section; and (iii) a protruding section, between the proximal and distal sections;
expanding the stent from the compressed configuration to an expanded configuration out of the catheter, the expanding comprising:
anchoring, in the first efferent vessel, the distal section;
anchoring, in the afferent vessel, the proximal section; and
positioning the protruding section to abut an ostium of the aneurysm on a side of the aneurysm that is adjacent to the second efferent vessel, wherein, while in the expanded configuration, a maximum cross-sectional dimension of the protruding section is greater than a maximum cross-sectional dimension of the proximal section and a maximum cross-sectional dimension of the distal section;
wherein, while in the compressed configuration, first cells of the proximal section and/or the distal section have a first compressed cell size greater than a second compressed cell size of second cells of the protruding section, and wherein, while in the expanded configuration, the first cells have a first expanded cell size that is substantially equal to a second expanded cell size of the second cells.