Systems and Methods for Cerebrospinal Fluid Repair

Abstract

A system and method for treating a defect. The system may comprise a first expandable barrier insertable into a defect interior space in a compact state and then expanded once positioned inside the defect. The first expandable barrier is expanded to be positioned against the inner surface of the defect. The system may also comprise a second barrier which may be expandable, positioned against the outer surface of the defect. Each of the first and second barriers may expand laterally to a greater extent than axially. The first and second barriers may be in communication through a connection member which couples the two barriers together. The barriers each obliterate the defect and can prevent subsequent CSF or other fluid leaks. Fibrin glue may be introduced into the defect to seal and secure the barriers to the defect. Each barrier may comprise a mesh, a basket, an umbrella or a balloon.

1 . A method for treating a defect, the defect having an inner surface, an outer surface, a defect interior space, and a defect opening communicating with the inner surface and the outer surface, the defect opening having a lateral dimension, the method comprising:
 introducing a first expandable barrier of a device into the defect interior space, the device further comprising a second expandable barrier and a connecting member attached to the first barrier and the second barrier to couple the first barrier to the second barrier;   positioning the first expandable barrier to contact the inner surface and extend across the defect opening to completely cover the defect opening from the inside of the defect interior space; and   positioning the second expandable barrier to contact the outer surface and extend across the defect opening to completely cover the defect opening from the outside of the cavity.   
     
     
         2 . The method of  claim 1 , further comprising:
 expanding the first barrier within the defect interior space so that an outer diameter of the expanded first barrier is greater than the lateral dimension of the defect opening.   
     
     
         3 . The method of  claim 2 , wherein at least one of the first and second expandable barriers comprises a mesh comprising a first compact configuration and a second expanded configuration, the mesh comprising material chosen from the group consisting of: nylon, polypropylene, polyester, polyurethane, polyvinyl chloride, polyethylene terephthalate (PET), Teflon, Dacron, polytetrafluoroethylene (PTFE), expanded polytetrafluoroethylene (ePTFE), polyethylene, silicone, polyarylethertherketone (PEEK), hydrogel, poly  1 -lactic acid (PLA), poly glycolic acid (PGA), tricalcium phosphate (TCP), Nitinol, titanium, and stainless steel. 
     
     
         4 . The method of  claim 2 , wherein at least one of the first and second expandable barriers comprises a balloon, the balloon selectively inflatable and deflatable. 
     
     
         5 . The method of  claim 1 , further comprising:
 expanding the second barrier outside of the defect interior space so that an outer diameter of the expanded second barrier is greater than the lateral dimension of the defect opening.   
     
     
         6 . The method of  claim 1 , wherein the connecting member comprises at least one port, the method further comprising:
 introducing a sealing material into the connecting member; and   expelling the sealing material through the port into the defect between the first and second barriers to secure the first and second barriers to the defect and to prevent movement of fluid into or out of the defect.   
     
     
         7 . The method of  claim 1 , further comprising:
 advancing the second barrier along a longitudinal axis of the connecting member to translate the second barrier toward the defect and the first barrier; and   compressing the second barrier against the outer surface.   
     
     
         8 . The method of  claim 7 , further comprising,
 engaging a collar of the second barrier with a stop of the connecting member to lock the position of the second barrier relative to the connecting member.   
     
     
         9 . The method of  claim 1 , further comprising:
 connecting an expansion tool to the connecting member; and   actuating the expansion tool to selectively expand at least one of the first expandable barrier and the second expandable barrier.   
     
     
         10 . A method for treating a defect, the defect having an inner surface, an outer surface, a defect interior space, and a defect opening communicating with the inner surface and the outer surface, the defect opening having a lateral dimension, the method comprising:
 introducing a first balloon through the defect opening into the defect interior space, the first balloon having a longitudinal axis, the first balloon comprising an elastomeric member; and   inflating the first balloon from a compact configuration to a first expanded configuration having a diameter greater than the defect opening lateral dimension, wherein the first balloon completely covers the defect opening from the inside of the defect interior space.   
     
     
         11 . The method of  claim 10 , wherein inflating the first balloon further comprises:
 expanding the first balloon axially along the longitudinal axis; and   expanding the first balloon radially relative to the longitudinal axis, wherein the extent of radial expansion is greater than the extent of axial expansion.   
     
     
         12 . The method of  claim 10 , wherein the first balloon comprises a distal portion and a proximal portion, wherein introducing the first balloon further comprises:
 introducing the distal portion through the defect opening into the defect interior space; and   wherein inflating the first balloon further comprises:   inflating the first portion within the defect interior space to completely cover the defect opening from the inside of the defect interior space; and   inflating the second portion outside of the defect interior space to completely cover the defect opening from the outside of the defect opening.   
     
     
         13 . The method of  claim 10 , further comprising:
 positioning a second balloon outside of the defect interior space, the second balloon coupled to the first balloon by a connecting member; and   inflating the second balloon to completely cover the defect opening from the outside of the defect opening.   
     
     
         14 . The method of  claim 10 , further comprising:
 connecting a first catheter assembly to the connecting member;   actuating the first catheter assembly to introduce fluid into the first balloon to inflate the first balloon;   introducing a sealing material into the defect to secure the first and second balloons to the defect; and   disconnecting the first catheter assembly from the connecting member.   
     
     
         15 . The method of  claim 13 , further comprising:
 partially deflating at least one of the first and second balloons to decrease a longitudinal dimension of the balloon.