Aortic arch baroreceptor implants for treatment of hypertension
Implant devices for hypertension and methods of treatment are provided. Implant devices are configured for placement in a target region of an aortic arch of the patient, thereby engaging arterial walls in the target region sufficiently to stretch and/or tension arterial walls, thereby inducing the baroreflex response. Such implants can include one or more expandable structures configured to engage an elongated target region in the aortic arch. The target region can extend along a majority of the aortic arch including a cylindrical segment of aortic arch between the left common carotid artery and the left subclavian artery. An elongated target zone can further extend at least between the brachiocephalic artery takeoff and the left subclavian artery takeoff. Such embodiments can utilize one or more expandable structures with a non-circular cross-section that stretch and reshape the arterial walls to induce tension in the arterial walls, thereby generating a robust baroreflex response.
1 . A method for treating hypertension in a patient, said method comprising:
deploying an implant within an aortic arch of the patient, the implant having a collapsed configuration for advancement through a vasculature of the patient and an expanded configuration for engagement of an arterial wall within the aortic arch of the patient, the implant having a length of at least 60 mm when deployed;
engaging the arterial wall with the implant in the expanded configuration along a target zone that includes a region that extends at least between a brachiocephalic artery takeoff and a left subclavian artery takeoff, wherein the implant has a non-circular cross-section when expanded thereby inducing wall tension along the target zone in the aortic arch;
exposing a majority of the arterial wall along the target zone to pulsatile blood flow via side openings of the implant so as to induce a long term baroreflex response;
wherein the implant is woven or braided from one or more wires; and
wherein, in the expanded configuration, the side openings each having an area of 9 mm 2 or greater to allow blood flow therethrough to any lateral arteries in the aortic arch and to expose arterial walls to pulsatile blood flow.
2 . The method of claim 1 , wherein the non-circular cross-section is elliptical.
3 . The method of claim 1 , wherein the non-circular cross-section is a regular polygonal shape.
4 . The method of claim 1 , wherein the non-circular cross-section is constant along an entire length of the implant.
5 . The method of claim 1 , wherein the length when deployed is between 60-100 mm.
6 . The method of claim 5 , wherein the implant is dimensioned so that a greatest lateral dimension is greater than 25 mm.
7 . The method of claim 1 , wherein the implant is self-expandable.
8 . The method of claim 1 , wherein the one or more wires are Nitinol.
9 . A method for treating hypertension in a patient, said method comprising:
deploying an implant within an aortic arch of the patient, the implant having a collapsed configuration for advancement through a vasculature of the patient and an expanded configuration for engagement of an arterial wall within the aortic arch of the patient, the implant having a length of at least 60 mm when deployed;
engaging the arterial wall with the implant in the expanded configuration along a target zone that includes a region that extends at least between a brachiocephalic artery takeoff and a left subclavian artery takeoff, wherein the implant has a non-circular cross-section when in the expanded configuration thereby inducing an increased wall tension along the target zone in the aortic arch and, wherein the implant includes expandable structure segments connected serially by multiple flexible connectors to allow the expandable structure segments to extend axially along a curvature of the aortic arch, and wherein, when the implant is deployed, the expandable structure segments positioned at a proximal end and a distal end of the implant have a diameter greater than a diameter of an expandable structure segment located at a mid-section of the implant to thereby prevent migration of the implant; and
exposing a majority of the arterial wall along the target zone to pulsatile blood flow via side openings of the expandable structure segments in order to induce a long term baroreflex response.
10 . A method for treating hypertension in a patient, said method comprising:
deploying an implant within an aortic arch of the patient, the implant having a collapsed configuration for advancement through a vasculature of the patient and an expanded configuration for engagement of an arterial wall within the aortic arch of the patient, the implant having a length of at least 60 mm;
engaging the arterial wall with the implant in the expanded configuration along a target zone that corresponds to an area of baroreceptor nerves and includes a region that extends at least between a brachiocephalic artery takeoff and a left subclavian artery takeoff, wherein the implant has a non-circular cross-section when in the expanded configuration thereby inducing increased wall tension along the target zone in the aortic arch;
exposing a majority of the arterial wall along the target zone to pulsatile blood flow via side openings of the implant in order to induce a long term baroreflex response; and
wherein the implant includes a middle expandable structure is that at the target location to activate the baroreceptor nerves, and wherein the implant further includes a proximal expandable anchor and a distal expandable anchor to secure the middle structure in the target zone.