Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M27/00—Drainage appliance for wounds or the like, i.e. wound drains, implanted drains
  • A61M27/002—Implant devices for drainage of body fluids from one part of the body to another
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/02—General characteristics of the apparatus characterised by a particular materials
  • A61M2205/0216—Materials providing elastic properties, e.g. for facilitating deformation and avoid breaking
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/02—General characteristics of the apparatus characterised by a particular materials
  • A61M2205/0244—Micromachined materials, e.g. made from silicon wafers, microelectromechanical systems [MEMS] or comprising nanotechnology
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/02—General characteristics of the apparatus characterised by a particular materials
  • A61M2205/0266—Shape memory materials
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/04—General characteristics of the apparatus implanted
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/33—Controlling, regulating or measuring
  • A61M2205/3331—Pressure; Flow
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
  • A61M2205/00—General characteristics of the apparatus
  • A61M2205/75—General characteristics of the apparatus with filters
  • A61M2205/7545—General characteristics of the apparatus with filters for solid matter, e.g. microaggregates

Definitions

• the present technology generally relates to implantable medical devices and, in particular, to adjustable shunting systems and associated methods for selectively controlling fluid flow between a first body region and a second body region of a patient.
• Implantable shunting systems are widely used to treat a variety of patient conditions by shunting fluid from a first body region/cavity to a second body region/cavity.
• the flow of fluid through the shunting systems is primarily controlled by the pressure gradient across the shunt and the physical characteristics of the flow path defined through the shunt (e.g., the resistance of the shunt lumen(s)).
• most shunting systems have a single static flow path that is not adjustable. Accordingly, one challenge with conventional shunting systems is selecting the appropriate size shunt for a particular patient. A shunt that is too small may not provide enough therapy to the patient, while a shunt that is too large may create new issues in the patient.
• FIG. 1 A is a perspective view of an adjustable shunting system including a screen element configured in accordance with various embodiments of the present technology.
• FIG. IB is a top view of the adjustable shunting system of FIG. 1 A.
• FIG. 1C is an enlarged top view of select aspects of the adjustable shunting system of FIG. IB with other aspects omitted for the purpose of clarity.
• FIG. 2 is a top view of the screen assembly of FIG. 1A and select aspects of the system of FIG. 1A, with other aspects of the system omitted for the purpose of clarity.
• FIG. 3 is a block diagram illustrating a method of operating an adjustable shunting system having a screen assembly and configured in accordance with various embodiments of the present technology.
• FIGS. 4A and 4B are top and cross-sectional views, respectively, of an adjustable shunting system including a screen assembly and configured in accordance with additional embodiments of the present technology.
• FIG. 4C is an enlarged cross-sectional view of a portion of the adjustable shunting system of FIG. 4B.
• FIGS. 5A and 5B are top and cross-sectional views, respectively, of another adjustable shunting system including a screen assembly and configured in accordance with various embodiments of the present technology.
• FIG. 6A is a top view
• FIGS. 6B and 6C are partially-exploded isometric views of an adjustable shunting system including screen assemblies and configured in accordance with further embodiments of the present technology.
• FIGS. 7A and 7B are a top view and an end view, respectively, of select aspects of an adjustable shunting system configured in accordance with embodiments of the present technology, with other aspects of the system omitted for illustrative clarity.
• FIGS. 8A and 8B are a top view and a bottom view, respectively, of an adjustable shunting system configured in accordance with embodiments of the present technology.
• the present technology is generally directed to systems, devices, and methods for maintaining flow in adjustable shunting systems.
• At least some of the adjustable shunting systems described herein can include screen assemblies configured to filter aqueous passing through the shunting system and at least partially or fully prevent debris from entering an internal portion (e.g., the fluid inlets, a plate assembly, one or more channels, etc.) of the shunting system.
• the disclosed screen assemblies can include a plurality of pores or openings formed therein, with the individual pores being sized to at least partially prevent debris or other contaminants from entering the internal portion of the shunting system while also at least partially allowing fluid (e.g., aqueous) to flow through the internal portion of the shunting system.
• the screen assemblies can be configured such that non-invasive energy (e.g., ablative laser energy) can be applied to the screen to at least partially dissolve, bum-off, or otherwise remove the captured debris.
• adjustable shunting systems include channels, lumens, or other paths through which fluid can flow from a first body region to a second body region.
• the fluid that flows through these systems can include cellular matter, particulate matter, and/or other debris that can partially or fully obstruct (e.g., block, clog, etc.) the fluid flow paths through these systems.
• the operation of many adjustable shunting systems can be adversely affected (e.g., rendered partially or fully inoperable) due to any such debris that enters these systems.
• adjustable shunting systems include actuators configured to provide an adjustable therapy to a patient; previous attempts to reduce or prevent debris from entering such adjustable shunting systems can interfere with the operation of the actuators of these systems. Accordingly, compared with conventional systems, adjustable shunting systems including screen assemblies configured in accordance with embodiments of the present technology are expected to provide an adjustable therapy to patients while inhibiting and/or at least partially preventing debris/contaminants from adversely affecting operation of such systems.
• the screen assemblies can include one or more sealing elements configured to sealingly engage at least a portion of the adjustable shunting system.
• the sealing elements are expected to further reduce the likelihood that debris will block or clog the adjustable shunting systems.
• the adjustable shunting systems can include a plurality of fluid inlets, and the screen assemblies (e.g., one or more pores of the screen assemblies) can be positioned above and/or cover the plurality of fluid inlets to define a fluid space between the screen assemblies and individual ones of the plurality of fluid inlets.
• the fluid space is expected to allow fluid to reach individual ones of the plurality of fluid inlets if the screen assembly becomes partially blocked or clogged.
• At least some of the adjustable shunting systems described herein include a plurality of fluid inlets configured to reduce or prevent tissue ingrowth, which, in turn, is expected to further reduce the likelihood that the adjustable shunting systems become blocked or clogged. Additionally, or alternatively, at least some of the adjustable shunting systems include one or more channels having varying dimensions, such as a channel having a first width at a first end of the channel and a second width at a second end of the channel. The second width can be greater than the first width; fluid (e.g., aqueous) can flow through the channel from the first end to the second end, such that the width of the channel can increase in the direction of the fluid flow through the channel.
• fluid e.g., aqueous
• channels with varying dimensions are expected to be less likely to become blocked or clogged.
• individual ones of the channels can be fluidly coupled to a plurality of inlets, such as two or more inlets arranged in series along the length of a channel. If a portion of the channel becomes blocked or clogged, an inlet downstream from the blockage/clog can be opened to bypass the blockage/clog and/or otherwise allow flow through the channel to resume.
• adjustable shunting system is described in terms of shunting fluid from an anterior chamber of an eye
• adjustable shunting systems having screen elements configured in accordance with embodiments of the present technology can be readily adapted to shunt fluid from and/or between other portions of the eye, or, more generally, from and/or between a first body region and a second body region.
• any of the embodiments herein, including those referred to as “glaucoma shunts” or “glaucoma devices” may nevertheless be used and/or modified to treat other diseases or conditions, including other diseases or conditions of the eye or other body regions.
• the systems described herein can be used to treat diseases characterized by increased pressure and/or fluid build-up, including but not limited to heart failure (e.g., heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, etc.), pulmonary failure, renal failure, hydrocephalus, and the like.
• heart failure e.g., heart failure with preserved ejection fraction, heart failure with reduced ejection fraction, etc.
• pulmonary failure pulmonary failure
• renal failure e.g., pulmonary failure, renal failure, hydrocephalus, and the like.
• the systems described herein may be applied equally to shunting other fluid, such as blood or cerebrospinal fluid, between the first body region and the second body region.
• FIGS. 1A and IB illustrate an adjustable shunting system 100 (“the system 100”) including a screen assembly 150 configured in accordance with various embodiments of the present technology.
• FIG. 1A illustrates a perspective view of the system 100
• FIG. IB illustrates a top view of the system 100.
• the screen assembly 150 is configured to filter aqueous passing through the system 100 and at least partially or fully prevent debris from entering an internal portion (e.g., the fluid inlets, a plate assembly, one or more channels, etc.) of the system 100.
• the system 100 includes a generally elongated housing 102 (“the housing 102”) and a plate assembly or cartridge 120.
• the housing 102 (which can also be referred to as a casing, membrane, shunting element, or the like) extends between a first end portion 102a and a second end portion 102b.
• the housing 102 can include one or more openings (e.g., the opening 104 of FIG. 1C) configured to receive fluid (e.g., aqueous) from an environment (e.g., the first body region) external to the system 100.
• the system 100 includes one or more fluid outlets 106 positioned proximate the second end portion 102b of the housing 102.
• the one or more fluid outlets 106 can have any other suitable position relative to the housing 102.
• the housing 102 further includes a main fluid conduit 110 fluidly coupling the plate assembly 120 to the one or more fluid outlets 106.
• the housing 102 can also optionally have one or more wings or appendages (not shown) having holes (e.g., suture holes) or other attachment features for securing the elongated housing 102 in a desired position.
• the housing 102 can be composed of a slightly elastic or flexible biocompatible material (e.g., silicone, etc.).
• the plate assembly 120 (which can also be referred to as a flow control plate, a flow control cartridge, a plate structure, or the like) is positioned at least partially or fully within the housing 102.
• the housing 102 substantially and/or fully encases the plate assembly 120 at or proximate the first end portion 102a of the housing 102.
• the plate assembly 120 can have any other suitable position at least partially or fully within the housing 102.
• the plate assembly 120 can be fluidly coupled to the one or more fluid outlets 106 via the main fluid conduit 110, and can be configured to control the flow of fluid through the system 100.
• an upper surface of the plate assembly 120 forms a substantial fluid seal with an interior surface of the elongated housing 102 at the first end portion 102a such that the only way for fluid to enter the system 100 is through the fluid inlets 124. Accordingly, for fluid to flow through the system 100, it generally must flow through the plate assembly 120.
• the plate assembly 120 can include: (i) one or more fluid apertures or inlets (e.g., the fluid inlets 124a-c of FIG. 1C) that align with the opening 104 (FIG.
• the actuators 130 in the elongated housing 102 and allow fluid to enter the plate assembly 120; (ii) one or more actuators 130a-b (“the actuators 130”), each of the actuators 130 positioned to control the flow of fluid through a corresponding one of the fluid inlets 124a-c; and/or (iii) one or more channels 136a-c through which fluid (e.g., aqueous) can flow through the system 100 (e.g., from the one or more fluid inlets 124a-c to and/or toward the one or more fluid outlets 106).
• the screen assembly 150 is positioned proximate the first end portion 102a of the housing 102.
• the screen assembly 150 can be positioned proximate the second end portion 102b of the housing 102, or can have any other suitable position relative to the housing 102 of the system 100.
• the screen assembly 150 can include a screen or filter 152 (“the screen 152”). At least part of the screen 152 can be aligned with at least a portion (e.g., the opening 104, the plate assembly 120, the actuators 130, etc.) of the system 100. In the illustrated embodiment, for example, the screen 152 is at least partially aligned with (e.g., positioned above) the plate assembly 120 and the actuators 130.
• the screen 152 is positioned within the housing 102, at least partially between the housing 102 and the plate assembly 120 with at least part of the screen 152 aligned with (e.g., covering, positioned above, etc.) the one or more fluid inlets 124a-c (FIG. 1C), such that fluid from the first body region can pass through the screen 152 before entering the plate assembly 120 via the fluid inlets 124.
• the screen 152 can protect at least one, a plurality, or all of the fluid inlets 124 of the system 100 from debris and/or other matter.
• the screen 152 can be positioned at least partially or fully external to the housing 102, such as above or at least partially within the opening 104 of the housing 102.
• the screen 152 can be positioned within the plate assembly 120, such as between one or more of the fluid inlets 124 and the actuators 130 and/or between the actuators 130 and one or more of the channels 136, such that fluid that enters the plate assembly 120 can pass through the screen 152 before entering one or more of the channels 136.
• the screen 152 can have any other suitable position relative to the system 100.
• the screen assembly 150 can include more screens, such as at least two, three, four, or any other suitable number of screens, each of which can have any suitable position relative to the system 100.
• the screen 152 can be formed from silicon, acrylic, a shape-memory material, and/or any other suitable material.
• the screen 152 is formed from poly dimethylsiloxane (PDMS), poly dimethylacrylamide (PDMA), and/or superelastic nitinol.
• PDMS poly dimethylsiloxane
• PDMA poly dimethylacrylamide
• superelastic nitinol superelastic nitinol.
• select portions of the screen 152 are illustrated as being opaque to better illustrate aspects of the present technology. It will be appreciated that, in other embodiments, all or part of the screen 152 can be transparent, translucent (e.g., partially transparent), opaque, or have any other suitable transmissivity.
• the system 100 is configured to provide an adjustable therapy for draining fluid from a first body region to a second, different body region, such as to drain aqueous from an anterior chamber of a patient’s eye.
• the plate assembly 120 is configured to selectively control the flow of fluid entering the system 100.
• each of the actuators 130 can be actuated (via, e.g., energy) to control the flow of fluid through a corresponding fluid inlet.
• the fluid e.g., aqueous
• the fluid can include one or more cellular masses, particulate matter, and/or any other debris in the first body region.
• screens in accordance with embodiments of the present technology can be configured: (i) to allow a first portion of the fluid to flow through at least an internal portion the system 100 (e.g., the fluid inlets 124, the plate assembly 120, the chambers 121, the channels 136, etc.); (ii) to at least partially prevent a second portion of the fluid (e.g., debris) from partially or fully clogging, obstructing, blocking, or otherwise preventing flow of the first portion of the fluid through the internal portion of the system 100; (iii) to be least partially cleaned or unclogged by application of a first non-invasive energy (e.g., laser energy); and/or (iv) to allow the actuators 130 to be accessible (e.g., through at least part of the screen 152) to second non-invasive energy (e.g., laser energy) to actuate one or more of the actuators 130.
• a first non-invasive energy e.g., laser energy
• the screen 152 can allow aqueous from the first body region to enter the system 100 while at least partially filtering or screening one or more cellular masses and/or other debris in the first body region (e.g., suspended in the aqueous) from entering the internal portion of the system 100.
• the cellular masses and/or other debris can accumulate on and/or within the screen 152 such that the screen 152 can become at least partially blocked or clogged by the cellular masses and/or other debris.
• adjustable shunting systems including screen assemblies configured in accordance with embodiments of the present technology can be at least partially cleaned or unclogged via delivery of non-invasive energy and without being removed from a patient.
• energy e.g., laser energy
• FIG. 1C illustrates an enlarged top view of a portion the system 100 with the screen assembly 150 omitted to better illustrate other aspects of the system 100.
• the housing 102 can include an opening 104 configured to receive fluid (e.g., aqueous) from an environment external to the system 100 (e.g., the first body region).
• the opening 104 can be aligned with one or more fluid inlets 124 in the plate assembly 120.
• the opening 104 is aligned with a first fluid inlet 124a, a second fluid inlet 124b, and a third fluid inlet 124c.
• the fluid inlets 124 permit fluid to enter an interior of the plate assembly 120 (and thus an interior of the elongated housing 102) from an environment external to the system 100.
• the screen 152 can be aligned with one or more of the fluid inlets 124 such that, before flowing through the plate assembly 120, fluid can flow through the screen 152 (e.g., as described previously and with reference to FIGS. 1 A and IB).
• the fluid path through the plate assembly 120 depends on which fluid inlet 124 the fluid enters through.
• fluid that enters the system 100 via the first fluid inlet 124a flows into a first chamber 121a of the plate assembly 120 and drains to the main fluid conduit 110 via the first channel 136a.
• Fluid that enters the system 100 via the second fluid inlet 124b flows into a second chamber 121b of the plate assembly 120 and drains to the main fluid conduit 110 via a second channel 136b.
• Fluid that enters the system 100 via the third fluid inlet 124c drains to the main fluid conduit 110 via the third channel 136c.
• the chambers 121a-b and the channels 136a-c can be fluidly isolated such that there are three discrete flow paths through the plate assembly 120.
• the channels 136a-c can also have different geometric configurations (e.g., lengths) relative to one another such that they have different fluid resistances and thus, can provide different flow rates.
• the relative level of therapy provided by each fluid path can be different so that a user may adjust/modulate the level of therapy provided by the system 100 by selectively opening and/or closing various fluid paths (e.g., by selectively interfering with or permitting flow through individual fluid inlets 124).
• the first fluid inlet 124a and/or the first channel 136a can provide a first fluid resistance when fluid travels primarily therethrough;
• the second fluid inlet 124b and/or the second channel 136b can provide a second fluid resistance less than the first fluid resistance when fluid travels primarily through the second fluid inlet 124b;
• the third fluid inlet 124c and/or the third channel 136c can provide a third fluid resistance less than the first fluid resistance when fluid travels primarily through the third fluid inlet 124c.
• each of the fluid inlets 124a-c can provide a different fluid flow rate through the system 100.
• the channels 136a-c can have the same or generally the same geometric configurations such that they have the same or generally the same fluid resistances, and thus provide similar flow rates for a given pressure.
• the first actuator 130a is positioned in the first chamber 121a and configured to control the flow of fluid through the first fluid inlet 124a and the second actuator 130b is positioned in the second chamber 121b and configured to control the flow of fluid through the second fluid inlet 124b.
• the first actuator 130a can include a first projection or gating element 134a configured to moveably interface with the first fluid inlet 124a, e.g., to move between a first (e.g., “open”) position in which the gating element 134a does not substantially prevent fluid from flowing through the first fluid inlet 124a (e.g., by being offset from and/or otherwise not interfering with the first fluid inlet 124a) and a second (e.g., “closed”) position in which the gating element 134a substantially prevent fluid from flowing through the first fluid inlet 124a (e.g., by blocking, being positioned within, and/or otherwise aligned with the first fluid inlet 124a).
• a first e.g., “open” position in which the gating element 134a does not substantially prevent fluid from flowing through the first fluid inlet 124a (e.g., by being offset from and/or otherwise not interfering with the first fluid inlet 124a)
• the gating element 134a can be configured to move to one or more intermediate positions between the first (e.g., open) and the second (e.g., closed) position.
• the second actuator 130b can include a second gating element 134b that operates in a similar manner as the gating element 134a (e.g., moveable between open and closed positions relative to the second fluid inlet 124b).
• the flow of fluid through the third inlet 124c is not controlled by an actuator, and the third inlet 124c and/or the third channel 136 can be configured to provide a constant or minimum flow rate of fluid through the system 100.
• the plate assembly 120 can include a third actuator generally similar to or the same as the first actuator 130a and/or the second actuator 130b, and the third actuator can have a third gating element that operates in a similar manner as the first gating element 134a and/or the second gating element 134b (e.g., moveable between open and closed positions relative to the third fluid inlet 124c).
• the third actuator can be positioned in a third chamber generally similar to or the same as the first chamber 121a and/or the second chamber 121b.
• the first actuator 130a can further include a first actuation element 132ai and a second actuation element 132a2 that drive movement of the gating element 134a between the first (e.g., open) position and the second (e.g., closed) position.
• the first actuation element 132ai and the second actuation element 132a2 can be composed at least partially of a shape memory material or alloy (e.g., nitinol).
• first actuation element 132ai and the second actuation element 132a2 can be transitionable at least between a first material phase or state (e.g., a martensitic state, a R-phase, a composite state between martensitic and R-phase, etc.) and a second material phase or state (e.g., an austenitic state, an R-phase state, a composite state between austenitic and R-phase, etc.).
• a first material phase or state e.g., a martensitic state, a R-phase, a composite state between martensitic and R-phase, etc.
• second material phase or state e.g., an austenitic state, an R-phase state, a composite state between austenitic and R-phase, etc.
• the first actuation element 132ai and the second actuation element 132a2 may have reduced (e.g., relatively less stiff) mechanical properties that cause the actuation elements to be more easily deformable (e.g., compressible, expandable, etc.) relative to when the actuation elements are in the first material state.
• the first actuation element 132ai and the second actuation element 132a2 may have increased (e.g., relatively stiffer) mechanical properties relative to the first material state, causing an increased preference toward a specific preferred geometry (e.g., original geometry, manufactured or fabricated geometry, heat set geometry, etc.).
• the first actuation element 132ai and the second actuation element 132a2 can be selectively and independently transitioned between the first material state and the second material state by applying energy (e.g., laser energy, electrical energy, etc.) to the first actuation element 132ai or the second actuation element 132a2 to heat it above a transition temperature (e.g., above an austenite finish (Af) temperature, which is generally greater than body temperature). If the first actuation element 132ai (or the second actuation element 132a2) is deformed relative to its preferred geometry when heated above the transition temperature, the first actuation element 132ai (or the second actuation element 132a2) will move to and/or toward its preferred geometry.
• energy e.g., laser energy, electrical energy, etc.
• first actuation element 132ai and the second actuation element 132a2 are operably coupled such that, when the actuated actuation element (e.g., the first actuation element 132ai) transitions toward its preferred geometry, the non-actuated actuation element (e.g., the second actuation element 132a2) is further deformed relative to its preferred geometry.
• the first actuation element 132ai and the second actuation element 132a2 generally act in opposition.
• the first actuation element 132ai can be actuated to move the gating element 134a to and/or toward the first (e.g., open) position
• the second actuation element 132a2 can be actuated to move the gating element 134a to and/or toward the second (e.g., closed) position.
• the first actuation element 132ai and the second actuation element 132a2 can be coupled such that as one moves toward its preferred geometry upon material phase transition, the other is deformed relative to its preferred geometry. This enables the actuation elements 132a to be repeatedly actuated and the gating element 134a to be repeatedly cycled between the first (e.g., open) position and the second (e.g., closed) position.
• each actuation element 132 can include one or more targets 138.
• the target(s) 138 can be thermally coupled to the corresponding actuation element(s) 132 such that that energy (e.g., laser energy) received at the target(s) 138 can dissipate through the corresponding actuation element(s) 132 as heat.
• the target(s) 138 can therefore be selectively targeted with energy to actuate the actuation elements 132.
• heat/energy can be applied to the first target 138ai, such as from an energy source positioned external to the patient’s eye (e.g., a laser).
• the heat applied to the first target 138ai spreads through at least a portion of the first actuation element 132ai, which can heat the first actuation element 132ai above its transition temperature.
• heat/energy can be applied to the second target 138a2.
• the heat applied to the second target 138a2 spreads through the second actuation element 132a2, which can heat at least the portion of the second actuation element 132a2 above its transition temperature.
• the targets 138 are positioned generally centrally along a length of each individual actuation element 132. In other embodiments, the targets 138 can be positioned at an end region of each individual actuation element 132.
• the targets 138 are composed of a same material (e.g., nitinol) as the actuation elements 132.
• a same material e.g., nitinol
• the increased surface area of the targets 138 relative to the actuation elements 132 is expected in increase the ease and consistency by which the actuators 130 can be actuated using an energy source (e.g., a laser) positioned external to the body.
• the second actuator 130b can also include a pair of opposing shape-memory actuators and operate in the same or similar fashion as the first actuator 130a.
• the third actuator can also include a pair of opposing shape-memory actuators and operate in the same or similar fashion as the first actuator 130a and/or the second actuator 130b.
• the system 100 is depicted as having two actuators 130a-b in FIGS. 1A-1C, in other embodiments the system 100 can include more or fewer actuators 130.
• the system 100 can include one, three, four, five, six, seven, eight, nine, ten, or any other suitable number of actuators 130.
• the system 100 is depicted as having three channels 136a-c in FIGS. 1 A-1C, in other embodiments the system 100 can include more or fewer channels 136.
• the system 100 can include one, two, four, five, six, seven, eight, nine, ten, or any other suitable number of channels 136.
• the number of channels 136 corresponds to the number of fluid inlets 124 and/or the number of actuators 130 in the system.
• the energy (e.g., “actuating energy”) used to actuate the actuation elements can have generally similar or the same properties (e.g., optical properties, such as a generally similar or the wavelength and/or amplitude) as the energy (e.g., “cleaning energy”) used to at least partially clean or unclog the screen 152. It at least some embodiments, for example, the actuating energy and the cleaning energy can be the same, such that the energy used to clean the screen 152 can also be used to actuate the actuators 130. In other embodiments, however, the actuating energy and the cleaning energy can have different properties (e.g., optical properties, such as different wavelengths and/or amplitudes).
• FIG. 2 is a top view of the screen assembly 150 and select aspects of the system 100 of FIGS. 1A-1C, with other aspects of the system 100 omitted for the purpose of clarity.
• the screen 152 of the screen assembly 150 can include a first end portion 252a and a second end portion 252b opposite the first end portion 252a.
• the first end portion 252a and/or the second end portion 252b of the screen 152 can include one or more screening or filtering elements 256 (“the screen elements 256”).
• One or more of the screening elements 256 can be at least partially aligned with (e.g., positioned above or below, positioned at least partially within, etc.) the opening 104 and/or at least one of the fluid inlets 124 described previously and with reference to FIGS. 1A-1C.
• each of the screening elements 256 is a circular hole or pore formed in the screen 152 and having a dimension (e.g., width, diameter, etc.) of about 10 pm.
• each of the screening elements 256 can have an oval, square, pentagonal, hexagonal, curvilinear, rectilinear, and/or any other suitable shape.
• each of the screening elements 256 can have a width of between about 0.1 pm to about 100 pm, such as at least 1 pm, 5 pm, 10 pm, 20 pm, 50 pm, and width therebetween, or another suitable width.
• the configuration of individual ones of the screening elements 256 can be configured based, at least partially, on a flow resistance associated with the configuration.
• individual ones of the screening elements 256 can be configured to provide a flow resistance less than individual ones of the channels 136a-c (FIGS. 1A-1C).
• the screening elements 256 can have any other suitable configuration.
• the first end portion 252a and the second end portion 252b of the screen 152 both include 126 screening elements, in other embodiments the first end portion 252a and/or the second end portion 252b can have more or fewer screening elements.
• the screen 152 can further include one or more actuator access or viewing regions 258 (“the regions 258”).
• Each of the region 258 can extend partially or fully between the first end portion 252a and the second end portion 252b of the screen 152, and/or can be at least partially aligned with (e.g., positioned above) a corresponding one of the actuators 130 and/or the chambers 121.
• the screen 152 includes (i) a first region 258a aligned with at least part of the first actuator 130a and the first chamber 121a and (ii) a second region 258b aligned with at least part of the second actuator 130b and the second chamber 121b.
• Each of the regions 258 can be configured such that at least a portion of the corresponding actuators 130 (e.g., the actuation elements 132, the target 138, etc.) can be accessible to energy (e.g., laser energy) applied from outside the adjustable shunting system.
• one or more of the regions 258 can be gaps or apertures in (e.g., formed in) the screen 152 and at least part (e.g., the actuator targets 138) of one or more of the actuators 130a-b can be accessible to energy through the corresponding regions 258 of the screen 152, such that energy directed toward one or more of the regions 258 can pass through the screen 152 and be incident on the correspond actuator(s) 130.
• one or more of the regions 258 can be a portion of the screen 152 formed from a material (e.g., PDMS, PDMA, etc.) that is at least partially or fully transparent.
• the entire screen 152 and/or screen assembly 150 can be formed from a material (e.g., PDMS, PDMA, etc.) that is at least partially or fully transparent.
• the screen 152 can be formed a single sheet of material.
• the screen assembly 150 can further include one or more indicator regions 260.
• Each of the indicator regions 260 can correspond to one of the actuators 130, such that each of the indicator regions 260 can be aligned with at least a portion of the corresponding actuator 130.
• the screen assembly 150 includes (i) a first indicator region 260a aligned with an end portion 235a of the first gating element 134a of the first actuator 130a and (ii) a second indicator region 260b aligned with an end portion 235b of the second gating element 134b of the second actuator 130b.
• Each of the indicator regions 260 can be at least partially or fully transparent, such that the corresponding end portions 235 can be visualized and/or observed (e.g., by a user and/or a practitioner of the system 100) through the corresponding indicator regions 260.
• each of the screening elements 256 can be configured (i) to allow at least a first portion of the fluid to enter an internal portion (e.g., the fluid inlets 124, the plate assembly 120, the chambers 121, etc.) of the system 100 and (ii) to at least partially or fully prevent at least a second portion of the fluid (e.g., debris) from entering the internal portion of the system 100.
• each of the screening elements 256 can be sized such that the second portion of the fluid can be captured on and/or within one or more of the screening elements 256.
• one or more of the screening elements 256 may become at least partially or fully blocked or clogged by the debris filtered from the fluid.
• Energy e.g., non-invasive energy, ablative laser energy, etc.
• the first end portion 252a and/or the second end portion 252b of the screen 152 can be configured to withstand exposure to energy such that the energy can be applied to the first end portion 252a and/or the second end portion 252b to partially or fully dissolve, bum-off, or otherwise remove debris from one or more of the screening elements 256.
• one or more of the regions 258 can be configured such that the corresponding actuator(s) 130 can be at least partially or fully accessible to energy (e.g., laser energy).
• the first actuator 130a and/or second actuator 130b can be accessible to energy from outside the system 100 via the corresponding regions 258, such that the energy can be applied to selectively and/or individually actuate the actuators 130a-b.
• one or more of the end portion 235 can be visualized via the corresponding indicator region 260 to determine whether the corresponding actuator 130 and/or gating element 134 is in the first (e.g., open) position or the second (e.g., closed configuration) position.
• FIG. 3 is a flow diagram illustrating a method 370 of operating an adjustable shunting system configured in accordance with various embodiments of the present technology.
• the method 370 is illustrated as a set of blocks, steps, operations, or processes 371-373. All or a subset of the blocks 371-373 can be executed at least in part by various components of a system, such as the system 100 of FIGS. 1A-1C, filter assembly 150 of FIGS. 1A, IB, and FIG. 2. For example, all or a subset of the blocks 371-373 can be executed at least in part by a screen assembly, a screen, a screening element, an actuator, an actuation assembly, and/or other portions of an adjustable shunting system.
• all or a subset of the blocks 371-373 can be executed at least in part by an operator (e.g., a user, a patient, a caregiver, a family member, a physician, etc.) of the system. Furthermore, any one or more of the blocks 371-373 can be executed in accordance with the discussion above. Many of the blocks 371- 373 of the method 370 are discussed in detail below with reference to FIGS. 1A-2 for the sake of clarity and understanding. It will be appreciated, however, that the method 370 may be used with other suitable adjustable shunting systems in addition to those described herein.
• the method 370 begins at block 371 by directing energy toward a screen assembly of an adjustable shunting system.
• directing energy toward the screen assembly can include applying energy to a screen and/or one or more screening elements of the screen assembly.
• the screen and/or screening elements can be similar to the screens and/or screening elements discussed above with reference to FIGS. 1A-2.
• applying the energy to a screen assembly can include applying energy to a first end portion 252a and/or a second end portion 252b of the screen 152, the first end portion 252a and/or the second end portion 252b including one or more screening elements 256, as described previously with reference to FIG. 2.
• directing energy toward the screen assembly can include directing energy toward one or more actuator access regions of the screen assembly.
• the one or more actuator access regions can be similar to the actuator access regions 258 discussed above with reference to FIG. 2.
• directing the energy to the screen assembly can include applying the energy to one or more actuators 130 of the adjustable shunting system 100 via a corresponding one of the one or more actuator access regions 258, such that the energy passes through at least a portion of the screen assembly 150 (via, e.g., the access regions 258).
• applying energy to the one or more actuators can include applying the energy to one or more targets 138 of the actuators 130 via the corresponding actuator access regions 258.
• the method 370 continues by removing at least a portion of any cellular masses, particulate matter, and/or any other debris from the screen of the screen assembly.
• removing at least the portion of the debris from the screen can include removing at least the portion of the debris from one or more screening elements of the screen.
• the screen and/or the screening elements can be similar to the screens 152 and/or screening elements 256 discussed above with reference to FIGS. 1A-2.
• removing at least the portion of the debris from the screen 152 can include dissolving and/or burning off one or more cellular masses and/or any other debris captured on and/or at least partially within one or more of the screening elements 256 of the screen 152.
• the method 370 continues by transitioning an actuator of the adjustable shunting system between a first position and a second position.
• transitioning the actuator between the first position and the second position can include (i) moving an actuation element of the actuator to and/or toward a preferred geometry of the actuation element or (ii) deforming the actuation element relative to the preferred geometry.
• the actuator and the actuation element can be generally similar to the actuators 130 and actuation elements 132 described previously with reference to FIGS. 1A-2.
• transitioning the actuator 130 between the first position and the second position can include (i) moving a first actuation element 132ai of a first actuator 130a to and/or toward a preferred geometry or (ii) deforming the first actuation element 132ai relative to the preferred geometry.
• the steps of the method 370 are discussed and illustrated in a particular order, the method 370 illustrated in FIG. 3 is not so limited. In other embodiments, the method 370 can be performed in a different order. In these and other embodiments, any of the steps of the method 370 (e.g., block 373) can be performed before, during, and/or after any of the other steps of the method 370 (e.g., block 372) Moreover, a person of ordinary skill in the relevant art will recognize that the illustrated method 370 can be altered and still remain within these and other embodiments of the present technology. For example, one or more steps of the method 370 (e.g., block 373) illustrated in FIG. 3 can be omitted and/or repeated in some embodiments.
• any of the screen assemblies and/or screens described above can be used as part of an adjustable shunting system, e.g., to control the flow of fluid therethrough.
• certain features described with respect to one screen assembly and/or screen can be added or combined with another screen assembly and/or screen. Accordingly, the present technology is not limited to the screen assemblies and actuators expressly identified herein.
• the screen assemblies could be utilized with the adjustable shunting systems and actuation assemblies described in U.S. Patent Nos. 11,291,585 and 11,166,849, and International Patent Application Nos.
• FIGS. 4 A and 4B are top and cross-sectional views, respectively, of another adjustable shunting system 400 (“the system 400”) including a screen assembly 450 configured in accordance with various embodiments of the present technology.
• the system 400 can be generally similar or identical in structure and/or function to one or more aspects of the system 100 of FIGS. 1A and IB, with like names and/or reference numbers (e.g., plate assembly or cartridge 420 versus the plate assembly 120 of FIGS. 1A-2) indicating generally similar or identical aspects.
• the screen assembly 450 can be generally similar or identical in structure and/or function to one or more aspects of the screen assembly 150 of FIGS. 1A-2.
• the system 400 can perform and/or be configured for use in one or more steps of the method 370 of FIG. 3.
• the screen assembly 450 includes a filter or screen 452 having one or more screening or filtering elements 456 (shown as one or more first screen elements 456a and one or more second screen elements 456b in FIGS. 4A and 4B).
• the screen assembly 450 can further include one or more sealing elements 454 (e.g., a first sealing element 454a and a second sealing element 454b).
• both the first sealing element 454a and the second sealing element 454b are configured as projections extending (e.g., downwardly) from the screen 452.
• first sealing elements 454a and the second sealing element 454b can be separate components from the screen 452 and positioned between the screen 452 and the plate assembly 420.
• one or both of the first sealing elements 454a and the second sealing element 454b can be formed from a same or different material, e.g., as each other, the screen 452, and/or another component of the system 400.
• the sealing elements 454a, 454b can correspond to one or more of the screen elements 456a, 456b.
• the first sealing element 454a is positioned around (e.g., extends around, surrounds, encircles, borders, defines, and/or the like) a perimeter and/or circumference of the one or more first screen elements 456a and the second sealing element 454b is positioned around a perimeter and/or circumference of the one or more second screen elements 456b.
• first sealing element 454a and the second sealing element 454b can be positioned around a portion of the perimeters/circumferences of the respective one or more first and second screen elements 456a, 456b and/or extend partially or fully around individual ones of the respective first and second screen elements 456a, 456b.
• the sealing elements 454a, 454b can sealingly engage the plate assembly 420 and create substantially fluid-impermeable seals (e.g., a first seal 425a and a second seal 425b) between the screen 452 and the plate assembly 420, such that all or substantially all fluid that passes through (e.g., is filtered by) the filtering elements 456a, 456b enters the plate assembly 420.
• substantially fluid-impermeable seals e.g., a first seal 425a and a second seal 425b
• the first sealing element 454a and the second sealing element 454b both sealingly engage a cover plate 421 of the plate assembly 420.
• the cover plate 421 can include one or more recessed areas (e.g., the first recessed area 423a and the second recessed area 423b) configured to correspond to individual ones of the sealing elements 454a, 454b.
• One or both of the first recessed area 423a and the second recessed area 423b can extend into and/or out of the cross-section plane shown in FIG. 4B through the cover plate 421, e.g., to define a channel extending through the cover plate 421 in a width-wise direction and/or at least generally perpendicular to a longitudinal axis of the system 400.
• the sealing elements 454a, 454b can extend into and/or out of the cross-section plane shown in FIG.
• the second sealing element 454b can be received within the second recessed area 423b to form the second seal 425b; likewise, although not shown in FIG. 4C, the first sealing element 454a can be received within the first recessed area 423a to form the first seal 425a.
• sealingly engaging the sealing elements 454a, 454b within the corresponding recessed areas 423a, 423b is expected to further improve the substantially fluid-impermeable seal formed between the screen assembly 450 and the plate assembly 420.
• the cover plate 421 can include one or more fluid inlets. Although only the third fluid inlet 424c is shown in FIG. 4B, it will be appreciated that the system 400 can also include a first fluid inlet and a second fluid inlet, such as the first and second fluid inlets 124a, 124b of FIG. 1C.
• One or more of the screen elements 456a, 456b can be aligned with (e.g., covering, positioned above, and the like) one or more of the fluid inlets, such that fluid can pass through the screen 452 before entering the plate assembly 420 via the fluid inlets (e.g., fluid first passes through the screen 452 before flowing through the fluid inlet 424c and into the plate assembly 420).
• the second screen elements 456b are aligned with the third fluid inlet 424c.
• the sealing elements 454a, 454b sealingly engage the cover plate 421
• the sealing elements 454a, 454b can also extend around the fluid inlets, such that the associated seals 425a, 425b are formed around the fluid inlets such that substantially all the fluid that flows through the screening elements 456a, 456b also flows into the plate assembly 420 via the fluid inlets.
• the second sealing element 454b extends around the third fluid inlet 424c such that the second seal 425b is formed around the third fluid inlet 424c and substantially all fluid that flows through the second screening elements 456b enters the plate assembly 420 via the third fluid inlet 424c. Accordingly, the sealing elements 454a, 454b can at least partially or fully prevent fluid that flows through the screen assembly 450 from leaking, for example, between the housing 402 and the plate assembly 420.
• FIGS. 5A and 5B are top and cross-sectional views, respectively, of another adjustable shunting system 500 (“the system 500”) including a screen assembly 550 configured in accordance with various embodiments of the present technology.
• the system 500 can be generally similar or identical in structure and/or function to one or more aspects of the system 100 of FIGS. 1A and IB and/or the system 400 of FIGS. 4A and 4B, with like names and/or reference numbers (e.g., plate assembly or cartridge 520 versus the plate assembly 120 of FIGS. 1A-2 and the plate assembly 420 of FIGS. 4A and 4B) indicating generally similar or identical aspects.
• the screen assembly 550 can be generally similar or identical in structure and/or function to one or more aspects ofthe screen assembly 150 of FIGS. 1A-2 and/orthe screen assembly 450 ofFIGS. 4A and 4B.
• the system 500 can perform and/or be configured for use in one or more steps of the method 370 of FIG. 3.
• the system 500 includes a first fluid inlet 524a, a second fluid inlet 524b and a third fluid inlet 524c.
• the inlets 524a-c can be formed in a cover plate 521 (FIG. 5B) of the plate assembly 520 (FIG. 5B).
• the cover plate 521 and/or the plate assembly 520 can be angled (e.g., radially inwardly) relative to a longitudinal axis of the system 500.
• the screen assembly 550 includes a screen 552 aligned with (e.g., positioned above) each of the first, second, and third fluid inlets 524a-c.
• the screen 552 includes one or more screen elements 556.
• screen elements 556 extend at least partially between the first, second, and/or third fluid inlets 524a-c to form a T-shaped array of screen elements.
• the screen elements 556 can be arranged in one or more rows, columns, a U-shaped array, a V-shaped array, and/or any other suitable configuration.
• the screen 552 can include one or more sealing elements 554 configured to sealingly engage the plate assembly 520 and form a substantially fluid- impermeable seal 525 between the screen assembly 550 and the plate assembly 520.
• the screen assembly 550 includes a single sealing element 554 configured to form a single seal 525 extending around the screen elements 556.
• the screen assembly 550 can include more sealing elements 554, individual ones of which can be configured to form respective seals 525 with the plate assembly 520.
• the sealing elements 554 can extend or project from screen 552, as described above with respect to the sealing elements 454a, 454b of FIGS. 4A and 4B.
• sealingly engaging the screen assembly 550 with the plate assembly 520 can create a fluid space or gap 557 between the sealing elements 554, the plate assembly 520, and the screen 552, as shown in FIG. 5B.
• the fluid space 557 can be fluidly coupled to the screen elements 556 and the fluid inlets 524a-c (FIG. 5A) in the plate assembly 520 and can allow fluid to flow between individual ones of the fluid inlets 524a-c within the housing 502 upstream from the plate assembly 520.
• fluid that flows through the screen elements 556 can pass through the fluid space 557 before entering the plate assembly 520 via the fluid inlets 524a-c and flowing through the channels (only third channel 536c is visible in FIG.
• the fluid space 557 can allow fluid that enters the system 500 to reach the given fluid inlet via one or more of the other, unobstructed screen elements 556 away from the given fluid inlet. Accordingly, the fluid space 557 is expected to maintain flow through the system 500 and/or improve the control of flow through the system 500 if individual ones of the screen elements 556 become blocked or clogged.
• the plate assembly 520 can be sloped or tapered.
• the plate assembly 520 has a first dimension (e.g., height) at or near the first end portion 502a and a second dimension distal from the first end portion 502a (e.g., at or near the main fluid conduit 510) that is less than the first dimension, such that the plate assembly 520 is sloped/angled downwardly toward the main fluid conduit 510.
• one or more of the channels 536 can be angled or sloped.
• the third channel 536c is angled relative to the longitudinal axis of the system 500, e.g., inwardly from the screen assembly 550 toward the main fluid conduit 510 and/or the interior of the housing 502.
• angled plate assemblies and/or channels are expected to reduce the likelihood that fluid will accumulate within the fluid space 557 and at least partially block flow through the system 500 during operation.
• FIG. 6A is a top view
• FIGS. 6B and 6C are partially-exploded isometric views of another adjustable shunting system 600 (“the system 600”) including screen assemblies 650a, 650b configured in accordance with various embodiments of the present technology.
• the system 600 can be generally similar or identical in structure and/or function to one or more aspects of the system 100 of FIGS. 1A and IB, the system 400 of FIGS. 4A and 4B, and/or the system 500 of FIGS. 5A and 5B, with like names and/or reference numbers (e.g., cartridge 620 versus the plate assembly 120 of FIGS. 1A-2, the plate assembly 420 of FIGS. 4A and 4B, and the plate assembly 520 of FIGS. 5A and 5B) indicating generally similar or identical aspects.
• the system 600 can perform and/or be configured for use in one or more steps of the method 370 of FIG. 3.
• the system 600 includes a generally elongated housing 602 and a plate assembly or cartridge 620.
• the housing 602 extends between a first end portion 602a and a second end portion 602b.
• the system 600 can include one or more openings or ports 604a-d (e.g., inlets and/or outlets) positioned within the housing 602 and through which fluid (e.g., aqueous) can enter and/or exit the interior of the system 600.
• the system 600 includes one or more first ports 604a, one or more second ports 604b, one or more third ports 604c, and one or more fourth ports 604d (referred to collectively as “ports 604”).
• the first and second ports 604a, 604b are fluidly coupled to the cartridge 620 and positioned in or near the first end portion of the housing 602, with the first ports 604a positioned on a first side of the cartridge 620, and the second ports 604b positioned on a second side of the cartridge 620 opposite the first side.
• the third and fourth ports 604c, 604d are spaced apart from the cartridge 620 in or near the second end portion 602b of the housing 602, with the third ports 604c positioned on a same side of the housing 602 as the first ports 604a and the fourth ports 604d positioned on a same side of the housing 602 as the second ports 604b.
• individual ones of the ports 604a-d can have another suitable configuration. In some aspects, having multiple ports 604a-d is expected to improve the clog-resistance of the system 600 and/or improve the ability of the system 600 to control fluid flow if one or more of the ports 604a-d become clogged or have otherwise reduced flow.
• Individual ones of the first and second ports 604a, 604b can be fluidly coupled to a chamber 621 within the housing 602 configured to receive fluid (e.g., aqueous) therefrom.
• the cartridge 620 is positioned at least partially or fully within the housing 602 and configured to control the flow of fluid that enters the system 600, e.g., via individual ones of the ports 604a-d.
• the illustrated cartridge 620 is configured to control the flow of fluid that enters the chamber 621 via individual ones of the ports 604a, 604b.
• the cartridge 620 can include: (i) one or more channels 636a-c through which the fluid within the chamber 621 can flow; (ii) one or more channel inlets 637a-c that fluidly couple individual ones of the channels 636a-c to the chamber 621; and (iii) one or more actuators 630a-b positioned to control the flow of fluid (shown using dashed line arrows Fl in FIG. 6B) through a corresponding one of the channel inlets 637a-c.
• the channel inlets 637a-c are not labeled in Figure 6B.
• the individual channel inlets 637a-c, the corresponding channels 636a-c, and/or the associated outlets 606a-c can be discrete features and spaced apart from one another. Accordingly, fluid that enters the chamber 621 via individual ones of the ports 604a, 604b can flow through individual ones of the channel inlets 637a-c (e.g., depending on the actuated state of the corresponding actuator 630a-b), into the corresponding channel 636a-c, and flow out of the system 600 via the associated outlet 606a-c.
• the individual outlets 606a-c can be positioned at the second end portion 602b of the housing, e.g., at a distal end of the system 600 and/or opposite the ports 604a-b, with the individual outlets 606a-c spaced apart from each other.
• Individual ones of the first and/or second ports 604a, 604b can be configured to reduce or prevent formation of blockages that affect rate of flow through the system 600 and/or reduce or prevent changes to resistance to flow through the system 600 when one or more of the ports 604a-b are blocked, such that flow through the system 600 is expected to be maintained without or substantially without interference from blockages.
• each of the first and second ports 604a, 604b include a widened portion 682 configured to reduce or prevent tissue growth into individual ones of the first and second ports 604a, 604b.
• the third channel inlet 637c is configured to remain in an open state, such that fluid within the chamber 621 can flow through the third channel inlet 637c, into the third channel 636c, and/or exit the system 600 via the third outlet 606a without or substantially without interference from one or more of the actuators 630.
• first and second channel inlets 637a-b can be configured to (i) allow fluid flow therethrough at a first flow rate when the corresponding actuator 630a-b is in the closed position, and (ii) allow fluid flow therethrough at a second flow rate greater than the first flow rate when the corresponding actuator 630a-b is in the open position, such that actuating the actuators 630a-b can change a resistance to flow through the channel inlets 637a-b, but some flow through the channel inlets 637a-b is maintained independent of an actuated state of the actuators 630a-b.
• maintaining flow through the channel inlets 637a-c and/or the corresponding channels 636a-c is expected to reduce or prevent fluid stagnation within the channel inlets 637a-c and/or the channels 636a-c, reduce or prevent formation of blockages that affect flow through the system 600, and/or otherwise improve patency to fluid flow of the system 600 during operation.
• FIG. 6C is an enlarged view of the screen assembly 650b of FIG. 6B with other portions of the system 600 omitted for purposes of illustration/clarity.
• individual ones of the third and fourth ports 604c, 604d can be fluidly coupled to one or more of the channels 636a-c.
• Each of the third and fourth ports 604c, 604d can be coupled to the channels 636a-c via an outlet channel 694 and an internal reservoir 696.
• the outlet channel 694 can be fluidly coupled to individual ones of the third and/or fourth ports 604c, 604d.
• the internal reservoir 696 can be downstream from the outlet channel 694, between the outlet channel 694 and the channels 636a-c, and fluidly couple the outlet channel 694 to individual ones of the channels 636a-c.
• fluid e.g., aqueous
• fluid can enter the internal reservoir 696 via one or more of the channels 636a-c, such as when one or more outlets 606 (individually identified as a first outlet 606a of the first channel 636a, a second outlet 606b of the second channel 636b, and a third outlet of the third channel 636c in FIGS. 6B and 6C) are partially or fully blocked/obstructed.
• the internal reservoir 696 can be fluidly coupled to one or more of the channels 636a-c at interface region 697, such that fluid flowing through the channels 636a-c can enter and/or begin to fill the internal reservoir 696, generally flowing in the direction indicated by dashed-line arrows F2 in FIG.
• the fluid can flow from the internal reservoir 696 into the outlet channel 694 and flow out of the system 600 via individual ones of the third and fourth ports 604c, 604d.
• the outlet channel 694 and/or the internal reservoir 696 can include one or more additional outlets 692, which may or may not be configured to reduce or prevent blockages, and through with fluid can flow out of the system 600.
• individual ones of the channels 636a-c can be configured to allow fluid to exit the system 600 through the second end portion 602b directly via the channels 636a-c.
• individual ones of the third and fourth ports 604c, 604d can be configured to reduce or prevent blockages that affect rate of flow through the system 600 and/or reduce or prevent changes to resistance to flow through the system 600 when one or more of the ports 604a-b are blocked, such that flow through the system 600 is expected to be maintained without or substantially without interference from blockages.
• each of the third and fourth ports 604c, 604d include an inwardly-angled portion 691 configured to reduce or prevent tissue growth into individual ones of the third and fourth ports 604c, 604d.
• the housing 602 can comprise one or more housing portions or layers 603 (individually identified as a first or intermediate layer 603a, a second or lower layer 603b, and a third or upper layer 603c in FIGS. 6B and 6C).
• Each of the layers 603 can be flexible and/or formed from an elastomeric material, such as silicone.
• the thickness of one or more of the layers 603 can be less than, equal to, or greater than the thickness of one or more of the other layers 603, such that each layer 603 can have a same or different thickness as one or more of the other layers 603.
• each of the layers 603 are formed separately and assembled together to form the system 600.
• the second layer 603b can be positioned on a first side of the first layer 603a and the third layer 603c can be positioned on a second side of the first layer 603a opposite the first side.
• Individual ones of the layers 603a-c can be separate structures coupled to one another to form the system 600 and/or respective regions of a continuous structure forming the system 600.
• Individual ones of the ports 604a-d, the chamber 621, the channel inlets 637a-c, the channels 636a-c, the outlets 606, the fluid reservoir 696, the outlets 692, and/or the outlet channel 694 can be positioned within and/or defined by one or more of the layers 603a-c.
• the first layer 603a includes the ports 604a-d, the chamber 621, the channel inlets 637a-c, the fluid reservoir 696, and the outlet channel 694
• the second layer 603b includes the channels 636a-c and the outlets 606a-c
• the third layer 603c includes the outlets 692.
• fluid can enter the system 600 via one or more of the layers 603a-c, flow through the system 600 (e.g., horizontally and/or longitudinally) within one or more of the layers 603a-c, flow between (e.g., vertically) one or more of the layers 603a- c, and/or flow out of the system 600 via one or more of the layers 603a-c.
• fluid can enter the first layer 603a via one or more of the ports 604a- b, flow from the first layer 603a toward and/or into the second layer 603b via one or more of the channel inlets 637a-c (FIG.
• Fluid within the second layer 603b (e.g., within one or more of the channels 636a-c) can exit the second layer 603b via one or more of the outlets 606a-c and/or return to the first layer 603a via the fluid reservoir 696.
• Fluid within the fluid reservoir can flow through the first layer 603a via the outlet channel 694 and exit the system 600 via one or more of the ports 604c-d in the first layer 603a and/or one or more of the outlets 692 in the third layer 603c.
• FIGS. 7A and 7B are a top view and an end view, respectively, of select aspects of an adjustable shunting system 700 (“system 700”) configured in accordance with embodiments of the present technology. Other aspects of the system 700 of FIGS. 7A and 7B are omitted for illustrative clarity. At least some aspects of the system 700 can be generally similar or identical in structure and/or function to one or more aspects of the system 100 of FIGS. 1A and IB, the system 400 of FIGS. 4A and 4B, the system 500 of FIGS. 5A and 5B, and/or the system 600 of FIGS. 6A-6C, with like names and/or reference numbers (e.g., first end portion 702a versus the first end portion 102a of FIGS. 1A and IB) indicating generally similar or identical aspects. In these and other embodiments, the system 700 can perform and/or be configured for use in one or more steps of the method 370 of FIG. 3.
• system 700 can perform and/or be configured for use in one or more steps of
• the system 700 can include a housing 702 having a first end portion 702a and a second end portion 702b.
• the system 700 further includes one or more channels 736a-c, individual ones of which can extend at least partially between the first end portion 702a and the second end portion 702b of the housing 702.
• the system 700 includes a first channel 736a, a second channel 736b, and a third channel 736c. In other embodiments, however, the system 700 can include more or fewer flow channels 736.
• Individual ones of the channels 736a-c can have a respective first end 736ai, 736bi, 736ci at or near the first end portion 702a, a respective second end 736a2, 736b2, 736C2 at or near the second end portion 702b and/or opposite the respective first end 736ai, 736bi, 736ci, and one or more dimensions that vary between the respective first and second ends 736ai-2, 736bi-2, 736CI-2.
• the first and second ends 736ai-2, 736bi-2, 736CI-2 are not labeled in FIG. 7B.
• a width of each of the channels 736a- c increases from a respective first width Ai, Bi, Ci at the first end 736ai, 736bi, 736ci to a respective second width A2, B2, C2 at the second end 736a2, 736b2, 736C2.
• the height, diameter, cross-sectional area, and/or another suitable dimension of one or more of the channels 736a-c can vary from a first value at the first end 736ai, 736bi, 736ci to a second value at the second end 736a2, 736b2, 736c2 that is different (e.g., greater) than the first value.
• the dimension(s) of the channels 736a-c change along the entire length of individual ones of the channels 736a-c. In other embodiments, the dimension(s) of individual ones of the channels 736a-c can change along a portion of the respective channel, such that individual ones of the channels 736a-c can have one or more constant dimensions along a first portion of the respective channel 736a-c and one or more varying dimensions along a second portion of the respective channel 736a-c.
• channels having one or more varying dimensions are expected to improve the flow of fluid through adjustable shunting systems.
• Fluid e.g., aqueous
• Fluid can flow through individual ones of the channels 736a-c from the first end portion 702a toward the second end portion 702b and exit the system 700.
• the increased dimension(s) of the channels 736a-c are expected to reduce or prevent blockages or clogs within the channels 736a-c that may affect fluid flow through the system 700.
• FIGS. 8A and 8B are a top view and a bottom view, respectively, of an adjustable shunting system 800 (“system 800”) configured in accordance with embodiments of the present technology.
• system 800 can be generally similar or identical in structure and/or function to one or more aspects of the system 100 of FIGS. 1A and IB, the system 400 of FIGS. 4A and 4B, the system 500 of FIGS. 5 A and 5B, the system 600 of FIGS. 6A-6C, and/or the system 700 of FIGS. 7A and 7B, with like names and/or reference numbers (e.g., plate assembly or cartridge 820 versus the plate assembly 120 of FIGS. 1A-2, the plate assembly 420 of FIGS.
• like names and/or reference numbers e.g., plate assembly or cartridge 820 versus the plate assembly 120 of FIGS. 1A-2, the plate assembly 420 of FIGS.
• the system 800 can perform and/or be configured for use in one or more steps of the method 370 of FIG. 3.
• the system 800 includes a housing 802 having a first end portion 802a and a second end portion 802b, a plate assembly 820, one or more fluid outlets 806, and one or more channels 836 (“channel 836”) that fluidly couple the plate assembly 820 to individual ones of the fluid outlets 806.
• the plate assembly 820 can include one or more actuators 830a-b.
• the channel 836 can be fluidly coupled to one or more inlets 837a-c and configured to receive fluid therefrom. Fluid flow through individual ones of the inlets 837a-c can be independently and/or selectively controlled by a corresponding one of the actuators 830a-b.
• the channel 836 includes a first inlet 837a open to fluid flow (e.g., always open to fluid flow and/or not configured to be selectively opened/closed by an actuator), a second inlet 837b configured to be selectively opened and/or closed to fluid flow by a first actuator 830a, and a third inlet 837c configured to be selectively opened and/or closed to fluid flow by a second actuator 830b.
• Individual ones of the inlets 837a-c can be positioned along the channel 836, such that the channel 836 can include multiple inlets 837a-c for receiving fluid and one or more channel portions or segments 839a-c defined by the inlets 837a-c.
• Individual ones of the inlets 837a-c can be positioned upstream and/or downstream from one or more of the other inlets 837a- c (e.g., the first inlet 837a is upstream from the second and third inlets 837b, 837c). Accordingly, the actuators 830a-b can be configured to control fluid flow into the channel 836 at various points (e.g., the inlets 837a-c) along the length of the channel 836.
• the channel 836 begins at the first inlet 837a, includes the second inlet 837b downstream from the first inlet 837a, and includes the third inlet 837c downstream from the second inlet, such that the first, second, and third inlets 837a-c are in series along the length of the channel 836.
• the channel 836 includes a first channel segment 839a (best seen in FIG. 8B) between the first inlet 837a and the second inlet 837b, a second channel segment 839b between the second inlet 837b and the third inlet 837c, and a third channel segment 839c between the third inlet 837c and the outlet 806.
• the system 800 can include more channels, and/or more or fewer channel segments, inlets, and/or actuators.
• each of the inlets 837a-c along the length of the channel 836 can be associated with a resistance to fluid flow through the channel 836.
• the third inlet 837c is positioned downstream from the first inlet 837a, fluid entering the channel 836 via the third inlet 837c is expected to flow through a reduced length of the channel 836 relative to fluid entering the channel 836 via the first inlet 837a, such that the channel 836 provides less resistance to fluid that enters via the third inlet 837c as compared to the first inlet 837a.
• fluid that enters the channel 836 via the second inlet 837b faces increased resistance to flow as compared to fluid that enters the channel 836 via the third inlet 837c but reduced resistance to flow as compared to fluid that enters the channel 836 via the first inlet 837a.
• channels that include multiple inlets are expected to be less likely to become blocked or clogged, and/or can allow fluid to drain when portions of these channels become blocked or clogged.
• individual ones of the inlets 837a-c can be opened in response to an upstream channel blockage to “tap in” or allow fluid flow into the channel 836 at a location downstream from the upstream channel blockage.
• the first actuator 830a can be actuated to allow fluid to enter the channel 836 via the second inlet 837b, bypassing the first channel segment 839a and the blockage/clog therein.
• the second actuator 830b can be actuated to allow fluid to enter the channel 836 via the third inlet 837c, bypassing the second channel segment 839b and the blockage/clog therein. Additionally, or alternatively, actuating one or both of the actuators 830a-b to allow fluid flow through one or both of the second and third inlets 837b-c can change (e.g., decrease) a resistance to fluid flow through the system 800, as described above. Fluid can preferentially enter the channel 836 via the most downstream open inlet (e.g., all or substantially all the fluid can enter the channel 836 via the third inlet 837c when the third inlet 837c is open).
• one or more of the inlets 837a-c, the channel 836 and/or one or more of the channel segments 839a-c thereof can include one or more varying dimensions, as described in detail with reference to FIGS. 7 A and 7B.
• a width of the third channel segment 839c increases over a portion of the third channel segment’s length, which can further reduce or prevent the likelihood of the channel 836 becoming blocked or clogged.
• the varying dimensions of individual ones of the inlets 837a-c and/or the channel segments 839a-c are expected to improve the control of flow through the system 800, e.g., by providing multiple resistances to flow and/or, under a given pressure, multiple flow rates through the system 800 in response to allowing or prevent flow through individual ones of the inlets 837a-c.
• a system for shunting fluid from a first body region to a second body region within a patient comprising: a first layer including a first fluid inlet and a second fluid inlet, each configured to receive fluid from the first body region; and a second layer coupled to the first layer and including a first fluid outlet and a second fluid outlet, each configured to be positioned within the second body region, wherein the first fluid outlet is fluidly coupled to the first fluid inlet via a first channel and the second fluid outlet is fluidly coupled to the second fluid inlet via a second channel; and an actuator positioned to control the flow of fluid from the first fluid inlet in the first layer into the first channel of the second layer, wherein, independent of a state of the actuator, the second channel is configured to receive fluid from the second fluid inlet.
• the first layer includes a third fluid outlet fluidly coupled to one or both of the first channel and the second channel and fluid reservoir positioned downstream from the first and second fluid inlets and upstream from the third fluid outlet, wherein the fluid reservoir is configured to substantially prevent fluid flow through the third fluid outlet until the fluid reservoir is at least partially filled with fluid received from one or both of the first channel and the second channel.
• any of examples 1-5 further comprising a third layer including a third fluid outlet fluidly coupled to one or both of the first channel and the second channel.
• a third layer including a third fluid outlet fluidly coupled to one or both of the first channel and the second channel.
• the first layer includes a first side and a second side opposite the first side, wherein the second layer is coupled to the first side, and wherein the third layer is coupled to the second side.
• first layer includes a fluid reservoir configured to fluidly couple one or both of the first channel and the second channel to the third fluid outlet.
• a system for shunting fluid from a first body region to a second body region within a patient comprising: a housing at least partially defining a channel configured to allow fluid flow from the first body region to the second body region, wherein the channel includes — a first inlet, and a second inlet positioned downstream from the first inlet; and an actuator positioned to control the flow of fluid through the second inlet, wherein the actuator is configured to transition between a first position and a second position, wherein — when the actuator is in the first position, the channel provides a first resistance to fluid flow therethrough, and when the actuator is in the second position, the channel provides a second resistance to fluid flow therethrough, the second resistance greater than the first resistance.
• the housing comprises a first layer and a second layer coupled to the first layer.
• the first layer at least partially defines the channel, and wherein the second layer at least partially defines a chamber configured to receive the actuator.
• a system for shunting fluid from a first body region to a second body region within a patient comprising: a housing including a plurality of fluid inlets, wherein individual ones of the plurality of fluid inlets include a widened middle portion; a plate assembly within the housing, the plate assembly including — a chamber fluidly coupled to at least one of the fluid inlets, and an actuator positioned within the chamber and configured to selectively control the flow of fluid through the system.
• first dimension is a first width
• second dimension is a second width and the second width is greater than the first width
• first dimension is a first cross-sectional area
• second dimension is a second cross-sectional area
• second cross- sectional area is greater than the first cross-sectional area
• a system for shunting fluid from a first body region to a second body region within a patient comprising: a housing; a plate assembly within the housing, the plate assembly including — a chamber, a plurality of fluid inlets positioned within the chamber, a flow channel, wherein each of the plurality of fluid inlets are fluidly coupled to the flow channel, and an actuator positioned within the chamber and configured to control the flow of fluid through the flow channel.
• first dimension is a first width and the second dimension is a second width, and wherein the second width is greater than the first width.
• first dimension is a first cross-sectional area and the second dimension is a second cross-sectional area, and wherein the second cross- sectional area is greater than the first cross-sectional area.
• a screen assembly for use with an adjustable shunting system for treating a patient comprising: a screen having a first end portion and a second end portion spaced apart from the first end portion, wherein the first end portion of the screen is at least partially aligned with fluid inlets of the shunting system, and wherein, during operation, the screen is configured to (i) at least partially prevent debris from entering the fluid inlets of the shunting system, and (ii) receive non-invasive ablative energy at the first end portion to at least partially remove the debris from the screen.
• each of the actuator access regions is at least partially aligned with at least one actuator of the shunting system.
• each of the one or more actuator access regions is (i) an aperture formed in the screen or (ii) at least partially transparent.
• each of the plurality of screening elements includes a pore formed in the screen, the individual pores being configured to at least partially prevent debris from entering the fluid inlets of the shunting system.
• each of the plurality of screening elements has a width between 0.1 pm and 100 pm.
• each of the plurality of screening elements has a circular, oval, square, pentagonal, hexagonal, curvilinear, or rectilinear shape.
• each of the plurality of second screening elements includes a pore formed in the second end portion of the screen.
• a system for shunting fluid comprising: a housing; a plate assembly within the housing, the plate assembly including — a plurality of fluid inlets; a chamber fluidly coupled to at least one of the fluid inlets, and an actuator positioned within the chamber and configured to control the flow of fluid through the system; and a screen at least partially aligned with a first portion of the system and configured to at least partially prevent debris from entering at least a second portion of the system.
• the first portion of the system includes the plate assembly, the chamber, the actuator, or the plurality of fluid inlets.
• each of the plurality of screening elements includes a pore formed in the filter, the individual pores being configured to at least partially prevent debris from entering at least the second portion of the shunting system.
• each of the screening elements has a width between 0.1 pm and 100 pm
• each of the plurality of screening elements has a width of about 10 pm.
• each of the plurality of screening elements has a circular, oval, square, pentagonal, hexagonal, curvilinear, or rectilinear shape.
• actuator access region (i) is an aperture formed in the filter or (ii) is a portion of the screen that is at least partially transparent.
• the actuator access region is configured to allow the actuator to be accessible to non-invasive ablative energy.
• 65 The system of any of examples 54-64 wherein the system is configured (i) to receive first non-invasive ablative energy to at least partially remove debris from the screen and (ii) to receive second non-invasive ablative energy to transition the actuator between a first position and a second position.
• PDMS polydimethylsiloxane
• PDMA polydimethylacrylamide
• superelastic nitinol superelastic nitinol
• the plurality of fluid inlets includes a first fluid inlet
• the chamber is a first chamber fluidly coupled to the first fluid inlet
• the actuator is a first actuator
• the plurality of fluid inlets includes a second fluid inlet
• the plate assembly includes — a second chamber fluidly coupled to the second fluid inlet, and a second actuator positioned within the second chamber and configured to control the flow of fluid through the system
• the screen is at least partially aligned with a third portion of the system and configured to at least partially prevent debris from entering at least a fourth portion of the system
• the third portion includes the plate assembly, the second chamber, the second actuator, or the second fluid inlet
• the fourth portion includes the second fluid inlet, the plate assembly, or the second chamber.
• the screen includes a sealing element configured to sealingly engage with the plate assembly to form a substantially fluid- impermeable seal therewith.
• sealing element is configured to extend at least partially around individual ones of the plurality of fluid inlets.
• sealing element is a first sealing element
• the screen includes a second sealing element
• the plurality of fluid inlets includes a first fluid inlet and a second fluid inlet, and wherein: the first sealing element sealingly engages the plate assembly around the first inlet; and the second sealing element sealingly engages the plate assembly around the second inlet.
• example 77 The system of example 76 wherein the screen includes a plurality of screening elements, and wherein the fluid space fluidly couples individual ones of the plurality of screen elements to individual ones of the fluid inlets.
• example 82 The system of example 80 or example 81 wherein the first dimension is a first cross-sectional area and the second dimension is a second cross-sectional area greater than the first cross-sectional area.
• the plurality of fluid inlets includes a first fluid inlet and a second fluid inlet, and wherein the second fluid inlet is positioned downstream from the first fluid inlet, and further wherein the actuator is configured to control the flow of fluid the second fluid inlet.
• a method for operating a shunting system comprising: directing non-invasive ablative energy toward a screen assembly of the shunting system; removing at least a portion of debris from a screen of the screen assembly; and transitioning an actuator of the adjustable shunting system between a first position and a second position.
• directing the non-invasive ablative energy toward the screen assembly includes applying the non-invasive ablative energy to at least a portion of the screen.
• directing the non-invasive ablative energy toward the screen assembly includes applying the non-invasive ablative energy to a first end portion or a second end portion of the screen.
• directing the non-invasive ablative energy toward the screen assembly includes applying the non-invasive ablative energy to one or more screening elements of the screen.
• directing the non-invasive ablative energy toward the screen assembly includes directing the non-invasive ablative energy toward one or more actuator access regions of the screen.
• directing the non-invasive ablative energy toward the one or more actuator access regions includes applying the non-invasive ablative energy to one or more actuators of the shunting system via the one or more actuator access regions, wherein each actuator is at least partially aligned with one of the one or more actuator access regions.
• directing the non-invasive ablative energy toward the one or more actuator access regions includes applying the non- invasive ablative energy to one or more actuation element target regions of one or more actuators of the shunting system via the one or more actuator access regions, wherein each actuation element target region is at least partially aligned with one of the one or more actuator access regions.
• directing the non-invasive ablative energy toward the screen assembly includes: applying first non-invasive ablative energy to the screen; and directing second non-invasive ablative energy toward one or more actuator access regions of the screen assembly.
• first non-invasive ablative energy includes a first laser energy
• second non-invasive ablative includes a second laser energy
• first non-invasive ablative energy and the second non-invasive ablative energy have a same optical property.
• first non-invasive ablative energy includes a first laser energy
• second non-invasive ablative includes a second laser energy
• the second non-invasive ablative energy has a different optical property than the first non-invasive ablative energy.
• removing at least the portion of the debris from the screen includes removing at least the portion of the debris from one or more screening elements of the screen.
• removing at least the portion of the debris from the screen includes at least partially dissolving or burning-off the debris from the screen.
• the words “comprise,” “comprising,” and the like are to be construed in an inclusive sense, as opposed to an exclusive or exhaustive sense; that is to say, in the sense of “including, but not limited to.”
• the terms “connected,” “coupled,” or any variant thereof means any connection or coupling, either direct or indirect, between two or more elements; the coupling of connection between the elements can be physical, logical, or a combination thereof.
• the words “herein,” “above,” “below,” and words of similar import when used in this application, shall refer to this application as a whole and not to any particular portions of this application.

Landscapes

• Health & Medical Sciences (AREA)
• Ophthalmology & Optometry (AREA)
• Otolaryngology (AREA)
• Engineering & Computer Science (AREA)
• Anesthesiology (AREA)
• Biomedical Technology (AREA)
• Heart & Thoracic Surgery (AREA)
• Hematology (AREA)
• Life Sciences & Earth Sciences (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• External Artificial Organs (AREA)
• Prevention Of Fouling (AREA)
• Prostheses (AREA)

Priority Applications (3)

Applications Claiming Priority (4)

Publications (2)

Family

ID=85987833

Family Applications (1)

Country Status (4)

Cited By (10)

Citations (2)

Family Cites Families (4)

• 2022
  • 2022-10-13 JP JP2024522282A patent/JP2024536503A/ja active Pending
  • 2022-10-13 EP EP22881792.0A patent/EP4415797A4/en active Pending
  • 2022-10-13 US US18/698,338 patent/US20240399122A1/en active Pending
  • 2022-10-13 WO PCT/US2022/046604 patent/WO2023064491A2/en not_active Ceased

Patent Citations (2)

Non-Patent Citations (1)

Also Published As

Similar Documents

Legal Events