Filamentary devices for treatment of vascular defects

Abstract

Devices and methods for treatment of a patient's vasculature are described. Embodiments may include a permeable implant having a radially constrained state configured for delivery within a catheter lumen, an expanded state, and a plurality of elongate filaments that are woven together. The permeable implant may include a stiffer proximal portion that is configured to sit at the neck of an aneurysm. The stiffer proximal portion may include additional mesh layers or a structural support with scaffolding wires.

1 . A device for treatment of a patient's cerebral aneurysm, comprising:
 a first permeable shell including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state, and a plurality of elongate filaments that are woven together to form a mesh, the expanded state having a proximal portion, a distal portion, and an interior cavity, wherein each of the plurality of filaments has a proximal end and a distal end, wherein the proximal ends of each of the plurality of filaments are gathered in a proximal hub and the distal ends of each of the plurality of filaments are gathered by a first distal hub that is located in the interior cavity; and   a second permeable shell including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state, and a plurality of elongate filaments that are woven together to form a mesh, wherein at least a portion of the second permeable shell is in contact with the proximal portion of the first permeable shell, wherein each of the plurality of filaments of the second permeable shell has a proximal end and a distal end, wherein the distal ends of each of the plurality of filaments of the second permeable shell are gathered in a second distal hub, and wherein the proximal ends of each of the plurality of filaments of the second permeable shell are gathered in the proximal hub with the proximal ends of each of the plurality of filaments of the first permeable shell, and   wherein a length of the expanded state of the second permeable shell is smaller than a length of the expanded state of the first permeable shell.   
     
     
         2 . The device of  claim 1 , wherein the first permeable shell has an inverted distal end. 
     
     
         3 . The device of  claim 1 , wherein the second permeable shell is stiffer than the first permeable shell. 
     
     
         4 . The device of  claim 1 , wherein the length of the expanded state of the second permeable shell is between about 10% to about 40% of the length of the expanded state of the first permeable shell. 
     
     
         5 . The device of  claim 1 , wherein the first distal hub and the second distal hub are coupled together. 
     
     
         6 . The device of  claim 1 , wherein the first distal hub is at a position about 0% to about 50% of a total length of the expanded state of the first permeable shell from a distal end of the first permeable shell. 
     
     
         7 . A device for treatment of a patient's cerebral aneurysm, comprising:
 a first permeable shell including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state, and a plurality of elongate filaments that are woven together to form a mesh, the expanded state having a proximal portion, a distal portion, and an interior cavity, wherein each of the plurality of filaments has a proximal end and a distal end, wherein the proximal ends of each of the plurality of filaments are gathered in a proximal hub and the distal ends of each of the plurality of filaments are gathered by a first distal hub that is located in the interior cavity; and   a second permeable shell including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state, and a plurality of elongate filaments that are woven together to form a mesh, wherein each of the plurality of filaments of the second permeable shell has a proximal end and a distal end, wherein the distal ends of each of the plurality of filaments of the second permeable shell are gathered in a second distal hub, and wherein the proximal ends of each of the plurality of filaments of the second permeable shell are gathered in the proximal hub with the proximal ends of each of the plurality of filaments of the first permeable shell, and   wherein the first distal hub and the second distal hub are coupled together.   
     
     
         8 . The device of  claim 7 , wherein a length of the expanded state of the second permeable shell is smaller than a length of the expanded state of the first permeable shell. 
     
     
         9 . The device of  claim 7 , wherein the first permeable shell has an inverted distal end. 
     
     
         10 . The device of  claim 7 , wherein the second permeable shell is stiffer than the first permeable shell. 
     
     
         11 . The device of  claim 7 , wherein the first distal hub and the second distal hub are coupled together through a tether, wire, or mesh. 
     
     
         12 . The device of  claim 7 , wherein the first permeable shell has a length of between about 7 mm and about 9 mm. 
     
     
         13 . A device for treatment of a patient's cerebral aneurysm, comprising:
 a first permeable shell including a first end, a second end, a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state, and a plurality of filaments that are woven together to form a mesh, wherein each of the plurality of filaments has a first end and a second end, wherein each of the plurality of filaments starts at the first end of the first permeable shell, extends to the second end of the first permeable shell, and extends back to the first end of the first permeable shell, and wherein the first and second ends of each of the plurality of filaments are gathered in a hub at the first end of the first permeable shell; and   a support structure including a radially constrained elongated state configured for delivery within a catheter lumen, an expanded state, and a plurality of scaffolding filaments that are associated with a portion of the first permeable shell that includes the first end of the first permeable shell, wherein each of the plurality of scaffolding filaments has a diameter that is larger than a diameter of each of the plurality of elongate filaments of the first permeable shell.   
     
     
         14 . The device of  claim 13 , wherein the plurality of scaffolding filaments are woven into the mesh of the first permeable shell. 
     
     
         15 . The device of  claim 13 , wherein the support structure is coupled to the first permeable shell. 
     
     
         16 . The device of  claim 13 , wherein the support structure is coupled to the first permeable shell using welding, adhesive, or mechanical ties. 
     
     
         17 . The device of  claim 13 , wherein the first permeable shell comprises a conical cavity extending from the distal end to the proximal end of the first permeable shell. 
     
     
         18 . The device of  claim 13 , wherein each of the scaffolding filaments has a diameter between about 0.001″ and about 0.004″. 
     
     
         19 . The device of  claim 13 , wherein the support structure has a height, and wherein the height of the support structure is between about 10 and about 60% of a height of the first permeable shell. 
     
     
         20 . The device of  claim 13 , wherein the support structure has an open distal end. 
     
     
         21 - 40 . (canceled)