Methods systems and kits for lung volume reduction

• US 6,878,141 B1
• Filed: 06/28/2000
• Issued: 04/12/2005
• Est. Priority Date: 07/02/1999
• Status: Expired due to Term

• Current Assignee: Pulmonx Corp.
• Original Assignee: Pulmonx Pulmonx
• Inventors: Wondka, Anthony D., Kotmel, Robert, Soltesz, Peter P., Perkins, Rodney A.
• Primary Examiner(s): MENDEZ, MANUEL A
• Application Number:
  US09/606,320
• Time in Patent Office: 1,749 Days
• Field of Search: 604/28, 604/35, 604/43, 604/516, 604/102.01, 604/102.02, 604/101.01, 604/101.04, 604/79, 604/509, 128/207.15, 128/207.14
• US Class Current: 604/516
• CPC Class Codes: A61B 1/00165 with light-conductive means, e.g. fibre optics A61B1/07 takes precedence
• CPC Class Codes: A61B 1/005 Flexible endoscopes
• CPC Class Codes: A61B 1/0051 with controlled bending of insertion part
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• 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 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12159 Solid plugs; being solid before insertion
• CPC Class Codes: A61B 17/12186 liquid materials adapted to be injected
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 2017/00535 pneumatically or hydraulically operated A61B2017/22051, A61B2090/401 take precedence
• CPC Class Codes: A61B 2017/1205 Introduction devices
• CPC Class Codes: A61B 2017/2905 flexible
• CPC Class Codes: A61B 2017/2927 the angular position of the head being adjustable with respect to the shaft
• CPC Class Codes: A61B 50/30 Containers specially adapted for packaging, protecting, dispensing, collecting or disposing of surgical or diagnostic appliances or instruments for wound clamps A61B17/10; for ligaturing clips A61B17/122; packages or dispensers for surgical gloves or finger-stalls A61B42/40
• CPC Class Codes: A61M 16/04 Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0404 with means for selective or partial lung respiration
• CPC Class Codes: A61M 16/0418 with integrated means for changing the degree of curvature, e.g. for easy intubation
• CPC Class Codes: A61M 16/0459 : one cuff behind another
• CPC Class Codes: A61M 16/0486 : Multi-lumen tracheal tubes
• CPC Class Codes: A61M 2016/0027 : pressure meter
• CPC Class Codes: A61M 2016/0413 : with detectors of CO2 in exhaled gases
• CPC Class Codes: A61M 2025/1052 : for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2205/058 : with ultrasound therapy
• CPC Class Codes: A61M 2209/06 : Packaging for specific medical equipment
• CPC Class Codes: A61M 2210/1039 : Lungs

Abstract

Lung volume reduction is performed in a minimally invasive manner by isolating a lung tissue segment, optionally reducing gas flow obstructions within the segment, and aspirating the segment to cause the segment to at least partially collapse. Further optionally, external pressure may be applied on the segment to assist in complete collapse. Reduction of gas flow obstructions may be achieved in a variety of ways, including over inflation of the lung, introduction of mucolytic or dilation agents, application of vibrational energy, induction of absorption atelectasis, or the like. Optionally, diagnostic procedures on the isolated lung segment may be performed, typically using the same isolation/access catheter.

Claims

1. A method for lung volume reduction, said method comprising:

isolating a lung tissue segment;

aspirating the segment through a lung passage to cause the segment to at least partially collapse; and

implanting a barrier formed at least in part from a metal composition which expands in situ across the lung passage.

2. A method as in claim 1, further comprising inflating the lung tissue segment to a pressure higher than its normal inflated pressure to reduce gas flow obstruction.

3. A method as in claim 2, further comprising deflating adjacent lung regions while the lung tissue segment is inflated.

4. A method as in claim 2, wherein inflating the lung tissue segment comprises positioning a catheter in an air passage leading into the segment, inflating a balloon on the catheter to seal the air passage, and introducing a gas through the catheter to inflate the segment.

5. A method as in claim 1, further comprising introducing an agent to the lung tissue segment, wherein the agent clears or dilates air passages within the segment to reduce gas flow obstructions.

6. A method as in claim 5, wherein the agent is selected from the group consisting of mucolytic agents, bronchodilators, surfactants, desiccants, solvents, necrosing agents, perfluorocarbons, and absorbents.

7. A method as in claim 5, wherein introducing the agent comprises positioning a catheter in an air passage leading to the segment and delivering the agent through the catheter to the segment.

8. A method as in claim 1, further comprising delivering mechanical energy to the lung segment to reduce gas flow obstructions.

9. A method as in claim 8, wherein the mechanical energy is vibrational energy.

10. A method as in claim 8, wherein the vibrational energy is delivered by inflating the segment with a non-compressible fluid and ultrasonically exciting the fluid to distribute ultrasonic energy throughout the segment.

11. A method as in claim 1, wherein isolating the lung tissue segment comprises positioning a catheter in an air passage leading to the lung tissue segment and inflating a balloon on the catheter to occlude the air passage.

12. A method as in claim 11, wherein aspirating comprises drawing gas and liquids present from the isolated lung segment through a lumen in the catheter while the balloon remains inflated.

13. A method as in claim 12, wherein aspirating is performed at a negative pressure in the range from 2 mmHg to 50 mmHg.

14. A method as in claim 1, wherein implanting the barrier further comprises introducing a collagen hydrogel which is not fully hydrated prior to deployment.

15. A method as in claim 1, wherein implanting a barrier further comprises introducing an adhesive in the air passage.

16. A method as in claim 15, wherein the adhesive includes a radiopaque tracer.

17. A method as in claim 1, wherein aspirating the segment is performed after implanting the barrier.

18. A method as in claim 1, wherein the barrier comprises a metal frame and an air impermeable cover.

19. A method as in claim 18, wherein the metal frame is resilient and adapted to expand upon release from constraint.

20. A method as in claim 18, wherein the metal frame is balloon expandable.

21. A method as in claim 1, further comprising inducing absorption atelectasis within the lung segment prior to aspirating the segment.

22. A method as in claim 20, wherein inducing absorption atelectasis comprises insufflating the lung segment with a high oxygen concentration gas.

23. A method as in claim 22, wherein the high oxygen concentration is at least 50% by volume.

24. A method as in claim 22, wherein the high oxygen concentration is at least 75% by volume.

25. A method as in claim 22, wherein the oxygen is substantially pure.

26. A method as in claim 22, wherein the lung is lavaged with a mixture of oxygen and a low molecular weight gas.