Systems and methods for enclosing an anatomical opening
Implantable therapeutic devices and methods for endovascular placement of devices at a target site, such an opening at a neck of an aneurysm, are disclosed. Selected embodiments of the present technology have closures ( 102 ) that at least partially occlude the neck of an aneurysm to stabilize embolic or coagulative treatment of the aneurysm. In one embodiment, for example, an aneurysm closure device comprises a closure structure ( 102 ) and a supplemental stabilizer ( 103 ). The closure structure can have a curved portion configured to extend along a first vessel, such as a side branch of a bifurcated vessel that extends along a lateral axis (T). The supplemental stabilizer extends from the closure structure along a longitudinal axis (L) transverse to the lateral axis of the first vessel. The supplemental stabilizer is configured to exert an outward force against a second vessel, such as a parent vessel, that extends transversely to the first vessel.
1. An aneurysm device endovascularly deliverable to a site proximate an aneurysm near a terminus of a parent artery with bifurcating downstream arteries, the aneurysm device comprising:
an arched closure structure comprising a distal-facing aspect configured to at least partially occlude the aneurysm and a proximal-facing aspect configured to arch over lumina of the downstream arteries, wherein the arched closure structure is configured to span unobtrusively over the lumina and forms no incursion into the vascular flow path; and
a supplemental stabilizer connected to the closure structure, the supplemental stabilizer configured to reside in the parent artery and press outward against a luminal wall thereof, and wherein the supplemental stabilizer has a proximal framework portion,
wherein the arched closure structure comprises a distal framework portion having a lateral axis orthogonal to a longitudinal axis of the supplemental stabilizer, and wherein the distal framework portion comprises two opposing lateral faces, wherein the distal framework portion is arched over the lumina of the downstream arteries about the lateral axis, and wherein the proximal framework portion and the two opposing lateral faces of the distal framework portion are biased away from the lateral axis to press outward against a luminal wall of the parent artery.
2. The aneurysm device of claim 1 wherein the distal-facing aspect of the distal framework portion forms a complex curved surface.
3. The aneurysm device of claim 2 wherein the complex curved surface comprises two opposing apices aligned longitudinally with respect to the downstream arteries, and extending thereinto.
4. The aneurysm device of claim 1 wherein a ratio of a surface area of the closure structure that is configured to align against an area of combined parent artery luminal wall and downstream artery luminal wall is less than about 5% of a total area within an area defined by an outer boundary of the aneurysm device.
5. The aneurysm device of claim 1 wherein a ratio of a proximal support framework surface area that is configured to be aligned against an area of parent artery luminal wall is less than about 1% of a total area within an area defined by the outer boundaries of the proximal framework contact against the wall.
6. The aneurysm device of claim 1 wherein the distal framework portion, if laid out in a planar form, comprises a quadrilateral form having two sets of paired opposing apices.
7. The aneurysm device of claim 1 wherein the device is axially compressible, at least in part, by a distal-ward foldability of the closure structure such that, in an axially-compressed configuration, at least a portion of the distal framework is folded distally inward toward the longitudinal axis and at least a portion of the distal-facing aspect faces the longitudinal axis.
8. The aneurysm device of claim 1 wherein the distal framework portion comprises at least one laterally elongated portion such that, when the device is deployed, the distal framework portion aligns lengthwise with a longitudinal axis of the downstream arteries.
9. The aneurysm device of claim 8 wherein the laterally elongated portion is sized and configured to at least one of (a) extend into a lumen of a downstream artery, beyond a circumferential boundary of the luminal wall of the parent artery or (b) contact a distal surface of a lumen of one of more of the downstream arteries without contacting a proximal surface of the lumen.
10. The aneurysm device of claim 1 wherein the distal framework portion comprises either (a) two laterally elongated portions of asymmetric length or (b) two laterally elongated portions of symmetric length.
11. The aneurysm device of claim 1 further comprising a barrier supported by at least the distal-facing aspect of the distal framework portion.
12. The aneurysm device of claim 11 wherein the distal-facing aspect of the distal framework portion comprises struts that form a polygonal face with a peripheral boundary, and wherein the barrier is a membrane that covers the face substantially to the peripheral boundary.
13. The aneurysm device of claim 11 wherein the distal-facing aspect of the distal framework portion comprises struts that form an inner support within a peripheral support, and wherein the barrier is a membrane that covers either (a) only the inner support or (b) only a space between the internal and the peripheral supports.
14. The device of claim 11 wherein the distal framework portion comprises two proximally deflected apices, and wherein the barrier is a membrane that forms a proximal-facing wedge that extends along an axis connecting the two proximally deflected apices.
15. The aneurysm device of claim 1 wherein a profile of the distal framework portion extends beyond the bounds of a cylindrical profile.
16. The aneurysm device of claim 1 wherein the aneurysm device comprises super elastic shape memory materials.
17. The aneurysm device of claim 1 wherein the aneurysm device comprises materials selected from the group comprising solid wire, tubular wire, and braided wire.
18. An implantable aneurysm device, comprising:
a closure structure comprising—
a distal-facing aspect configured to at least partially occlude an aneurysm near a terminus of a parent artery with bifurcating downstream arteries, and
a proximal-facing aspect,
wherein, when deployed, the closure structure is configured to arch unobtrusively over lumina of the downstream arteries; and
a supplemental stabilizer coupled to the closure structure, wherein the supplemental stabilizer is configured to reside in the parent artery and press outward against a luminal wall thereof, and wherein the supplemental stabilizer has a proximal framework portion,
wherein the closure structure comprises a distal framework portion having a lateral axis orthogonal to a longitudinal axis of the supplemental stabilizer,
wherein the distal framework portion comprises two opposing lateral faces, and
wherein the distal framework portion is arched over the lumina of the downstream arteries about the lateral axis, and wherein the proximal framework portion and the two opposing lateral faces of the distal framework portion are biased away from the lateral axis to press outward against a luminal wall of the parent artery.