US20170042551A1 - Implantable damping devices for treating dementia and associated systems and methods of use - Google Patents

Abstract

Devices, systems, and methods for reducing stress on a blood vessel are disclosed herein. A damping device configured in accordance with embodiments of the present technology can include an anchoring member coupled to a flexible, compliant damping member including a generally tubular sidewall having an outer surface, an inner surface defining a lumen configured to direct blood flow, a first end portion and a second end portion, and a damping region between the first and second end portions. The inner and outer surfaces of the damping member can be spaced apart by a distance that is greater at the damping region than at either of the first or second end portions. When blood flows through the damping member during systole, the damping member absorbs a portion of the pulsatile energy of the blood, thereby reducing a magnitude of the pulse pressure transmitted to a portion of the blood vessel distal to the damping device.

Description

CROSS-REFERENCE TO RELATED APPLICATIONS
• The present application claims the benefit of U.S. Provisional Application No. 62/341,575, filed May 25, 2016, and Australian Provisional Application No. 2015903253, filed Aug. 13, 2015, both of which are incorporated herein by reference in their entireties.
TECHNICAL FIELD
• The present technology relates to implantable damping devices for treating dementia and associated systems and methods of use. In particular, the present technology is directed to damping devices for treating an artery.
BACKGROUND
• The heart supplies oxygenated blood to the body through a network of interconnected, branching arteries starting with the largest artery in the body—the aorta. As shown in the schematic view of the heart and selected arteries inFIG. 1A, the portion of the aorta closest to the heart is divided into three regions: the ascending aorta (where the aorta initially leaves the heart and extends in a superior direction), the aortic arch, and the descending aorta (where the aorta extends in an inferior direction). Three major arteries branch from the aorta along the aortic arch: the brachiocephalic artery, the left common carotid artery, and the left subclavian artery. The brachiocephalic artery extends away from the aortic arch and subsequently divides into the right common carotid artery, which supplies oxygenated blood to the head and neck, and the right subclavian artery, which predominantly supplies blood to the right arm. The left common carotid artery extends away from the aortic arch and supplies the head and neck. The left subclavian artery extends away from the aortic arch and predominantly supplies blood to the left arm. Each of the right common carotid artery and the left common carotid artery subsequently branches into separate internal and external carotid arteries.
• During the systole stage of a heartbeat, contraction of the left ventricle forces blood into the ascending aorta that increases the pressure within the arteries (known as systolic blood pressure). The volume of blood ejected from the left ventricle creates a pressure wave—known as a pulse wave—that propagates through the arteries propelling the blood. The pulse wave causes the arteries to dilate, as shown schematically inFIG. 1B. When the left ventricle relaxes (the diastole stage of a heartbeat), the pressure within the arterial system decreases (known as diastolic blood pressure), which allows the arteries to contract.
• The difference between the systolic blood pressure and the diastolic blood pressure is the “pulse pressure,” which generally is determined by the magnitude of the contraction force generated by the heart, the heart rate, the peripheral vascular resistance, and diastolic “run-off” (e.g., the blood flowing down the pressure gradient from the arteries to the veins), amongst other factors. High flow organs, such as the brain, are particularly sensitive to excessive pressure and flow pulsatility. To ensure a relatively consistent flow rate to such sensitive organs, the walls of the arterial vessels expand and contract in response to the pressure wave to absorb some of the pulse wave energy. As the vasculature ages, however, the arterial walls lose elasticity, which causes an increase in pulse wave speed and wave reflection through the arterial vasculature. Arterial stiffening impairs the ability of the carotid arteries and other large arteries to expand and dampen flow pulsatility, which results in an increase in systolic pressure and pulse pressure. Accordingly, as the arterial walls stiffen over time, the arteries transmit excessive force into the distal branches of the arterial vasculature.
• Research suggests that consistently high systolic pressure, pulse pressure, and/or change in pressure over time (dP/dt) increases the risk of dementia, such as vascular dementia (e.g., an impaired supply of blood to the brain or bleeding within the brain). Without being bound by theory, it is believed that high pulse pressure can be the root cause or an exacerbating factor of vascular dementia and age-related dementia (e.g., Alzheimer's disease). As such, the progression of vascular dementia and age-related dementia (e.g., Alzheimer's disease) may also be affected by the loss of elasticity in the arterial walls and the resulting stress on the cerebral vessels. Alzheimer's Disease, for example, is generally associated with the presence of neuritic plaques and tangles in the brain. Recent studies suggest that increased pulse pressure, increased systolic pressure, and/or an increase in the rate of change of pressure (dP/dt) may, over time, cause microbleeds within the brain that may contribute to the neuritic plaques and tangles. Accordingly, there is a need for improved devices, systems, and methods for treating vascular and/or age-related dementia.
BRIEF DESCRIPTION OF THE DRAWINGS
• Many aspects of the present disclosure can be better understood with reference to the following drawings. The components in the drawings are not necessarily to scale. Instead, emphasis is placed on illustrating clearly the principles of the present disclosure.
• FIG. 1A is a schematic illustration of a human heart and a portion of the arterial system near the heart.
• FIG. 1B is a schematic illustration of a pulse wave propagating along a blood vessel.
• FIG. 2A is a front view of a damping device in accordance with the present technology, shown in a deployed, relaxed state.
• FIG. 2B is a front cross-sectional view of the damping device shown inFIG. 2A.
• FIG. 2C is a front cross-sectional view of the damping device shown inFIG. 2A, shown in a deployed state positioned within a blood vessel.
• FIG. 2D is a front cross-sectional view of another embodiment of a damping device in accordance with the present technology, shown in a deployed, relaxed state
• FIGS. 2E-2G are front cross-sectional views of several embodiments of damping members in accordance with the present technology, all shown in a deployed, relaxed state.
• FIG. 3A is a front cross-sectional view of another embodiment of a damping device in accordance with the present technology shown in a deployed, relaxed state.
• FIGS. 3B-3D are front cross-sectional views of several embodiments of damping members in accordance with the present technology, all shown in a deployed, relaxed state.
• FIG. 4A is a front view of a damping device in accordance with another embodiment of the present technology, shown in a deployed, relaxed state.
• FIG. 4B is a front cross-sectional view of the damping device shown inFIG. 4A.
• FIG. 4C is a front cross-sectional view of the damping device shown inFIG. 4A, shown in a deployed state positioned within a blood vessel.
• FIG. 4D is a front cross-sectional view of a portion of a damping member in accordance with the present technology showing deformation of the damping member (in dashed lines) in response to a pulse wave.
• FIG. 4E is a front cross-sectional view of a portion of another damping member in accordance with the present technology showing deformation of the damping member (in dashed lines) in response to a pulse wave.
• FIGS. 5-7 are front cross-sectional views of several embodiments of damping devices in accordance with the present technology.
• FIGS. 8A-8E illustrate a method of delivering a damping device to an artery in accordance with the present technology.
• FIGS. 9A-9F are schematic cross-sectional views of several embodiments of damping members in accordance with the present technology.
• FIGS. 10 and 11 are front cross-sectional views of embodiments of damping devices shown positioned at or near a resected blood vessel in accordance with the present technology.
• FIG. 12A is a front view of a helical damping device in accordance with the present technology, shown positioned around a blood vessel in a deployed, relaxed state.
• FIG. 12B is a cross-sectional view of the damping device ofFIG. 12A (taken alongline12B-12B inFIG. 12A), shown positioned around the blood vessel as a pulse pressure wave travels through the vessel.
• FIGS. 13 and 14 show different embodiments of a wrapped damping device, each shown positioned around a blood vessel in accordance with the present technology.
• FIG. 15 is a cross-sectional view of another embodiment of a damping device in accordance with the present technology.
• FIG. 16A is a perspective view of another embodiment of a damping device in accordance with the present technology.
• FIG. 16B is a cross-sectional view of the damping device shown inFIG. 16A, taken alongline16B-16B.
• FIG. 17A is a perspective view of another embodiment of a damping device in accordance with the present technology.
• FIG. 17B is a cross-sectional view of the damping device shown inFIG. 17A.
• FIG. 18A is a perspective view of another embodiment of a damping device in accordance with the present technology.
• FIG. 18B is a front view of the damping device shown inFIG. 18A, shown in a deployed state positioned around a blood vessel.
• FIG. 19A is a perspective view of a damping device in accordance with another embodiment of the present technology, shown in an unwrapped state.
• FIG. 19B is a top view of the damping device shown inFIG. 19A, shown in an unwrapped state.
DETAILED DESCRIPTION
• The present technology is directed to implantable damping devices for treating or slowing the progression of dementia, which includes both vascular dementia and age-related dementia, and associated systems and methods of use. Some embodiments of the present technology, for example, are directed to damping devices including an anchoring member and a flexible, compliant damping member having an outer surface and an inner surface defining a lumen configured to direct blood flow. The inner surface is configured such that a cross-sectional dimension of the lumen varies. For example, the outer surface and the inner surface can be separated from each other by a distance that varies along the length of the damping member. The damping member can further include a first end portion, a second end portion opposite the first end portion, and a damping region between the first and second end portions. The distance between the outer surface and the inner surface of the damping member can be greater at the damping region than at either of the first or second end portions. When blood flows through the damping member during systole, the damping member absorbs a portion of the pulsatile energy of the blood to reduce the magnitude of the pulse pressure transmitted to a portion of the blood vessel distal to the damping device. Specific details of several embodiments of the technology are described below with reference toFIGS. 2A-19B.
• With regard to the terms “distal” and “proximal” within this description, unless otherwise specified, the terms can reference a relative position of the portions of a damping device and/or an associated delivery device with reference to an operator, direction of blood flow through a vessel, and/or a location in the vasculature. For example, in referring to a delivery catheter suitable to deliver and position various damping devices described herein, “proximal” refers to a position closer to the operator of the device or an incision into the vasculature, and “distal” refers to a position that is more distant from the operator of the device or further from the incision along the vasculature (e.g., the end of the catheter).
• As used herein, “artery” and “arteries that supply blood to the brain,” include any arterial blood vessel (or portion thereof) that provides oxygenated blood to the brain. For example, “arteries” or “arteries that supply blood to the brain” can include the ascending aorta, the aortic arch, the brachiocephalic trunk, the right common carotid artery, the left common carotid artery, the left and right internal carotid arteries, the left and right external carotid arteries, and/or any branch and/or extension of any of the arterial vessels described above.
I. SELECTED INTRAVASCULAR EMBODIMENTS OF DAMPING DEVICES
• FIGS. 2A and 2B are a front view and a front cross-sectional view, respectively, of a dampingdevice100 configured in accordance with the present technology shown in an expanded or deployed state.FIG. 2C is a front view of the dampingdevice100 in a deployed state positioned in a carotid artery CA (e.g., the left or right carotid artery). Referring toFIGS. 2A-2C together, the dampingdevice100 includes a flexible, viscoelastic damping member102 (e.g., a cushioning member) and anchoring members104 (identified individually as first andsecond anchoring members104aand104b, respectively). The dampingmember102 includes an undulating or hourglass-shaped sidewall having anouter surface115 and an inner surface113 (FIGS. 2B and2C) that defines alumen114 configured to receive blood flow therethrough. Theouter surface115 is separated from theinner surface113 by a distance t (FIG. 2B). The dampingmember102 has a length L, afirst end portion106, and asecond end portion108 opposite thefirst end portion106 along its length L, and a dampingregion120 between thefirst end portion106 and thesecond end portion108. In the embodiment shown inFIGS. 2A-2C, the distance t between the outer andinner surfaces115 and113 varies along the length L of the dampingmember102 when it is in a deployed, relaxed state. In some embodiments, the distance t between the outer andinner surfaces115 and113, on average, can be greater at the dampingregion120 than at either of the first orsecond end portions106,108. In other embodiments, the dampingmember102 can have other suitable shapes (for example,FIGS. 2E-2G), sizes, and/or configurations. For example, as shown inFIG. 2D, the distance t between the outer andinner surfaces115 and113 may be generally constant along the length of the dampingmember102 and/or the dampingregion120 when the dampingmember102 is in a deployed, relaxed state.
• The dampingmember102 shown inFIGS. 2A-2C is a solid piece of material that is molded, extruded, or otherwise formed into the desired shape. The dampingmember102 can be made of a biocompatible, compliant, viscoelastic material that is configured to deform in response to local fluid pressure in the artery. As the dampingmember102 deforms, the dampingmember102 absorbs a portion of the pulse pressure. The dampingmember102, for example, can be made of a biocompatible synthetic elastomer, such as silicone rubber (VMQ), Tufel I and Tufel III elastomers (GE Advanced Materials, Pittsfield, Mass.), Sorbothane® (Sorbothane, Incorporated, Kent, Ohio), and others. The dampingmember102 can be flexible and elastic such that the inner diameter ID of the dampingmember102 at the dampingregion120 increases as a systolic pressure wave propagates through the dampingregion120. For example, a systolic pressure wave may push theinner surface113 radially outwardly, thus forcing a portion of theouter surface115 to also deform radially outwardly. Additionally, the dampingmember102 can also optionally be compressible such that the distance t between the inner andouter surfaces115 and113 decreases to further open the inner diameter ID of the dampingregion120 as the systolic pressure wave engages the dampingregion120. For example, a systolic pressure wave may push theinner surface113 radially outwardly while the contour of theouter surface115 remains generally unaffected.
• In the embodiment shown inFIGS. 2A-2C, the anchoring members104a-104b individually comprise a generally cylindrical structure configured to expand from a low-profile state to a deployed state in apposition with the blood vessel wall. Each of the anchoring members104a-bcan be a stent formed from a laser cut metal, such as a superelastic material (e.g., Nitinol) or stainless steel. All or a portion of each of the anchoring members can include a radiopaque coating to improve visualization of the device during delivery, and/or the anchoring members may include one or more radiopaque markers. In other embodiments, the individual anchoring members104a-104bcan comprise a mesh or woven (e.g., a braid) construction in addition to or in place of a laser cut stent. For example, the individual anchoring members104a-104bcan include a tube or braided mesh formed from a plurality of flexible wires or filaments arranged in a diamond pattern or other configuration. In some embodiments, all or a portion of one or both of the anchoring members104a-104bcan be covered by a graft material (such as Dacron) to promote sealing with the vessel wall. Additionally, all or a portion of one or both anchoring members can include one or more biomaterials.
• In the embodiment shown inFIGS. 2A-2B, the anchoring members104a-104bare positioned around the dampingmember102 at the first andsecond end portions106,108, respectively. As such, in this embodiment, the outer diameter OD of the dampingmember102 is less than the inner diameter of the anchoring members104a-104b. Also in the embodiment shown inFIGS. 2A-2B, the anchoring members104a-104bare positioned around the dampingmember102 only at the first andsecond end portions106,108, respectively. As such, in several embodiments of the present technology, the dampingregion120 of the dampingmember120 is not surrounded by a stent-like structure or braided material. In other embodiments, the anchoring members104 and dampingmember102 may have other suitable configurations. For example, the anchoring members104a-104bmay be positioned at other locations along the length L of the dampingmember102, though not along the full length of the dampingmember102. Also, in some embodiments, all or a portion of one or both anchoring members104a-104bmay be positioned radially outwardly of all or a portion of the dampingmember102. Although the dampingdevice100 shown inFIGS. 2A-2B includes two anchoring members104a-104b, in other embodiments the dampingdevice100 can have more or fewer anchoring members (e.g., one anchoring member, three anchoring members, four anchoring members, etc.).
• In some embodiments, a biocompatible gel or liquid may be located between the wall of the artery A and theouter surface115 of the dampingmember102 to prevent the ingression of blood into the void defined between thefirst anchoring member104a, thesecond anchoring member104b, the dampingmember102, and the inner wall of the artery CA. Alternatively, air or another gas may be located between the internal wall of the carotid artery CA and the dampingmember102 to prevent the ingression of blood into the void.
• FIG. 3A is a front cross-sectional view of another embodiment of a dampingdevice100′ in accordance with the present technology. The embodiment of the dampingdevice100′ shown inFIG. 3A is similar to the embodiment of the dampingdevice100 shown inFIGS. 2A-2C, and like reference numbers refer to like components inFIGS. 2A-2C andFIG. 3A. As shown inFIG. 3A, the dampingdevice100′ includes an inner dampingmember102 and anouter layer130 surrounding the dampingmember102. Theouter layer130 has anouter surface131 and, in the embodiment shown inFIG. 3A, the first and second anchoring members104a-b are attached to theouter surface131. At least along the dampingregion120, theouter layer130 is spaced apart from theouter surface115 of the dampingmember102 to form achamber132. Thechamber132 can be at least partially filled with a fluid, such as a gas, liquid, or gel. Thedevice100′ has a length L and a distance d between theouter surface131 of theouter layer130 and theinner surface113 of the dampingmember102. Along the dampingregion120, the distance d between the outer andinner surfaces131 and113 increases then decreases in a radial direction when the dampingmember102 is in a deployed, relaxed state. On average, the distance d between theouter surface131 and theinner surface113 of the dampingmember102 is greater at the dampingregion120 than at either of the first orsecond end portions106,108. As a result, the diameter ID of thelumen114 varies along the length L. For example, theouter surface131 and/or theouter layer130 can be generally cylindrical in an unbiased state, and theinner surface113 and/or the dampingmember102 can have an undulating or hourglass shape. In other embodiments, theouter surface131 and/or theouter layer130 can be other suitable shapes, and theinner surface113 and/or the dampingmember102 can be other suitable shapes (FIGS. 3B-3D).
• In some embodiments, instead of the dampingdevice100′ having a separateouter layer130, the dampingmember102 can be molded, formed, or otherwise extruded to enclose a cavity. For example, as shown inFIGS. 3B-3D, the dampingmember102′ can include aninner layer116, anouter layer118, and acavity119 therebetween. Thecavity119 can be at least partially filled with a fluid, such as a gas, liquid, or gel.
• FIGS. 4A and 4B are a front view and a front cross-sectional view, respectively, of another embodiment of a dampingdevice200 configured in accordance with the present technology shown in an expanded or deployed state.FIG. 4C is a front cross-sectional view of the dampingdevice200 in a deployed state positioned in a carotid artery (e.g., the left or right carotid artery). Referring toFIGS. 4A-4C together, the dampingdevice200 includes a flexible, viscoelastic damping member202 (e.g., a cushioning member) and anchoring members204 (identified individually as first and second anchoring members204a-204b, respectively). As shown inFIGS. 4B and 4C, the dampingmember202 includes a generally tubular sidewall having a cylindricalouter surface210 and aninner surface212 that defines alumen214 configured to receive blood flow therethrough. Theouter surface210 is separated from theinner surface212 by a distance t (FIG. 4B). The dampingmember202 has a length L, afirst end portion206, and asecond end portion208 opposite thefirst end portion206 along its length L, and a dampingregion220 between thefirst end portion206 and thesecond end portion208. Along the dampingregion220, the distance t between the outer andinner surfaces210 and212 increases then decreases in a radial direction when the dampingmember202 is in a deployed, relaxed state. On average, the distance t between the outer andinner surfaces210 and212 of the dampingmember202 is greater at the dampingregion220 than at either of the first orsecond end portions206,208. As a result, the inner diameter ID of the dampingmember202 varies along its length L relative to the outer diameter OD of the dampingmember202. For example, theouter surface210 can be generally cylindrical in an unbiased state, and theinner surface212 can have an undulating or hourglass shape. As described in greater detail below with respect toFIGS. 9A-9F, the dampingmember202 can have other suitable shapes, sizes, and/or configurations.
• The dampingmember202 shown inFIGS. 4A-4C is a solid piece of material that is molded, extruded, or otherwise formed into the desired shape. The dampingmember202 can be made of a biocompatible, compliant, viscoelastic material that is configured to deform in response to local fluid pressure in the artery. As the dampingmember202 deforms, the dampingmember202 absorbs a portion of the pulse pressure. The dampingmember202, for example, can be made of a biocompatible synthetic elastomer, such as silicone rubber (VMQ), Tufel I and Tufel III elastomers (GE Advanced Materials, Pittsfield, Mass.), Sorbothane (ID (Sorbothane, Incorporated, Kent, Ohio), and others. The dampingmember202 can be flexible and elastic such that the inner diameter ID of the dampingmember202 at the dampingregion220 increases as a systolic pressure wave P (FIG. 4D) propagates through the dampingregion220. For example, as shown schematically in the isolated, cross-sectional view of a portion of a dampingmember202 before and during deformation (dampingmember202′, shown in dashed lines) inFIG. 4D, the systolic pressure wave P may push theinner surface212′ radially outwardly, thus forcing a portion of theouter surface210′ to also deform radially outwardly. Additionally, the dampingmember202 can also optionally be compressible such that the distance t between the inner andouter surfaces210 and212 decreases to further open the inner diameter ID of the dampingregion220 as the systolic pressure wave P engages the dampingregion220. For example, as shown schematically in the isolated, cross-sectional view of a portion of a dampingmember202 before and during deformation (dampingmember202′, shown in dashed lines) inFIG. 4E, the systolic pressure wave P may push theinner surface212′ radially outwardly while the contour of theouter surface210′ remains generally unaffected.
• In the embodiment shown inFIGS. 4A-4C, the anchoring members204a-204bindividually comprise a generally cylindrical structure configured to expand from a low-profile state to a deployed state in apposition with the blood vessel wall. Each of the anchoring members204a-bcan be a stent formed from a laser cut metal, such as a superelastic material (e.g., Nitinol) or stainless steel. All or a portion of each of the anchoring members can include a radiopaque coating to improve visualization of the device during delivery, and/or the anchoring members may include one or more radiopaque markers. In other embodiments, the individual anchoring members204a-204bcan comprise a mesh or woven (e.g., a braid) construction in addition to or in place of a laser cut stent. For example, the individual anchoring members204a-204bcan include a tube or braided mesh formed from a plurality of flexible wires or filaments arranged in a diamond pattern or other configuration. In some embodiments, all or a portion of one or both of the anchoring members204a-204bcan be covered by a graft material (such as Dacron) to promote sealing with the vessel wall.
• In the embodiment shown inFIGS. 4A-4B, the anchoring members204a-204bare positioned around the dampingmember202 at the first andsecond end portions206,208, respectively. As such, in this embodiment, the outer diameter OD (FIG. 4A) of the dampingmember202 is less than the inner diameter of the anchoring members204a-204b. Also in the embodiment shown inFIGS. 4A-4B, the anchoring members204a-204bare positioned around the dampingmember202 only at the first andsecond end portions206,208, respectively. As such, in several embodiments of the present technology, the dampingregion220 of the dampingmember220 is not surrounded by a stent-like structure or braided material. In other embodiments, the anchoring members204a-204band dampingmember202 may have other suitable configurations. For example, the anchoring members204a-204bmay be positioned at other locations along the length L of the dampingmember202, though not along the full length of the dampingmember202. Also, in some embodiments, all or a portion of one or both anchoring members204a-204bmay be positioned radially outwardly of all or a portion of the dampingmember202. Although the dampingdevice200 shown inFIGS. 4A-4B includes two anchoring members204a-204b, in other embodiments the dampingdevice200 can have more or fewer anchoring members (e.g., one anchoring member, three anchoring members, four anchoring members, etc.).
• In some embodiments, one or both of the anchoring members204a-204bcan optionally include one or more fixation elements205 (FIG. 4B) configured to engage the blood vessel wall. Thefixation elements205 can include, for example, one or more hooks or barbs that, in the deployed state, extend outwardly away from the corresponding frames of the anchoring member204a-204bto penetrate the vessel wall at the treatment site. In these and other embodiments, one or more of the fixation elements can be atraumatic. Additionally, referring to the dampingdevice200A shown inFIG. 5, in certain embodiments the dampingdevice200 may not include a stent-type or braid-type anchoring member, but rather the frame of the anchoring members204 can be one or more expandable rings230. For example, in some embodiments the dampingdevice200 can include tworings230, each attached to arespective end portion206 and208, and the plurality offixation elements205 can extend outwardly from therings230. In still other embodiments, such as the dampingdevice200B shown inFIG. 6, the anchoring members204 can be integral portions of theend portions206,208, such as thick wall portions240a-bof the dampingmember202 that extend radially outward from the outer wall of the dampingregion220, instead of separate metal or polymeric components. In this embodiment, thefixation elements205 can extend outwardly from integral anchoring members240a-bat the first andsecond end portions206,208 of the dampingmember202. When the dampingdevice200 is in a deployed state, thefixation elements205 extend outwardly away from the outer surface of the dampingmember202 to engage vessel wall tissue. In yet other embodiments, thefixation elements205 can extend outwardly from theouter surface210 of the dampingmember202, as shown in the dampingdevice200C ofFIG. 7.
• FIGS. 8A-8E illustrate a method for positioning a damping device of the present disclosure at a treatment location within an artery A (such as the left and/or right common carotid artery CA). AlthoughFIGS. 8B-8E depict the dampingdevice200 shown inFIGS. 4A and 4B, the methods and systems described with respect toFIGS. 8A-8E can be utilized for any of the dampingdevices100,100′,200,200A,200B, and200C described with respect toFIGS. 2A-7 andFIGS. 9A-9F.
• As shown inFIG. 8A, aguidewire602 may first be advanced intravascularly to the treatment site from an access site, such as a femoral or a radial artery. Aguide catheter604 may then be advanced along theguidewire602 until at least a distal portion of theguide catheter604 is positioned at the treatment site. In these and other embodiments, a rapid-exchange technique may be utilized. In some embodiments, theguide catheter604 may have a pre-shaped or steerable distal end portion to direct theguide catheter604 through one or more bends in the vasculature. For example, theguide catheter604 shown inFIGS. 8A-8E has a curved distal end portion configured to navigate through the ascending aorta AA and preferentially bend or flex at the left and/or right common carotid artery A to direct theguide catheter604 into the artery A.
• Image guidance, e.g., computed tomography (CT), fluoroscopy, angiography, intravascular ultrasound (IVUS), optical coherence tomography (OCT), or another suitable guidance modality, or combinations thereof, may be used to aid the clinician's positioning and manipulation of the dampingdevice200. For example, a fluoroscopy system (e.g., including a flat-panel detector, x-ray, or c-arm) can be rotated to accurately visualize and identify the target treatment site. In other embodiments, the treatment site can be determined using IVUS, OCT, and/or other suitable image mapping modalities that can correlate the target treatment site with an identifiable anatomical structure (e.g., a spinal feature) and/or a radiopaque ruler (e.g., positioned under or on the patient) before delivering the dampingdevice200. Further, in some embodiments, image guidance components (e.g., IVUS, OCT) may be integrated with the delivery catheter and/or run in parallel with the delivery catheter to provide image guidance during positioning of the dampingdevice200.
• Once theguide catheter604 is positioned at the treatment site, theguidewire602 may be withdrawn. As shown inFIGS. 8B and 8C, adelivery assembly610 carrying the dampingdevice200 may then be advanced distally through theguide catheter604 to the treatment site. In some embodiments, thedelivery assembly610 includes anelongated shaft612 having an atraumatic distal tip614 (FIG. 8B) and an expandable member616 (e.g., an inflatable balloon, an expandable cage, etc.) positioned around a distal portion of theelongated shaft612. The dampingdevice200 can be positioned around theexpandable member616. As shown inFIG. 8D, expansion or inflation of theexpandable member616 forces at least a portion of the dampingdevice200 radially outwardly into contact with the arterial wall. In some embodiments, thedelivery assembly610 can include a distal expandable member for deploying a distal portion of the dampingdevice200, and a proximal expandable member for deploying a proximal portion of the dampingdevice200. In other embodiments, the entire length of the dampingdevice200 may be expanded at the same time by deploying one or more expandable members.
• In some procedures the clinician may want to stretch or elongate the dampingdevice200 before deploying the proximalsecond anchoring member204bagainst the arterial wall. To address this need, thedelivery assembly610 and/or dampingdevice200 can optionally include a tensioning mechanism for pulling or providing a tensile stress on thesecond anchoring member204b, thereby increasing the length of the dampingmember202 and/or a distance between the first and second and anchoringmembers204a,204b. For example, as shown inFIG. 8C, thesecond anchoring member204bcan include one or more coupling portions205 (e.g., one or more eyelets extending proximally from the anchoring frame) and one or more coupling members618 (e.g., a suture, a thread, a filament, a tether, etc.) extending between thesecond anchoring member204band a proximal portion (not shown) of the delivery assembly610 (e.g., a handle). Thecoupling members618 are configured to releasably engage thecoupling portions205 to mechanically couple thesecond anchoring member204bto a proximal portion of thedelivery assembly610. A clinician can apply a tensile force to thecoupling member618 to elongate the dampingdevice200 and/or dampingmember202 and adjust the longitudinal position of thesecond anchoring member204b. Once thesecond anchoring member204bis positioned at a desired longitudinal position relative to thefirst anchoring member204aand/or the local anatomy, thesecond anchoring member204bcan be expanded into contact with the arterial wall (e.g., via deployment of one or more expandable members). Before, during, and/or after expansion of thesecond anchoring member204b, the coupling member(s)618 may be disengaged from thesecond anchoring member204b. For example, in some embodiments, the operator can force thecoupling members618 to break along their lengths by applying a tensile force that is less than a force that would be required to dislodge one or both of the first andsecond anchoring members204a,204b. Once disengaged from thesecond anchoring member204band/or the dampingdevice200, the coupling member(s)618 can then be withdrawn from the treatment site through theguide catheter604.
• In other embodiments, other tensioning mechanisms may be utilized. For example, in some embodiments, the dampingdevice200 includes a releasable clasp, ring, or hook which is selectively releasable by the operator. The clasp, ring or hook may be any type that permits securement of the thread to thesecond anchoring member204b, and which can be selectively opened or released to disengage the thread from thesecond anchoring member204b. The releasing can be controlled by the clinician from an extracorporeal location. Although the tensioning mechanism is described herein with respect to thesecond anchoring member204b, it will be appreciated that other portions of the dampingdevice200 and/or the delivery assembly610 (such as thefirst anchoring member204a) can be coupled to a tensioning mechanism.
• In certain embodiments, the dampingmember202 and/orindividual anchoring members204a,204bmay be self-expanding. For example, thedelivery assembly610 can include a delivery sheath (not shown) that surrounds and radially constrains the dampingdevice200 during delivery to the treatment site. Upon reaching the treatment site, the delivery sheath may be at least partially withdrawn or retracted to allow the dampingmember202 and/or theindividual anchoring members204a,204bto expand. In some embodiments, expansion of the anchoring members204 may drive expansion of the dampingmember202. For example, the anchoring members204 may be fixedly attached to the dampingmember202, and expansion of one or both anchoring204 pulls or pushes (depending on the relative positioning of the dampingmember202 and anchoring members204) the dampingmember202 radially outwardly.
• As best shown inFIG. 8C, once the dampingdevice200 is positioned at the treatment site (e.g., in a left or right common carotid artery), oxygenated blood ejected from the left ventricle flows through thelumen214 of the dampingmember202. As the blood contacts the dampingregion220 of the dampingmember202, the dampingregion220 deforms to absorb a portion of the pulsatile energy of the blood, which reduces a magnitude of a pulse pressure transmitted to the portions of the artery distal to the damping device200 (such as the more-sensitive cerebral arteries). The dampingregion202 acts a pressure limiter that distributes the pressure of the systolic phase of the cardiac cycle more evenly downstream from the dampingdevice200 without unduly compromising the volume of blood flow through the dampingdevice200. Accordingly, the dampingdevice200 reduces the pulsatile stress on downstream portions of the arterial network to prevent or at least partially reduce the manifestations of vascular dementia and/or age-related dementia.
• In some procedures, it may be beneficial to deliver multiple dampingdevices200 to multiple arterial locations. For example, after deploying a first dampingdevice200 at a first arterial location (e.g., the left or right common carotid artery, an internal or external carotid artery, the ascending aorta, etc.), the clinician may then position and deploy a second dampingdevice200 at a second arterial location different than the first arterial location (e.g., the left or right common carotid artery, an internal or external carotid artery, the ascending aorta etc.). In a particular application, a first damping device is deployed in the left common carotid artery and the second damping device is deployed in the right common carotid artery. In other embodiments, two or more dampingdevices200 may be delivered simultaneously.
• In some embodiments, an additional stent of larger diameter may be placed within the vessel prior to deployment of the dampingdevice200 to expand the diameter of the vessel in preparation for the device. Subsequently, the dampingdevice200 can be deployed within the larger stent. This may assist to reduce impact on the residual diameter of the vessel, and thereby reduce impact on blood flow rate.
• FIGS. 9A-9F are schematic cross-sectional views of several embodiments of damping members in accordance with the present technology. Like reference numbers refer to similar or identical components inFIGS. 2A-9F. In the embodiment shown inFIG. 9A, theinner surface212 of the dampingmember202 is curved along its entire length. The distance between theouter surface210 and theinner surface212 gradually increases then decreases in a distal direction. As such, the dampingregion220 extends the entire length of the dampingmember202.FIGS. 9B and 9C illustrate embodiments of the dampingmember202 in which theinner surface212 has a series of dampingregions220 defined by undulations in theinner surface212. In these embodiments, the distance t increases, then decreases, then increases, then decreases, etc. in a distal direction. InFIG. 9B, the dampingregions220 are generally linear, while inFIG. 9C, the dampingregions220 are generally curved.FIGS. 9D-9E illustrate embodiments of dampingmembers202 having dampingregions220 comprising an annular ring projecting radially inwardly into thelumen214. One or more portions of the annular ring may flex in a longitudinal direction in response to blood flow. As shown inFIG. 9F, in some embodiments the dampingmember220 can comprise two or moreopposing leaflets221.
II. Selected Resection Embodiments of Damping Devices
• FIGS. 10 and 11 are schematic cross-sectional views of several embodiments of damping devices in accordance with the present technology. Like reference numbers refer to similar or identical components inFIGS. 2A-15.FIG. 10, for example, shows a dampingdevice1000 comprising only the dampingmember202. A portion of the arterial wall A may be resected, and the dampingmember202 may be coupled to the open ends of the resected artery (e.g., via sutures1002) such that the dampingmember202 spans the resected portion of the artery A. In some embodiments, the dampingmember202 may have a generally cylindrical shape with a constant wall thickness, as shown inFIG. 11. In such embodiments, an inner diameter ID of the dampingmember202 may be generally constant along the length of the dampingmember202. In operation, the dampingdevices1000 and1100 shown inFIGS. 10 and 11 are highly flexible, elastic members that expand radially outward as the systolic pressure wave passes through the dampingdevices1000 and1100. Since the resected portions of the arterial wall A cannot limit the expansion of the dampingdevices1000 and1100, these devices can expand more than the native arterial wall A to absorb more energy from the blood flow.
III. SELECTED ADDITIONAL EMBODIMENTS OF DAMPING DEVICES
• FIGS. 12A-19B illustrate additional embodiments of damping devices configured in accordance with the present technology. For example,FIG. 12A shows a dampingdevice1200 comprising a dampingmember1202 coupled to anchoringmembers1204aand1204bat its proximal and distal end portions. The dampingmember1202 comprises astrand1203 having a pre-set helical configuration such that, in a deployed state, thestrand1203 forms a generally tubular structure defining a lumen extending therethrough. The tubular structure has an inner surface1209 (FIG. 12B) and anouter surface1211. Thestrand1203 may be formed of any suitable biocompatible material such as one or more elastic polymers that are configured to stretch in response to the radially outward forces exerted by the pulse wave on the helical strand. In some embodiments, thestrand1203 may additionally or alternatively include one or more metals such as stainless steel and/or a superelastic and/or shape memory alloy, such as Nitinol. In a particular embodiment, the dampingmember1202 may be fabricated from a recombinant human protein such as tropo-elastin or elastin.
• The anchoringmembers1204aand1204bcan be generally similar to the anchoringmembers104aand104bdescribed with respect toFIGS. 2A-2C. In some embodiments, the dampingdevice1200 includes more or fewer than two anchoring members1204 (one anchoring member, three anchoring members, etc.). In a particular embodiment, the dampingdevice1200 does not include anchoring members1204.
• In the deployed state, the dampingmember1202 is configured to be wrapped along the circumference of an artery that supplies blood to the brain. For example, in the embodiment shown inFIG. 12A, the dampingmember1202 is configured to be positioned around the exterior of the artery A such that theinner surface1209 of the dampingmember1202 contacts an outer surface of the artery A (seeFIG. 12B). In other embodiments (not shown), the dampingmember1202 is configured to be positioned around the lumen of the artery such that theouter surface1211 of the dampingmember1202 contacts an inner surface of the arterial wall.
• FIG. 12B is a cross-sectional side view of the dampingdevice1200 during transmission of a pulse wave PW through the portion of the artery A surrounded by the dampingdevice1200. InFIG. 12B, the dashed lines A represent the artery during diastole, or when the artery is relaxed. The solid line A′ represents the artery in response to a pulse wave PW traveling through the artery during systole. As shown inFIG. 12B, as the wave front WF (or leading edge of the pulse wave PW) travels through the artery, the wavefront dilates the artery A at an axial location L₁corresponding to the wavefront WF. The wavefront WF pushes the arterial wall radially outwardly against the coil, thereby radially expanding the portion R₁of the coil axially aligned with the wave front WF. For example, in those embodiments where thestrand1203 is made of a stretchable material, such as an elastic polymer, the coil stretches along the portion R₁to expand and accommodate the pulse wave, thereby absorbing some of the energy transmitted with the pulse wave and reducing the stress on the arterial wall. In any of the above embodiments, the portions of the coil distal or proximal the wave-affected region are forced to contract (R₂), thereby causing the artery to narrow relative to its relaxed diameter. This narrowing of the artery creates a temporary impedance to the pulse wave which absorbs some of the energy. Once the pulse wave has passed, the arterial wall returns to its relaxed state.
• FIG. 13 illustrates another embodiment of a dampingdevice1300 in accordance with the present technology. As shown inFIG. 13, the dampingdevice1300 can include a dampingmember1302 defined by an extravascular wrap. The dampingmember1302 may be fabricated from a generally rectangular portion of a suitable bio-compatible and elastically deformable material which is configured to be wrapped around the blood vessel. Alternatively, the dampingmember1302 may be initially provided having a cylindrical configuration including alongitudinal slit1304 for receiving the vessel. The dampingmember1302 may be fabricated from a synthetic such as an elastic polymer, a shape memory and/or superelastic material such as Nitinol (nickel titanium), a recombinant human protein such as tropo-elastin or elastin, and other suitable materials. As shown inFIG. 13, the dampingmember1302 is configured to be secured around an artery (e.g., a carotid artery) between the aortic arch and the junction where the left common carotid artery divides into the internal (IC) and external (EC) carotid arteries. It will be appreciated by those skilled in the art that the dampingmember1302 may alternatively or additionally be deployed around the brachiocephalic trunk (not shown) or the right common carotid artery (not shown), or any distal branch of the aforementioned arteries, or any proximal branch of the aforementioned arteries, such as the ascending aorta. Opposing edges of the dampingmember1302 can be secured to each other with a coupling device such as stitching/sutures1310, stapling, or another coupling device such that the external diameter of the artery is reduced. In some embodiments, the coupling device can be made from an elastic material so that it can stretch to accommodate the pulse wave and absorb its energy. The elastically deformable dampingmember1302 is adapted to radially expand during the systole stage and radially contract during the diastole stage. The dampingmember1302 is secured such that an internal diameter of the elastically deformable material is smaller than an initial, outer diameter of the artery during a systole stage, but not smaller than an outer diameter of the artery during a diastole stage.
• FIG. 14 depicts another embodiment of a dampingdevice1400 for treating an arterial blood vessel. Thedevice1400 can be structurally similar to the dampingdevice1300 shown inFIG. 13, with the exception that the two opposing edges of the elastically deformable dampingmember1402 ofFIG. 14 are secured to each other using a zip-locktype coupling mechanism1410.
• FIG. 15 shows another embodiment of a dampingdevice1500 configured in accordance with the present technology. The dampingdevice1500, includes a generally tubular anchoring member1504 (e.g., a stent, a mesh, a braid, etc.) defining alumen1514 therethrough. The anchoring member may be made of a resilient, biocompatible material such as stainless steel, titanium, nitinol, etc. In some embodiments, the anchoringmember1504 is made of a shape memory and/or superelastic material. A radially outer surface of the anchoringmember1504 is configured to be positioned in apposition with an inner surface of an arterial wall. A radially inner surface of the anchoringmember1504 is lined or otherwise coated with an absorptive material1503 (e.g., a cushioning material), such as an elastically deformable material, which is adapted to absorb shock. Thelumen1514 is configured to receive blood flow therethrough. Thelumen1514 is present when the anchoringmember1504 is radially expanded, but it may not be present in the initial, contracted configuration prior to deployment
• In some embodiments (not shown), the damping device can be a biocompatible gel which is injected around a portion of the left or right carotid artery or the brachiocephalic trunk. The gel increases the external pressure acting on the artery and thus reduces the external diameter of the artery. As blood pressure increases within the artery, the gel elastically deforms, such that the artery radially expands during the systole stage and radially contracts during the diastole stage.
• FIG. 16A is a perspective, cut-away view of a dampingdevice1600 in accordance with the present technology in a deployed, relaxed state.FIG. 16B is a cross-sectional view of the dampingdevice1600 positioned in an artery A during transmission of a pulse wave PW through the portion of the artery A surrounded by the dampingdevice1600. Referring toFIGS. 16A and 16B together, the dampingdevice1600 includes a dampingmember1602 and astructural member1604 coupled to the dampingmember1602. InFIG. 16A, a middle portion of thestructural member1604 has been removed to show features of the structure of the dampingmember1602. As shown inFIG. 16A, the dampingdevice1600 can have a generally cylindrical shape in the deployed, relaxed state. The dampingdevice1600 may be configured to wrap around the circumference of the artery with opposing longitudinal edges (not shown) secured to one another via sutures, staples, adhesive, and/or other suitable coupling devices. Alternatively, the dampingdevice1600 can have a longitudinal slit for receiving the artery therethrough. In either of the foregoing extravascular embodiments, the dampingdevice1600 is configured to be positioned around the circumference of the artery A so that the inner surface1612 (FIG. 16B) is adjacent and/or in contact with the outer surface of the arterial wall. In other embodiments, the dampingdevice1600 can be configured to be positioned intravascularly (e.g., within the artery lumen) such that an outer surface of the dampingdevice1600 is adjacent and/or in contact with the inner surface of the arterial wall. In such intravascular embodiments, theinner surface1612 of the dampingmember1602 is adjacent or directly in contact with blood flowing through the artery A.
• Thestructural member1604 can be a generally cylindrical structure configured to expand from a low-profile state to a deployed state. Thestructural member1604 is configured to provide structural support to secure the dampingdevice1600 to a selected region of the artery. In some embodiments, thestructural member1604 can be a stent formed from a laser cut metal, such as a superelastic and/or shape memory material (e.g., Nitinol) or stainless steel. All or a portion of thestructural member1604 can include a radiopaque coating to improve visualization of thedevice1600 during delivery, and/or thestructural member1604 may include one or more radiopaque markers. In other embodiments, thestructural member1604 may comprise a mesh or woven (e.g., a braid) construction in addition to or in place of a laser cut stent. For example, thestructural member1604 can include a tube or braided mesh formed from a plurality of flexible wires or filaments arranged in a diamond pattern or other configuration. In some embodiments, all or a portion of thestructural member1604 can be covered by a graft material (such as Dacron) to promote sealing with the vessel wall. Additionally, all or a portion of thestructural member1604 can include one or more biomaterials.
• In the embodiment shown inFIGS. 16A and 16B, thestructural member1604 is positioned radially outwardly of the dampingmember1602 and extends along the entire length of the damping member1602 (though a middle portion of thestructural member1604 is cut-away inFIG. 16A for illustrative purposes only). In other embodiments, thestructural member1604 and the dampingmember1602 may have other suitable configurations. For example, the dampingdevice1600 can include more than one structural member1604 (e.g., two structural members, three structural members, etc.). Additionally, in some embodiments the structural member(s)1604 may extend along only a portion of the dampingmember1602 such that a portion of the length of the dampingmember1602 is not surrounded and/or axially aligned with any portion of thestructural member1604. Also, in some embodiments, all or a portion of the dampingmember1602 may be positioned radially outwardly of all or a portion of thestructural member1604.
• In the embodiment shown inFIGS. 16A and 16B, the dampingmember1602 includes a proximal dampingelement1606aand a distal dampingelement1606b. The dampingmember1602 may further includeoptional channels1608 extending between the proximal and distal dampingelements1606a,1606b. Thechannels1608, for example, can extend in a longitudinal direction along the dampingdevice1600 and fluidly couple the proximal dampingelement1606ato the distal dampingelement1606b. The dampingmember1602 may further include an abatingsubstance1610 configured to deform in response to fluid stress (such as blood flow), thereby absorbing at least a portion of the stress. For example, as best shown inFIG. 16B, in one embodiment the abatingsubstance1610 includes a plurality of fluid particles F (only one fluid particle labeled) contained in the proximal dampingelement1606a, distal dampingelement1606b, and channel(s)1608. As used herein, the term “fluid” refers to liquids and/or gases, and “fluid particles” refers to liquid particles and/or gas particles. In some embodiments, the dampingmember1602 is a gel, and the plurality of fluid particles F are dispersed within a network of solid particles. In other embodiments, the dampingmember1602 may include only fluid particles F (e.g., only gas particles, only liquid particles, or only gas and liquid particles) contained within a flexible and/or elastic membrane that defines the proximal dampingmember1606a, the distal dampingmember1606b, and the channel(s)1608. The viscosity and/or composition of the abatingsubstance1610 may be the same or may vary along the length and/or circumference of the dampingmember1602.
• In the embodiment shown inFIGS. 16A and 16B, thechannels1608 have a resting radial thickness t_rand circumferential thickness t_c(FIG. 16A) that is less than the resting radial thickness t_rand circumferential thickness t_c, respectively, of the proximal and distal dampingelements1606a,1606b. As best shown inFIG. 16A, in some embodiments the proximal and distal dampingelements1606aand1606bmay extend around the full circumference of the dampingdevice1600 and thechannels1608 may extend around only a portion of the circumference of the dampingdevice1600. In other embodiments, thechannels1608 can have a resting radial thickness t_rthat is generally the same as that of the proximal and distal dampingelements1606a,1606b(see damping elements1906a-candchannels1908 inFIGS. 19A and 19B) and/or a resting circumferential thickness t_cthat is generally the same as that of the proximal and distal dampingelements1606a,1606b.
• Referring toFIG. 16B, when a pulse wave PW traveling through the artery A applies a stress at a first axial location L₁along the length of the damping member1602 (e.g., at wavefront WF), at least a portion of the fluid particles move away from the first axial location L₁to a second axial location L₂along the length of the dampingmember1602. As such, at least a portion of the fluid particles are redistributed along the length of the dampingmember1602 such that the inner diameter ID of the dampingmember1602 increases at the first axial location L₁while the inner diameter ID decreases at another axial location (e.g., L₂). For example, as the wavefront WF passes through theproximal portion1600aof thedevice1600, the portion of the artery A aligned with the wavefront WF dilates, thereby applying a stress to the proximal dampingelement1606aand forcing at least some of the fluid particles in the proximal dampingelement1606ato move distally within the dampingmember1602. At least some of the displaced fluid particles are forced through the channel(s)1608 and into the distal dampingelement1606b, thereby increasing the volume of the distal dampingelement1606band decreasing the inner diameter ID of the dampingdevice1600 at thedistal portion1600b. The decreased inner diameter ID of the dampingdevice1600 provides an impedance to the blood flow that absorbs at least a portion of the energy in the pulse wave when the blood flow reaches the distal dampingmember1606b. As the wavefront WF then passes through thedistal portion1600bof thedevice1600, the portion of the artery A aligned with the wavefront WF dilates, thereby applying a stress to the distal dampingelement1606band forcing at least some of the fluid particles currently in the distal dampingelement1606bto move proximally within the dampingmember1602. At least some of the displaced fluid particles are forced through the channel(s)1608 and into the proximal dampingelement1606a, thereby increasing the volume of the proximal dampingelement1606aand decreasing the inner diameter ID of thedevice1600 at theproximal portion1600a. Movement of the fluid particles and/or deformation of the dampingmember1602 in response to the pulse wave absorbs at least a portion of the energy carried by the pulse wave, thereby reducing the stress on the arterial wall distal to the device.
• When the dampingmember1602 deforms in response to the pulse wave, the shape of thestructural member1604 may remain generally unchanged, thereby providing the support to facilitate redistribution of the fluid particles within and along the dampingmember1602. In other embodiments, thestructural member1604 may also deform in response to the local fluid stress.
• FIG. 17A is a perspective view of another embodiment of a dampingdevice1700 in accordance with the present technology.FIG. 17B is a cross-sectional view of the dampingdevice1700 positioned in an artery A during transmission of a pulse wave PW through the portion of the artery A surrounded by the dampingdevice1700. The dampingdevice1700 can include astructural member1704 and a dampingmember1702. Thestructural member1704 can be generally similar to thestructural member1604 shown inFIGS. 16A and 16B. The dampingmember1702 is defined by asingle chamber1705 including an abatingsubstance1610 and a plurality ofbaffles1720 that separate thechamber1705 into three fluidically-coupledcompartments1706a,1706b, and1706c. Thebaffles1720 extend only a portion of the radial thickness of the dampingmember1702, thereby leaving a gap G between the end of thebaffles1720 and aninner wall1722 of the dampingmember1702. In other embodiments, the dampingdevice1700 can include more or fewer compartments (e.g., a single, tubular compartment (no baffles), two compartments, four compartments, etc.). Moreover, thebaffles1720 may extend around all or a portion of the circumference of the dampingmember1702.
• FIG. 18A is a perspective view of another embodiment of a dampingdevice1800 in accordance with the present technology, andFIG. 18B is a front view of the dampingdevice1800, shown in a deployed state positioned around an artery A. Referring toFIGS. 18A-18B together, the dampingdevice1800, in a deployed, relaxed state, includes a generallytubular sidewall1805 that defines a lumen. The dampingdevice1800 can be formed of a generally parallelogram-shaped element that is wrapped around a mandrel in a helical configuration and heat set. In other embodiments, the dampingdevice1800 can have other suitable shapes and configurations in the unfurled, non-deployed state. As shown inFIG. 18B, in the deployed state, the dampingdevice1800 is configured to be wrapped helically along or around the circumference of an artery supplying blood to the brain. Opposinglongitudinal edges1807 of the dampingdevice1800 come together in the deployed state to form a helical path along the longitudinal axis of the artery A. The dampingdevice1800 can include any of the coupling devices described with respect toFIGS. 13-15 to secure all or a portion of the opposing longitudinal edges to one another.
• As best shown inFIG. 18A, thesidewall1805 of the dampingdevice1800 includes astructural member1804 and a dampingmember1802. Thestructural member1804 can be generally similar to thestructural member1604 shown inFIGS. 16A and 16B, except thestructural member1804 ofFIGS. 18A and 18B has a helical configuration in the deployed state. The dampingmember1802 can be generally similar to any of the damping members described herein, especially those described with respect toFIGS. 13-17B and 19A and 19B. In the embodiment shown inFIGS. 18A and 18B, the dampingmember1802 is positioned radially inwardly of thestructural member1804 when the dampingdevice1800 is in the deployed state. In other embodiments, the dampingmember1802 may be positioned radially outwardly of thestructural member1804 when the dampingdevice1800 is in the deployed state.
• The dampingdevice1800 may be configured to wrap around the circumference of the artery A so that the inner surface1812 (FIG. 18A) is adjacent and/or in contact with the outer surface of the arterial wall. In other embodiments, the dampingdevice1800 can be configured to be positioned intravascularly (e.g., within the artery lumen) such that an outer surface of the dampingdevice1800 is adjacent and/or in contact with the inner surface of the arterial wall. In such intravascular embodiments, theinner surface1812 of the dampingmember1802 is adjacent or directly in contact with blood flowing through the artery A.
• FIGS. 19A and 19B are perspective and top views, respectively, of a dampingdevice1900 that can define one embodiment of the dampingdevice1800 shown inFIGS. 18A and 18B. InFIGS. 19A and 19B, the dampingdevice1900 is shown in an unfurled, non-deployed state. The dampingdevice1900 includes a dampingmember1902 having a plurality ofchambers1906a,1906b,1906cspaced apart along a longitudinal dimension of the dampingdevice1900 in the unfurled state. Thechambers1906a,1906b,1906cmay be fluidly coupled bychannels1908 extending between adjacent chambers. The dampingdevice1900 can thus operate in a manner similar to the dampingdevice1600 where an abating substance (not shown inFIGS. 19A and 19B) in the chambers1906a-cmoves through thechannels1908 to inflated/deflate individual chambers in response to a pressure wave traveling through the blood vessel. The displacement of the abating substance within the chambers1906a-cattenuates the energy of the pulse wave to reduce the impact of the pulse wave distally of the dampingdevice1900.
IV. EXAMPLES
• The following examples are illustrative of several embodiments of the present technology:
• • 1. A device for treating or slowing the progression of dementia, comprising:
    • a flexible, compliant damping member configured to be intravascularly positioned within an artery at a treatment site, the damping member being transformable between a low-profile state for delivery to the treatment site and an expanded state, wherein the damping member includes a generally tubular sidewall having (a) an outer surface, (b) an inner surface defining a lumen configured to direct blood flow, (c) a first end portion, (d) a second end portion opposite the first end portion along the length of the damping member, and (e) a damping region between the first and second end portions, wherein the inner surface and outer surface are spaced apart by a distance that is greater at the damping region than at either of the first or second end portions; and
    • a first anchoring member coupled to the first end portion of the damping member and a second anchoring member coupled to the second end portion of the damping member, wherein the first and second anchoring members, in a deployed state, extend radially to a deployed diameter configured to contact a portion of the arterial wall at the treatment site, thereby securing the damping member at the treatment site, and wherein the first and second anchoring members extend along only a portion of the length of the damping member such that at least a portion of the damping region is exposed between the first and second anchoring members and allowed to expand to a diameter greater than the deployed diameter.
  • 2. The device of example 1 wherein the damping member is configured to deform in response to a change in blood pressure.
  • 3. The device of example 1 or example 2 wherein, at a location along the damping member coincident with a leading end of a pulse pressure wave, the distance between the inner surface and the outer surface of the damping member decreases in response to the pressure.
  • 4. The device of any one of examples 1-3 wherein the lumen of the damping member has an hourglass shape.
  • 5. The device of any one of examples 1-4 wherein the outer surface is generally cylindrical and the inner surface is undulating.
  • 6. The device of any one of examples 1-5 wherein each of the first and second anchoring members is an expandable stent.
  • 7. The device of any one of examples 1-5 wherein the each of the first and second anchoring members is an expandable mesh.
  • 8. The device of any one of examples 1-5 wherein each of the first and second anchoring members is at least one of an expandable stent and an expandable mesh.
  • 9. The device of any one of examples 1-8 wherein each of the first and second anchoring members is positioned around a circumference of the damping member.
  • 10. The device of any one of examples 1-8 wherein at least a portion of each of the first and second anchoring members is positioned within the damping member and extends through at least a portion of the thickness of the sidewall.
  • 11. The device of any one of examples 1-10 wherein the damping region is a first damping region, and wherein the damping member includes a plurality of damping regions between the first and second end portions.
  • 12. The device of any one of examples 1-11 wherein at least one of the first and second anchoring members comprise a plurality of fixation devices extending radially outwardly from the outer surface of the damping device.
  • 13. The device of any one of examples 1-12 wherein the device is configured to be positioned at a treatment site within the left common carotid artery.
  • 14. The device of any one of examples 1-13 wherein the device is configured to be positioned at a treatment site within the right common carotid artery.
  • 15. The device of any one of examples 1-14 wherein the device is configured to treat Alzheimer's disease.
  • 16. The device of any one of examples 1-15 wherein the device is configured to reduce the occurrence of microbleeds in one or more branches of the artery downstream from the treatment site.
  • 17. A device for treating dementia, comprising:
    • a damping member configured to be intravascularly positioned within an artery at a treatment site and having a lumen configured to direct blood flow to distal vasculature, the damping member being transformable between a low-profile state for delivery to the treatment site and an expanded state, wherein the damping member includes a damping region having a pressure limiter projecting laterally inwardly into the lumen to distribute pressure downstream from the damping member when a pulse pressure wave propagates along the damping member during systole; and
    • an anchoring member coupled to the damping member, wherein the anchoring member, in a deployed state, is configured to extend outwardly to a deployed diameter and contact a portion of the blood vessel wall at the treatment site, thereby securing the damping member at the treatment site, wherein the anchoring member extends along only a portion of the length of the damping member such that the damping region of the damping member is allowed to extend radially outward beyond the deployed diameter of the anchoring member.
  • 18. The device of example 17 wherein the damping member is configured to deform in response to a change in blood pressure.
  • 19. The device of example 17 or example 18 wherein, at a location along the damping member coincident with a leading end of a pulse pressure wave, the distance between the inner surface and the outer surface of the damping member decreases in response to the pressure.
  • 20. The device of any one of examples 17-19 wherein the lumen of the damping member has an hourglass shape.
  • 21. The device of any one of examples 17-20 wherein the anchoring member is an expandable stent.
  • 22. The device of any one of examples 17-20 wherein the anchoring member is an expandable mesh.
  • 23. The device of any one of examples 17-20 wherein the anchoring member is at least one of an expandable stent and an expandable mesh.
  • 24. The device of any one of examples 17-23 wherein the anchoring member is positioned around a circumference of the damping member.
  • 25. The device of any one of examples 17-23 wherein at least a portion of the anchoring member is positioned within the damping member and extends through at least a portion of the thickness of the sidewall.
  • 26. The device of any one of examples 17-25 wherein the damping region is a first damping region, and wherein the damping member includes a plurality of damping regions between the first and second end portions.
  • 27. The device of any one of examples 17-26 wherein the anchoring member includes a plurality of fixation devices extending radially outwardly from the outer surface of the damping device.
  • 28. The device of any one of examples 17-27 wherein the device is configured to be positioned at a treatment site within the left common carotid artery.
  • 29. The device of any one of examples 17-28 wherein the device is configured to be positioned at a treatment site within the right common carotid artery.
  • 30. The device of any one of examples 17-29 wherein the device is configured to treat Alzheimer's disease.
  • 31. The device of any one of examples 17-29 wherein the device is configured to reduce the occurrence of microbleeds in portions of the blood vessel downstream from the treatment site.
  • 32. A device for treating dementia, comprising:
    • a flexible, compliant damping member configured to be intravascularly positioned within an artery at a treatment site, the damping member being transformable between a low-profile state for delivery to the treatment site and an expanded state, wherein the damping member includes a generally tubular sidewall having (a) an outer surface, (b) an inner surface defining a lumen configured to direct blood flow, (c) a first end portion, (d) a second end portion opposite the first end portion along the length of the damping member, and (e) a damping region between the first and second end portions, wherein the inner surface and outer surface are spaced apart by a distance that is greater at the damping region than at either of the first or second end portions; and
    • a first anchoring member coupled to the first end portion of the damping member and a second anchoring member coupled to the second end portion of the damping member, wherein the first and second anchoring members, in a deployed state, extend radially to a deployed diameter configured to contact a portion of the blood vessel wall at the treatment site, thereby securing the damping member at the treatment site, and
    • wherein, when blood flows through the damping member during systole, the damping member absorbs a portion of the pulsatile energy of the blood, thereby reducing a magnitude of a pulse pressure transmitted to a portion of the blood vessel distal to the damping device.
  • 33. A device for treating a blood vessel, comprising:
    • an anchoring system having a first portion and a second portion; and
    • a cushioning member located between the first and second portions of the anchoring system such that a portion of the cushioning member is not constrained by the anchoring system, and wherein the cushioning member is configured to absorb pulsatile energy transmitted by blood flowing with the vessel.
  • 34. The device of example33 wherein the cushioning member is configured to expand in response to an increase of blood pressure within the vessel, and relax as the blood pressure within the vessel subsequently decreases.
  • 35. A device for treating a blood vessel, comprising:
    • an endovascular cushioning device having a proximal anchor and a distal anchor, each of the proximal and distal anchors being configured to abut against an inner wall of a major artery; and
    • an elastically deformable member extending between the proximal and distal anchors,
    • wherein the elastically deformable member is configured to expand in response to an increase of blood pressure within the vessel, and relax as the blood pressure within the vessel subsequently decreases.
  • 36. The device of example 35 wherein a portion of the elastically deformable membrane located longitudinally between the proximal and distal anchors defines a region of reduced internal cross-sectional area relative to the proximal and distal anchors when the elastically deformable membrane is radially relaxed.
  • 37. The device of example 35 or example 36 wherein the proximal and distal anchors are each radially expandable between a first diameter before deployment and a second diameter after deployment.
  • 38. The device of any one of examples 35-37, further comprising one or more threads secured to the proximal anchor.
  • 39. The device of example 38 wherein each thread is secured to an eyelet.
  • 40. A device for treating an artery selected from a left common carotid artery, a right common carotid artery, a brachiocephalic artery, the ascending aorta, an internal carotid artery, or an abdominal aorta, the device comprising:
    • a wrap fabricated from an elastically deformable material, and
    • an engagement formation adapted to secure two opposing edges of the wrap around the artery,
    • wherein the elastically deformable material is configured to radially expand during a systole stage and radially contract during a diastole stage.
  • 41. The device of example 40 wherein the engagement formation includes sutures and/or staples.
  • 42. The device of example 41 wherein the engagement formation includes a zip lock.
  • 43. A device for treating a left common carotid artery, a right common carotid artery, a brachiocephalic artery, or an ascending aorta, the device comprising:
    • a proximal anchor configured to be wrapped around the artery;
    • a distal anchor configured to be wrapped around the artery and longitudinally spaced relative to the proximal anchor; and
    • a helical band adapted to be wound around the artery, the helical band having a first end securable to the proximal anchor and an opposing second end securable to the distal anchor, wherein the helical band is adapted to radially expand during a systole stage and radially contract during a diastole stage.
  • 44. A device for treating or slowing the effects of dementia, comprising:
    • a damping member having a low-profile state and a deployed state, wherein, in the deployed state, the damping member comprises a deformable, generally tubular sidewall having an outer surface and an inner surface that is undulating in a longitudinal direction, and wherein the sidewall is configured to be positioned in apposition with a blood vessel wall to absorb pulsatile energy transmitted by blood flowing through the blood vessel.
  • 45. The device of example 1 wherein the damping member is configured to be positioned in apposition with at least one of a left common carotid artery, a right common carotid artery, and a brachiocephalic artery.
  • 46. The device of example 44 or example 45 wherein the damping member is configured to be positioned in apposition with an ascending aorta.
  • 47. The device of any one of examples 44-46 wherein the damping member is configured to be positioned in apposition with an inner surface of the blood vessel wall.
  • 48. The device of any one of examples 44-46 wherein the damping member is configured to be positioned in apposition with an outer surface of the blood vessel wall.
  • 49. The device of any one of examples 44-48 wherein the sidewall has an inner diameter, and, when the damping member is in a deployed state, the inner diameter increases then decreases in an axial direction.
  • 50. The device of any one of examples 44-49 wherein the cross-sectional area decreases then increases in longitudinal direction.
  • 51. The device of any one of examples 44-50 wherein the outer surface has a generally cylindrical shape.
  • 52. The device of any one of examples 44-50 wherein the outer surface has an undulating shape.
  • 53. The device of any one of examples 44-52, further comprising an anchoring member coupled to the damping member and axially aligned with only a portion of the damping member, wherein the anchoring member is configured to engage the blood vessel wall and secure the damping member to the blood vessel wall.
  • 54. The device of any one of examples 44-53 wherein the anchoring member is a first anchoring member and the device further comprises a second anchoring member coupled to the damping member, and wherein the second anchoring member:
    • is axially aligned with only a portion of the damping member, and
    • is spaced apart from the first anchoring member along the longitudinal axis of the damping member.
  • 55. The device of any one of examples 44-54 wherein, when the damping member is positioned adjacent the blood vessel wall, the damping member does not constrain the diameter of the blood vessel wall.
  • 56. A device for treating or slowing the effects of dementia, comprising:
    • an elastic member having a low-profile state for delivery to a treatment site at a blood vessel wall and a deployed state, wherein, in the deployed state, the elastic member is configured to abut an arterial wall and form a generally tubular structure having an inner diameter, an outer diameter, an outer surface, and an undulating inner surface, and wherein at least one of the outer diameter and the inner diameter increases and decreases in response to an increase and a decrease in pulse pressure within the blood vessel, respectively.
  • 57. The device of example 56 wherein the elastic member is configured to be positioned in apposition with at least one of a left common carotid artery, a right common carotid artery, and a brachiocephalic artery.
  • 58. The device of example 56 or example 57 wherein the elastic member is configured to be positioned in apposition with an ascending aorta.
  • 59. The device of any one of examples 56-58 wherein the elastic member is configured to be positioned in apposition with an inner surface of the blood vessel wall.
  • 60. The device of any one of examples 56-58 wherein the elastic member is configured to be positioned in apposition with an outer surface of the blood vessel wall.
  • 61. The device of any one of examples 56-60 wherein the sidewall has an inner diameter, and, when the elastic member is in a deployed state, the inner diameter increases then decreases in an axial direction.
  • 62. The device of any one of examples 56-61 wherein the cross-sectional area decreases then increases in longitudinal direction.
  • 63. The device of any one of examples 56-62 wherein the outer surface has a generally cylindrical shape.
  • 64. The device of any one of examples 56-62 wherein the outer surface has an undulating shape.
  • 65. The device of any one of examples 56-64, further comprising an anchoring member coupled to the elastic member and axially aligned with only a portion of the elastic member, wherein the anchoring member is configured to engage the blood vessel wall and secure the elastic member to the blood vessel wall.
  • 66. The device of example 65 wherein the anchoring member is a first anchoring member and the device further comprises a second anchoring member coupled to the elastic member, and wherein the second anchoring member:
    • is axially aligned with only a portion of the elastic member, and
    • is spaced apart from the first anchoring member along the longitudinal axis of the elastic member.
  • 67. The device of any one of examples 56-66 wherein, when the elastic member is positioned adjacent the blood vessel wall, the elastic member does not constrain the diameter of the blood vessel wall.
  • 68. A device for treating or slowing the effects of dementia, comprising:
    • a damping member including an abating susbtance, the damping member having a low-profile configuration and a deployed configuration, wherein, when the damping member is in the deployed configuration, the damping member forms a generally tubular structure configured to be positioned along the circumference of an artery such that, when a pulse wave traveling through the artery applies a stress at a first axial location along the length of the tubular structure, at least a portion of the abating substance moves away from the first location to a second axial location along the length of the tubular structure.
  • 69. The device of example 68, further comprising a structural element coupled to the damping member.
  • 70. The device of example 68 or example 69 wherein, in the deployed state, the damping member is configured to wrap around at least a portion of the circumference of the artery.
  • 71. The device of any one of examples 68-70 wherein, in the deployed state, the device has a pre-set helical configuration.
  • 72. The device of any one of examples 68-71 wherein the damping member includes a liquid.
  • 73. The device of any one of examples 68-72 wherein the damping member includes a gas.
  • 74. The device of any one of examples 68-73 wherein the damping member includes a gel.
  • 75. The device of any one of examples 68-74 wherein the damping member, in the deployed configuration, is configured to be positioned in apposition with an outer surface of the arterial wall.
  • 76. The device of any one of examples 68-74 wherein the damping member, in the deployed configuration, is configured to be positioned around the arterial wall such that an inner surface of the damping member is in contact with blood flowing through the artery.
  • 77. A device for treating or slowing the effects of dementia, comprising:
    • a damping member including a plurality of fluid particles, the damping member having a low-profile configuration and a deployed configuration, wherein, when the damping member is in the deployed configuration, the damping member is configured to be positioned along the circumference of an artery at a treatment site along a length of the artery,
    • wherein, when the damping member is in a deployed configuration and positioned at the treatment site, a wavefront traveling through the length of the artery redistributes at least a portion of the fluid particles along the length of the damping member such that the inner diameter of the damping member increases at the axial location along the damping member aligned with the wavefront while the inner diameter of the damping member at another axial location along the damping member decreases.
  • 78. The device of example 77, further comprising a structural element coupled to the damping member.
  • 79. The device of example 77 or example 78 wherein, in the deployed state, the damping member is configured to wrap around at least a portion of the circumference of the artery.
  • 80. The device of any one of examples 77-79 wherein, in the deployed state, the device has a pre-set helical configuration.
  • 81. The device of any one of examples 77-80 wherein the damping member includes a liquid.
  • 82. The device of any one of examples 77-81 wherein the damping member includes a gas.
  • 83. The device of any one of examples 77-82 wherein the damping member includes a gel.
  • 84. The device of any one of examples 77-83 wherein the damping member, in the deployed configuration, is configured to be positioned in apposition with an outer surface of the arterial wall.
  • 85. The device of any one of examples 77-84 wherein the damping member, in the deployed configuration, is configured to be positioned around the arterial wall such that an inner surface of the damping member is in contact with blood flowing through the artery.
  • 86. A method for treating or slowing the effects of dementia, comprising:
    • positioning a damping device in apposition with at least one of the brachiocephalic artery, the right common carotid artery, the left common carotid artery, the ascending aorta, and the aortic arch, the damping device comprising an elastic, generally tubular sidewall whereby the damping device absorbs pulsatile energy transmitted by blood flowing through the at least one of the brachiocephalic artery, the right common carotid artery, the left common carotid artery, the ascending aorta, and the aortic arch.
  • 87. A method for treating or slowing the effects of dementia, comprising:
    • positioning a damping device in apposition with the wall of an artery that delivers blood to the brain, the damping device comprising an elastic, generally tubular sidewall having an outer surface and an undulating inner surface; and
    • in response to a pulse pressure wave in blood flowing through the blood vessel, a contour of at least one of the inner surface and the outer surface changes.
  • 88. A method for treating at least one of the brachiocephalic artery, the right common carotid artery, the left common carotid artery, the ascending aorta, and the aortic arch, the method comprising:
    • positioning a damping device in apposition with a blood vessel wall, the damping device comprising an elastic, generally tubular sidewall;
    • expanding at least one of the inner diameter and the outer diameter of the damping device in response to an increase in pulse pressure; and
    • contracting at least one of the inner diameter and the outer diameter of the damping device in response to a decrease in pulse pressure.
  • 89. A method of treating a blood vessel, comprising:
    • inserting a catheter into a vessel and directing a tip of the catheter to a desired vascular location;
    • transferring a distal anchor from within the catheter tip into the vessel;
    • expanding the distal anchor such that a radially outer portion of the distal anchor engages with an inner wall of the vessel;
    • withdrawing the catheter slightly and transferring a proximal anchor from the tip of the catheter into the vessel;
    • longitudinally positioning the proximal anchor at a desired location;
    • expanding the proximal anchor such that a radially outer portion of the proximal anchor engages with an inner wall of the vessel, wherein an elastically deformable member extends longitudinally between the proximal and distal anchors.
  • 90. The method of example 89 wherein transferring the distal anchor includes advancing the distal anchor from the tip of the catheter.
  • 91. The method of example 89 or example 90 wherein transferring the distal anchor includes withdrawing the tip of the catheter whilst the distal anchor remains at a generally constant longitudinal position within the vessel, and exits from the tip of the catheter.
  • 92. The method of any one of examples 89-91 wherein longitudinally positioning the proximal anchor includes applying a first tensile force to one or more threads frangibly secured to the proximal anchor.
  • 93. The method of example 92, further including frangibly rupturing the thread(s) after expanding the proximal anchor by applying a second tensile force which is greater than the first tensile force.
  • 94. The method of example 92, further including disengaging a ring, latch or clasp secured to the thread(s) after expanding the proximal anchor in order to disengage the thread from the proximal anchor.
  • 95. The method of any one of examples 89-94, further including imaging to determine the location of the proximal and/or distal anchors.
  • 96. A method of treating a blood vessel selected from a left common carotid artery, a right common carotid artery or a brachiocephalic artery, a carotid artery, a branch of any of the foregoing, and an ascending aorta, the method comprising:
    • wrapping an elastically deformable material around the artery; and
    • attaching a first edge of the elastically deformable material to an opposing second edge of the elastically deformable material such that an internal diameter of the elastically deformable material is smaller than an initial outer diameter of the artery during a systole stage.
  • 97. A method for treating dementia, comprising:
    • intravascularly positioning a damping device within an artery at a treatment site, wherein the damping device includes an anchoring member coupled to an elastic, tubular damping member defining a lumen therethrough;
    • expanding the anchoring member and the damping member from a low profile state to an expanded state such that at least the anchoring member is in apposition with the arterial wall at the treatment site; and
    • changing a contour of the damping member in response to a pulse pressure wave in blood flow through the damping member.
  • 98. The method of example 97, further comprising reducing a magnitude of the pulse pressure transmitted to a portion of the blood vessel distal to the damping device.
  • 99. The method of example 98 wherein reducing a magnitude of the pulse pressure includes absorbing a portion of the pulsatile energy of blood flowing through the artery.
  • 100. The method of any one of examples 97-99 wherein changing a contour of the damping member includes increasing an inner diameter of the lumen damping member while an outer diameter of the damping member remains generally constant.
  • 101. The method of any one of examples 97-99 wherein changing a contour of the damping member includes increasing an inner diameter and an outer diameter of the lumen of the damping member.
  • 102. The method of any one of examples 97-99 wherein changing a contour of the damping member includes decreasing a distance between an inner surface of the damping member and an outer surface of the damping member.
  • 103. The method of example 1 wherein intravascularly positioning a damping device includes intravascularly positioning a damping device within a left common carotid artery at a treatment site.
  • 104. The method of any one of examples 97-103 wherein intravascularly positioning a damping device includes intravascularly positioning a damping device within a right common carotid artery at a treatment site.
  • 105. The method of any one of examples 97-104 wherein expanding the anchoring member and expanding the damping member occurs simultaneously.
  • 106. The method of any one of examples 97-105 wherein expanding the anchoring member includes expanding the anchoring member with a balloon.
  • 107. The method of any one of examples 97-105 wherein expanding the anchoring member includes withdrawing a sheath to expose the anchoring member to allow the anchoring member to self-expand.
  • 108. The method of any one of examples 97-107 wherein expanding the damping member includes expanding the damping member with a balloon.
  • 109. The method of any one of examples 97-107 wherein expanding the damping member includes withdrawing a sheath to expose the damping member to allow the anchoring member to self-expand.
  • 110. The method of any one of examples 97-109 wherein expanding the anchoring member forces the damping member to expand.
  • 111. The method of any one of examples 97-110 wherein:
    • the damping device is a first damping device,
    • the first damping device is intravascularly positioned at a first arterial location, and
    • the method further comprises intravascularly positioning a second damping device at a second arterial location different than the first arterial location.
  • 112. The method of example 111 wherein the first arterial location is one of a left common carotid artery, a right common carotid artery, an external carotid artery, an internal carotid artery, and an ascending aorta, and the second arterial location is one of a left common carotid artery, a right common carotid artery, an external carotid artery, an internal carotid artery, and an ascending aorta.
  • 113. The method of example 111 wherein the first arterial location is a left common carotid artery and the second arterial location is a right common carotid artery.
  • 114. A method for treating or slowing the effects of dementia, comprising:
    • positioning a damping member along a length of an artery, the damping member including an abating substance; and
    • in response to a pulse wave traveling through blood in the artery, redistributing at least a portion of the abating compound along the length of the damping member, thereby attenuating at least a portion of the energy of the pulse wave in the blood.
  • 115. A method for treating or slowing the effects of dementia, comprising:
    • positioning a damping member along a length of an artery, the damping member including a plurality of fluid particles; and
    • moving a portion of the fluid particles away from an axial location along the damping member aligned a wavefront of a pulse wave, thereby increasing the inner diameter of the damping member.
  • 116. A device for treating or slowing the progression of dementia, comprising:
    • a flexible, compliant damping member configured to be intravascularly positioned within an artery at a treatment site, the damping member being transformable between a low-profile state for delivery to the treatment site and an expanded state, wherein the damping member includes a generally tubular sidewall having (a) an outer surface, (b) an inner surface defining a lumen configured to direct blood flow, (c) a first end portion, (d) a second end portion opposite the first end portion along the length of the damping member, and (e) a damping region between the first and second end portions, wherein the inner surface and outer surface are spaced apart by a distance that is greater at the damping region than at either of the first or second end portions; and
    • a first anchoring member coupled to the first end portion of the damping member and a second anchoring member coupled to the second end portion of the damping member, wherein the first and second anchoring members, in a deployed state, extend radially to a deployed diameter configured to contact a portion of the arterial wall at the treatment site, thereby securing the damping member at the treatment site, and wherein the first and second anchoring members extend along only a portion of the length of the damping member such that at least a portion of the damping region is exposed between the first and second anchoring members and allowed to expand to a diameter greater than the deployed diameter.
  • 117. The device of example 116 wherein the damping member is elastically deformable, and is configured to deform in response to a change in blood pressure.
  • 118. The device of example 116 or example 117 wherein, at a location along the damping member coincident with a leading end of a pulse pressure wave, the distance between the inner surface and the outer surface of the damping member decreases in response to the pressure.
  • 119. The device of any one of examples 116-118 wherein the lumen of the damping member has an hourglass shape.
  • 120. The device of any one of example 116-119 wherein the outer surface is generally cylindrical and the inner surface is undulating.
  • 121. The device of any one of examples 116-120 wherein each of the first and second anchoring members is an expandable stent.
  • 122. The device of any one of examples 116-120 wherein the each of the first and second anchoring members is an expandable mesh.
  • 123. The device of any one of examples 116-120 wherein each of the first and second anchoring members is at least one of an expandable stent and an expandable mesh.
  • 124. The device of any one of examples 116-123 wherein each of the first and second anchoring members is positioned around a circumference of the damping member.
  • 125. The device of any one of examples 116-124 wherein at least a portion of each of the first and second anchoring members is positioned within the damping member and extends through at least a portion of the thickness of the sidewall.
  • 126. The device of any one of examples 116-125 wherein the damping region is a first damping region, and wherein the damping member includes a plurality of damping regions between the first and second end portions.
  • 127. The device of any one of examples 116-126 wherein at least one of the first and second anchoring members comprise a plurality of fixation devices extending radially outwardly from the outer surface of the damping device.
  • 128. The device of any one of examples 116-127 wherein the device is configured to be positioned at a treatment site within the left common carotid artery.
  • 129. The device of any one of examples 116-127 wherein the device is configured to be positioned at a treatment site within the right common carotid artery.
  • 130. The device of any one of examples 116-129 wherein the device is configured to treat Alzheimer's disease.
  • 131. The device of any one of examples 116-129 wherein the device is configured to reduce the occurrence of microbleeds in one or more branches of the artery downstream from the treatment site.
  • 132. A device for treating dementia, comprising:
    • a damping member configured to be intravascularly positioned within an artery at a treatment site and having a lumen configured to direct blood flow to distal vasculature, the damping member being transformable between a low-profile state for delivery to the treatment site and an expanded state, wherein the damping member includes a damping region having a pressure limiter projecting laterally inwardly into the lumen to distribute pressure downstream from the damping member when a pulse pressure wave propagates along the damping member during systole; and
    • an anchoring member coupled to the damping member, wherein the anchoring member, in a deployed state, is configured to extend outwardly to a deployed diameter and contact a portion of the blood vessel wall at the treatment site, thereby securing the damping member at the treatment site, wherein the anchoring member extends along only a portion of the length of the damping member such that the damping region of the damping member is allowed to extend radially outward beyond the deployed diameter of the anchoring member.
  • 133. The device of example 132 wherein the damping member is elastically deformable, and is configured to deform in response to a change in blood pressure.
  • 134. The device of example 132 or 133 wherein, at a location along the damping member coincident with a leading end of a pulse pressure wave, the distance between the inner surface and the outer surface of the damping member decreases in response to the pressure.
  • 135. The device of any one of examples 132-134 wherein the lumen of the damping member has an hourglass shape.
  • 136. The device of any one of examples 132-135 wherein the anchoring member is an expandable stent.
  • 137. The device of any one of examples 132-136 wherein the anchoring member is an expandable mesh.
  • 138. The device of any one of examples 132-137 wherein the anchoring member is at least one of an expandable stent and an expandable mesh.
  • 139. The device of any one of examples 132-138 wherein the anchoring member is positioned around a circumference of the damping member.
  • 140. The device of any one of examples 132-139 wherein at least a portion of the anchoring member is positioned within the damping member and extends through at least a portion of the thickness of the sidewall.
  • 141. The device of any one of examples 132-140 wherein the damping region is a first damping region, and wherein the damping member includes a plurality of damping regions between the first and second end portions.
  • 142. The device of any one of examples 132-141 wherein the anchoring member includes a plurality of fixation devices extending radially outwardly from the outer surface of the damping device.
  • 143. The device of any one of examples 132-142 wherein the device is configured to be positioned at a treatment site within the left common carotid artery.
  • 144. The device of any one of examples 132-142 wherein the device is configured to be positioned at a treatment site within the right common carotid artery.
  • 145. The device of any one of examples 132-144 wherein the device is configured to treat Alzheimer's disease.
  • 146. The device of any one of examples 132-145 wherein the device is configured to reduce the occurrence of microbleeds in portions of the blood vessel downstream from the treatment site.
  • 147. A device for treating dementia, comprising:
    • a flexible, compliant damping member configured to be intravascularly positioned within an artery at a treatment site, the damping member being transformable between a low-profile state for delivery to the treatment site and an expanded state, wherein the damping member includes a generally tubular sidewall having (a) an outer surface, (b) an inner surface defining a lumen configured to direct blood flow, (c) a first end portion, (d) a second end portion opposite the first end portion along the length of the damping member, and (e) a damping region between the first and second end portions, wherein the inner surface and outer surface are spaced apart by a distance that is greater at the damping region than at either of the first or second end portions; and
    • a first anchoring member coupled to the first end portion of the damping member and a second anchoring member coupled to the second end portion of the damping member, wherein the first and second anchoring members, in a deployed state, extend radially to a deployed diameter configured to contact a portion of the blood vessel wall at the treatment site, thereby securing the damping member at the treatment site, and
    • wherein, when blood flows through the damping member during systole, the damping member absorbs a portion of the pulsatile energy of the blood, thereby reducing a magnitude of a pulse pressure transmitted to a portion of the blood vessel distal to the damping device.
  • 148. A device for treating a blood vessel, comprising:
    • an anchoring system having a first portion and a second portion which is spaced apart from the first portion in a first direction; and
    • a cushioning member located between the first and second portions of the anchoring system such that movement of a portion of the cushioning member in a second direction, which is orthogonal to the first direction, is not constrained by the anchoring system, and wherein the cushioning member is configured to absorb pulsatile energy transmitted by blood flowing with the vessel.
  • 149. The device of example 148 wherein the cushioning member is elastically deformable and is configured to expand in response to an increase of blood pressure within the vessel, and relax as the blood pressure within the vessel subsequently decreases.
  • 150. A device for treating a blood vessel, comprising:
    • an endovascular cushioning device having a proximal anchor and a distal anchor which is spaced apart from the proximal anchor, each of the proximal and distal anchors being configured to abut against an inner wall of a major artery; and
    • an elastically deformable member extending between the proximal and distal anchors,
    • wherein the elastically deformable member is configured to expand in response to an increase of blood pressure within the vessel, and relax as the blood pressure within the vessel subsequently decreases.
  • 151. The device of example 150 wherein a portion of the elastically deformable membrane located longitudinally between the proximal and distal anchors defines a region of reduced internal cross-sectional area relative to the proximal and distal anchors when the elastically deformable membrane is radially relaxed.
  • 152. The device of example 150 or example 151 wherein the proximal and distal anchors are each radially expandable between a first diameter before deployment and a second diameter after deployment.
  • 153. The device of any one of examples 150-152, further comprising one or more threads secured to the proximal anchor.
  • 154. The device of example 153 wherein each thread is secured to an eyelet.
  • 155. A device for treating an artery selected from a left common carotid artery, a right common carotid artery, a brachiocephalic artery, the ascending aorta, an internal carotid artery, or an abdominal aorta, the device comprising:
    • a wrap fabricated from an elastically deformable material, and
    • an engagement formation adapted to secure two opposing edges of the wrap around the artery,
    • wherein the elastically deformable material is configured to radially expand during a systole stage and radially contract during a diastole stage.
  • 156. The device of example 155 wherein, when the wrap is in position around the artery, the wrap entirely or substantially entirely surrounds the artery over a portion of its length.
  • 157. The device of example 155 wherein the engagement formation includes sutures and/or staples.
  • 158. The device of example 155 wherein the engagement formation includes a zip lock.
  • 159. A device for treating a left common carotid artery, a right common carotid artery, a brachiocephalic artery, or an ascending aorta, the device comprising:
    • a proximal anchor configured to be wrapped around the artery;
    • a distal anchor configured to be wrapped around the artery and longitudinally spaced relative to the proximal anchor; and
    • a helical band adapted to be wound around the artery, the helical band having a first end securable to the proximal anchor and an opposing second end securable to the distal anchor, wherein the helical band is adapted to radially expand during a systole stage and radially contract during a diastole stage.
  • 160. The device of example 159 wherein the first end of the helical band is secured to the proximal anchor and the second end of the helical band is secured to the distal anchor.
  • 161. A device for treating or slowing the effects of dementia, comprising:
    • a damping member comprising a deformable, generally tubular sidewall having an outer surface and an inner surface that is undulating in a longitudinal direction, and wherein the sidewall is configured to be positioned in apposition with a blood vessel wall to absorb pulsatile energy transmitted by blood flowing through the blood vessel.
  • 162. The device of example 161 wherein the damping member is configured to be positioned in apposition with at least one of a left common carotid artery, a right common carotid artery, and a brachiocephalic artery.
  • 163. The device of example 161 wherein the damping member is configured to be positioned in apposition with an ascending aorta.
  • 164. The device of any one of examples 161-163 wherein the damping member is configured to be positioned in apposition with an inner surface of the blood vessel wall.
  • 165. The device of any one of examples 161-163 wherein the damping member is configured to be positioned in apposition with an outer surface of the blood vessel wall.
  • 166. The device of any one of examples 161-165 wherein the sidewall has an inner diameter, and, when the damping member is in a deployed state, the inner diameter increases then decreases in an axial direction.
  • 167. The device of any one of examples 161-166 wherein the cross-sectional area decreases then increases in longitudinal direction.
  • 168. The device of any one of examples 161-167 wherein the outer surface has a generally cylindrical shape.
  • 169. The device of any one of examples 161-167 wherein the outer surface has an undulating shape.
  • 170. The device of any one of examples 161-169, further comprising an anchoring member coupled to the damping member and axially aligned with only a portion of the damping member, wherein the anchoring member is configured to engage the blood vessel wall and secure the damping member to the blood vessel wall.
  • 171. The device of example 170 wherein the anchoring member is a first anchoring member and the device further comprises a second anchoring member coupled to the damping member, and wherein the second anchoring member:
    • is axially aligned with only a portion of the damping member, and
    • is spaced apart from the first anchoring member along the longitudinal axis of the damping member.
  • 172. The device of any one of examples 161-171 wherein, when the damping member is positioned adjacent the blood vessel wall, the damping member does not constrain the diameter of the blood vessel wall.
  • 173. A device for treating or slowing the effects of dementia, comprising:
    • an elastic member which is configured to abut an arterial wall and form a generally tubular structure having an inner diameter, an outer diameter, an outer surface, and an undulating inner surface, and wherein at least one of the outer diameter and the inner diameter increases and decreases in response to an increase and a decrease in pulse pressure within the blood vessel, respectively.
  • 174. The device of example 173 wherein the elastic member is configured to be positioned in apposition with at least one of a left common carotid artery, a right common carotid artery, and a brachiocephalic artery.
  • 175. The device of example 173 wherein the elastic member is configured to be positioned in apposition with an ascending aorta.
  • 176. The device of any one of examples 173-175 wherein the elastic member is configured to be positioned in apposition with an inner surface of the blood vessel wall.
  • 177. The device of any one of examples 173-175 wherein the elastic member is configured to be positioned in apposition with an outer surface of the blood vessel wall.
  • 178. The device of any one of examples 173-177 wherein the sidewall has an inner diameter, and, when the elastic member is in a deployed state, the inner diameter increases then decreases in an axial direction.
  • 179. The device of any one of examples 173-178 wherein the cross-sectional area decreases then increases in longitudinal direction.
  • 180. The device of any one of examples 173-179 wherein the outer surface has a generally cylindrical shape.
  • 181. The device of any one of examples 173-179 wherein the outer surface has an undulating shape.
  • 182. The device of any one of examples 173-181, further comprising an anchoring member coupled to the elastic member and axially aligned with only a portion of the elastic member, wherein the anchoring member is configured to engage the blood vessel wall and secure the elastic member to the blood vessel wall.
  • 183. The device of example 182 wherein the anchoring member is a first anchoring member and the device further comprises a second anchoring member coupled to the elastic member, and wherein the second anchoring member:
    • is axially aligned with only a portion of the elastic member, and
    • is spaced apart from the first anchoring member along the longitudinal axis of the elastic member.
  • 184. The device of any one of examples 173 to 23 wherein, when the elastic member is positioned adjacent the blood vessel wall, the elastic member does not constrain the diameter of the blood vessel wall.
  • 185. The device of any one of examples 173-184 wherein the damping member or elastic member has a low-profile state and a deployed state.
  • 186. The device of example 185 wherein the deployed state is for delivery to a treatment site at a blood vessel wall.
  • 187. The device of example 185 or 186 wherein the damping member or elastic member has a first, lesser outer diameter when in the low-profile state and a second, greater diameter when in the deployed state.
  • 188. A device for treating or slowing the effects of dementia, comprising:
    • a damping member including an abating substance, wherein the damping member forms a generally tubular structure having an axis, wherein the abating substance is able to move axially relative to the tubular structure, and wherein the damping member is configured to be positioned along the circumference of an artery such that, when a pulse wave traveling through the artery applies a stress at a first axial location along the length of the tubular structure, at least a portion of the abating substance moves away from the first location to a second axial location along the length of the tubular structure.
  • 189. The device of example 188, wherein the abating substance comprises a quantity of a fluid and/or gel comprising particles, contained within a flexible member, and the particles may move axially relative to the tubular structure within the flexible member.
  • 190. The device of example 189 wherein the flexible member may, at at least some locations along the length of the tubular structure, be deformed radially with respect to the tubular structure.
  • 191. The device of any one of examples 188-190, further comprising a structural element coupled to the damping member.
  • 192. The device of any one of examples 188-191 wherein, in a deployed state, the damping member is configured to wrap around at least a portion of the circumference of the artery.
  • 193. The device of example 192 wherein the damping member includes a break along its length, to allow it to be fitted around the portion of the circumference of the artery.
  • 194. The device of example 193, further comprising cooperating sealing arrangements located on or near opposing edges of the break, to allow the edges to be joined together once the damping member has been fitted around the portion of the circumference of the artery.
  • 195. The device of any one of examples 188-194 wherein, in a deployed state, the device has a pre-set helical configuration.
  • 196. The device of any one of examples 188-195 wherein the damping member includes a liquid.
  • 197. The device of any one of examples 188-196 wherein the damping member includes a gas.
  • 198. The device of any one of examples 188-197 wherein the damping member includes a gel.
  • 199. The device of any one of examples 188-198 wherein the damping member, in a deployed configuration, is configured to be positioned in apposition with an outer surface of the arterial wall.
  • 200. The device of any one of examples 188-199 wherein the damping member, in a deployed configuration, is configured to be positioned around the arterial wall such that an inner surface of the damping member is in contact with blood flowing through the artery.
  • 201. A device for treating or slowing the effects of dementia, comprising:
    • wherein the fluid particles are able to move axially along at least a part of the length of the damping structure, the damping member being configured to be positioned along the circumference of an artery at a treatment site along a length of the artery,
    • wherein, when the damping member is in a deployed configuration and positioned at the treatment site, a wavefront traveling through the length of the artery redistributes at least a portion of the fluid particles along the length of the damping member such that the inner diameter of the damping member increases at the axial location along the damping member aligned with the wavefront while the inner diameter of the damping member at another axial location along the damping member decreases.
  • 202. The device of example201 wherein the fluid particles are contained within a flexible member, and the particles may move along the length of the damping member within the flexible member.
  • 203. The device of example 202 wherein the flexible member may, at at least some locations along the length of the damping member, be deformed radially with respect to the damping member.
  • 204. The device of any one of examples 201-203, further comprising a structural element coupled to the damping member.
  • 205. The device of any one of examples 201-204 wherein, in the deployed state, the damping member is configured to wrap around at least a portion of the circumference of the artery.
  • 206. The device of example 205 wherein the damping member includes a break along its length, to allow it to be fitted around the portion of the circumference of the artery.
  • 207. The device of example 206, further comprising cooperating sealing arrangements located on or near opposing edges of the break, to allow the edges to be joined together once the damping member has been fitted around the portion of the circumference of the artery.
  • 208. The device of any one of examples 201-207 wherein, in the deployed state, the device has a pre-set helical configuration.
  • 209. The device of any one of examples 201-208 wherein the damping member includes a liquid.
  • 210. The device of any one of examples 201-209 wherein the damping member includes a gas.
  • 211. The device of any one of examples 201-210 wherein the damping member includes a gel.
  • 212. The device of any one of examples 201-211 wherein the damping member, in the deployed configuration, is configured to be positioned in apposition with an outer surface of the arterial wall.
  • 213. The device of any one of examples 201-212 wherein the damping member, in the deployed configuration, is configured to be positioned around the arterial wall such that an inner surface of the damping member is in contact with blood flowing through the artery.
  • 214. The device of any one of examples 201-213 wherein the damping member has a low profile configuration and a deployed configuration.
V. CONCLUSION
• Although many of the embodiments are described above with respect to systems, devices, and methods for treating and/or slowing the progression of vascular and/or age-related dementia via intravascular methods, the technology is applicable to other applications and/or other approaches, such as surgical implantation of one or more damping devices and/or treatment of blood vessels other than arterial blood vessels supplying blood to the brain, such as the abdominal aorta. Any appropriate site within a blood vessel may be treated including, for example, the ascending aorta, the aortic arch, the brachiocephalic artery, the right subclavian artery, the left subclavian artery, the left common carotid artery, the right common carotid artery, the internal and external carotid arteries, and/or branches of any of the foregoing. Moreover, other embodiments in addition to those described herein are within the scope of the technology. Additionally, several other embodiments of the technology can have different configurations, components, or procedures than those described herein. A person of ordinary skill in the art, therefore, will accordingly understand that the technology can have other embodiments with additional elements, or the technology can have other embodiments without several of the features shown and described above with reference toFIGS. 2A-19B.
• The above detailed descriptions of embodiments of the technology are not intended to be exhaustive or to limit the technology to the precise form disclosed above. Where the context permits, singular or plural terms may also include the plural or singular term, respectively. Although specific embodiments of, and examples for, the technology are described above for illustrative purposes, various equivalent modifications are possible within the scope of the technology, as those skilled in the relevant art will recognize. For example, while steps are presented in a given order, alternative embodiments may perform steps in a different order. The various embodiments described herein may also be combined to provide further embodiments.
• Moreover, unless the word “or” is expressly limited to mean only a single item exclusive from the other items in reference to a list of two or more items, then the use of “or” in such a list is to be interpreted as including (a) any single item in the list, (b) all of the items in the list, or (c) any combination of the items in the list. Additionally, the term “comprising” is used throughout to mean including at least the recited feature(s) such that any greater number of the same feature and/or additional types of other features are not precluded. It will also be appreciated that specific embodiments have been described herein for purposes of illustration, but that various modifications may be made without deviating from the technology. Further, while advantages associated with certain embodiments of the technology have been described in the context of those embodiments, other embodiments may also exhibit such advantages, and not all embodiments need necessarily exhibit such advantages to fall within the scope of the technology. Accordingly, the disclosure and associated technology can encompass other embodiments not expressly shown or described herein.

Claims (20)

I/we claim:

1. A device for treating a blood vessel, comprising:

an anchoring system having a first portion and a second portion; and

a cushioning member located between the first and second portions of the anchoring system such that a portion of the cushioning member is not constrained by the anchoring system, and wherein the cushioning member is configured to absorb pulsatile energy transmitted by blood flowing with the vessel.

2. The device ofclaim 1 wherein the cushioning member is configured to expand in response to an increase of blood pressure within the vessel, and relax as the blood pressure within the vessel subsequently decreases.

3. A device for treating a blood vessel, comprising:

an endovascular cushioning device having a proximal anchor and a distal anchor, each of the proximal and distal anchors being configured to abut against an inner wall of a major artery; and

an elastically deformable member extending between the proximal and distal anchors,

wherein the elastically deformable member is configured to expand in response to an increase of blood pressure within the vessel, and relax as the blood pressure within the vessel subsequently decreases.

4. The device ofclaim 3 wherein a portion of the elastically deformable membrane located longitudinally between the proximal and distal anchors defines a region of reduced internal cross-sectional area relative to the proximal and distal anchors when the elastically deformable membrane is radially relaxed.

5. The device ofclaim 3 wherein the proximal and distal anchors are each radially expandable between a first diameter before deployment and a second diameter after deployment.

6. The device ofclaim 3, further comprising one or more threads secured to the proximal anchor.

7. The device ofclaim 6 wherein each thread is secured to an eyelet.

8. A device for treating an artery selected from a left common carotid artery, a right common carotid artery, a brachiocephalic artery, the ascending aorta, an internal carotid artery, or an abdominal aorta, the device comprising:

a wrap fabricated from an elastically deformable material, and

an engagement formation adapted to secure two opposing edges of the wrap around the artery,

wherein the elastically deformable material is configured to radially expand during a systole stage and radially contract during a diastole stage.

9. The device ofclaim 8 wherein the engagement formation includes sutures and/or staples.

10. The device ofclaim 8 wherein the engagement formation includes a zip lock.

11. A device for treating a left common carotid artery, a right common carotid artery, a brachiocephalic artery, or an ascending aorta, the device comprising:

a proximal anchor configured to be wrapped around the artery;

a distal anchor configured to be wrapped around the artery and longitudinally spaced relative to the proximal anchor; and

a helical band adapted to be wound around the artery, the helical band having a first end securable to the proximal anchor and an opposing second end securable to the distal anchor, wherein the helical band is adapted to radially expand during a systole stage and radially contract during a diastole stage.

12. A method of treating a blood vessel, comprising:

inserting a catheter into a vessel and directing a tip of the catheter to a desired vascular location;

transferring a distal anchor from within the catheter tip into the vessel;

expanding the distal anchor such that a radially outer portion of the distal anchor engages with an inner wall of the vessel;

withdrawing the catheter slightly and transferring a proximal anchor from the tip of the catheter into the vessel;

longitudinally positioning the proximal anchor at a desired location;

expanding the proximal anchor such that a radially outer portion of the proximal anchor engages with an inner wall of the vessel, wherein an elastically deformable member extends longitudinally between the proximal and distal anchors.

13. The method ofclaim 12 wherein transferring the distal anchor includes advancing the distal anchor from the tip of the catheter.

14. The method ofclaim 12 wherein transferring the distal anchor includes withdrawing the tip of the catheter whilst the distal anchor remains at a generally constant longitudinal position within the vessel, and exits from the tip of the catheter.

15. The method ofclaim 12 wherein longitudinally positioning the proximal anchor includes applying a first tensile force to one or more threads frangibly secured to the proximal anchor.

16. The method ofclaim 15, further including frangibly rupturing the thread(s) after expanding the proximal anchor by applying a second tensile force which is greater than the first tensile force.

17. The method ofclaim 15, further including disengaging a ring, latch or clasp secured to the thread(s) after expanding the proximal anchor in order to disengage the thread from the proximal anchor.

18. The method ofclaim 12, further including imaging to determine the location of the proximal and/or distal anchors.

19. A method of treating a blood vessel selected from a left common carotid artery, a right common carotid artery or a brachiocephalic artery, a carotid artery, a branch of any of the foregoing, and an ascending aorta, the method comprising:

wrapping an elastically deformable material around the artery; and

attaching a first edge of the elastically deformable material to an opposing second edge of the elastically deformable material such that an internal diameter of the elastically deformable material is smaller than an initial outer diameter of the artery during a systole stage.

20. The method ofclaim 19, further including stretching the deformable material in response to a pulse wave travelling through the artery.

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