Systems, devices and methods for maintaining flow in adjustable shunt systems

Abstract

The present technology is generally directed to an adjustable shunt system for draining fluid from a first body region to a second body region. The adjustable shunt system can include a screen assembly configured to at least partially prevent debris from entering an interior portion of the adjustable shunt system. For example, the screen can be at least partially aligned with one or more fluid inlets of the adjustable shunt system. In some embodiments, the adjustable shunt system includes one or more actuators that can be actuated via energy. In such embodiments, the screen assembly can be configured such that the actuators are accessible to energy through the screen.

Description

[Technical field]

[0001] (CROSS REFERENCE TO RELATED APPLICATIONS) This application claims priority to U.S. Provisional Patent Application No. 63 / 255,379, filed October 13, 2021, and U.S. Provisional Patent Application No. 63 / 340,825, filed May 11, 2022, the disclosures of which are incorporated by reference in their entireties herein.

[0002] FIELD OF THEINVENTION The present technology relates generally to implantable medical devices, and more particularly to adjustable shunt systems and associated methods for selectively controlling fluid flow between a first body region and a second body region of a patient. [Background technology]

[0003] Implantable shunt systems are widely used to treat various patient conditions by shunting fluid from a first body region / cavity to a second body region / cavity. Fluid flow through a shunt system 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). However, most shunt systems have a single static flow path that is not adjustable. As such, one challenge with conventional shunt systems is selecting an appropriately sized shunt for a particular patient. A shunt that is too small may not provide sufficient therapy to the patient, and a shunt that is too large may create new problems for the patient. Despite this, most conventional shunts cannot be adjusted after implantation and therefore cannot be adjusted or titrated to meet the individual and varying needs of patients and / or to account for changes in flow-related characteristics such as flow rate, inflow pressure, and / or outflow resistance. Summary of the Invention [Means for solving the problem]

[0004] The present technology is generally directed to systems, devices, and methods for maintaining flow in an adjustable shunt system. At least some of the adjustable shunt systems described herein may include a screen assembly configured to filter water passing through the shunt system and at least partially or completely prevent debris from entering the interior portions of the shunt system (e.g., a fluid inlet, a plate assembly, one or more channels, etc.). The disclosed screen assemblies may include a plurality of holes or openings formed therein, each hole sized to at least partially prevent debris or other contaminants from entering the interior portions of the shunt system while also at least partially allowing fluid (e.g., water) to flow through the interior portions of the shunt system. Additionally, the screen assemblies may be configured such that non-invasive energy (e.g., ablative laser energy) can be applied to the screen to at least partially melt, burn off, or otherwise remove trapped debris.

[0005] As described in more detail below, it is expected that the present technology may exhibit one or more advantageous characteristics that improve the operation of adjustable shunt systems. Many adjustable shunt systems include channels, lumens, or other pathways through which fluid may flow from a first body region to a second body region. The fluid flowing through these systems may include cellular matter, particulate matter, and / or other debris that may partially or completely obstruct (e.g., block, clog, etc.) the fluid flow path through these systems. Thus, the operation of many adjustable shunt systems may be adversely affected (e.g., become partially or completely inoperable) due to such debris entering these systems. In addition, it may be difficult to remove or clean such debris from many adjustable shunt systems without first removing these systems from the patient. Furthermore, some adjustable shunt systems include actuators configured to provide adjustable therapy to the patient. Previous attempts to reduce or prevent debris from entering such adjustable shunt systems may impede the operation of the actuators of these systems. Thus, compared to conventional systems, adjustable shunt systems including screen assemblies configured in accordance with embodiments of the present technology are expected to provide adjustable therapy to patients while reducing and / or at least partially preventing debris / contaminants from adversely affecting the operation of such systems.

[0006] In some embodiments, the screen assembly may include one or more sealing elements configured to sealingly engage at least a portion of the adjustable shunt system. The sealing elements are expected to further reduce the likelihood of debris blocking or clogging the adjustable shunt system. Additionally or alternatively, the adjustable shunt system may include multiple fluid inlets, and the screen assembly (e.g., one or more holes in the screen assembly) may be positioned over and / or cover the multiple fluid inlets to define a fluid space between the screen assembly and each of the multiple fluid inlets. During operation, the fluid space is expected to allow fluid to reach each of the multiple fluid inlets if the screen assembly becomes partially blocked or clogged.

[0007] At least some of the adjustable shunt systems described herein include multiple fluid inlets configured to reduce or prevent tissue ingrowth, which in turn is expected to further reduce the likelihood of the adjustable shunt system becoming blocked or clogged. Additionally or alternatively, at least some of the adjustable shunt systems include one or more channels having various 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. A fluid (e.g., water) can flow through the channel from a first end to a second end such that the width of the channel can increase in the direction of fluid flow through the channel. In some aspects, channels having various dimensions are expected to be less likely to become blocked or clogged. In these and other embodiments, individual channels of the channel can be fluidly coupled to multiple inlets, such as two or more inlets arranged in series along the length of the channel. If a portion of the channel becomes blocked or clogged, an inlet downstream of the blockage / clog can be opened to bypass the blockage / clog and / or otherwise resume flow through the channel. [Brief description of the drawings]

[0008] Many aspects of the present technology can be better understood with reference to the following drawings. Components in the drawings are not necessarily drawn to scale. Instead, emphasis has been placed on clearly illustrating the principles of the present technology. Additionally, components may be shown as transparent in certain figures for clarity of illustration only, and are not intended to imply that the components shown are necessarily transparent. Components may also be shown in schematic form.

[0009] [Figure 1A] FIG. 1A is a perspective view of an adjustable shunt system including a screen element configured in accordance with various embodiments of the present technology. [Figure 1B] FIG. 1B is a top view of the adjustable shunt system of FIG. 1A. [Figure 1C] FIG. 1C is an enlarged top view of selected embodiments of the adjustable shunt system of FIG. 1B, with other embodiments omitted for clarity. [Diagram 2] FIG. 2 is a top view of the screen assembly of FIG. 1A and selected aspects of the system of FIG. 1A, with other aspects of the system omitted for clarity. [Diagram 3] FIG. 3 is a block diagram illustrating a method of operating an adjustable shunt system having a screen assembly and configured in accordance with various embodiments of the present technology. [Figure 4A] 4A and 4B are top and cross-sectional views, respectively, of an adjustable shunt system including a screen assembly and configured in accordance with an additional embodiment of the present technology. [Figure 4B] 4A and 4B are top and cross-sectional views, respectively, of an adjustable shunt system including a screen assembly and configured in accordance with an additional embodiment of the present technology. [Figure 4C] FIG. 4C is an enlarged cross-sectional view of a portion of the adjustable shunt system of FIG. 4B. [Figure 5A]5A and 5B are top and perspective views, respectively, of another adjustable shunt system including a screen assembly and constructed in accordance with various embodiments of the present technology. [Figure 5B] 5A and 5B are top and perspective views, respectively, of another adjustable shunt system including a screen assembly and constructed in accordance with various embodiments of the present technology. [Figure 6A] FIG. 6A is a top view, and FIGS. 6B and 6C are partial enlarged isometric views, of an adjustable shunt system including a screen assembly and configured in accordance with a further embodiment of the present technology. [Figure 6B] FIG. 6A is a top view, and FIGS. 6B and 6C are partial enlarged isometric views, of an adjustable shunt system including a screen assembly and configured in accordance with a further embodiment of the present technology. [Figure 6C] FIG. 6A is a top view, and FIGS. 6B and 6C are partial enlarged isometric views, of an adjustable shunt system including a screen assembly and configured in accordance with a further embodiment of the present technology. [Figure 7A] 7A and 7B are top and end views, respectively, of selected aspects of an adjustable shunt system constructed in accordance with an embodiment of the present technology, with other aspects of the system omitted for clarity of illustration. [Figure 7B] 7A and 7B are top and end views, respectively, of selected aspects of an adjustable shunt system constructed in accordance with an embodiment of the present technology, with other aspects of the system omitted for clarity of illustration. [Figure 8A] 8A and 8B show top and bottom views of an adjustable shunt system constructed in accordance with an embodiment of the present technology. [Figure 8B] 8A and 8B show top and bottom views of an adjustable shunt system constructed in accordance with an embodiment of the present technology. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0010] The terminology used in the description presented herein is intended to be interpreted in its broadest reasonable manner, even when used in conjunction with the detailed description of certain specific embodiments of the present technology. Certain terms may even be emphasized below, however, any terms intended to be interpreted in any limited manner are so clearly and specifically defined in this detailed description section. Additionally, the present technology may include other embodiments within the scope of the examples that are not described in detail with respect to Figures 1A-8B.

[0011] Throughout this specification, references to "one embodiment" or "an embodiment" mean that a particular feature, structure, or characteristic described in connection with that embodiment is included in at least one embodiment of the technology. Thus, the appearances of the phrase "in one embodiment" or "in an embodiment" in various places throughout this specification are not necessarily all referring to the same embodiment. Furthermore, particular features or characteristics described herein may be combined in any suitable manner in one or more embodiments.

[0012] Throughout this specification, references to relative terms, such as "generally," "approximately," and "about," are used herein to mean the stated value plus or minus 10%. References throughout this specification to the term "resistance" refer to fluid resistance unless the context clearly dictates otherwise. The terms "discharge rate" and "flow rate" are used interchangeably to describe the movement of a fluid through a structure at a particular volumetric flow rate. The term "flow" is used generally herein to refer to the movement of a fluid.

[0013] Although certain embodiments of the adjustable shunt system are described with respect to shunting fluid from the anterior chamber of the eye, those skilled in the art will understand that an adjustable shunt system having a screen element 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. Additionally, although certain embodiments herein are described in the context of glaucoma treatment, 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. For example, the systems described herein can be used to treat diseases characterized by increased pressure and / or accumulation of fluid, 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, etc. Additionally, although generally described with respect to shunting water, the systems described herein may be equally applied to shunt other fluids, such as blood or cerebrospinal fluid, between a first body region and a second body region.

[0014] 1A and 1B illustrate an adjustable shunt system 100 ("system 100") that includes a screen assembly 150 configured in accordance with various embodiments of the present technology. Specifically, FIG. 1A illustrates a perspective view of system 100, and FIG. 1B illustrates a top view of system 100. As described in more detail below, screen assembly 150 is configured to filter water passing through system 100 and to at least partially or completely prevent debris from entering interior portions of system 100 (e.g., a fluid inlet, a plate assembly, one or more channels, etc.).

[0015] 1A and 1B together, the system 100 includes a generally elongated housing 102 ("housing 102") and a plate assembly or cartridge 120. The housing 102 (which may also be referred to as a casing, membrane, shunt element, etc.) extends between a first end 102a and a second end 102b. The housing 102 may include one or more openings (e.g., opening 104 in FIG. 1C) configured to receive a fluid (e.g., water) from an environment (e.g., a first body region) external to the system 100. In an illustrated embodiment, the system 100 includes one or more fluid outlets 106 positioned proximate the second end 102b of the housing 102. In other embodiments, the one or more fluid outlets 106 may have any other suitable location relative to the housing 102. The housing 102 further includes a primary fluid conduit 110 that fluidly couples the plate assembly 120 to the one or more fluid outlets 106. The housing 102 may also optionally have one or more wings or appendages (not shown) with holes (e.g., suture holes) or other attachment mechanisms for securing the elongated housing 102 in a desired position. The housing 102 may be constructed from a slightly elastic or flexible biocompatible material (e.g., silicone, etc.).

[0016] The plate assembly 120 (which may also be referred to as a flow control plate, flow control cartridge, plate structure, etc.) is positioned at least partially or completely within the housing 102. In the illustrated embodiment, for example, the housing 102 substantially and / or completely encases the plate assembly 120 at or proximate the first end 102a of the housing 102. In other embodiments, the plate assembly 120 may have any other suitable location at least partially or completely within the housing 102. The plate assembly 120 may be fluidly coupled to one or more fluid outlets 106 via the primary fluid conduit 110 and may be configured to control the flow of fluid through the system 100. In some embodiments, the top surface of the plate assembly 120 forms a substantial fluid seal with the interior surface of the elongated housing 102 at the first end 102a such that the only path for fluid to enter the system 100 is through the fluid inlet 124. As such, in order for fluid to flow through the system 100, the fluid must generally flow through the plate assembly 120. As described in more detail below and with reference to FIG. 1C, the plate assembly 120 may include (i) one or more fluid openings or inlets (e.g., fluid inlets 124a-124c, FIG. 1C ) that align with the openings 104 ( FIG. 1C ) in the elongated housing 102 and allow fluid to enter the plate assembly 120, (ii) one or more actuators 130a-130b ("actuators 130"), each of the actuators 130 positioned to control the flow of fluid through a corresponding one of the fluid inlets 124a-124c, and / or (iii) one or more channels 136a-136c through which a fluid (e.g., water) may flow through the system 100 (e.g., from the one or more fluid inlets 124a-124c to and / or toward the one or more fluid outlets 106).

[0017] In the illustrated embodiment, the screen assembly 150 is positioned proximate the first end 102a of the housing 102. However, in other embodiments, the screen assembly 150 can be positioned proximate the second end 102b of the housing 102, or can have any other suitable location relative to the housing 102 of the system 100. The screen assembly 150 can include a screen or filter 152 ("screen 152"). At least a portion of the screen 152 can be aligned with at least a portion of the system 100 (e.g., the opening 104, the plate assembly 120, the actuator 130, etc.). 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 actuator 130. Continuing with this example, the screen 152 is positioned within the housing 102, at least partially between the housing 102 and the plate assembly 120, with at least a portion of the screen 152 aligned with (e.g., covering, positioned over, etc.) one or more fluid inlets 124a-124c (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. Thus, the screen 152 can protect at least one, more than one, or all of the fluid inlets 124 of the system 100 from debris and / or other materials. In other embodiments, the screen 152 can be positioned at least partially or completely outside the housing 102, such as above or at least partially inside the opening 104 of the housing 102. In further embodiments, at least a portion of the screen 152 may be positioned within the plate assembly 120, such as between one or more of the fluid inlets 124 and the actuator 130 and / or between the actuator 130 and one or more of the channels 136, such that fluid entering the plate assembly 120 may pass through the screen 152 before entering one or more of the channels 136. In further embodiments, the screen 152 may have any other suitable position relative to the system 100.Although described as having a single screen 152, in other embodiments, 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.

[0018] The screen 152 can be formed from silicon, acrylic, shape memory material, and / or any other suitable material. In at least some embodiments, for example, the screen 152 is formed from poly dimethylsiloxane (PDMS), poly dimethylacrylamide (PDMA), and / or superelastic nitinol. In Figures 1A and 1B, selected portions of the screen 152 are shown as being opaque to better illustrate aspects of the present technology. It will be understood that in other embodiments, all or a portion of the screen 152 can be transparent, translucent (e.g., partially transparent), opaque, or have any other suitable transmittance.

[0019] In operation, 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 draining aqueous humor from the anterior chamber of a patient's eye. The plate assembly 120 is configured to selectively control the flow of fluid entering the system 100. As described in more detail below and with reference to FIG. 1C, each of the actuators 130 can be actuated (e.g., via energy) to control the flow of fluid through a corresponding fluid inlet. In some embodiments, the fluid (e.g., water) can include one or more cell clumps, particulate matter, and / or any other debris within the first body region. Thus, a screen according to an embodiment of the present technology, such as screen 152, may be configured to: (i) allow a first portion of a fluid to flow through at least the internal portion of system 100 (e.g., fluid inlet 124, plate assembly 120, chamber 121, channel 136, etc.); (ii) at least partially prevent a second portion of the fluid (e.g., debris) from partially or completely clogging, obstructing, blocking, or otherwise impeding the flow of the first portion of the fluid through the internal portion of system 100; (iii) be at least partially cleaned or unclogged by application of a first non-invasive energy (e.g., laser energy); and / or (iv) allow actuators 130 to be accessible (e.g., via at least a portion of screen 152) to a second non-invasive energy (e.g., laser energy) for actuating one or more of actuators 130.

[0020] As a particular example, the screen 152 may allow water from the first body region to enter the system 100 while at least partially filtering or screening one or more cell clumps and / or other debris (e.g., suspended in the water) in the first body region from entering an interior portion of the system 100. Continuing with this example, during operation, cell clumps and / or other debris may accumulate on and / or within the screen 152 such that the screen 152 may become at least partially blocked or clogged by the cell clumps and / or other debris. Unlike many conventional adjustable shunt systems, an adjustable shunt system including a screen assembly configured in accordance with embodiments of the present technology may be at least partially cleaned or unclogged by delivery of non-invasive energy without being removed from the patient. For example, as described in more detail below with reference to FIG. 2, energy (e.g., laser energy) may be applied to the screen 152 to partially or completely unblock, unclog, or otherwise remove (e.g., melt, burn off, etc.) some or all of the cell clumps and / or debris captured, filtered, or otherwise screened by the screen 152.

[0021] 1C shows an enlarged top view of a portion of the system 100, with the screen assembly 150 omitted to better illustrate other aspects of the system 100. With reference to FIG. 1C, as previously described, the housing 102 may include an opening 104 configured to receive fluid (e.g., water) from an environment (e.g., a first body region) external to the system 100. The opening 104 may be aligned with one or more fluid inlets 124 in the plate assembly 120. In the illustrated embodiment, for example, 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 allow fluid to enter the interior of the plate assembly 120 (and thus the interior of the elongated housing 102) from an environment external to the system 100. Although not shown in FIG. 1C, it can be understood that the screen 152 can be aligned with one or more of the fluid inlets 124 (e.g., as described above with reference to FIGS. 1A and 1B) so that fluid can flow through the screen 152 before flowing through the plate assembly 120.

[0022] The fluid path through the plate assembly 120 depends on which fluid inlet 124 the fluid enters through. For example, fluid entering the system 100 through the first fluid inlet 124a flows into the first chamber 121a of the plate assembly 120 and is discharged into the main fluid conduit 110 through the first channel 136a. Fluid entering the system 100 through the second fluid inlet 124b flows into the second chamber 121b of the plate assembly 120 and is discharged into the main fluid conduit 110 through the second channel 136b. Fluid entering the system 100 through the third fluid inlet 124c is discharged into the main fluid conduit 110 through the third channel 136c. The chambers 121a-121b and channels 136a-136c can be fluidly isolated such that there are three separate flow paths through the plate assembly 120. The channels 136a-136c can also have different geometric configurations (eg, lengths) relative to one another such that they have different fluid resistances and therefore can provide different flow rates.

[0023] The relative level of therapy provided by each fluid pathway can be different such that a user can adjust / modulate the level of therapy provided by system 100 by selectively opening and / or closing various fluid pathways (e.g., by selectively impeding or allowing flow through individual fluid inlets 124). For example, (i) first fluid inlet 124a and / or first channel 136a can provide a first fluidic resistance when fluid moves primarily therethrough, (ii) second fluid inlet 124b and / or second channel 136b can provide a second fluidic resistance less than the first fluidic resistance when fluid moves primarily through second fluid inlet 124b, and (iii) third fluid inlet 124c and / or third channel 136c can provide a third fluidic resistance less than the first fluidic resistance when fluid moves primarily through third fluid inlet 124c. Continuing with this example, under a given pressure, each of the fluid inlets 124a-124c can provide a different fluid flow rate through the system 100. In other embodiments, the channels 136a-136c can have the same or generally the same geometric configuration to have the same or generally the same fluid resistance and therefore provide similar flow rates for a given pressure.

[0024] In the illustrated embodiment, a first actuator 130a is positioned within the first chamber 121a and configured to control the flow of fluid through the first fluid inlet 124a, and a second actuator 130b is positioned within 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 protrusion or gate element 134a configured to movably interface with the first fluid inlet 124a, for example, to move between a first (e.g., “open”) position in which the gate element 134a does not substantially prevent fluid from flowing through the first fluid inlet 124a (e.g., by being offset from and / or not otherwise interfering with the first fluid inlet 124a) and a second (e.g., “closed”) position in which the gate element 134a substantially prevents fluid from flowing through the first fluid inlet 124a (e.g., by blocking the first fluid inlet 124a, by being positioned within the first fluid inlet 124a, and / or by being otherwise aligned with the first fluid inlet 124a). In some embodiments, the gate element 134a can be configured to move to one or more intermediate positions between the first (e.g., open) position and the second (e.g., closed) position. The second actuator 130b may include a second gate element 134b that operates similarly to the gate element 134a (e.g., movable between an open position and a closed position relative to the second fluid inlet 124b). In an illustrated embodiment, 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 may be configured to provide a constant or minimum flow rate of fluid through the system 100. However, in other embodiments, the plate assembly 120 may include a third actuator generally similar or identical to the first actuator 130a and / or the second actuator 130b, and the third actuator may have a third gate element that operates similarly to the first gate element 134a and / or the second gate element 134b (e.g., movable between an open position and a closed position relative to the third fluid inlet 124c).In such embodiments, the third actuator may be positioned within a third chamber that is generally similar or identical to the first chamber 121a and / or the second chamber 121b.

[0025] The first actuator 130a may further include a first actuating element 132a1 and a second actuating element 132a2 that drive movement of the gate element 134a between a first (e.g., open) position and a second (e.g., closed) position. The first actuating element 132a1 and the second actuating element 132a2 may be at least partially comprised of a shape memory material or alloy (e.g., Nitinol). As such, the first actuating element 132a1 and the second actuating element 132a2 may be transitionable between at least a first material phase or state (e.g., a martensite state, an R-phase, a composite state between martensite and R-phase, etc.) and a second material phase or state (e.g., an austenite state, an R-phase state, a composite state between austenite and R-phase, etc.). In the first material state, the first and second actuating elements 132a1 and 132a2 may have reduced (e.g., relatively less stiff) mechanical properties that render the actuating elements more easily deformable (e.g., compressible, expandable, etc.) compared to when the actuating elements are in the first material state. In the second material state, the first and second actuating elements 132a1 and 132a2 may have increased (e.g., relatively more stiff) mechanical properties compared to the first material state, causing an increased preference for a particular preferred geometry (e.g., original geometry, manufactured or fabricated geometry, heat set geometry, etc.). The first and second actuating elements 132a1 and 132a2 apply energy (e.g., laser energy, electrical energy, etc.) to the first actuating element 132a1 or the second actuating element 132a2 to raise it above a transition temperature (e.g., an austenite finish temperature (A ) generally above body temperature). f) can selectively and independently transition between a first material state and a second material state. When heated above a transition temperature, if the first actuating element 132a1 (or the second actuating element 132a2) is deformed relative to its preferred geometry, the first actuating element 132a1 (or the second actuating element 132a2) will move to and / or toward its preferred geometry. In some embodiments, the first actuating element 132a1 and the second actuating element 132a2 are operatively coupled such that when the actuated actuating element (e.g., the first actuating element 132a1) transitions toward its preferred geometry, the unactuated actuating element (e.g., the second actuating element 132a2) is further deformed relative to its preferred geometry.

[0026] The first actuating element 132a1 and the second actuating element 132a2 generally act in opposition. For example, the first actuating element 132a1 can be actuated to move the gate element 134a to and / or toward a first (e.g., open) position, and the second actuating element 132a2 can be actuated to move the gate element 134a to and / or toward a second (e.g., closed) position. Additionally, as described above, the first actuating element 132a1 and the second actuating element 132a2 can be coupled such that as one moves toward its preferred geometric shape during a material phase transition, the other deforms relative to its preferred geometric shape. This allows the actuating element 132a to be repeatedly actuated and the gate element 134a to be repeatedly cycled between the first (e.g., open) position and the second (e.g., closed) position.

[0027] In some embodiments, each actuating element 132 can include one or more targets 138. The targets 138 can be thermally coupled to the corresponding actuating element 132 such that energy (e.g., laser energy) received at the targets 138 can dissipate as heat through the corresponding actuating element 132. Thus, the targets 138 can be selectively targeted with energy to actuate the actuating elements 132. For example, to actuate the first actuating element 132a1, heat / energy can be applied to the first target 138a1, such as from an energy source (e.g., laser) positioned outside the patient's eye. The heat applied to the first target 138a1 can spread through at least a portion of the first actuating element 132a1, thereby heating the first actuating element 132a1 above its transition temperature. To actuate the second actuating element 132a2, heat / energy can be applied to the second target 138a2. Heat applied to the second target 138a2 can spread through the second actuating element 132a2, thereby heating at least a portion of the second actuating element 132a2 above its transition temperature. In an illustrated embodiment, the target 138 is generally centrally positioned along the length of each individual actuating element 132. In other embodiments, the target 138 can be positioned at an end region of each individual actuating element 132. In some embodiments, the target 138 is made of the same material (e.g., Nitinol) as the actuating element 132. Without being bound by theory, it is expected that the increased surface area of ​​the target 138 relative to the actuating element 132 increases the ease and consistency with which the actuator 130 can be actuated using an energy source (e.g., a laser) positioned outside the body.

[0028] The second actuator 130b may also include a pair of opposing shape memory actuators and may operate in the same or similar manner as the first actuator 130a. In embodiments where the flow of fluid through the third inlet 124c is controlled by a third actuator, the third actuator may also include a pair of opposing shape memory actuators and may operate in the same or similar manner as the first actuator 130a and / or the second actuator 130b. Although the system 100 is illustrated in FIGS. 1A-1C as having two actuators 130a-130b, in other embodiments, the system 100 may include more or fewer actuators 130. In at least some embodiments, for example, the system 100 may include 1, 3, 4, 5, 6, 7, 8, 9, 10, or any other suitable number of actuators 130. Although the system 100 is illustrated in FIGS. 1A-1C as having three channels 136a-136c, in other embodiments, the system 100 may include more or fewer channels 136. In at least some embodiments, for example, the system 100 can include 1, 2, 4, 5, 6, 7, 8, 9, 10, or any other suitable number of channels 136. In some embodiments, the number of channels 136 corresponds to the number of fluid inlets 124 and / or the number of actuators 130 in the system. Additional details regarding the operation of shape memory actuators and adjustable glaucoma shunts are described in U.S. Patent Nos. 11,291,585, 11,166,849, and International Application Nos. PCT / US20 / 55144, PCT / US20 / 55141, PCT / US21 / 14774, PCT / US21 / 18601, PCT / US21 / 23238, and PCT / US21 / 27742, the disclosures of which are incorporated herein by reference in their entireties for all purposes.

[0029] The energy used to actuate the actuation elements (e.g., "actuation energy") can have generally similar or identical characteristics (e.g., generally similar or optical characteristics such as wavelength and / or amplitude) as the energy used to at least partially clean or unclog the screen 152 (e.g., "cleaning energy"). In at least some embodiments, for example, the actuation 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 actuator 130. However, in other embodiments, the actuation energy and the cleaning energy can have different characteristics (e.g., different optical characteristics such as wavelength and / or amplitude).

[0030] 2 is a top view of selected aspects of the screen assembly 150 and the system 100 of FIGS. 1A-1C, with other aspects of the system 100 omitted for clarity. The screen 152 of the screen assembly 150 can include a first end 252a and a second end 252b opposite the first end 252a. The first end 252a and / or the second end 252b of the screen 152 can include one or more screening or filtering elements 256 ("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.) at least one of the openings 104 and / or the fluid inlets 124 described above with reference to FIGS. 1A-1C.

[0031] In the illustrated embodiment, each of the screening elements 256 is a circular hole or aperture formed in the screen 152 and having a dimension (e.g., width, diameter, etc.) of about 10 μm. In other embodiments, each of the screening elements 256 may have an oval, square, pentagonal, hexagonal, curved, straight, and / or any other suitable shape. In these and other embodiments, each of the screening elements 256 may have a width of about 0.1 μm to about 100 μm, such as at least 1 μm, 5 μm, 10 μm, 20 μm, 50 μm, and widths therebetween, or another suitable width. Additionally or alternatively, the configuration of the individual screening elements of the screening elements 256 may be configured, at least in part, based on a flow resistance associated with the configuration. In at least some embodiments, for example, the individual screening elements of the screening elements 256 may be configured to provide a flow resistance less than the individual channels of the channels 136a-136c (FIGS. 1A-1C). In further embodiments, the screening elements 256 can have any other suitable configuration. In the illustrated embodiment, both the first end 252a and the second end 252b of the screen 152 include 126 screening elements, although in other embodiments, the first end 252a and / or the second end 252b can have more or fewer screening elements.

[0032] The screen 152 may further include one or more actuator access or display areas 258 ("areas 258"). Each of the areas 258 may extend partially or completely between a first end 252a and a second end 252b of the screen 152 and / or may be at least partially aligned with (e.g., positioned on) a corresponding one of the actuators 130 and / or chambers 121. In an illustrated embodiment, for example, the screen 152 includes (i) a first area 258a aligned with at least a portion of the first actuator 130a and the first chamber 121a, and (ii) a second area 258b aligned with at least a portion of the second actuator 130b and the second chamber 121b. Each of the areas 258 may be configured such that at least a portion of the corresponding actuator 130 (e.g., actuation element 132, target 138, etc.) may be accessible to energy (e.g., laser energy) applied from outside the adjustable shunt system. In some embodiments, one or more of the regions 258 may be a gap or opening in the screen 152 (e.g., formed in the screen 152), and at least a portion of one or more of the actuators 130a-130b (e.g., actuator target 138) may be accessible to energy through a corresponding region 258 of the screen 152 such that energy directed to one or more of the regions 258 may pass through the screen 152 and be incident on a corresponding actuator 130. In other embodiments, one or more of the regions 258 may be a portion of the screen 152 formed from a material that is at least partially or completely transparent (e.g., PDMS, PDMA, etc.). In further embodiments, the screen 152 and / or the entire screen assembly 150 may be formed from a material that is at least partially or completely transparent (e.g., PDMS, PDMA, etc.). In these and other embodiments, the screen 152 may be formed from a single sheet of material.

[0033] The screen assembly 150 may further include one or more indicator regions 260. Each of the indicator regions 260 may correspond to one of the actuators 130 such that each of the indicator regions 260 may be aligned with at least a portion of the corresponding actuator 130. In the illustrated embodiment, for example, the screen assembly 150 includes (i) a first indicator region 260a aligned with an end 235a of the first gate element 134a of the first actuator 130a, and (ii) a second indicator region 260b aligned with an end 235b of the second gate element 134b of the second actuator 130b. Each of the indicator regions 260 may be at least partially or completely transparent such that the corresponding end 235 may be visualized and / or observed (e.g., by a user and / or practitioner of the system 100) through the corresponding indicator region 260.

[0034] During operation, as previously described, each of the screening elements 256 may be configured to (i) allow at least a first portion of the fluid to enter the interior portions of the system 100 (e.g., fluid inlet 124, plate assembly 120, chamber 121, etc.) and (ii) at least partially or completely prevent at least a second portion of the fluid (e.g., debris) from entering the interior portions of the system 100. In at least some embodiments, for example, each of the screening elements 256 may be sized such that a second portion of the fluid may be trapped on and / or within one or more of the screening elements 256. This may at least partially prevent the second portion of the fluid from entering the interior portions of the system 100. Thus, during operation, one or more of the screening elements 256 may become at least partially or completely blocked or clogged by debris filtered from the fluid. Energy (e.g., non-invasive energy, ablative laser energy, etc.) may be applied to the screening elements 256 to at least partially or completely unblock or unclogging the screening elements 256. For example, the first end 252a and / or the second end 252b of the screen 152 may be configured to withstand exposure to energy such that energy may be applied to the first end 252a and / or the second end 252b to partially or completely melt, burn off, or otherwise remove debris from one or more of the screening elements 256. Additionally, as discussed above, one or more of the regions 258 may be configured such that the corresponding actuator 130 may be at least partially or completely accessible to energy (e.g., laser energy). For example, the first actuator 130a and / or the second actuator 130b may be accessible to energy from outside the system 100 via the corresponding region 258 such that energy may be applied to selectively and / or individually actuate the actuators 130a-130b.In some embodiments, before, during, and / or after one or more of the actuators 130 are actuated, one or more of the ends 235 can be visualized via a corresponding indicator area 260 to determine whether the corresponding actuator 130 and / or gate element 134 is in a first (e.g., open) position or a second (e.g., closed configuration) position.

[0035] FIG. 3 is a flow diagram illustrating a method 370 of operating an adjustable shunt 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 may be performed at least in part by various components of a system, such as the system 100 of FIGS. 1A-1C, the filter assembly 150 of FIGS. 1A, 1B, and 2. For example, all or a subset of the blocks 371-373 may be performed at least in part by a screen assembly, a screen, a screening element, an actuator, an actuation assembly, and / or other parts of the adjustable shunt system. Additionally or alternatively, all or a subset of the blocks 371-373 may be performed at least in part by an operator of the system (e.g., a user, a patient, a caregiver, a family member, a physician, etc.). Furthermore, any one or more of the blocks 371-373 may be performed in accordance with the description above. Many of the blocks 371-373 of method 370 are described in detail below with reference to Figures 1A-2 for clarity and understanding, however, it will be understood that method 370 may be used with other suitable adjustable shunt systems in addition to the systems described herein.

[0036] The method 370 begins at block 371 by directing energy towards a screen assembly of an adjustable shunt system. In some embodiments, for example, directing energy towards 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 screen and / or screening elements described above with reference to FIGS. 1A-2. For example, applying energy to the screen assembly can include applying energy to a first end 252a and / or a second end 252b of the screen 152, where the first end 252a and / or the second end 252b include one or more screening elements 256, as described above with reference to FIG. 2.

[0037] In these and other embodiments, directing the energy to the screen assembly may include directing the energy towards one or more actuator access areas of the screen assembly. The one or more actuator access areas may be similar to the actuator access areas 258 described above with reference to FIG. 2. For example, directing the energy to the screen assembly may include applying energy to one or more actuators 130 of the adjustable shunt system 100 through a corresponding one of the one or more actuator access areas 258 such that the energy passes through at least a portion of the screen assembly 150 (e.g., through the access area 258). In such embodiments, applying the energy to the one or more actuators may include applying the energy to one or more targets 138 of the actuator 130 through a corresponding actuator access area 258.

[0038] At block 372, the method 370 continues by removing at least a portion of any cell clumps, particulate matter, and / or any other debris from the screens of the screen assembly. In some embodiments, for example, removing at least a portion of the debris from the screens may include removing at least a portion of the debris from one or more screening elements of the screen. The screens and / or screening elements may be similar to the screen 152 and / or screening elements 256 described above with reference to FIGS. 1A-2. For example, removing at least a portion of the debris from the screen 152 may include melting and / or burning off one or more cell clumps and / or any other debris trapped on and / or at least partially within one or more of the screening elements 256 of the screen 152.

[0039] At block 373, the method 370 continues by transitioning an actuator of the adjustable shunt system between a first position and a second position. In some embodiments, for example, transitioning the actuator between the first position and the second position may include (i) moving an actuating element of the actuator to and / or toward a preferred geometry of the actuating element, or (ii) deforming the actuating element relative to the preferred geometry. The actuator and actuating element may be generally similar to the actuator 130 and actuating element 132 described above with reference to FIGS. 1A-2. For example, transitioning the actuator 130 between the first position and the second position may include (i) moving a first actuating element 132a1 of the first actuator 130a to and / or toward a preferred geometry, or (ii) deforming the first actuating element 132a1 relative to the preferred geometry.

[0040] Although the steps of method 370 are described and illustrated in a particular order, method 370 shown in FIG. 3 is not so limited. In other embodiments, method 370 may be performed in a different order. In these and other embodiments, any of the steps of method 370 (e.g., block 373) may be performed before, between, and / or after any of the other steps of method 370 (e.g., block 372). Additionally, one of ordinary skill in the art will recognize that the illustrated method 370 may be modified and still be within the scope of these and other embodiments of the present technology. For example, in some embodiments, one or more steps of method 370 shown in FIG. 3 (e.g., block 373) may be omitted and / or repeated.

[0041] As one skilled in the art will appreciate, any of the above-mentioned screen assemblies and / or screens can be used as part of an adjustable shunt system, for example, to control the flow of fluid therethrough. Furthermore, certain features described with respect to one screen assembly and / or screen can be added to or combined with another screen assembly and / or screen. Thus, the present technology is not limited to the screen assemblies and actuators explicitly identified herein. For example, screen assemblies may be utilized with adjustable shunt systems and actuation assemblies described in U.S. Patent Nos. 11,291,585, 11,166,849, and International Application Nos. PCT / US20 / 55144, PCT / US20 / 55141, PCT / US21 / 14774, PCT / US21 / 18601, PCT / US21 / 023238, and PCT / US21 / 27742, the disclosures of which are previously incorporated herein by reference in their entirety for all purposes. As such, although the screen is described in the context of a particular adjustable shunt system and actuation assembly, a screen assembly constructed in accordance with embodiments of the present technology may be used with any of the adjustable shunt systems, actuation assemblies, and / or actuators previously incorporated by reference. Similarly, although the screen assembly is described in the context of an adjustable shunt system, the screen assemblies described herein may be used to filter fluid flow through other types of medical devices.

[0042] 4A and 4B are top and cross-sectional views, respectively, of another adjustable shunt system 400 ("system 400") including a screen assembly 450 and configured in accordance with various embodiments of the present technology. At least some aspects of system 400 may be generally similar or identical in structure and / or function to one or more aspects of system 100 of FIGS. 1A and 1B, and like names and / or reference numbers (e.g., plate assembly or cartridge 420 to plate assembly 120 of FIGS. 1A-2) indicate generally similar or identical aspects. Additionally or alternatively, at least some aspects of screen assembly 450 may be generally similar or identical in structure and / or function to one or more aspects of screen assembly 150 of FIGS. 1A-2. In these and other embodiments, system 400 may be capable of performing and / or be configured for use in one or more steps of method 370 of FIG. 3.

[0043] 4A and 4B together, the screen assembly 450 includes a filter or screen 452 having one or more screening or filtering elements 456 (shown in FIGS. 4A and 4B as one or more first screen elements 456a and one or more second screen elements 456b). As best seen in FIG. 4B, the screen assembly 450 can further include one or more sealing elements 454 (e.g., first sealing element 454a and second sealing element 454b). In the illustrated embodiment, both the first sealing element 454a and the second sealing element 454b are configured as protrusions extending (e.g., downwardly) from the screen 452. However, in other embodiments, one or both of the first sealing element 454a and the second sealing element 454b may be separate components from the screen 452 and may be positioned between the screen 452 and the plate assembly 420. In these and other embodiments, one or both of the first sealing element 454a and the second sealing element 454b can be formed from the same or different materials as, for example, each other, the screen 452, and / or other components of the system 400.

[0044] The sealing elements 454a, 454b can correspond to one or more of the screen elements 456a, 456b. In the illustrated embodiment, for example, the first sealing element 454a is positioned around (e.g., extends around, surrounds, encircles, abuts, defines, etc.) the periphery and / or circumference of one or more of the first screen elements 456a, and the second sealing element 454b is positioned around (e.g., extends around, surrounds, encircles, abuts, defines, etc.) the periphery and / or circumference of one or more of the second screen elements 456b. In other embodiments, one or both of the first sealing element 454a and the second sealing element 454b may be positioned around a portion of the periphery / circumference of the respective one or more of the first and second screen elements 456a, 456b, and / or may extend partially or completely around each of the respective first and second screen elements 456a, 456b.

[0045] Additionally, the sealing elements 454a, 454b can sealingly engage the plate assembly 420 to form a substantially fluid-impermeable seal (e.g., first seal 425a and second seal 425b) between the screen 452 and the plate assembly 420 such that all or substantially all of the fluid passing through (e.g., filtered) the filtration elements 456a, 456b enters the plate assembly 420. In the illustrated embodiment, for example, the first sealing element 454a and the second sealing element 454b both sealingly engage the cover plate 421 of the plate assembly 420. The cover plate 421 can include one or more recessed areas (e.g., first recessed area 423a and second recessed area 423b) configured to correspond to the individual sealing elements of the sealing elements 454a, 454b. One or both of the first recessed area 423a and the second recessed area 423b can extend through the cover plate 421 into and / or out of the cross-sectional plane shown in FIG. 4B to define, for example, a channel extending widthwise through the cover plate 421 and / or at least generally perpendicular to the longitudinal axis of the system 400. Similarly, one or both of the sealing elements 454a, 454b can extend into and / or out of the cross-sectional plane shown in FIG. 4B along the screen 452 to, for example, define a perimeter and / or circumference around the corresponding screen elements 456a, 456b. With additional reference to FIG. 4C, which is an enlarged view of area 4C of FIG. 4B, the second sealing element 454b can be received within the second recessed area 423b to form the second seal 425b. 4C, the first sealing element 454a can be received within the first recessed area 423a to form the first seal 425a. In some aspects, the sealing engagement of the sealing elements 454a, 454b within the corresponding recessed areas 423a, 423b is expected to further improve the substantially fluid-tight seal formed between the screen assembly 450 and the plate assembly 420.

[0046] 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 understood 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 in FIG. 1C. One or more of the screen elements 456a, 456b can be aligned with (e.g., cover, be positioned over, etc.) one or more of the fluid inlets such that the fluid can pass through the screen 452 before entering the plate assembly 420 via the fluid inlet (e.g., the fluid first passes through the screen 452 before entering the plate assembly (420) through the fluid inlet 424c). In the illustrated embodiment, for example, the second screen element 456b is aligned with the third fluid inlet 424c. Thus, when the sealing elements 454a, 454b sealingly engage the cover plate 421, the sealing elements 454a, 454b may also extend around the fluid inlets such that an associated seal 425a, 425b is formed around the fluid inlets such that substantially all of the fluid flowing through the screening elements 456a, 456b also flows through the fluid inlets to the plate assembly 420. In the illustrated embodiment, for example, the second seal 425b is formed around the third fluid inlet 424c, and the second sealing element 454b extends around the third fluid inlet 424c such that substantially all of the fluid flowing through the second screening element 456b enters the plate assembly 420 through the third fluid inlet 424c. Thus, the sealing elements 454a, 454b may at least partially or completely prevent fluid flowing through the screen assembly 450 from leaking, for example, between the housing 402 and the plate assembly 420.

[0047] 5A and 5B are top and cross-sectional views, respectively, of another adjustable shunt system 500 ("system 500") including a screen assembly 550 and configured in accordance with various embodiments of the present technology. At least some aspects of system 500 may be generally similar or identical in structure and / or function to one or more aspects of system 100 of FIGS. 1A-1B and / or system 400 of FIGS. 4A-4B, and like names and / or reference numbers (e.g., plate assembly or cartridge 520 for plate assembly 120 of FIGS. 1A-2 and plate assembly 420 of FIGS. 4A-4B) indicate generally similar or identical aspects. Additionally or alternatively, at least some aspects of screen assembly 550 may be generally similar or identical in structure and / or function to one or more aspects of screen assembly 150 of FIGS. 1A-2 and / or screen assembly 450 of FIGS. 4A-4B. In these and other embodiments, system 500 may perform and / or be configured for use in one or more steps of method 370 of FIG.

[0048] 5A, the system 500 includes a first fluid inlet 524a, a second fluid inlet 524b, and a third fluid inlet 524c. The inlets 524a-524c can be formed in a cover plate 521 (FIG. 5B) of a plate assembly 520 (FIG. 5B). In some embodiments, the cover plate 521 and / or the plate assembly 520 can be angled (e.g., radially inward) 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-524c. The screen 552 includes one or more screen elements 556. In the illustrated embodiment, the screen elements 556 extend at least partially between the first, second, and / or third fluid inlets 524a-524c to form a T-shaped array of screen elements. In other embodiments, the screen elements 556 may be arranged in one or more rows, columns, a U-shaped array, a V-shaped array, and / or any other suitable configuration.

[0049] 5B, the screen 552 may include one or more sealing elements 554 configured to sealingly engage the plate assembly 520 and form a substantially fluid-tight seal 525 between the screen assembly 550 and the plate assembly 520. In the illustrated embodiment, for example, the screen assembly 550 includes a single sealing element 554 configured to form a single seal 525 extending around the screen element 556. However, in other embodiments, the screen assembly 550 may include more sealing elements 554, each of which may be configured to form a respective seal 525 with the plate assembly 520. In these and other embodiments, the sealing elements 554 may extend or protrude from the screen 552, as described above with respect to the sealing elements 454a, 454b of FIGS. 4A and 4B. Thus, as best seen in FIG. 5B, sealing engagement of the screen assembly 550 with the plate assembly 520 can form a fluid space or gap 557 between the sealing element 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 element 556 and the fluid inlets 524a-524c (FIG. 5A) in the plate assembly 520 and can allow fluid to flow between the individual ones of the fluid inlets 524a-524c in the housing 502 upstream of the plate assembly 520. Thus, fluid flowing through the screen element 556 can enter the plate assembly 520 via the fluid inlets 524a-524c and pass through the fluid space 557 before flowing through the channels (only the third channel 536c is visible in FIG. 5B) into the main fluid conduit 510 of the system. If one or more of the screen elements 556 proximate to a given fluid inlet (e.g., the third fluid inlet 524c) are blocked, the fluid space 557 can allow fluid entering the system 500 to reach the given fluid inlet through one or more of the other unblocked screen elements 556 away from the given fluid inlet.Thus, fluid space 557 is expected to maintain flow through system 500 and / or improve control of flow through system 500 in the event that an individual screen element of screen element 556 becomes blocked or clogged.

[0050] The plate assembly 520 may be inclined or tapered. In at least some embodiments, for example, the plate assembly 520 has a first dimension (e.g., height) at or near the first end 502a and a second dimension less than the first dimension distally from the first end 502a (e.g., at or near the main fluid conduit 510) such that the plate assembly 520 is inclined / angled downwardly toward the main fluid conduit 510. Additionally or alternatively, one or more of the channels 536 can be angled or tilted. In the illustrated embodiment, for example, the third channel 536c is angled inwardly relative to the longitudinal axis of the system 500, e.g., from the screen assembly 550 toward the main fluid conduit 510 and / or the interior of the housing 502. In some aspects, the angled plate assemblies and / or channels are expected to reduce the likelihood of fluid accumulating in the fluid space 557 and at least partially blocking flow through the system 500 during operation.

[0051] FIG. 6A is a top view, and FIGS. 6B and 6C are enlarged isometric views of another adjustable shunt system 600 ("system 600") including screen assemblies 650a, 650b and configured in accordance with various embodiments of the present technology. At least some aspects of system 600 may be generally similar or identical in structure and / or function to one or more aspects of system 100 of FIGS. 1A and 1B, system 400 of FIGS. 4A and 4B, and / or system 500 of FIGS. 5A and 5B, and like names and / or reference numbers (e.g., cartridge 620 for plate assembly 120 of FIGS. 1A-2, plate assembly 420 of FIGS. 4A and 4B, and plate assembly 520 of FIGS. 5A and 5B) indicate generally similar or identical aspects. In these and other embodiments, system 600 may be capable of performing and / or be configured for use in one or more steps of method 370 of FIG. 3.

[0052] 6A and 6B together, the system 600 includes a generally elongated housing 602 and a plate assembly or cartridge 620. The housing 602 extends between a first end 602a and a second end 602b. The system 600 can include one or more openings or ports 604a-604d (e.g., inlets and / or outlets) positioned within the housing 602 through which a fluid (e.g., water) can enter and / or exit the interior of the system 600. In the illustrated embodiment, for example, 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 (collectively referred to as "ports 604"). In the illustrated embodiment, the first and second ports 604a, 604b are fluidly coupled to the cartridge 620 and positioned in or near a first end of the housing 602, with the first port 604a positioned on a first side of the cartridge 620 and the second port 604b positioned on a second side of the cartridge 620 opposite the first side. Additionally, in the illustrated embodiment, the third and fourth ports 604c, 604d are spaced apart from the cartridge 620 in or near a second end 602b of the housing 602, with the third port 604c positioned on the same side of the housing 602 as the first port 604a and the fourth port 604d positioned on the same side of the housing 602 as the second port 604b. In other embodiments, the individual ports 604a-d can have other suitable configurations. In some embodiments, having multiple ports 604a-604d is expected to improve the clog resistance of system 600 and / or improve the ability of system 600 to control fluid flow if one or more of ports 604a-604d becomes clogged or otherwise reduces flow.

[0053] Each of the first and second ports 604a, 604b can be fluidly coupled to a chamber 621 in the housing 602 configured to receive a fluid (e.g., water) therefrom. A cartridge 620 is positioned at least partially or completely within the housing 602 and configured to control the flow of fluid entering the system 600, for example, through each of the ports 604a-604d. For example, the illustrated cartridge 620 is configured to control the flow of fluid entering the chamber 621 through each of the ports 604a, 604b. The cartridge 620 includes (i) one or more channels 636a-636c through which fluid in the chamber 621 can flow, (ii) one or more channel inlets 637a-637c fluidly coupling individual ones of the channels 636a-636c to the chamber 621, and (iii) one or more actuators 630a-630b positioned to control the flow of fluid through a corresponding one of the channel inlets 637a-637c (indicated using dashed arrows F1 in FIG. 6B). For purposes of illustration, the channel inlets 637a-637c are not labeled in FIG. 6B. The individual channel inlets 637a-637c, corresponding channels 636a-636c, and / or associated outlets 606a-606c (FIG. 6B) may be separate features and may be spaced apart from one another. Thus, fluid entering chamber 621 via an individual one of ports 604a, 604b can flow through an individual one of channel inlets 637a-637c to a corresponding channel 636a-636c (e.g., in response to an actuation state of a corresponding actuator 630a-630b) and out of system 600 via an associated outlet 606a-606c. The individual outlets 606a-606c can be positioned at the second end 602b of the housing, e.g., at a distal end of system 600 and / or opposite ports 604a-604b, and the individual outlets 606a-606c are spaced apart from one another.Each of the first and / or second ports 604a, 604b may be configured to reduce or prevent the formation of blockages that affect flow rate through the system 600 and / or reduce or prevent changes in resistance to flow through the system 600 when one or more of the ports 604a-604b are blocked, such that flow through the system 600 is expected to be maintained without or substantially without interference from blockages. As best seen in FIG. 6A, in an illustrative embodiment, each of the first and second ports 604a, 604b includes a widened portion 682 that is configured to reduce or prevent tissue in-growth into the respective one of the first and second ports 604a, 604b.

[0054] 6A and 6B together, in an illustrative embodiment, the third channel inlet 637c is configured to remain open such that fluid in 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. Additionally or alternatively, one or both of the first and second channel inlets 637a-637b can be configured to (i) allow fluid flow therethrough at a first flow rate when the corresponding actuator 630a-630b is in a closed position, and (ii) allow fluid flow therethrough at a second flow rate greater than the first flow rate when the corresponding actuator 630a-630b is in an open position, such that resistance to flow through the channel inlets 637a-637b can be changed by actuating the actuators 630a-630b, but a portion of the flow through the channel inlets 637a-637b is maintained regardless of the actuation state of the actuators 630a-630b. In some embodiments, maintaining flow through the channel inlets 637a-637c and / or corresponding channels 636a-636c is expected to reduce or prevent fluid stagnation within the channel inlets 637a-637c and / or channels 636a-636c, reduce or prevent the formation of blockages that affect flow through the system 600, and / or otherwise improve the patency of the system 600 to fluid flow during operation.

[0055] FIG. 6C is an enlarged view of the screen assembly 650b of FIG. 6B, with other portions of the system 600 omitted for illustration / clarity. Referring to FIG. 6B and FIG. 6C together, each of the third and fourth ports 604c, 604d can be fluidly coupled to one or more of the channels 636a-636c. Each of the third and fourth ports 604c, 604d can be coupled to the channels 636a-636c via an outlet channel 694 and an internal reservoir 696. The outlet channel 694 can be fluidly coupled to each of the third and / or fourth ports 604c, 604d. The internal reservoir 696 can be downstream of the outlet channel 694, between the outlet channel 694 and the channels 636a-636c, and can fluidly couple the outlet channel 694 to each of the channels 636a-636c.

[0056] In operation, fluid (e.g., water) can enter the internal reservoir 696 via one or more of the channels 636a-c, such as when one or more of the outlets 606 (individually identified in FIGS. 6B and 6C as the first outlet 606a of the first channel 636a, the second outlet 606b of the second channel 636b, and the third outlet of the third channel 636c) are partially or completely blocked / occluded. The internal reservoir 696 can be fluidly coupled to one or more of the channels 636a-c at an interface region 697, such that fluid flowing through the channels 636a-c can enter and / or begin to fill the internal reservoir 696, generally in the direction indicated by the dashed arrow F2 in FIG. 6C. Once fluid fills the internal reservoir 696, the fluid can flow from the internal reservoir 696 into the outlet channel 694 and out of the system 600 via the respective ones of the third and fourth ports 604c, 604d. Additionally or alternatively, 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, through which the fluid can flow out of the system 600. In these and other embodiments, the respective ones of the channels 636a-636c can be configured to allow the fluid to exit the system 600 through the second end 602b directly through the channels 636a-636c.

[0057] Additionally, the respective ones of the third and / or fourth ports 604c, 604d may be configured to reduce or prevent blockages affecting flow rate through the system 600 and / or reduce or prevent changes in resistance to flow through the system 600 when one or more of the ports 604a-604b are blocked, such that flow through the system 600 is expected to be maintained without or substantially without interference from blockages. For example, as best seen in FIG. 6A, in an illustrative embodiment, the third and fourth ports 604c, 604d each include an inwardly angled portion 691 that is configured to reduce or prevent tissue in-growth into the respective ones of the third and fourth ports 604c, 604d.

[0058] As best seen in FIGS. 6B and 6C, the housing 602 may comprise one or more housing portions or layers 603 (individually identified in FIGS. 6B and 6C as a first or middle layer 603a, a second or bottom layer 603b, and a third or top layer 603c). Each of the layers 603 may be flexible and / or may be formed from an elastomeric material, such as silicone. The thickness of one or more of the layers 603 may be less than, equal to, or greater than the thickness of one or more of the other layers 603, such that each layer 603 may have the same or different thickness as one or more of the other layers 603. In some embodiments, each of the layers 603 is formed separately and assembled together to form the system 600. For example, the second layer 603b may be positioned on a first side of the first layer 603a and the third layer 603c may be positioned on a second side of the first layer 603a opposite the first side. Individual ones of layers 603a-603c may be separate structures coupled together to form system 600, and / or respective regions of a continuous structure forming system 600. Individual ones of ports 604a-604d, chambers 621, channel inlets 637a-637c, channels 636a-636c, outlets 606, fluid reservoirs 696, outlets 692, and / or outlet channels 694 may be positioned within and / or defined by one or more of layers 603a-603c. In the illustrated embodiment, for example, the first layer 603a includes ports 604a-604d, chambers 621, channel inlets 637a-637c, fluid reservoirs 696, and outlet channel 694, the second layer 603b includes channels 636a-636c and outlets 606a-606c, and the third layer 603c includes outlet 692.

[0059] During operation of the system 600, fluid may enter the system 600 via one or more of the layers 603a-603c, flow through the system 600 (e.g., horizontally and / or longitudinally) within one or more of the layers 603a-603c, flow between one or more of the layers 603a-603c (e.g., vertically), and / or flow out of the system 600 via one or more of the layers 603a-603c. In an illustrated embodiment, for example, fluid may enter the first layer 603a via one or more of the ports 604a-604b, flow from the first layer 603a towards and / or into the second layer 603b via one or more of the channel inlets 637a-637c (FIG. 6A), and flow through / into the second layer 603b via one or more of the channels 636a-636c. Fluid in the second layer 603b (e.g., in one or more of channels 636a-636c) can exit the second layer 603b via one or more of the outlets 606a-606c and / or return to the first layer 603a via the fluid reservoir 696. Fluid in 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-604d in the first layer 603a and / or one or more of the outlets 692 in the third layer 603c.

[0060] 7A and 7B are top and end views, respectively, of selected aspects of an adjustable shunt system 700 ("system 700") configured in accordance with embodiments of the present technology. Other aspects of system 700 in FIGS. 7A and 7B have been omitted for clarity of illustration. At least some aspects of system 700 may be generally similar or identical in structure and / or function to one or more aspects of system 100 of FIGS. 1A and 1B, system 400 of FIGS. 4A and 4B, system 500 of FIGS. 5A and 5B, and / or system 600 of FIGS. 6A-6C, where like names and / or reference numbers (e.g., first end 702a versus first end 102a of FIGS. 1A and 1B) generally indicate similar or identical aspects. In these and other embodiments, system 700 may be capable of performing and / or be configured for use in one or more steps of method 370 of FIG. 3.

[0061] The system 700 may include a housing 702 having a first end 702a and a second end 702b. The system 700 may further include one or more channels 736a-c, each of which may extend at least partially between the first end 702a and the second end 702b of the housing 702. In the illustrated embodiment, the system 700 includes a first channel 736a, a second channel 736b, and a third channel 736c. However, in other embodiments, the system 700 may include more or fewer flow channels 736. Each of the channels 736a-736c may have a respective first end 736a1, 736b1, 736c1 at or near the first end 702a, a respective second end 736a2, 736b2, 736c2 at or near the second end 702b and / or opposite the respective first end 736a1, 736b1, 736c1, and may have one or more dimensions that are variable between the respective first and second ends 736a1-736a2, 736b1-736b2, 736c1-736c2. The first and second ends 736a1-736a2, 736b1-736b2, 736c1-736c2 are not labeled in FIG.

[0062] In illustrative embodiments, for example, the width of each of channels 736a-736c increases from a first width A1, B1, C1 at a first end 736a1, 736b1, 736c1, respectively, to a second width A2, B2, C2 at a second end 736a2, 736b2, 736c2, respectively. In these and other embodiments, the height, diameter, cross-sectional area, and / or another suitable dimension of one or more of channels 736a-736c may vary from a first value at a first end 736a1, 736b1, 736c1 to a second value at a second end 736a2, 736b2, 736c2 that is different (e.g., larger) than the first value. In illustrative embodiments, the dimensions of channels 736a-736c vary along the entire length of the individual channels 736a-736c. In other embodiments, the dimensions of each of the channels 736a-736c can vary along a portion of each of the channels, such that each of the channels 736a-736c can have one or more constant dimensions along a first portion of each of the channels 736a-736c and one or more varying dimensions along a second portion of each of the channels 736a-736c.

[0063] In some embodiments, channels having one or more varying dimensions are expected to improve fluid flow through the adjustable shunt system. Fluid (e.g., water) can flow from the first end 702a through individual ones of the channels 736a-c toward the second end 702b and exit the system 700. As the fluid flows through the channels 736a-c toward the second end 702b, the increased dimensions of the channels 736a-c are expected to reduce or prevent blockages or clogging within the channels 736a-c that may affect the flow of fluid through the system 700.

[0064] 8A and 8B are top perspective and bottom views, respectively, of an adjustable shunt system 800 ("device 800") configured in accordance with an embodiment of the present technology. At least some aspects of system 800 may be generally similar or identical in structure and / or function to one or more aspects of system 100 of FIGS. 1A and 1B, system 400 of FIGS. 4A and 4B, system 500 of FIGS. 5A and 5B, system 600 of FIGS. 6A-6C, and / or system 700 of FIGS. 7A-7B, and like names and / or reference numbers (e.g., plate assembly 120 of FIGS. 1A-2, plate assembly 420 of FIGS. 4A-4B, plate assembly 520 of FIGS. 5A-5B, and plate assembly or cartridge 820 as opposed to cartridge 620 of FIGS. 6A-6C) generally indicate similar or identical aspects. In these and other embodiments, system 800 may perform and / or be configured for use in one or more steps of method 370 of FIG.

[0065] The system 800 includes a housing 802 having a first end 802a and a second end 802b, a plate assembly 820, one or more fluid outlets 806, and one or more channels 836 ("channels 836") fluidly coupling the plate assembly 820 to respective ones of the fluid outlets 806. The plate assembly 820 may include one or more actuators 830a-830b. The channels 836 may be fluidly coupled to, and configured to receive fluid from, one or more inlets 837a-837c. The flow of fluid through respective ones of the inlets 837a-837c may be independently and / or selectively controlled by corresponding ones of the actuators 830a-830b. In the illustrated embodiment, for example, channel 836 includes a first inlet 837a that is open to fluid flow (e.g., always open to fluid flow and / or not configured to be selectively opened and closed by an actuator), a second inlet 837b that is configured to be selectively opened and closed to fluid flow by a first actuator 830a, and a third inlet 837c that is configured to be selectively opened and closed to fluid flow by a second actuator 830b. Individual ones of the inlets 837a-837c can be positioned along channel 836 such that channel 836 can include multiple inlets 837a-837c for receiving fluid and one or more channel portions or segments 839a-839c defined by the inlets 837a-837c. Each of the inlets 837a-837c can be positioned upstream and / or downstream of one or more of the other inlets 837a-837c (e.g., the first inlet 837a is upstream of the second and third inlets 837b, 837c).Accordingly, the actuators 830a-830b can be configured to control the flow of fluid into the channel 836 at various points (e.g., at the inlets 837a-837c) along the length of the channel 836.In the illustrated embodiment, the channel 836 begins with a first inlet 837a, includes a second inlet 837b downstream of the first inlet 837a, and includes a third inlet 837c downstream of the second inlet, such that the first, second, and third inlets 837a-837c are in series along the length of the channel 836. Continuing with reference to the illustrated embodiment, 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. In other embodiments, the system 800 can include more channels and / or more or fewer channel segments, inlets, and / or actuators.

[0066] The position of each of the inlets 837a-837c along the length of the channel 836 can be associated with a resistance to the flow of fluid through the channel 836. In the illustrated embodiment, for example, because the third inlet 837c is positioned downstream of the first inlet 837a, fluid entering the channel 836 via the third inlet 837c is expected to flow through a shortened length of the channel 836 relative to fluid entering the channel 836 via the first inlet 837a, such that the channel 836 offers less resistance to fluid entering via the third inlet 837c compared to the first inlet 837a. As another example, because the second inlet 837b is positioned upstream of the third inlet 837c and downstream of the first inlet 837a, a fluid entering the channel 836 via the second inlet 837b experiences increased resistance to flow compared to a fluid entering the channel 836 via the third inlet 837c, but experiences decreased resistance to flow compared to a fluid entering the channel 836 via the first inlet 837a.

[0067] In some aspects, channels that include multiple inlets are expected to be less likely to become blocked or clogged and / or can drain fluid when a portion of these channels become blocked or clogged. In at least some embodiments, for example, individual inlets of inlets 837a-837c can be opened in response to an upstream channel blockage to "tap in" or allow fluid flow into channel 836 at a location downstream of the upstream channel blockage. With reference to the illustrated embodiment, if first channel segment 839a becomes blocked or clogged, first actuator 830a can be actuated to allow fluid to enter channel 836 via second inlet 837b and bypass first channel segment 839a and the blockage / clog therein. Continuing with reference to example embodiments, if the second channel segment 839b becomes blocked or clogged, 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-830b to allow fluid flow through one or both of the second and third inlets 837b-837c can change (e.g., decrease) the 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., when the third inlet 837c is open, all or substantially all of the fluid can enter the channel 836 via the third inlet 837c). In these and other embodiments, one or more of the inlets 837a-837c, the channel 836, and / or one or more of its channel segments 839a-839c can include one or more varying dimensions, as described in detail with reference to Figures 7A and 7B. In an illustrative embodiment, for example, the width of the third channel segment 839c increases over a portion of the length of the third channel segment, which can further reduce or prevent the possibility that the channel 836 will become blocked or clogged.In these and others, the varying dimensions of individual ones of the inlets 837a-837c and / or channel segments 839a-839c are expected to improve control of flow through system 800 by providing multiple resistances to flow through system 800 and / or multiple flow rates under a given pressure, for example, in response to allowing or preventing flow through individual ones of the inlets 837a-837c.

[0068] Working Example Several aspects of the present technology are described in the following examples. 1. A system for shunting a 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 a first body region; 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 a second body region, the first fluid outlet fluidly coupled to the first fluid inlet via a first channel and the second fluid outlet fluidly coupled to the second fluid inlet via a second channel; an actuator positioned to control a flow of fluid from a first fluid inlet in the first layer to a first channel in the second layer; The system, wherein the second channel is configured to receive fluid from the second fluid inlet regardless of a state of the actuator. 2. The system of Example 1, wherein the first fluid outlet and the second fluid outlet are positioned at a distal end of the second layer, and the first fluid outlet is spaced apart and separate from the second fluid outlet. 3. The system of Example 1 or Example 2, wherein the first layer defines a chamber configured to receive fluid from a first body region, and the actuator is located within the chamber and configured to regulate the flow of fluid within the chamber through the first fluid inlet. 4. The system of any of Examples 1-3, wherein the first layer includes a third fluid outlet fluidly coupled to one or both of the first channel and the second channel, and a fluid reservoir positioned downstream of the first and second fluid inlets and upstream of the third fluid outlet, the fluid reservoir 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. 5. The system of example 4, wherein the third fluid outlet is fluidly coupled to the fluid reservoir by a third channel extending between the fluid reservoir and the third fluid outlet. 6. The system of 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. 7. The system of Example 6, wherein the first layer includes a first side and a second side opposite the first side, the second layer is bonded to the first side, and the third layer is bonded to the second side. 8. The system of example 6 or example 7, wherein the first layer, second layer, and third layer are configured to allow fluid to flow (i) from the first layer to the second layer in a first direction perpendicular to a longitudinal axis of the system, and (ii) from the second layer through the first layer to the third layer in a second direction opposite to the first direction and perpendicular to the longitudinal axis. 9. A system described in any of Examples 6 to 8, wherein the first layer includes a fluid reservoir configured to fluidly couple one or both of the first channel and the second channel to a third fluid outlet. 10. The system of example 9, wherein the first layer includes a third channel configured to fluidly couple the fluid reservoir and a third fluid outlet. 11. The system of Example 10, wherein at least a first portion of one or both of the first channel and the second channel is configured to direct fluid flow in a first direction, and at least a second portion of the third channel is configured to direct fluid flow in a second direction opposite to the first direction. 12. A system described in any of Examples 1-11, wherein the first channel is configured to receive fluid from the first fluid inlet regardless of the state of the actuator. 13. The system of any of Examples 1-12, wherein the actuator is configured to transition between (i) a first position in which the actuator allows fluid to flow between the first fluid inlet and the first fluid outlet at a first velocity, and (ii) a second position in which the actuator allows fluid to flow between the first fluid inlet and the first fluid outlet at a second velocity that is less than the first velocity. 14. A system for shunting a 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 permit fluid flow from a first body region to a second body region, the channel including a first inlet and a housing including a second inlet positioned downstream of the first inlet; an actuator positioned to control flow of fluid through the second inlet, the actuator being configured to transition between a first position and a second position; When the actuator is in the first position, the channel provides a first resistance to fluid flow therethrough. The system, wherein when the actuator is in the second position, the channel provides a second resistance to fluid flow therethrough, the second resistance being greater than the first resistance. 15. The system of example 14, wherein when the actuator is in the first position, at least a portion of the actuator is offset from the second inlet, and when the actuator is in the second position, a portion of the actuator is at least partially aligned with the second inlet. 16. The system of example 14 or example 15, wherein in a first position, the actuator allows fluid to flow through the second inlet at a first velocity, and in a second position, the actuator allows fluid to flow through the second inlet at a second velocity that is less than the first velocity. 17. A system described in any of Examples 14-16, wherein the first inlet is configured to allow fluid to enter the channel regardless of the position of the actuator. 18. The system of any of Examples 14-17, wherein when the actuator is in the first position, substantially all of the fluid flow into the channel is through the second inlet. 19. The system of any of Examples 14-18, wherein the housing comprises a first layer and a second layer coupled to the first layer. 20. The system of example 19, wherein the first layer at least partially defines a channel and the second layer at least partially defines a chamber configured to receive an actuator. 21. A system for shunting a fluid from a first body region to a second body region within a patient, comprising: a housing including a plurality of fluid inlets, each of the plurality of fluid inlets including a widened intermediate portion; a plate assembly within the housing, the plate assembly comprising: a chamber fluidly coupled to at least one of the fluid inlets; an actuator positioned within the chamber and configured to selectively control flow of fluid through the system. 22. The system of Example 21, wherein the multiple fluid inlets are multiple first fluid inlets, and the system further comprises multiple second inlets, each of the multiple second inlets including an angled intermediate portion. 23. The system of Example 22, further comprising a channel fluidly coupled to the plate assembly, the actuator being positioned to selectively control the flow of fluid through the channel, and each inlet of the plurality of second inlets being fluidly coupled to the channel. 24. The system of example 23, further comprising a fluid reservoir, the fluid reservoir fluidly coupling each inlet of the plurality of second inlets to the channel. 25. A system described in example 23 or example 24, wherein the channel has a first end and a second end opposite the first end, the first end of the channel having a first dimension, and the second end of the channel having a second dimension different from the first end. 26. The system of example 25, wherein the first dimension is a first width, the second dimension is a second width, and the second width is greater than the first width. 27. The system of example 25, wherein the first dimension is a first cross-sectional area, the second dimension is a second cross-sectional area, and the second cross-sectional area is greater than the first cross-sectional area. 28. A system for shunting a fluid from a first body region to a second body region within a patient, comprising: Housing and a plate assembly within the housing, the plate assembly comprising: A chamber; a plurality of fluid inlets positioned within the chamber; a flow channel, each of a plurality of fluid inlets being fluidly coupled to the flow channel; an actuator positioned within the chamber and configured to control a flow of fluid through the flow channel. 29. The system of example 28, wherein each of the multiple fluid inlets is fluidly coupled in series to the channel. 30. A system described in Example 28 or Example 29, wherein the multiple fluid inlets include a first fluid inlet and a second fluid inlet, the second fluid inlet being positioned downstream of the first fluid inlet, and further wherein the actuator is configured to control the fluid flow through the second fluid inlet. 31. A system described in any of examples 28 to 30, wherein the flow channel has a first end and a second end opposite the first end, the first end of the flow channel having a first dimension, and the second end of the flow channel having a second dimension different from the first end. 32. The system of example 31, wherein the first dimension is a first width, the second dimension is a second width, and the second width is greater than the first width. 33. The system of example 31, wherein the first dimension is a first cross-sectional area, the second dimension is a second cross-sectional area, and the second cross-sectional area is greater than the first cross-sectional area. 34. A screen assembly for use with an adjustable shunt system for treating a patient, the screen assembly comprising: a screen having a first end and a second end spaced from the first end; a first end of the screen at least partially aligned with a fluid inlet of the shunt system; A screen assembly, wherein during operation, the screen is configured to (i) at least partially prevent debris from entering a fluid inlet of the shunt system, and (ii) receive non-invasive ablation energy at the first end to at least partially remove debris from the screen. 35. The screen assembly of example 34, wherein the screen further comprises one or more actuator access areas positioned at least partially between the first end of the screen and the second end of the screen. 36. The screen assembly of example 35, wherein each of the actuator access areas is at least partially aligned with at least one actuator of the shunt system. 37. The screen assembly of Example 35 or Example 36, wherein each of the one or more actuator access areas is either (i) an opening formed in the screen or (ii) at least partially transparent. 38. the first end includes a plurality of screening elements; The screen assembly of any of Examples 34-37, wherein each of the fluid inlets is at least partially aligned with one or more of the plurality of screening elements. 39. A screen assembly as described in Example 38, wherein each of the plurality of screening elements includes a hole formed in the screen, and each individual hole is configured to at least partially prevent debris from entering the fluid inlet of the shunt system. 40. A screen assembly described in Example 38 or Example 39, wherein each of the multiple screening elements has a width of 0.1 μm to 100 μm. 41. A system described in any of Examples 38 to 40, wherein each of the multiple screening elements has a width of 10 μm. 42. A system described in any of Examples 38 to 41, wherein each of the multiple screening elements has a circular, elliptical, square, pentagonal, hexagonal, curved, or rectilinear shape. 43. The plurality of screening elements is a plurality of first screening elements, and the plurality of fluid inlets is a plurality of first fluid inlets; a second end of the screen at least partially aligned with one or more second fluid inlets of the shunt system; A screen assembly described in any of Examples 38 to 42, wherein the second end further comprises a plurality of second screening elements, and each of the second fluid inlets is at least partially aligned with one or more of the plurality of second screening elements. 44. The screen assembly of example 43, wherein each of the plurality of second screening elements comprises a hole formed in the second end of the screen. 45. The screen assembly of Example 43 or Example 44, wherein the first screening element and the second screening element have the same dimensions. 46. ​​A screen assembly described in any of Examples 43-45, wherein the first screening element and the second screening element have the same shape. 47. A screen assembly according to any of Examples 34-46, wherein the screen is formed, at least in part, from polydimethylsiloxane (PDMS), polydimethylacrylamide (PDMA), or superelastic nitinol. 48. A screen assembly described in any of Examples 34-47, further comprising a sealing element configured to sealingly engage the adjustable shunt system to form a substantially fluid-tight seal with the adjustable shunt system. 49. The screen assembly of example 48, wherein the sealing element is configured to extend at least partially around the fluid inlet. 50. The screen assembly of example 48 or example 49, wherein the sealing element extends outwardly from the screen. 51. The screen assembly of any of Examples 34-50, wherein the screen defines a fluid space between the screen and the fluid inlet. 52. The screen assembly of example 51, wherein the screen comprises a plurality of screening elements, and the fluid spaces fluidly couple individual screen elements of the plurality of screen elements to individual fluid inlets of the fluid inlet. 53. The screen assembly of example 52, wherein the fluid space fluidly couples the plurality of screen elements to the fluid inlet. 54. A system for shunting a fluid, comprising: Housing and A plate assembly within a housing, the plate assembly comprising: A plurality of fluid inlets; a chamber fluidly coupled to at least one of the fluid inlets; 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. 55. The system of Example 54, wherein the first part of the system includes a plate assembly, a chamber, an actuator, or multiple fluid inlets. 56. The system of example 54 or example 55, wherein the second part of the system includes a plurality of fluid inlets, a plate assembly, or a chamber. 57. A system described in any of Examples 54 to 56, wherein the screen includes a plurality of screening elements, one or more of the plurality of screening elements being at least partially aligned with the first portion of the system. 58. The system described in Example 57, wherein each of the multiple screening elements includes a hole formed in a filter, and each hole is configured to at least partially prevent debris from entering at least a second portion of the shunt system. 59. A system described in example 57 or example 58, wherein each of the screening elements has a width of 0.1 μm to 100 μm. 60. A system described in any of examples 57 to 59, wherein each of the multiple screening elements has a width of about 10 μm. 61. A system described in any of Examples 57 to 60, wherein each of the multiple screening elements has a circular, elliptical, square, pentagonal, hexagonal, curved, or rectilinear shape. 62. The system of any of claims 54-61, wherein the screen further comprises an actuator access area at least partially aligned with the actuator. 63. The system of Example 62, wherein the actuator access area is (i) an opening formed in a filter, or (ii) a portion of an at least partially transparent screen. 64. A system described in example 62 or example 63, wherein the actuator access area is configured to enable the actuator to be accessible to non-invasive ablation energy. 65. A system described in any of Examples 54 to 64, wherein the system is configured to (i) receive a first non-invasive ablation energy to at least partially remove debris from the screen, and (ii) receive a second non-invasive ablation energy to transition the actuator between the first position and the second position. 66. A system described in any of examples 54 to 65, wherein the actuator is a shape memory actuator. 67. The screen, The system of any of Examples 54-66, which is at least partially formed from silicone, acrylic, or a shape memory material. 68. A system described in any of Examples 54-67, wherein the screen is formed, at least in part, from polydimethylsiloxane (PDMS), polydimethylacrylamide (PDMA), or superelastic nitinol. 69. The plurality of fluid inlets includes a first fluid inlet, the chamber is a first chamber fluidly coupled to the first fluid inlet, and the actuator is a first actuator; the plurality of fluid inlets includes a second fluid inlet; The plate assembly is a second chamber fluidly coupled to the second fluid inlet; a second actuator positioned within the second chamber and configured to control the flow of fluid through the system; 69. The system of any of claims 54-68, wherein 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. 70. the third portion includes a plate assembly, a second chamber, a second actuator, or a second fluid inlet; The system of Example 69, wherein the fourth part includes a second fluid inlet, a plate assembly, or a second chamber. 71. The system of any of Examples 54-70, wherein the screen includes a sealing element configured to sealingly engage the plate assembly to form a substantially fluid-tight seal with the plate assembly. 72. The system of example 71, wherein the sealing element is configured to extend at least partially around each of the multiple fluid inlets. 73. The sealing element is a first sealing element, the screen includes a second sealing element, and the plurality of fluid inlets includes a first fluid inlet and a second fluid inlet; The system of example 71 or example 72, wherein a first sealing element sealingly engages with the plate assembly around the first inlet and a second sealing element sealingly engages with the plate assembly around the second inlet. 74. A system described in any of Examples 71-73, wherein the sealing element extends outward from the screen toward the plate assembly. 75. A system described in any of Examples 71-74, wherein the plate assembly includes a recess configured to receive a sealing element. 76. A system described in any of embodiments 54-75, wherein the screen defines a fluid space between the screen and the plate assembly. 77. The system of example 76, wherein the screen includes a plurality of screening elements and the fluid space fluidly couples each screen element of the plurality of screen elements to each fluid inlet of the fluid inlet. 78. The system of example 77, wherein the fluid space fluidly couples the multiple screen elements to the fluid inlet. 79. A system described in any of Examples 54 to 78, further comprising a channel fluidly connected to one or more of the fluid inlets and configured to receive fluid from one or more of the fluid inlets. 80. The system of Example 79, wherein the channel has a first end and a second end opposite the first end, the first end of the channel having a first dimension, and the second end of the channel having a second dimension different from the first end. 81. The system of example 80, wherein the first dimension is a first width and the second dimension is a second width that is greater than the first width. 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 that is larger than the first cross-sectional area. 83. A system described in any of embodiments 79 to 82, wherein each of the multiple fluid inlets is fluidly coupled in series to the channel. 84. The system of Example 83, wherein the multiple fluid inlets include a first fluid inlet and a second fluid inlet, the second fluid inlet being positioned downstream of the first fluid inlet, and further wherein the actuator is configured to control the flow of fluid through the second fluid inlet. 85. A method for operating a shunt system, comprising: A method comprising: directing non-invasive ablation energy toward a screen assembly of a shunt system; removing at least a portion of debris from a screen of the screen assembly; and transitioning an actuator of the adjustable shunt system between a first position and a second position. 86. The method of example 85, wherein directing non-invasive ablative energy toward the screen assembly includes applying non-invasive ablative energy to at least a portion of the screen. 87. The method of example 85 or example 86, wherein directing non-invasive ablative energy toward the screen assembly includes applying non-invasive ablative energy to a first end or a second end of the screen. 88. The method of any of examples 85-87, wherein directing non-invasive ablative energy toward the screen assembly includes applying non-invasive ablative energy to one or more screening elements of the screen. 89. The method of any of examples 85-88, wherein directing non-invasive ablation energy toward the screen assembly includes directing non-invasive ablation energy toward one or more actuator access areas of the screen. 90. The method of example 89, wherein directing non-invasive ablation energy toward one or more actuator access regions includes applying non-invasive ablation energy to one or more actuators of the shunt system via the one or more actuator access regions, each actuator being at least partially aligned with one of the one or more actuator access regions. 91. The method of example 89 or example 90, wherein directing non-invasive ablation energy toward one or more actuator access regions includes applying non-invasive ablation energy to one or more working element target regions of one or more actuators of the shunt system via the one or more actuator access regions, each working element target region being at least partially aligned with one of the one or more actuator access regions. 92. Directing non-invasive ablation energy towards the screen assembly; applying a first non-invasive ablation energy to the screen; The method of any of Examples 85-91, comprising directing a second non-invasive ablation energy toward one or more actuator access areas of the screen assembly. 93. The method of example 92, wherein the first non-invasive ablation energy comprises a first laser energy, the second non-invasive ablation energy comprises a second laser energy, and the first non-invasive ablation energy and the second non-invasive ablation energy have the same optical characteristics. 94. The method of example 92 or example 93, wherein the first non-invasive ablation energy comprises a first laser energy, the second non-invasive ablation energy comprises a second laser energy, and the second non-invasive ablation energy has different optical properties than the first non-invasive ablation energy. 95. The method of any of Examples 85-94, wherein removing at least a portion of the debris from the screen comprises removing at least a portion of the debris from one or more screening elements of the screen. 96. The method of any of examples 85-95, wherein removing at least a portion of the debris from the screen comprises at least partially melting or burning the debris off the screen.

[0069] conclusion The above detailed description of embodiments of the present technology is not intended to be exhaustive or to limit the present technology to the precise forms disclosed above. Although specific embodiments and examples of the present technology have been described above for illustrative purposes, various equivalent modifications are possible within the scope of the present technology, as those skilled in the art will recognize. For example, any of the features of the adjustable shunt system and / or screen assembly described herein can be combined with any of the features of the other adjustable shunt system and / or screen assembly described herein, and vice versa. Furthermore, while steps are presented in a given order, in alternative embodiments, steps may be performed in a different order. Various embodiments described herein may also be combined to provide further embodiments.

[0070] From the foregoing, it will be understood that, while specific embodiments of the present technology have been described herein for purposes of illustration, well-known structures and functions associated with adjustable shunt systems have not been shown or described in detail to avoid unnecessarily obscuring the description of the embodiments of the present technology. Where the context permits, singular or plural terms may also include the plural or singular terms, respectively.

[0071] Unless the context clearly dictates otherwise, throughout the description and examples, words such as "comprise", "comprising", and the like, are to be construed in an inclusive sense, i.e., "including, but not limited to", and not in an exclusive or exhaustive sense. As used herein, the terms "connected", "coupled", or any variation thereof, refer to any direct or indirect connection or coupling between two or more elements. The coupling of connections between elements may be physical, logical, or a combination thereof. Additionally, the words "herein", "above", "below", and words of similar import, when used in this application, refer to this application as a whole and not to any particular portions of this application. Where the context permits, words in the above detailed description using the singular or plural may each be in the plural or singular. As used herein, the phrase "and / or" appearing in "A and / or B" may refer to A only, B only, or both A and B. Additionally, the term "comprising" is used throughout to mean including at least the recited features, without excluding any more of the same features and / or other features of additional types. It will also be understood that, although certain embodiments have been described herein for purposes of illustration, various modifications may be made without departing from the technology. Furthermore, although advantages associated with some embodiments of the technology have been described in the context of these embodiments, other embodiments may also exhibit such advantages, and not all embodiments necessarily exhibit such advantages to fall within the scope of the technology. Thus, the present disclosure and related technology may encompass other embodiments not explicitly shown or described herein.

Claims

1. 1. A system for shunting a fluid from a first body region to a second body region within a patient, the system comprising: a first layer including a first fluid inlet and a second fluid inlet, the first and second fluid inlets each configured to receive fluid from the first body region; a second layer coupled to the first layer and including a first fluid outlet and a second fluid outlet, the first and second fluid outlets each configured to be positioned within the second body region, the first fluid outlet fluidly coupled to the first fluid inlet via a first channel, and the second fluid outlet fluidly coupled to the second fluid inlet via a second channel; an actuator positioned to selectively control the flow of the fluid from the first fluid inlet of the first layer into the first channel of the second layer; Equipped with The system, wherein the second channel is configured to receive fluid from the second fluid inlet regardless of the state of the actuator.

2. 2. The system of claim 1, wherein the first fluid outlet and the second fluid outlet are positioned at a distal end of the second layer, and the first fluid outlet is spaced apart from and separate from the second fluid outlet.

3. 2. The system of claim 1, wherein the first layer defines a chamber configured to receive fluid from the first body region, and the actuator is positioned within the chamber and configured to regulate the flow of the fluid within the chamber through the first fluid inlet.

4. the first layer comprising: (i) a third fluid outlet fluidly coupled to one or both of the first channel and the second channel; (ii) a fluid reservoir positioned downstream of the one or both of the first fluid inlet and the second fluid inlet and upstream of the third fluid outlet, the fluid reservoir 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; The system of claim 1 , comprising:

5. The system of claim 4 , wherein the third fluid outlet is fluidly coupled to the fluid reservoir by a third channel extending between the fluid reservoir and the third fluid outlet.

6. The system of claim 1 , further comprising a third layer including a third fluid outlet fluidly coupled to one or both of the first channel and the second channel.

7. 7. The system of claim 6, wherein the first layer includes a first side and a second side opposite the first side, and (i) the second layer is bonded to the first side, and (ii) the third layer is bonded to the second side.

8. 7. The system of claim 6, wherein the first layer, the second layer, and the third layer are configured to allow fluid to flow (i) from the first layer to the second layer in a first direction perpendicular to a longitudinal axis of the system, and (ii) from the second layer through the first layer to the third layer in a second direction opposite to the first direction and perpendicular to the longitudinal axis.

9. The system of claim 6 , wherein a 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.

10. The system of claim 9 , wherein the first layer includes a third channel configured to fluidly couple the fluid reservoir and the third fluid outlet.

11. 11. The system of claim 10, wherein at least a first portion of one or both of the first channel and the second channel is configured to direct fluid flow in a first direction, and at least a second portion of the third channel is configured to direct fluid flow in a second direction opposite the first direction.

12. The system of claim 1 , wherein the first channel is configured to receive fluid from the first fluid inlet regardless of the state of the actuator.

13. 2. The system of claim 1, wherein the actuator is configured to transition between (i) a first position in which the actuator allows fluid to flow between the first fluid inlet and the first fluid outlet at a first velocity, and (ii) a second position in which the actuator allows fluid to flow between the first fluid inlet and the first fluid outlet at a second velocity that is less than the first velocity.

14. A system for shunting fluid from a first body region to a second body region within a patient, the system comprising: a first layer including a fluid inlet, a reservoir, and a plurality of fluid outlets, the reservoir being positioned downstream of the fluid inlet and upstream of the fluid outlets; a second layer coupled to the first layer and at least partially defining a channel, the channel fluidly coupling the fluid inlet to the reservoir; and an actuator positioned to selectively control the flow of the fluid from the fluid inlet into the channel; A system comprising:

15. The system described in claim 14, wherein the fluid reservoir is configured to substantially prevent fluid flow through the plurality of fluid outlets until the fluid reservoir is at least partially filled with fluid received from the channel.

16. The system described in claim 14, wherein at least one of the plurality of outlets includes an inwardly angled portion.

17. The method of claim 16, wherein the first layer includes a first surface bonded to the second layer, a second surface facing away from the first surface, and a lateral surface connecting the first surface and the second surface; The system of claim 14 , wherein the plurality of fluid outlets are in the lateral surface.

18. The system described in claim 14, wherein the inlet is a first inlet, the channel is a first channel, and the system further comprises a second inlet and a second channel, and the second channel is configured to receive fluid from the second fluid inlet regardless of the state of the actuator.

19. A system for shunting a fluid from a first body region to a second body region within a patient, the system comprising: a housing; The housing comprises: a fluid inlet; a channel downstream of and fluidly coupled to the fluid inlet; a reservoir downstream of and fluidly coupled to the channel; a plurality of fluid outlets downstream of and fluidly coupled to the reservoir; Including, the system.

20. The system described in claim 19, wherein the housing extends in a plane and the plurality of fluid outlets are oriented relative to the housing so that fluid flows out of the plurality of outlets in a direction within the plane.

21. The system described in claim 19, wherein the housing extends in a plane and the plurality of fluid outlets are oriented relative to the housing so that fluid flows out of the plurality of outlets in a direction perpendicular to the plane.

22. The system described in claim 19, wherein the plurality of fluid outlets includes a first subset of outlets and a second subset of outlets, and the first subset of outlets are oriented at a different angle than the second subset of outlets.

23. The system described in claim 19, wherein at least one of the plurality of outlets includes an inwardly angled portion.

24. The system described in claim 19, wherein at least some of the plurality of outlets are configured to reduce tissue growth into the outlets.

25. The system of claim 19, wherein the housing comprises multiple layers.

26. The system described in claim 19, further comprising an actuator positioned to selectively control the flow of the fluid from the fluid inlet into the channel.

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