Retrograde perfusion

• US 4,883,459 A
• Filed: 12/21/1987
• Issued: 11/28/1989
• Est. Priority Date: 07/29/1983
• Status: Expired due to Term

• Current Assignee: Reynaldo Calderon
• Original Assignee: Reynaldo Calderon
• Inventors: Calderon, Reynaldo
• Primary Examiner(s): NOT, DEFINED
• Assistant Examiner(s): Costantino, Mario
• Application Number:
  US07/139,065
• Time in Patent Office: 708 Days
• Field of Search: 128/328, 128/334 R, 128/654-656, 128/658, 128/804, 604/4, 604/8, 604/9, 604/27, 604/28, 604/35, 604/38, 604/40, 604/41, 604/43, 604/49, 604/52, 604/53, 604/93, 604/96, 604/101, 604/118, 604/121, 604/151, 604/264, 604/284, 600/1-4, 600/9, 600/10
• US Class Current: 604/28
• CPC Class Codes: A61M 1/3613 Reperfusion, e.g. of the coronary vessels, e.g. retroperfusion
• CPC Class Codes: A61M 1/3615 Cleaning blood contaminated by local chemotherapy of a body part temporarily isolated from the blood circuit
• CPC Class Codes: A61M 1/77 Suction-irrigation systems aspiration tips supplying fluids A61M1/85; specific for negative pressure wound therapy A61M1/92; combined with tracheal tubes A61M16/0463
• CPC Class Codes: A61M 1/85 with gas or fluid supply means, e.g. for supplying rinsing fluids or anticoagulants for negative pressure wound therapy A61M1/92, A61M1/94; combined with tracheal tubes A61M16/0463; dental instruments with combined rinsing and aspirating A61C17/0208
• CPC Class Codes: A61M 2025/1015 having two or more independently movable balloons where the distance between the balloons can be adjusted, e.g. two balloon catheters concentric to each other forming an adjustable multiple balloon catheter system
• CPC Class Codes: A61M 25/00 Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/0026 Multi-lumen catheters with stationary elements catheter assemblies comprising a catheter in combination with a guide tube, sheath or sleeve A61M2025/0681; catheters comprising telescoping coaxial elements A61M2025/0175

Abstract

Tumors in the body of a patient are studied in situ by a monitor, such as computer assisted tomography, X-ray or the like, while optimal flow paths through the tumor area are established. A catheter with a suction lumen and an infusion lumen, with seals associated with each, is placed in the patient'"'"'s vein near the tumor. Flow is then sealed in the vein with the infusion seal. A carrier medium dye is injected into the tumor at selected flow rates and differential pressures. Flow of the dye through the tumor is observed on the monitor to determine optimal retrograde perfusion paths through the tumor for the selected flow rates and differential pressures. Once the optimal perfusion paths are noted, a preferential attack area in the tumor is located using a different, less dense carrier dye and increased fluid back pressure in the infusion system. Once the attack area in the tumor is located, microspheres with active ingredients, such as chemotherapy, can be selectively perfused through one of the paths in the tumor to the attack site and forced into the tumor, once at the attack site, using increased back pressure. The process may be cyclically repeated using the same or different active ingredients. The procedure may be repeated through the tumor in different paths and attack points at desired active ingredient dosages using increased back pressures.

Claims

1. An apparatus for treating a tumor in the body of a patient with an active ingredient, comprising:

(a) a catheter means for location in a vein of the patient near the tumor, said catheter means comprising;

(1) a suction lumen for removing fluids; and

(2) an infusion lumen extending beyond said suction lumen for passing fluids into the tumor;

(b) infusion seal means on said catheter means between said infusion lumen and said suction lumen for sealing the patient'"'"'s vein;

(c) suction seal means on said catheter means for sealing the flow of fluid in the patient'"'"'s vein past said suction lumen;

(d) a source of carrier medium and a flow path injector means for injecting said carrier medium into the tumor from said infusion lumen at selected flow rates and pressures to establish preferential flow paths through the tumor;

(e) said flow path means further comprising means for establishing a steady state flow rate and pressure in a selected one of the flow paths;

(f) a source of a less dense carrier medium and a means for introducing said less dense carrier medium through said infusion lumen;

(g) means for selectively increasing back pressure on the fluids in the tumor to determine a preferred target area in the tumor where said less dense carrier medium is driven into interstitial spaces in the tumor;

(h) a source of a first fluid and an active ingredient and a treatment injector means for injecting said first fluid and thereafter said active ingredient into the patient'"'"'s vein from said infusion lumen;

(i) said means for selectively increasing back pressure further comprising means for increasing back pressure on said first fluid and active ingredient in the patient'"'"'s vein when said active ingredient is at the preferred target area; and

(j) means for collecting said first fluid and active ingredient from said suction lumen after perfusion through the tumor.

2. The apparatus of claim 1, wherein said treatment injector means further comprises:

means for selectively injecting different active ingredients into the patient'"'"'s vein from said infusion lumen so that the different active ingredients may perfuse through the tumor from the preferred target area.

3. The apparatus of claim 1, further including:

heat sensor means for detecting temperature conditions near the tumor in the patient to monitor treatment of the patient.

4. The apparatus of claim 1, further including:

heat sensor means for detecting temperature conditions at the preferred target area in the tumor in the patient to monitor treatment of the patient.

5. A method for treating a tumor in the body of a patient with an active ingredient, comprising the steps of:

(a) placing a catheter having a suction lumen and an infusion lumen extending beyond the suction lumen and an infusion seal associated with the infusion lumen and a suction seal associated with the suction lumen in a vein of the patient near the tumor;

(b) sealing the flow of fluid in the patient'"'"'s vein between the infusion lumen and the suction lumen with the infusion seal;

(c) injecting a carrier medium into the tumor from the infusion lumen at selected flow rates and pressures to establish preferential flow paths through the tumor;

(d) sealing the flow of fluid in the patient'"'"'s vein past the suction lumen with the suction seal;

(e) injecting a carrier medium from the infusion lumen in a selected one of the established flow paths at a desired flow rate and pressure until steady state flow is established;

(f) injecting a second, less dense carrier medium from the infusion lumen in the selected one of the established flow paths;

(g) increasing the back pressure on the carrier medium when the second carrier medium is in the tumor to force the second carrier medium into interstitial spaces in the tumor at an attack site;

(h) injecting an active ingredient behind a carrier fluid into the patient'"'"'s vein from the infusion lumen along the established flow path;

(i) increasing the back pressure on the carrier fluid and active ingredient when the active ingredient is at the attack site to force the active ingredient into interstitial spaces in the tumor so that the active ingredient is driven into the interstitial spaces in the tumor; and

(j) collecting the active ingredient in the suction lumen after perfusion through the tumor.

6. The method of claim 5, further including the steps of:

repeating said steps of injecting an active ingredient and increasing the back pressure on the carrier fluid and active ingredient.

7. The method of claim 5, further including the steps of:

(a) selectively injecting different active ingredients behind the carrier fluid; and

(b) increasing the back pressure when the different active ingredients are at the attack site so that the different active ingredients are driven into the tumor.

8. The method of claim 5, further including the steps of:

(a) changing the flow rate and pressure of the carrier medium to a new value to establish a different flow path through the tumor;

(b) maintaining the flow rate and pressure at the new valve until steady state flow is established in the different flow path;

(c) injecting a second, less dense carrier medium from the infusion lumen in the different flow path;

(d) increasing the back pressure on the carrier medium when the second carrier medium is in the tumor to force the second carrier medium into interstitial spaces in the tumor at an attack site in the different flow path;

(e) injecting an active ingredient behind a carrier fluid into the patient'"'"'s vein from the infusion lumen along the different flow path;

(f) increasing the back pressure on the carrier fluid and active ingredient when the active ingredient is at the attack site to force the active ingredient into interstitial spaces in the different flow path in the tumor so that the active ingredient is driven into the interstitial spaces in the different flow path in the tumor.

9. The method of claim 5, further including the step of:

monitoring temperature conditions in the tumor.

10. The method of claim 5, further including the steps of:

(a) injecting a heated fluid behind the carrier fluid into the patient'"'"'s vein from the infusion lumen along the established flow path;

(b) increasing the back pressure on the carrier fluid and heated fluid when the heated fluid is at the attack site to force the heated fluid into interstitial spaces in the tumor so that the heated fluid is driven into the interstitial spaces in the tumor.

11. The method of claim 10, further including the step of:

monitoring temperature conditions at the attack site in the tumor.