Method of containing embolic material in the left atrial appendage

Abstract

Disclosed are methods and devices for containing embolic material within a left atrial appendage of a patient. The device is deployed such that a barrier substantially obstructs the passage of embolic material from the left atrial appendage. The barrier may be self expandable, and may include a polymeric or wire mesh. The device may additionally include a plurality of tissue engagement members, for engaging tissue.

What is claimed:  
     
         1 . A method of containing embolic material within a left atrial appendage of a patient, comprising: 
 a) providing a containment device comprising a barrier for preventing the escape of embolic material from the left atrial appendage;    b) providing a delivery catheter having a proximal end and a distal end;    c) advancing the delivery catheter through the patient's vasculature to position the containment device within the patient's left atrium; and    d) deploying the containment device such that the barrier substantially obstructs the passage of embolic material from the left atrial appendage.    
     
     
         2 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises a mesh.  
     
     
         3 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises polyethylene.  
     
     
         4 . A method of containing embolic material as in  claim 2 , wherein the mesh comprises polyethylene.  
     
     
         5 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises a polymer film.  
     
     
         6 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises a polymer mesh.  
     
     
         7 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises a nickel titanium alloy.  
     
     
         8 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises stainless steel.  
     
     
         9 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises ePTFE.  
     
     
         10 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises Dacron.  
     
     
         11 . A method of containing embolic material as in  claim 1 , where the barrier comprises nylon.  
     
     
         12 . A method of containing embolic material as in  claim 1 , wherein the barrier has a pore size of no greater than about 0.04 inches.  
     
     
         13 . A method of containing embolic material as in  claim 1 , further comprising the step of removing thrombotic or fibrotic material from the patient's left atrial appendage prior to deployment of the containment device.  
     
     
         14 . A method of containing embolic material as in  claim 13 , wherein the thrombotic or fibrotic material is removed from the patient's left atrial appendage by aspiration through an aspiration lumen of a catheter having a port in the distal end thereof in fluid communication with the aspiration lumen which is operatively connected at its proximal end to a vacuum source.  
     
     
         15 . A method of containing embolic material as in  claim 1 , wherein the containment device comprises an expandable member configured to engage an inside surface of the left atrial appendage and the containment device is at least partially deployed by expanding the expandable member within the left atrial appendage so as to engage at least a portion of an inner surface of the left atrial appendage.  
     
     
         16 . A method of containing embolic material as in  claim 1 , wherein the barrier comprises a self expandable frame.  
     
     
         17 . A method of containing embolic material as in  claim 16 , further comprising a mesh on the frame.  
     
     
         18 . A method of containing embolic material as in  claim 17 , wherein the mesh comprises a polymer selected from the group consisting of Dacron, Nylon, TFE, PTFE, ePTFE, polyethylene and polyurethane.  
     
     
         19 . A method of containing embolic material as in  claim 1 , wherein the containment device is self expandable.  
     
     
         20 . A method of containing embolic material as in  claim 1 , wherein the containment device comprises a self expandable wire structure.  
     
     
         21 . A method of containing embolic material as in  claim 1 , wherein the advancing step comprises advancing the delivery catheter through the femoral vein.  
     
     
         22 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises wire mesh.  
     
     
         23 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises braided wire.  
     
     
         24 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises wire coil.  
     
     
         25 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises shape memory material.  
     
     
         26 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises pseudoelastic alloy.  
     
     
         27 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises nickel titanium alloy.  
     
     
         28 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises stainless steel.  
     
     
         29 . A method of containing embolic material as in  claim 20 , wherein the self expandable wire structure comprises composite material.  
     
     
         30 . A method of treating the left atrial appendage of a patient, comprising the steps of: 
 providing a delivery catheter having a proximal end and a distal end, and a self expandable wire structure for acting as a barrier to the passage of embolic material from the left atrial appendage, removeably carried by the distal end;    advancing the delivery catheter into the patient's left atrium;    positioning the self expandable wire structure at the left atrial appendage; and    deploying the self expandable wire structure such that it substantially obstructs the passage of embolic material from the left atrial appendage.    
     
     
         31 . The method of  claim 30 , further comprising the step of removing thrombotic or fibrotic material from the patient's left atrial appendage prior to deployment of the self expandable wire structure.  
     
     
         32 . The method of  claim 31 , wherein the thrombotic or fibrotic material is removed from the patient's left atrial appendage by aspiration through an aspiration lumen of a catheter having a port in the distal end thereof in fluid communication with the aspiration lumen which is operatively connected at its proximal end to a vacuum source.  
     
     
         33 . The method of  claim 30 , wherein the deploying step comprises deploying the self expandable wire structure such that it engages at least a portion of an inner surface of the left atrial appendage.  
     
     
         34 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises wire mesh.  
     
     
         35 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises braided wire.  
     
     
         36 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises wire coil.  
     
     
         37 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises shape memory material.  
     
     
         38 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises pseudoelastic alloy.  
     
     
         39 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises nickel titanium alloy.  
     
     
         40 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises stainless steel.  
     
     
         41 . A method of treating the left atrial appendage as in  claim 30 , wherein the self expandable wire structure comprises composite material.  
     
     
         42 . A method as in  claim 30 , further comprising a barrier on the wire structure.  
     
     
         43 . A method as in  claim 42 , wherein the barrier comprises a polymer selected from the group consisting of Dacron, Nylon, TFE, PTFE, ePTFE, polyethylene and polyurethane.  
     
     
         44 . A method as in  claim 43 , wherein the barrier has a pore size of up to about 0.04 inches.  
     
     
         45 . A method as in  claim 30 , wherein the advancing step comprises advancing the delivery catheter through the right femoral vein.  
     
     
         46 . A method as in  claim 30 , wherein the advancing step comprises advancing the delivery catheter to the left atrial appendage intraoperatively.  
     
     
         47 . A method as in  claim 30 , wherein the self expandable wire structure comprises a plurality of tissue engagement members, and the method further comprises the step of engaging tissue with the tissue engagement members.  
     
     
         48 . A method as in  claim 1 , wherein the containment device comprises a plurality of tissue engagement members, and the method further comprises the step of engaging tissue with the tissue engagement members.