Devices and methods for treating vascular malformations

Abstract

A device for treating vascular malformations includes a primary coil and secondary windings. The primary coil provides resilience and structural integrity while the secondary windings fill interstitial spaces in the primary coil to isolate the vascular malformation. The device may have increased density along a central portion to isolate the malformation. In another aspect, the device may have a central opening through which embolic materials may be delivered.

What is claimed is:  
     
         1 . A method of treating a vascular malformation, comprising the steps of: 
 providing a first vascular element and a second vascular element;    positioning the first vascular element at a vascular malformation;    delivering an embolic material through the first vascular element and into the vascular malformation;    moving the second vascular element to the vascular malformation after the delivering step.    
     
     
         2 . The method of  claim 1 , wherein: 
 the providing step is carried out with the first and second vascular elements being tubular shaped.    
     
     
         3 . The method of  claim 1 , wherein: 
 the providing step is carried out with at least one of the first and second vascular elements being a helical coil.    
     
     
         4 . The method of  claim 1 , wherein: 
 the providing step is carried out with both the first and second vascular elements being helical coils.    
     
     
         5 . The method of  claim 1 , wherein: 
 the delivering step is carried out with the embolic material being delivered through a catheter extending through the first vascular element.    
     
     
         6 . The method of  claim 1 , wherein: 
 the delivering step is carried out with the embolic material being a hydrogel.    
     
     
         7 . The method of  claim 1 , wherein: 
 the moving step is carried out by rotating the second vascular element.    
     
     
         8 . The method of  claim 1 , wherein: 
 the moving step is carried out with the second vascular element being positioned in interstitial spaces of the first vascular element.    
     
     
         9 . The method of  claim 1 , wherein: 
 the moving and positioning steps are carried out with the first and second vascular elements engaging one another.    
     
     
         10 . The method of  claim 1 , wherein: 
 the positioning step is carried out with the vascular malformation being a cerebral aneurysm.    
     
     
         11 . A device for treating a vascular malformation, comprising: 
 a delivery catheter;    a first vascular element coupled to the delivery catheter;    a second vascular element coupled to the delivery catheter, the second vascular element being movable into engagement with the first vascular element after at least partially deploying the first vascular element; and    an embolic material lumen configured to extend through the first vascular element.    
     
     
         12 . The device of  claim 11 , wherein: 
 the first and second vascular elements are tubular shaped.    
     
     
         13 . The device of  claim 11 , wherein: 
 the first vascular element is a helical coil.    
     
     
         14 . The device of  claim 11 , wherein: 
 the first and second vascular elements are helical coils.    
     
     
         15 . The device of  claim 11 , wherein: 
 the embolic material lumen extends through the first vascular element when delivering the embolic material.    
     
     
         16 . The device of  claim 11 , wherein: 
 the embolic material is a hydrogel.    
     
     
         17 . The device of  claim 11 , wherein: 
 the second vascular element rotatably engages the first vascular element.    
     
     
         18 . The device of  claim 11 , wherein: 
 the second vascular element is shaped to be positioned in interstitial spaces of the first vascular element.    
     
     
         19 . The device of  claim 11 , wherein: 
 the first and second vascular elements engage one another within the delivery catheter.    
     
     
         20 . A method of treating a vascular malformation, comprising the steps of: 
 providing a vascular element;    positioning the first vascular element at a vascular malformation;    delivering an embolic material through the first vascular element and into the vascular malformation; and    removing the vascular element after a period of time so that the embolic material fills the vascular malformation.    
     
     
         21 . The method of  claim 20 , wherein: 
 the positioning step is carried out with the vascular malformation being a cerebral aneurysm.    
     
     
         22 . The method of  claim 20 , wherein: 
 the providing step is carried out with the first vascular element being tubular shaped.    
     
     
         23 . The method of  claim 20 , wherein: 
 the providing step is carried out with the first vascular element being a helical coil.    
     
     
         24 . The method of  claim 20 , wherein: 
 the delivering step is carried out with the embolic material being delivered through a catheter extending through the first vascular element.    
     
     
         25 . The method of  claim 20 , wherein: 
 the delivering step is carried out with the embolic material being a hydrogel.    
     
     
         26 . A system for treating a vascular malformation, comprising: 
 a delivery catheter;    a first vascular element having a first coil coupled to the delivery catheter;    an embolic material delivery lumen configured to deliver an embolic material through the first vascular element after the first vascular element has been positioned at a vascular malformation.    
     
     
         27 . The system of  claim 26 , wherein: 
 the first vascular element has a single helical coil.    
     
     
         28 . The system of  claim 26 , further comprising: 
 means for removing the first vascular element.    
     
     
         29 . The system of  claim 28 , wherein: 
 the removing means is an element extending through the delivery catheter.    
     
     
         30 . The system of  claim 28 , wherein: 
 the removing means is the delivery catheter.    
     
     
         31 . A method of treating a vascular malformation, comprising the steps of: 
 providing a vascular element having a main coil and a plurality of secondary windings, the main coil being naturally biased toward an expanded position and carrying the secondary windings;    delivering the vascular element to a vascular malformation;    releasing the vascular element so that the main coil expands, the main coil also expanding the secondary windings, the vascular element forming a lumen to permit blood to pass therethrough, the vascular element isolating the vascular malformation.    
     
     
         32 . The method of  claim 31 , wherein: 
 the providing step is carried out with at least two main coils, the at least two main coils being interwoven.    
     
     
         33 . The method of  claim 31 , wherein: 
 the providing step is carried out with two main coils, the main coils being interwoven and each having a generally helical shape.    
     
     
         34 . The method of  claim 31 , wherein: 
 the providing step is carried out with the device having a side opening, the side opening being larger than other openings in the vascular element.    
     
     
         35 . The method of  claim 34 , further comprising the step of: 
 delivering an embolic material through the side opening after the releasing step.    
     
     
         36 . The method of  claim 34 , wherein: 
 the providing step is carried out with the side opening extending circumferentially around the vascular element.    
     
     
         37 . The method of  claim 34 , wherein: 
 the providing step is carried out with the side opening being formed by an absence of the secondary windings.    
     
     
         38 . The method of  claim 34 , wherein: 
 the providing step is carried out with the side opening being formed by a continuous length of the secondary winding with a spacing between the secondary winding being enlarged at the side opening.    
     
     
         39 . The method of  claim 34 , wherein: 
 the providing step is carried out with the side opening being formed by a larger spacing between adjacent windings of the secondary windings.    
     
     
         40 . The method of claims  31  and  34 , wherein: 
 the providing step is carried out with about 3-30 secondary windings.  
 
     
     
         41 . The method of claims  31  and  34 , wherein: 
 the providing step is carried out with about 10-50 secondary windings.  
 
     
     
         42 . A device for treating a vascular malformation, comprising: 
 a main coil; and    a plurality of secondary windings, the main coil being naturally biased toward an expanded position, the secondary windings being substantially expanded and collapsed by the main coil.    
     
     
         43 . The device of  claim 42 , further comprising: 
 at least two main coils, the at least two main coils being interwoven.    
     
     
         44 . The device of  claim 42 , wherein: 
 the two main coils each having a generally helical shape.    
     
     
         45 . The device of  claim 42 , wherein: 
 the main coil and secondary windings form a side opening, the side opening being larger than other openings in the vascular element.    
     
     
         46 . The device of  claim 45 , further comprising: 
 an embolic material lumen configured to extend through the side opening.    
     
     
         47 . The device of  claim 45 , wherein: 
 the side opening extending circumferentially around the vascular element.    
     
     
         48 . The device of  claim 45 , wherein: 
 the side opening is formed by an absence of the secondary windings.    
     
     
         49 . The device of  claim 45 , wherein: 
 the side opening is formed by an enlarged spacing between the secondary winding at the side opening.    
     
     
         50 . The device of  claim 45 , wherein: 
 the side opening is formed by a larger spacing between adjacent windings of the secondary windings.    
     
     
         51 . The device of claims  42  and  45 , wherein: 
 the secondary windings number about 3-30.  
 
     
     
         52 . The device of  claim 42  and  45 , wherein: 
 the secondary windings number about 10-50.  
 
     
     
         53 . The device of  claim 42 , wherein: 
 the secondary windings have an increased density along a central portion.    
     
     
         54 . A method of treating a cerebral aneurysm, comprising the steps of: 
 providing an expandable structure movable from a collapsed shape to an expanded shape;    introducing the expandable structure into a blood vessel of a patient;    advancing the expandable structure through the patient's vasculature to a cerebral aneurysm while the expandable structure is in the collapsed position;    moving the expandable structure into the cerebral aneurysm;    expanding the expandable structure to the expanded position in the cerebral aneurysm;    shrinking the wall of the aneurysm; and    leaving the expandable structure in the aneurysm after the shrinking step.    
     
     
         55 . A method of isolating a cerebral aneurysm from the parental vessel, comprising the steps of: 
 providing a device movable from a collapsed position to an expanded position, the device having a proximal portion when in the expanded position;    introducing the device into the aneurysm in the collapsed position;    expanding the device to the expanded position after the introducing step;    shrinking the dome of the aneurysm so that that the proximal portion of the expandable device extends around the neck of the aneurysm.    
     
     
         56 . A system for treating a cerebral aneurysm, comprising: 
 a shaft having a length and flexibility sufficient to extend into a patient's cerebral vasculature;    an expandable device movable from a collapsed shape to an expanded shape, the expandable device being removably coupled to the shaft;    means for shrinking the aneurysmal wall toward the expandable device when the expandable device is contained within the aneurysm.    
     
     
         57 . A method of treating a cerebral aneurysm, comprising the steps of: 
 providing an expandable structure movable from a collapsed shape to an expanded shape, the expandable structure having a deforming portion which is displaced beyond the yield strength when moving from the collapsed position to the expanded position;    introducing the expandable structure into a blood vessel of a patient;    advancing the expandable structure through the patient's vasculature to a cerebral aneurysm while the expandable structure is in the collapsed position;    moving the expandable structure into the cerebral aneurysm;    expanding the expandable structure to the expanded position in the cerebral aneurysm; and    leaving the expandable structure in the aneurysm after the expanding step.    
     
     
         58 . A method of treating an aneurysm, comprising the steps of: 
 providing a device having a cover and a lateral extension, the cover and extension being movable from a collapsed position to an expanded position;    advancing the device through a patient's vascular system to an aneurysm with the cover in the collapsed position;    moving the lateral extension into the neck of the aneurysm and the cover over the neck of the aneurysm to isolate the aneurysm from the parental vessel.    
     
     
         59 . A device for treating an aneurysm, comprising: 
 a cover which covers the neck of the aneurysm to isolate the aneurysm from a parental vessel; and    a lateral extension coupled to the cover, the lateral extension extending from the cover and into the aneurysm when the cover is positioned over the neck of the aneurysm.    
     
     
         60 . A method of treating an aneurysm, comprising the steps of: 
 providing a cover which is positioned around an expandable element in a collapsed position, the cover being covered by a sheath;    advancing the cover to an aneurysm in a patient with the cover in the collapsed position;    withdrawing the sheath to expose the cover;    expanding the expandable member thereby expanding the cover, the cover expanding to an expanded condition, the cover being positioned over a neck of the aneurysm.    
     
     
         61 . A device for treating an aneurysm, comprising: 
 a cover for covering a neck of an aneurysm    a delivery catheter having an expandable element and a sheath, the cover being mounted around the expandable element, the sheath being retractable and overlying the cover thereby trapping the cover between the sheath and expandable element, the sheath being movable to a position in which the cover is exposed to permit expansion of the expandable element and the cover.