Methods, systems and devices for treatment of cerebrospinal venous insufficiency and multiple sclerosis
Methods and devices for relieving stenoses in, or otherwise improving blood flow through, body lumens. Although applicable in a variety of different body lumens, the methods and devices of this invention are specifically useable for relieving stenoses in, or otherwise improving blood flow through, veins which drain blood from the brain for treatment of multiple sclerosis or other neurodegenerative disorders that are caused, triggered or exacerbated by venous occlusion or venous insufficiency.
1. A method for treating a rising venous backpressure due to an intrathoracic pressure that affects venous outflow through a cerebrospinal vein involving a stent device comprising:
providing at least one self-expanding stent member configured to be placed within a right internal jugular vein;
configuring the at least one self-expanding stent member within the right internal jugular vein to apply a non-continuous force on the right internal jugular vein, the at least one self-expanding stent member having a first applied force;
providing the at least one self-expanding stent member with a sensor and configuring the sensor to sense a physiological triggering variable, the physiological triggering variable being a rising venous backpressure due to an intrathoracic pressure that affects venous outflow through a cerebrospinal vein;
providing the at least one self-expanding stent member with a microprocessor and configuring the microprocessor to automatically actuate the at least one self-expanding stent member to apply a second applied force that is different from the first applied force when the sensor senses the physiological triggering variable;
providing at least one deformable constraining member connected to the at least one self-expanding stent member;
wherein the at least one self-expanding stent member being initially deployable in a collapsed configuration and thereafter self-expandable to a first expanded configuration, the at least one deformable constraining member being operative to diametrically constrain the at least one self-expanding stent member so that it does not self expand beyond the first expanded configuration; and
wherein all or part of the at least one deformable constraining member being thereafter deformable to a deformed configuration that allows all or part of the at least one self-expanding stent member to further expand to a second expanded configuration, the second expanded configuration of the at least one self-expanding stent configured to exert a varying force in response to information provided by the sensor to the microprocessor.
2. The method of claim 1 wherein the at least one self-expanding stent member comprises one or more self-expanding rings.
3. The method of claim 1 wherein the at least one self-expanding stent member comprises one or more self-expanding zig-zag rings.
4. The method of claim 1 wherein the at least one self-expanding stent member comprises one or more self-expanding mesh rings.
5. The method of claim 1 wherein the at least one deformable constraining member comprises one or more deformable filaments.
6. The method of claim 1 wherein the at least one deformable constraining member comprises one or more deformable bands.
7. The method of claim 1 wherein the at least one deformable constraining member comprises at least one deformable sheaths that is configured to define a tube extending a length of the stent device.
8. The method of claim 7 wherein the at least one deformable sheath comprises an inner polymer layer and an outer polymer layer and wherein the least one self-expanding stent member is positioned between the inner and outer polymer layers.
9. The method of claim 7 wherein the at least one deformable sheath has perforations formed therein.
10. The method of claim 9 wherein the size, shape, number and location of the perforations are selected to provide desired amounts of flexibility and diametric constraint.
11. The method of claim 9 wherein the perforations are round.
12. The method of claim 9 wherein the perforations are polygonal.
13. The method of claim 1 wherein the at least one deformable constraining member is formed at least in part by a deformable metal or polymer.
14. The method of claim 13 wherein a pressure deformable metal or polymer is selected from the group consisting of: PTFE, ePTFE, polyurethane, stainless steel or nickel-titanium.
15. The method of claim 1 wherein the at least one self-expanding stent member comprises a plurality of self-expanding ring members and wherein the at least one deformable constraining member comprises a plurality of deformable constraining members that, in addition to providing diametric constraint, connect the plurality of self-expanding ring members to one another in series.
16. The method of claim 15 wherein the plurality of self-expanding ring members comprise zig-zag rings having apices and wherein, in addition to providing diametric constraint, the deformable constraining members connect apices of one self-expanding zig-zag ring member to apices of another self-expanding zig-zag ring member.