Janjua Aneurysm Saddle

The patented Janjua Aneurysm Saddle parent-vessel device involves first expanding a laterally-expandable member, such as a balloon or resilient patch, within the parent vessel over the neck of the aneurysm and then expanding a radially-expandable member, such as a porous stent, in the parent vessel.  It is not approved by the FDA or available for patient use.  Janjua Aneurysm Saddle concept video.

The stent compresses the laterally-expandable member against the aneurysm neck in order to seal the aneurysm.  This device can be especially useful for treating wide-neck aneurysms without blocking nearby branching vessels. Figures 4 through 6 provide a three-sequence series of deployment views of one possible embodiment of the Janjua Aneurysm Saddle. 

Figure 4 shows a longitudinal cross-sectional view (on the left) and a lateral cross-sectional view (on the right) of the first stage of deployment of the Janjua Aneurysm Saddle into the parent vessel of the aneurysm.  The aneurysm is shown protruding from the top of a parent blood vessel.  Smaller blood vessels are also shown branching off from the bottom of the parent vessel. 

In this example, the device includes an upper catheter and lower catheter.  The upper catheter delivers a laterally-expandable member such as an expandable, relatively-flat balloon.  In other examples, this upper catheter may deliver a relatively flat mesh, net, lattice, membrane, layer of fabric, layer of shape memory material, or patch of compressible material.  The lower catheter delivers a radially-expandable structural member, such as a stent.  The lateral cross-sectional view (on the right) more clearly shows how the flat balloon has been inwardly-curved to fit into the catheter before its release and lateral expansion.  The lateral cross-sectional view also more clearly shows the cross-sectional stent with an expansion-powering balloon in its core.

Figure 4: Janjua Aneurysm Saddle: Insertion into Parent Vessel of Aneurysm
(longitudinal cross-sectional view and lateral cross-sectional view)

Figure 5 shows the second stage of deployment of the Janjua Aneurysm Saddle, wherein the upper balloon has been pushed forward out of catheter and laterally expanded so that it underlies the neck of aneurysm. This lateral expansion is more clearly seen in the lateral cross-sectional view (on the right). 

Figure 5: Janjua Aneurysm Saddle: Deployment of Upper Balloon
(longitudinal cross-sectional view and lateral cross-sectional view)

Figure 6 shows the third stage of deployment of the Janjua Aneurysm Saddle wherein the stent has been deployed from the lower catheter and both catheters have been withdrawn.  Expansion of the stent presses the upper balloon against the neck of aneurysm to seal off the aneurysm.  The formation of a "saddle" shape by the upper balloon over the neck of the aneurysm is the origin of the descriptive name for this device.   The stent is sufficiently porous to allow blood flow to branching vessels.  The ability to selectively block blood flow to the aneurysm, but not block blood flow to nearby branching vessels, is an advantage of this invention over prior art involving stents with uniform porosity.

Figure 6: Janjua Aneurysm Saddle: Final Deployment
(longitudinal cross-sectional view and lateral cross-sectional view)

Expansion of the stent member occurs after, or concurrently with, expansion of the upper balloon.  This provides more thorough coverage and sealing of the aneurysm neck than is possible with devices and methods in the prior art wherein a stent is expanded first and then embolic members are inserted through the wall of the stent into the aneurysm.  In such devices and methods in the prior art, embolic members may be "jailed" in the aneurysm, which is good for avoiding their prolapse into the parent vessel, but there can be gaps between the inserted embolic members and the perimeter of the aneurysm neck, which can lead to recanalization.  These gaps and this recanalization can be greatly reduced, or even avoided entirely, by the Janjua Aneurysm Saddle device shown here.

Disclaimer: These products are not yet approved by the FDA 
and are not available for patient care.

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