CN111528951A - 用于动脉瘤治疗的粘合剂覆盖物阻塞装置 - Google Patents

用于动脉瘤治疗的粘合剂覆盖物阻塞装置 Download PDF

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CN111528951A
CN111528951A CN202010081600.0A CN202010081600A CN111528951A CN 111528951 A CN111528951 A CN 111528951A CN 202010081600 A CN202010081600 A CN 202010081600A CN 111528951 A CN111528951 A CN 111528951A
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D.索伦
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Abstract

本发明题为“用于动脉瘤治疗的粘合剂覆盖物阻塞装置”。本发明提供一种装置，该装置包括用于阻塞动脉瘤颈部的网部分和固定网部分的粘合剂。装置还可包括在网部分中的通道孔开口以及用于将快速固化剂通过孔递送到动脉瘤中的试剂通道。可通过导管将装置递送到动脉瘤，网可扩张以阻塞动脉瘤颈部，网可粘附到动脉瘤颈部。在包括通道孔和试剂通道的装置中，可将快速固化剂注射到动脉瘤中。在快速固化剂的注射期间，网部分可形成屏障以抑制快速固化剂离开动脉瘤。在注射凝固剂之后，可从患者体内提取治疗装置的除网部分之外的部分。

Description

用于动脉瘤治疗的粘合剂覆盖物阻塞装置
技术领域
本发明整体涉及医疗器械，并且更具体地涉及用于动脉瘤治疗的治疗装置。
背景技术
动脉瘤可以是复杂且难以治疗的。例如，当动脉瘤位于关键组织附近时，治疗通路可受到限制或不可用。此类因素对于颅内动脉瘤而言尤其受到关注，这归因于颅内血管周围的脑组织以及对应的受限治疗通路。
现有解决方案包括血管内治疗通路，其中动脉瘤囊的内部体积被移除或排除在动脉血压和血流之外。在这方面，因为动脉瘤的内壁可继续经受血液流动和相关的压力，所以动脉瘤破裂仍是可能的。
血管内或其他外科方法的替代方案可包括阻塞装置。此类装置通常具有并入的多个栓塞线圈，这些线圈使用微导管递送***将其递送到脉管***。例如，当治疗颅内动脉瘤时，通常首先通过髋部或腹股沟区的股动脉将具有栓塞线圈的递送导管***非颅脉管***。然后，将导管引导至脑壳内的感兴趣位置。然后，动脉瘤的囊可以填充有栓塞材料以形成血栓块，该血栓块保护动脉壁不受血流和相关压力的影响。然而，此类阻塞装置确实存在某些缺点，包括质量效应，这会导致大脑及其神经受到压迫。获得足以阻塞动脉瘤颈部或填充动脉瘤囊的栓塞线圈堆积密度是困难且耗时的。此外，动脉瘤形态(例如，宽颈部、分叉等)可需要辅助装置诸如支架或球囊来支撑线圈质量并获得期望的堆积密度。线圈和附带的辅助装置可在其整个生命中保持在患者体内，并且可对动脉瘤施加破坏性的应力。当前栓塞线圈方法还可涉及将各种线圈递送到线圈块中。在每个线圈***的情况下，发生不良事件的风险增加。因此，创建一种在一个手术期间不需要***多个产品或线圈的***是有利的。另外，栓塞线圈并不总是有效地治疗动脉瘤，因为动脉瘤的再通和/或线圈压实可随时间推移而发生。
一种特定类型的阻塞方法致力于递送和治疗动脉瘤的入口或“颈部”而不是通过将装置植入动脉瘤的载瘤血管中来确定动脉瘤的体积。在此类“颈部”方法中，通过最小化横跨颈部的血流量，可实现进入动脉瘤中的流动停止。继而，血栓块可自然形成，而不必将栓塞材料递送到动脉瘤囊中，如前所述。然而，颈部阻塞方法(诸如在载瘤血管中植入阻流装置)并非没有缺点。这种类型的方法可阻止血流进入外周血管中，同时堵塞载瘤血管中的动脉瘤颈部。如果血管的开口被堵塞，则阻止向外周血管的流动可无意地导致严重损伤。
另一种类型的阻塞方法是使用胶水、粘合剂或其他类似产品(例如NBCA(氰基丙烯酸正丁酯))来阻碍血液流向大脑区域。然而，当单独***颅内血管中时，这些产品可在下游移动，并且在不期望的区域中引起栓塞。因此，期望具有一种装置，该装置容易、准确且安全地阻塞载瘤血管中的动脉瘤或其他动静脉畸形的颈部，并且可保持所使用的任何胶水或粘合剂的放置而无需***多种产品或堵塞进入与载瘤血管连通的外周血管中的流动，同时最小化对动脉瘤的作用力。
本发明的目的是解决本领域的这些和其他问题。
发明内容
本文公开了用粘合剂覆盖物治疗装置治疗动脉瘤的各种示例性装置。该装置一般来讲可包括用于阻塞动脉瘤颈部的网部分和固定网部分的粘合剂。该装置还可包括在网部分中的通道孔开口以及用于将快速固化剂通过所述孔递送到所动脉瘤中的试剂通道。可通过导管将装置递送到动脉瘤，网可扩张以阻塞动脉瘤颈部，网可粘附到动脉瘤颈部。在包括通道孔和试剂通道的装置中，可将快速固化剂注射到动脉瘤中。在快速固化剂的注射期间，网部分可形成屏障以抑制快速固化剂离开动脉瘤。在注射凝固剂之后，可从患者体内提取治疗装置的除网部分之外的部分。
用于阻塞动脉瘤的示例治疗装置可包括能够从塌缩构型扩张到阻塞构型的网部分以及用于固定网部分的粘合剂。处于阻塞构型的网部分可阻塞动脉瘤颈部以在动脉瘤和血管之间形成屏障。粘合剂可将处于阻塞构型的网部分固定在其位于动脉瘤颈部附近的位置，以防止网部分移位并破坏动脉瘤和血管之间的屏障。当由网部分形成的屏障粘附到位时，动脉瘤可自行栓塞。可使用微导管将示例装置递送到动脉瘤。
在网部分达到阻塞构型之前或之后，诸如在网部分递送到动脉瘤之前、在网部分递送到动脉瘤时、当网部分达到阻塞构型时、或者在网部分达到阻塞构型之后，粘合剂可被活化。
用于阻塞动脉瘤的示例装置还可包括海波管，该海波管跨越网部分的周边的至少一部分，该海波管含有处于未固化状态的粘合剂。海波管可包括至少一个海波管孔，该至少一个海波管孔将处于未固化状态的粘合剂中的至少一些暴露于网部分外部的环境。固化通道可将固化剂递送到网部分以将粘合剂从未固化状态活化。然后，粘合剂可将处于阻塞构型的网部分粘附到其阻塞动脉瘤颈部的位置。
示例装置还可包括用于将粘合剂递送到网部分的递送通道。递送通道可具有连接到网部分的远侧端部。在网部分达到阻塞构型之前或之后，诸如在网部分递送到动脉瘤之前、在网部分递送到动脉瘤时、当网部分达到阻塞构型时、或者在网部分达到阻塞构型之后，粘合剂可被递送到网部分。
用于阻塞动脉瘤的示例装置还可包括通道孔和试剂通道。通道孔可限定网部分中的开口，通过该开口可注射快速固化剂。当网部分处于阻塞构型时，通道孔可通向动脉瘤。试剂通道可与通道孔连通，并且可将快速固化剂通过通道孔递送到动脉瘤囊中。
试剂通道可具有近侧端部和远侧端部。试剂通道的远侧端部可与通道孔连通，以将快速固化剂输送到动脉瘤囊中。试剂通道的近侧端部可接收快速固化剂。通道孔也可为在试剂通道的远侧端部中的开口，由此使得单个开口用作通道孔和试剂通道的远侧端部两者。
示例装置还可包括与试剂通道的近侧端部连通的触发机构。触发机构可与试剂通道的近侧端部连通，以接收快速固化剂或将快速固化剂引入试剂通道中。触发机构可有利于将快速固化剂从试剂通道的近侧端部递送到远侧端部，并且然后通过通道孔递送到动脉瘤囊中。
一种用于治疗动脉瘤的示例方法可包括：提供示例性治疗装置，该治疗装置可包括网部分和粘合剂；将示例性治疗装置递送到动脉瘤治疗部位；将网部分在动脉瘤颈部处扩张到阻塞构型，以阻塞动脉瘤颈部的至少一部分，以在血管和动脉瘤之间形成屏障；以及邻近动脉瘤颈部粘附网部分。
该方法还可包括将处于未固化状态的粘合剂***跨越网部分的周边的至少一部分的海波管中，其中海波管包括至少一个海波管孔，该至少一个海波管孔使粘合剂中的至少一些暴露于网部分外部的环境；以及将固化剂经由固化通道递送到网部分以活化粘合剂。
用于治疗动脉瘤的另一示例方法可包括提供示例性治疗装置，该治疗装置可包括网部分、粘合剂、限定网部分中的开口的通道孔、以及试剂通道；将试剂通道接合到通道孔；将示例性治疗装置递送到动脉瘤治疗部位；在动脉瘤颈部处将网部分扩张到阻塞构型，以阻塞动脉瘤颈部的至少一部分，以在血管和动脉瘤之间形成屏障，以防止快速固化剂进入血管；邻近动脉瘤颈部粘附网部分；以及通过试剂通道、通过通道孔递送快速固化剂并进入动脉瘤囊中以凝固动脉瘤中存在的血液。
该方法还可包括提供触发机构；通过在试剂通道的近侧端部处激活触发机构来触发试剂的递送；以及将试剂从试剂通道的近侧端部递送到试剂通道的远侧端部。
附图说明
将参考下面的描述并结合附图进一步讨论本发明的上述方面和另外的方面，
在这些附图中，类似的编号指示各种图中类似的结构元件和特征。附图未必按比例绘制，相反，将重点放在示出本发明的原理。附图仅以举例方式而非限制方式描绘了本发明装置的一种或多种具体实施。
图1a至图1c为根据本发明的各方面的用于阻塞动脉瘤的示例性治疗装置的治疗序列的图示；
图2a至图2b为根据本发明的各方面的用于阻塞动脉瘤的示例性治疗装置的治疗序列的图示；
图3a至图3d为根据本发明的各方面的用于阻塞动脉瘤并将快速固化剂递送到动脉瘤的示例性治疗装置的治疗序列的图示；
图4a至图4d为根据本发明的各方面的用于阻塞动脉瘤并将粘合剂递送到网部分且将快速固化剂递送到动脉瘤的示例性治疗装置的治疗序列的图示；
图5a至图5g为根据本发明的各方面的用于阻塞动脉瘤并将固化剂递送到网部分且将快速固化剂递送到动脉瘤的示例性治疗装置的治疗序列的图示；
图6a至图6d为根据本发明的各方面的用于阻塞动脉瘤并将快速固化剂递送到动脉瘤的结合触发机构的示例性治疗装置的治疗序列的图示；
图7为概述根据本发明的各方面的可在治疗装置的递送和使用期间执行的示例方法步骤的流程图；并且
图8为概述根据本发明的各方面的可在治疗装置的递送和使用期间执行的示例方法步骤的流程图。
具体实施方式
本文所包含的描述为本发明的示例，并且不旨在以任何方式限制本发明的范围。一般来讲，本文所述的示例装置描述了可放置并粘附在动脉瘤的颈部上方以在血管和动脉瘤之间形成屏障的治疗装置。然后，至少一种快速固化剂可被递送到动脉瘤囊中。快速固化剂可即时地凝固动脉瘤中的血液。
示例装置可包括可从塌缩构型扩张到阻塞构型的网部分，其中处于阻塞构型的网部分被成形为阻塞动脉瘤颈部。可将网部分粘附在适当位置以阻塞动脉瘤颈部。在阻塞构型中，网部分可通常具有通道孔，该通道孔结合试剂通道来工作以通过通道孔递送快速固化剂并进入动脉瘤囊中。
必须注意，除非上下文明确地指明，否则如本说明书和所附权利要求所用，单数形式“一个”、一种”、“该”和“所述”包括复数指代物。所谓“包含”或“含有”或“包括”是指至少命名的化合物、元素、颗粒或方法步骤存在于组合物或制品或方法中，但不排除存在其他化合物、材料、颗粒、方法步骤，即使其他此类化合物、材料、颗粒、方法步骤具有与命名的那些相同的功能。
在描述示例时，为了清楚起见，将采用术语。旨在使每个术语设想其本领域技术人员理解的最广泛的含义，并且包括以类似方式操作以实现类似目的的所有技术等同物。还应当理解，提到方法的一个或多个步骤不排除存在附加的方法步骤或在那些明确标识的步骤之间的中间方法步骤。在不脱离所公开技术的范围的情况下，可按照与本文所述的顺序不同的顺序执行方法的步骤。类似地，还应当理解，提到装置或***中的一个或多个部件不排除存在附加的部件或在那些明确标识的部件之间的中间部件。
图1a至图1c为在递送到动脉瘤10的示例性治疗装置100的治疗序列期间可发生的阶段或步骤的图示。图1a为示例治疗装置100的图示，其中所示的网部分102在递送导管400内部处于塌缩递送构型。网部分102可具有位于网部分102的外周边的至少一部分上的粘合试剂108和覆盖粘合试剂108的粘合剂屏障110。网部分102可被定尺寸成在网部分102处于塌缩构型时适配在递送导管400的管腔内。当网部分102处于塌缩构型时，网部分102可具有足够的柔性，以通过递送导管400被递送、操纵弯曲的解剖学几何结构、被递送到动脉瘤10。处于塌缩构型的网部分102可具有基本上管状的形状。
转到图1b，通过在网部分102处于塌缩构型时朝远侧滑动装置100以通过递送导管400，可将治疗装置100递送到动脉瘤10。治疗装置100可通过血管106被递送到治疗部位。图1b示出位于定位在动脉瘤颈部12附近的递送导管400内部的治疗装置100。图1b还示出被部分推出递送导管400以部署在动脉瘤囊16内部的网部分102。网部分102可在其离开递送导管400时扩张。网部分102可包含形状记忆材料，诸如镍钛诺、镍钛诺合金、聚合物形状记忆材料，或具有如本文所述的用于再成形的特性的其他形状记忆材料。网部分102可在塌缩构型中呈变形形状，并且可在离开递送导管400之后基于预定形状而再成形。如在此所示，在网部分102离开递送导管400时，可以移除粘合剂屏障110以暴露位于网部分的周边的至少一部分上的粘合试剂108。另选地，在网部分102达到阻塞构型之前或之后，诸如在网部分102递送到动脉瘤10之前、在网部分102递送到动脉瘤10时、当网部分102达到阻塞构型时、或者在网部分102达到阻塞构型之后，可移除粘合剂屏障110。粘合试剂108可包括医用级有机硅类粘合剂以及可光固化的粘合剂。粘合试剂108可包括粘合剂，诸如氰基丙烯酸正丁酯(NBCA)、聚(甲基丙烯酸甲酯)(PMMA996)、N-甲基-2-吡咯烷酮(NMP)、碳酸酐酶相关蛋白10(CA10)、EA/MMA以及DME。
图1c示出示例治疗装置100，其中网部分102在动脉瘤10中处于阻塞构型。处于阻塞构型的网部分102可被定尺寸成阻塞动脉瘤颈部12的至少一部分。处于阻塞构型的网部分102可完全阻塞动脉瘤颈部12，如图1c所示。处于阻塞构型的网部分102可阻塞颈部12以在血管106和动脉瘤10之间形成屏障。网部分102可从动脉瘤囊16内部阻塞动脉瘤10。如图1c所示，当网部分102处于阻塞构型时，暴露的粘合试剂108可与动脉瘤壁14接触。在阻塞构型中，网部分102可能够使血流从动脉瘤10偏转、使血流从动脉瘤10转向、使进入动脉瘤10中的血流减慢、或它们的任何组合。
在阻塞构型中，网部分102可延伸到动脉瘤壁14，并且粘合试剂108可将网部分102相对于动脉瘤壁14和动脉瘤颈部12保持在其位置，使得治疗装置100不会移位，并因此无法有效抑制血流进入动脉瘤10中。网部分102还可提供抵靠动脉瘤壁14的力，以帮助维持网部分102的阻塞构型，并协助粘合试剂108粘附到动脉瘤壁14。例如，网部分102可由具有第一预定形状和处于塌缩构型的第二塌缩形状的形状记忆材料制成。当网部分102在动脉瘤10内处于阻塞构型时，网部分102可移动到第三部署形状，该第三部署形状至少部分地基于动脉瘤10的第一预定形状和解剖学几何结构。在该示例中，第一预定形状可被定尺寸成大于动脉瘤囊16内的壁14；网部分102可移动以延伸到壁14；并且当形状记忆材料的特性导致网部分102试图打开到预定形状时，网部分102可抵靠壁14提供力。该力可帮助粘合试剂108粘附到壁以保持网部分102的位置。处于阻塞构型的网部分102可呈动脉瘤颈部12的形状和/或靠近动脉瘤颈部12的动脉瘤的内壁14的形状。
图2a以与图1b中所述相同的方式示出网部分102的部署。然而，图2a示出网部分102被部分地从递送导管400推出，以横跨动脉瘤颈部12在动脉瘤囊16外部部署。图2b示出示例治疗装置100，其中网部分102在动脉瘤10外部处于阻塞构型。在该示例中，粘合试剂108可将网部分102粘附到血管106的壁并粘附在动脉瘤颈部12上方，以使血流从动脉瘤10偏转、使血流从动脉瘤10转向、使进入动脉瘤10中的血流减慢、或它们的任何组合。粘合试剂108可将网部分102保持在其在动脉瘤颈部12上方的位置，使得治疗装置100不会移位，并因此无法有效地抑制血流进入动脉瘤10中并成为血管中其他地方的潜在的堵塞。
图3a至图3c为在示例性治疗装置100的治疗序列期间可发生的阻塞动脉瘤并将快速固化剂114递送到动脉瘤10的阶段或步骤的图示。图3a为示例治疗装置100的图示，其中所示的具有被粘合剂屏障110覆盖的粘合试剂108的网部分102在递送导管400内部处于塌缩递送构型，类似于图1a。网部分102可包括定位在塌缩网部分102的近侧端部上的通道孔104。通道孔104可结合试剂通道112来工作。通道孔104可连接到试剂通道112的远侧端部112a。治疗装置100可被定尺寸成在网部分102处于塌缩构型时适配在递送导管400的管腔内。试剂通道112可具有足够的长度以在网部分102到达治疗部位时能够从患者体外触及。所示的网部分102在递送导管400内部处于塌缩递送构型。
图3b示出递送导管400内部的治疗装置100，其中网部分102离开递送导管400以部署在动脉瘤10的囊16外部，类似于图1b所述的方式。另选地，网部分102可部署在动脉瘤10的囊16内部。当装置100离开递送导管400时，粘合试剂108以图1b所述的方式暴露。
图3c示出治疗装置100，其中网部分102在动脉瘤囊16外部处于阻塞构型，类似于图2b。如图所示，通道孔104可位于网部分102中，使得通道孔104通向动脉瘤10。通道孔104可居中地位于网部分102中。网部分102中的通道孔104可结合试剂通道112来工作。试剂通道112可允许一种或多种快速固化剂114通过通道112输送到通道孔104。快速固化剂114可包括试剂，诸如胶原、壳聚糖、高岭土、沸石、有机或生物相容性溶剂，或具有如本文所述的用于快速固化的特性的其他试剂。试剂通道112可具有远侧端部112a和近侧端部112b(参见图6)。试剂通道112的远侧端部112a可连接到通道孔104。近侧端部112b可将快速固化剂114接收到试剂通道112中，并且将快速固化剂114从近侧端部递送到连接到通道孔104的远侧端部112a。近侧端部112b能够从患者体外触及以用于将快速固化剂114注射到患者体内。通过试剂通道112的管腔传送到远侧端部112a的快速固化剂114可随后在到达试剂通道112的远侧端部112a时穿过通道孔104并进入动脉瘤囊16中。试剂通道112的远侧端部112a也可为网部分102的通道孔104。快速固化剂114可凝固动脉瘤10内部的血液。根据快速固化剂114的凝固特性，快速固化剂114可在接触动脉瘤10内部的血液时实际上瞬间地凝固动脉瘤10内部的血液。
如图3d所示，一旦将快速固化剂114泵入动脉瘤囊16中，就可从动脉瘤10中移除治疗装置100的除网部分102之外的部件(未示出)。一旦快速固化剂114已经使动脉瘤10中的血液凝固，就可移除治疗装置100的除网部分102之外的部件。治疗装置100的除网部分102之外的部件可被定尺寸成横穿回收导管(未示出)的管腔。
图4a至图4d为在示例性治疗装置100的治疗序列期间可发生的阻塞动脉瘤10，将粘合剂108递送到网部分102，并且将快速固化剂114递送到动脉瘤10的阶段或步骤的图示。图4a为示例治疗装置100的图示，其中所示的网部分102在递送导管400内部处于塌缩递送构型。装置100可具有通道孔104和试剂通道112，如图3a所述。装置100还可具有可与网部分102连通工作的递送通道118。递送通道118可具有与网部分102连通的远侧端部118a。递送通道108可将粘合剂108递送到网部分102，以邻近颈部12粘附网部分102。治疗装置100可被定尺寸成在网部分102处于塌缩构型时适配在递送导管400的管腔内。
图4b示出网部分102在动脉瘤10的囊16内部的部署。如图4b所示，通过在网部分102处于塌缩构型时朝远侧滑动装置100以通过递送导管400，可将治疗装置100递送到动脉瘤10。治疗装置100可通过血管106被递送到治疗部位。图1b示出位于定位在动脉瘤颈部12附近的递送导管400内部的治疗装置100。图4b还示出被部分推出递送导管400以部署在动脉瘤囊16内部的网部分102。网部分102可在其离开递送导管400时扩张。另选地，网部分102可部署在动脉瘤10的囊16外部。
图4c示出治疗装置100，其中网部分102在动脉瘤囊16内部处于阻塞构型。如图4c所示，在网部分102达到阻塞构型之后，粘合试剂108可通过递送通道118被递送到网部分102，以在动脉瘤囊16内部将网部分102粘附在动脉瘤颈部12上方。另选地，递送通道118可将粘合剂108递送到网部分102，以将处于阻塞构型的网部分102在动脉瘤囊16外部粘附在动脉瘤颈部12上方。在网部分102达到阻塞构型之前或之后，诸如在网部分102递送到动脉瘤10之前、在网部分102递送到动脉瘤10时、或者当网部分102达到阻塞构型时，也可递送粘合剂108。在将网部分102粘附在颈部12上方之后，可以图3c所述的方式将快速固化剂114递送到动脉瘤囊16。
如在图3d中一样，图4d示出将快速固化剂114泵入动脉瘤囊16中之后的动脉瘤10，之后可从动脉瘤10中移除治疗装置100的除网部分102之外的部件(未示出)。
图5a至图5f为在示例性治疗装置100的治疗序列期间可发生的阻塞动脉瘤10，将固化剂124递送到网部分102，并且将固化剂114递送到动脉瘤10的阶段或步骤的图示。图5a为示例治疗装置100的图示，其中所示的网部分102在递送导管400内部处于塌缩递送构型。装置100可具有通道孔104和试剂通道112，如图3a所述。装置100还可具有跨越网部分102的周边的至少一部分的海波管120。海波管120可跨越网部分102的整个周边。海波管120可含有处于未固化状态的粘合剂108。海波管120可包括一个或多个海波管孔122(参见图5d)，其将未固化的粘合剂108暴露于海波管120外部的环境。
装置100还可具有可与网部分102连通工作的固化通道126。固化通道126可具有结合网部分102的远侧端部126a。固化通道126可将固化剂(如上所述)递送到装置100的网部分102。固化剂126可活化网部分102中的未固化的粘合剂108。整个治疗装置100可被定尺寸成在网部分102处于塌缩构型时适配在递送导管400的管腔内。
图5b示出网部分102在动脉瘤10的囊16内部的部署，类似于图4b。图5c示出治疗装置100，其中网部分102以图4c所示的方式在动脉瘤囊16内部处于阻塞构型。如在此所示，在网部分102达到阻塞构型之后，可通过固化通道126将固化剂124递送到网部分102以活化粘合试剂108并且在动脉瘤囊16内部将网部分102粘附在动脉瘤颈部12上方。另选地，可通过固化通道126将固化剂124递送到网部分102以活化粘合试剂108并且在动脉瘤囊16外部将网部分102粘附在动脉瘤颈部12上方。在网部分102达到阻塞构型之前或之后，诸如在网部分102递送到动脉瘤10之前、在网部分102递送到动脉瘤10时、或者当网部分102达到阻塞构型时，可递送固化剂124。
图5d示出海波管120的放大和横截面视图。海波管120可包括至少一个海波管孔122以及处于未固化状态的粘合剂108。海波管孔122可将未固化的粘合剂108暴露于海波管120外部的环境。图5e为装有粘合剂108的网部分102的横截面。例如，在图5d和图5e中，未固化的粘合剂108可通过首先被机械地保持在网部分102内而被递送。网部分102可包括沿圆周的管腔(海波管122)，该管腔具有允许未固化的粘合剂暴露的孔。粘合剂108的粘度可被表征为使得其可被注射到网部分102的管腔中，但足够粘稠，使得其在递送期间不会重新定位或分散。在放置网部分102并随后递送固化剂时，网内的粘合剂将被活化。网将具有将粘合剂中的一些暴露于动脉瘤的孔，从而允许其将网的边缘粘附到动脉瘤壁。在这种情况下，网将充当堵塞进入动脉瘤中的流动的装置。
图5f示出治疗装置100，其中网部分102以图4c所示的方式在动脉瘤囊16内部处于阻塞构型。当将固化剂124递送到网部分102时，粘合剂108可将处于阻塞构型的网部分102固化并粘附在动脉瘤颈部12上方以阻塞动脉瘤10。一旦网部分102已经粘附就位，就可以将快速固化剂114递送到动脉瘤10，如图3c所示。
类似于图3d，图5g示出将快速固化剂114泵入动脉瘤囊16中之后的动脉瘤10，之后从动脉瘤10中移除治疗装置100的除网部分102之外的部件。
图6a至图6d为在示例性治疗装置100的另一示例实施序列期间可发生的阻塞动脉瘤10并将快速固化剂114递送到动脉瘤10的阶段或步骤的图示。
图6a为包括网部分102、通道孔104、试剂通道112和触发机构116的示例治疗装置100的图示。所示的网部分102在递送导管400内部处于塌缩递送构型。网部分102可包括可与试剂通道112连通的通道孔104。试剂通道112可具有与触发机构116连通的近侧端部112b。试剂通道112的近侧端部112b可将快速固化剂114接收到试剂通道112中以用于递送。触发机构116可有利于将快速固化剂114递送到动脉瘤囊16。当网部分102处于塌缩构型时，治疗装置100的除触发机构116之外的部件被定尺寸成适配在递送导管400的管腔内。
图6b示出位于递送导管400内部的治疗装置100，其中网部分102离开递送导管400从而以类似于图4b的方式部署在动脉瘤囊16外部。如图6b至图6d所示，治疗部位可包括邻近分叉血管分支定位的动脉瘤10，并且治疗装置100可通过向分叉血管分支供血的干分支106递送到动脉瘤10。
图6c示出治疗装置100，其中网部分102在动脉瘤10中处于阻塞构型。在网部分102达到阻塞构型时，触发机构116可有利于通过试剂通道112将快速固化剂114递送到动脉瘤囊16。
如在图3d中一样，图6d示出将快速固化剂114泵入动脉瘤囊16中之后的动脉瘤10，之后可从动脉瘤10中移除治疗装置100的除网部分102之外的部件。
图7为概述可在治疗装置100的施用期间执行的示例方法步骤的流程图。方法步骤可通过本文所述的示例方式中的任一种或通过本领域的普通技术人员已知的任何方式来实现。
参见图7中概述的方法700，在步骤710中，可以提供包括网部分和粘合剂的治疗装置，以施用到患者。在步骤720中，可将治疗装置递送到动脉瘤治疗部位。在步骤730中，可邻近动脉瘤颈部的中心将网部分扩张到阻塞构型，其中扩张的网部分阻塞动脉瘤颈部的至少一部分，以在血管和动脉瘤之间形成屏障。在步骤740中，可邻近动脉瘤颈部粘附网部分。
方法700还可包括以下步骤：将处于未固化状态的粘合剂***跨越网部分的周边的至少一部分的海波管中，其中海波管包括至少一个海波管孔，该至少一个海波管孔将处于未固化状态的粘合剂的一部分暴露于网部分外部的环境，并且将固化剂经由固化通道递送到网部分以活化粘合剂。
图8为概述可在治疗装置100的施用期间执行的示例方法步骤的流程图。方法步骤可通过本文所述的示例方式中的任一种或通过本领域的普通技术人员已知的任何方式来实现。
参见图8中概述的方法800，在步骤810中，可提供包括网部分、粘合剂、限定网部分中的开口的通道孔、以及试剂通道的治疗装置以施用到患者。在步骤820中，可接合试剂通道以与通道孔连通。在步骤830中，可将治疗装置递送到动脉瘤治疗部位。在步骤840中，可邻近动脉瘤颈部的中心将网部分扩张到阻塞构型。当网部分扩张到步骤840中的阻塞构型时，网部分可阻塞动脉瘤颈部的至少一部分。步骤840还可在血管106和动脉瘤之间形成屏障，以防止快速固化剂进入血管。在步骤850中，可邻近动脉瘤颈部粘附网部分。在步骤860中，可将快速固化剂通过试剂通道和通道孔递送到动脉瘤囊中，以凝固动脉瘤中存在的血液。
方法800还可包括以下步骤：提供触发机构和通过激活位于试剂通道的近侧端部处的触发机构来触发试剂的递送以将试剂从试剂通道的近侧端部递送到试剂通道的远侧端部。
对于本领域的技术人员应当显而易见的是，本教导内容涵盖具有网部分、粘合剂、通道孔、试剂通道、海波管、递送通道、固化通道和/或触发机构的任何可能组合的装置。本文所包含的描述为本发明的示例，并且不旨在以任何方式限制本发明的范围。如本文所述，本发明考虑了用于阻塞动脉瘤的装置的许多变型和修改，包括例如本文所述的元件和部件的另选几何结构，利用本领域已知的用于编织、针织、织造或以其他方式形成网部分的任何数量的已知方式，利用用于每个部件或元件的多种材料中的任一种(例如，不透射线材料、形状记忆材料等)，利用包括将治疗装置递送到动脉瘤或从递送导管中推出治疗装置的部件在内的附加部件，或者利用用于执行本文未描述的功能的附加部件。这些修改将对本领域中的普通技术人员将是显而易见的，并且旨在处于以下权利要求的范围内。

Claims (20)

1. 一种用于治疗动脉瘤的治疗装置，包括：
网部分，所述网部分能够从塌缩构型扩张到阻塞构型，所述阻塞构型被定尺寸成延伸横跨并阻塞所述动脉瘤的颈部的至少一部分，以在血管和所述动脉瘤之间形成屏障；以及
粘合剂，所述粘合剂将所述网部分固定在邻近所述动脉瘤颈部的位置。
2.根据权利要求1所述的治疗装置，其中处于所述塌缩构型的所述网部分被定尺寸成横穿递送导管的管腔。
3.根据权利要求1所述的治疗装置，其中所述粘合剂在所述网部分达到所述阻塞构型之后被活化。
4.根据权利要求3所述的治疗装置，其中所述网部分还包括：
海波管，所述海波管跨越所述网部分的周边的至少一部分，所述海波管含有处于未固化状态的所述粘合剂；
至少一个海波管孔，所述至少一个海波管孔将处于所述未固化状态的所述粘合剂的一部分暴露于所述网部分外部的环境；以及
固化通道，所述固化通道用于将固化剂递送到所述网部分以活化所述粘合剂。
5.根据权利要求1所述的治疗装置，其中所述粘合剂在所述网部分达到所述阻塞构型之前被活化。
6.根据权利要求1所述的治疗装置，还包括将所述粘合剂递送到所述网部分的递送通道，所述递送通道包括连接到所述网部分的远侧端部。
7.根据权利要求6所述的治疗装置，其中在所述网部分达到所述阻塞构型之前，所述粘合剂通过所述递送通道被递送到所述网部分。
8.根据权利要求6所述的治疗装置，其中在所述网部分达到所述阻塞构型之后，所述粘合剂通过所述递送通道被递送到所述网部分。
9. 根据权利要求1所述的治疗装置，还包括：
通道孔，所述通道孔限定所述网部分中的开口，其中在所述阻塞构型中，所述通道孔通向所述动脉瘤；以及
试剂通道，所述试剂通道与所述通道孔连通，从而将快速固化剂通过所述通道孔递送到动脉瘤囊。
10.根据权利要求9所述的治疗装置，还包括：
触发机构，所述触发机构用于将所述快速固化剂引入所述试剂通道中；
其中所述试剂通道包括与所述触发机构连通以将所述快速固化剂接收到所述试剂通道中的近侧端部以及与所述通道孔连通的远侧端部；并且
其中所述试剂通道将所述快速固化剂从所述近侧端部递送到所述远侧端部，并且通过所述通道孔递送到所述动脉瘤的所述囊中。
11.根据权利要求9所述的治疗装置，其中所述粘合剂在所述网部分达到所述阻塞构型之前被活化。
12.根据权利要求9所述的治疗装置，其中所述粘合剂在所述网部分达到所述阻塞构型之后被活化。
13.根据权利要求9所述的治疗装置，还包括将所述粘合剂递送到所述网部分的递送通道，所述递送通道包括连接到所述网部分的远侧端部。
14.根据权利要求13所述的治疗装置，其中在所述网部分达到所述阻塞构型之前，所述粘合剂通过所述递送通道被递送到所述网部分。
15.根据权利要求13所述的治疗装置，其中在所述网部分达到所述阻塞构型之后，所述粘合剂通过所述递送通道被递送到所述网部分。
16.根据权利要求13所述的治疗装置，还包括：
触发机构，所述触发机构用于将所述快速固化剂引入所述试剂通道中；
其中所述试剂通道包括与所述触发机构连通以将所述快速固化剂接收到所述试剂通道中的近侧端部以及与所述通道孔连通的远侧端部；并且
其中所述试剂通道将所述快速固化剂从所述近侧端部递送到所述远侧端部，并且通过所述通道孔递送到所述动脉瘤的所述囊中。
17.一种用于治疗动脉瘤的方法，包括
提供包括网部分和粘合剂的治疗装置；
将所述治疗装置递送到动脉瘤治疗部位；
邻近动脉瘤颈部的中心将所述网部分扩张到阻塞构型，其中所述扩张的网部分阻塞所述动脉瘤颈部的至少一部分，以在血管和所述动脉瘤之间形成屏障；以及
邻近所述动脉瘤颈部粘附所述网部分。
18. 根据权利要求17所述的方法，还包括以下步骤：
将处于未固化状态的所述粘合剂***跨越所述网部分的周边的至少一部分的海波管中，其中所述海波管包括至少一个海波管孔，所述至少一个海波管孔将处于所述未固化状态的所述粘合剂的一部分暴露于所述网部分外部的环境；以及
将固化剂经由固化通道递送到所述网部分以活化所述粘合剂。
19.一种用于治疗动脉瘤的方法，包括：
提供治疗装置，所述治疗装置包括网部分、粘合剂、限定所述网部分中的开口的通道孔、以及试剂通道；
将所述试剂通道与所述通道孔接合；
将所述治疗装置递送到动脉瘤治疗部位；
邻近动脉瘤颈部的中心将所述网部分扩张到阻塞构型，其中所述扩张的网部分阻塞所述动脉瘤颈部的至少一部分，以在血管和所述动脉瘤之间形成屏障，以防止快速固化剂进入所述血管；
邻近所述动脉瘤颈部粘附所述网部分；以及
将所述快速固化剂通过所述试剂通道和所述通道孔递送到动脉瘤囊中以凝固所述动脉瘤中存在的血液。
20.根据权利要求19所述的方法，还包括以下步骤：
提供触发机构；
通过在所述试剂通道的近侧端部处激活所述触发机构来触发所述快速固化剂的所述递送；以及
将所述试剂从所述试剂通道的所述近侧端部递送到所述试剂通道的远侧端部。
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