Partial aortic occlusion devices and methods for cerebral perfusion augmentation

• US 6,565,552 B1
• Filed: 03/20/2000
• Issued: 05/20/2003
• Est. Priority Date: 03/01/1999
• Status: Expired due to Term

• Current Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Original Assignee: Coaxis Incorporated (Trimble Inc.)
• Inventors: Barbut, Denise R.
• Primary Examiner(s): Nguyen, Anhtuan T.
• Assistant Examiner(s): Thompson, Michael M
• Application Number:
  US09/528,969
• Time in Patent Office: 1,156 Days
• Field of Search: 604/22, 604/96.01, 604/101-1-1, 604/507, 604/509, 604/532, 604/236, 604/915, 604/919, 604/48, 604/98.01, 604/500, 604/505, 604/506, 604/103, 604/103.03, 604/104, 604/164.1, 604/164.01, 604/164.03, 604/264, 604/158, 606/159, 606/194, 606/198, 606/200, 606/192, 600/17, 600/18, 600/465, 600/470, 128/898
• US Class Current: 604/507
• 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 17/12036 partial occlusion
• 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 17/12136 Balloons
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/4064 Evaluating the brain A61B5/031, A61B5/369, A61B5/14553 take precedence
• CPC Class Codes: A61B 5/4076 Diagnosing or monitoring particular conditions of the nervous system A61B5/4821, A61B5/4824 take precedence
• CPC Class Codes: A61M 2025/0073 Tip designed for influencing the flow or the flow velocity of the fluid, e.g. inserts for twisted or vortex flow
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2210/127 Aorta
• CPC Class Codes: A61M 2230/30 Blood pressure A61M2230/04 takes precedence
• 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 25/0074 Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/0662 Guide tubes

Abstract

Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially occlude aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. Partial occlusion of a vessel can be accomplished by a device comprising an elongate catheter, a distally mounted expandable occluder, a variable flow mechanism, and a manometer. The occluder may comprise two conical shells or an inflatable ring-shaped balloon disposed about a cylindrical sleeve. Other medical devices, such as an atherectomy catheter, can be inserted distal the occluder to provide therapeutic intervention.

Claims

1. A method for increasing blood flow to a patient'"'"'s cerebral vasculature, comprising the steps of:

providing a constrictor free of a catheter, the constrictor adapted for releasable attachment to a catheter, the constrictor being expandable;

attaching the constrictor to a catheter having a proximal end and a distal end;

inserting the distal end of the catheter into the descending aorta;

locating the constrictor downstream from the takeoff of the brachiocephalic artery; and

expanding the constrictor without rupturing the constrictor to at least partially occlude blood flow in the aorta during systole and diastole, wherein blood pressure in the proximal aorta increases and blood pressure in the distal aorta decreases.

2. The method of claim 1, wherein the constrictor further comprises a lumen, and wherein the lumen of the constrictor is adapted for blood flow.

3. The method of claim 2, further comprising the step of advancing a medical instrument through the lumen of the constrictor and into an artery that branches from the aorta.

4. The method of claim 3, wherein the medical instrument is selected from the group consisting of a guiding catheter, an infusion catheter, an angioplasty catheter, a laser catheter, an angiography catheter, a therapeutic ultrasound catheter, a hypothermia catheter, a stent catheter, an imaging catheter, a perfusion catheter, an atherectomy catheter, an occlusion catheter, an EP catheter, and an aspiration catheter.

5. The method of claim 2, wherein the constrictor further comprises a second lumen adapted to receive a medical instrument.

6. The method of claim 2, wherein the step of expanding the constrictor comprises reducing the luminal diameter of the constrictor to reduce blood flow, while an outer diameter of the constrictor remains constant.

7. The method of claim 1, wherein the constrictor is used to treat vasospasm.

8. The method of claim 7, wherein the vasospasm is iatrogenic.

9. The method of claim 7, wherein the vasospasm is subarachnoid hemorrhage-induced.

10. The method of claim 1, wherein the constrictor is used to treat shock.

11. The method of claim 10, wherein the shock is hemorrhagic shock.

12. The method of claim 1, wherein the constrictor comprises a toroidal balloon, and wherein the step of expanding the constrictor comprises inflating the constrictor.

13. The method of claim 12, further comprising the step of slowly deflating the constrictor.

14. The method of claim 1, wherein the catheter is selected from the group consisting of a guiding catheter, an infusion catheter, an angioplasty catheter, a laser catheter, an angiography catheter, a therapeutic ultrasound catheter, a hypothermia catheter, a stent catheter, an imaging catheter, a perfusion catheter, an atherectomy catheter, an occlusion catheter, an EP catheter, and an aspiration catheter.

15. The method of claim 1, wherein the step of expanding the constrictor includes maintaining the expanded constrictor during systole.

16. The method of claim 1, wherein the constrictor comprises a spring disposed circumferentially about a flexible lumenal wall of the constrictor.