Aneurysm treatment with pushable ball segment

Abstract

The present invention provides a braided implant with a retractable dual proximal layer and methods for administering the braided implant to treat aneurysms. The implant can include a tubular braid that can be set into a predetermined shape, compressed for delivery through a microcatheter, and implanted in at least one implanted position that is based on the predetermined shape and the geometry of the aneurysm in which the braid is implanted. The implant can also have a retractable ball segment at the proximal end of the device made of the same braid that can be heat treated into an ellipsoid shape. The retractable ball segment can be movable from a position outside the aneurysm to a position at least partially enclosed within the implant to increase or decrease the height of the implant relative to the aneurysm or better conform the implant to the neck of the aneurysm.

What is claimed is: 
     
         1 . A method for treating an aneurysm, the method comprising:
 positioning a first portion of a tubular braided implant, the tubular braided implant comprising a tubular braid, an open end, and a pinched end, within a sac of the aneurysm such that the first portion circumferentially apposes walls within the aneurysm sac, extends from the open end of the tubular braid, and comprises one or more inversions, including a distal inversion positioned approximate a distal portion of the aneurysm wall;   expanding a second portion of the tubular braided implant in connection with the first portion of the tubular braided implant radially to occlude a majority of a neck of the aneurysm;   pressing the second portion distally into the first portion to provide a radial force against the first portion towards the aneurysm wall approximate a neck of the aneurysm; and   moving the distal inversion toward a distal portion of the aneurysm wall as a result of pressing the second portion distally into the first portion,   wherein the second portion is pressed distally into the first portion in a plane defining a boundary between the aneurysm and a blood vessel branch.   
     
     
         2 . The method of  claim 1 , wherein expanding the second portion of the tubular braided implant further comprises:
 compressing the second portion along a central axis of the tubular braided implant such that the second portion forms a substantially ellipsoidal shape.   
     
     
         3 . The method of  claim 1 , further comprising shaping the tubular braided implant to a delivery shape comprising a single layer of braid and sized to traverse a lumen of a microcatheter. 
     
     
         4 . The method of  claim 1 , wherein pressing the second portion distally into the first portion further comprises apposing at least a part of the first portion with the second portion to provide an outwardly radial force along a central axis of the tubular braided implant from the second portion to the first portion. 
     
     
         5 . The method of  claim 1 , wherein pressing the second portion distally into the first portion disrupts the flow of blood into the aneurysm by placing multiple layers of braid approximate the neck of the aneurysm. 
     
     
         6 . The method of  claim 1 , wherein positioning the first portion of the tubular braided implant further comprises:
 positioning the open end of the tubular braided implant to circumferentially appose the aneurysm wall;   positioning a proximal inversion in the first portion of the tubular braided implant approximate the neck of an aneurysm; and   shaping a first segment of the tubular braid extending between the open end and the proximal inversion to appose an at least a portion of the wall of the aneurysm within the aneurysm's sac.   
     
     
         7 . The method of  claim 6 ,
 wherein pressing the second portion distally into the first portion further comprises pressing the second portion of the tubular braided implant against the proximal inversion in the first portion of the tubular braided implant until the second portion of the tubular braided implant is at least partially enclosed by the proximal inversion, providing an outwardly radial force in a plane defining a boundary between the aneurysm and blood vessel branches.   
     
     
         8 . The method of  claim 1 ,
 wherein pressing the second portion distally into the first portion further comprises enclosing the second portion of the tubular braided implant within the first portion of the tubular braided implant.   
     
     
         9 . A method for treating an aneurysm, the method comprising:
 positioning a first segment of a tubular braided implant, the tubular braided implant comprising a tubular braid, an open end, and a pinched end, within a sac of the aneurysm such that the first segment extends from the open end of the tubular braid to a proximal inversion;   positioning a second segment of the tubular braided implant within the aneurysm sac, the second segment encircled by the open end and extending from the proximal inversion to a distal inversion; and   positioning a third segment of the tubular braided implant within the aneurysm sac, the third segment surrounded by the second segment and extending from the distal inversion, and   advancing a ball segment depending from the third segment distally into the proximal inversion, the ball segment extending radially outward from a central axis, providing a radially outward force, and converging at the pinched end to appose the proximal inversion.   
     
     
         10 . The method of  claim 9 , wherein the ball segment is enclosed by the second segment distal to the proximal inversion. 
     
     
         11 . The method of  claim 9 , wherein when the tubular braided implant is implanted in the aneurysm, the ball segment occludes at least a portion of an aneurysm neck. 
     
     
         12 . The method of  claim 9 , wherein the radially outward force is exerted against the proximal inversion so that the tubular braided implant contacts a wall of the aneurysm approximate a neck of the aneurysm. 
     
     
         13 . The method of  claim 9 , wherein when the tubular braided implant is implanted in the aneurysm, the second segment forms a sack, at least a portion of the third segment is positioned within the sack, and at least a portion of the ball segment is positioned external to the sack. 
     
     
         14 . The method of  claim 9 , wherein when the tubular braided implant is implanted in the aneurysm,
 the first segment forms an outer layer positioned to contact an aneurysm wall of the aneurysm,   the proximal inversion is positioned to be placed approximate an aneurysm neck of the aneurysm, and   the second segment forms a sack positioned to appose a portion of the aneurysm wall of the aneurysm and to appose the outer layer.   
     
     
         15 . A method for forming an occlusive device to treat an aneurysm comprising:
 inverting a tubular braid comprising an open end and a pinched end to form a distal inversion;   inverting the tubular braid to form a proximal inversion by moving the open end over at least a portion of the braid;   shaping a first segment of the tubular braid extending between the open end and the proximal inversion;   shaping a second segment of the tubular braid extending between the proximal inversion and the distal inversion;   positioning the open end to encircle the second segment;   shaping a third segment extending from the distal inversion to the pinched end;   positioning the second segment to surround the third segment;   shaping a ball segment of the tubular braid extending from the third segment radially outward from a central axis to form a substantially ellipsoid shape and converge at the pinched end; and   applying a mold to the ball segment of the tubular braid and treating the ball segment with heat to conform the ball segment to the formed shape, the ball segment movable along a central axis of the tubular braid.   
     
     
         16 . The method of  claim 15  further comprising:
 positioning the first segment, second segment, and third segment within an aneurysm, and 
 advancing the ball segment distally into the proximal inversion. 
 
     
     
         17 . The method of  claim 16 , whereby advancing the ball segment distally into the proximal inversion moves the distal inversion towards a distal portion of a wall of the aneurysm to conform the device to the height of the aneurysm. 
     
     
         18 . The claim of method  16 , further comprising moving the ball segment to a position at least partially enclosed by the second segment distal to the proximal inversion. 
     
     
         19 . The method of  claim 16 , wherein when the tubular braided implant is implanted in the aneurysm, the ball segment occludes at least a portion of an aneurysm neck. 
     
     
         20 . The method of  claim 16 , wherein the ball segment provides a radially outward force, the radially outward force being exerted against the proximal inversion so that the tubular braided implant contacts a wall of the aneurysm approximate a neck of the aneurysm.