Bidirectional Vascular Filter and Method of Use
The present invention relates to a device for filtering obstructive material within the vasculature of a subject. The device includes a generally ellipsoid shaped frame having a plurality of shape-memory arms with a collapsible, sieve-like structure positioned within the elliptical frame. The device may be used as an inferior vena cava (IVC) filter for the prevention of pulmonary embolism, or any other procedure requiring filtering of a vein.
This application claims priority to U.S. Provisional Application No. 62/014,334, filed on Jun. 19, 2014, incorporated herein by reference in its entirety.
BACKGROUND OF THE INVENTIONIt is estimated that each year, between 300,000 and 600,000 people in the United States are negatively affected by deep vein thrombosis (DVT) and pulmonary embolism (PE). Further, it is estimated that between 60,000 and 100,000 people in the United States die each year as a result of venous thromboembolism (VTE), a disease that includes both DVT and PE, and occurs when a blood clot breaks loose and travels in the blood towards the lungs. Patients who are at risk of developing DVT or PE but cannot undergo anticoagulation therapy due to bleeding complications or ineffectiveness may opt for a vascular filter implant as an alternative treatment. Patients undergoing surgery for blunt trauma, penetrating trauma, and falls also benefit from vascular filters. These filters, commonly called inferior vena cava (IVC) filters, capture dislodged blood clots from the inferior vena cava and iliac veins before they can reach the lungs and heart.
A typical IVC filter consists of several wire legs arranged in a small conical shape. The filter is inserted into the IVC through either the jugular vein in the neck or the femoral vein in the groin, with the mouth of the cone facing towards the oncoming flow of blood. Barbs on the filter legs secure the filter to the internal walls of the vein, and the conical shape of the legs permits normal blood flow while capturing and holding loose blood clots and emboli.
After insertion, these filters may only be retrieved from one direction (the jugular or the femoral vein). Migration within the patient may cause the filter to tilt, positioning the retrieval hook in apposition to the blood vessel wall and out of reach of the filter retrieval device. The filter legs may also adhere to and even perforate the vessel wall, which may require an invasive surgical removal of the filter, increasing treatment costs and risk of complications to the patient. Further, a tilted filter changes the cross-sectional profile of the filter relative to the oncoming flow path of blood, which can lead to an inefficient and sub-optimal filter performance. Still further, some filters, such as the OPTEASE® IVC filter (Cordis Corp., Freemont, Calif., USA) have features at either pole that potentially push the incoming clot towards vessel walls and thereby increase the incidence of in-situ thrombus formation and filter occlusion. A recent attempt to create an improved retrievable IVC filter is the Crux® vena cava filter (Volcano Corp., San Diego, Calif., USA), which can be deployed and retrieved from either the jugular or femoral veins. However, the design of these types of filters leads to significant contact along the vessel wall and therefore does not minimize the problem of adhesions. Also, such elongated filters cannot be placed in patients with a short infrarenal IVC. Further, recent studies have also shown an increased incidence of DVT in patients with conventional filters, which may be linked to thrombotic occlusion of the filter leading to venous stasis upstream in the legs.
Thus, there is need in the art for a removable IVC filter that is less likely to adhere to a vessel wall, can be bidirectionally deployed and retrieved, minimizes the occurrence of tilt after deployment, minimizes the risk of vessel perforation, may be adjustable during deployment, and minimizes the occurrence of thrombotic occlusion in the filter. The present invention satisfies these needs.
SUMMARY OF THE INVENTIONThe present invention relates to a device for filtering obstructive material within the vasculature of a subject. The device includes a generally ellipsoid shaped frame having a plurality of shape-memory arms with a collapsible, sieve-like web structure positioned within the ellipsoid frame. The device may be used as an IVC filter for preventing pulmonary embolism, or any other procedure requiring filtering of a vein.
Accordingly, the device relates to a vascular filter. The filter includes a frame having a plurality of ellipses each having a major axis and a minor axis, with the major axes of each ellipse overlapping one another in a proximal and distal direction, and a web positioned along its circumference to the minor axis of at least one ellipse, wherein the minor axes of the plurality of ellipses expand away from a central axis formed by their major axes, such that the web is held taut along its circumference when the plurality of ellipses are in an expanded state.
In one embodiment, the filter includes a hook coupled to the proximal end of the frame where the plurality of ellipses intersect at their proximal major axis vertices and a hook coupled to the distal end of the frame where the plurality of ellipses intersect at their distal major axis vertices. In another embodiment, the frame is composed of nonferromagnetic and flexible material. In another embodiment, the nonferromagnetic and flexible material is stainless steel. In another embodiment, the nonferromagnetic and flexible material is a shape-memory material. In another embodiment, the shape-memory material is Nitinol. In another embodiment, the web is positioned along its circumference to the minor axis vertices of each ellipse. In another embodiment, the web is fastened to at least one ellipse by a hook or loop. In another embodiment, the hook or loop is composed of a heat shrinking material. In another embodiment, the heat shrinking material is fluorinated ethylene propylene. In another embodiment, the web is composed of a plurality of crossing fibers. In another embodiment, the fibers are partially connected or bonded to each other. In another embodiment, the fibers are molded as a single unit. In another embodiment, the fibers are composed of a biocompatible material that is flexible, elastic, or both. In another embodiment, the fibers form a set of holes in the web. In another embodiment, the holes are sized between 3×3 mm and 10×10 mm. In another embodiment, the frame is compressible into a substantially cylindrical conformation, such that it fits within a catheter having a lumen of between about 3F and 15F. In another embodiment, the frame further includes at least one barb on the outer edge of the minor axis vertices of at least one ellipse. In another embodiment, the frame comprises 2 ellipses. In another embodiment, the frame comprises 3 ellipses.
In another embodiment, the vascular filter includes a frame having a plurality of hemi-ellipses each having a major axis and a semi-minor axis, with the major axes of each hemi-ellipse overlapping one another in a proximal and distal direction, and a web positioned along its circumference to the semi-minor axis of at least two hemi-ellipses, wherein the semi-minor axes of the plurality of hemi-ellipses expand away from a central axis formed by their major axes, such that the web is held taut along its circumference when the plurality of hemi-ellipses are in an expanded state. In another embodiment, the filter includes a hook coupled to the proximal end of the frame where the plurality of hemi-ellipses meet at their proximal major axis point and a hook coupled to the distal end of the frame where the plurality of hemi-ellipses meet at their distal major axis point. In another embodiment, the web is positioned along its circumference to the semi-minor axis vertex of the at least two hemi-ellipses. In another embodiment, the filter includes at least one barb on the outer edge of the semi-minor axis vertex of at least two hemi-ellipses. In another embodiment, the frame comprises 3 hemi-ellipses. In another embodiment, the frame comprises 5 hemi-ellipses. In another embodiment, the frame comprises 7 hemi-ellipses.
The following detailed description of preferred embodiments of the invention will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the invention, there are shown in the drawings embodiments which are presently preferred. It should be understood, however, that the invention is not limited to the precise arrangements and instrumentalities of the embodiments shown in the drawings.
It is to be understood that the figures and descriptions of the present invention have been simplified to illustrate elements that are relevant for a clear understanding of the present invention, while eliminating, for the purpose of clarity, many other elements found in typical vascular filters. Those of ordinary skill in the art may recognize that other elements and/or steps are desirable and/or required in implementing the present invention. However, because such elements and steps are well known in the art, and because they do not facilitate a better understanding of the present invention, a discussion of such elements and steps is not provided herein. The disclosure herein is directed to all such variations and modifications to such elements and methods known to those skilled in the art.
Unless defined elsewhere, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present invention, the preferred methods and materials are described.
As used herein, each of the following terms has the meaning associated with it in this section.
The articles “a” and “an” are used herein to refer to one or to more than one (i.e., to at least one) of the grammatical object of the article. By way of example, “an element” means one element or more than one element.
“About” as used herein when referring to a measurable value such as an amount, a temporal duration, and the like, is meant to encompass variations of ±20%, ±10%, ±5%, ±1%, and ±0.1% from the specified value, as such variations are appropriate.
Throughout this disclosure, various aspects of the invention can be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6, etc., as well as individual numbers within that range, for example, 1, 2, 2.7, 3, 4, 5, 5.3, 6, and any whole and partial increments therebetween. This applies regardless of the breadth of the range.
The present invention relates to a device for filtering obstructive material within the vasculature of a subject. As contemplated herein, the device may be used as an inferior vena cava (IVC) filter for the prevention of pulmonary embolism, or any other procedure requiring filtering of a vein.
As shown in
In one embodiment, the frame 16 is composed of a nonferromagnetic, flexible, shape memory material, such as Nitinol. It should be appreciated that any rigid, yet flexible material may be used, such as a medical grade alloy or polymer, so that when the ellipses 14 or hemi-ellipses 19 are collapsed inwardly toward each other in a compressed state, an expanding bias is created, forcing ellipses 14 or hemi-ellipses 19 to return to their relaxed, expanded state. The medical grade materials described herein may also include an anti-thrombogenic coating or admixture to reduce the incidence of thrombus buildup, promoting hemocompatability and the maintenance of high blood flow rates through the filter.
In a preferred embodiment, a web element 18 is positioned within the ellipses 14 of the frame 16. As shown in the exemplary embodiment of
As shown in
To prevent slippage of the filter 10 when positioned in a subject's vein and to anchor the device at a target treatment area, one or more barbs 29 may be positioned on a plane that bisects the filter's 10 longitudinal axis and runs along the minor axis of the ellipses 14 or the semi-minor axis of the hemi-ellipses 19 as shown in
As shown in
In its relaxed state, the frame 16 expands the web element 18 so that each point of coupling between the web element 18 and the ellipses 14 or hemi-ellipses 19 holds the web element 18 substantially taut. When the frame 16 is compressed inwardly and towards the longitudinal axis of the filter 10, the web element 18 collapses within the frame 16 and assumes a much smaller profile, capable of sliding within the lumen of a delivery or retrieval device. The filter 10 can be sized so as to compress and collapse into a generally cylindrical conformation that fits within a standard catheter, sized to fit into a lumen of between about 3F to 15F. In one embodiment, the filter 10 is sized for use with a 6F to 12F catheter, and more preferably, a 6F to 9F catheter for delivery to or retrieval from the subject's vein. The filter 10 can be deployed into and retrieved from a subject's vein using a catheter-based system. As shown in the exemplary embodiment of
When retrieving the filter 10, a conventional snare 30 can latch onto the proximal hook 12 or the distal hook 17 of the filter 10, as shown in
The advantages and improved performance of the filter 10 disclosed herein is further illustrated in
An alternative embodiment of a deployment system 200 is shown in
In some embodiments, the filter 10 can be used in conjunction with one or more drug-eluting materials, such as the Translute™ drug carrying polymer (Boston Scientific Co., Natick, Mass., USA) or other commercially available drug-eluting materials as would be understood by those skilled in the art. For example, the frame of the device may be coated with a polymer carrying an anticoagulant, anti-fibrosis, or cytotoxin. In this embodiment, the device may release medication in a targeted fashion, thereby enhancing the ability of the device to prevent DVT and PE. In other embodiments, the device can be manufactured from or coated with polymer admixtures (e.g. fluoropolymers) that promote device hemocompatability.
The device of the present invention marks a significant improvement over current IVC filters. First, the bidirectional design of the filter reduces error of the filter being inserted in the wrong direction. Further, the symmetrical design and the presence of hooks at both proximal and distal ends allows for the deployment and retrieval of the device from either end. Further still, the inclusion of a web creates a single unit device to better capture smaller materials in the bloodstream without the use of secondary, loose components. In addition, the hooks or barbs along the circumference of the frame secures the device with fewer and less traumatic points of contact with a blood vessel wall to facilitate easier and less traumatic removal. Also, the filter is less prone to tilt, which increases the performance of the filter, increases the flow rate of blood through the filter, minimizing the chance that the patient will develop complications such as venous stasis downstream of the filter or thrombotic occlusion of the filter, further providing health professionals with a more accurate and predictable filtering rate.
The disclosures of each and every patent, patent application, and publication cited herein are hereby incorporated herein by reference in their entirety. While this invention has been disclosed with reference to specific embodiments, it is apparent that other embodiments and variations of this invention may be devised by others skilled in the art without departing from the true spirit and scope of the invention. The appended claims are intended to be construed to include all such embodiments and equivalent variations.
Claims
1-30. (canceled)
31. A vascular filter device, comprising:
- a frame having a proximal end, a distal end, and a plurality of flexible arms connecting the proximal and distal frame ends, wherein the flexible arms when in a relaxed state expand away from a central axis running through the proximal and distal frame ends; and
- a flexible web positioned between the plurality of flexible arms, wherein the flexible web is held taut and substantially perpendicular to the central axis when the plurality of arms are in an expanded state.
32. The vascular filter of claim 31 further comprising:
- at least one barb positioned on an outer surface of at least one flexible arm, wherein the at least one barb protrudes beyond the outer surface of the at least one flexible arm when in an expanded state, and retracts from the outer surface of the at least one flexible arm when in a semi-collapsed or collapsed state.
33. The vascular filter of claim 32, wherein the at least one barb is positioned along a plane that bisects the central axis.
34. The vascular filter of claim 32, wherein the barb remains below the outer surface of the at least one flexible arm when it is in a semi-collapsed or collapsed state.
35. The vascular filter device of claim 31, wherein the web has a circumference positioned within the plurality of flexible arms.
36. The vascular filter of claim 35, wherein the circumference is positioned along a plane that bisects the central axis.
37. The vascular filter of claim 31, wherein the web is substantially planar in the expanded state.
38. The device of claim 31, wherein the web is fastened to at least one flexible arm by a hook or loop.
39. The device of claim 38, wherein the hook or loop is secured to the at least one flexible arm by a heat shrinking material.
40. The device of claim 31, wherein the web is composed of a plurality of crossing fibers that form a plurality of openings.
41. The device of claim 31, wherein at least a portion of the frame or flexible web includes a coating comprising at least one agent selected from the group consisting of an antithrombogenic, an anticoagulant, an antifibrotic, a cytotoxin, and a non-stick, low-friction lubricant.
42. The device of claim 31, further comprising at least one drug eluting material.
43. A vascular filter device, comprising:
- a frame having a proximal end, a distal end, and a plurality of flexible arms connecting the proximal and distal frame ends, wherein the flexible arms expand away from a central axis running through the proximal and distal frame ends in a relaxed state, and compress toward the central axis when in a semi-collapsed or collapsed state; and
- at least one barb positioned on an outer surface of at least one flexible arm, such that the at least one barb protrudes beyond the outer surface of the at least one flexible arm when in an expanded state, and retracts from the outer surface of the at least one flexible arm when in a semi-collapsed or collapsed state.
44. The vascular filter device of claim 43 further comprising:
- a flexible web positioned between the plurality of flexible arms, wherein the flexible web is held taut and substantially perpendicular to the central axis when the plurality of arms are in an expanded state
45. The vascular filter device of claim 44, wherein the web has a circumference positioned within the plurality of flexible arms.
46. The vascular filter of claim 45, wherein the circumference is positioned along a plane that bisects the central axis.
47. The vascular filter of claim 44, wherein the web is substantially planar in the expanded state.
48. The device of claim 44, wherein the web is fastened to at least one flexible arm by a hook or loop.
49. The device of claim 44, wherein the web is composed of a plurality of crossing fibers that form a plurality of openings.
50. The device of claim 44, wherein the hook or loop is secured to the at least one flexible arm by a heat shrinking material.
51. The vascular filter of claim 43, wherein the at least one barb is positioned along a plane that bisects the central axis.
52. The vascular filter of claim 43, wherein the barb remains below the outer surface of the at least one flexible arm when it is in a semi-collapsed or collapsed state.
53. The device of claim 43, further comprising a coating having at least one agent selected from the group consisting of an antithrombogenic, an anticoagulant, an antifibrotic, a cytotoxin, and a non-stick, low-friction dry lubricant.
54. The device of claim 43, further comprising at least one drug eluting material.
Type: Application
Filed: Mar 18, 2016
Publication Date: Jul 14, 2016
Inventors: Bashir A. Tafti (Los Angeles, CA), Edward W. Lee (Los Angeles, CA), Stephen T. Kee (Santa Monica, CA)
Application Number: 15/074,766