Narrowing implant

Abstract

A reducer implant for insertion in a blood vessel, for reducing an inner diameter of said vessel and flow therethrough, having at least one narrowed section having a first diameter; and at least one flared section having a diameter substantially greater than said first diameter. Optionally, the reducer is formed of a material and has a geometry that does not cause coagulation of blood in its vicinity.

1 . A reducer for insertion in a blood vessel, comprising: 
 at least one narrowed section having a first diameter; and    at least one flared section having a diameter at least 20% greater than said first diameter,    wherein said reducer is formed of a material and has a geometry that does not cause coagulation of blood in its vicinity.    
     
     
         2 . A reducer according to  claim 1 , wherein said reducer is operative to increase a coronary artery blood pressure when inserted in a coronary vein.  
     
     
         3 . A reducer according to  claim 1 , wherein said reducer is operative to modify a coronary artery blood flow distribution when inserted in a coronary vein.  
     
     
         4 . A reducer according to  claim 1 , wherein said reducer is operative to increase a coronary sinus blood pressure when inserted in a coronary sinus.  
     
     
         5 . A reducer according to  claim 1 , wherein said reducer is operative to increase an intra-myocardial perfusion when inserted in a coronary sinus.  
     
     
         6 . A reducer according to any of claims  1 - 5 , wherein said flared section includes at least one area adapted to contact a wall of a vein.  
     
     
         7 . A reducer according to  claim 6 , wherein said area is made large enough to prevent damage to the wall.  
     
     
         8 . A reducer according to  claim 7 , wherein said area has an axial extent of at least 2 mm.  
     
     
         9 . A reducer according to  claim 7 , wherein said area has an axial extent of at least 4 mm.  
     
     
         10 . A reducer according to any of claims  1 - 9 , wherein said flared section has an outside edge.  
     
     
         11 . A reducer according to  claim 10 , wherein said outside edge lies on a single plane.  
     
     
         12 . A reducer according to  claim 10  or  claim 11 , wherein said outside edge is defined by a plurality of elongate sections that cooperate to define a maximal rim for said reducer.  
     
     
         13 . A reducer according to any of claims  10 - 12 , wherein said outside edge is smooth.  
     
     
         14 . A reducer according to any of claims  10 - 13 , wherein said outside edge is curved inwards towards an axis of said reducer.  
     
     
         15 . A reducer according to any of claims  10 - 14 , wherein said outside edge is coated with a soft material.  
     
     
         16 . A reducer according to any of claims  1 - 15 , wherein said reducer doesn't cause turbulence inside a lumen defined by said narrowed section and said flared section.  
     
     
         17 . A reducer according to any of claims  1 - 16 , wherein said narrowed section comprises a ring segment having a different surface design from flared section.  
     
     
         18 . A reducer according to any of claims  1 - 17 , wherein said narrowed section comprises a solid ring.  
     
     
         19 . A reducer according to any of claims  1 - 17 , wherein said narrowed section comprises an array of cell elements.  
     
     
         20 . A reducer according to any of claims  1 - 19 , wherein said reducer is expanded, after insertion, from an unexpanded configuration to an expanded configuration.  
     
     
         21 . A reducer according to  claim 20 , wherein said flared section is plastically deformable to provide said configuration change.  
     
     
         22 . A reducer according to  claim 20 , wherein said flared section is self-expanding to provide said configuration change.  
     
     
         23 . A reducer according to any of claims  20 - 22 , wherein said narrowed section self-expanding to provide said configuration change.  
     
     
         24 . A reducer according to any of claims  20 - 22 , wherein said narrowed section is plastically deformable to provide said configuration change.  
     
     
         25 . A reducer according to  claim 20 , wherein said narrowed section does not expand.  
     
     
         26 . A reducer according to  claim 20 , wherein said narrowed section is further expandable after said reducer is in said expanded configuration.  
     
     
         27 . A reducer according to any of claims  1 - 26 , comprising a ring mounted outside of said narrowed section, said ring defining a maximal diameter of said narrowed section.  
     
     
         28 . A reducer according to any of claims  1 - 27 , wherein said narrowed section is formed of a pliable material.  
     
     
         29 . A reducer according to any of claims  1 - 27 , wherein said reducer is formed of at least one of an elastic material, a shape-memory material and a super-elastic material.  
     
     
         30 . A reducer according to any of claims  1 - 29 , wherein different parts of said reducer have different degrees of resistance to deforming.  
     
     
         31 . A reducer according to  claim 30 , wherein said narrowed section has a greater resistance to deformation than said flared section.  
     
     
         32 . A reducer according to  claim 30 , wherein a rim area of said flared section has a greater resistance to deformation than an adjacent part of said flared section.  
     
     
         33 . A reducer according to any of claims  1 - 32 , wherein said narrowed section has an axial extent of between 1 mm and 5 mm.  
     
     
         34 . A reducer according to any of claims  1 - 33 , wherein said reducer has an axial extent of between 10 nm and 30 mm.  
     
     
         35 . A reducer according to any of claims  1 - 34 , wherein said narrowed section has a cross-sectional area of less than 70% of a maximum cross-sectional area of said flared section.  
     
     
         36 . A reducer according to any of claims  1 - 34 , wherein said narrowed section has a cross-sectional area of less than 50% of a maximum cross-sectional area of said flared section.  
     
     
         37 . A reducer according to any of claims  1 - 34 , wherein said narrowed section has a cross-sectional area of less than 40% of a maximum cross-sectional area of said flared section.  
     
     
         38 . A reducer according to any of claims  1 - 34 , wherein said narrowed section has a cross-sectional area of less than 30% of a maximum cross-sectional area of said flared section.  
     
     
         39 . A reducer according to any of claims  1 - 34 , wherein said narrowed section has a cross-sectional area of less than 20% of a maximum cross-sectional area of said flared section.  
     
     
         40 . A reducer according to any of claims  1 - 39 , wherein said flared section has an axial extent of between 4 mm and 10 mm.  
     
     
         41 . A reducer according to any of claims  1 - 40 , wherein said reducer is adapted for insertion in a human coronary sinus.  
     
     
         42 . A reducer according to any of claims  1 - 41 , wherein said reducer is adapted for insertion in a human coronary vein.  
     
     
         43 . A reducer according to  claim 41  or  claim 42 , wherein said adaptation is by size.  
     
     
         44 . A reducer according to any of claims  1 - 43 , wherein said at least one flared section comprises at least two flared sections.  
     
     
         45 . A reducer according to any of claims  1 - 44 , wherein said reducer describes an hourglass figure.  
     
     
         46 . A reducer according to any of claims  1 - 45 , wherein said flared section is dense, to reduce blood flow therethrough.  
     
     
         47 . A reducer according to any of claims  1 - 46 , wherein said flared section is coated, to reduce blood flow therethrough.  
     
     
         48 . A reducer according to any of claims  1 - 47 , wherein said reducer is formed of a soft material, to reduce contact force against an enclosing vessel wall.  
     
     
         49 . A reducer according to any of claims  1 - 48 , wherein said reducer is operative to release a slow release molecule after it is deployed.  
     
     
         50 . A reducer according to any of claims  1 - 49 , wherein said reducer has an outside surface adapted to attach to a wall of a vein.  
     
     
         51 . A reducer according to any of claims  1 - 50 , wherein said narrowed section comprises a valve.  
     
     
         52 . A reducer for insertion in a blood vessel having a diameter, comprising: 
 at least one narrowed section having a first diameter; and    at least one flared section having a diameter at least 20% greater than said first diameter,    wherein said reducer is adapted to be plastically deformed from a first configuration in which said reducer is unexpanded to a second configuration in which said reducer is expanded.    
     
     
         53 . A reducer according to  claim 52 , wherein said narrowing section has a length of at least 10% of a total axial length of said reducer.  
     
     
         54 . A reducer according to  claim 52 , wherein said narrowing section has a length of at least 20% of a total axial length of said reducer.  
     
     
         55 . A reducer for insertion in a blood vessel having a diameter, comprising: 
 at least one narrowed section having a first diameter; and    at least one flared section having a diameter greater than said first diameter,    wherein said reducer is adapted to contact a vein at said flared section.    
     
     
         56 . A reducer according to  claim 55 , wherein said adaptation comprises forming said flared section to reduce a probability of damage to said vein.  
     
     
         57 . A reducer according to  claim 55 , wherein said adaptation comprises forming said reducer of a soft material to reduce a contact force between said reducer and said vein.  
     
     
         58 . A reducer according to  claim 55 , wherein said reducer is adapted to cause coagulation in an area defined between said reducer and a wall of said vein.  
     
     
         59 . A reducer for insertion in a blood vessel having a diameter, comprising: 
 at least one narrowed section having a first diameter; and    at least one flared section having a diameter at least 20% greater than said first diameter,    wherein said flared section is resistant to blood flow across a wall of said section, such that at least 50% of blood flow through the reducer passes through a lumen defined by said flared section and said narrowed section.    
     
     
         60 . A reducer according to  claim 59 , wherein at least 80% of blood flow through the reducer passes through a lumen defined by said flared section and said narrowed section.  
     
     
         61 . A reducer according to  claim 59 , wherein at least 90% of blood flow through the reducer passes through a lumen defined by said flared section and said narrowed section.  
     
     
         62 . A reducer for insertion in a blood vessel having a diameter, comprising: 
 at least one narrowed section having a first diameter; and    at least one flared section having a diameter substantially greater than said first diameter,    wherein said flared section and said narrowed section cooperate to substantially reduce blood flow through a lumen defined by said sections, relative to flow through a cylinder having a maximal diameter of the flared section    
     
     
         63 . A blood vessel reducer delivery kit, comprising: 
 a guide catheter;    a plastically deformable reducer having an hour-glass figure when deformed and adapted to ride on said catheter; and    a balloon having an inflation profile matching said hour-glass figure.    
     
     
         64 . A method of reducer selection, comprising: 
 determining a desired hemodynamic effect in a coronary vascular system; and    selecting a reducer having a suitable geometry to achieve said desired hemodynamic effect, from a set of reducers of different geometries.    
     
     
         65 . A method according to  claim 64 , wherein said desired effect is at least one of: increase in myocardial perfusion pressure, increase in myocardial pressure, increase in myocardial perfusion duration, increase in coronary artery pressure, redistribution of blood flow in coronary arteries, increase in pressure in a coronary sinus and/or a restarting of a coronary artery autoregulation mechanism.  
     
     
         66 . A method of affecting hemodynamic parameters of a coronary system, comprising: 
 selecting a reducer for reducing a diameter of a coronary vein; and    implanting said reducer in said coronary vein.    
     
     
         67 . A method according to  claim 66 , wherein said coronary vein is a coronary sinus.  
     
     
         68 . A kit for reducing blood flow in a venous system, comprising: a plurality of vascular implants, each defining a narrowed section, said plurality of implants including at least two implants with different geometrical properties.  
     
     
         69 . A kit according to  claim 68 , wherein said two implants have different degrees of narrowing.  
     
     
         70 . A kit according to  claim 68  or  claim 69 , wherein said two implants have different outer diameters, for matching different coronary veins.