Devices and methods for maintaining collateral channels in tissue

• US 20020111620A1
• Filed: 09/04/2001
• Published: 08/15/2002
• Est. Priority Date: 02/14/2001
• Status: Active Grant

• Current Assignee: Broncus Medical Incorporated
• Original Assignee: Broncus Technologies, Inc
• Inventors: Tanaka, Don, Loomas, Bryan, Kaplan, Gary, Davenport, James M., Cooper, Joel D.
• Granted Patent: US 7,175,644 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00601 Cutting
• CPC Class Codes: A61B 2018/00738 Depth, e.g. depth of ablation
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/1417 Ball
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/395 with marking agent for marking skin or other tissue
• CPC Class Codes: A61B 2218/002 Irrigation
• CPC Class Codes: A61B 5/489 : Blood vessels
• CPC Class Codes: A61B 8/06 : Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 : Details of catheter construction
• CPC Class Codes: A61B 90/36 : Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61F 2/07 : Stent-grafts
• CPC Class Codes: A61F 2/2412 : with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/90 : characterised by a net-like or mesh-like structure
• CPC Class Codes: A61F 2/91 : made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/92 : Stents in the form of a rolled-up sheet expanding after insertion into the vessel , e.g. with a spiral shape in cross-section
• CPC Class Codes: A61F 2002/043 : Bronchi
• CPC Class Codes: A61F 2002/061 : provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/072 : Encapsulated stents, e.g. wire or whole stent embedded in lining
• CPC Class Codes: A61F 2002/8483 : Barbs
• CPC Class Codes: A61F 2220/0008 : Fixation appliances for connecting prostheses to the body
• CPC Class Codes: A61F 2220/0016 : with sharp anchoring protrusions, e.g. barbs, pins, spikes
• CPC Class Codes: A61F 2230/005 : Rosette-shaped, e.g. star-shaped
• CPC Class Codes: A61F 2230/0058 : X-shaped
• CPC Class Codes: A61F 2230/0067 : conical
• CPC Class Codes: A61F 2230/0076 : ellipsoidal or ovoid
• CPC Class Codes: A61F 2230/0078 : hyperboloidal

Abstract

The devices and methods of placement of such devices disclosed herein are directed to altering gaseous flow within a lung to improve the expiration cycle of, for instance, an individual having Chronic Obstructive Pulmonary Disease. More particularly, these devices produce and maintain collateral openings or channels through the airway wall so that oxygen depleted/carbon dioxide rich air is able to pass directly out of the lung tissue to facilitate both the exchange of oxygen ultimately into the blood and/or to decompress hyper-inflated lungs. The medical kits disclosed herein are also directed to produce and maintain collateral openings through airway walls.

Claims

1. A method of placing a conduit within lung tissue comprising:

feeding a guide-wire to a site within the lung;

advancing a conduit to the site using the guide-wire; and

placing the conduit within lung tissue at the site.

2. The method of claim 1, further comprising inserting an access device within the lung, the access device adapted to locate the site prior to the feeding step, wherein the access device includes at least one lumen.

3. The method of claim 2, wherein the access device comprises a bronchoscope.

4. The method of claim 2, further comprising:

feeding a blood-vessel detection device through the lumen of the access device; and

selecting the site within the lungs using the blood-vessel detection device to avoid blood vessels within the lung.

5. The method of claim 2, further comprising:

feeding a guide-wire through the lumen of the access device; and

creating a collateral channel with the guide-wire at the site prior to placing the conduit.

6. The method of claim 5, further comprising:

leaving the guide-wire extending through the collateral channel and withdrawing the access device from the lung

7. The method of claim 6, further comprising:

returning the access device to a point near the collateral channel to allow visualization of the collateral channel

8. The method of claim 2, further comprising:

feeding a hole-making device through the lumen of the access device; and

creating a collateral channel with the hole-making device at the site prior to placing the conduit.

9. The method of claim 8, wherein feeding the guide-wire to the site comprises feeding the guide-wire through the collateral channel.

10. The method of claim 2, wherein advancing the conduit comprises feeding a catheter having a conduit attached thereto over the guide-wire to the collateral channel.

28. A medical kit for improving gaseous flow within a diseased lung comprising:

a conduit; and

a set of instructions teaching any of claims 1-11.

11. The method of 10, wherein placing the conduit within lung tissue further includes expanding the conduit within the collateral channel.

13. The conduit of claim 12, wherein said weakened section comprises a reduced wall thickness being less than a thickness of said wall of said center section.

14. The conduit of claim 12, wherein said conduit comprises a material selected from the group consisting of polytetrafluoroethylene, polypropylene, and a combination thereof.

15. The conduit of claim 12, wherein said center section is radially expandable away from said central axis to allow said center section to assume an expanded profile from a reduced profile.

16. The conduit of claim 15, wherein a length of said center section is less than twice the square root of a cross sectional area of said center section when said center section is in said expanded profile.

17. The conduit of claim 15, wherein a length of said center section measured along said central axis decreases as said center section expands from said reduced profile to said expanded profile.

18. The conduit of claim 15, wherein said center section is spring biased to assume said expanded profile.

19. The conduit of claim 12, where said end section extending from said first end of said conduit are longer than said end section extending from a second end of said conduit.

20. The conduit of claim 12, wherein said passageway has a cross sectional area between 0.196 mm² to 254 mm².

21. The conduit of claim 12, wherein said passageway has a cross sectional area between 3 mm² to 20 mm².

22. The conduit of claim 12, wherein said conduit has an asymmetrical profile.

23. The conduit of claim 12, wherein said conduit has a ratio of a length to a diameter of approximately 1:

1.

24. The conduit of claim 12, further comprising a self-cleaning mechanism within said passageway.

25. The conduit of claim 24, wherein said self-cleaning mechanism is a ball bearing shaker valve.

26. The conduit of claim 12, further comprising a one-way valve located within said passageway.

27. The conduit of claim 12, further comprising a gas-permeable bacterial-resistant barrier located within said passageway.

29. The medical kit of claim 28, further comprising a bronchoscope.

30. The medical kit of claim 28, further comprising a guide-wire.

31. The medical kit of claim 28, further comprising a blood-vessel detection device.

32. The medical kit of claim 28, further comprising a hole-making device.

12. A conduit for maintaining the patency of an opening in tissue comprising:

a center section having a first end and a second end and a central axis extending between said ends, a passageway within said center section extending between said ends, said center section having a wall;

at least one end section having a first end which abuts an end of the center section and a second end, a central axis extending between said ends, a passageway within said center section extending between said ends, said end section having a wall

wherein at least a portion of each of said end sections being connected to said center section have a weakened section such that each of said free ends of said end section may bend at said respective weakened section when an outward radial force is applied to said extension member.

33. A medical kit for improving gaseous flow within a diseased lung comprising:

a conduit; and

an instruction teaching;

selecting at least one site for collateral ventilation of the lung;

creating a collateral channel at each of the sites for collateral ventilation;

inserting the conduit in the collateral channel.

34. The medical kit of claim 33, further comprising a bronchoscope.

35. The medical kit of claim 33, further comprising a guide-wire.

36. The medical kit of claim 33, wherein the conduit comprises a tubular center section having a first end and a second end and a central axis extending between said ends, a plurality of extension members having a free end extending from each end of said center section, said extension members arranged around a circumference of said center section, each of said free ends of said extension members being independently moveable in a direction orthogonal to said central axis to form an angle with said central axis.

37. The medical kit of claim 33, wherein the conduit comprises a tubular center section having a first end and a second end and a central axis extending between said ends, wherein said ends of said conduit are configured to expand radially outward from said tubular center section.