Treatment planning with implantable bronchial isolation devices

• US 20050016530A1
• Filed: 07/08/2004
• Published: 01/27/2005
• Est. Priority Date: 07/09/2003
• Status: Abandoned Application

• Current Assignee: Pulmonx Pulmonx
• Original Assignee: Pulmonx Pulmonx
• Inventors: Campbell, Randy, McCutcheon, John, Fields, Antony
• Application Number:
  US10/887,337
• Publication Number:
  US 20050016530A1
• Time in Patent Office: Days
• US Class Current: 128/200.240
• CPC Class Codes: A61B 17/12022 Occluding by internal devices, e.g. balloons or releasable wires plugging an opening in the wall of an organ A61B17/0057; occluders for the cervical canal A61F6/146; vas deferens occluders A61F6/20
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12159 Solid plugs; being solid before insertion
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity

Abstract

Disclosed is a treatment planning method that can be used to maximize the effectiveness of minimally invasive treatment on a patient. Pursuant to the treatment planning method, the presence of lung disease, such as emphysema, is first identified, followed by a determination of the distribution and extent of damage of the disease, followed by a determination of whether the patient is suitable for treatment, and a determination of the appropriate strategy for treatment for a suitable patient.

Claims

1. A method of determining a treatment strategy for minimally invasive lung treatment, comprising:

performing at least one diagnostic procedure on a patient to obtain at least one diagnostic result; and

determining that the patient is eligible for minimally invasive lung treatment if at least one diagnostic result satisfies predetermined eligibility criteria.

2. The method of claim 1, wherein the at least one diagnostic procedure comprises a spirometric test and wherein the at least one diagnostic result includes at least one of the group consisting of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and forced expiratory flow, 25% to 75% (FEF_25%-75% ).

3. The method of claim 1, wherein the at least one diagnostic procedure comprises a spirometric test and wherein the at least one diagnostic result includes a combination of two or more of the group consisting of forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and forced expiratory flow, 25% to 75% (FEF_25%-75% ).

4. The method of claim 2, wherein the eligibility criteria comprises FVC and wherein the patient is eligible for minimally invasive lung treatment if the patient'"'"'s FVC is less than 80 percent of FVC predicted.

5. The method of claim 2, wherein the eligibility criteria comprises FVC and wherein the patient is eligible for minimally invasive lung treatment if the patient'"'"'s FVC is less than 70 percent of FVC predicted.

6. The method of claim 2, wherein the eligibility criteria comprises FVC and wherein the patient is eligible for minimally invasive lung treatment if the patient'"'"'s FVC is less than 60 percent of FVC predicted.

7. The method of claim 2, wherein the eligibility criteria comprises FVC and wherein the patient is eligible if the patient'"'"'s FVC is less than 50 percent of FVC predicted.

8. The method of claim 2, wherein the eligibility criteria comprises FVC and wherein the patient is eligible if the patient'"'"'s FVC is less than 40 percent of FVC predicted.

9. The method of claim 2, wherein the diagnostic procedure comprises at least one plethysmographic test.

10. The method of claim 1, wherein the diagnostic procedure comprises an imaging procedure.

12. The method of claim 1, wherein the at least one diagnostic procedure yields multiple diagnostic results, and wherein the patient is eligible if a combination of the diagnostic results meet eligibility criteria.

13. The method of claim 1, further comprising identifying at least one lung region to be targeted for minimally-invasive lung treatment based on the diagnostic results.

14. The method of claim 1, further comprising performing a second diagnostic procedure to obtain second diagnostic results and identifying at least one lung region to be targeted for minimally-invasive lung treatment based on the second diagnostic results.

15. The method of claim 1, wherein the diagnostic procedure provides diagnostic results that indicate aggregate information regarding the lung function of both lungs.

16. The method of claim 1, wherein the diagnostic procedure provides diagnostic results that provide regional or localized information about the disease state of the patient'"'"'s lungs.

17. A method as defined in claim 1, further comprising developing a treatment strategy and wherein the treatment strategy is to completely isolate a lung lobe using minimally invasive bronchial isolation device.

18. A method as defined in claim 1, further comprising developing a treatment strategy and wherein the treatment strategy is to intentionally refrain from placing a minimally invasive bronchial isolation device in at least one bronchial airway leading to the target lobe, while placing at least one minimally invasive bronchial isolation device in a bronchial airway leading to that target lobe.

11. The method of 10, wherein the imaging procedure comprises a computed tomography (CT) scan.

19. A method of determining a treatment strategy for minimally invasive lung treatment of a patient, comprising:

performing at least one test on the patient to obtain data indicative of a lung disease;

developing a treatment plan based on the data, wherein the treatment plan specifically identifies at least one lung region to be targeted for minimally-invasive lung treatment.

20. A method as defined in claim 19, wherein the data provides information relating to localized lung characteristics.

21. A method as defined in claim 19, wherein the data provides information relating to global lung characteristics.

22. A method as defined in claim 19, wherein the at least one test comprises a computed tomography (CT) scan or a high-resolution computed tomography (HRCT) scan and wherein the data comprises at least one cross-sectional image of the patient'"'"'s lung.

23. A method as defined in claim 19, wherein the at least one test is performed repeatedly during the time it takes for the patient to perform a breathing maneuver.

24. A method as defined in claim 19, further comprising analyzing the data to obtain at least one score indicative of the level of disease in at least one region of the patient'"'"'s lung.

25. A method as defined in claim 24, wherein the at least one region comprises a lobe of the lung.

26. A method as defined in claim 24, wherein the score is obtained by a computer.

27. A method as defined in claim 24, wherein the treatment plan is developed based on a comparison of the scores obtained for the lung regions.

28. A method as defined in claim 19, wherein the minimally invasive treatment includes placing one or more bronchial isolation devices in the lung to completely isolate a targeted lung region.

29. A method as defined in claim 19, wherein a plurality of bronchial passageways provide air to the targeted lung region, and wherein the treatment plan selectively identifies at least one of the bronchial passageways for placement of a bronchial isolation device.

30. A method as defined in claim 19, wherein the treatment plan intentionally refrains from placing a bronchial isolation device in at least one of the bronchial passageways leading to the targeted lung region.

31. A method of planning lung treatment, comprising:

detecting the presence, degree, and distribution of a disease in the lung;

analyzing results of the detecting step to obtain at least one grade indicative of the level of disease in at least one region of the lung; and

identifying a lung or a region of the lung to be treated based on at least one grade obtained in the analyzing step.

32. A method as defined in claim 31, additionally comprising determining whether a patient is suitable for treatment based on the grades obtained in the analyzing step.

33. A method as defined in claim 31, wherein detecting the presence, degree, and distribution of a disease in the lung comprises determining a region of the lung that is diseased.

34. A method as defined in claim 31, wherein a computed tomography (CT) scan is used to detect the presence, degree, and distribution of the disease in the lung.

35. A method as defined in claim 31, wherein a high-resolution computed tomography (HRCT) scan is used to detect the presence, degree, and distribution of the disease in the lung.

36. A method as defined in claim 31, wherein the at least one grade obtained in the analyzing step includes emphysema score, heterogeneity score, and destruction score.