Partial aortic occlusion devices and methods for renal and coronary perfusion augmentation

• US 20030083617A1
• Filed: 11/08/2002
• Published: 05/01/2003
• Est. Priority Date: 03/01/1999
• Status: Active Grant

• Current Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Original Assignee: Coaxis Incorporated (Trimble Inc.)
• Inventors: Barbut, Denise R., St. Germain, Jon P.
• Granted Patent: US 6,767,345 B2
• Time in Patent Office: Days
• US Class Current: 604/104
• CPC Class Codes: A61B 17/12036 partial occlusion
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12145 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/4076 Diagnosing or monitoring particular conditions of the nervous system A61B5/4821, A61B5/4824 take precedence
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61F 2002/068 Modifying the blood flow model, e.g. by diffuser or deflector
• CPC Class Codes: A61F 2007/126 for invasive application, e.g. for introducing into blood vessels
• CPC Class Codes: A61F 7/12 Devices for heating or cooling internal body cavities
• CPC Class Codes: A61M 2025/0002 with a pressure sensor at the distal end
• CPC Class Codes: A61M 2025/0034 characterized by elements which are assembled, connected or fused, e.g. splittable tubes, outer sheaths creating lumina or separate cores
• CPC Class Codes: A61M 2025/0073 Tip designed for influencing the flow or the flow velocity of the fluid, e.g. inserts for twisted or vortex flow
• CPC Class Codes: A61M 2025/0081 Soft tip
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2210/127 : Aorta
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• CPC Class Codes: A61M 25/00 : Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/003 : characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves catheter tips A61M25/0067
• CPC Class Codes: A61M 25/0032 : characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• CPC Class Codes: A61M 25/0068 : Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/0069 : Tip not integral with tube
• CPC Class Codes: A61M 25/0074 : Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/008 : Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0662 : Guide tubes
• CPC Class Codes: A61M 25/1011 : Multiple balloon catheters

Abstract

A method for increasing renal and/or coronary blood flow. A catheter is inserted into the descending aorta. An expandable member on a distal region of the catheter is positioned in the aorta downstream from the takeoff of a renal artery or downstream from a coronary ostium. The expandable member is expanded to partially occlude blood flow in the aorta. Blood pressure in the proximal aorta increases, blood pressure in the distal aorta decreases, and renal and/or coronary blood flow increases by this technique. Blood pressure in the proximal aorta may be measured to monitor the effects of the procedure. The expansion of the expandable member may be adjusted based on the measured blood pressure.

Claims

1. A method for increasing renal blood flow, comprising the steps of:

inserting a catheter into the descending aorta, the catheter having a proximal region, a distal region, and an expandable member mounted on the distal region;

locating the expandable member in the aorta downstream from the takeoff of a renal artery;

expanding the expandable member to partially occlude blood flow in the aorta, wherein blood pressure in the proximal aorta increases, blood pressure in the distal aorta decreases, and renal blood flow increases;

measuring blood pressure in the proximal aorta; and

adjusting the expansion of the expandable member based on the measured blood pressure.

2. The method of claim 1, wherein a lumen of the catheter is adapted for blood flow.

3. The method of claim 2, wherein the catheter further comprises a second lumen adapted to receive a medical instrument.

4. The method of claim 1, further comprising the step of advancing a medical instrument through a lumen of the catheter and into an artery that branches from the aorta.

5. The method of claim 4, wherein the medical instrument is selected from the group consisting of a guiding catheter, an infusion catheter, an angioplasty catheter, a laser catheter, an angiography catheter, a therapeutic ultrasound catheter, a hypothermia catheter, a stent catheter, an imaging catheter, a perfusion catheter, an atherectomy catheter, an occlusion catheter, an EP catheter, and an aspiration catheter.

6. The method of claim 1, wherein the step of expanding the expandable member comprises reducing the luminal diameter of the expandable member to reduce blood flow, while an outer diameter of the expandable member remains constant.

7. The method of claim 1, wherein the step of expanding the expandable member includes maintaining the expanded expandable member during systole.

8. The method of claim 1, wherein the expandable member comprises a toroidal balloon, and wherein the step of expanding the expandable member comprises inflating the expandable member.

9. The method of claim 1, wherein the expandable member comprises a balloon, and wherein the step of expanding the expandable member comprises inflating the expandable member.

10. A method for increasing coronary blood flow, comprising the steps of:

inserting a catheter into the descending aorta, the catheter having a proximal region, a distal region, and an expandable member mounted on the distal region;

locating the expandable member in the aorta downstream from a coronary ostium;

expanding the expandable member to partially occlude blood flow in the aorta, wherein blood pressure in the proximal aorta increases, blood pressure in the distal aorta decreases, and coronary blood flow increases;

measuring blood pressure in the proximal aorta; and

adjusting the expansion of the expandable member based on the measured blood pressure.

11. The method of claim 10, wherein a lumen of the catheter is adapted for blood flow.

12. The method of claim 11, wherein the catheter further comprises a second lumen adapted to receive a medical instrument.

13. The method of claim 10, further comprising the step of advancing a medical instrument through a lumen of the catheter and into an artery that branches from the aorta.

14. The method of claim 13, wherein the medical instrument is selected from the group consisting of a guiding catheter, an infusion catheter, an angioplasty catheter, a laser catheter, an angiography catheter, a therapeutic ultrasound catheter, a hypothermia catheter, a stent catheter, an imaging catheter, a perfusion catheter, an atherectomy catheter, an occlusion catheter, an EP catheter, and an aspiration catheter.

15. The method of claim 10, wherein the step of expanding the expandable member comprises reducing the luminal diameter of the expandable member to reduce blood flow, while an outer diameter of the expandable member remains constant.

16. The method of claim 10, wherein the step of expanding the expandable member includes maintaining the expanded expandable member during systole.

17. The method of claim 10, wherein the expandable member comprises a toroidal balloon, and wherein the step of expanding the expandable member comprises inflating the expandable member.

18. The method of claim 10, wherein the expandable member comprises a balloon, and wherein the step of expanding the expandable member comprises inflating the expandable member.