Apparatus and Methods for Accessing the Lymphatic System

• US 20110276023A1
• Filed: 05/03/2011
• Published: 11/10/2011
• Est. Priority Date: 05/04/2010
• Status: Active Grant

• Current Assignee: LXS, LLC
• Original Assignee: Christian S. Eversull, Stephen A. Leeflang
• Inventors: Leeflang, Stephen A., Eversull, Christian S.
• Granted Patent: US 9,421,316 B2
• Time in Patent Office: Days
• US Class Current: 604/500
• CPC Class Codes: A61M 1/3496 Plasmapheresis; Leucopheresis; Lymphopheresis A61M1/3472 takes precedence
• CPC Class Codes: A61M 1/367 Circuit parts not covered by the preceding subgroups of group A61M1/3621
• CPC Class Codes: A61M 2202/0405 Lymph

Abstract

Systems and methods are provided for performing a medical procedure within a patient'"'"'s body that involves a thoracic duct including an ostium communicating with the patient'"'"'s venous system. A distal end of a catheter is introduced through the patient'"'"'s venous system into a body lumen adjacent the ostium of the thoracic duct. An expandable member on the distal end of the tubular may be expanded adjacent the ostium, e.g., within the body lumen or the thoracic duct itself, and used to isolate the thoracic duct from the body lumen, whereupon a medical procedure may be performed via the thoracic duct. For example, lymphatic fluid may be removed from the thoracic duct through a lumen of the tubular member and/or one or more agents may be introduced into the thoracic duct through the tubular member.

Claims

1. A system for performing a medical procedure via a thoracic duct of a patient'"'"'s body, comprising:

a tubular member comprising a proximal end, a distal end sized for introduction into a body lumen, an aspiration lumen extending from the proximal end to a port in the distal end, and an expandable member on the distal end sized for substantially isolating the thoracic duct when expanded within the body lumen;

a detector for analyzing the fluid removed from the body lumen to identify lymphatic fluid;

a separator coupled to the proximal end of the tubular member for separating the lymphatic fluid or components of the lymphatic fluid from other fluid in the fluid removed from the body lumen; and

a container coupled to the separator for collecting the lymphatic fluid or components of the lymphatic fluid separated from other fluid.

2. The system of claim 1, further comprising a controller coupled to the detector for identifying when the fluid removed from the body lumen is lymphatic fluid, whereupon the controller activates the separator to direct the lymphatic fluid or components of the lymphatic fluid to the container.

3. The system of claim 1, wherein the separator comprises a valve comprising an inlet that receives fluid from the tubular member, a first outlet for directing the lymphatic fluid or components of the lymphatic fluid to the container, and a second outlet for directing other fluids to a waste container, the valve being selectively operable between the first and second outlets.

4. The system of claim 1, wherein the separator comprises at least one of a mechanical filtration system, an osmotic gradient system, a concentration gradient system, and a centrifuge.

5. The system of claim 1, wherein the detector comprises one or more sensors for distinguishing lymphatic fluid from blood.

6. The system of claim 1, wherein the one or more sensors comprise at least one of an optical sensor that detects the presence of red blood cells by light transmission or reflection characteristics, a chemical sensor that detects one or more of pH, oxygen concentration, lactate, and leukocyte esterase, a sensor that measures hematocrit, an electrical sensor that measures impedance, a mechanical sensor that detects pressure waves that differ between the venous system and the thoracic duct, and a Doppler ultrasound sensor.

7. The system of claim 1, wherein the expandable member comprises a balloon, and wherein the tubular member comprises an inflation lumen for delivering inflation between into and out of the balloon for selectively expanding and collapsing the balloon.

8. The system of claim 7, wherein the tubular member terminates in a flexible distal tip beyond the balloon.

9. The system of claim 1, wherein the expandable member comprises an expandable hood, the tubular member comprising a constraint for maintaining the expandable hood in a contracted condition for introduction in a body lumen, the constraint selectively removable for expanding the expandable hood to an enlarged condition sized for substantially isolating the thoracic duct.

10. The system of claim 1, further comprising a source of vacuum for removing fluid within the body lumen via the port and aspiration lumen.

11. A method for performing a medical procedure within a patient'"'"'s body, the body comprising a thoracic duct including an ostium communicating with the patient'"'"'s venous system, comprising:

introducing a distal end of a tubular member through the patient'"'"'s venous system into a body lumen adjacent the ostium of the thoracic duct;

expanding an expandable member on the distal end of the tubular adjacent the ostium;

substantially isolating the thoracic duct from the body lumen with the expandable member; and

performing a medical procedure via the thoracic duct.

12. The method of claim 11, wherein the medical procedure comprises removing lymphatic fluid from the thoracic duct through a lumen of the tubular member.

13. The method of claim 11, wherein the medical procedure comprises introducing one or more agents into the thoracic duct through a lumen of the tubular member.

14. The method of claim 11, wherein the expandable member is expanded within the body lumen, and wherein the thoracic duct is substantially isolated by directing the expanded expandable member at least partially into the ostium.

15. The method of claim 11, wherein the expandable member is expanded within the body lumen, and wherein the thoracic duct is substantially isolated by directing the expanded expandable member against a wall of the body lumen surrounding the ostium.

16. The method of claim 11, further comprising advancing the distal end of the tubular member into the thoracic duct through the ostium, and wherein the expandable member is expanded within the thoracic duct adjacent the ostium to substantially isolate the thoracic duct from the body lumen.

17. The method of claim 11, wherein the body lumen comprises a brachiocephalic vein.

18. The method of claim 11, wherein the medical procedure comprises:

removing fluid from the patient'"'"'s body through a lumen of the tubular member; and

analyzing the removed fluid to determine whether the fluid comprises lymphatic fluid or blood.

19. The method of claim 18, wherein, if the fluid comprises blood, the medical procedure further comprises directing the fluid to a waste container.

20. The method of claim 18, wherein, if the fluid comprises lymphatic fluid, the medical procedure further comprises directing the fluid to a storage container.

21. The method of claim 18, wherein, if the fluid comprises lymphatic fluid, the medical procedure further comprises separating components of the lymphatic fluid from other components of the fluid.

22. The method of claim 21, wherein the medical procedure further comprises directing the separated components of the lymphatic fluid to a storage container.

23. The method of claim 21, wherein the medical procedure further comprises infusing the separated components of the lymphatic fluid into the patient'"'"'s body.

24. A system for performing a medical procedure via a thoracic duct of a patient'"'"'s body, comprising:

a tubular member comprising a proximal end, a distal end sized for introduction into a body lumen, an aspiration lumen extending from the proximal end to a port in the distal end, and an expandable member on the distal end sized for substantially isolating the thoracic duct when expanded within the body lumen; and

a container communicating with the aspiration lumen for collecting the lymphatic fluid or components of the lymphatic fluid.