Filamentary devices having a flexible joint 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 implant may include first and second permeable shells. The first permeable shell having a proximal end with a concave or recessed section and a second permeable shell having a convex section that mates with the concave or recessed section. The implant also includes a flexible, articulating joint between the first and second permeable shells.

1 .- 40 . (canceled) 
     
     
         41 . A method for treating a cerebral aneurysm having an interior cavity and a neck, comprising the steps of:
 advancing an implant coupled to a pusher in a microcatheter to a region of interest in a cerebral artery, wherein the implant comprises a permeable shell having a proximal end, a distal end, a radially constrained elongated state configured for delivery within a lumen of the microcatheter, an expanded state with a longitudinally shortened configuration relative to the radially constrained state, and a plurality of elongate filaments that are woven together to form a mesh, wherein the implant is coupled to the pusher through a flexible connection;   advancing the permeable shell into the interior cavity of the cerebral aneurysm with the flexible connection in an angled configuration; and   deploying the permeable shell within the cerebral aneurysm, wherein the permeable shell expands to the expanded state in the interior cavity of the aneurysm.   
     
     
         42 . The method of  claim 41 , wherein the flexible connection comprises an elongate proximal extension of the permeable shell. 
     
     
         43 . The method of  claim 42 , wherein the implant further comprises a second permeable shell having a proximal end, a distal end, a radially constrained elongated state configured for delivery within the lumen of the microcatheter, an expanded state with a longitudinally shortened configuration relative to the radially constrained state, and a plurality of elongate filaments that are woven together to form a mesh, wherein the expanded state of the second permeable shell is configured to sit within a concave section of the permeable shell. 
     
     
         44 . The method of  claim 43 , wherein the permeable shell and second permeable shell are coupled through the elongate proximal extension. 
     
     
         45 . The method of  claim 43 , wherein the permeable shell is coupled to the pusher through the elongate proximal extension and the second permeable shell. 
     
     
         46 . The method of  claim 43 , wherein the second permeable shell is releasably coupled to the pusher. 
     
     
         47 . The method of  claim 43 , wherein the second permeable shell does not extend proximally past a plane defined by a proximal most edge of the permeable shell when both the permeable shell and the second permeable shell are in their expanded states. 
     
     
         48 . The method of  claim 43 , wherein the expanded state of the second permeable shell further contains a distal concave section at the distal end of the second permeable shell, wherein the distal concave section is configured to receive the elongate proximal extension of the permeable shell. 
     
     
         49 . The method of  claim 43 , wherein the permeable shell and the second permeable shell are formed from the same plurality of filaments. 
     
     
         50 . The method of  claim 43 , wherein the plurality of filaments forming the permeable shell is different from the plurality of filaments forming the second permeable shell. 
     
     
         51 . The method of  claim 43 , further comprising a proximal hub attached to a proximal end of the second permeable shell. 
     
     
         52 . The method of  claim 41 , further comprising a distal hub attached to a distal end of the permeable shell. 
     
     
         53 . The method of  claim 43 , wherein a proximal end of the second permeable shell is coupled to the pusher. 
     
     
         54 . The method of  claim 41 , wherein the permeable shell further comprises an elongate distal extension and a distal concave section, wherein at least a portion of the elongate distal extension sits within the distal concave section of the permeable shell. 
     
     
         55 . The method of  claim 54 , wherein the elongate distal extension is longer than the elongate proximal extension of the permeable shell. 
     
     
         56 . The method of  claim 43 , wherein the elongate proximal extension is a wire braid. 
     
     
         57 . The method of  claim 43 , wherein the permeable shell is capable of deflecting relative to a longitudinal axis formed by the pusher and the second permeable shell. 
     
     
         58 . The method of  claim 57 , wherein the permeable shell is capable of deflecting at an angle up to about 180° relative to a longitudinal axis formed by the pusher and the second permeable shell. 
     
     
         59 . The method of  claim 41 , wherein the flexible connection allows for the permeable shell to deflect at an angle relative to a longitudinal axis formed by the pusher. 
     
     
         60 . The method of  claim 43 , wherein the permeable shell is more flexible than the second permeable shell. 
     
     
         61 . The method of  claim 43 , wherein the second permeable shell is stiffer than the permeable shell. 
     
     
         62 . The method of  claim 43 , further comprising the steps of:
 deploying the second permeable shell, wherein the second permeable shell expands to the expanded state and sits within the concave section of the permeable shell; and   detaching the second permeable shell from the pusher.