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 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 and a supplemental stabilizer. 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. The supplemental stabilizer extends from the closure structure along a longitudinal axis 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:
a 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 closure structure is configured to span unobtrusively over the lumina and forms no incursion onto the vascular flow path;
a barrier supported by at least the distal-facing aspect; 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;
wherein the closure structure further comprises a distal framework portion having a lateral axis orthogonal to the supplemental stabilizer, wherein opposing lateral faces of the distal framework portion are biased away from the lateral axis to press against the parent artery;
wherein the supplemental stabilizer has a proximal framework portion, and the lateral axis of the distal framework portion comprises a vertex from which the proximal framework portion is biased to press outward against a luminal wall of the parent artery.
2. The aneurysm device of claim 1 wherein the distal-facing aspect comprises struts that form a polygonal face with a peripheral boundary, and wherein the barrier is a membrane that covers the polygonal face substantially to the peripheral boundary.
3. The aneurysm device of claim 1 wherein the distal-facing aspect comprises struts that form an inner support within a peripheral support, and wherein the barrier is a membrane that covers only the inner support.
4. The aneurysm device of claim 1 wherein the distal-facing aspect comprises struts that form an inner support within a peripheral support, and wherein the barrier is a membrane that covers only a space between the inner and the peripheral supports.
5. The aneurysm device of claim 1 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.
6. The aneurysm device of claim 1 wherein the distal-facing aspect forms a complex curved surface.
7. The aneurysm device of claim 6 wherein the complex curved surface comprises two opposing apices aligned longitudinally with respect to the downstream arteries, and extending thereinto.
8. An aneurysm treatment device, comprising:
a closure structure comprising:
a curved portion configured to extend longitudinally along a first vessel,
a distal-facing aspect configured to at least partially occlude an aneurysm and a proximal-facing aspect configured to arch over lumina of the first vessel,
a distal framework portion having a lateral axis, wherein opposing lateral faces of the distal framework portion are biased away from the lateral axis to press against a second vessel orthogonal to the first vessel;
the curved portion defining an arch about a longitudinal axis of the first vessel, and
the curved portion being configured to exert an outward force against the first vessel and extend across at least a portion of a neck of an aneurysm at the first vessel;
a barrier attached to at least a portion of the closure structure; and
a supplemental stabilizer orthogonal to the lateral axis of the distal framework and extending from the closure structure transversely to the longitudinal axis of the first vessel, the supplemental stabilizer being configured to exert an outward force against the second vessel;
wherein the closure structure forms no incursion into the vascular flow path, the supplemental stabilizer has a proximal framework portion, and the lateral axis of the distal framework portion comprises a vertex from which the proximal framework portion is biased to press outward against a luminal wall of the second vessel.
9. The device of claim 8 wherein: the closure structure has a perimeter support and an inner support;
the inner and perimeter supports have a curved portion that is convex in the distal direction and sides projecting proximally from the curved portion;
the curved portion is configured to bias the sides outwardly; and
the barrier is attached to at least the perimeter support.
10. The device of claim 8 wherein: the closure structure has a perimeter support and an inner support;
the inner and perimeter supports have a curved portion that is convex in the distal direction and sides projecting proximally from the curved portion;
the curved portion is configured to bias the sides outwardly; and
the barrier is attached to only the inner support.
11. The device of claim 8 wherein: the closure structure has a support; and the barrier is attached to the support.
12. The device of claim 11 wherein the barrier comprises a permeable membrane.
13. The device of claim 12 wherein the permeable membrane is porous.
14. The device of claim 11 wherein the barrier comprises an impermeable membrane.
15. The device of claim 11 wherein the barrier comprises a sheet and at least one one-way valve through the sheet.
16. The device of claim 11 wherein the barrier comprises a plurality of flexible, polymeric strands attached to the support.