Methods and apparatus for perfusion of isolated tissue structure

• US 6,699,231 B1
• Filed: 12/30/1998
• Issued: 03/02/2004
• Est. Priority Date: 12/31/1997
• Status: Expired due to Term

• Current Assignee: Pinpoint Therapeutics, Inc.
• Original Assignee: Heartport, Inc. (Johnson & Johnson)
• Inventors: Sterman, Wesley D., Siegel, Lawrence C., Putnam, Joe B., Gifford, Hanson S. III, Stevens, John H.
• Primary Examiner(s): Casler, Brian L.
• Assistant Examiner(s): WILLIAMS, CATHERINE SERKE
• Application Number:
  US09/223,229
• Time in Patent Office: 1,889 Days
• Field of Search: 604/500, 604/507, 604/508, 604/509, 604/6.14, 604/5.01, 604/4.01, 604/6.16, 604/8, 604/6.11, 604/93.01, 604/96.01, 604/264, 606/27-31, 128/DIG.3, 435/1.1, 435/1.2, 435/284.1, 210/758, 422/44, 422/45, 261/19
• US Class Current: 604/509
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 2017/12127 Double occlusion, e.g. for creating blood-free anastomosis site
• 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 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 25/1011 Multiple balloon catheters

Abstract

Organs and other tissue structures are isolated and perfused with a therapeutic agent. Isolation is effected by endovascularly positioning catheters having occlusion balloons within the arteries or other blood vessels which supply blood to the organ. Similarly, blood flow from the organ back to the patient'"'"'s circulatory system is blocked by endovascularly positioning one or more catheters carrying occlusion members within the veins or other blood vessels leading from the organ. The therapeutic agent may then be perfused through the organ in either an antegrade or retrograde fashion using the endovascularly positioned catheters while maintaining isolation.

Claims

1. A method of treatment of a tissue structure in a patient, the tissue structure being coupled to an artery through which blood flows from the patient'"'"'s circulatory system to the tissue structure and to a vein through which blood flows away from the tissue structure to the circulatory system, the method comprising:

endovascularly positioning a first catheter in the artery;

endovascularly positioning a second catheter in the vein;

occluding the artery around the first catheter;

occluding the vein around the second catheter;

delivering a perfusate comprising a therapeutic agent and an oxygen carrier to the tissue structure through at least one of the first and second catheters while the artery and vein remain occluded, the tissue structure being an organ selected from the group consisting of the brain, at least one breast, at least one lung, at least one kidney, the liver, the spleen, the stomach, the intestines, the pancreas, the colon, the bladder, the thyroid gland, and the prostate;

collecting the perfusate through the other of the at least one of the first and second catheters after the perfusate has perfused at least a portion of the tissue structure;

extracorporeally pumping the perfusate back to the at least one of the first and second catheters; and

extracorporeally oxygenating the oxygen carrier.

2. The method as in claim 1, wherein the perfusate is delivered through the first catheter into the artery and collected from the vein by the second catheter to establish antegrade perfusion.

3. The method as in claim 1, wherein the perfusate is delivered through the second catheter into the vein and collected from the artery by the first catheter to establish retrograde perfusion.

4. A method as in claim 1, wherein the perfusate comprises an agent selected from the group consisting of a drug, a diagnostic agent, and a biologic material.

5. The method as in claim 1, wherein the oxygenated carrier is a synthetic oxygen carrier.

6. The method as in claim 1, wherein the oxygenated carrier is oxygenated blood.

7. The method of claim 1, comprising the step of heating the tissue structure during the delivering step.

8. The method of claim 7, wherein the heating step raises the temperature of the tissue structure to at least about 100°

F.

9. The method of claim 7, wherein the heating step raises the temperature of the tissue structure to at least about 105°

F.

10. The method of claim 7, wherein the heating step comprises heating the perfusate before the delivering step, and wherein the perfusate transfers heat to the tissue structure.

11. A method of treatment of a tissue structure in a patient, the tissue structure being coupled to an artery through which blood flows from the patient'"'"'s circulatory system to the tissue structure and to a vein through which blood flows away from the tissue structure to the circulatory system, the method comprising:

endovascularly positioning a first catheter in the artery;

endovascularly positioning a second catheter in the vein;

occluding the artery around the first catheter; and

occluding the vein around the second catheter; and

delivering a perfusate to the tissue structure through at least one of the first and second catheters while the artery and vein remain occluded, wherein the tissue structure is a liver, the first catheter occludes a hepatic artery, the second catheter occludes a hepatic vein, and a third catheter occludes a portal vein.

12. The method as in claim 11, further comprising adding therapeutic agent to the perfusate.

13. The method as in claim 11, wherein the perfusate is delivered through at least one of the first and third catheters and collected in the second catheter to establish antegrade perfusion.

14. The method as in claim 11, wherein the perfusate is delivered through the second catheter and collected in at least one of the first and third catheters to establish retrograde perfusion.

15. The method of claim 11, comprising the step of heating the tissue structure during the delivering step.

16. The method of claim 15, wherein the heating step raises the temperature of the tissue structure to at least about 100°

F.

17. The method of claim 15, wherein the heating step raises the temperature of the tissue structure to at least about 105°

F.

18. The method of claim 15, wherein the heating step comprises heating the perfusate before the delivering step, and wherein the perfusate transfers heat to the tissue structure.