Methods for Preventing Retropulsion of Concretions and Fragments During Lithotripsy

• US 20080103481A1
• Filed: 09/28/2007
• Published: 05/01/2008
• Est. Priority Date: 09/29/2006
• Status: Abandoned Application

• Current Assignee: Genzyme Corporation (Sanofi )
• Original Assignee: Pluromed, Inc. (Sanofi )
• Inventors: Wilkie, James, Vogel, Jean-Marie
• Application Number:
  US11/864,118
• Publication Number:
  US 20080103481A1
• Time in Patent Office: Days
• US Class Current: 604/514
• 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 17/12099 characterised by the location of the occluder
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12186 liquid materials adapted to be injected
• CPC Class Codes: A61B 17/12195 comprising a curable material
• CPC Class Codes: A61B 17/22012 in direct contact with, or very close to, the obstruction or concrement for removing obstructions in blood vessels by laser A61B18/245
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61M 5/007 for contrast media
• CPC Class Codes: A61P 1/00 Drugs for disorders of the alimentary tract or the digestive system
• CPC Class Codes: A61P 1/02 Stomatological preparations, e.g. drugs for caries, aphtae, periodontitis
• CPC Class Codes: A61P 1/16 for liver or gallbladder disorders, e.g. hepatoprotective agents, cholagogues, litholytics
• CPC Class Codes: A61P 13/04 for urolithiasis
• CPC Class Codes: A61P 13/12 of the kidneys

Abstract

One aspect of the present invention provides a method for the treatment of lithiasis, which mitigates the risk of damage to surrounding body tissue when removing a calculi (e.g., biological concretions, such as urinary, biliary, and pancreatic stones) that obstructs or may otherwise be present within a body'"'"'s anatomical lumen. In one embodiment, the instant invention provides a method of using a polymer plug to occlude a lumen distal to a calculi, whereby calculi fragments resulting from lithotripsy are prevented from traveling up the lumen. In certain embodiments, a dual lumen catheter is utilized to inject two solutions proximal to the calculi, the mixing of said solutions causing a polymer plug to form.

Claims

1. A method of lithotripsy, comprising the steps of:

injecting a first composition into a lumen of a mammal distal to a concretion;

thereby forming a polymer plug; and

directing energy to said concretion causing the fragmentation of said concretion into a plurality of fragments.

2. The method of claim 1, further comprising the step of:

injecting a second composition into said lumen of a mammal distal to said concretion, wherein said second composition contacts said first composition.

3. The method of claim 1, wherein the distance from said concretion to said plug is between about 1 cm and about 5 cm.

4. The method of claim 1, wherein the distance from said concretion to said plug is between about 2 cm and about 4 cm.

5. The method of claim 1, wherein the distance from said concretion to said plug is about 3 cm.

6. The method of claim 1, wherein said energy is an acoustic shock wave, a pneumatic pulsation, an electrical hydraulic shock wave, or a laser beam.

7. The method of claim 1, wherein said lumen is or is part of a kidney, a gall bladder, a ureter, a urinary bladder, a pancreas, a salivary gland, a small intestine or a large intestine.

8. The method of claim 1, wherein said lumen is or is part of the ureter or kidney.

9. The method of claim 1, wherein said concretion is a kidney stone, pancreatic stone, salivary stone, or biliary stone.

10. The method of claim 1, wherein said concretion is a kidney stone.

11. The method of claim 1, wherein said mammal is a human.

12. The method of claim 1, wherein said first composition further comprises a contrast-enhancing agent selected from the group consisting of radiopaque materials, paramagnetic materials, heavy atoms, transition metals, lanthanides, actinides, dyes, and radionuclide-containing materials.

13. The method of claim 2, wherein said second composition further comprises a contrast-enhancing agent selected from the group consisting of radiopaque materials, paramagnetic materials, heavy atoms, transition metals, lanthanides, actinides, dyes, and radionuclide-containing materials.

14. The method of claim 1, wherein said first composition comprises an anionic, cationic, or non-ionically crosslinkable polymer.

15. The method of claim 1, wherein said first composition comprises collagen, gelatin, elastin, albumin, protamine, fibrin, fibrinogen, keratin, reelin, caseine, or a mixture thereof.

16. The method of claim 1, wherein said first composition comprises hyaluronic acid or chitosan, or a mixture thereof.

17. The method of claim 1, wherein said first composition comprises alginate, pectin, methylcellulose, carboxymethylcellulose, or a mixture thereof.

18. The method of claim 1, wherein said first composition comprises alginic acid, sodium alginate, potassium alginate, sodium gellan, potassium gellan, carboxymethylcellulose, hyaluronic acid, polyvinyl alcohol, or a mixture thereof.

19. The method of claim 2, wherein said second composition comprises a crosslinker selected from the group consisting of phosphate, citrate, borate, succinate, maleate, adipate, oxalate, calcium, magnesium, barium, strontium, or a combination thereof.

20. The method of claim 2, wherein said first composition comprises alginic acid, sodium alginate, potassium alginate, sodium gellan or potassium gellan;

and said second composition comprises calcium, magnesium or barium.

21. The method of claim 2, wherein said first composition comprises alginic acid, sodium alginate or potassium alginate;

and said second composition comprises calcium.

22. The method of claim 2, wherein said first composition comprises sodium gellan or potassium gellan;

and said second composition comprises magnesium.

23. The method of claim 2, wherein said first composition comprises hyaluronic acid;

and

said second composition comprises calcium.

24. The method of claim 2, wherein said first composition comprises polyvinyl alcohol;

and

said second composition comprises borate.