Methods and apparatuses for navigating the subarachnoid space
First Claim
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1. A method of creating flow of CSF in a subararchnoid space of a vertebrate organism, the method comprising:
- providing a catheter having a proximal end, a distal end, and an elongate shaft extending therebetween, the catheter coupled to a device having the capacity for moving a fluid;
percutaneously introducing the catheter with the device into the subarachnoid space at an entry location corresponding to a spinal portion of the subarachnoid space;
advancing the catheter within the subarachnoid space so that the device is at least partially within the subarachnoid space; and
activating the device to create a flow of CSF within the subarachnoid space.
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Abstract
Disclosed are methods and devices for navigating a subarachnoid space in a vertebrate organism including percutaneously introducing a device into the spinal subarachnoid space at an entry location. Navigation of the spinal subarachnoid space is disclosed for the purpose of reaching a desired location in the subarachnoid space or the intracranial space, including areas in and around the spinal cord and brain. Once a desired location is reached, methods and devices for cooling or heating the desired location to cause physiologic changes are suggested.
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Citations
88 Claims
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1. A method of creating flow of CSF in a subararchnoid space of a vertebrate organism, the method comprising:
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providing a catheter having a proximal end, a distal end, and an elongate shaft extending therebetween, the catheter coupled to a device having the capacity for moving a fluid;
percutaneously introducing the catheter with the device into the subarachnoid space at an entry location corresponding to a spinal portion of the subarachnoid space;
advancing the catheter within the subarachnoid space so that the device is at least partially within the subarachnoid space; and
activating the device to create a flow of CSF within the subarachnoid space. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
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26. A catheter having a proximal end and a distal end and an elongate shaft therebetween, the catheter comprising:
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a fluid moving apparatus for moving a fluid disposed proximate the distal end; and
a heat exchanger for providing heat exchange with a fluid or tissue disposed proximate the distal end. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40)
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41. A catheter having a proximal end and a distal end, the catheter comprising:
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a fluid displacer disposed along a location between the proximal end and the distal end; and
a pumping lumen extending from a location proximal the fluid displacer to a location distal the fluid displacer;
wherein the fluid displacer causes a fluid to move within the pumping lumen. - View Dependent Claims (42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 54, 55, 56, 57)
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58. A method of infusing a fluid to a location within the body of a patient, the method including:
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providing a first catheter having an outlet and a first lumen for infusing the fluid via the outlet;
providing a diffusing catheter for reducing the pressure of fluid exiting the outlet;
inserting the diffusing catheter into the patient and advancing the diffusing catheter to a first location;
inserting the first catheter inside the diffusing catheter and advancing the first catheter until the outlet is adjacent a desired location; and
pumping a fluid through the first catheter. - View Dependent Claims (59, 60, 61, 62)
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63. A catheter having a distal end, a proximal end and an elongate shaft therebetween, the catheter comprising:
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a first lumen;
a second lumen;
a first port, the first port in fluid communication with the first lumen;
a second port, the second port in fluid communication with the second lumen; and
wherein the second lumen is adapted for carrying a fluid under a higher pressure proximal of the first port and a lower pressure distal of the first port. - View Dependent Claims (64, 65, 66)
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67. A method of reducing cellular metabolic rates in a portion of tissue of a patient comprising:
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introducing a catheter into a spinal subarachnoid space;
advancing the catheter through the spinal subarachnoid space to location within either the spinal subarachnoid space or an adjacent intracranial subarachnoid space;
providing an infusion port as part of the catheter;
providing a cooling fluid at a temperature below the patient'"'"'s normal body temperature; and
pumping the cooling fluid through the infusion port.
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68. A catheter having a distal end, a proximal end, and an elongate shaft therebetween, the catheter comprising:
a fluid displacer adapted to displace a bodily fluid of a living organism while at least part of the fluid displacer is disposed within the living organism. - View Dependent Claims (69, 70, 71, 72)
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73. A catheter having a distal end, a proximal end, and an elongate shaft therebetween, the catheter comprising:
a heat exchanger adapted to perform heat exchange with a bodily fluid of an organism while at least part of the heat exchanger is disposed within the living organism. - View Dependent Claims (74, 75, 76, 77)
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78. A catheter having a proximal end and a distal end and an elongate shaft therebetween, the catheter comprising:
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a first section; and
a second section disposed distal the first section;
wherein the thermal conductivity of the first section is less than the thermal conductivity of the second section. - View Dependent Claims (79, 80, 81, 82, 83)
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84. A method for cooling tissue in a subarachnoid space of a vertebrate organism, the method comprising:
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providing a catheter including an elongate shaft having a proximal end, a distal end, a first lumen, a second lumen, and a heat exchanger disposed adjacent the distal end in fluid communication with the first lumen and the second lumen;
advancing the distal end of the catheter within the subarachnoid space and positioning the heat exchanger adjacent the tissue;
providing a flow of cooling fluid through the first lumen to the heat exchanger; and
removing the cooling fluid from the heat exchanger through the second lumen.
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85. A method of cooling CSF in a subarachnoid space of a vertebrate organism, the method comprising:
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providing a catheter including an elongate shaft having a distal end, a proximal end, a first lumen having an output port, and a second lumen having an intake port, wherein the output port is disposed distally of the input port;
advancing the distal end of the catheter at least ten centimeters within the subarachnoid space;
removing CSF from the subarachnoid space through the intake port and the second lumen;
cooling the removed CSF; and
introducing the cooled CSF back into the subarachnoid space through the first lumen and the output port. - View Dependent Claims (86)
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87. A catheter adapted for changing the temperature of tissue in or adjacent the subarachnoid space of a vertebrate organism, the catheter comprising:
an elongate shaft including a distal portion and a proximal portion, wherein the distal portion is adapted for insertion and advancement within the subarachnoid space;
wherein the distal portion includes a heat exchanger.
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88. A method of analyzing the biochemistry of a patient, the method comprising:
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introducing a catheter into the spinal subarachnoid space of the patient;
advancing the catheter at least ten centimeters within the subarachnoid space of the patient to a desired location within the subarachnoid space;
removing a quantity of fluid from the subarachnoid space; and
determining at least one characteristic of the fluid.
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Specification