Methods for treating airways

• US 20060254600A1
• Filed: 04/04/2006
• Published: 11/16/2006
• Est. Priority Date: 03/27/2000
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Asthmatx, Inc. (Boston Scientific Corporation)
• Inventors: Wizeman, William J., Laufer, Michael D., Danek, Christopher J., Loomas, Bryan E., Kaplan, Gary S., Shriner, Kelly M., Biggs, Michael
• Granted Patent: US 8,251,070 B2
• Time in Patent Office: Days
• US Class Current: 128/898
• CPC Class Codes: A61B 1/00085 Baskets
• CPC Class Codes: A61B 10/04 Endoscopic instruments
• CPC Class Codes: A61B 18/06 caused by chemical reaction , e.g. moxaburners
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2010/045 Needles pointed biopsy devices with vacuum aspiration A61B10/0283
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00244 adapted to separate target tissue from other tissue
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00773 Sensed parameters
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/00898 Alarms or notifications created in response to an abnormal condition
• CPC Class Codes: A61B 2018/1472 for use with liquid electrolyte, e.g. virtual electrodes
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/064 for measuring force, pressure or mechanical tension
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/053 : Measuring electrical impedance or conductance of a portion of the body
• CPC Class Codes: A61B 5/0538 : invasively, e.g. using a catheter
• CPC Class Codes: A61B 5/08 : Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0809 : by impedance pneumography
• CPC Class Codes: A61B 5/1076 : for measuring dimensions inside body cavities, e.g. using catheters A61B3/1005 takes precedence
• CPC Class Codes: A61B 5/411 : Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/4519 : Muscles A61B5/389, A61B5/224 take precedence
• CPC Class Codes: A61B 5/4836 : Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4878 : Evaluating oedema
• CPC Class Codes: A61B 5/6853 : with a balloon
• CPC Class Codes: A61B 5/6858 : with a distal basket, e.g. expandable basket
• CPC Class Codes: A61N 5/1001 : using radiation sources introduced into or applied onto the body; brachytherapy

Abstract

This relates to treating airways in a lung to decrease asthmatic symptoms. The also includes steps of measuring a parameter of an airway at a plurality of locations in a lung, identifying at least one treatment site from at least one of the plurality of locations based on the parameter, and applying energy to the treatment site to reduce the ability of the site to narrow.

Claims

1. A method of treating airways in a lung to decrease asthmatic symptoms of the lung, the method comprising:

measuring a parameter of an airway at a plurality of locations in a lung;

identifying at least one treatment site from at least one of the plurality of locations based on the parameter; and

applying energy to the treatment site to reduce the ability of the site to narrow.

2. The method of claim 1, further comprising repeating the treatment on a new treatment site.

3. The method of claim 1, where identifying the plurality of treatment sites comprises correlating the sites to a map of the lung anatomy to provide a treatment plan for a medical practitioner to treat less than all of the lungs.

4. The method of claim 1, where measuring the parameter comprises first stimulating the airway and subsequently measuring the parameter.

5. The method of claim 4, where stimulating the airway comprises electrically stimulating airway smooth muscle to measure contraction of the airway.

6. The method of claim 4, where stimulating the airway comprises stimulating the airway with at least one agent.

7. The method of claim 4, where stimulating the airway comprises stimulating the airway mechanically.

8. The method of claim 6, where the agent causes contraction of the airway.

9. The method of claim 8, where measuring contraction of the airway further comprises measuring the contraction without making contact with the airway wall via a mode selected from the group consisting of visually, optically, or non-invasively.

10. The method of claim 8, where measuring contraction of the airway further comprises measuring a contractile force of the airway to assess smooth muscle tissue hyper-responsiveness.

11. The method of claim 10, where measuring the contractile force comprises placing an expandable member in the airway and measuring deflection of the expandable member.

12. The method of claim 10, where measuring the contractile force comprises placing a balloon expandable member in the airway and measuring increase in pressure of the balloon.

13. The method of claim 8, where the agent comprises methacholine.

14. The method of claim 1, where measuring the parameter comprises measuring a thickness of airway wall at the location.

15. The method of claim 14, where measuring the thickness of airway wall comprises using ultrasound to measure the thickness.

16. The method of claim 14, where measuring the thickness of airway wall comprises measuring impedance to measure the thickness.

17. The method of claim 14, where measuring the thickness of airway wall comprises use of a non-invasive imaging technique to measure the thickness.

18. The method of claim 17, where the non-invasive imaging technique comprises computer aided tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), optical coherence tomography, and ultrasonic imaging.

19. The method of claim 1, where measuring the parameter comprises measuring a thickness of airway smooth muscle at the location.

20. The method of claim 19, where measuring the thickness of airway smooth muscle comprises using ultrasound to measure the thickness.

21. The method of claim 19, where measuring the thickness of airway smooth muscle comprises measuring impedance to measure the thickness.

22. The method of claim 19, where measuring the thickness of airway smooth muscle comprises use of a non-invasive imaging technique to measure the thickness.

23. The method of claim 22, where the non-invasive imaging technique comprises computer aided tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), optical coherence tomography, and ultrasonic imaging.

24. The method of claim 1, where applying energy to the treatment site comprises applying a mode of energy selected from the group consisting of light, radio frequency, chemical, radioactivity, radiant, laser, microwave, mechanical energy (such as in the form of cutting, punching, abrading, rubbing, or dilating), ultrasound, and thermal.

25. The method of claim 1, where measuring the parameter comprises measuring eosinophil counts at the location.

26. The method of claim 1, where measuring the parameter comprises measuring airway diameter.

27. The method of claim 26, where measuring the diameter of airway comprises using ultrasound to measure the diameter.

28. The method of claim 26, where measuring the diameter of the airway comprises use of a non-invasive imaging technique to measure the diameter.

29. The method of claim 26, where measuring the diameter of the airway comprises use of a non-invasive imaging technique to measure the diameter.

30. The method of claim 29, where the non-invasive imaging technique comprises computer aided tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), optical coherence tomography, and ultrasonic imaging.

31. The method of claim 26, where measuring airway diameter further comprises measuring the diameter without making contact with the airway wall (visually with a retical;

or optically, via a camera).

32. The method of claim 1, where measuring the parameter comprises measuring airflow at the location.

33. The method of claim 32, where measuring airflow at the location comprises measuring the rate of cooling of an element located at the site.

34. The method of claim 1, where measuring the parameter comprises using hyperpolarized helium to assess ventilation in the lung and where identifying at least one of the locations comprises selecting areas of constricted airways within the lung.

35. The method of claim 1, where measuring the parameter comprises obtaining a first image of the airways, applying an agent to induce contraction of the airways, and obtaining a second image of the airways, and where identifying the locations comprises comparing the first and second images for contraction of the airways.

36. The method of claim 35, where the image is obtained using a radioactive isotope.

37. The method of claim 35, where the image is obtained using a mode selected from computer aided tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), optical coherence tomography, and ultrasonic imaging.

38. The method of claim 1, where measuring the parameter comprises assessing a metabolic rate at the location, and where identifying the location as the treatment site comprises determining if the metabolic rate indicates significant presence of smooth muscle.

39. The method of claim 1, where measuring the parameter comprises measuring impedance at the location.

40. The method of claim 1 further comprising applying a customized energy delivery profile at each treatment sited based upon the measured values of the parameters measured at each corresponding site.