# US 9,867,723 B2 · Procedures for vascular occlusion

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- Number: US 9,867,723 B2
- Document ID: US9867723B2
- Status: Granted
- Kind: B2
- Application number: 15/083,529
- Filed: 2016-03-29
- Published: 2016-09-29
- Granted: 2018-01-16
- Earliest claimed: 2009-06-23
- Applicants: Covidien LP
- Inventors: Aaron Berez; Quang Quoc Tran
- Web page: https://patentgrep.com/patent/US9867723B2

## CPC

- A61F 2/82: Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents (stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07)
- A61B 17/12036: {partial occlusion}
- A61B 17/12109: {in a blood vessel}
- A61B 17/12118: {for positioning in conjunction with a stent}
- A61B 17/12172: {having a pre-set deployed three-dimensional shape (methods of manufacturing A61B2017/00526)}
- A61B 17/320758: {with a rotating cutting instrument, e.g. motor driven (A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002)}
- A61F 2/01: Filters implantable into blood vessels
- A61F 2/06: Blood vessels
- A61F 2/852: Two or more distinct overlapping stents
- A61F 2/90: characterised by a net-like or mesh-like structure
- A61F 2/95: Instruments specially adapted for placement or removal of stents or stent-grafts
- A61M 5/007: {for contrast media}
- A61M 25/00: Catheters; Hollow probes (dilators A61M29/00; {peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00} ; for measuring or testing A61B; {materials for catheters A61L29/00})
- A61M 29/00: Dilators with or without means for introducing media, e.g. remedies
- A61B 17/12177: {comprising additional materials, e.g. thrombogenic, having filaments, having fibers or being coated}
- A61B 2017/00336: {with a protective sleeve, e.g. retractable or slidable}
- A61B 2017/1205: {Introduction devices}
- A61B 2017/12054: {Details concerning the detachment of the occluding device from the introduction device}
- A61B 2017/22079: {with suction of debris}
- A61B 2017/320716: {comprising means for preventing embolism by dislodged material}
- A61B 2017/320766: {eccentric}
- A61B 2017/320791: {with cutter extending outside the cutting window}
- A61B 2090/3966: {Radiopaque markers visible in an X-ray image}
- A61F 2/011: {Instruments for their placement or removal}
- A61F 2/013: {Distal protection devices, i.e. devices placed distally in combination with another endovascular procedure, e.g. angioplasty or stenting}
- A61F 2/966: with relative longitudinal movement between outer sleeve and prosthesis, e.g. using a push rod
- A61F 2002/823: {Stents, different from stent-grafts, adapted to cover an aneurysm}
- A61F 2002/826: {more than one stent being applied sequentially}
- A61F 2002/9528: {for retrieval of stents}
- A61F 2230/0078: hyperboloidal
- A61F 2230/0091: helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
- A61F 2230/0095: Saddle-shaped
- A61F 2250/0018: differing in elasticity, stiffness or compressibility
- A61F 2250/0026: differing in surface structures
- A61F 2250/0065: telescopic
- A61F: FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS (dental prosthetics A61C)
- A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D)
- A61M: DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY (introducing media into or onto the bodies of animals A61D7/00; means for inserting tampons A61F13/26; devices for administering food or medicines orally A61J; containers for collecting, storing or administering blood or medical fluids A61J1/05); DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY (surgery A61B; chemical aspects of surgical articles A61L); DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR {(Electrotherapy, e.g. producing anaesthesia by the use of alternating or intermittent currents A61N1/36021)}

## Abstract

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; deploying an occlusion device across the aneurysm; producing an image of the aneurysm including the contrast agent; and withdrawing the delivery device from the vessel after observing that the aneurysm has been stagnated by a desired amount. The image may be two-dimensional or three-dimensional. Observing that the aneurysm has been stagnated may include determining a degree of stagnation, for example by comparing an area or volume of the contrast agent in a first image and a second image. The desired amount may be a certain degree of stagnation, identification of a shape indicative of stasis such as a flat surface, an approximate hemisphere, a mushroom, or a crescent. If the occlusion device does not achieve the desired amount, a second occluding device may be deployed.

## Claims

### Claim 1

A method of reducing blood flow within an aneurysm, the method comprising:
expanding a stent, from a delivery device, across the aneurysm, such that a stagnated area forms in the aneurysm;
injecting a contrast agent into a blood vessel comprising an aneurysm;
imaging the stagnated area; and
upon observing that the stagnated area occupies more than 30% and less than 70% of a body of the aneurysm, withdrawing the delivery device from the vessel.

### Claim 2 (depends on 1)

The method of claim 1, wherein, after withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

### Claim 3 (depends on 1)

The method of claim 1, wherein the imaging is sufficient to determine that the expanding the stent is sufficient to lead to thrombosis of the aneurysm.

### Claim 4 (depends on 1)

The method of claim 1, wherein the stent, when expanded, has a porosity that is configured to result in a delayed thrombosis of the aneurysm.

### Claim 5 (depends on 4)

The method of claim 4, wherein the porosity is between about 60% and about 85%.

### Claim 6 (depends on 1)

The method of claim 1, wherein the withdrawing is while the stagnated area occupies more than about 50% of the body of the aneurysm.

### Claim 7 (depends on 1)

The method of claim 1, wherein the imaging comprises comparing a first image of the aneurysm before expanding the stent to a second image of the aneurysm after expanding the stent.

### Claim 8 (depends on 1)

The method of claim 1, wherein withdrawing the delivery device from the vessel comprises releasing the stent from the delivery device.

### Claim 9 (depends on 1)

The method of claim 1, further comprising expanding a second stent across the aneurysm while the stagnated area does not occupy more than 30% and less than 70% of the body of the aneurysm.

### Claim 10

A method of reducing blood flow within an aneurysm, the method comprising:
expanding a stent, from a delivery device, across the aneurysm, such that a stagnated area forms in the aneurysm;
injecting a contrast agent into a blood vessel comprising an aneurysm;
imaging the stagnated area; and
upon observing that the stagnated area occupies more than 20% and less than 100% of a body of the aneurysm, withdrawing the delivery device from the vessel.

### Claim 11 (depends on 10)

The method of claim 10, wherein, after withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

### Claim 12 (depends on 10)

The method of claim 10, wherein the imaging is sufficient to determine that the expanding the stent is sufficient to lead to thrombosis of the aneurysm.

### Claim 13 (depends on 10)

The method of claim 10, wherein the stent, when expanded, has a porosity that is configured to result in a delayed thrombosis of the aneurysm.

### Claim 14 (depends on 13)

The method of claim 13, wherein the porosity is between about 60% and about 85%.

### Claim 15 (depends on 10)

The method of claim 10, wherein the withdrawing is while the stagnated area occupies more than 50% of the body of the aneurysm.

### Claim 16 (depends on 10)

The method of claim 10, wherein the withdrawing is while the stagnated area occupies more than 70% of the body of the aneurysm.

### Claim 17 (depends on 10)

The method of claim 10, wherein the withdrawing is while the stagnated area occupies less than 90% of the body of the aneurysm.

### Claim 18 (depends on 10)

The method of claim 10, wherein the withdrawing is while the stagnated area occupies less than 70% of the body of the aneurysm.

### Claim 19 (depends on 10)

The method of claim 10, wherein the imaging comprises comparing a first image of the aneurysm before expanding the stent to a second image of the aneurysm after expanding the stent.