Patent Publication Number: US-2023149023-A1

Title: Spiral delivery system for embolic braid

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application is a Continuation of U.S. Pat. Application No. 17/128,338 filed Dec. 21, 2020, which is a Continuation of U.S. Pat. Application No. 16/054,055 filed on Aug. 3, 2018, now issued as U.S. Pat. No. 10,905,431, which are incorporated herein by reference in their entirety. 
    
    
     FIELD OF INVENTION 
     This disclosure relates to medical instruments, and more particularly, delivery systems for a device for aneurysm therapy. 
     BACKGROUND 
     Cranial aneurysms can be complicated and difficult to treat due to their proximity to critical brain tissues. Prior solutions have included endovascular treatment whereby an internal volume of the aneurysm sac is removed or excluded from arterial blood pressure and flow. Current alternatives to endovascular or other surgical approaches can include occlusion devices that either fill the sac of the aneurysm with embolic material or treating the entrance or neck of the aneurysm. Both approaches attempt to prevent blood flow into the aneurysm. When filling an aneurysm sac, the embolic material clots the blood, creating a thrombotic mass within the aneurysm. When treating the aneurysm neck, blood flow into the entrance of the aneurysm is inhibited, inducing venous stasis in the aneurysm and facilitating a natural formation of a thrombotic mass within the aneurysm. 
     Current occlusion devices typically utilize multiple embolic coils to either fill the sac or treat the entrance. In either treatment, obtaining an embolic coil packing density sufficient to either occlude the aneurysm neck or fill the aneurysm sac is difficult and time consuming. Further, aneurysm morphology (e.g. wide neck, bifurcation, etc.) can required ancillary devices such a stents or balloons to support the coil mass and obtain the desired packing density. 
     Naturally formed thrombotic masses formed by treating the entrance of the aneurysm with embolic coils can improve healing compared to aneurysm masses packed with embolic coils by reducing possible distention from arterial walls and permitting reintegration into the original parent vessel shape along the neck plane. However, embolic coils delivered to the neck of the aneurysm can potentially have the adverse effect of impeding the flow of blood in the adjoining blood vessel; at the same time, if the entrance is insufficiently packed, blood flow can persist into the aneurysm. Properly implanting embolic coils is therefore challenging, and once implanted, the coils cannot easily be retracted or repositioned. 
     Furthermore, embolic coils do not always effectively treat aneurysms as aneurysms treated with multiple coils often recanalize or compact because of poor coiling, lack of coverage across the aneurysm neck, because of flow, or even aneurysm size. 
     An example alternative occlusion device is described in U.S. Pat. No. 8,998,947. However, this approach relies upon the use of embolic coils or mimics the coil approach and therefore suffers many of the limitations of embolic coil approaches such as difficulty achieving a safe packing density and inability to reposition once implanted. 
     It is therefore desirable to have a device which easily, accurately, and safely occludes a neck of an aneurysm or other arterio-venous malformation in a parent vessel without blocking flow into perforator vessels communicating with the parent vessel. 
     SUMMARY 
     Disclosed herein are various exemplary devices and systems of the present invention that can address the above needs. The devices generally can include a delivery tube having a spiral groove on an outer surface of the delivery tube and a braided implant having a spiral segment. The spiral segment can engage the spiral groove as the braided implant is delivered to an aneurysm treatment site. At the treatment site, the braided implant can be implanted, and the delivery tube can be rotated to disengage the spiral segment from the spiral groove. Once released, the spiral segment can reshape to occlude the neck of the aneurysm. 
     In one example, a system can include a delivery tube and a braided implant. The delivery tube can have a lumen, a proximal end, a distal end, and an outer surface with a spiral groove positioned near the distal end. The braided implant can have a spiral segment movable from a delivery configuration that engages the spiral groove to a deployed configuration that disengages the spiral groove. A rotation of the delivery tube in relation to the implant can move the spiral segment from the delivery configuration to the deployed configuration. 
     In the delivery configuration, the spiral segment and the spiral groove can each have a circular helix shape, and the spiral segment can be positioned in the spiral groove. 
     The braided implant can include an outer fold segment attached to the spiral segment that can be positioned over a portion of the outer surface of the delivery tube, a fold that can be positioned distal the distal end of the delivery tube, and an inner fold segment having a substantially tubular structure that can be positioned within the lumen of the delivery tube. 
     An inner elongated member can be positioned within the lumen of the delivery tube and can have a proximal end extending proximally from the proximal end of the delivery tube and a distal end positioned within the lumen of the delivery tube detachably attached to an end of the inner fold segment of the braided implant. 
     The braided implant can form an occlusive sack having an opening, and the opening can be at least partially obstructed by the spiral segment when in the deployed configuration. The opening can have a perimeter and a center. In the deployed configuration, one end of the spiral segment can attach to the occlusive sack near the perimeter while the other end can terminate near the center. 
     The outer fold segment and the spiral segment can each have a woven structure with a woven fiber common to both segments. Alternatively, the spiral segment can have a non-woven structure. 
     An example device for treating an aneurysm can include a tubular delivery member, a braided tubular implant, and a coiled element. The tubular delivery member can have a lumen, a distal end, an outer surface, and a helical structure on the outer surface. The braided tubular implant can be movable from a delivery configuration having a tubular segment extending proximally within the lumen of the tubular delivery member and an outer fold segment covering a portion of the outer surface of the delivery tube member to an implanted configuration having an occlusive sack with an opening. The coiled element can be movable from an engaging configuration that engages the helical structure on the tubular delivery member to an occluding configuration that obstructs at least a portion of the opening of the occlusive sack. 
     In the engaged configuration, the coiled element can have a coiled segment in the shape of a circular helix that can engage the helical structure. The helical structure can be an indentation in the shape of a circular helix. 
     In the occluding configuration, the coiled element can have a coiled segment in the shape of a conical helix or a planar spiral. The coiled element can have an affixed portion that can be affixed to the braided implant, and the coiled segment can have an affixed end that can be affixed to the affixed portion and a terminating end. The coiled segment can be in a shape having a first circumference measured along the coiled segment from the affixed end through one turn of the conical helix or planar spiral in the direction of the terminating end and a second circumference measured along the coiled segment from the terminating end through one turn of the conical helix or planar spiral in the direction of the affixed end such that the second circumference measures shorter than the first circumference. 
     The coiled element can be made of a memory shape metal, and the coiled element can move from a deformed shape in the engaging configuration to a predetermined shape in the occluding configuration. 
     An example method for treating an aneurysm can include the steps of providing a braided implant delivery system having a delivery tube and a braided implant, engaging a spiral segment of the braided implant with a spiral groove of the delivery tube, implanting the braided implant in the aneurysm, rotating the delivery tube in relation to the spiral segment to disengage the spiral segment from the spiral groove, and releasing the spiral segment from the delivery tube which releases the braided implant from the delivery tube. 
     The step of implanting the braided implant in the aneurysm can include the step of forming an occlusive sack within an aneurysm, the occlusive sack having an opening. 
     The method can include the step of occluding at least portion of the neck of the aneurysm with the spiral segment, and the neck can be occluded by obstructing the at least a portion of the opening of the occlusive sack. 
     The method can include the step of moving a portion of the spiral segment from a circular helix shape to a conical helix shape. 
     The method can include the steps of contacting a wall of the aneurysm with the occlusive sack, and resisting, via the contact between the aneurysm wall and the occlusive sack, a rotation of the occlusive sack in response to the rotating of the delivery tube. 
     The step of providing the braided implantation delivery system can include providing a delivery system that additionally includes an inner elongated member, and the method can further comprise the steps of positioning the inner elongated member in a lumen of the delivery tube and attaching the braided implant to the inner elongated member. The step of implanting the braided implant in the aneurysm can further include the steps of pushing the inner elongated member distally to invert the braided implant and form an occlusive sack within the aneurysm and detaching the braided implant from the inner elongated member. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The above and further aspects of this invention are further discussed with reference to the following description in conjunction with the accompanying drawings, in which like numerals indicate like structural elements and features in various figures. The drawings are not necessarily to scale, emphasis instead being placed upon illustrating principles of the invention. The figures depict one or more implementations of the inventive devices, by way of example only, not by way of limitation. 
         FIG.  1   a    illustrates an exploded view of a braided implant and a delivery tube according to the present invention; 
         FIG.  1   b    illustrates a braided implant engaged with a delivery tube according to the present invention; 
         FIG.  1   c    illustrates a cross-sectional view of the braided implant and the delivery tube of  FIG.  1   b    according to the present invention; 
         FIG.  2    illustrates a cut-sectional view delivery system according to the present invention; 
         FIG.  3    illustrates a cut-away of an aneurysm during treatment according to the present invention; 
         FIGS.  4   a  to  4   e    illustrate a method of use of a device of the present invention; 
         FIG.  5    illustrates a cut-away of an aneurysm implanted with a braided implant according to the present invention; 
         FIG.  6    illustrates a view of a braided implant as viewed at the neck of an aneurysm treated according to the present invention; 
         FIGS.  7   a  to  7   b    illustrate a braided implant and a coiled element according to the present invention; 
         FIG.  8   a    illustrates a braided implant and a coiled element according to the present invention; 
         FIG.  8   b    illustrates a view of the braided implant and coiled element of  FIG.  8   a    as viewed at the neck of an aneurysm treated according to the present invention; and 
         FIGS.  9  to  11    are flow diagrams outlining example method steps for use of a device according to the present invention. 
     
    
    
     DETAILED DESCRIPTION 
     Previous approaches utilizing embolic coils can be improved upon by treating the aneurysm entrance and/or packing the aneurysm with an embolic braided implant. For example, see U.S. Pat. Application No. 15/903,860, incorporated herein, in its entirety, by reference. Treating the aneurysm with the braided implant can have potential advantages over treatments utilizing embolic coils such as a higher packing density, ability to retract and reposition the implant during the implantation procedure, ability to be implanted without ancillary devices such as stents or balloons, reduced risk of recanalizing or compacting, and improved coverage across the aneurysm neck, for example. 
     In braided implant delivery systems, it can be advantageous to maintain an attachment between the implant and the delivery system until the implant is in place at the treatment site, then detach the implant so that the delivery system can be extracted. When implanted in an aneurysm, for example, the delivery system can also serve to occlude the neck of the aneurysm. The present disclosure describes various example systems, devices, and methods that can be utilized for at least such purposes. 
       FIG.  1   a    illustrates an exploded view of a braided implant  300  and a delivery tube  500 . The braided implant  300  is shown in a delivery configuration, shaped to be delivered to a treatment site by the delivery tube  500 .  FIG.  1   b    illustrates the braided implant  300  engaged with the delivery tube  500 . The assembly illustrated in  FIG.  1   b    is sized to be inserted into and travel through a microcatheter  600  to a treatment site. The microcatheter  600  is shown cut-away in  FIG.  1   b   , and the delivery system is shown approaching a distal end  614  of the microcatheter  600 .  FIG.  1   c    illustrates a cross-section of the braided implant  300 , delivery tube  500 , and microcatheter as indicated in  FIG.  1   b   . 
     Referring to  FIGS.  1   a  to  1   c    collectively, the braided implant  300  can have an inner fold segment  304  shaped to be positioned within a lumen  504  of the delivery tube  500 , a fold  303  that can be positioned distal a distal end  514  of the delivery tube  500 , an outer fold segment  302  that can extend proximally from the fold  303  to cover a portion of an outer surface  508  of the delivery tube  500 , and a spiral segment  350  that can engage a spiral groove  550  on the delivery tube  500 . 
     The spiral segment  350  can be elongated with a helical, coiled, or spiral shape. The spiral segment  350  can have an attached end  354  attached to the outer fold segment  302  and can extend proximally to a terminating end  352 . The spiral segment  350  can include a woven material with a weave that is common to the braided implant  300  such that the weave of the outer fold segment  302  and the weave of the spiral segment  350  share a common fiber. Alternatively, the spiral segment  350  can include a non-woven material and can be attached to the braided implant  300  by some other means. 
     The spiral segment  350  and the spiral groove  550  can be compatibly dimensioned so that the spiral segment  350  stays in place within the groove as the system is delivered through a catheter  600  to a treatment site. The groove can be deep enough for the spiral segment  350  to fit in without falling out. The width of the groove can be dimensioned to a fit such that the spiral segment  350  has minimal room to move within the groove. 
       FIG.  2    shows a cross-section of a delivery system including a delivery tube  500 , a braided implant  300 , and an inner elongated member  400 . The length of the delivery system has been truncated for the purposes of the illustration. 
     The delivery system can be sized to be delivered to a treatment site through a catheter or microcatheter  600 . The proximal end  412  of the inner elongated member  400  can extend from the proximal end  512  of the delivery tube  500 , which can in turn extend from the proximal end  612  of the delivery catheter  600 . The proximal end of the delivery system can be made available to a user to facilitate positioning and implantation of the braided implant  300  at a treatment site. 
     The braided implant  300  can include an inner fold segment  304 , extending proximally during delivery and attaching at a first end  312  to the inner elongated member  400 . A first end  312  of the braided implant  300  can be detachably attached to the inner elongated member  400  at a distal end  414  by a braid release  404 . The inner elongated member  400  can be positioned within the lumen  504  of the delivery tube  500  having a proximal end  412  extending proximal from a proximal end  512  of the delivery tube  500 . The braided implant  300  can have a second end  314 . 
     During delivery, the inner fold segment  304  can be enveloped by the delivery tube  500  and held at the first end  312  by the inner elongated member  400 . Once the delivery system is positioned at a treatment site, the inner elongated member  400  can be pushed distally, causing the inner fold segment  304  of the braided implant  300  to exit the distal end  514  of the delivery tube  500 . The first end  312  of the braided implant  300  can be detached from the inner elongated member  400  at the braid release  404 . 
     As shown in  FIG.  2   , the braided implant  300  can have a fold  303  distal the distal end  514  of the delivery tube  500  and an outer fold segment  302  extending proximally over an outer surface  508  of the delivery tube  500  to a second end  314  of the braided implant  300 . The second end  314  of the braided implant  300  can be attached to a spiral segment  350  that can engage a spiral groove  550  in the outer surface  508  of the delivery tube  500 . 
       FIG.  3    illustrates a cut-away of an aneurysm  10  during treatment of a delivery system including a braided implant  300 . The braided implant  300  can be delivered through a blood vessel  20  to an opening  16  in the blood vessel wall  22  by a microcatheter  600 . As shown, the braided implant  300  can invert to form an occlusive sack  308  that can extend to contact the aneurysm wall  14  and fill the aneurysm sac  12 . Portions of the braided implant  300  not inverted can be pushed into the occlusive sack  308  by the inner elongated member  400  (shown in  FIG.  2   ), forming an embolic filler braid  310 .  FIG.  3    shows the braided implant  300  partially implanted, such that a portion of the inner fold segment  304  remains in the delivery catheter  600 . 
       FIGS.  4   a  to  4   e    illustrate a method of treating an aneurysm  10  with a braided implant delivery system.  FIG.  4   a    shows the system positioned within a blood vessel  20  at the aneurysm neck  16 .  FIG.  4   a    shows the braided implant  300  in a delivery configuration and the spiral segment  350  in an engaging configuration engaging the spiral groove  550  of delivery tube  500 . 
       FIG.  4   b    shows an occlusive sack  308  and an embolic filler braid  310  that can be formed by inverting a portion of an inner fold segment  304  of the braided implant  300  and ejecting a non-inverted portion of the inner fold segment  304  respectively. 
       FIG.  4   c    shows the spiral segment  350  moving distally in response to a rotation of the delivery tube  500 . The spiral segment  350  can be sized to easily glide within the spiral groove  550  as the delivery tube  500  is rotated. The occlusive sack  308  can contact the aneurysm wall  14 , providing a resistance to prevent the implant  300  from rotating in response to the rotation of the delivery tube  500 . As shown, the spiral segment  350  can exit the distal end  614  of the microcatheter  600  as it moves distally in response to the rotation. Alternatively (not shown), the microcatheter  600  can be retracted before rotation of the delivery tube  500 . 
       FIG.  4   d    shows the spiral segment  350  continuing to move distally in response to continued rotation of the delivery tube  500 . As portions of the spiral segment  350  disengage the spiral groove  550 , the spiral segment  350  can begin to flatten or reshape. 
       FIG.  4   e    shows the spiral segment  350  disengaged with the delivery tube  500  and reshaped to an occluding configuration. As shown, the spiral segment  350  can move from a circular helix shape in the engaged configuration to a conical helix shape in the occluding configuration. Alternatively, the spiral segment  350  can be otherwise shaped in either the engaging or occluding configuration as will be understood by a person of ordinary skill in the art; for example, the spiral segment  350  can occlude an aneurysm neck with a shape such as a planar spiral. 
     Movement of the spiral segment  350  from the engaged configuration to the occluding configuration can be accomplished by various means. For example, the spiral segment  350  can be made with a memory shape metal having a predetermined shape and a deformed shape. In such an example, the spiral segment  350  can have a deformed shape in the engaging configuration; a rotation of the delivery tube  500  can cause the spiral segment  350  to contact bodily fluid as the spiral segment  350  exits the microcatheter  600 ; and the spiral segment  350  can move to the predetermined shape in response to contacting the bodily fluids, the spiral segment  350  having the predetermined shape in the occluding configuration. 
     Alternatively, the spiral segment  350  can be made with an elastically deformable material. In such an example, the spiral segment  350  can have a stretched shape in the engaging configuration and can be sized to fit within a spiral groove  550  on an outer surface  508  of the delivery tube  500 ; a rotation of the delivery tube  500  can cause the spiral segment  350  to glide off of the distal end  514  of the delivery tube  500 ; and the spiral segment  350 , now uninhibited by the delivery tube  500 , can return to its original shape, the spiral segment  350  having the original shape in the occluding configuration. 
       FIG.  5    shows a cut-away view of an aneurysm  10  implanted with a braided implant  300 . The braided implant  300  can form an occlusive sack  308  that can extend to the aneurysm wall  14 , and the occlusive sack  308  can be filled with an embolic braid  310 . The occlusive sack  308  and the embolic braid  310  can pack the aneurysm  10  to create a thrombotic mass, thereby providing one method of treatment to the aneurysm  10 . As shown, the occlusive sack  308  can at least partially occlude the neck  16  of the aneurysm  10  reducing blood flow across the entrance to the aneurysm  10  and thereby providing a second method of treatment to the aneurysm  10 . However, the occlusive sack  308  can have an opening  309  positioned in the aneurysm neck  16 . Blood flow across the entrance of the aneurysm  10  can be further inhibited by obstructing the opening  309 . As shown in  FIG.  5   , the spiral segment  350  can obstruct at least a portion of the opening  309 , thereby occluding at least a portion of the neck  16  of the aneurysm  10 . 
       FIG.  6    depicts braided implant  300  having a spiral segment  350  implanted into an aneurysm  10  as viewed from within a blood vessel  20 . From this perspective, the blood vessel wall  22  surrounds the aneurysm neck  16 , and the occlusive sack  308  is shown occluding the aneurysm neck  16  around the perimeter of the aneurysm neck  16 . The occlusive sack  308  is shown having an opening  309  with a perimeter  319  that is measured from the attached end  354  of the spiral segment  350 , around the perimeter  319  of the opening  309  one turn. The spiral segment  350  is shown spiraling counterclockwise inward from the attached end  354  to a terminating end  352 . As shown, the spiral segment  350  can have an outer circumference  358  measured starting from the attached end  354  counterclockwise in the direction of the terminating end  352  through one turn, and an inner circumference  356  measured starting from the terminating end  352  clockwise in the direction of the attached end  354  through one turn. Because the spiral segment  350  spirals inward from the attached end  354 , the outer circumference  358  measures greater than the inner circumference  356 . As shown, the terminating end  352  can be positioned near a center  329  of the occlusive sack opening  309 . 
       FIGS.  7   a  to  7   b    illustrate a braided implant  300  and a coiled element  200 . As shown, the coiled element  200  can include an affixed portion  210  that is affixed to an end  314  of the outer fold segment  302  of the braided implant  300  and a coiled segment  220  extending from the affixed end  224  of the affixed portion  210  to a terminating end  222  over inner fold segment  304 . The affixed portion  210  can be circular, having a circumference sized to fit over an outer surface of a delivery tube (not shown), and the coiled segment  220  can have a helical shape sized to engage a helical structure on the outside of a delivery tube (not shown).  FIGS.  7   a  and  7   b    show the braided implant  300  in a delivery configuration and the coiled element  200  in an engaged configuration, each configured to be delivered by a delivery tube  500  through a catheter  600  to a treatment site. 
       FIG.  8   a    shows a braided implant  300  in a deployed configuration and a coiled element  200  in an occluding configuration. The braided implant  300  can invert to form an occlusive sack  308 , and the coiled segment  220  can move to obstruct an opening  309  in the occlusive sack  308 . The occlusive sack  308  and the affixed portion  210  of the coiled element  200  can be joined at the opening  309  of the occlusive sack  308 , and the affixed end  224  can be positioned at the perimeter of the opening  309 . The braided implant  300  can collapse to form a conical helix, a flattened spiral, or some other shape to obstruct the opening  309  of the occlusive sack  308 . 
       FIG.  8   b    depicts a braided implant  300  and a coiled element  200  implanted into an aneurysm  10  as viewed from within a blood vessel  20 . From this perspective, the blood vessel wall  22  surrounds the aneurysm neck  16 . The implant  300 , as shown, can include an occlusive sack  308 , and the coiled element can be in an occluding configuration, for example as shown in  FIG.  8   a   . The occlusive sack  308  can occlude a portion of the aneurysm neck  16 .  FIG.  8   b    shows the occlusive sack  308  occluding a portion of the aneurysm neck  16  around a perimeter of the aneurysm neck  16 . The affixed portion  210  of the coiled element  200  can define an opening  309  of the occlusive sack  308  that is not occluded by the occlusive sack  308 . The coiled element can have a coiled structure that obstructs the opening  309  of the occlusive sack  308  thereby occluding a portion of the neck  16  of the aneurysm  10 . 
     The coiled segment  220  can rotate clockwise (as shown) or counterclockwise. The coiled segment  220  can have an outer circumference  228  measured starting at the affixed end  224  affixed to the affixed portion  210  of the coiled element in the direction of the terminating end  222  through one turn and an inner circumference  226  measured starting at the terminating end  222  through one turn in the direction of the affixed end  224 . The terminating end  222  can be positioned near the center  329  of the opening  309  of the occlusive sack  308 , and the affixed end  224  can be positioned at the perimeter of the opening  309 . So oriented, the outer circumference  228  can measure greater than the inner circumference  226 . 
       FIGS.  9  to  11    are flow diagrams outlining example method steps for use of a device or system for treating an aneurysm  10 . The method steps can be implemented by any of the example means described herein or by any means that would be known to one of ordinary skill in the art. 
     Referring to method  700  outlined in  FIG.  9   , in step  710  a braided implant delivery system having a delivery tube and a braided implant can be provided. The braided implant can have a spiral segment and the delivery tube can have a spiral groove. The braided implant delivery system can be any of the delivery systems described herein having any combination of the features described herein, as well as any features that would be known to one skilled in the art. In step  720  the spiral segment of the braided implant can be engaged with the spiral groove of the delivery tube. In step  730  the braided implant can be implanted in the aneurysm. In step  740  the delivery tube can be rotated in relation to the spiral segment to disengage the spiral segment from the spiral groove. In step  750  the spiral segment can be released from the delivery tube thereby releasing the braided implant from the delivery tube. 
     Referring to method  800  outlined in  FIG.  10   , in step  810  a braided implant delivery system having a braided implant and a delivery tube can be provided. The braided implant can have a spiral segment and the delivery tube can have a spiral groove. The braided implant delivery system can be any of the delivery systems described herein having any combination of the features described herein, as well as any features that would be known to one skilled in the art. In step  820  the spiral segment of the braided implant can be engaged with the spiral groove of the delivery tube. In step  830  the braided implant can be implanted in the aneurysm by forming an occlusive sack having an opening within the aneurysm. In step  835  the occlusive sack can contact a wall of the aneurysm. In step  840  the delivery tube can be rotated in relation to the spiral segment to disengage the spiral segment from the spiral groove. In step  845  a contact between the aneurysm wall and the occlusive sack can resist a rotation of the occlusive sack in response to the rotation of the delivery tube. In step  850  the spiral segment can be released from the delivery tube thereby releasing the braided implant from the delivery tube. In step  860  a portion of the spiral segment can be moved from a circular helix shape to a conical helix or flat spiral shape. In step  870  at least a portion of the neck of the aneurysm can be occluded by obstructing at least a portion of the opening of the occlusive sack with the spiral segment. 
     Referring to method  900  outlined in  FIG.  11   , in step  910  a braided implant delivery system having a braided implant, a delivery tube, and an inner elongated member can be provided. The braided implant can have a spiral segment and the delivery tube can have a spiral groove and a lumen. The braided implant delivery system can be any of the delivery systems described herein having any combination of the features described herein, as well as any features that would be known to one skilled in the art. In step  920  the spiral segment of the braided implant can be engaged with the spiral groove of the delivery tube. In step  923  the inner elongated member can be positioned in the lumen of the delivery tube. In step  927  the braided implant can be attached to the inner elongated member. In step  930  the braided implant can be implanted in the aneurysm by pushing the inner elongated member distally, thereby inverting the braided implant and forming an occlusive sack within the aneurysm then detaching the braided implant from the inner elongated member. In step  940  the delivery tube can be rotated in relation to the spiral segment of the braided implant to disengage the spiral segment from the spiral groove. In step  950  the spiral segment can be released from the delivery tube thereby releasing the braided implant from the delivery tube. 
     The descriptions contained herein are examples of embodiments of the invention and are not intended to limit the scope of the invention. As described herein, the invention contemplates many variations and modifications of a system, device, or method that can be used to treat an aneurysm with a braided implant. Variations can include but are not limited to alternative geometries of elements and components described herein, utilizing any of numerous materials for each component or element (e.g. radiopaque materials, memory shape metals, etc.), utilizing additional components including components to position the braided implant at a treatment site, extract the braided implant, or eject a portion of the braided implant from the interior of the delivery tube, utilizing additional components to perform functions described herein, or utilizing additional components to perform functions not described herein, for example. These modifications would be apparent to those having ordinary skill in the art to which this invention relates and are intended to be within the scope of the claims which follow.