Methods for treating airways

• US 10,561,458 B2
• Filed: 03/26/2019
• Issued: 02/18/2020
• Est. Priority Date: 03/27/2000
• Status: Active Grant

• Current Assignee: Asthmatx Co.
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Danek, Christopher J., Biggs, Michael, Loomas, Bryan E., Laufer, Michael D., Kaplan, Gary S., Shriner, Kelly M., Wizeman, William
• Primary Examiner(s): Matthews, William H
• Application Number:
  US16/364,614
• Publication Number:
  US 20190216529A1
• Time in Patent Office: 329 Days
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 18/06 caused by chemical reaction , e.g. moxaburners
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2010/045 Needles pointed biopsy devices with vacuum aspiration A61B10/0283
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00244 adapted to separate target tissue from other tissue
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00773 Sensed parameters
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/053 : Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 : invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/08 : Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0809 : by impedance pneumography
• CPC Class Codes: A61B 5/1076 : for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/411 : Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/4519 : Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/4836 : Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4878 : Evaluating oedema
• CPC Class Codes: A61B 5/6853 : with a balloon
• CPC Class Codes: A61B 5/6858 : with a distal basket, e.g. expandable basket
• CPC Class Codes: A61N 5/1001 : using radiation sources introduced into or applied onto the body; brachytherapy

Abstract

This relates to treating airways in a lung to decrease asthmatic symptoms. The also includes steps of measuring a parameter of an airway at a plurality of locations in a lung, identifying at least one treatment site from at least one of the plurality of locations based on the parameter, and applying energy to the treatment site to reduce the ability of the site to narrow.

Claims

1. A method of treating a lung, the method comprising:

inserting a medical device into an airway of the lung, the medical device including a catheter and a balloon disposed at a distal end of the catheter, wherein a distalmost portion of the catheter extends distally of a distalmost portion of the balloon;

stimulating tissue surrounding an airway in the lung by introducing, via a port of the catheter, a pharmacological agent into the airway to constrict the airway;

after stimulating the tissue, measuring a constriction of the airway via the balloon;

delivering a fluid to the airway to electrically couple an electrode to the tissue surrounding the airway;

applying energy to the tissue, via the electrode and the fluid, to damage a portion of nerves disposed radially outward of the airway to reduce the ability of the lung to constrict in response to a stimulus, wherein the portion of the nerves is damaged to a greater extent than epithelium of the lung disposed radially inward of the portion of the nerves is damaged;

conveying the fluid from the airway; and

after applying energy, determining an effectiveness of applying energy by determining whether the lung has a reduced ability to produce at least one symptom of reversible obstructive pulmonary disease.

2. The method of claim 1, wherein delivering the fluid to the airway and applying energy to the tissue occur only if the measured constriction is greater than a threshold value.

3. The method of claim 1, further including monitoring electrical impedance of the tissue.

4. The method of claim 1, wherein applying energy to the tissue includes applying RF energy to the tissue.

5. The method of claim 1, wherein the pharmacological agent is methacholine.

6. The method of claim 1, wherein applying the energy to the tissue causes the tissue to reach a temperature from 60°

C. to 80°

C.

7. A method of treating a lung, the method comprising:

inserting a medical device into an airway of the lung, the medical device including a catheter and a balloon disposed at a distal end of the catheter, wherein a distalmost portion of the catheter extends distally of a distalmost portion of the balloon;

stimulating tissue surrounding the airway in the lung;

after stimulating the tissue, measuring a parameter of the airway via the balloon;

delivering a fluid to the airway to electrically couple an electrode to the tissue surrounding the airway; and

applying energy to the tissue to damage a portion of nerves disposed radially outward of the airway to reduce the ability of the lung to constrict in response to a stimulus, wherein the portion of the nerves is damaged to a greater extent than epithelium of the lung disposed radially inward of the portion of the nerves is damaged, wherein applying energy to the tissue occurs through the electrode and the fluid.

8. The method of claim 7, further including conveying the fluid from the airway.

9. The method of claim 7, wherein applying energy occurs only if the measured parameter is greater than a threshold value.

10. The method of claim 7, wherein the measured parameter is a contraction of the airway.

11. The method of claim 7, wherein, after applying energy, the method further includes determining an effectiveness of applying energy by determining whether the lung has a reduced ability to produce at least one symptom of reversible obstructive pulmonary disease.

12. The method of claim 7, wherein stimulating the tissue includes introducing a pharmacological agent into the airway.

13. A method of treating a lung, the method comprising:

stimulating tissue surrounding an airway in the lung to constrict the airway;

after stimulating the tissue, measuring a parameter of the airway;

delivering a fluid to the airway to electrically couple an electrode to the tissue surrounding the airway; and

applying energy to the tissue, via the electrode and the fluid, to damage a portion of nerves disposed radially outward of the airway to reduce the ability of the lung to constrict in response to a stimulus, while minimizing damage to epithelium of the lung radially inward of the portion of the nerves.

14. The method of claim 13, further including conveying the fluid from the airway.

15. The method of claim 13, further including, before stimulating the tissue, inserting a medical device into the airway, the medical device including a catheter and a balloon disposed at a distal end of the catheter, wherein a distalmost portion of the catheter extends distally of a distalmost portion of the balloon.

16. The method of claim 13, wherein delivering the fluid and applying energy to the tissue occur only if the measured parameter is greater than a threshold value.

17. The method of claim 13, wherein the measured parameter is a contractile force of the airway.

18. The method of claim 13, wherein stimulating the tissue includes introducing a pharmacological agent into the airway.

19. The method of claim 18, wherein the pharmacological agent is methacholine.

20. The method of claim 13, further including after applying energy, determining an effectiveness of applying energy by determining whether the lung has a reduced ability to produce at least one symptom of reversible obstructive pulmonary disease.