阅读说明：本技术 用于递送栓塞装置的系统和方法 (Systems and methods for delivering embolic devices ) 是由 布雷特·A·弗尔莫 瑞恩·M·星野 尼古拉斯·戴比尔 安德鲁·斯科特·哈夫马斯特 卡尔·斯特 于 2018-10-24 设计创作，主要内容包括：本发明提出一种用于递送栓塞装置的系统和方法。在一种实施方案中,所述系统和方法可以涉及导管、联接器和栓塞装置的组合。联接器设置于导管的内部。栓塞装置在近端处与固位机构联接。在将栓塞装置递送到动脉内的特定位置之前,通过使联接器与固位机构接合而使栓塞装置与导管接合。通过将联接器与导管上形成的固定机构固定,将栓塞装置进一步固定到递送导管。当递送导管到达动脉中的期望位置时,通过简单地向近端拉动联接器,使得联接器的环状部分首先与锁定窗口脱离,然后与固位机构脱离,从而使栓塞装置从递送导管中释放。(The present invention provides a system and method for delivering an embolic device. In one embodiment, the systems and methods may involve a combination of a catheter, a coupler, and an embolic device. The coupler is disposed inside the conduit. The embolic device is coupled at a proximal end with a retention mechanism. The embolic device is engaged with the catheter by engaging the coupler with the retention mechanism prior to delivering the embolic device to the specific location within the artery. The embolic device is further secured to the delivery catheter by securing the coupler to a securing mechanism formed on the catheter. When the delivery catheter reaches the desired location in the artery, the embolic device is released from the delivery catheter by simply pulling the coupler proximally so that the loop portion of the coupler disengages first from the locking window and then from the retention mechanism.)

1. An embolic surgical device, comprising:

a catheter having a resilient coupling disposed therein and configured to engage an orifice of an embolic device; and

an actuator operatively coupled to the coupler and configured to manipulate the coupler to engage the embolic device.

2. The embolic surgical device of claim 1, wherein the resilient coupling comprises a steerable tip that curves upward and extends into the aperture.

3. The embolic surgical device of claim 2, wherein the resilient coupling comprises an elongate member having an axis, wherein continued manipulation of the steerable tip away from the axis.

4. The embolic surgical device of claim 1, wherein the catheter comprises a locking window disposed on the catheter and configured to engage the resilient coupler at the locking window.

5. The embolic surgical device of claim 4, wherein the resilient coupling comprises a steerable tip and is configured to secure the resilient coupling at the locking window.

6. The embolic surgical device of claim 4, wherein the catheter comprises a distal end such that the locking window is disposed on the distal end of the catheter.

7. The embolic surgical device of claim 1, wherein the resilient coupler comprises an annular body.

8. The embolic surgical device of claim 1, wherein the orifice of the embolic device is formed by a retention mechanism of the embolic device.

9. The embolic surgical device of claim 1, wherein the resilient coupling comprises a shape memory material.

10. The embolic surgical device of claim 1, wherein the catheter comprises a crossbar disposed within the catheter and spanning the axis of the engagement member.

11. An embolic device delivery system, comprising:

an embolic device having a retention ring with an orifice;

an elongated catheter; and

a resilient coupling slidably disposed within the elongated conduit and configured to retain the embolic device through the aperture.

12. The embolic device delivery system of claim 11, wherein the elongate catheter further comprises a locking window disposed on the elongate catheter and configured to engage the resilient coupler with the embolic device.

13. The embolic device delivery system of claim 12, wherein the resilient coupler further comprises a tip configured to engage with the aperture and protrude from the locking window to secure the embolic device to the elongate catheter.

14. The embolic device delivery system of claim 13, wherein the tip comprises a flexible material configured to bend upward to engage the aperture and the locking window.

15. The embolic device delivery system of claim 13, wherein the tip comprises a shape memory alloy configured to change shape to engage with the aperture and the locking window.

16. The embolic device delivery system of claim 13, wherein the elongate catheter comprises a proximal end configured to manipulate a tip of the coupler toward the proximal end to release the coupler from the locking window and the aperture.

17. The embolic device delivery system of claim 12, wherein the elongate catheter comprises a distal end and the locking window is located adjacent the distal end of the elongate catheter such that the embolic device is partially contained within the elongate catheter.

18. The embolic device of claim 11, wherein the elongated catheter comprises a crossbar disposed within the elongated catheter and spanning the axis of the engaging member.

19. A method for delivering an embolic device, comprising the steps of:

engaging the embolic device with a catheter by engaging an orifice of the embolic device with a resilient coupler having a steerable tip, the coupler disposed in the catheter;

inserting the catheter into an artery of a patient;

manipulating the embolization device such that the catheter is positioned within the artery adjacent the aneurysm;

withdrawing the coupler from the orifice; and

removing the catheter from the artery.

20. The method of claim 19, further comprising securing the steerable tip to a locking window disposed on the catheter.

21. The method of claim 20, further comprising actuating the coupler by pulling the coupler in a proximal direction to release the embolic device.

22. The method of claim 19, the engaging step further comprising advancing the coupler to a distal end of the catheter to secure the embolic device.

23. The method of claim 19, further comprising straightening the coupler with a crossbar disposed within the conduit while withdrawing the coupler.

Background

Aneurysms are blood cells that form on the walls of arteries and may grow in any artery, including the brain, aorta, lower extremities, and spleen. Various aneurysms often form sacs, and if they rupture, stroke, also known as subarachnoid hemorrhage, can occur. Performing open surgery to clamp or seal an aneurysm is one option for treating and resecting aneurysms. However, surgery is often associated with risks, and may not be suitable or dangerous for larger sized aneurysms and/or aneurysms in more sensitive locations. Therefore, treating, debulking and/or ablating aneurysms is important to the long-term health of the patient.

As an alternative to open surgery, the surgeon may perform minimally invasive surgery to place an occluding and embolizing device within the artery for treatment of growing aneurysms. In such procedures, an occluding embolic device (e.g., an occlusion device) is placed in a position within the saccular aneurysm to isolate or occlude the saccular aneurysm from the blood vessel. Placement of the occluding device is typically accomplished using a catheter carrying the occluding device so that the device can be inserted into a blood vessel and maneuvered (Steer) through the vessel to treat the aneurysm.

Conventional embolic device deployment systems have difficulty in, and have proven to be cumbersome to, manipulate (maneuver), place, and release the embolic device in an artery within a patient. This is particularly true for cerebral aneurysms where the deployment procedure requires accurate placement of the embolic device and any errors in the procedure can cause serious damage to the brain.

Drawings

The aspects and many of the attendant advantages of the claims will become more readily apparent and appreciated by reference to the following detailed description when taken in conjunction with the accompanying drawings wherein:

FIG. 1(a) is a perspective view of a patient with a cerebral aneurysm;

FIG. 1(b) shows a detailed view of a cerebral aneurysm as shown in FIG. 1(a) during treatment;

fig. 2(a) -2 (c) are illustrations of an embolic device delivery system according to an embodiment of the present subject matter;

fig. 3 is a diagrammatic view of a steerable tip of a coupler extending through an upper locking window in an embolic device delivery system according to an embodiment of the present subject matter, as shown in fig. 2(a) -2 (c);

FIG. 4 is an illustration of a steerable tip of a coupler protruding through a lower locking window in an embolic device delivery system according to an embodiment of the present subject matter, as shown in FIGS. 2(a) -2 (c);

FIG. 5 is a diagrammatic view of an actuator handle connected to a proximal end in an embolic device delivery system according to an embodiment of the present subject matter, as shown in FIGS. 2(a) through 2 (c);

FIG. 6 is an exploded view of the actuator handle shown in FIG. 5 in one embodiment according to the present subject matter;

FIG. 7 is a flow chart illustrating a method for delivering an embolic device in an embodiment according to the present subject matter;

fig. 8(a) -8 (b) are illustrations of an embolic device delivery system according to another embodiment of the present subject matter; and

fig. 9(a) -9 (c) are illustrations of an embolic device delivery system according to yet another embodiment of the present subject matter.

It should be noted that the same numbers are used throughout the text and figures to reference like components and features.

Detailed Description

The subject matter of the embodiments disclosed herein is described with specificity herein to meet statutory requirements, but such description is not necessarily intended to limit the scope of the claims. The claimed subject matter may be embodied in other ways, may include different elements or steps, and may be used in conjunction with other present or future technologies. This description should not be construed as implying any particular order or arrangement between various steps or elements, except when the order of individual steps or elements is explicitly described.

Various embodiments are described more fully hereinafter with reference to the accompanying drawings, which form a part hereof, and which illustrate exemplary embodiments by which the systems and methods described herein may be practiced. However, the embolic device delivery system can be embodied in many different forms and should not be construed as limited to the embodiments set forth herein, which are provided for the purpose of complying with statutory requirements and conveying the scope of the subject matter of the invention to those skilled in the art.

In general, the subject matter of the disclosure can relate to an embolic device delivery system, method, and device. In one embodiment, for example, an embolic device delivery system includes a delivery catheter, a coupler disposed inside the delivery catheter, and an embolic device that can be carried and placed by the coupler. The delivery catheter may be a hollow tube such that the coupler is slidably disposed within the interior of the tube and the coil engagement mechanism is disposed toward the distal end of the tube. In one embodiment, the coupler may be in an elongated shape with a looped portion for engaging the coil toward the distal end of the delivery catheter. The loop portion of the coupler may be a resilient material or a shape memory alloy, such as nitinol or nickel titanium, so that the loop portion can be bent at various angles. The delivery catheter and coupler may be inserted into the artery together and the embolic device carried to the aneurysm for placement adjacent and treatment of the aneurysm.

The embolic device may be coupled to the distal end of the coupler by a retention mechanism (e.g., an orifice). The embolic device may be secured to a coupler disposed within the delivery catheter by interlocking the loop portion of the coupler with a retention mechanism of the embolic device prior to delivery of the embolic device to a particular location within the artery. As described in detail below, the coupling-manipulable engagement member may engage a retention mechanism at one end of the embolic device and then protrude into a securing mechanism (e.g., an upper locking window) to prevent the embolic device from disengaging the delivery catheter until needed. The engagement member that the coupler can manipulate may be U-shaped bent such that the bottom of the U-shape bend may extend out of another securing mechanism (e.g., a lower locking window) to limit movement of the coupler. An upper locking window is formed in the body on at least one side proximate the distal end such that a top end of the ring portion engages the upper locking window to secure the embolic device to the coupler at the delivery location. A lower locking window is formed in the tubular body on the other side thereof, adjacent the distal end, opposite the upper locking window, such that the lowest bend of the U-shaped curve engages the lower locking window and the tip of the manipulable engagement member simultaneously engages the upper locking window. A crossbar formed across the axis of the body within the delivery catheter further assists in holding the coupler in place between the crossbar and the distal end of the delivery catheter by limiting movement of the steerable engagement member in the distal and proximal directions. The proximal end of the coupler is coupled to the actuator such that the coupler is available for manipulation by the surgeon. The actuator has a handle for use by the surgeon to manipulate the coupler and mechanism for releasing the embolic device. When the delivery catheter reaches the desired location in the artery, the embolic device can be released from the delivery catheter by simply pulling the coupler proximally via the actuator such that the U-shaped bend portion of the coupler and the loop portion of the coupler first disengage from the locking window, and then causing the coupler to release the embolic device by disengaging the retention mechanism. The loop portion of the coupler without the hook or bent end poses little risk of collision, pulling or dislodging the embolic device after placement during pulling because the flexible loop end of the coupler is straightened by the edge of the retention mechanism with or without the crossbar and is easier to maneuver from the locking window and retention mechanism. In addition, it is easy to pull the straightened coupler through the body of the delivery catheter. This facilitates easy removal or movement of the embolic device after placement relative to conventional embolic device delivery systems that use hooks or other non-flexible engagement/delivery members. In addition, the simple structure of the embodiments described herein is more cost effective and efficient to manufacture. These and other advantages will be more apparent in the detailed description below with respect to fig. 1-6.

Fig. 1(a) is a perspective view of a patient 10 with a cerebral aneurysm 30. Aneurysms may form in any artery of the human body, including the heart and brain. An aneurysm formed in a blood vessel (e.g., artery) 40 of the brain 20 is referred to as a intracranial aneurysm (cerebral aneurysm) or a cerebral aneurysm (brain aneurysm) 30. In this example, the cerebral aneurysm 30 is similar to a balloon (balloon). The aneurysm 30 is caused by weakness in the artery, and thus the aneurysm 30 may rupture when it contacts or comes close to the thin wall 40 of the artery. A ruptured aneurysm (not shown) may significantly contribute to the stroke and should be treated prior to rupture. Fig. 1(b) shows details of a cerebral aneurysm as shown in fig. 1(a) in a procedure using an embolic delivery device. The embolic device deployment system shown in fig. 1(b) comprises a deployment catheter 50, sometimes comprising a microcatheter 60 inside the deployment catheter 50. A conventional embolic deployment system is inserted into the artery 40 and passed through the artery 40 to the desired location. At the desired location, the deployment catheter 50 and/or microcatheter 60 releases the embolic device 70 inside the aneurysm 30 or near the aneurysm 30.

Depending on the location or nature of the aneurysm 30, the embolic device 70 is placed inside the saccular aneurysm 30 (as shown in fig. 1 (b)) or at the neck of the aneurysm to prevent further blood flow into the aneurysm 30. The deployment mechanism of the embolic device 70 may include: pushing the embolic device 70 away from the deployment catheter 50 (as shown in fig. 1 (b)); engaging the embolic device 70 with a thread or fiber (not shown) and cutting the thread or fiber upon detachment of the embolic device 70; releasing the embolic device 70 using pressure (not shown), heat (not shown), or electricity (not shown); and unlocking an interlock mechanism (not shown) to release the embolic device 70 from the deployment catheter 50. The interlocking mechanism of the embolic device delivery system typically interlocks the embolic device 70 with a portion of the deployment catheter 50 to carry the embolic device 70 to the interior of the artery 40, thereby allowing the deployment catheter 50 to manipulate the artery 40 through the embolic device 70 securely coupled to the deployment catheter 50. However, the interlocking mechanism in conventional embolic device deployment systems requires many components or features to achieve reliability, e.g., securely hold the embolic device until the deployment catheter 70 reaches the desired location to effectively release the embolic device 70. Many conventional interlocking mechanisms require additional locking components to fixedly interlock the deployment catheter 50 with the embolic device 70. However, the probability of a loss of regularity or failure of the deployed system is extremely high, and thus the use of many components to achieve reliable and smooth delivery may violate the goal of achieving continuous reliable delivery, resulting in serious errors in the procedure.

Fig. 2(a) -2 (c) are illustrations of an embolic device delivery system 100 according to an embodiment of the present subject matter. Fig. 2(a) shows an embolic device 160 coupled to the delivery catheter 110 in one embodiment. The delivery catheter 110 may include a proximal end 112 and a distal end 120 along an axis (not shown) of the delivery catheter 110. When the distal end 120 of the delivery catheter 110 is inserted into an artery, the distal end 120 can be guided through the artery to a desired location (e.g., where an aneurysm is located). Because the distal end 120 of the delivery catheter 110 is to be guided through the artery, the embolic device 160 should be securely coupled to the distal end 120 of the delivery catheter 110. The delivery catheter 110 may be designed as an elongated cylinder with a hollow inner tube extending from a proximal end 112 to a distal end 120. As the delivery catheter 110 is maneuvered through the artery, a flexible material may be used as the elongated cylinder for the delivery catheter 110. In one embodiment, the flexible material used for the delivery catheter 110 may include silicone, Polyurethane (PU), Polyethylene (PE), polyvinyl chloride (PVC), Polytetrafluoroethylene (PTFE), Polyetheretherketone (PEEK), nylon, and metal catheter components, such as, for example, helical hollow strand tubing and laser cut flexible tubing. The flexible material for the delivery catheter 110 may comprise a helical hollow strand^TMFor example, Fort Wayne Metals (wainburg Metals) available from Fort Wayne Fort (Fort Wayne) of iowa.

The elongated cylinder of the delivery catheter 110 further includes a coupler 130 disposed along the central axis of the delivery catheter 110. The coupler 130 may have a proximal end 132 and a distal end 140. In one embodiment, the proximal end 132 of the coupler 130 may be a linear member that extends through the proximal end 112 of the delivery catheter 110. Proximal end 132 may further include a mechanism for the surgeon to actuate coupler 130 by moving coupler 130 rearwardly within delivery catheter 110, as will be discussed further below in connection with fig. 5. The linear member of the coupler 130 may also form an engagement member toward the distal end 140 of the coupler 130. In one embodiment, coupling member 140 may be formed as a small diameter annular body made of a shape memory alloy such as nitinol, NiTi, or nickel titanium. Shape memory alloys have superelastic and unique memory properties to the original shape. Thus, the shape memory alloy may be stretched and held in the stretched phase; however, once the alloy is released from the stretched state, it will return to its original shape. The manipulable engagement member 140 may be further configured to become stiffer/less rigid and/or more/less flaccid when exposed to thermal, electrical, or physical forces. As described in fig. 2(b) and 2(c), this allows the coupler 130 to engage, manipulate and disengage the embolic device 160 during the embolic device delivery process.

The embolic device 160 coupled to the delivery catheter 110 can include an embolic device 160 configured to be deployed (expanded) once placed in place within the artery or near the aneurysm. In certain embodiments, the embolic device 160 can be a platinum coil. The embolic device 160 can further include a proximal end 172 and a distal end 174, and a retention mechanism 180 can be formed at the proximal end 172 of the embolic device 170 to fixedly couple with the delivery catheter 110. In various embodiments, the retention mechanism 180 may be formed as a closed ring, annulus, clip, or eyelet that is formed separately from the embolic device 160 and secured at the proximal end 172 of the embolic device 160. In another embodiment, the retention mechanism 180 may be integrally formed with the embolic device 160. The proximal end 172 is adapted to engage the coupler 130, and the proximal end 172 of the coupler may engage and penetrate the coupler through an aperture 190 formed in the retention mechanism 180. The retention mechanism 180 may be made of polypropylene or of platinum wire of the primary winding of the coil. During placement and delivery of the embolic device, a retention mechanism 180 (and sometimes the entire embolic device 160) may be disposed within the delivery catheter 110 near the distal end 120 of the delivery catheter 110. Thus, the diameter of the orifice 190 and the width of the embolic device 160 can be narrower than the inner diameter of the delivery catheter 110, such that the retention mechanism 180 and the embolic device 160 remain inside the distal end 120 of the delivery catheter 110 when manipulated through the artery.

When the delivery catheter 110 is engaged with the embolic device 160, the steerable engagement member 140 of the coupler 130 engages the retention mechanism 180 at the distal end 120 of the delivery catheter 110 by extending into the aperture 190 of the retention mechanism 180. With this arrangement, the inner diameter of the aperture 190 may be slightly wider than the diameter of the steerable engaging member 140, such that the retention mechanism 180 allows the steerable engaging member 140 to move back and forth a small amount inside the aperture 190 of the retention mechanism 180. In one embodiment, the manipulable engagement member 140 may extend upwardly through the aperture 190 by assuming an upwardly curved shape. As the surgeon manipulates the delivery catheter, the steerable engaging member 140 may extend downward or sideways rather than upward in response to rotation of the delivery catheter 110, so that one of ordinary skill in the art may change the direction of the curve accordingly. In another embodiment, the steerable engagement member 140 is steered away from the axis of the delivery catheter 110. Because of the super-elastic and shape-memory properties of the steerable engaging member 140, it can deform, e.g., from an upright configuration to an upwardly bent shape. In another embodiment, a portion of the steerable engaging member 140 may be bent vertically to extend through the aperture 190 of the retention mechanism 180.

As briefly described above, the delivery catheter 110 forms an upper locking window 150 on one side of the inner wall of the hollow tube near the distal end 120 of the delivery catheter 110, and a lower locking window 152 on the other side of the inner wall of the hollow tube near the distal end 120 of the delivery catheter 110. In one embodiment, the steerable engaging member 140 can form a U-shaped bend 154, and the downwardly bent portion 154 of the steerable engaging member 140 can be retained by a locking feature such as an upper locking window 150 and a lower locking window 152. In this configuration, the bottom of the downward curve 154 of the steerable engaging member 140 may be retained within the lower locking window 152, while the tip 200 of the steerable engaging member 140 may be retained within the upper locking window 150 within the delivery catheter 110 while guiding the delivery catheter 110 into the artery. In another embodiment, the upper locking window 150 is closer to the distal end 120 of the delivery catheter 110 than the lower locking window 152, such that the steerable engagement member 140 is locked by the upper and lower locking windows 150, 152 at the distal end 120 of the delivery catheter 110. Fig. 3 and 4 show cross-sectional views of the steerable engagement member 140 of the coupler 130 extending through portions of the upper and lower locking windows 150, 152 of the delivery catheter 110 according to one embodiment of the present subject matter, as shown in fig. 2(a) -2 (c). Specifically, fig. 3 shows a left elevational view of the upper locking window 150 of the delivery catheter 110, while fig. 4 shows a front elevational view of the lower locking window 152 of the delivery catheter 110. When the embolic device 160 is in a position to be coupled to the delivery catheter 110 (see fig. 2(a)), the steerable engaging member 140 engages the aperture 190 of the retention mechanism 180 and may further extend through the lower locking window 152 and the upper locking window 150 above the location of the aperture 190 of the retention mechanism 180 to secure the steerable engaging member 140 in this position. As the tip 200 of the manipulable engagement member 140 passes through the lower lock window 152 and reaches the upper lock window 150, the manipulable engagement member 140 is further bent upward such that the tip 200 of the manipulable engagement member 140 extends through the upper lock window 150. In another embodiment, the manipulable engagement member 140 may be vertically bent to also extend through the upper lock window 150. Once the steerable engaging member 140 is shaped in the upwardly curved position, the steerable engaging member 140 retains its shape until any physical force is applied to the steerable engaging member 140. The upwardly curved shape of the manipulatable engagement member 140 may be formed by physically bending the manipulatable engagement member 140, such as by freehand or by manipulating the distal end 120 of the coupler 130, to extend the manipulatable engagement member 140 through the aperture 190 such that the upright, original configuration is deformed into the curved shape. In various embodiments, the upper and lower locking windows 150, 152 may be formed in a rectangular, elliptical, oval, or circular shape. In yet another embodiment, the width of the locking window 150 may be slightly wider than the width of the tip 200 of the manipulable engagement member 140. As such, the locking window 150 allows limited movement of the tip 200 back and forth within its interior such that the tip 200 is secured within the locking window 150.

In addition to locking mechanisms such as upper and lower locking windows 150, 152, a crossbar 156 extending perpendicular to the axis of the hollow tube of the delivery catheter 110 may further limit movement of the coupler 130 in the distal and proximal directions 140, 132. When the embolic device 160 is in a position to be coupled to the delivery catheter 110 (see fig. 2(a)), the coupler 130 can be slid in a distal direction. However, during sliding, the curved portion of the manipulatable engagement member 140 contacts the crossbar 156 and prevents further movement in the distal direction. Additionally, as the coupler 130 moves proximally, the retention mechanism 180 and the manipulatable engagement member 140 may contact the crossbar 156 to prevent further movement in the proximal direction 132.

Fig. 5 illustrates an actuation mechanism or handle 300 connected to the proximal end 112 of an embolic device delivery system 100 according to one embodiment of the present subject matter, as shown in fig. 2(a) through 2 (c). As shown in fig. 2(a) -2 (c), the embolic device 160 is released from the coupler 130 of the delivery catheter 110 using an actuating handle 300 that manipulates the coupler 130. Actuation handle 300 may be any suitable mechanism for a surgeon to easily manipulate coupler 130 in a linear direction within a patient's artery. In one embodiment, handle 300 is a simple mechanical handle 250 that can pull the coupler in a distal direction. In fig. 5, the actuator handle 300 is shown to include a distal member 310, a proximal member 330, a rotation barrel 320, an outer shaft 350, and an inner shaft 360. These components 310, 320, 330, 350, and 360 are coupled to each other. In another embodiment, an adhesive may be placed between the outer shaft 350 and the proximal member 330 such that the outer shaft 370 is stably secured to the proximal member 330. The actuator handle 330 is designed to allow a surgeon to hold the distal member 310 with his/her index finger and thumb while grasping the rotary cylinder 320 to rotate it to the right or left. In one embodiment, rotating barrel 320 to the left can cause inner shaft 360 to elongate in a proximal direction, and rotating barrel 320 to the right can cause inner shaft 360 to shorten in a distal direction.

Fig. 6 shows an exploded view of the actuator handle 300 of fig. 5. The distal member 310 is directly coupled to the rotary cylinder 320 and may be coupled by a screw structure formed inside the rotary cylinder 320. The proximal member 330 has two windows, a viewing window 334 and a shuttle window 332. Shuttle 340 is placed within shuttle window 332 and moved from a distal direction toward a proximal direction. In one embodiment, shuttle 340 may move from a distal direction toward a proximal direction when rotating drum 320 rotates to the left. Shuttle 340 is coupled to inner shaft 360 such that by moving shuttle 340 in a proximal direction, rotating drum 320 is moved to the left, extending inner shaft 360 in a proximal direction. The viewing window 334 can use a marker that slides within the viewing window 334 so that the surgeon can see how far the inner shaft 360 has moved in the proximal direction. The outer shaft, on the other hand, is coupled to the proximal member 330 and allows the inner shaft 360 to move through the interior of the outer shaft 350.

Referring back to fig. 2(a) -2 (c), fig. 2(b) shows an embolic device 160 according to an embodiment of the present subject matter in a released position from the delivery catheter 110. When the delivery catheter 110 reaches the desired location (e.g., an aneurysm), the surgeon may release the steerable engagement member 140 by pulling on the linear member of the coupler. In this embodiment, the steerable engaging member 140 is released when the proximal end 132 of the coupler 130 is pulled toward the proximal end 112 of the delivery catheter 110. The downwardly curved portion 154 of the steerable engaging member 140 can then be pulled upward from the lower locking window 152, while the top end 200 of the steerable engaging member 140 can be pulled downward from the locking window 150. The tip 200 of the steerable engaging member 140 can be pulled further downward through the aperture 190 of the retention mechanism 180 of the embolic device 160 and the downward curved portion 154 of the steerable engaging member 140 is completely removed from the lower locking window 152. As the steerable engaging member 140 passes through the aperture 190, the edge 210 of the retention mechanism 180 pushes against the upwardly curved or bent portion of the steerable engaging member 140 and the underside of the crossbar 156 to slightly straighten the curved or bent portion so that the steerable engaging member 140 can be easily pulled out of the aperture 190. When the top end 200 of the manipulatable engagement member 140 passes through the lower portion of the crossbar 156, the crossbar 156 pushes the upwardly curved or bent portion further downward, causing the top end 200 to straighten. This will help to pull the steerable engaging member 140 clearly into the interior of the delivery catheter 110 without dragging or scraping against the interior wall of the catheter 110.

Figure 2(c) shows one embodiment in which the embolic device 160 is completely detached from the delivery catheter 110. When the coupler 130 is pulled proximally, the embolic device 160 disengages from the distal end 120 of the delivery catheter 110 once the tip 200 of the steerable engaging member 140 is pulled out of the aperture 190 of the retention mechanism 180. The surgeon may then carefully remove the entire delivery catheter 110 by pulling the delivery catheter 110 out of the artery to complete the procedure.

Fig. 7 is a flow diagram illustrating a method 400 for delivering an embolic device 160 according to an embodiment of the present subject matter. Prior to insertion into any artery, the embolic device 160 may be engaged with the delivery catheter 110 by engaging the steerable engaging member 140 of the coupler 130 with the orifice 190 of the retention mechanism 180 (step 410). The steerable engagement member 140 of the coupler 130 is formed into a curved shape and further extends into the upper and lower locking windows 150, 152 of the delivery catheter 110 such that the coupler 130 secures the embolic device 160 with the delivery catheter 110 (step 420). The delivery catheter 110 is inserted into the artery and guided to a desired location in the artery, wherein the embolic device 160 is retained by the delivery catheter 110 (step 430). When the delivery catheter 110 reaches the desired location, the proximal end of the coupler 130 is pulled proximally (step 440). By pulling, the manipulable engagement member 140 of the coupler 130 is withdrawn from the upper and lower locking windows 150, 152 (step 450). By pulling further proximally, the steerable engaging member 140 is further withdrawn from the aperture 190 of the retention mechanism 180 (step 460). When the tip 200 of the steerable engaging member 140, and in particular the curved shape of the steerable engaging member 140, contacts the crossbar 156, the crossbar 156 pushes the steerable engaging member 140 downward so that the tip 200 does not drag or scrape within the delivery catheter 110 (step 470). Once the tip 200 of the steerable engaging member 140 is fully withdrawn from the port 190, the embolic device 160 is released from the delivery catheter 110 and the delivery catheter is withdrawn from the artery (step 480).

Fig. 8(a) -8 (b) are illustrations of an embolic device delivery system 500 according to another embodiment of the present subject matter. The embolic device delivery system 500 can similarly include a delivery catheter 510, a steerable coupler 530, and an embolic device 560 and a retention mechanism 580 integrally formed with the embolic device 560. The delivery catheter 510 may be a hollow tube to house the steerable coupler 530 and the retention ring 580 of the embolic device 560. The steerable coupler 530 forms a U-shaped curved engagement member 540 toward the distal end 520 of the delivery catheter 510 for engagement with the retention mechanism 580. Engaging member 540 may be formed as a small diameter annular body made of a shape memory alloy such as nitinol, NiTi, or nickel titanium. Shape memory alloys have superelastic and unique memory properties to the original shape. Thus, the shape memory alloy may be stretched and held in the stretched phase; however, once the alloy is released from the stretched state, it will return to its original shape. The manipulable engagement member 540 may be further configured to become stiffer/less rigid and/or more/less flaccid when exposed to thermal, electrical, or physical forces. This allows the steerable coupler 530 to engage, steer and disengage the embolic device 560 during the embolic device delivery process, as described with reference to fig. 8 (b).

Delivery catheter 510 forms an upper locking window 550 on one side of the inner wall of the hollow tube near the distal end 520 of delivery catheter 510 and a lower locking window 552 on the other side of the inner wall of the hollow tube near the distal end 520 of delivery catheter 510. In this embodiment, the upper locking window 552 is located relatively closer to the distal end 520 of the delivery catheter 510 than the upper locking window 150 of the embolic device delivery system 100 as described in fig. 2(a) through 2 (c). In one embodiment, steerable engaging member 540 can form a U-shaped bend 554, and the downward bend 554 of steerable engaging member 540 can be retained by a locking feature such as upper locking window 550 and lower locking window 552. In this configuration, the bottom of the downward bend 554 of the steerable engaging member 540 can be retained within the lower locking window 552, while the tip 600 of the steerable engaging member 540 can be retained within the upper locking window 550 while guiding the delivery catheter 510 into the artery. In this locked position, the elongated portion 556 of the manipulable engagement member 540 between the U-bend 554 and the top end 600 forms an almost straight line, and the top end 600 may stably extend into the upper locking window 550 in a vertical position. In another embodiment, the upper locking window 550 is closer to the distal end 520 of the delivery catheter 510 than the lower locking window 552, such that the steerable engaging member 540 is locked by the upper and lower locking windows 150, 552 at the distal end 520 of the delivery catheter 510. Similar to the upper locking window 150 in the left elevational view shown in fig. 3 and the lower locking window 152 in the front elevational view shown in fig. 4, the manipulatable engagement member 540 extends through the upper locking window 550 and the lower locking window 552 of the delivery catheter 510.

When the embolic device 560 is in a position to be coupled to the delivery catheter 510 (see fig. 8(a)), the steerable engaging member 540 engages the aperture 590 of the retention mechanism 580 and may further extend through the lower locking window 552 and the upper locking window 550 above the location of the aperture 590 of the retention mechanism 580 to secure the steerable engaging member 540 in this position. Once the steerable engaging member 540 is shaped in the upwardly curved position, the steerable engaging member 540 retains its shape until any physical force is applied to the steerable engaging member 540. The upwardly curved shape of the manipulatable engagement member 540 may be formed by physically bending the manipulatable engagement member 540, such as freehand or by manipulating the distal end 520 of the manipulatable engagement member 540, to extend the manipulatable engagement member 540 through the aperture 590, such that the upright, original configuration is deformed into the curved shape. In various embodiments, the upper and lower locking windows 550, 552 may be formed in a rectangular, elliptical, oval, or circular shape. In yet another embodiment, the width of the locking window 550 may be slightly wider than the width of the tip 600 of the manipulatable engagement member 540. As such, the locking window 550 allows limited movement of the tip 600 back and forth within the tip to secure the tip 600 within the locking window 550.

Fig. 8(b) shows the embolic device 560 in a released position from the delivery catheter 510 according to an embodiment of the present subject matter. When the delivery catheter 510 reaches the desired location (e.g., an aneurysm), the surgeon may release the steerable engaging member 540 from the retention mechanism 580 by pulling on the linear member of the steerable engaging member 540. In this embodiment, the steerable engaging member 540 is released when the proximal end (not shown) of the steerable engaging member 540 is pulled toward the proximal end of the delivery catheter 510. The downward curve 554 of the manipulatable engagement member 540 may then be pulled upward from the lower locking window 552, while the top end 600 of the manipulatable engagement member 540 may be pulled downward from the locking window 550. The tip 600 of the steerable engaging member 540 may be pulled further downward through the aperture 590 of the retention mechanism 580 of the embolic device 560 and the downward bend 554 of the steerable engaging member 540 is completely removed from the lower locking window 552. When the steerable engaging member 540 passes through the aperture 590, the edge 610 of the retention mechanism 580 pushes against the upwardly bent or bent portion of the steerable engaging member 540 to slightly straighten the bent or bent portion so that the steerable engaging member 540 can be easily pulled out of the aperture 590. When the steerable engaging member 540 is pulled proximally, the embolic device 560 disengages from the delivery catheter 510 once the tip 600 of the steerable engaging member 540 is pulled out of the aperture 590 of the retention mechanism 580. The surgeon may then carefully remove the entire delivery catheter 510 by pulling the delivery catheter 510 out of the artery to complete the procedure.

Fig. 9(a) -9 (c) are illustrations of an embolic device delivery system 700 according to yet another embodiment of the present subject matter. The embolic device delivery system 700 may similarly include a delivery catheter 710, a steerable coupler 730, and an embolic device 760 and a retention mechanism 780 integrally formed with the embolic device 760. The delivery catheter 710 may be a hollow tube to receive the steerable coupler 730 and the retention ring 780 of the embolic device 760. The steerable coupler 730 forms a U-shaped curved open loop engagement member 740 toward the distal end 720 of the delivery catheter 710 for engagement with the retention mechanism 780. In one embodiment, the steerable engaging ring 740 may form an upward U-shaped bend and the retention mechanism 780 may form a downward bend such that the steerable engaging ring 740 may engage the retention mechanism 780 in an interlocked position. The mating ring 740 may be formed as a small diameter annular body made of a shape memory alloy such as nitinol, NiTi, or nickel titanium. Shape memory alloys have superelastic and unique memory properties to the original shape. Thus, the shape memory alloy may be stretched and held in the stretched phase; however, once the alloy is released from the stretched state, it will return to its original shape. The steerable mating ring 740 may be further configured to become stiffer/less rigid and/or more/less flaccid when exposed to thermal, electrical, or physical forces. This allows the manipulatable coupler 730 to engage, manipulate and disengage the embolic device 760 during an embolic device delivery procedure, as described with reference to fig. 9(b) and 9 (c). Within the hollow tubular body of the delivery catheter 710, a ring retractor 820 may be placed for the steerable mating ring 740 to maintain its position inside the delivery catheter 710. The ring retractor 820 has an opening (not shown) to receive a linear member of a steerable coupler 730 that extends from the proximal end (not shown) of the delivery catheter 710 to the distal end 720. In another embodiment, the distal end 720 of the delivery catheter may have an incision 830 that facilitates retention of the retention mechanism 580 of the embolic device.

When the embolic device 760 is in a position to be coupled to the delivery catheter 710 (see fig. 9(a)), the steerable engagement ring 740 may simply extend through the aperture 790 of the retention mechanism 780. Once the steerable mating ring 740 is shaped in the upwardly curved position, the steerable mating ring 740 retains its shape until any physical force is applied to the steerable mating ring 740. In one embodiment, the upwardly curved shape of the steerable engaging ring 740 may be formed by physically bending the steerable engaging ring 740, such as by freehand or by manipulating the distal end 720 of the steerable engaging ring 740, such that the steerable engaging ring 740 extends through the aperture 790, deforming the upright, original configuration into a curved shape. In another embodiment, the width of the steerable engagement ring 740 may be slightly narrower than the width of the aperture 790 of the retention mechanism 780. As such, the aperture 790 of the retention mechanism 780 allows for limited movement of the steerable engagement ring 740 back and forth within its interior to secure the steerable engagement ring 740 in the retention mechanism 780.

Fig. 9(b) illustrates an embolic device 760 in a position released from a delivery catheter 710, according to yet another embodiment of the present subject matter. When the delivery catheter 710 reaches the desired location (e.g., an aneurysm), the surgeon may release the steerable engagement ring 740 from the retention mechanism 780 by pulling on the linear member of the steerable coupler 730. In this embodiment, the steerable engagement ring 740 is released when the linear member of the steerable coupler 730 is pulled toward the proximal end (not shown) of the delivery catheter 710. The steerable engagement ring 740 may then be pulled from the aperture 790 of the retention mechanism 780 of the embolic device 760 and through the opening of the ring retractor 820. When the manipulable engagement ring 740 passes through the opening of the ring retractor 820, the edge 800 of the manipulable engagement ring 740 pushes against the open loop of the manipulable engagement ring 740 to partially close the open loop so that the manipulable engagement ring 740 can be easily pulled out of the opening of the ring retractor 820.

Figure 9(c) shows one embodiment in which the embolic device 760 is completely detached from the delivery catheter 710. When the steerable engagement ring 740 is pulled proximally, the embolic device 760 disengages the delivery catheter 710 once the tip 800 of the steerable engagement ring 740 is pulled out of the bore 790 of the retention mechanism 780. The surgeon may then carefully remove the entire delivery catheter 710 by pulling the delivery catheter 710 out of the artery to complete the procedure.

All references, including publications, patent applications, and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and/or were set forth in its entirety herein.

The terms "a" and "an" and "the" and similar referents in the specification and the appended claims are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms "having," "including," "containing," and similar referents in the specification and the appended claims are to be construed as open-ended terms (e.g., meaning "including, but not limited to,") unless otherwise noted. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., "such as") provided herein, is intended merely to better illuminate embodiments and does not pose a limitation on the scope of the disclosure unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the various embodiments of the invention.

Different arrangements of components, not depicted or described above, may be possible, as well as components and steps not depicted or described. Similarly, certain features and subcombinations may be of benefit and may be employed without reference to other features and subcombinations. Embodiments have been described herein for illustrative, but not limiting purposes, and alternative embodiments will be apparent to the reader of this patent. The subject matter of the invention is therefore not limited to the embodiments described above or depicted in the drawings, but various embodiments and modifications can be provided without departing from the scope of the appended claims.