Patent Description:
Vaso-occlusive devices or implants are used for a wide variety of reasons, including treatment of intra-vascular aneurysms. Commonly used vaso-occlusive devices include soft, helically wound coils formed by winding a platinum (or platinum alloy) wire strand about a "primary" mandrel. The coil is then wrapped around a larger, "secondary" mandrel, and heat treated to impart a secondary shape. For example, <CIT>, describes a vaso-occlusive device that assumes a linear, helical primary shape when stretched for placement through the lumen of a delivery catheter, and a folded, convoluted secondary shape when released from the delivery catheter and deposited in the vasculature.

In order to deliver the vaso-occlusive devices to a desired site in the vasculature, e.g., within an aneurysmal sac, it is well-known to first position a small profile, delivery catheter or "micro-catheter" at the site using a steerable guidewire. Typically, the distal end of the micro-catheter is provided, either by the attending physician or by the manufacturer, with a selected pre-shaped bend, e.g., <NUM>°, <NUM>°, "J", "S", or other bending shape, depending on the particular anatomy of the patient, so that it will stay in a desired position for releasing one or more vaso-occlusive device(s) into the aneurysm once the guidewire is withdrawn. A delivery or "pusher" assembly or "wire" is then passed through the micro-catheter, until a vaso-occlusive device coupled to a distal end of the delivery assembly is extended out of the distal end opening of the micro-catheter and into the aneurysm. Once in the aneurysm, portions of the vaso-occlusive device deform or bend to allow more efficient and complete packing. The vaso-occlusive device is then released or "detached" from the distal end of the delivery assembly, and the delivery assembly is withdrawn back through the catheter. Depending on the particular needs of the patient, one or more additional vaso-occlusive devices may be pushed through the catheter and released at the same site.

One well-known way to release a vaso-occlusive device from the end of the delivery assembly is through the use of an electrolytically severable junction, which is a small exposed section or detachment zone located along a distal end portion of the delivery assembly. The detachment zone is typically made of stainless steel and is located just proximal of the vaso-occlusive device. An electrolytically severable junction is susceptible to electrolysis and disintegrates when the delivery assembly is electrically charged in the presence of an ionic solution, such as blood or other bodily fluids. Thus, once the detachment zone exits out of the catheter distal end and is exposed in the vessel blood pool of the patient, a current applied through an electrical contact to the conductive pusher completes an electrolytic detachment circuit with a return electrode, and the detachment zone disintegrates due to electrolysis. Other detachment mechanisms for releasing a vaso-occlusive device from a delivery assembly include mechanical, thermal, and hydraulic mechanisms.

In order to better frame and fill aneurysms, complex three-dimensional secondary shapes can be imparted on vaso-occlusive coils and the stiffness/flexibility of vaso-occlusive coils can be modified. However, vaso-occlusive coils continue to have performance limitations including breaking performance, shape retention and anchoring ability.

The proximal end of some vaso-occlusive devices is coupled to the distal end of the delivery assembly with an adhesive at what is known as a "major junction" of the vaso-occlusive treatment system, or a "delivery assembly junction. " Another major junction design is disclosed in <CIT>, which is fully incorporated herein by reference as though set forth in full. The major junction includes a flat adapter coupling a delivery wire to a vaso-occlusive coil. The delivery wire has a hook or "J" shape distal end configured to be received in an aperture in the proximal end of the adapter to couple the delivery wire to adapter. The vaso-occlusive coil has windings that define openings configured to receive fingers in the distal end of the adapter to couple the vaso-occlusive coil to the adapter. Consequently, the adapter facilitates coupling of the delivery wire to the vaso-occlusive coil. Other major junction designs are disclosed in <CIT> The documents <CIT> and <CIT> disclose vaso-occlusive treatment systems. Patent document <CIT> discloses a vaso-occlusion coil, which may be segmented, onto which a fibrous, woven or braided, tubular covering is attached.

While major junctions coupled with an adhesive and those including a flat adapter have performed well, coupling of the delivery assembly and the vaso-occlusive device can be improved. Accordingly, there remains a need for other systems and methods for coupling a vaso-occlusive device to a delivery assembly at a major junction.

In one embodiment, an implantable vaso-occlusive device includes a braid formed out of one or more drawn filled tubes. Each drawn filled tube includes a core made from a core metallic material, and an external layer made from an external metallic material different from the core metallic material. Each of the core and external metallic materials has a respective radiopacity and a respective stiffness. One of the core and external metallic materials has a greater radiopacity and a lesser stiffness, respectively, than the other one of the core and external metallic materials. Each of the one or more drawn filled tubes has a "yield strength to ultimate strength" ratio of less than <NUM>%.

In one or more embodiments, the core metallic material comprises platinum, and the external metallic material comprises Nitinol. In other embodiments, the core metallic material comprises Nitinol, and the external metallic material comprises platinum. The braid may include first and second drawn filled tubes that are twisted together. Each of the one or more drawn filled tubes may have a "yield strength to ultimate strength" ratio of less than <NUM>%, <NUM>% or <NUM>%.

In another embodiment, an implantable vaso-occlusive device includes a braid formed out of <NUM>-<NUM> drawn filled tubes. Each drawn filled tube has a core comprising platinum and an external layer comprising Nitinol. Each of the plurality of drawn filled tubes has a platinum content of <NUM>% to <NUM>% by volume, and an outer diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in.

In one or more embodiments, the braid is formed out of <NUM>-<NUM> drawn filled tubes, each having a platinum content of <NUM>% to <NUM>% by volume, and an outer diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in. The Nitinol may have an austenite finish temperature between <NUM> and <NUM>. The drawn filled tubes may include an oxide coating.

In another embodiment, a vaso-occlusive treatment system includes a delivery assembly and a vaso-occlusive device detachably coupled to the delivery assembly by a delivery assembly junction, wherein the vaso-occlusive device includes a braided portion, a coiled portion, and an intra-device junction coupling the braided portion to the coiled portion.

In one or more embodiments, the braided portion includes a proximal end and a middle, where a diameter of the proximal end is less than a diameter of the middle. The braided portion may include a distal end and a middle, where a diameter of the distal end is less than a diameter of the middle. The coiled portion may include a proximal end and a middle, where a diameter of the proximal end is less than a diameter of the middle. The coiled portion may include a distal end and a middle, where a diameter of the distal end is less than a diameter of the middle.

In one or more embodiments, the delivery assembly has a distal end, where the distal end forms a hook. The braided portion may include an elongate member forming a loop at a proximal end thereof. The hook may pass through the loop, thereby coupling the delivery assembly and the vaso-occlusive device. The vaso-occlusive device may have a reduced diameter proximal end configured to prevent the hook from moving proximally.

In various embodiments, the delivery assembly junction includes a link having a proximal end and a distal end, and the distal end of the link includes a plurality of fingers. The plurality of fingers may be configured to interface between adjacent elongate members of the braided portion. The plurality of fingers may be configured to interface between adjacent opening windings of the coiled portion.

In the invention, the delivery assembly junction includes a braided member, and at least a portion of the braided member is disposed inside of the vaso-occlusive device.

In one or more embodiments, the delivery assembly junction includes a tubular body disposed around least a portion of the vaso-occlusive device. The tubular body may include a metallic band and/or a laminated polymer tube.

In one or more embodiments, the vaso-occlusive device includes a stretch-resisting member. The stretch-resisting member may be an elongate member and/or a braided tube. The intra-device junction may include a loop formed at a proximal end of the stretch-resisting member. The loop may encircle an elongate member of the braided portion to anchor the stretch-resisting member thereto. The loop may encircle a reduced diameter portion of the vaso-occlusive device to anchor the stretch-resisting member thereto. The intra-device junction may include a wire having a hook formed at an end thereof, and the hook may pass through the loop.

In one or more embodiments, the intra-device junction includes an enlarged body formed at a proximal end of the stretch-resisting member, and the enlarged body is disposed adjacent a reduced diameter portion of the vaso-occlusive device to anchor the stretch-resisting member thereto. The intra-device junction may include a hook formed at a proximal end of the stretch-resisting member. A central portion of the stretch-resisting member may be configured to facilitate articulation of the vaso-occlusive device. The stretch-resisting member may include an elongate member, which also forms at least a part of the vaso-occlusive device.

In one or more embodiments, the intra-device junction includes a tubular body disposed around least a portion of the vaso-occlusive device. The tubular body may be a metallic band and/or a laminated polymer tube.

In one or more embodiments, the intra-device junction includes a tubular body disposed in a lumen defined by a portion of the vaso-occlusive device. The tubular body may include a braided tube, a coil and/or a solid body. The intra-device junction may include a pin extending radially through the braided and coiled portions, thereby coupling the braided and coiled portions. The coiled portion may include a flattened winding disposed at an end thereof. A long axis of the flattened winding may be substantially parallel to a longitudinal axis of the vaso-occlusive device.

In one or more embodiments, the braided portion includes a braided distal end, and the coiled portion includes a coiled proximal end. The braided distal end may be disposed inside of the coiled proximal end. The coiled proximal end may be disposed inside of the braided distal end.

In one or more embodiments, the braided portion includes a braided proximal end, and the coiled portion includes a coiled distal end. The braided proximal end may be disposed inside of the coiled distal end. The coiled distal end may be disposed inside of the braided proximal end. The coiled portion may be configured to facilitate articulation of the vaso-occlusive device.

In accordance with another aspect, embodiments of the disclosed inventions include vaso-occlusive treatment systems having a delivery assembly and a vaso-occlusive device detachably coupled to the delivery assembly by a severable junction, the vaso-occlusive device including a proximal coil having an inner axial lumen and a proximal end portion coupled to the severable junction, and a braid having a proximal end portion coupled to a distal end portion of the proximal coil by a first intra-device junction, the braid comprising a plurality of elongate braid members, wherein two or more of the braid members extend proximally from the braid through the axial lumen of proximal coil and are secured to the proximal end portion of the proximal coil, respectively, to thereby form proximal coil stretch-resisting members.

In one such embodiment, each of the proximal coil stretch-resisting members has a proximal end attached to a distal portion of the severable junction that is coupled to the proximal end portion of the proximal coil, the severable junction being configured such that the distal portion of the severable junction remains coupled to the proximal end portion of the proximal coil when the severable junction is severed. By way of one, non-limiting example, the proximal ends of the proximal coil stretch-resisting members may comprise respective hooks that engage an aperture formed in the distal portion of the severable junction. Similarly, the vaso-occlusive member may include a distal coil having a proximal end portion attached to a distal end portion of the braid by a second intra-device junction, the distal coil having an inner axial lumen, wherein the same or a different two or more of the braid members extend distally from the braid through the axial lumen of distal coil and are secured to the distal end portion of the distal coil, respectively, to thereby form distal coil stretch-resisting members. In such embodiments, the vaso-occlusive device may further comprise a distal end joint coupled to the distal end portion of the distal coil and formed at least in part by joining together respective distal ends of the distal coil stretch-resisting members.

In accordance with still another embodiment of the disclosed inventions vaso-occlusive treatment systems have a delivery assembly and a vaso-occlusive device detachably coupled to the delivery assembly by a severable junction, the vaso-occlusive device including a distal coil having an inner axial lumen and a braid having a distal end portion coupled to a proximal end portion of the proximal coil by an intra-device junction, the braid comprising a plurality of elongate braid members, wherein two or more of the braid members extend distally from the braid through the axial lumen of distal coil and are secured to a distal end portion of the distal proximal coil, respectively, to thereby form distal coil stretch-resisting members.

In one such embodiment, the system also includes a distal end joint coupled to the distal end portion of the distal coil and formed at least in part by joining together respective distal ends of the distal coil stretch-resisting members.

In accordance with yet another aspect of the disclosed inventions, an implantable vaso-occlusive device includes a braid formed out of one or more elongate braid members, each elongate braid member comprising a core, an intermediate layer at least partially surrounding the core, and an outer layer at least partially surrounding the intermediate layer, each of the core, intermediate layer and outer lays being composed of metallic materials, and each having a respective radiopacity and a respective stiffness, wherein one of the core, intermediate layer and outer layer has a greater radiopacity and/or a lesser stiffness than the other ones. By way of one, non-limiting example, the core metallic materials may comprise platinum, the intermediate layer metallic materials may comprise Nitinol, and the outer layer metallic materials may comprise titanium. By way of another, non-limiting example, the core may comprise radiopaque metallic materials, the intermediate layer may comprise a superelastic metallic material, and the outer layer may comprise an oxidation resistant metallic material. By way of yet another, non-limiting example, the core may have a higher radiopacity than the each of the intermediate layer and outer layer, the intermediate layer may have a lower stiffness than each of the core and the outer layer, and the outer layer may have a higher resistance to oxidation than each of the core and the intermediate layer.

In still another embodiment, a vaso-occlusive treatment system includes a delivery assembly; and a vaso-occlusive device detachably coupled to the delivery assembly by a delivery assembly junction. The vaso-occlusive device includes a braided portion formed out of one or more composite wires, a coiled portion coupled to the braided portion, and an intra-device junction coupling the braided portion to the coiled portion. Each composite wire includes a core made from a core metallic material, and an external layer made from an external metallic material different from the core metallic material. One of the core and the external layer has a greater radiopacity and a lesser stiffness, respectively, than the other one of the core and the external layer.

In one or more embodiments, the core metallic material includes platinum, and the external metallic material includes Nitinol. In other embodiments, the core metallic material includes Nitinol, and the external metallic material includes platinum.

In one or more embodiments, each of the one or more composite wires may have a yield strength to ultimate strength ratio of less than <NUM>%.

In one or more embodiments, the braid portion includes a braid formed out of a plurality of composite wires, each composite wire having a core including platinum and an external layer including Nitinol, the plurality of composite wires consists of <NUM>-<NUM> composite wires, each of the plurality of composite wires has a platinum content of <NUM>% to <NUM>% by volume, and each of the plurality of composite wires has an outer diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in.

In one or more embodiments, the plurality of composite wires consists of <NUM>-<NUM> composite wires, each having a platinum content of <NUM>% to <NUM>% by volume, and an outer diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in.

In one or more embodiments, the delivery assembly has a distal end, where the distal end forms a hook. The delivery assembly junction may include a link having a proximal end and a distal end, where the distal end of the link includes a plurality of fingers. The delivery assembly junction may include a braided member, where at least a portion of the braided member is disposed radially inside of the vaso-occlusive device. The delivery assembly junction may include a tubular body disposed around least a portion of the vaso-occlusive device.

In one or more embodiments, the intra-device junction includes a tubular body disposed around least a portion of the vaso-occlusive device. The intra-device junction may include a tubular body disposed in a lumen defined by a portion of the vaso-occlusive device. The tubular body may include a braided tube.

In one or more embodiments, the intra-device junction includes a pin extending radially through the braided and coiled portions, thereby coupling the braided and coiled portions.

In one or more embodiments, the coiled portion includes a flattened winding disposed at an end thereof, a long axis of the flattened winding being substantially parallel to a longitudinal axis of the vaso-occlusive device.

In one or more embodiments, the braided portion has a substantially constant width.

In one or more embodiments, each of the core and external metallic materials have a respective radiopacity and a respective stiffness.

In one or more embodiments, each of the one or more composite wires has a yield strength to ultimate strength ratio of less than <NUM>%.

In one or more embodiments, one of the core and the external layer provides radiopacity to the composite wire, while the other of the core and the external layer provides superelasticity and/or shape memory (i.e. the ability for the braid to recover to its original width) to the composite wire.

In one or more embodiments, the core is made from discontinuous segments of wire and/or powder. In such embodiments, the core would be less stiff than a comparable core made from a continuous wire.

In one or more embodiments, a width of the braided portion ranges from <NUM> to <NUM>. A width to thickness ratio of the braided portion may range from <NUM>:<NUM> to <NUM>:<NUM>. A braid angle of the braided portion can range from <NUM>° to <NUM>°.

Other and further aspects and features of embodiments of the disclosed inventions will become apparent from the ensuing detailed description in view of the accompanying figures.

The drawings illustrate the design and utility of various embodiments of the disclosed inventions, in which similar elements are referred to by common reference numerals. These drawings are not necessarily drawn to scale. In order to better appreciate how the above-recited and other advantages and objects are obtained, a more particular description of the embodiments will be rendered, which are illustrated in the accompanying drawings. These drawings depict only exemplary embodiments of the disclosed inventions for purposes of illustration and facilitating the below detailed description, and are not therefore to be considered limiting of its scope.

This specification describes exemplary embodiments and applications of the disclosed invention. The disclosed invention, however, is not limited to these exemplary embodiments and applications or to the manner in which the exemplary embodiments and applications operate or are described herein. Further, the figures may show simplified or partial views, and the dimensions of elements in the figures may be exaggerated or otherwise not in proportion. Moreover, elements of similar structures or functions are represented by like reference numerals throughout the figures. An aspect or an advantage described in conjunction with a particular embodiment is not necessarily limited to that embodiment, and can be practiced in any other embodiments even if not so illustrated.

As the terms "on," "attached to," "connected to," "coupled to," "secured to" or similar words are used herein, one element (e.g., a material, a layer, a substrate, etc.) can be "on," "attached to," "connected to," "coupled to" or "secured to" another element regardless of whether the one element is directly on, attached to, connected to, coupled to or secured to the other element or there are one or more intervening elements between the one element and the other element. Directions (e.g., above, below, top, bottom, side, up, down, under, over, upper, lower, horizontal, vertical, "x," "y," "z," etc.), if provided, are relative and provided solely by way of example and for ease of illustration and discussion and not by way of limitation. Where reference is made to a list of elements (e.g., elements a, b, c), such reference is intended to include any one of the listed elements by itself, any combination of less than all of the listed elements, and/or a combination of all of the listed elements.

As used herein, "substantially" means sufficient to work for the intended purpose. The term "substantially" thus allows for minor, insignificant variations from an absolute or perfect state, dimension, measurement, result, or the like such as would be expected by a person of ordinary skill in the field but that do not appreciably affect overall performance. The term "ones" means more than one.

In many instances, he terms "about" may include numbers that are rounded to the nearest significant figure.

As used herein, a plurality of "elongate members" used to form a braid can include only a single elongate member used to form the braid, i.e., wherein the single elongate member turns back on itself at the ends of the braid. As used herein, the terms "tube," "tubular," "diameter," "radius" and "circumference" encompass objects with non-circular cross section as well as those with circular cross sections.

<FIG> depict a vaso-occlusive treatment system <NUM> that includes an implantable vaso-occlusive device <NUM> coupled to a delivery assembly <NUM>. The vaso-occlusive device <NUM> includes a central braided portion <NUM> disposed axially between proximal and distal portions <NUM>, <NUM>. A major junction <NUM> couples a distal end of the delivery assembly <NUM> to a proximal end of the proximal portion <NUM>. The "major junction" is also known as a "delivery assembly junction. " A proximal intra-device junction <NUM>-<NUM> couples the proximal end of the central portion <NUM> to a distal end of the proximal portion <NUM>. A distal intra-device junction <NUM>-<NUM> couples the distal end of the central portion <NUM> to a proximal end of the distal portion <NUM>.

The central portion <NUM> is a braided from drawn filled tubing ("DFT") elongate members (e.g., "wires"), such as those available from Fort Wayne Metals in Fort Wayne, Indiana. DFTs are a type of composite wire. For instance, the central portion <NUM> can be braided from <NUM> DFT wires, each wire having a cross-sectional diameter of <NUM> microns (<NUM> in. The braid can be a flat braid or a round braid. In other embodiments, the central portion <NUM> can be braided from <NUM> to <NUM> DFT wires, each wire having a cross-sectional diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in. The proximal and distal portions <NUM>, <NUM> are coils wound from one or more of the same DFT wires. In alternative embodiments, the proximal and distal portions <NUM>, <NUM> may be coils wound from one or more substantially pure NiTi wire instead of DFT wires.

The DFT wire includes a substantially pure Platinum ("Pt") core at least partially surrounded by a substantially pure Nitinol ("NiTi") external layer. As used in this application, "substantially pure" Pt includes but is not limited to <NUM>% commercial purity produced in accordance with ASTM B561. The Pt core is approximately <NUM>%-<NUM>% of the DFT wire by volume ("Pt core content"). In some embodiments, the DFT wires are formed by inserting a core component (a solid elongate member) into an external component (a tubular elongate member) to form a composite elongate member (e.g., a composite wire). The composite elongate member is repeatedly mechanically drawn and annealed by heating to increase its axial length and decrease its cross-sectional diameter. For example, the drawing and annealing process can serially reduce the diameter of a composite elongate member from <NUM> to <NUM>, from <NUM> to <NUM>, from <NUM> to <NUM>, from <NUM> to <NUM> (from <NUM> in. to <NUM> in. , from <NUM> in. to <NUM> in. , from <NUM> in. to <NUM> in. , and from <NUM> in. to <NUM> in.

While the materials (e.g., Pt and NiTi) forming various portions (e.g., core and external layer) of the DFT wire may have different stiffnesses (i.e., bending stiffness), the relative stiffnesses (i.e., bending stiffness) of the resulting portions of the DFT may not necessarily reflect the stiffnesses of the material from which they are made. For instance, even though Pt's bending modulus (i.e., stiffness) is greater than that of NiTi, in various embodiments, Pt's bending modulus in combination with the Pt wire's diameter results in a platinum wire that is softer (i.e., less stiff) than the corresponding NiTi external layer.

The central portion <NUM> of the vaso-occlusive device <NUM> can be braided on a mandrel, which can be flat or round depending on the desired final shape. After braiding, the central portion <NUM> can be heat set (e.g., at <NUM> to <NUM> for <NUM> to <NUM> minutes). The heat set completed braid forms the linear "primary shape" of the central portions <NUM>. The heat set completed braid can then be wrapped around a second mandrel (e.g., a three-dimensional mandrel) and heat set for a second time to impart a three-dimensional "secondary shape. " The NiTi external layer improves retention of the secondary shape, as shown in <FIG>.

While vascular implants (i.e., stents) have been formed from NiTi-DFT-Pt wires where the Pt core content is up to around <NUM>%, NiTi-DFT-Pt wires with Pt core content around <NUM>% to <NUM>% have not been used to form stents. This is because stents typically require wires having higher yield strength to ultimate strength ratios (i.e., ><NUM>% of ultimate strength ("UTS")) to maintain vessel patency. On the other hand, the instant vaso-occlusive device <NUM> includes DFT wires with lower yield strength to UTS ratios, which improves device characteristics including lower bending moments and improved breaking performance. In various embodiments, the DFT wires that form (portions of) the vaso-occlusive device <NUM> have yield strength to UTS ratios of <<NUM>% UTS, <<NUM>% UTS, <<NUM>% UTS and <<NUM>% UTS. Yield strength is the maximum amount of force which can be applied to a material before it begins to plastically deform. UTS is the minimum amount of force which must be applied to a material before it fails. Braiding at least a portion of a vaso-occlusive device from wires having a yield strength to UTS ratio of less than <NUM>% UTS is critical to simultaneously achieving the characteristics of improved radiopacity, shape retention and breaking performance.

It was not previously known to form vascular implants, including vaso-occlusive devices, from NiTi-DFT-Pt wires with Pt core content of around <NUM>% to <NUM>%. Braiding the central portion <NUM> from DFT wires with Pt core content of around <NUM>% to <NUM>% ("NiTi-DFT-<NUM>/50Pt") provides a central portion <NUM> that has (<NUM>) radiopacity throughout its entire length, (<NUM>) improved shape retention, and (<NUM>) improved breaking performance along the entire length of the braid. The Pt core provides the radiopacity for a substantial proportion of the vaso-occlusive device <NUM>, as shown in <FIG> are radiographic images showing the radiopacity of various vaso-occlusive devices <NUM> implanted into patients. The radiographic image in <FIG> has the following characteristics: <NUM>° caudal, <NUM>° right anterior oblique, <NUM> kVp, and <NUM> mA. The radiographic image in <FIG> has the following characteristics: <NUM>° caudal, <NUM>° right anterior oblique, <NUM> kVp, and <NUM> mA. The superelastic properties of the NiTi external layer contribute to the improved shape retention. The softness of the Pt contributes to the improved breaking performance, i.e., the ability of the vaso-occlusive device <NUM> to bend and fold to conform to the shape of body cavities. These characteristics of the central portion <NUM> results in a vaso-occlusive device <NUM> that is more suitable for intra-saccular embolization of vascular defects, such as aneurysms, i.e., substantially consistent visualization grey scale throughout the device <NUM> and optimal softness profile.

Braiding at least a portion of a vaso-occlusive device <NUM> from <NUM> to <NUM> DFT wires, each wire having a cross-sectional diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in. ) and having a Pt content of <NUM>% to <NUM>% is critical to simultaneously achieving the characteristics of improved radiopacity, shape retention and breaking performance. Unexpectedly, as the Pt content is increased, the effect of the increasing Pt content on decreasing flexible is reduced. Accordingly, braids woven from DFT wires having Pt content of <NUM>% to <NUM>% are surprisingly suitable for vaso-occlusive applications, e.g., endo-saccular applications requiring flexible devices. Such braids are especially well suited when they are woven from <NUM> to <NUM> DFT wires, each wire having a cross-sectional diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in. In a preferred embodiment, at least a portion of a vaso-occlusive device <NUM> is braided from <NUM> to <NUM> DFT wires, each wire having a cross-sectional diameter of <NUM> to <NUM> microns (<NUM> in. to <NUM> in. ) and having a Pt content of <NUM>% to <NUM>%.

Normally the austenite finish, or "Af" temperature of the NiTi is around <NUM>, which is the temperature where the martensitic phase completes its transformation into the austenitic phase. Modifying the NiTi in the DFT such that its Af temperature is between <NUM> and <NUM> results in a softer vaso-occlusive device. Setting the Af temperature in this range achieves a desirable balance between device softness and conformability, which improves the suitability of the device for aneurysm treatment. Setting the Af of the NiTi can be accomplished by adjusting the composition of Ni in NiTi from the normal of <NUM>% to <NUM>%-<NUM>%. Further, the Af can be tuned with heat treatment of the NiTi. In a preferred embodiment, the Af temperature is between <NUM> and <NUM>.

The DFT can also include an oxide coating with a controlled thickness, which will enhance thrombogenisis (e.g., clotting) to increase vaso-occlusion within aneurysms. Preferably, the oxide coating has an average thickness between <NUM> and <NUM>. This is contrary to previous DFT braided implants (e.g., stents), from which oxide coatings are substantially removed (e.g., via electro-polishing), to generate "bright" stents. In previous DFT braided stents, oxide coating thickness is limited to less than <NUM>.

Again referring to <FIG>, the proximal and distal portions <NUM>, <NUM> are atraumatic coils for minimize tissue damage during insertion and deployment of the vaso-occlusive device <NUM>. The central portion <NUM> also includes pre-determined breaking points <NUM>, which are formed by twisting segments of the central portion <NUM> relative to each other or necking down points in the central portion <NUM> braid during formation of the secondary shape. In some embodiments, some breaking points <NUM> can include <NUM>° bends for better anchoring with a body cavity. The delivery assembly <NUM> also includes an electrolytically degradable segment <NUM> at a distal end thereof. In other embodiments, alternative detachment mechanisms for releasing the vaso-occlusive device <NUM> from the delivery assembly <NUM> include mechanical, thermal, and hydraulic mechanisms.

In other embodiments, instead of DFT wires, the central portion <NUM> may be braided from elongate members <NUM> formed from smaller DFT wires <NUM> twisted together, as shown in <FIG>. Each DFT wire <NUM> may be made of Niti-DFT-40Pt. Braiding elongate members <NUM> (made from smaller DFT wires) instead of larger DFT wires results in a central portion <NUM> that is softer at approximately the same Pt core content. Accordingly, the central portion <NUM> according to this embodiment (i.e., twisted elongate member <NUM> braid) provides similar radiopacity with a softer braid. The braid according to this embodiment also provides higher surface area to promote thrombus formation, thereby enhancing aneurysm occlusion.

<FIG> depicts a vaso-occlusive treatment system <NUM> according to one embodiment. The vaso-occlusive treatment system <NUM> includes a vaso-occlusive device <NUM> coupled to a delivery assembly <NUM> by a major junction <NUM>. The delivery assembly <NUM> includes an electrolytically degradable segment <NUM> at a distal end thereof. The vaso-occlusive device <NUM> includes a central braided portion <NUM> coupled to a distal portion <NUM> by an intra-device junction <NUM>. The central portion <NUM> is braided from DFT (i.e., composite) wires as described above, and has a substantially constant width (i.e., cross-sectional dimension). The distal coiled portion <NUM> is a coil wound from one or more DFT wires as described above. In other embodiments, the central and distal portions <NUM>, <NUM> can be formed from other elongate members. The distal portion <NUM> also has an atraumatic distal tip <NUM>, which may be formed from a small amount of adhesive. A stretch-resisting member <NUM> extends from the major junction <NUM>, through the intra-device junction <NUM> and to the atraumatic distal tip <NUM>, and reduces elongation of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery. The stretch-resisting member <NUM> can be made from a polymer (e.g., polypropylene) or a metal (e.g., NiTi).

The major junction <NUM> includes a hook <NUM> formed at the distal end of the delivery assembly <NUM>. The hook <NUM> may be formed from a distal end of a core wire of the delivery assembly <NUM>, as described in <CIT>. The stretch-resisting member <NUM> forms a proximal loop <NUM> at a proximal end thereof. The hook <NUM> passes through the proximal loop <NUM>, mechanically coupling the delivery assembly <NUM> to the central portion <NUM> of the vaso-occlusive device <NUM>. The major junction <NUM> also includes a necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The necked down proximal end <NUM> has a small profile that coupled to the hook <NUM>. The proximal end <NUM> of the vaso-occlusive device <NUM> surrounds the hook <NUM> and the proximal loop <NUM> of the stretch-resisting member <NUM>. The major junction <NUM> also includes an adhesive drop <NUM>, which permeates the braided proximal end <NUM> of central portion <NUM> of the vaso-occlusive device <NUM> and binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; (<NUM>) the proximal loop <NUM> of the stretch-resisting member <NUM>; and (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>.

The intra-device junction <NUM> includes a necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and an open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>. The distal end <NUM> of the central portion <NUM> is necked down so that it fits inside of the open proximal end <NUM> of the distal portion <NUM>. The intra-device junction <NUM> also includes an adhesive drop <NUM>, which permeates the coiled open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM> and binds it together with the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> thereby forming the intra-device junction <NUM>. Further, the adhesive drop <NUM> also binds the portion of the stretch-resisting member <NUM> passing through the intra-device junction <NUM>.

<FIG> depicts a vaso-occlusive treatment system <NUM> according to another embodiment. The vaso-occlusive treatment system <NUM> includes a vaso-occlusive device <NUM> coupled to a delivery assembly <NUM> by a major junction <NUM>. The delivery assembly <NUM> includes an electrolytically degradable segment <NUM> at a distal end thereof. The vaso-occlusive device <NUM> includes a central braided portion <NUM> coupled to proximal and distal coiled portions <NUM>, <NUM> by respective proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM>. The central portion <NUM> is braided from DFT (i.e., composite) wires as described above, and has a substantially constant width (i.e., cross-sectional dimension). The proximal and distal portions <NUM>, <NUM> are coils wound from one or more DFT wires as described above. In other embodiments, the central, proximal and distal portions <NUM>, <NUM>, <NUM> can be formed from other elongate members. The distal portion <NUM> also has an atraumatic distal tip <NUM>, which may be formed from a small amount of adhesive. A stretch-resisting member <NUM> extends from the major junction <NUM>, through the intra-device junction <NUM> and to the atraumatic distal tip <NUM>.

The major junction <NUM> includes a link/adapter <NUM> coupled to both the distal end of the delivery assembly <NUM> and the open proximal end <NUM> of the proximal portion <NUM>, thereby coupling the delivery assembly <NUM> and the proximal portion <NUM>. The link <NUM> may be formed from a sheet, as described in <CIT>. The link <NUM> is generally flat, and includes a plurality of fingers <NUM> formed in a proximal end thereof. The link <NUM> also includes proximal and distal apertures <NUM>, <NUM>. The proximal portion <NUM> of the vaso-occlusive device <NUM> is a coil with open pitch proximal windings <NUM> at the open proximal end <NUM> thereof. At least some of these proximal windings <NUM> interlace with the fingers <NUM> of the link <NUM>, coupling the link <NUM> to the proximal portion <NUM> of the vaso-occlusive device <NUM>.

The major junction <NUM> also includes a hook <NUM> formed from a distal end of a core wire of the delivery assembly <NUM>, as described above. The hook <NUM> passes through the proximal aperture <NUM> of the link <NUM>, coupling the delivery assembly <NUM> and link <NUM> (and the proximal portion <NUM> coupled thereto). The stretch-resisting member <NUM> forms a proximal loop <NUM> at a proximal end thereof. The proximal loop <NUM> passes through the distal aperture <NUM> of the link <NUM>, mechanically coupling the link <NUM> (and the delivery assembly <NUM> coupled thereto) to the proximal portion <NUM> of the vaso-occlusive device <NUM>. The major junction <NUM> also includes an adhesive drop <NUM>, which permeates the open proximal end <NUM> of the vaso-occlusive device <NUM> through the open pitch proximal windings <NUM>, and binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; (<NUM>) the link <NUM>; (<NUM>) the proximal loop <NUM> of the stretch-resisting member <NUM>; and (<NUM>) proximal end <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>.

The proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM> are mirror images of each other. The proximal intra-device junction <NUM>-<NUM> includes an open distal end <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM> and a necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The proximal end <NUM> of the central portion <NUM> is necked down so that it fits inside of the open distal end <NUM> of the proximal portion <NUM>. The proximal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which permeates the coiled open distal end <NUM> of proximal portion <NUM> of the vaso-occlusive device <NUM>. The adhesive <NUM> binds together the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open distal end <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the proximal intra-device junction <NUM>-<NUM>. Further, the adhesive drop <NUM> also binds the portion of the stretch-resisting member <NUM> passing through the proximal intra-device junction <NUM>-<NUM>.

The distal intra-device junction <NUM>-<NUM> includes a necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and an open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>. The distal end <NUM> of the central portion <NUM> is necked down so that it fits inside of the open proximal end <NUM> of the distal portion <NUM>. The distal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which permeates the coiled open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>. The adhesive <NUM> binds together the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the distal intra-device junction <NUM>-<NUM>. Further, the adhesive drop <NUM> also binds the portion of the stretch-resisting member <NUM> passing through the distal intra-device junction <NUM>-<NUM>.

<FIG> depicts a vaso-occlusive treatment system <NUM> according to still another embodiment. The vaso-occlusive treatment system <NUM> depicted in <FIG> is almost identical to the vaso-occlusive treatment system <NUM> depicted in <FIG>. One difference is that the major junction <NUM> also includes an inner braid <NUM> disposed radially between the hook <NUM> at the distal end of the delivery assembly <NUM> and the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The inner braid <NUM> also surrounds the proximal loop <NUM> of the stretch-resisting member <NUM>. The inner braid <NUM> can be woven from DFT, Pt and/or NiTi wires, as described above. The major junction <NUM> also includes an adhesive drop <NUM>, which permeates the braided proximal end <NUM> of central portion <NUM> of the vaso-occlusive device <NUM> and binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; (<NUM>) a proximal portion of the inner braid <NUM>; (<NUM>) the proximal loop <NUM> of the stretch-resisting member <NUM>; and (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>. The inner braid <NUM> enhances pushability, reduces kinking of the central portion <NUM> (particularly at the major junction <NUM>), and protects and strengthens the major junction <NUM>. In particular, the inner braid <NUM> prevents kinking by bringing the respective effective stiffness of the distal end of the delivery assembly <NUM> and the proximal end of the vaso-occlusive device <NUM> closer together to minimize the stiffness differential, which can lead to kinking.

<FIG> depicts a vaso-occlusive treatment system <NUM> according to yet another embodiment. The vaso-occlusive treatment system <NUM> depicted in <FIG> is similar to the vaso-occlusive treatment system <NUM> depicted in <FIG>. One difference is that the inner braid <NUM> extends from the major junction <NUM>, through the intra-device junction <NUM>, and to the distal tip <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>. The inner braid <NUM> traverses the entire vaso-occlusive device, and acts as a stretch-resisting member, thereby eliminating the need for a separate stretch-resisting member (a second difference). A third difference is that the hook <NUM> at the distal end of the delivery assembly <NUM> may be mechanically coupled to a proximal end of the inner braid <NUM>. The inner braid <NUM> can be woven from DFT, Pt and/or NiTi wires, as described above. The major junction <NUM> also includes an adhesive drop <NUM>, which permeates the braided proximal end <NUM> of central portion <NUM> of the vaso-occlusive device <NUM> and binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; (<NUM>) a proximal portion of the inner braid <NUM>; and (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>. In this embodiment, the inner braid <NUM> further enhances pushability, reduces kinking of the entire vaso-occlusive device <NUM>, protects both the major junction <NUM> and the intra-device junction <NUM>, and prevents stretching of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery.

While the vaso-occlusive treatment systems <NUM> depicted in <FIG> include various vaso-occlusive devices <NUM>, major junctions <NUM>, and intra-device junctions <NUM> in various combinations, this disclosure is not intended to be limited by the exemplary vaso-occlusive treatment systems <NUM>. Accordingly, the respective vaso-occlusive devices <NUM>, major junctions <NUM>, and intra-device junctions <NUM> disclosed herein can be assembled in any reasonable fashion to form different vaso-occlusive treatment systems <NUM>. Also, it will be apparent that some components of the disclosed vaso-occlusive treatment systems <NUM> need not be present in all vaso-occlusive treatment systems <NUM>.

<FIG> depict major junctions <NUM> according to various embodiments. While the major junctions <NUM> depicted in <FIG> and <FIG> do not include a stretch-resisting member, they can be modified to include one or more stretch-resisting members. Further, the major junctions <NUM> can be modified to function as intra-device junctions <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the major junction <NUM> depicted in <FIG> includes a pair of marker bands <NUM> surrounding the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The marker bands <NUM> reinforce the coupling of the hook <NUM> (and the delivery assembly <NUM>) and the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby strengthening the major junction <NUM>. The marker bands <NUM> also maintain the reduced diameter of the necked down proximal end <NUM>. The more proximal marker band <NUM> also mechanically interferes (e.g., interlocks) with the hook <NUM> to reinforce the coupling of the hook <NUM> and the proximal end <NUM>, also strengthening the major junction <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the vaso-occlusive device <NUM> partially depicted in <FIG> does not include a proximal portion <NUM>. Accordingly, the major junction <NUM> depicted in <FIG> includes a link/adapter <NUM> and a necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The braid in the necked down proximal end <NUM> is sufficiently open such that the fingers <NUM> of the link can pass through the braid in a radial direction. In addition, the portions of the necked down proximal end <NUM> adjacent to the link <NUM> may be welded or soldered to the link <NUM> to reinforce the coupling of the link <NUM> (and the delivery assembly <NUM> coupled thereto) and the central portion <NUM> of the vaso-occlusive device <NUM>.

The vaso-occlusive treatment system <NUM> partially depicted in <FIG> is similar to the one depicted in <FIG>, except that the proximal intra-device junction <NUM>-<NUM> of the vaso-occlusive treatment system <NUM> partially depicted in <FIG> is axially longer than the proximal intra-device junction <NUM>-<NUM> of the vaso-occlusive treatment system <NUM> depicted in <FIG>. The proximal intra-device junction <NUM>-<NUM> depicted in <FIG> includes an open distal end <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM>, a necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, and an adhesive drop <NUM>. The necked down proximal end <NUM> of the central portion <NUM> includes an extended length of the braid disposed inside of the distal end <NUM> of the proximal portion <NUM>, thereby lengthening the proximal intra-device junction <NUM>-<NUM>. The area of the proximal portion <NUM> (i.e., coil) of the vaso-occlusive device <NUM> between the major junction <NUM> and the proximal intra-device junction <NUM>-<NUM> forms an articulation portion <NUM> configured to facilitate bending of the vaso-occlusive device <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> depicted in <FIG> is reduced in diameter until the sides of the braid abut, thereby mechanically interfering with the hook <NUM>. This modification of the necked down proximal end <NUM> reinforces the coupling of the hook <NUM> and the proximal end <NUM>. The hook <NUM> and the proximal end <NUM> can be further joined by laser welding, soldering or with an adhesive drop.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the major junction <NUM> depicted in <FIG> includes a lamination layer <NUM> surrounding the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The lamination layer <NUM> reinforces the coupling of the hook <NUM> (and the delivery assembly <NUM>) and the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The lamination layer <NUM> also maintains the reduced diameter of the necked down proximal end <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the braid in the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> depicted in <FIG> is partially open to define an aperture <NUM>. The hook <NUM> formed at the distal end of the delivery assembly <NUM> passes through the aperture <NUM>, thereby coupling the hook <NUM> and the proximal end <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the braid in the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> depicted in <FIG> forms a proximal loop <NUM>. The proximal loop <NUM> can be formed from one or more elongate members <NUM> from which the central portion <NUM> is braided. The hook <NUM> formed at the distal end of the delivery assembly <NUM> passes through the proximal loop <NUM>, thereby coupling the hook <NUM> and the proximal end <NUM>. The major junction <NUM> also includes an adhesive drop <NUM>, which couples the hook <NUM> of the delivery assembly <NUM> and the proximal loop <NUM> formed at the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the inner braid <NUM> is shorter and does not extend over the hook <NUM>. The inner braid <NUM> is still disposed radially between the distal end of the delivery assembly <NUM> and the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The inner braid <NUM> mechanically interferes (e.g., interlocks) with the hook <NUM>. The inner braid <NUM> can be woven from DFT, Pt and/or NiTi wires, as described above. The major junction <NUM> also includes an adhesive drop <NUM>, which permeates the braided proximal end <NUM> of central portion <NUM> of the vaso-occlusive device <NUM> and binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; (<NUM>) a proximal portion of the inner braid <NUM>; and (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>. The inner braid <NUM> reinforces the coupling of the hook <NUM> and the proximal end <NUM>. The inner braid <NUM> also enhances pushability, reduces kinking of the central portion <NUM> (particularly at the major junction <NUM>), and protects and strengthens the major junction <NUM>.

The major junction <NUM> depicted in <FIG> is almost identical to the one depicted in <FIG>, except that the major junction <NUM> depicted in <FIG> does not include a stretch-resisting member. Therefore, the adhesive drop <NUM> in the major junction <NUM> binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; (<NUM>) a proximal portion of the inner braid <NUM>; and (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>. The inner braid <NUM> reinforces the coupling of the hook <NUM> and the proximal end <NUM>. The inner braid <NUM> also enhances pushability, reduces kinking of the central portion <NUM> (particularly at the major junction <NUM>), and protects and strengthens the major junction <NUM>.

The major junction <NUM> depicted in <FIG> is almost identical to the one depicted in <FIG>, except that the major junction <NUM> depicted in <FIG> does not include a stretch-resisting member. The hook <NUM> mechanically interferes (e.g., interlocks) with the necked down the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> to strengthen the major junction <NUM>. Therefore, the adhesive drop <NUM> in the major junction <NUM> binds together: (<NUM>) the hook <NUM> of the delivery assembly <NUM>; and (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the major junction <NUM>.

The major junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the major junction <NUM> depicted in <FIG> includes one instead of two marker bands <NUM>. The marker band <NUM> surrounds the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The marker bands <NUM> reinforce the coupling of the hook <NUM> (and the delivery assembly <NUM>) and the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby strengthening the major junction <NUM>. The marker band <NUM> also maintains the reduced diameter of the necked down proximal end <NUM>.

<FIG> generally depicts a major junction <NUM> coupling a delivery assembly <NUM> and a central portion <NUM> of a vaso-occlusive device <NUM> according to one embodiment. The major junction <NUM> depicted in <FIG> can be similar or identical to the ones depicted in <FIG>, <FIG>and <FIG>, because the adhesive drop <NUM> obscures the details of the major junction <NUM>.

<FIG> depict intra-device junctions <NUM> according to various embodiments. While specific intra-device junctions <NUM> depicted in <NUM>-<NUM> either include or not include a stretch-resisting member, they can be modified to not include or include one or more stretch-resisting members. Further, the intra-device junctions <NUM> can be modified to function as major junctions <NUM>. Moreover, while the intra-device junctions <NUM> depicted in <NUM>-<NUM> couple a central portion <NUM> to a distal portion <NUM>, they can be modified to couple a central portion <NUM> to a proximal portion <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>. One difference is that the stretch-resisting member <NUM> ends immediately proximal of the intra-device junction <NUM> in a loop <NUM> instead of extending all the way to the major junction <NUM>. The loop <NUM> encircles portions of the braid forming the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby anchoring the proximal end of the stretch-resisting member <NUM>. The stretch-resisting member <NUM> extends from proximal of the intra-device junction <NUM> to the atraumatic distal tip <NUM>, and reduces elongation of the distal portion <NUM> of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery. The stretch-resisting member <NUM> couples the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. The intra-device junction <NUM> also includes an adhesive drop <NUM>, which binds together: (<NUM>) the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; (<NUM>) the stretch-resisting member <NUM>; (<NUM>) the loop <NUM>; and (<NUM>) the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the intra-device junction <NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, with one difference being that the intra-device junction <NUM> depicted in <FIG> includes a DFT braid <NUM>, which acts as a stretch-resisting member. As such, the intra-device junction <NUM> depicted in <FIG> does not include a stretch-resisting member such as the one depicted in <FIG>. The DFT braid <NUM> extends from the intra-device junction <NUM> to the atraumatic distal tip <NUM>, and reduces elongation of the distal portion <NUM> of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery. While the DFT braid <NUM> shown in <FIG> terminates at the intra-device junction <NUM>, in other embodiments, the DFT braid <NUM> can extend proximally all the way to the major junction <NUM>. The DFT braid <NUM> couples the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. The intra-device junction <NUM> also includes proximal and distal adhesive drops <NUM>-<NUM>, <NUM>-<NUM>. The proximal adhesive drop <NUM>-<NUM> penetrates the necked down distal end <NUM> of the braided central portion <NUM>, and binds together the proximal end of the DFT braid <NUM> and the necked down distal end <NUM> of the central portion <NUM>. The distal adhesive drop <NUM>-<NUM> penetrates open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM>, and binds together a middle portion of the DFT braid <NUM> and the proximal end <NUM> of the distal portion <NUM>. The portion of the DFT braid <NUM> between the proximal and distal adhesive drops <NUM>-<NUM>, <NUM>-<NUM> form an articulation portion <NUM> configured to facilitate bending of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the distal end <NUM> of the central portion <NUM> is necked down less than the one in <FIG>. Instead of necking down the distal end <NUM> so that it fits inside of the open proximal end <NUM> of distal portion <NUM>, the distal end <NUM> of the central portion <NUM> is necked down so that its diameter is substantially the same as the diameter of the proximal end <NUM> of the distal portion <NUM>. Also, the intra-device junction <NUM> depicted in <FIG> includes a tube <NUM> (e.g., a PET tube), which is melted onto (and into) and couples the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. The tube <NUM> penetrates open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM> and the braid at the distal end <NUM> of the central portion <NUM> to more securely couple the central and distal portions <NUM>, <NUM> together.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, one difference being that the intra-device junction <NUM> does not include a stretch-resisting member. The adhesive drop <NUM> penetrates open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM> and the braid at the distal end <NUM> of the central portion <NUM>. The adhesive drop <NUM> binds together the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the intra-device junction <NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, with one difference being that the distal end <NUM> of the central portion <NUM> is necked down less than the one in <FIG>. Instead of necking down the distal end <NUM> so that it fits inside of the open proximal end <NUM> of distal portion <NUM>, the distal end <NUM> of the central portion <NUM> is necked down so that its diameter is slightly larger than the diameter of the proximal end <NUM> of the distal portion <NUM>. Also, instead of the distal end <NUM> of the central portion <NUM> being disposed in the proximal end <NUM> of the distal portion <NUM>, the proximal end <NUM> of the distal portion <NUM> is disposed in the distal end <NUM> of the central portion <NUM>. Further, the intra-device junction <NUM> does not include a stretch-resisting member. The adhesive drop <NUM> penetrates the braid at the distal end <NUM> of the central portion <NUM> and open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM>. The adhesive drop <NUM> binds together the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the intra-device junction <NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that, in addition to the necked down distal end <NUM> of the central portion <NUM>, the proximal end <NUM> of the distal portion <NUM> is also necked down. The distal end <NUM> of the central portion <NUM> and the proximal end <NUM> of the distal portion <NUM> are necked down such that the diameter of the distal end <NUM> of the central portion <NUM> is slightly larger than the diameter of the proximal end <NUM> of the distal portion <NUM>. This allows the proximal end <NUM> of the distal portion <NUM> to be disposed in the distal end <NUM> of the central portion <NUM>. Therefore, when the vaso-occlusive device <NUM> is pushed distally during delivery, the distal end <NUM> of the central portion <NUM> pushes against the proximal end <NUM> of the distal portion <NUM>, transmitting force distally. Further, the intra-device junction <NUM> does not include a stretch-resisting member. The adhesive drop <NUM> penetrates the braid at the distal end <NUM> of the central portion <NUM> and open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM>. The adhesive drop <NUM> binds together the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the intra-device junction <NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>. One difference is that, instead of binds together the distal end <NUM> of the central portion <NUM> and the proximal end <NUM> of the distal portion <NUM> with an adhesive drop, the central and distal portions <NUM>, <NUM> are welded (e.g., laser welded) together. As shown in <FIG>, a weld <NUM> couples the distal end <NUM> of the central portion <NUM> and the proximal end <NUM> of the distal portion <NUM>. The weld <NUM> strengthen the intra-device junction <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the intra-device junction <NUM> does not include a stretch-resisting member. The adhesive drop <NUM> penetrates open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM> and the braid at the distal end <NUM> of the central portion <NUM>. The adhesive drop <NUM> binds together the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the intra-device junction <NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, one difference being that the stretch-resisting member <NUM> ends immediately proximal of the intra-device junction <NUM> in an enlargement <NUM> instead of extending all the way to the major junction <NUM>. The stretch-resisting member <NUM> extends from proximal of the intra-device junction <NUM> to the atraumatic distal tip <NUM>, and reduces elongation of the distal portion <NUM> of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery. The stretch-resisting member <NUM> couples the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. The intra-device junction <NUM> also includes an adhesive drop <NUM>, which binds together: (<NUM>) the necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; (<NUM>) the stretch-resisting member <NUM> passing through the distal end <NUM>; and (<NUM>) the enlargement <NUM>.

<FIG> generally depicts three intra-device junctions <NUM> coupling respective central and distal portions <NUM>, <NUM> of a vaso-occlusive device <NUM> according to one embodiment. The intra-device junctions <NUM> depicted in <FIG> are similar or identical to the one depicted in <FIG>. An enlargement <NUM> formed at the proximal end of the stretch-resisting member <NUM> is visible in each of the three intra-device junctions <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>. One difference is that the adhesive drop <NUM> only impregnates the necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, instead of the entire intra-device junction <NUM>. The stretch-resisting member <NUM> ends immediately proximal of the intra-device junction <NUM> in a loop <NUM>, which encircles portions of the braid forming the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby anchoring the proximal end of the stretch-resisting member <NUM>. The stretch-resisting member <NUM> extends from proximal of the intra-device junction <NUM> to the atraumatic distal tip <NUM>, and reduces elongation of the distal portion <NUM> of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery. The stretch-resisting member <NUM> couples the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. The adhesive drop <NUM> binds together: (<NUM>) the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; (<NUM>) the stretch-resisting member <NUM>; and (<NUM>) the loop <NUM>.

The intra-device junction <NUM> depicted in <FIG> is almost identical to the one depicted in <FIG>, one difference being that the adhesive drop <NUM> only impregnates the necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, instead of the entire intra-device junction <NUM>. The loop <NUM> (at the proximal end of the stretch-resisting member <NUM>) encircles portions of the braid forming the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby anchoring the proximal end of the stretch-resisting member <NUM>. The stretch-resisting member <NUM> extends from proximal of the intra-device junction <NUM> to the atraumatic distal tip <NUM>, and reduces elongation of the distal portion <NUM> of the vaso-occlusive device <NUM> as it is withdrawn proximally during delivery. The stretch-resisting member <NUM> couples the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. The adhesive drop <NUM> binds together: (<NUM>) the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; and (<NUM>) the stretch-resisting member <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, one difference being that the intra-device junction <NUM> does not include a stretch-resisting member. Another difference is that the intra-device junction <NUM> also includes a "U" shaped locking pin <NUM>. The locking pin <NUM> passes radially through both (<NUM>) the proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM> and (<NUM>) the necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>, thereby coupling the central and distal portions <NUM>, <NUM>. The locking pin <NUM> passes through both sides of the central and distal portions <NUM>, <NUM> to reinforce the coupling. The intra-device junction <NUM> also includes an adhesive drop <NUM>, which binds together: (<NUM>) the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; (<NUM>) the proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>; and (<NUM>) the locking pin <NUM>, thereby forming the intra-device junction <NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that, instead of an adhesive drop, the intra-device junction <NUM> depicted in <FIG> includes a marker band <NUM> surrounding the necked down distal end <NUM> of the central portion <NUM> and the necked down proximal end <NUM> of the distal portion <NUM>. A portion of the marker band <NUM> is laser welded to melt (<NUM>) the portion of the mark band <NUM>; (<NUM>) a portion of the distal end <NUM> of the central portion <NUM>; and (<NUM>) a portion of the proximal end <NUM> of the distal portion <NUM>. When these portions cool and solidify, they are coupled together. Further, the distal end <NUM> of the central portion <NUM> and the proximal end <NUM> of the distal portion <NUM> are necked down such that the diameter of the distal end <NUM> of the central portion <NUM> is slightly larger than the diameter of the proximal end <NUM> of the distal portion <NUM>. This allows the proximal end <NUM> of the distal portion <NUM> to be disposed in the distal end <NUM> of the central portion <NUM>, so that when the vaso-occlusive device <NUM> is pushed distally during delivery, the distal end <NUM> of the central portion <NUM> pushes against the proximal end <NUM> of the distal portion <NUM>, transmitting force distally.

<FIG> generally depicts a marker band <NUM> disposed around a braided vaso-occlusive device <NUM>, demonstrating that a marker band <NUM> may be coupled to a braided vaso-occlusive device <NUM> using laser welding in a manner similar to the laser welded coupling depicted in <FIG> shows a weld spot <NUM> on the marker band <NUM>, formed by a <NUM> burst of a fiber laser at <NUM>% power. The braided vaso-occlusive device <NUM> is formed from <NUM> NiTi filaments, with a <NUM> picks/in. The outer diameter of the braided vaso-occlusive device <NUM> is <NUM> microns (<NUM> in. The marker band <NUM> is made from metal with an inner diameter of <NUM> microns (<NUM> in. ), an outer diameter of <NUM> microns (<NUM> in. ), and a length of <NUM> microns (<NUM> in.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, one difference being that the inner braid <NUM> in the intra-device junction <NUM> does not extend the length of the vaso-occlusive device <NUM>, as does the inner braid <NUM> in <FIG>. Another difference is that the distal end <NUM> of the central portion <NUM> is necked down less than the one in <FIG>. Instead of necking down the distal end <NUM> so that it fits inside of the open proximal end <NUM> of the distal portion <NUM>, the distal end <NUM> of the central portion <NUM> is necked down so that its diameter is substantially the same as the diameter of the proximal end <NUM> of the distal portion <NUM>. The inner braid <NUM> underlies both the distal end <NUM> of the central portion <NUM> and the proximal end <NUM> of the distal portion <NUM>. The intra-device junction <NUM> also includes an adhesive drop <NUM>, which permeates the braided distal end <NUM> of central portion <NUM> of the vaso-occlusive device <NUM> and open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM>. The adhesive drop <NUM> binds together: (<NUM>) the distal end <NUM> of the central portion <NUM>; (<NUM>) the proximal end <NUM> of the coiled distal portion <NUM>; and (<NUM>) the inner braid <NUM>, thereby forming the intra-device junction <NUM>. The inner braid <NUM> enhances pushability, reduces kinking of the central portion <NUM> (particularly at the intra-device junction <NUM>), and protects and strengthens the intra-device junction <NUM>.

The intra-device junction <NUM> depicted in <FIG> is almost identical to the one depicted in <FIG>, except that the inner braid <NUM> depicted in <FIG> has been replaced with an inner coil <NUM> in <FIG>. The amount of necking down of the distal end <NUM> of the central portion <NUM> and the adhesive drop <NUM> are substantially identical between the intra-device junctions <NUM> depicted in <FIG>. The inner coil <NUM> enhances pushability, reduces kinking of the central portion <NUM> (particularly at the intra-device junction <NUM>), and protects and strengthens the intra-device junction <NUM>.

The intra-device junction <NUM> depicted in <FIG> is almost identical to the one depicted in <FIG>, except that the inner braid <NUM> in the intra-device junction <NUM> does not extend the length of the vaso-occlusive device <NUM>, as does the inner braid <NUM> in <FIG>. The inner braid <NUM> enhances pushability, reduces kinking of the central portion <NUM> (particularly at the intra-device junction <NUM>), and protects and strengthens the intra-device junction <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the DFT braid <NUM> depicted in <FIG> is replaced with a wire <NUM> and a stretch-resisting member <NUM>. Another difference is that the intra-device junction <NUM> also includes proximal and distal adhesive drops <NUM>-<NUM>, <NUM>-<NUM>. The wire <NUM> has a proximal hook <NUM> and a distal hook <NUM>. The proximal hook <NUM> is coupled to the necked down distal end <NUM> of the central portion <NUM> by the proximal adhesive drop <NUM>-<NUM>. The distal hook <NUM> passes through a loop <NUM> formed at a proximal end of the stretch-resisting member <NUM>, thereby coupling the wire <NUM> to the distal portion <NUM> of the vaso-occlusive device <NUM>. The distal adhesive drop <NUM>-<NUM> penetrates open pitch windings <NUM> at the proximal end <NUM> of the coiled distal portion <NUM>, and binds together: (<NUM>) the distal end of the wire <NUM> (including the distal hook <NUM>); (<NUM>) the proximal end of the stretch-resisting member <NUM>; and (<NUM>) the proximal end <NUM> of the distal portion <NUM>. The proximal adhesive drop <NUM>-<NUM> penetrates the necked down distal end <NUM> of the braided central portion <NUM>, and binds together the proximal end of the wire <NUM> (including the proximal hook <NUM>) and the necked down distal end <NUM> of the central portion <NUM>. The portion of the wire <NUM> between the proximal and distal adhesive drops <NUM>-<NUM>, <NUM>-<NUM> form an articulation portion <NUM> configured to facilitate bending of the vaso-occlusive device <NUM>.

The intra-device junction <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, one difference being that the inner braid <NUM> depicted in <FIG> is replaced with a solid support <NUM> (e.g., a Pt rod) in <FIG>. Another difference is that the adhesive drop <NUM> depicted in <FIG> is replaced with a crimped marker band <NUM> in <FIG>. Assembling the intra-device junction <NUM> depicted in <FIG> can begin by inserting the solid support <NUM> half way into the open proximal end <NUM> of a coiled distal portion <NUM>. Then a distal end <NUM> of the braided central portion <NUM> can be placed over the exposed half of the solid support <NUM>. Next, the marker band <NUM> can be placed over portions of the central and distal portions <NUM>, <NUM> overlying the solid support <NUM>. Finally, the marker band <NUM> is crimped to mechanically bond the marker band <NUM>, portions of the central and distal portions <NUM>, <NUM>, and the solid support <NUM> to form the intra-device junction <NUM>. The solid support <NUM> and the marker band <NUM> enhance pushability, reduce kinking of the central portion <NUM> (particularly at the intra-device junction <NUM>), and protect and strengthen the intra-device junction <NUM>.

<FIG> depict methods of forming an intra-device junction <NUM>, according to two embodiments. <FIG> depicts a mandrel <NUM> inserted into the open proximal end <NUM> of a coiled distal portion <NUM>. Next the windings <NUM> at the proximal end <NUM> of the distal portion <NUM> are swaged against the mandrel <NUM> from a circular cross-section to an elliptical cross-section, while retaining the same outer coil diameter, as shown in <FIG>. Next, a necked down distal end <NUM> of the central portion <NUM> is inserted into the swaged proximal end <NUM> of the distal portion <NUM>. The elliptical cross-section of the windings <NUM> results in a larger contact area between the central and distal portions <NUM>, <NUM>. Finally, the overlapping central and distal portions <NUM>, <NUM> are coupled with an adhesive drop <NUM>, as shown in <FIG>.

In an alternative embodiment, the distal end <NUM> of the central portion <NUM> is necked down such that its diameter is slightly larger than the diameter of the swaged proximal end <NUM> of the distal portion <NUM>. After swaging, the swaged proximal end <NUM> of the distal portion <NUM> is inserted into the necked down distal end <NUM> of the central portion <NUM>. The elliptical cross-section of the windings <NUM> results in a larger contact area between the central and distal portions <NUM>, <NUM>. Then, the overlapping central and distal portions <NUM>, <NUM> are coupled with a laser weld <NUM>, as shown in <FIG>.

<FIG> and <FIG> generally depict intra-device junctions <NUM> coupling central and distal portions <NUM>, <NUM> of a vaso-occlusive device <NUM> according to various embodiments. The intra-device junctions <NUM> depicted in <FIG> and <FIG> can be similar or identical to the ones depicted in <FIG>, <FIG>, <FIG>, <FIG>, <FIG> and <FIG>, because the adhesive drops <NUM> obscures the details of the respective intra-device junctions <NUM>.

The vaso-occlusive treatment system <NUM> depicted in <FIG> is similar to the one depicted in <FIG>, except that the proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM> include respective proximal and distal inner coils <NUM>-<NUM>, <NUM>-<NUM>. The structure and function of the proximal and distal inner coils <NUM>-<NUM>, <NUM>-<NUM> are similar to the inner coil depicted in <FIG> and described above. However, because the vaso-occlusive device <NUM> depicted in <FIG> include a stretch-resisting member <NUM> that runs the length of the vaso-occlusive device <NUM>, the proximal and distal inner coils <NUM>-<NUM>, <NUM>-<NUM> perform the additional function of centering the stretch-resisting member <NUM> and providing a smooth transition for same. The proximal and distal inner coils <NUM>-<NUM>, <NUM>-<NUM> also enhance pushability, reduce kinking of the central portion <NUM> (particularly at the proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM>), and protect and strengthen the proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM>.

The vaso-occlusive treatment system <NUM> partially depicted in <FIG> is similar to the one depicted in <FIG>. One difference is that the proximal intra-device junction <NUM>-<NUM> depicted in <FIG> does not include a proximal inner coil <NUM>-<NUM>. Instead the distal end <NUM> of the coiled proximal portion <NUM> is necked down to fit inside of the open proximal end <NUM> of the central portion <NUM>. Further, the stretch-resisting member <NUM> does not extend distally past the proximal intra-device junction <NUM>-<NUM>. The stretch-resisting member <NUM> has a proximal loop <NUM>, which passes through the proximal aperture <NUM> in the link <NUM>, coupling the stretch-resisting member <NUM> to the link <NUM>, like in the system <NUM> depicted in <FIG>. Unlike the system <NUM> depicted in <FIG>, the distal end of the stretch-resisting member <NUM> forms two distal hooks <NUM> disposed just distal of the distal end <NUM> of the coiled proximal portion <NUM>. The distal hooks <NUM> are prevented from moving proximally by mechanical interference from the necked down distal end <NUM> of the coiled proximal portion <NUM>, thereby anchoring the distal end of the stretch-resisting member <NUM>. The stretch-resisting member <NUM> is made from DFT or NiTi wire to facilitate formation of distal hooks <NUM> with sufficient strength to anchor the distal end of the stretch-resisting member <NUM>.

The proximal intra-device junction <NUM>-<NUM> also includes a marker band <NUM>, which is crimped down over the proximal end <NUM> of the central portion <NUM>, the distal end <NUM> of the coiled proximal portion <NUM>, and stretch-resisting member <NUM>, thereby forming the proximal intra-device junction <NUM>-<NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The vaso-occlusive treatment system <NUM> partially depicted in <FIG> is almost identical to the one depicted in <FIG>, one difference being that the major junction <NUM> depicted in <FIG> does not include a link. Instead, the major junction <NUM> includes a hook <NUM> formed at the distal end of the delivery assembly <NUM>, which pass through a loop <NUM> formed at the proximal end of the stretch-resisting member <NUM>, thereby mechanically coupling the delivery assembly <NUM> and the stretch-resisting member <NUM>. <FIG> depicts the system <NUM> rotated approximately <NUM> degrees from the orientation as the system <NUM> depicted in <FIG>, such that view is orthogonal to the plane of hook <NUM>, which appears as a line in <FIG>.

While not shown in <FIG>, the distal end of the vaso-occlusive device <NUM> may include a coiled distal portion, with a distal intra-device junction having a distal stretch-resisting member anchored similarly to the stretch-resisting member <NUM> depicted in <FIG>.

The vaso-occlusive treatment system <NUM> partially depicted in <FIG> is similar to the one depicted in <FIG>, except that the proximal intra-device junction <NUM>-<NUM> depicted in <FIG> does not include a proximal inner coil <NUM>-<NUM>. Another difference is that the stretch-resisting member <NUM> does not extend distally past the proximal intra-device junction <NUM>-<NUM>. Instead, the stretch-resisting member <NUM> has a proximal loop <NUM>, which passes through the proximal aperture <NUM> in the link <NUM>, coupling the stretch-resisting member <NUM> to the link <NUM>, like in the system <NUM> depicted in <FIG>. Unlike the system <NUM> depicted in <FIG>, the distal end of the stretch-resisting member <NUM> forms two distal hooks <NUM> disposed just distal of the distal end <NUM> of the distal end of the necked down proximal end <NUM> of the central portion <NUM>. The distal hooks <NUM> are prevented from moving proximally by mechanical interference from the necked down proximal end <NUM> of the central portion <NUM>, thereby anchoring the distal end of the stretch-resisting member <NUM>. The stretch-resisting member <NUM> is made from DFT or NiTi wire to facilitate formation of distal hooks <NUM> with sufficient strength to anchor the distal end of the stretch-resisting member <NUM>.

The proximal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which binds together: (<NUM>) the distal end <NUM> of the coiled proximal portion <NUM>; (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; (<NUM>) the distal portion of the stretch-resisting member <NUM>; and (<NUM>) the hooks <NUM>, thereby forming the proximal intra-device junction <NUM>-<NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>.

The vaso-occlusive treatment system <NUM> partially depicted in <FIG> is similar to the one partially depicted in <FIG>, except that the proximal intra-device junction <NUM>-<NUM> also includes a weld <NUM> (e.g. formed by a laser), which further secures the necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> together. Further, the stretch-resisting member <NUM> does not extend distally past the proximal intra-device junction <NUM>-<NUM>. The stretch-resisting member <NUM> has a proximal loop <NUM>, which passes through the hook <NUM> formed at the distal end of the delivery assembly <NUM>, coupling the stretch-resisting member <NUM> to the delivery assembly <NUM>, like in the system <NUM> depicted in <FIG>. Unlike the system <NUM> depicted in <FIG>, the distal end of the stretch-resisting member <NUM> forms a distal loop <NUM> (instead of a hook) disposed around the necked down and welded proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The distal loop <NUM> is prevented from moving proximally by mechanical interference from the necked down and welded proximal end <NUM> of the central portion <NUM>, thereby anchoring the distal end of the stretch-resisting member <NUM>. The stretch-resisting member <NUM> is made from DFT or NiTi wire to facilitate formation of the distal loop <NUM> with sufficient strength to anchor the distal end of the stretch-resisting member <NUM>.

The proximal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which binds together: (<NUM>) the distal end <NUM> of the coiled proximal portion <NUM>; (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; (<NUM>) the distal portion of the stretch-resisting member <NUM>; and (<NUM>) the distal loop <NUM>, thereby forming the proximal intra-device junction <NUM>-<NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. While not shown in <FIG>, the distal end of the vaso-occlusive device <NUM> may include a coiled distal portion, with a distal intra-device junction having a distal stretch-resisting member anchored similarly to the stretch-resisting member <NUM> depicted in <FIG>.

The vaso-occlusive treatment system <NUM> partially depicted in <FIG> is similar to the one partially depicted in <FIG>, one difference being that the stretch-resisting member <NUM> depicted in <FIG> is made from an elongate member <NUM>, the other end of which is braided with other braid wires to form the central portion <NUM> of the vaso-occlusive device <NUM>. The other braid wires are trimmed at or adjacent to the proximal intra-device junction <NUM>-<NUM> to leave the elongate member <NUM> to act as a stretch-resisting member <NUM>. The stretch-resisting member <NUM> has a proximal loop <NUM>, which passes through the hook <NUM> formed at the distal end of the delivery assembly <NUM>, coupling the stretch-resisting member <NUM> to the delivery assembly <NUM>, like in the system <NUM> depicted in <FIG>. In the system <NUM> depicted in <FIG>, the proximal loop <NUM> is welded to the hook <NUM> to further secure these two components of the major junction <NUM>.

The proximal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which binds together: (<NUM>) the distal end <NUM> of the coiled proximal portion <NUM>; (<NUM>) the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>; and (<NUM>) the distal portion of the stretch-resisting member <NUM> / the elongate member <NUM>, thereby forming the proximal intra-device junction <NUM>-<NUM> and coupling the central and distal portions <NUM>, <NUM> of the vaso-occlusive device <NUM>. While not shown in <FIG>, the distal end of the vaso-occlusive device <NUM> may include a coiled distal portion, with a distal intra-device junction having a distal stretch-resisting member anchored similarly to the stretch-resisting member <NUM> depicted in <FIG>.

While not shown in <FIG>, the distal ends of the respective vaso-occlusive devices <NUM> may include coiled distal portions, with distal intra-device junctions having distal stretch-resisting members anchored similarly to the stretch-resisting member <NUM> depicted in any of <FIG>.

The adhesive drops <NUM>, <NUM> described herein can be shaped by placing a polymer (e.g., PET) tube over the adhesive drop <NUM>, <NUM> and a portion of a vaso-occlusive treatment system <NUM> on a mandrel before the adhesive is set. Then the tube is heat shrunk to shape the adhesive drop <NUM>, <NUM>. While adhesive drops <NUM>, <NUM> are used in various embodiments described herein, other substances and techniques can be used to join respective parts. For instance, laser welding and soldering may be used to join parts of the vaso-occlusive treatment systems <NUM> described herein.

<FIG> and <FIG> depict a vaso-occlusive treatment system <NUM> constructed according to yet another disclosed embodiment. The system <NUM> includes a vaso-occlusive device <NUM> having a central portion <NUM> configured to be coupled to proximal and distal portions <NUM>, <NUM> (seen in <FIG>) by respective proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM>. The central portion <NUM> is braided from DFT (i.e., composite) wires as described above, and has a substantially constant width (i.e., cross-sectional dimension). The proximal and distal intra-device junctions <NUM>-<NUM>, <NUM>-<NUM> are mirror images of each other. The proximal intra-device junction <NUM>-<NUM> includes an open distal end <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM> and a necked down proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM>. The proximal end <NUM> of the central portion <NUM> is necked down so that it fits inside of the open distal end <NUM> of the proximal portion <NUM>. The proximal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which permeates the coiled open distal end <NUM> of proximal portion <NUM> of the vaso-occlusive device <NUM>. The adhesive <NUM> binds together the proximal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open distal end <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the proximal intra-device junction <NUM>-<NUM>. Further, the adhesive drop <NUM> also binds portions of the stretch-resisting member <NUM> extending into the proximal intra-device junction <NUM>-<NUM>.

The stretch-resisting member <NUM> of the proximal portion <NUM> of the vaso-occlusive device <NUM> includes at least two members <NUM>-<NUM> and <NUM>-<NUM>, each member formed from one or more wires extending from the proximal end <NUM> of the vaso-occlusive device <NUM>. By way of non-limited example, the braided DFT wires at the proximal end <NUM> of the vaso-occlusive device <NUM> are trimmed to thereby form the stretch-resisting member <NUM> (i.e., members <NUM>-<NUM> and <NUM>-<NUM>). The at least two members <NUM>-<NUM> and <NUM>-<NUM> have respective proximal ends <NUM>-1a, <NUM>-2a, and distal ends <NUM>-1b, <NUM>-2b. A hook <NUM> is formed at each of the proximal ends <NUM>-1a and <NUM>-2a of the respective stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM>. The hooks <NUM> are configured to be coupled to the link/adapter <NUM> of the major junction <NUM>, shown in <FIG>. The distal ends <NUM>-1b and <NUM>-2b of the respective stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM> are coupled to the proximal intra-device junction <NUM>-<NUM>.

The distal intra-device junction <NUM>-<NUM> includes a necked down distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and an open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>. The distal end <NUM> of the central portion <NUM> is necked down so that it fits inside of the open proximal end <NUM> of the distal portion <NUM>. The distal intra-device junction <NUM>-<NUM> also includes an adhesive drop <NUM>, which permeates the coiled open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>. The adhesive <NUM> binds together the distal end <NUM> of the central portion <NUM> of the vaso-occlusive device <NUM> and the open proximal end <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM>, thereby forming the distal intra-device junction <NUM>-<NUM>. Further, the adhesive drop <NUM> also binds the portion of the stretch-resisting member <NUM> extending into the distal intra-device junction <NUM>-<NUM>.

The stretch-resisting member <NUM> of the distal portion <NUM> of the vaso-occlusive device <NUM> includes at least two members <NUM>-<NUM> and <NUM>-<NUM>, each member formed from one or more wires extending from the distal end <NUM> of the braided vaso-occlusive device <NUM>. For example, the braided DFT wires at the distal end <NUM> of the vaso-occlusive device <NUM> may be trimmed to thereby form the stretch-resisting member <NUM> (i.e., members <NUM>-<NUM> and <NUM>-<NUM>). The two members <NUM>-<NUM> and <NUM>-<NUM> have respective proximal ends <NUM>-3a, <NUM>-4a, and distal ends <NUM>-3b, <NUM>-4b. Each of the proximal ends <NUM>-3a and <NUM>-4a of the respective stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM> are coupled to the distal intra-device junction <NUM>-<NUM>. The distal ends <NUM>-3b and <NUM>-4b of the respective stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM> are jointly coupled forming a distal end joint <NUM>. The joint <NUM> is formed by twisting the respective distal ends <NUM>-3b and <NUM>-4b together. The joint <NUM> may be formed by any other suitable coupling techniques, such as adhesive, bonding, welds, or the like. The joint <NUM> is configured to be coupled to the atraumatic distal tip <NUM>, shown in <FIG>.

As seen in <FIG>, the vaso-occlusive treatment system <NUM> includes a vaso-occlusive device <NUM> coupled to a delivery assembly <NUM> by a major junction <NUM>. The delivery assembly <NUM> includes an electrolytically degradable segment <NUM> at a distal end thereof. The central portion <NUM> of the vaso-occlusive device <NUM> is braided from DFT wires as described above. The proximal and distal portions <NUM>, <NUM> are coils wound from one or more DFT wires as described above.

The vaso-occlusive treatment system <NUM> depicted in <FIG> is similar to the system depicted in <FIG> and to the system partially depicted in <FIG>. One difference with <FIG> is that system depicted in <FIG> includes at least two sets of stretch-resisting members <NUM>, each set is composed by one or more wires of the respective proximal end <NUM> and distal end <NUM> of the braided vaso-occlusive device <NUM>. The first set of stretch-resisting members <NUM>, including members <NUM>-<NUM> and <NUM>-<NUM>, extend from the proximal end <NUM> of vaso-occlusive device <NUM> and the proximal intra-device junction <NUM>-<NUM> into the link/adapter <NUM> of the major junction <NUM>. The second set of stretch-resisting members <NUM>, including members <NUM>-<NUM> and <NUM>-<NUM>, extend from the distal end <NUM> of the vaso-occlusive device <NUM> and intra-device junction <NUM>-<NUM> into the atraumatic distal tip <NUM>. One difference with <FIG> is that the first set of stretch-resisting members depicted in <FIG> includes two members <NUM>-<NUM> and <NUM>-<NUM>, each having distal end hooks <NUM>.

As shown in <FIG>, the major junction <NUM> includes a link/adapter <NUM> coupled to both the distal end of the delivery assembly <NUM> and the open proximal end <NUM> of the proximal portion <NUM>, thereby coupling the delivery assembly <NUM> and the proximal portion <NUM>. The link <NUM> also includes a distal aperture <NUM>. The hooks <NUM> at each of the proximal ends <NUM>-1a and <NUM>-2a of the respective stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM> pass through the distal aperture <NUM> of the link <NUM>, coupling the delivery assembly <NUM> and link <NUM> (and the proximal portion <NUM> coupled thereto).

The distal portion <NUM> of the system <NUM> of <FIG> has the atraumatic distal tip <NUM>, which may be formed from a suitable amount of adhesive. The stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM> extending from the distal intra-device junction <NUM>-<NUM> extend distally into the atraumatic distal tip <NUM>. The distal ends <NUM>-3b and <NUM>-4b of the respective stretch-resisting members <NUM>-<NUM> and <NUM>-<NUM> are jointly coupled forming a distal end joint <NUM>. The joint <NUM> is coupled to and/or disposed within the atraumatic distal tip <NUM>.

<FIG> depicts is a cross-section view of an elongate member from which the vaso-occlusive treatment system <NUM>, the vaso-occlusive device <NUM>, or portions thereof, may be formed. The elongate member <NUM> (e.g., "wire") comprises a core <NUM> composed of radiopaque materials, an intermediate layer <NUM> composed of superelastic materials, and an outer layer <NUM> composed of materials configured to provide oxidation protection. In the embodiment of <FIG>, the wire <NUM> includes a substantially pure Platinum ("Pt") core <NUM> at least partially surrounded by a substantially pure Nitinol ("NiTi") intermediate layer <NUM>; the intermediate layer <NUM> is at least partially surrounded by a substantially pure Titanium ("Ti") thin outer layer <NUM>. As used in this application, the "thin" outer layer includes but is not limited to a range between about <NUM> to <NUM> micrometers. The Ti outer layer <NUM> is configured to avoid impacting or minimally impact on the flexibility and/or stiffness of the wire <NUM> and elements formed with wires <NUM> (e.g., braid). It should be appreciated that the thin outer layer <NUM> may be composed of other biocompatible materials with suitable density to provide an oxidation protection to the wire <NUM>.

Variations on the thickness of the intermediate layer <NUM> and/or the outer layer <NUM>, and/or variations on the diameter of the core <NUM>, may be contemplated to optimize the desired features of the wire <NUM> (e.g., flexibility, stiffness, radio-opacity, or the like). The wire <NUM> may be manufactured by coextrusion techniques or other suitable manufacturing techniques. For example, the Ti outer layer <NUM> can be applied on DFT wires as described above (Niti-DFT-<NUM>/5OPt) by plating, coating or Physical Vapor Deposition ("PVD").

Braids woven from wires <NUM> are suitable for vaso-occlusive applications. During heat set processing of braids formed with wires <NUM>, the Ti outer layer <NUM> will oxidize to form Ni-free protection layer for the underlying intermediate NiTi layer <NUM>. The use of wires <NUM> to form a braid is configured to eliminate the step of removing surface oxide by etching/EP and passivating processes, and/or eliminate Ni leaching issue in use. Further, the braid formed with wires <NUM> can be heat set in air environment.

Claim 1:
A vaso-occlusive treatment system (<NUM>), comprising:
a delivery assembly (<NUM>); and
a vaso-occlusive device (<NUM>) detachably coupled to the delivery assembly (<NUM>) by a severable junction (<NUM>), the vaso-occlusive device (<NUM>) comprising
a proximal coil (<NUM>) having an inner axial lumen and a proximal end portion (<NUM>) coupled to the severable junction (<NUM>), and
a braid (<NUM>) having a proximal end portion coupled to a distal end portion (<NUM>) of the proximal coil (<NUM>) by a first intra-device junction (<NUM>-<NUM>), the braid comprising a plurality of elongate braid members, wherein at least one (<NUM>) of the braid members extends proximally from the braid through the axial lumen of proximal coil (<NUM>) and is secured to the proximal end portion (<NUM>) of the proximal coil (<NUM>), respectively, to thereby form proximal coil stretch-resisting member (<NUM>).