A method for occluding an anatomical structure (such as a vessel or duct) having a lumen comprises: introducing percutaneously into the body of the patient a delivery device; advancing the delivery device to an occlusion site outside the lumen of an anatomical structure; deploying an occlusion instrument from the delivery device; and occluding the anatomical structure with the occlusion instrument. The advance of the delivery device and the deployment of the occlusion instrument are guided by near-real-time imaging of a target region of a body of a patient, the target region including the occlusion site on the anatomical structure. The delivery device is guided to the occlusion site outside the lumen of the anatomical structure, and the structure is occluded with the deployed occlusion instrument engaging the exterior of the structure.