System, Methods and Apparatus for Cerebral Protection

• US 20100241047A1
• Filed: 05/15/2008
• Published: 09/23/2010
• Est. Priority Date: 05/17/2007
• Status: Active Grant

• Current Assignee: Hrayr Karnig Shahinian, Vahe Stephan Yacoubian
• Original Assignee: Hrayr Karnig Shahinian, Vahe Stephan Yacoubian
• Inventors: Shahinian, Hrayr Karnig, Yacoubian, Vahe Stephan
• Granted Patent: US 8,628,490 B2
• Time in Patent Office: Days
• US Class Current: 604/8
• CPC Class Codes: A61M 1/3613 Reperfusion, e.g. of the coronary vessels, e.g. retroperfusion
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/004 characterized by lumina being arranged circumferentially
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2025/1095 with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft
• CPC Class Codes: A61M 2025/1097 with perfusion means for enabling blood circulation only while the balloon is in an inflated state, e.g. temporary by-pass within balloon
• CPC Class Codes: A61M 25/0029 characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports catheter shaft surface irregularities A61M2025/006
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters

Abstract

A device, system and method for perfusing an oxygenated medium in the cerebral vasculature. In the case of bihemispheric brain perfusion, it includes positioning pressure cuffs on upper extremities; providing a catheter having a multi-region configuration with a balloon; inserting the catheter into a subclavian or femoral vein; advancing the catheter such that the balloon is positioned substantially in the superior vena cava junction substantially proximal to the take-off of the left innominate vein. During a perfusion mode, the cuffs and balloon are inflated causing an increase in cerebral blood flow, retrogradely; and oxygenated blood which may be cooled is pumped from a femoral artery into the catheter for a suitable period. During a non-perfusion mode the cuffs and balloon are deflated. The catheter has at least two regions, namely, guide wire and fluid delivery regions. Optionally, a separate balloon inflation region may be provided. In the case of unilateral (single hemisphere) brain perfusion, it includes providing a catheter having a multi-region configuration with a balloon, inserting the catheter into a subclavian, jugular or femoral vein, advancing the catheter such that the balloon is positioned in the internal jugular vein on the side ipsilateral to the side of the brain requiring perfusion. In this unilateral scenario where the balloon is inflated in the ipsilateral internal jugular vein, no pressure cuffs are needed and only the balloon is inflated and deflated during the perfusion and non-perfusion modes respectively.

Claims

1. A method of unilaterally perfusing blood in a retrograde direction to a brain comprising:

positioning a catheter at a target location within a vein of a patient;

occluding said target location;

directing oxygenated blood from an artery of said patient to said catheter;

perfusing said oxygenated blood from said catheter for a period of time;

said oxygenated blood perfusing from a location on said catheter between said target location and said brain so as to move in a retrograde direction towards a single hemisphere of said brain.

2. The method of claim 1, further comprising:

stopping said perfusing of said oxygenated blood and at least partially stopping said occluding for a second period of time;

occluding said target location;

perfusing said oxygenated blood from said catheter for a period of time;

said oxygenated blood perfusing from a location on said catheter between said target location and said brain so as to move in a retrograde direction towards a single hemisphere of said brain.

3. The method of claim 2, further comprising cooling said oxygenated blood prior to perfusing said oxygenated blood.

4. The method of claim 1, wherein occluding said target location includes restricting a second location within a vein of a patient.

5. The method of claim 1, wherein said target location is selected from a location within the following veins:

a right subclavian vein, a left subclavian vein, a superior vena cave, a left internal jugular vein, a right internal jugular vein and a left innominate vein

6. The method of claim 4, wherein said restricting a second location within a vein of a patient further comprises inflating a blood pressure cuff around an arm of said patient.

7. The method of claim 2, wherein said occluding said target location comprises inflating a first balloon on said catheter.

8. The method of claim 7, wherein said at least partially stopping said occluding for a second period of time further comprises applying a suction to a second balloon, wherein said second balloon is disposed over said first balloon.

9. The method of claim 7, wherein said first balloon is self inflating.

10. A method of supplying blood through the venous system to a single hemisphere of a patient'"'"'s brain comprising:

advancing a catheter to a first position within a vein of a patient;

occluding said venous system so as to prevent drainage of blood from a side of said brain;

perfusing oxygenated blood from said catheter in a retrograde direction through a first internal jugular vein;

preventing perfusion of said oxygenated blood from said catheter from moving through a second internal jugular vein in a retrograde direction.

11. The method of claim 10, wherein said first position is selected from the following group:

a right subclavian vein, a left subclavian vein, a superior vena cave, a left internal jugular vein, a right internal jugular vein and a left innominate vein.

12. The method of claim 11, wherein said occluding said venous system further comprises inflating a balloon on said catheter.

13. The method of claim 12, further comprising restricting a second position simultaneously with said occluding said venous system.

14. The method of claim 11, wherein said catheter enters said venous system of said patient through one of the following locations:

a femoral vein, a right subclavian vein, a left subclavian vein, a superior vena cave, a left internal jugular vein, a right internal jugular vein and a left innominate vein.

15. The method of claim 14, wherein said occluding said venous system so as to prevent drainage of blood from a side of said brain further comprises inserting a second occlusion catheter in said venous system of said patient.

16-20. -20. (canceled)

21. A system for unilaterally perfusing blood to a brain comprising:

a catheter;

a first end of said catheter configured for receiving an oxygenated blood supply from a patient;

a second end of said catheter configured for placement in a venous lumen in communication with brain tissue of a patient;

an occlusion element disposed towards said second end of said catheter;

a control system for periodically actuating said occlusion element so as to substantially occlude said venous lumen and for periodically delivering said oxygenated blood supply through said venous lumen in a retrograde direction to one side of said brain tissue.

22-23. -23. (canceled)