Methods and apparatus for localized and semi-localized drug delivery
First Claim
1. A catheter system for creating an isolated blood vessel region comprising:
- a first catheter and a second catheter, each having a proximal and a distal end, the first catheter having a first expandable occlusion device associated therewith and the second catheter having a second expandable occlusion device associated therewith, the first catheter being adapted to expand the first occlusion device distally of the second occlusion device on the second catheter, the first catheter being slidably housed within a first lumen in the second catheter such that the distance between the first and second occlusion devices may be varied, the occlusion devices being expandable to engage a wall of a blood vessel thereby substantially isolating an interior region of a desired extent between the first and second occlusion devices, wherein the second catheter has a relatively stiff proximal region and a softer distal region.
1 Assignment
0 Petitions
Accused Products
Abstract
A catheter system for localized or semi-localized administration of agents through the wall of a blood vessel is provided. Various catheter system constructions which use at least one expandable occluding device to create an isolated region are provided. Constructions using one catheter and one occlusion device are provided, along with constructions using two catheters and multiple occlusion devices. The catheter system may include a catheter with a variable stiffness along its length. The catheter system may also include a guide wire integrated with an inner catheter. The catheter can infuse the agent into the blood vessel in a pressure regulated manner. Methods for delivery and infusion of the agent within a blood vessel are also provided.
271 Citations
217 Claims
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1. A catheter system for creating an isolated blood vessel region comprising:
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a first catheter and a second catheter, each having a proximal and a distal end, the first catheter having a first expandable occlusion device associated therewith and the second catheter having a second expandable occlusion device associated therewith, the first catheter being adapted to expand the first occlusion device distally of the second occlusion device on the second catheter, the first catheter being slidably housed within a first lumen in the second catheter such that the distance between the first and second occlusion devices may be varied, the occlusion devices being expandable to engage a wall of a blood vessel thereby substantially isolating an interior region of a desired extent between the first and second occlusion devices, wherein the second catheter has a relatively stiff proximal region and a softer distal region. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20)
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21. A catheter system for creating an isolated blood vessel region comprising:
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a first catheter and a second catheter, each having a proximal and a distal end, the first catheter having a first balloon associated therewith, and a second catheter having a second balloon associated therewith, wherein the first catheter is adapted to expand the first balloon distally of the second balloon on the second catheter, the first catheter being slidably housed within a first lumen in the second catheter such that the distance between the first and second balloons may be varied, the balloons being expandable to engage a wall of a blood vessel thereby substantially isolating an interior region of a desired extent between the first and second balloons, wherein the balloons are cylindrically shaped and configured to achieve a nominal diameter at substantially between 0.25 and 6 atmospheres of pressure. - View Dependent Claims (22, 23, 24, 25, 26, 27, 28)
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29. A catheter system for creating an isolated blood vessel region comprising:
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an inner catheter and an outer catheter, each having a proximal and a distal end, the inner catheter having a first and a second expandable occlusion device associated therewith and the outer catheter having a third expandable occlusion device associated therewith, the inner catheter being adapted to expand the first occlusion device distally of the second occlusion device on the inner catheter and the third occlusion device on the outer catheter, the inner catheter being slidably housed within a first lumen in the outer catheter such that the distance between the first and third occlusion devices may be varied, wherein the first and second occlusion devices are expandable to engage a wall of a blood vessel thereby substantially isolating a fixed interior region between the first and second occlusion devices, and wherein the first and third occlusion devices are expandable to engage a wall of a blood vessel thereby substantially isolating an interior region of a desired extent between the first and third occlusion devices. - View Dependent Claims (30)
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31. A catheter system for creating an isolated blood vessel region comprising:
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a first catheter comprising a proximal and a distal end, an inner lumen and a first occlusion device, wherein the first catheter is configured to expand the first occlusion device; and
a guide wire comprising a proximal and a distal end and housed within the inner lumen of the first catheter, wherein the guide wire is integrated with the distal region of the first catheter. - View Dependent Claims (32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44)
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45. A catheter system for creating an isolated blood vessel region comprising:
a catheter having a proximal and a distal end and an expandable occlusion device associated therewith, the expandable occlusion device having a cylindrical shape and an axial indent in a middle section of the device, wherein a portion of the indentation is coupled with a region of the catheter, and wherein an aperture is located in the region where the device and catheter are coupled together, the aperture providing fluid communication with an inner lumen of the catheter. - View Dependent Claims (46, 47, 48, 49)
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50. A catheter system for creating an isolated blood vessel region comprising:
a catheter having a proximal and a distal end, the catheter having an expandable occlusion device associated therewith and being adapted to expand the occlusion device, the occlusion device being expandable to engage a wall of a blood vessel thereby substantially isolating an interior region of a desired extent between the occlusion device and a flow restricting configuration of the vessel, wherein the catheter has a relatively stiff proximal region and a softer distal region. - View Dependent Claims (51, 52, 53, 54, 55)
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56. A catheter system for creating an isolated blood vessel region comprising:
a catheter having a distal and a proximal end, comprising;
an outer tubing with an expandable occlusion device associated therewith, the outer tubing having a distal end;
a middle tubing having a distal end and extending within the outer tubing, the space between the middle tubing and the outer tubing defining a first lumen; and
an inner tubing having a third distal end and coupled with the middle tubing and extending within the middle tubing such that the distal end of the inner tubing is located distal to the distal end of the middle tubing, the space between the middle tubing and the inner tubing defining a second lumen and the space within the inner tubing defining a third lumen, a cone-shaped element coupled with the exterior of the inner tubing and having an opening in fluid communication with the second lumen. - View Dependent Claims (57, 58, 59, 60, 61, 62, 63)
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64. A catheter system for isolating a segment of a blood vessel, comprising:
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a catheter having a distal end and a lumen configured to slidably receive a guide wire, the distal end having a valve configured to allow the guide wire to pass therethrough and at least partially close upon removal of the guide wire;
wherein the catheter has an aperture for delivering an agent from the lumen therethrough, and further wherein the valve is configured such that the pressure exerted by the agent within the lumen causes the valve to seal. - View Dependent Claims (65, 66, 67)
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68. A method of infusing an agent into a localized or semi-localized region of the body, comprising:
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positioning an inner catheter and an outer catheter within a blood vessel, wherein the inner and outer catheters each have an occlusion device associated therewith, and the outer catheter has an open distal end and is configured to slidably receive the inner catheter;
positioning the inner catheter occlusion device distally from the distal end of the outer catheter;
expanding the occlusion devices such that the blood vessel is occluded by the inner catheter occlusion device in a first location and by the outer catheter occlusion device in a second location proximal to the first location;
delivering an agent in the region of the blood vessel located between the two expanded occlusion devices at a pressure sufficient to infuse the agent into a region of the body external to the blood vessel. - View Dependent Claims (69, 70, 71, 72, 73, 74, 75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 90, 91, 92, 93, 94)
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- 87. The method of claim 87, further comprising regulating the pressure during delivery of the agent with a pressure regulator.
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95. A method of infusing an agent into a localized or semi-localized region of the body, comprising:
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advancing a guide wire into the blood vessel;
slidably advancing a catheter over the guide wire using a lumen within the catheter;
positioning the catheter within a blood vessel, the catheter having a first and a second occlusion device associated therewith, wherein the first occlusion device is located distally from the second occlusion device;
expanding the occlusion devices such that the blood vessel is occluded by the first occlusion device in a first location and by the second occlusion device in a second location proximal to the first location;
delivering an agent from the lumen and into the region of the blood vessel located between the two expanded occlusion devices at a pressure sufficient to infuse the agent into a region of the body external to the blood vessel. - View Dependent Claims (96, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106)
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107. A method of infusing an agent into a localized or semi-localized region of the body, comprising:
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positioning an inner catheter and an outer catheter within a blood vessel, the outer catheter having an open distal end and configured to slidably receive the inner catheter, the outer catheter having an occlusion device associated therewith and the inner catheter having a first and a second occlusion device associated therewith with the first occlusion device located distally from the second occlusion device;
positioning at least one of the inner catheter occlusion devices distally from the distal end of the outer catheter;
expanding at least two of the occlusion devices such that the blood vessel is occluded by one occlusion device in a first location and by another occlusion device in a second location proximal to the first location, wherein the occlusion device in the first location is either the first inner catheter occlusion device or the second inner catheter occlusion device if the second device is positioned distally from the distal end of the outer catheter, and wherein the occlusion device in the second location is either the outer catheter occlusion device or the proximally located inner catheter occlusion device if that device is positioned distally from the distal end of the outer catheter and not used to occlude the vessel in the first location;
delivering an agent in the region of the blood vessel located between the at least two expanded occlusion devices at a pressure sufficient to infuse the agent into a localized region of the body. - View Dependent Claims (108, 109, 110, 111, 112, 113, 114, 115, 116, 117)
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118. A kit for providing a catheter system for use in the delivery of an infusion agent to an isolated blood vessel region, comprising:
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a first catheter having a proximal end, a distal end and a first expandable occlusion device associated therewith, and a second catheter having a proximal end and a distal end and a second expandable occlusion device associated therewith, wherein the first catheter is configured to expand the first occlusion device distally of the second occlusion device on the second catheter, the first catheter being slidably housed within a first lumen in the second catheter such that the distance between the first and second occlusion devices may be varied, the occlusion devices being expandable to engage a wall of a blood vessel thereby substantially isolating an interior region of a desired extent between the first and second occlusion devices, wherein the first lumen is configured to deliver an agent to the isolated interior region; and
a pressure regulator configured to regulate the fluid pressure of the agent. - View Dependent Claims (119, 120, 121, 122, 123, 124, 125, 126, 127, 128, 129, 130)
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131. A method of delivering an infusion agent to a semi-localized region of the body, comprising:
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advancing a catheter into a blood vessel using a guide wire integrated with the catheter;
positioning an occlusion device located on the catheter within the blood vessel, the blood vessel connecting with a plurality of smaller vessels located distal to the occlusion device, wherein the plurality of smaller vessels are in a flow restricting configuration;
expanding the occlusion device to occlude the blood vessel and substantially isolate a region of the blood vessel defined by the occlusion device and the distally located flow restricting configuration;
delivering an agent to the substantially isolated region of the blood vessel at a pressure sufficient to infuse the agent through at least one of the plurality of smaller vessels and into the semi-localized region of the body. - View Dependent Claims (132, 133, 134, 135, 136, 137, 138, 139)
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140. A method of infusing an agent into a localized or semi-localized region of the body, comprising:
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positioning a catheter within a blood vessel, the catheter having an occlusion device associated therewith, wherein the occlusion device has an axially indented portion in a middle section of the device;
expanding the occlusion device to occlude the blood vessel and create an isolated space in the blood vessel adjacent to the axially indented portion of the occlusion device;
delivering an agent in the space of the blood vessel adjacent to the indented portion of the occlusion device and not in contact with the indented portion of the occlusion device at a pressure sufficient to infuse the agent into a region of the body expanding the occlusion device. - View Dependent Claims (141, 142, 143, 144, 145, 146, 147, 148, 149, 150, 151, 152, 153)
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154. A method of infusing an agent into a localized or semi-localized region of the body of a patient, comprising:
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expanding an occlusion device located on a catheter within a blood vessel to isolate a portion of the blood vessel;
delivering an agent from a first lumen within the catheter to the isolated portion of the vessel at a pressure sufficient to infuse the agent through the wall of the blood vessel;
monitoring the fluid pressure of the agent in the isolated portion of the blood vessel with a second lumen; and
regulating the fluid pressure of the agent to maintain the fluid pressure below a desired level. - View Dependent Claims (155, 156, 157, 158)
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159. An injection system for pressure regulated injection of a fluid into an isolated blood vessel region having a pressure regulator comprising:
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a housing having a lumen located between a fluid input and a fluid output;
a spool movably disposed within the housing, the spool having a first end, a second end and a through-hole alignable with the lumen such that fluid can pass through the lumen only when the through-hole is at least partially aligned with the lumen; and
a fluid pressure feedback coupled with the spool and configured to monitor the fluid pressure at the isolated blood vessel region and move the spool at least partially out of alignment with the lumen when the fluid pressure at the blood vessel exceeds a predetermined level. - View Dependent Claims (160, 161, 162, 163)
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164. An injection system having a pressure regulator for pressure regulated injection of a fluid into an isolated blood vessel region, comprising:
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a housing having a first lumen and a second lumen, wherein the first lumen is at least partially composed of a flexible tube and has a fluid input coupled with an injection device and a fluid output coupled with a catheter system, and wherein the second lumen has a fluid input coupled with a pressure monitoring lumen and is at least partially composed of a flexible diaphragm; and
a piston movably disposed within the housing, the piston comprising a first face adjacent to the diaphragm and a pinching member adjacent the flexible tube;
wherein the flexible diaphragm is configured to flex in a first direction when the fluid pressure in the second lumen exceeds a predetermined level, the diaphragm configured to contact the first face and move the piston in the first direction and at least partially seal the tube with the pinching member. - View Dependent Claims (165, 166, 167, 168, 169, 170, 171, 172, 173)
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174. An injection system having a pressure regulator for pressure regulated injection of a fluid into an isolated blood vessel region, comprising:
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a lumen having a fluid input coupled with an injection device and a fluid output coupled with a catheter system, wherein the lumen is mounted in a frame and is at least partially composed of a flexible tube;
an inflatable balloon having an input coupled with a pressure monitoring lumen, the balloon being configured to inflate when the fluid pressure in the pressure monitoring lumen increases past a predetermined level; and
a lever arm pivotably coupled with the frame at a pivot point and located between the balloon and the flexible tube, the lever arm having a first pinching member extending outwards from the lever arm towards the flexible tube;
wherein the balloon, lever arm and tube are located within the frame such that the inflation of the balloon causes the pinching member to rotate towards the flexible tube and at least partially seal the flexible tube. - View Dependent Claims (175, 176, 177, 178, 179)
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180. An injection system having a pressure regulator for pressure regulated injection of a fluid into an isolated blood vessel region, comprising:
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a housing having a lumen having a fluid input coupled with an injection device and a fluid output coupled with a catheter system, wherein the lumen is at least partially composed of a flexible tube;
a piston movably disposed within the housing, the piston having a body located on a first side of the tube and a pinching member extending from the body to a second side of the tube opposite the first side such that the tube is located between the body and the pinching member, wherein the body has a first face;
a fluid cavity located in the housing between the piston body and the flexible tube and having a fluid input coupled with a pressure monitoring lumen and a first wall comprising a flexible diaphragm located adjacent to the first face of the piston body;
wherein the diaphragm is configured to flex in a first direction when the fluid pressure in the cavity exceeds a predetermined amount and contact the first face of the piston body and move the piston in the first direction and at least partially seal the tube with the pinching member. - View Dependent Claims (181, 182, 183, 184, 185, 186, 187)
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188. An injection system having a pressure regulator for pressure regulated injection of a fluid into an isolated blood vessel region, comprising:
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a housing having a first lumen at least partially composed of a flexible tube, a first and second fluid input and a first fluid output, wherein the first fluid input is coupled with an injection device, the second fluid input is coupled with a pressure monitoring lumen and the first fluid output is coupled with a catheter system;
an inflatable balloon having an input coupled with the second fluid input;
a bias member coupled between the housing and a cam movably disposed within the housing between the flexible tube and the balloon;
the cam having a first side in contact with the inflatable balloon and a second side opposite to the first, wherein a pinching member extends outwards from the second side towards the flexible tube;
wherein the balloon, pinching member and tube are located within the housing such that the inflation of the balloon causes the pinching member to move towards the flexible tube and at least partially seal the flexible tube. - View Dependent Claims (189, 190, 191, 192)
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193. An injection system for pressure controlled injection of a fluid into an isolated blood vessel region, comprising:
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a housing having a first chamber coupled to a fluid input and a second chamber coupled to a fluid output;
a deflectable piston having a through-hole and located between the two chambers such that fluid can pass between the chambers by way of the through-hole, wherein the deflectable piston is biased towards an open position; and
a valve, located in one of the two chambers and aligned with the through-hole such that the valve can at least partially seal the through-hole, wherein the deflectable piston deflects towards the valve and away from the open position when the fluid pressure in the chamber opposite the valve exceeds the bias on the deflectable piston. - View Dependent Claims (194, 195, 196, 197, 198, 199, 200, 201, 202, 203)
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204. An injection system for pressure regulated injection of a fluid into an isolated blood vessel region having a pressure regulator comprising:
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a housing having a fluid output and slidably coupled with a plunger, the housing configured to house a fluid and dispense the fluid through the output upon depression of the plunger; and
the plunger comprising a plunger body, a bias member and a piston located between the housing and the bias member and configured to slide within the plunger body, wherein the bias member is configured to apply pressure to the piston in a first direction towards an extended state;
further wherein upon depression of the plunger, the fluid in the fluid housing applies pressure to the piston in a second direction opposite to the first direction such that the piston retracts from the extended state at a threshold point where the fluid pressure exceeds the bias member pressure. - View Dependent Claims (205, 206, 207, 208, 209, 210, 211, 212, 213)
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214. An injection system for pressure regulated injection of a fluid into an isolated blood vessel region having a pressure regulator comprising:
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an injection device having a first fluid output and configured to output fluid from the first fluid output;
an output port having a second fluid output; and
an expandable bellows coupled with the first fluid output and the output port, the bellows configured to expand and accumulate the fluid output from the injection device when the fluid pressure at the first fluid output exceeds a threshold point defined by a resistance to expansion by the bellows and the fluid pressure exerted on the piston and bellows to expand. - View Dependent Claims (215)
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216. An injection system for pressure regulated injection of a fluid into an isolated blood vessel region having a pressure regulator comprising:
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an injection device having a first fluid output and configured to output fluid from the first fluid output;
an output port having a second fluid output and a sleeve configured to slide over the first fluid output such that when the sleeve slides away from the first fluid output a cavity is created; and
a spring coupled with the first fluid output and the output port, the spring configured to extend and slide the sleeve away from the first fluid output and accumulate the fluid output from the injection device in the cavity when the fluid pressure at the first fluid output exceeds a threshold point defined by a resistance to extension by the spring and the fluid pressure exerted on the output port to extend. - View Dependent Claims (217)
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Specification