阅读说明：本技术 用于血管装置的改良的射线不可透标记物 (Radiopaque markers for vascular devices ) 是由 J.A.洛伦佐 H.吉纳里 于 2014-03-11 设计创作，主要内容包括：本发明公开了一种有助于在患者脉管系统内对装置例如可膨胀支架的位置进行定位的标记物,其包括由生物相容性射线不可透材料形成的细长主体,所述细长主体在使用至少一种成像技术时增强对所述标记物的定位。所述主体具有第一端部、第二端部、内表面、外表面,以及在所述第一端部和第二端部之间延伸并在所述内表面和所述外表面之间形成边界的至少两个相对边缘。所述主体的所述内表面限定了在所述第一端部和第二端部之间延伸的通道。在第一状态下,所述主体限定了所述至少两个相对边缘之间的间隙,所述间隙能够使所述通道与所述主体的所述外表面的连通畅通无阻。在第二状态下,所述间隙被阻塞,以基本防止所述通道与所述主体的所述外表面的连通。(A marker for facilitating positioning of a device, such as an expandable stent, within a patient's vasculature includes an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when at least one imaging technique is used. The body has a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first and second ends and forming a boundary between the inner and outer surfaces. The inner surface of the body defines a channel extending between the first and second ends. In a first state, the body defines a gap between the at least two opposing edges, the gap enabling unobstructed communication of the channel with the outer surface of the body. In a second state, the gap is blocked to substantially prevent communication of the channel with the outer surface of the body.)

1. A marker to aid in positioning a device within a vasculature of a patient, comprising:

an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when using at least one imaging technique, the body having a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first end and the second end and forming a boundary between the inner surface and the outer surface;

the inner surface of the body defines a channel extending between the first and second ends;

in a first state, the body defines a gap between the at least two opposing edges, the gap enabling unobstructed communication of the channel with the outer surface of the body; and is

In a second state, the gap is blocked to substantially prevent communication of the channel with the outer surface of the body.

2. The marker of claim 1, wherein the body is deformable to bring the opposing edges into proximity with one another in the second state.

3. The marker of claim 1, wherein the body is formed of a malleable radiopaque material.

4. The marker of claim 1, wherein the body is substantially cylindrical in at least one of the first and second states.

5. In combination, at least one marker and a device insertable within the vasculature of a patient, comprising:

the apparatus comprising a strut extending between at least two supports;

the marker comprising an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when using at least one imaging technique, the body having a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first and second ends and forming a boundary between the inner and outer surfaces;

the inner surface of the body defines a channel extending between the first and second ends;

in a first state, the body defines a gap between the at least two opposing edges, the gap enabling unobstructed communication of the channel with the outer surface of the body and enabling insertion of the post into the channel; and is

In a second state, the gap is blocked to substantially prevent communication of the channel with the outer surface of the body and prevent accidental removal of the marker from the device, thereby securing the marker to the device such that the post securely carries the marker.

6. The combination of claim 5, wherein the body is deformed to bring the opposing edges into proximity with each other in the second state.

7. The combination of claim 5, wherein the body is formed of a malleable radiopaque material.

8. The combination of claim 5, wherein the body is substantially cylindrical in at least one of the first and second states.

9. The combination of claim 5, wherein the gap is at least partially obstructed by at least one weld.

10. The combination of claim 5, wherein the opposing edges are brought into substantial abutment with one another to block the gap.

11. The combination of claim 5, wherein the marker is positioned between two protrusions that limit longitudinal movement of the marker.

12. The combination of claim 5, wherein the device is a stent having a compressed state during insertion through the vasculature and an expanded state when positioned at a desired location.

13. The combination of claim 11, wherein the strut carrying the marker is part of a closed deformable aperture of the stent.

14. A method of enhancing the locatability of a device within the vasculature of a patient, comprising:

selecting means comprising a strut extending between at least two supports;

selecting a marker comprising an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when using at least one imaging technique, the body having a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first and second ends and forming a boundary between the inner and outer surfaces, the inner surface of the body defining a channel extending between the first and second ends, the body initially defining a gap between the at least two opposing edges that enables unobstructed communication of the channel with the outer surface of the body;

inserting the post into the channel; and

blocking the gap to substantially prevent communication of the channel with the outer surface of the body and prevent accidental removal of the marker from the device, thereby securing the marker to the device such that the post securely carries the marker.

15. The method of claim 14, wherein blocking the gap comprises deforming the body to bring the opposing edges closer together in the second state.

16. The method of claim 14, wherein the body is formed of a malleable radiopaque material.

17. The method of claim 14, wherein the body is substantially cylindrical in at least one of the first and second states.

18. The method of claim 14, wherein the gap is at least partially obstructed by at least one weld.

19. The method of claim 14, wherein the opposing edges are brought into substantial abutment with one another to block the gap.

20. The method of claim 14, wherein the marker is positioned between two protrusions that limit longitudinal movement of the marker.

21. The method of claim 14, wherein the device is a stent having a compressed state during insertion through the vasculature and an expanded state when positioned at a desired location.

22. The method of claim 21, wherein the strut bearing the marker is part of a closed deformable aperture of the stent.

1.Technical Field

The present invention relates to implants and other devices insertable into a body vessel, and more particularly to mechanisms for enhancing tracking and positioning of stents and other vascular devices, particularly expandable implants.

2.Description of the related Art

Vascular diseases and defects such as aneurysms, embolisms, and other arteriovenous malformations are particularly difficult to treat when they are located near critical tissue or are not readily accessible at the site of the malformation. These two difficulties are particularly true for intracranial aneurysms. Because brain tissue surrounding intracranial blood vessels is sensitive and has limited access, surgically treating intracranial vascular defects is very challenging and often dangerous.

Alternative treatments include vaso-occlusive devices, such as stents and embolic coils that are deployed using a delivery catheter having a distal end positioned at the occlusion site or aneurysm. Several types of stent delivery systems are disclosed, for example, in U.S. patent publication 2005/0049670 to Jones et al. Accurate positioning of stents and other vascular devices is important. Surgeons typically use one or more imaging systems in an attempt to confirm that the vascular device has been properly placed.

Typically, a delivery catheter is first used to guide a stent-like revascularization device beneath the aneurysm to be treated. For exampleA commercially available reconstituted product is available in Codman&CODMN ENTERPRISE described in Navigate Tough Antomo brochure (2009 edition) by Shurtleff, Inc. (325 Paramout Drive, Raynham, Massachusetts)^®Vascular reconstruction devices and systems. CODMN ENTERPRISE^®The stent device is carried by a central delivery wire and is initially held in place on the delivery wire in a contracted state by a sheath-type introducer. In general, for example, Codman is likewise available from&Such as PROWLER, commercially available from Shurtleff and disclosed in U.S. Pat. No. 5,662,622 to Gore et al^®SELECT^®The delivery catheter of the Plus microcatheter was first positioned within the vessel with its distal tip slightly beyond the neck of the aneurysm. The tapered distal tip of the introducer mates with the proximal hub of the delivery catheter and the delivery wire is then advanced through the delivery catheter.

CODMAN ENTERPRISE^®The stent device has a highly flexible self-expanding closed cell design with multiple coils of radiopaque wire at each flared end of the device serving as markers, similar to the stent shown in the above-referenced Jones et al published patent application. These markers are relatively time consuming and expensive to manufacture due to the small size of the stent and the need to wrap radiopaque wires around the struts on the stent multiple times, which is particularly difficult within the obturator foramens of the stent.

Stent-like devices, which are not generally flexible in positioning, are also used to treat diseases caused by emboli and atherosclerosis. Embolization is the sudden blockage of a blood vessel by a blood clot, a plaque containing cholesterol, a large number of bacteria and other debris. Blood clots that obstruct a blood vessel are also known as thrombi. If an embolism occurs in the brain, it may cause a sudden loss of nerve function called stroke, especially acute ischemic stroke.

Various devices for treating embolic stroke and atherosclerotic deposits are described, for example, in U.S. patent 5,972,019 to Engelson et al, which uses one or more coils of radiopaque wire "to provide a measure of radiopacity to the distal tip" to aid in tracking the device during use. Monitoring the fixation of a polymer scaffoldThe method of bits is disclosed by Sabaria in U.S. patent publication 2009/0076594. In addition, newer neurological devices include Codman&Micrus Revasc from Shurtleff, Inc^™Solitaire of Microthereutics, Inc. (d/b/aev3 Neurovacular)^™Device, and centralized Medical Trevo^™And MerciRetreiver^™Provided is a device.

Accordingly, it would be desirable to have an improved device marking system that facilitates placement and/or positioning of a vascular device during and/or after insertion to treat a vascular abnormality.

Background

Disclosure of Invention

It is an object of the present invention to provide a radiopaque marker that can be quickly and securely placed on a strut or other elongate member of a vascular device.

It is another object of the present invention to provide a stent or other vascular device having a highly visible radiopaque marker positioned as desired.

The present invention features a marker that facilitates positioning of a device within a vasculature of a patient that includes an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when at least one imaging technique is used. The body has a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first end and the second end and forming a boundary between the inner surface and the outer surface. The inner surface of the body defines a channel extending between the first end and the second end. In the first state, the body defines a gap between at least two opposing edges that enables the passageway to be unobstructed from communication with the outer surface of the body. In the second state, the gap is blocked to substantially prevent communication of the passage with the outer surface of the body.

In some embodiments, the body is deformable to bring the opposing edges into proximity with each other in the second state. In certain embodiments, the body is formed of a ductile radiopaque material (e.g., platinum alloy or tantalum). In one embodiment, the body is substantially cylindrical in at least one of the first state and the second state.

The invention may also be expressed as a combination of at least one marker and a device insertable into the vascular system of a patient. The apparatus includes a strut extending between at least two supports. The marker includes an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when using at least one imaging technique, the body having a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first end and the second end and forming a boundary between the inner surface and the outer surface. The inner surface of the body defines a channel extending between the first end and the second end. In the first state, the body defines a gap between at least two of the opposing edges that enables unobstructed communication of the passage with the outer surface of the body and insertion of the post into the passage. In the second state, the gap is blocked to substantially prevent communication of the channel with the outer surface of the body and to prevent accidental removal of the marker from the device, thereby securing the marker to the device such that the post securely carries the marker.

In certain embodiments, the marker is positioned between two protrusions that limit longitudinal movement of the marker. In some embodiments, at least one of the protrusions is one of the supports for the strut. In many embodiments, the device is a stent having a compressed state during insertion through the vasculature and an expanded state when positioned at a desired location. In one embodiment, the marker-bearing strut is part of a closed deformable aperture of the stent.

The invention may be further expressed as a method of improving the locatability of a device, such as a stent within a patient's vasculature, comprising selecting a device having a strut extending between two supports, and selecting a marker having an elongated body formed of a biocompatible radiopaque material that enhances the location of the marker when using at least one imaging technique. The body has a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first end and the second end and forming a boundary between the inner surface and the outer surface. The inner surface of the body defines a channel extending between the first end and the second end. The body initially defines a gap between at least two opposing edges that enables the passage to be unobstructed from communication with the outer surface of the body. The method further includes inserting the post into the channel and blocking the gap to substantially prevent communication of the channel with the outer surface of the body and to prevent accidental removal of the marker from the device, thereby securing the marker to the device such that the post securely carries the marker.

Drawings

Preferred embodiments of the present invention are explained in more detail below with reference to the attached drawing figures, wherein:

FIG. 1 is a schematic perspective view of a stent illustrating several types of radiopaque markers of the present invention;

FIG. 2 is a detail view of the free end portion of the stanchion showing the first marker of the present invention shown in FIG. 1;

FIG. 3 is an exploded view of the strut and radiopaque marker of FIG. 2;

FIG. 4 is a detail view of struts forming closed expandable pores for the stent of FIG. 1, the struts having markers according to the present invention;

FIG. 5 is an exploded view of the strut and radiopaque marker of FIG. 4;

FIG. 6 is a front elevational view of a post having a pair of tabs in accordance with an aspect of the present invention;

FIG. 7 is a front elevational view of the stanchion of FIG. 6 with a marker according to the present invention;

FIG. 8 is an exploded view of another marker and another strut from the stent of FIG. 1 according to the present invention;

FIG. 9 shows the marker of FIG. 8 placed over a portion of the post of FIG. 8;

FIG. 10 shows the tag of FIG. 9 after deformation such that the opposing edges substantially abut to form a closed seam; and is

Fig. 11 shows the tag of fig. 10 after several solder joints have been applied.

Detailed Description

The invention may be implemented by a marker for vascular implants or other vascular devices, where the terms "vascular" and "vasculature" are used in their broadest sense, including any conduit or network of tubes in the human or other animal body. A marker according to the present invention includes an elongated body formed of a biocompatible radiopaque material that enhances positioning of the marker when using at least one imaging technique. The body has a first end, a second end, an inner surface, an outer surface, and at least two opposing edges extending between the first end and the second end and forming a boundary between the inner surface and the outer surface. The inner surface of the body defines a channel extending between the first end and the second end. In the first state, the body defines a gap between at least two opposing edges that enables the passageway to be unobstructed from communication with the outer surface of the body. In the second state, the gap is blocked to substantially prevent communication of the passage with the outer surface of the body.

The stent 10 of fig. 1 is implantable within the vasculature of a patient, preferably within an intracranial aneurysm. The stent 10 in this configuration is a substantially tubular vascular device formed from a plurality of interconnected struts 12 fabricated by laser cutting, water jet cutting, etching, or other known methods. The struts 12 define a plurality of pores 14 that are expandable and/or deformable to allow the stent 10 to move between a small diameter "compressed" or "delivery" state (typically during manufacture and delivery to a patient) and a large diameter "expanded" or "deployed" state upon reaching a selected treatment site within the vasculature, as shown in fig. 1. Stents with markers according to the present invention are self-expandable in some configurations, balloon-expandable in other configurations, or combinations thereof.

One strut 16 is shown having a radiopaque marker 18 according to the original patent application of the first inventor of the present patent application, which was published as U.S. patent publication 2008/0243227, incorporated herein in its entirety, and referred to hereinafter as "Lorenzo 2007" for its column name inventor and for the date of filing 3-30/2007. Struts 16 are shown as free end portions at the proximal end 20 of stent 10, but it should be understood that radiopaque markers according to the present invention may be incorporated into any strut of a vascular device. A desired number of markers, for example two, three or four markers, may be utilized on each end of the vascular implant. As detailed below, for exemplary purposes, the stent 10 also includes a marker 50 of the present invention at the central region 23 and a marker 100 of the present invention at the distal end 21.

The post 16 and marker 18 are shown in more detail in fig. 2 and 3. The marker 18 has an inner surface 22 adapted to engage the post 16. Preferably, the curvature of the inner surface 22 is similar to the curvature of the strut portions to be joined, such as being generally "U" or "C" shaped (i.e., arcuate in cross-section) in this configuration, so as to mate with the curved surface 17 of the strut 16.

The marker 18 includes an outer surface 24 spaced from the inner surface 22 by a thickness 26 that is uniform in some configurations and non-uniform in other configurations. A portion of the outer surface 24 may be selected or configured to have one or more functions, such as engaging a delivery or deployment device.

Marker 18 according to the invention of Lorenzo 2007 further comprises at least one through hole 28. In this configuration, prior to application of the weld 30 of FIG. 2, the tag 18 has two through holes 28, as shown in FIG. 3. Portions 29 and 31 of marker 18 may be crimped against post 16 to further secure marker 18 to post 16.

In accordance with the present invention, the markers 50 and 100 of FIG. 1 are preferably sized to more fully surround the selected struts 52 and 102 of the obturator foramens 54 and 104, respectively, and do not require through-holes. As shown in fig. 4 and 5, the marker 50 includes an elongated body 60 formed of a biocompatible radiopaque material that enhances positioning of the marker when at least one imaging technique is used. The body 60 has a first end 62, a second end 64, an inner surface 66, an outer surface 68, and at least two opposing edges 70 and 72 extending between the first end 62 and the second end 64 and forming a boundary between the inner surface 66 and the outer surface 68. The inner surface 66 of the body 60 defines a channel 74 extending between the first end 62 and the second end 64.

In the first state shown in fig. 5, the body 60 defines a gap 76 between at least two of the opposing edges 70, 72. The gap 76 allows the passage 74 to communicate unobstructed with the body outer surface 68, thereby allowing the post 52 to be inserted through the gap 76 and into the passage 74 to achieve the combination shown in fig. 4.

In the second condition shown in fig. 4, the gap 76 is blocked to substantially prevent communication of the passage 74 with the outer surface 68 of the body 60. In this configuration, the gap 76 is closed by: the opposing edges 70 and 72 are brought into substantial abutment to form a closed seam, such as by deforming the body 60, i.e., by squeezing, clamping or crimping the legs 80 and 82 together, preferably for clamping the marker 50 to the post 52. In other constructions, at least a portion of the gap 76 is closed by welding or other bridging or attachment techniques.

Fig. 6 is a front elevational view of a post 32 having a pair of tabs 34 and 36 in accordance with an aspect of the present invention. The projections may take on a number of shapes, including semi-circular, square, triangular, or annular configurations extending along the perimeter or other portion of the strut 32, or smaller cylindrical or nipple-like structures extending radially away from the strut 32. In addition, the shapes of the projections 34 and 36 may be different from each other. In some configurations, at least one tab is integrally formed with the post 32, while in other configurations, the at least one tab is applied as a separate manufacturing step. In other constructions, one or both of the projections 32 and 34 are laterally extending support members connected to the strut 32, such as other struts that define closed cells with the strut 32.

The projections 34 and 36 define a receiving area or surface 38 therebetween, as shown in phantom in FIG. 6. A marker 50a according to the present invention is shown in fig. 7 secured to the post 32 with the inner surface 66a disposed generally against the receiving surface 38 in a second condition similar to the condition of the marker 50 in fig. 4. Preferably, the distance between the projections is selected to be substantially equal to the length of the marker 50a in fig. 7, such that the marker 50a is retained against possible longitudinal movement along the strut 32 and is retained at a known geometric position within the stent 10.

As shown in fig. 7, the height of each protrusion is greater than the thickness of the tag. However, the height of the one or more protrusions may be substantially equal to the thickness of the marker, or even less than the thickness of the marker, provided that the one or more protrusions (when used) are configured to abut at least one or both ends of the marker to minimize or prevent longitudinal movement of the marker.

The tab is particularly useful when the tag 50a is secured to the post 32 by merely clipping or crimping. The projections also serve to precisely locate the marker at the exact location on the strut of the vascular device.

Fig. 8 is an exploded view of another marker 100 according to the present invention and another strut 102 from the stent of fig. 1. The marker 100 includes an elongated body 160 formed of a biocompatible radiopaque material that enhances positioning of the marker when at least one imaging technique is used. The body 160 has a first end 162, a second end 164, an inner surface 166, an outer surface 168, and at least two opposing edges 170 and 172 extending between the first end 162 and the second end 164 and forming a boundary between the inner surface 166 and the outer surface 168. The inner surface 166 of the body 160 defines a channel 174 extending between the first end 162 and the second end 164.

In one configuration suitable for treating an intracranial aneurysm, in at least one of the first and second states, the body 160 is generally cylindrical, about 0.5mm to 2.0mm in length, more preferably about 1.0mm, and is preferably formed from hypotube having an outer diameter of about 0.203mm (0.008 inches) and an inner diameter of 0.102mm (0.004 inches). One suitable source of such hypotubes formed from platinum alloys or tantalum is the Johnson Matthey medical assembly (see "www.jmmedical.com"). In one configuration, the gap 176 is formed by removing a length of hypotube using laser cutting such that the body 160 is substantially cylindrical in the first state. In another configuration, a small cut is made to form opposing edges 170 and 172, and then body 160 is deformed to distract gap 176; in the second state the body 160 returns to a cylindrical shape as described below with respect to fig. 10 and 11. The marker according to the invention, also referred to as marker band, may have different cross-sections to optimize the imaging profile and/or to maximize the radiopacity, including circular, square or elliptical cross-sections.

In the first state shown in fig. 8 and 9, the body 160 defines a gap 176 between at least two opposing edges 170, 172. The gap 176 allows the passage 174 to be unobstructed from communication with the body outer surface 168, thereby allowing the post 102 to be inserted through the gap 176 and into the passage 174 to achieve the combination shown in fig. 9 when the marker 100 is placed on a portion of the post of fig. 8 between the projections 134 and 136.

In the second condition shown in fig. 10, the gap 176 is blocked to substantially prevent communication of the passage 174 with the outer surface 168 of the body 160. In this configuration, the gap 176 is closed by: the opposing edges 170 and 172 are brought into substantial abutment to form a closed seam 198, such as by deforming the body 160, i.e., by squeezing, clamping or crimping the legs 180 and 182 together, preferably for clamping the marker 100 to the post 102. In other constructions, at least a portion of the gap 176 is closed by welding or other bridging or attachment techniques. Fig. 10 shows the tag of fig. 9 after deformation so that the opposing edges are substantially contiguous.

The projections 134 and 136 include opposing pairs of stops 190, 192 and 194, 196, as best shown in fig. 8. The spacing between pairs of stops or other projections may vary at different geometric locations within and around the stent 10 or other vascular device to accommodate markers of different diameters and lengths. Additionally, a support such as another strut 106 can replace one or both of the protrusions, for example, the use of struts 106 can eliminate the need for protrusions 136 for markers having a longitudinal length greater than the longitudinal length of marker 100.

Fig. 11 shows the tag of fig. 10 after several optional welds 200, 202, and 204 have been applied. Markers according to the present invention may be welded, glued or swaged to further secure the marker to a stent or other vascular device.

Thus, while there have been shown, described, and pointed out fundamental novel features of the invention as applied to a preferred embodiment thereof, it will be understood that various omissions and substitutions and changes in the form and details of the devices illustrated, and in their operation, may be made by those skilled in the art without departing from the spirit and scope of the invention. For example, the explicit intent of this application is: it is expressly intended that all combinations of those elements and/or steps which perform substantially the same function in substantially the same way to achieve the same results are within the scope of the invention. It is also fully intended and contemplated to replace elements in one described embodiment with another. It should also be understood that the drawings are not necessarily drawn to scale and that they are merely conceptual in nature. Accordingly, the invention is not to be restricted except in light of the attached claims.

Each issued patent, pending patent application, patent publication, journal article, book, or any other reference cited in this application is incorporated by reference in its entirety.