DEVICES AND METHODS FOR CLOSURE OF TRANSVASCULAR OR TRANSCAMERAL ACCESS PORTS
The present disclosure provides a variety of prostheses, delivery systems and techniques to facilitate closure of transvascular or transcameral access ports. Various embodiments of prostheses are provided including a plurality of radially expandable mesh discs filled with material to facilitate coagulation and to reduce or stop leakage from punctures in vessel walls.
1 . A prosthesis comprising:
a) a radially expandable mesh body that is configured to self-expand into at least one disc after becoming radially unconstrained, the radially expandable mesh body defining a volume therein when expanded, the at least one disc including a deployable paddle attached to a proximal or distal face the at least one disc, the paddle being configured to assume a radial orientation as the at least one disc expands outwardly radially, the deployable paddle being configured to extend radially outwardly beyond the at least one disc; and
b) at least one tether attached to the radially expandable mesh body that is configured to cause the radially expandable mesh body to collapse radially when tension is applied to the at least one tether.
2 . A prosthesis according to claim 1 , further comprising at least one tether attached to the radially expandable mesh body that is configured to cause the radially expandable mesh body to collapse radially when tension is applied to the at least one tether.
3 . The prosthesis of claim 1 , wherein the radially expandable mesh body is configured to self-expand into at least two discs connected by a neck region after becoming radially unconstrained, a first disc of the two discs being configured to mitigate high pressure leaks in an artery, and a second disc of the two discs being configured to mitigate low pressure leaks originating from a vein, and further wherein the neck region is configured to cooperate with the first and second discs to prevent leakage from the artery and the vein.
4 . The prosthesis of claim 1 , wherein the radially expandable mesh body is configured to self-expand into at least three discs connected by two neck regions after becoming radially unconstrained, a first disc of the two discs being configured to mitigate high pressure leaks in an artery, and a second disc of the two discs being configured to mitigate low pressure leaks originating from a vein, and further wherein the neck region is configured to cooperate with the first and second discs to prevent leakage from the artery and the vein.
5 . The prosthesis of claim 1 , wherein the radially expandable mesh body is configured to self-expand into at least four discs connected by three neck regions after becoming radially unconstrained, a first disc of the two discs being configured to mitigate high pressure leaks in an artery, and a second disc of the two discs being configured to mitigate low pressure leaks originating from a vein, and further wherein the neck region is configured to cooperate with the first and second discs to prevent leakage from the artery and the vein.
6 . The prosthesis of claim 1 , wherein the at least one tether is threaded through all of the discs to cause all of the discs to collapse radially inwardly upon applying sufficient tension to the at least one tether.
7 . The prosthesis of claim 1 , further comprising a material disposed within the mesh that is configured to encourage coagulation when exposed to blood.
8 . The prosthesis of claim 1 , wherein at least a portion of the prosthesis is formed from a composite wire.
9 . The prosthesis of claim 8 , wherein the composite wire is drawn filled wire.
10 . The prosthesis of claim 9 , wherein the drawn filled wire include a first material and a second material in a different region of the drawn filled wire that has greater radiopacity than the first material.
11 . The prosthesis of claim 10 , wherein the second material is located along a core region of the wire, and further wherein the first material surrounds or substantially surrounds the first material.
12 . The prosthesis of claim 10 , wherein at least one of the first and second materials includes bioresorbable material.
13 . An implantable prosthesis comprising:
a) an inflatable bioresorbable body having a proximal end and a distal end, the body being configured to be expanded radially by directing fluid into the body; and
b) at least one radially expandable strut attached to each of the proximal end and distal end of the body, each of the struts being configured to expand outwardly to prevent the prosthesis from being pulled through an anatomical opening into which it has been inserted.
14 . The prosthesis of claim 13 , further comprising a coupling located at the proximal end of the prosthesis configured to be attached to a delivery system.
15 . The prosthesis of claim 13 , wherein the coupling is configured to permit inflation fluid to pass therethrough.
16 . The prosthesis of claim 13 , wherein the prosthesis defines a guidewire lumen therethrough.
17 . The prosthesis of claim 16 , wherein the guidewire lumen defined in the prosthesis is configured to register with a guidewire lumen in the delivery system.
18 . The prosthesis of claim 17 , wherein the struts extend from a radially central portion of the prosthesis to a radially outer periphery of the prosthesis.
19 . The prosthesis of claim 1 , wherein the radially expandable mesh body is configured to self-expand into at least two discs connected by the neck region after becoming radially unconstrained, a first disc of the at least two discs being configured to mitigate leaks and a second disc of the at least two discs being configured to cause appropriate positioning of the prosthesis in the presence of cardiovascular motion.
20 . A method, comprising:
a) providing the delivery system of claim 14 ;
b) delivering the delivery system over a guidewire routed to a target location;
c) fully deploying the prosthesis at the target location to obstruct a vascular opening to be sealed;
d) detaching the prosthesis from the delivery system;
e) withdrawing the delivery system over the guidewire after the prosthesis has been detached therefrom;
f) advancing the delivery system over the guidewire after withdrawing it;
g) reattaching the prosthesis to the delivery system; and
h) performing a further step with the prosthesis including at least one of:
(i) partially collapsing the prosthesis,
(ii) repositioning the prosthesis, and
(iii) collapsing and withdrawing the prosthesis into the delivery system, and removing the delivery system and prosthesis over the guidewire.