Apparatus and methods for implanting objects, such as a bronchoscopically implanting markers in the lung of patients

• US 10,653,496 B2
• Filed: 03/11/2016
• Issued: 05/19/2020
• Est. Priority Date: 09/19/2005
• Status: Active Grant

• Current Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Original Assignee: Varian Medical Systems Incorporated (Siemens AG)
• Inventors: Mayse, Martin L., Dimmer, Steven C., Hildwein, Roger, Nielson, Eric D.
• Primary Examiner(s): Nguyen, Hien N
• Application Number:
  US15/068,152
• Publication Number:
  US 20160206397A1
• Time in Patent Office: 1,530 Days
• CPC Class Codes: A61B 1/018 for receiving instruments
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/00951 adhesive
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/252 indicating steps of a surgical procedure
• CPC Class Codes: A61B 2090/101 for stereotaxic radiosurgery
• CPC Class Codes: A61B 2090/3912 Body cavities
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 2090/397 electromagnetic other than visible, e.g. microwave
• CPC Class Codes: A61B 2090/3987 Applicators for implanting markers
• CPC Class Codes: A61B 2090/3991 having specific anchoring means to fixate the marker to the tissue, e.g. hooks
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 34/30 Surgical robots
• CPC Class Codes: A61B 90/39 Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61N 2005/1009 Apparatus for loading seeds into magazines or needles

Abstract

Apparatuses and methods for implanting objects, such as a marker, in the lungs of patients. In one embodiment, a bronchoscopic catheter assembly for implanting an object in the lung of a patient includes a handle, a delivery catheter projecting outwardly from the handle, and a push wire contained within the catheter. In one aspect of this embodiment, the catheter can be configured to releasably hold a plurality of markers at a distal end. In another aspect of this embodiment, the push wire can be operably connected to the handle and axially moveable within the delivery catheter to eject the marker out of the catheter within the bronchi of the patient. In a further aspect of this embodiment, the marker can further include an anti-migration device associated with the marker for holding the marker in place once the marker is deployed in the bronchi. The anti-migration device can be integral with the marker or positioned proximate to the marker to prevent migration of the marker.

Claims

1. A method of deploying a marker into a lumen within a body, comprising:

advancing a distal end of a catheter to a desired position in the lumen within the body, wherein the distal end of the catheter is pre-loaded with and releasably retains the marker such that a portion of the marker extends beyond the distal end of the catheter before and during the advancement of the catheter and until deployment, the marker providing a rounded leading edge as the distal end of the catheter is advanced to the desired position in the lumen;

engaging an actuator to move a push wire contained in the catheter toward the distal end of the catheter to engage the marker, the push wire including indicator marks to delineate a predetermined distance to displace the push wire in order to deploy the marker; and

deploying the marker by moving the push wire toward the distal end of the catheter or by fixing the push wire in place and retracting the catheter toward a proximal end of the push wire.

2. The method of claim 1, wherein advancing the distal end of the catheter in the lumen within the body includes passing the catheter, the push wire, and the marker down a working channel of a bronchoscope a selected distance for deployment of the marker into a bronchial lumen of a lung, a lumen within a digestive tract, and/or a lumen within a cardiovascular system.

3. The method of claim 1, wherein deploying the marker includes deploying a leadless marker having a transponder that has a response signal to an external energy source.

4. The method of claim 1, wherein deploying the marker includes deploying a radiographically opaque marker.

5. The method of claim 1, further comprising:

providing the marker, wherein the marker is used to provide positional location information, and wherein the marker is configured to be held positionally in place within a pulmonary airway by an anti-migration device;

advancing, via the catheter, the marker and the anti-migration device through pulmonary airways; and

wherein deploying the marker comprises releasing the marker and the anti-migration device in one of the pulmonary airways, wherein the deployed marker is held in place in the pulmonary airway by the anti-migration device.

6. The method of claim 5, wherein deploying the marker and the anti-migration device comprises advancing the marker and the anti-migration device through a bronchoscope.

7. The method of claim 5, wherein providing the marker further includes providing the marker with a cylindrical casing.

8. The method of claim 7, wherein providing the marker with a cylindrical casing includes providing the cylindrical casing that has a larger diameter than an inside diameter of a distal portion of the catheter.

9. The method of claim 7, wherein advancing the distal end of the catheter further comprises advancing the distal end of the catheter that is further preloaded with an anti-migration device, wherein the marker is integral with the anti-migration device, and wherein the anti-migration device includes one or more legs that project away from the cylindrical casing in a deployed position.

10. The method of claim 9, wherein deploying the marker that is integral with the anti-migration device includes having the one or more legs being molded projections of the cylindrical casing.

11. The method of claim 9, wherein deploying the marker that is integral with the anti-migration device includes having the one or more legs that are small springs biased to project away from the cylindrical casing.

12. The method of claim 1, further comprising preloading the distal end of the catheter with an anti-migration device, wherein the marker is integral with the anti-migration device, and wherein the anti-migration device includes one or more shape memory loops.

13. The method of claim 7, further comprising preloading the distal end of the catheter with an anti-migration device, wherein the marker is integral with the anti-migration device, and wherein the anti-migration device includes one or more scales that project away from the cylindrical casing.

14. The method of claim 1, further comprising preloading the distal end of the catheter with an anti-migration device, wherein the marker is integral with the anti-migration device, and wherein the anti-migration device includes one or more barbs or hooks.

15. The method of claim 1, further comprising preloading the distal end of the catheter with an anti-migration device, wherein the marker is integral with the anti-migration device, and wherein the anti-migration device includes a spring or a serpentine element extruding from an end of the marker opposite the portion of the marker that extends beyond the distal end of the catheter.

16. The method of claim 1, further comprising preloading the distal end of the catheter with an anti-migration device, wherein the anti-migration device is separate from the marker, wherein deploying the marker comprises releasing the anti-migration device adjacent to the marker.

17. The method of claim 16, wherein the anti-migration device includes an expandable member, the method further comprising storing the expandable member within the distal end of the catheter in a stored position having a first size, the expandable member configured to be released and assume a deployed position having a second size greater than the first size.

18. The method of claim 17, wherein the expandable member is a stent, an umbrella structure, or an expandable cylindrical section.