Abstract: A device for treatment of a vascular defect within a patient's vasculature includes a self-expanding permeable shell having a proximal end, a distal end, and a longitudinal axis, the shell comprising a plurality of elongate resilient filaments having a braided structure, wherein the filaments are secured at at least one of the proximal end or the distal end of the permeable shell, wherein the permeable shell has a radially constrained elongated state configured for delivery within a microcatheter and has an expanded state with an axially shortened configuration relative to the radially constrained state, the permeable shell having a plurality of openings formed between the braided filaments, wherein the permeable shell in its expanded state comprises a plurality of circumferentially-arrayed lobes.

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 coils, stiffening elements, or reinforcement elements disposed about or associated with the filaments or woven together with the filaments.

Abstract: Methods of braiding using a braiding mechanism are described. The braiding mechanism includes an array of filament engagement elements, a mandrel extending from the center of the circular array, a plurality of actuators disposed operably about the array, and a rotating mechanism adapted to rotate one or more filaments. The plurality of filaments are loaded onto the mandrel by looping a middle portion of each filament of the plurality of filaments over an end of the mandrel and extend radially toward and contact the circumferential edge of the circular array of filament engagement elements. The plurality of actuators are operated to engage a first subset of the plurality of filaments and move the engaged filaments in a generally radial direction to a position beyond the circumferential edge of the array. The rotating mechanism is operated to move the engaged filaments about the mandrel axis.

Abstract: Devices and methods for treatment of a patient's vasculature are described. Embodiments may include a permeable implant such as a permeable shell or mesh 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 on either the inside or the outside of a first permeable shell. The distal portion of the device may be softer and deformable.

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.

Abstract: Methods of implanting a device in the lumen of a blood vessel are described. The method includes providing a microcatheter and a device. The device includes a first hub, a second hub, a support structure including a plurality of struts disposed between the first hub and the second hub, and a layer of material disposed over the plurality of struts. The support structure has a low profile, radially constrained state with an elongated tubular configuration suitable for delivery from a microcatheter. The support structure also has an expanded state, a smooth outer surface, and has an axially shortened configuration relative to the radially constrained state. The microcatheter is advanced to a region of interest within the blood vessel. The support structure is advanced through the lumen of and out the distal end of the microcatheter where it expands to the expanded state.

Abstract: An occlusion device including a tubular braided member having a first end and a second end and extending along a longitudinal axis, the tubular braided member having a repeating pattern of larger diameter portions and smaller diameter portions arrayed along the longitudinal axis, and at least one metallic coil member extending coaxially along at least a portion of the braided member, the at least one metallic coil member having an outer diameter and an inner diameter, wherein the smaller diameter portions of the tubular braided member have an outer diameter and an inner diameter, and wherein at least one of the outer diameter and inner diameter of the tubular braided member is configured to closely match a directly opposing diameter of the metallic coil member.

Abstract: A device for treatment of a vascular defect within a patient's vasculature includes a self-expanding permeable shell having a proximal end, a distal end, and a longitudinal axis, the shell comprising a plurality of elongate resilient filaments having a braided structure, wherein the filaments are secured at at least one of the proximal end or the distal end of the permeable shell, wherein the permeable shell has a radially constrained elongated state configured for delivery within a microcatheter and has an expanded state with an axially shortened configuration relative to the radially constrained state, the permeable shell having a plurality of openings formed between the braided filaments, wherein the permeable shell in its expanded state comprises a plurality of circumferentially-arrayed lobes.

Abstract: A system for delivering an implant device to a vascular site in a patient a delivery pusher apparatus, an implant device detachably connected to the delivery pusher apparatus by a tether having a distal end connected to a proximal end of the implant device, wherein the tether is substantially non-tensioned when connecting the implant device to the delivery pusher, and an electrical heating element configured coaxially around at least a portion of the tether, wherein heat generated by the heating element severs the tether at a point near the proximal end of the implant device.

Abstract: Systems for treating an aneurysm in a cerebral vessel and methods of use are described. In one embodiment, the system includes an elongate tubular member having a lumen, an expandable stent, and a delivery device. The expandable stent has a constrained state that is configured for delivery through the lumen of the elongate tubular member, and an expanded state configured for placement within the cerebral vessel adjacent the aneurysm. The delivery device includes an elongate member and a self-expandable portion. The proximal end of the self-expandable portion is coupled to the elongate member at or near the distal end of the elongate member. The self-expandable portion of the delivery device includes a tubular mesh structure having a constrained state and an expanded state. The stent is engaged (e.g., mechanical, frictional, or intermeshing) with the self-expandable portion of the delivery device.

Abstract: Devices and methods for treatment of a patient's vasculature are described. The device includes a self-expanding resilient permeable shell having a radially constrained state and an expanded state with a globular, axially shortened configuration. The permeable shell may be a single layer of braided elongate filaments having first and second ends that are secured at the proximal end of the permeable shell. The devices may also include permeable shells made of woven braided mesh having a variable mesh density, i.e., the average size of pores in one region are a different than the average size of pores in another region. Methods of using the device to treat a cerebral aneurysm are also described. Methods of forming a tubular braid are also described. Methods of forming a tubular braid with variable braid densities are described. Methods of forming a tubular braid using a castellated mandrel are also described.

Abstract: A system for delivering an implant device to a vascular site in a patient a delivery pusher apparatus, an implant device detachably connected to the delivery pusher apparatus by a tether having a distal end connected to a proximal end of the implant device, wherein the tether is substantially non-tensioned when connecting the implant device to the delivery pusher, and an electrical heating element configured coaxially around at least a portion of the tether, wherein heat generated by the heating element severs the tether at a point near the proximal end of the implant device.

Abstract: Methods of braiding using a braiding mechanism are described. The braiding machine includes first and second annular members, the second annular member being concentric with the first annular member. A mandrel extends perpendicularly to and intersects a horizontal plane defined by a substantially circular region of the second annular member substantially at the center of the circular region. Each of the annular members has a plurality of tubular guide wires slideably mounted thereon and a plurality of wires extend from the mandrel through each of the tubular wire guides. The first annular member rotates circumferentially relative to the second annular member. The first plurality of tubular wire guides slides radially inward to align with the second annular member, and the second plurality of tubular wire guides slides radially outward so as to align with the first annular member.

Abstract: A device for treatment of a vascular defect within a patient's vasculature includes a self-expanding permeable shell having a proximal end, a distal end, and a longitudinal axis, the shell comprising a plurality of elongate resilient filaments having a braided structure, wherein the filaments are secured at at least one of the proximal end or the distal end of the permeable shell, wherein the permeable shell has a radially constrained elongated state configured for delivery within a microcatheter and has an expanded state with an axially shortened configuration relative to the radially constrained state, the permeable shell having a plurality of openings formed between the braided filaments, wherein the permeable shell in its expanded state comprises a plurality of circumferentially-arrayed lobes.

Abstract: Devices and methods for treatment of a patient's vasculature are described. Embodiments may include a resilient self-expanding permeable implant having a radially constrained elongated state configured for delivery within a catheter lumen and an expanded state with a longitudinally shortened configuration, and a plurality of elongate filaments which are woven together. Each of the plurality of elongate filaments may have a diameter between about 0.0005 and about 0.005 inches. The implant includes at least some filaments consisting of nitinol and at least some composite filaments that are drawn filled tube wires comprising an external nitinol tube and a highly radiopaque material concentrically disposed within the external tube. The implant has at least about 40% composite filaments relative to a total number of filaments, and wherein a total number of filaments is about 10 to about 300.

Abstract: Methods for treatment of a cerebral aneurysm within a cerebral vasculature of a patient are described. A microcatheter and a device for treatment of the aneurysm are provided. The device is a self-expanding resilient permeable shell having a plurality of elongate resilient filaments with a woven structure. The plurality of filaments includes small and large filaments. The filaments are bundled and secured to each other at a proximal end. A ratio of the total cross-sectional area of small filaments to the total cross-sectional area of large filaments may be between 0.56 and 1.89. The distal end of the microcatheter is advanced to a region of interest within a cerebral artery. The device is advanced through the lumen and out of the distal end of the microcatheter such that the permeable shell deploys and expands within the cerebral aneurysm. The microcatheter is then withdrawn from the cerebral artery.

Abstract: Methods and devices for treating a cerebral aneurysm are described. The device may include a self-expanding resilient permeable shell made from elongate resilient filaments. At least some of the filaments have a distal region that extends beyond the distal end of the permeable shell and form an extension having a generally circular shape when expanded. The permeable shell has a radially constrained elongated state configured for delivery within a microcatheter and has an expanded state with a globular, axially shortened configuration. The permeable shell has a plurality of openings formed between the braided filaments. The distal regions of the plurality of filaments that form the extension may be braided, partially braided, or unraveled. Once deployed within the cerebral aneurysm, the extension is positioned near a dome of the cerebral aneurysm.

Abstract: Methods of braiding using a braiding mechanism are described. The braiding machine includes first and second annular members, the second annular member being concentric with the first annular member. A mandrel extends perpendicularly to and intersects a horizontal plane defined by a substantially circular region of the second annular member substantially at the center of the circular region. Each of the annular members has a plurality of tubular guide wires slideably mounted thereon and a plurality of wires extend from the mandrel through each of the tubular wire guides. The first annular member rotates circumferentially relative to the second annular member. The first plurality of tubular wire guides slides radially inward to align with the second annular member, and the second plurality of tubular wire guides slides radially outward so as to align with the first annular member.

Abstract: Devices and methods for treatment of a patient's vasculature are described. Embodiments may include a resilient self-expanding permeable implant having a radially constrained elongated state configured for delivery within a catheter lumen and an expanded state with a longitudinally shortened configuration, and a plurality of elongate filaments which are woven together. Each of the plurality of elongate filaments may have a diameter between about 0.0005 and about 0.005 inches. The implant includes at least some filaments consisting of nitinol and at least some composite filaments that are drawn filled tube wires comprising an external nitinol tube and a highly radiopaque material concentrically disposed within the external tube. The implant has at least about 40% composite filaments relative to a total number of filaments, and wherein a total number of filaments is about 10 to about 300.

Abstract: Methods for forming a tubular braid are described. The method for braiding includes providing a braiding mechanism including a disc, a mandrel, and a plurality of actuators. The disc defines a plane and a circumferential edge and the mandrel extends from a center of the disc. A plurality of filaments are loaded on the mandrel, each extending radially toward the circumferential edge and contacting the disc at a point of engagement. The plurality of actuators are operated to engage and move a first subset of filaments in a generally radial direction to a position beyond the circumferential edge. The disc or the engaged first subset are rotated relative to one another, thereby crossing the first subset over a second subset of filaments. The actuators are then operated to move the first subset to a radial position on the circumferential edge different from its previous point of engagement.