Systems, assemblies, and methods for treating a bronchial tree

• US 8,088,127 B2
• Filed: 05/08/2009
• Issued: 01/03/2012
• Est. Priority Date: 05/09/2008
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Innovative Pulmonary Solutions, Incorporated
• Inventors: Mayse, Martin L., Dimmer, Steven C.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): Giuliani, Thomas
• Application Number:
  US12/463,304
• Publication Number:
  US 20090306644A1
• Time in Patent Office: 970 Days
• Field of Search: 607/42, 607/98, 607/99, 606/28
• US Class Current: 606/41
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• CPC Class Codes: A61B 18/1482 having a long rigid shaft for accessing the inner body transcutaneously in minimal invasive surgery, e.g. laparoscopy
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2018/1432 curved
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 8/12 : in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

Systems, assemblies, and methods to treat pulmonary diseases are used to decrease nervous system input to distal regions of the bronchial tree within the lungs. Treatment systems damage nerve tissue to temporarily or permanently decrease nervous system input. The treatment systems are capable of heating nerve tissue, cooling the nerve tissue, delivering a flowable substance that cause trauma to the nerve tissue, puncturing the nerve tissue, tearing the nerve tissue, cutting the nerve tissue, applying pressure to the nerve tissue, applying ultrasound to the nerve tissue, applying ionizing radiation to the nerve tissue, disrupting cell membranes of nerve tissue with electrical energy, or delivering long acting nerve blocking chemicals to the nerve tissue.

Claims

1. A method for decreasing resistance to airflow within a bronchial tree of a subject, the method comprising:

moving an intraluminal device along a lumen of an airway of a bronchial tree; and

at least partially denervating a portion of the bronchial tree by damaging substantially all nerve trunks extending along a tubular section of the airway using the intraluminal device so as to prevent substantially all nervous system signals transmitted along the airway from traveling past the denervated portion to a higher generation airway.

2. The method of claim 1, wherein the nerve trunks extend along an outside surface of the airway.

3. The method of claim 1, further comprising:

inhibiting damage to smooth muscle in a wall of the airway while the nerve trunks are damaged.

4. The method of claim 1, wherein denervating the portion of the bronchial tree comprises:

outputting energy from an activatable element of the intraluminal device in the lumen to heat and ablate nerve tissue of the nerve trunks; and

cooling a portion of the intraluminal device to cool an interior of the wall of the airway while outputting the energy to inhibit damage to an inner surface of the airway while the nerve tissue is ablated.

5. The method of claim 1, wherein denervating the portion of the bronchial tree comprises:

delivering energy from an ablation element of the intraluminal device to destroy nerve tissue of the nerve trunks while avoiding injury to airway tissue distal of the damaged nerve tissue of the nerve trunks.

6. The method of claim 1, wherein the damaged nerve tissue of the nerve trunks is positioned between the trachea and a lung of the subject.

7. The method of claim 1, wherein denervating the portion of the bronchial tree includes ablating nerve tissue along a right main bronchus, ablating nerve tissue along a left main bronchus, or both.

8. A method for decreasing resistance to airflow within a bronchial tree of a subject, the method comprising:

moving an intraluminal device along a lumen of an airway of a bronchial tree; and

damaging nerve tissue in a portion of the bronchial tree using the intraluminal device while inhibiting damage to smooth muscle in a wall of the airway between the intraluminal, device and the nerve tissue.

9. The method of claim 8, wherein at least partially denervating the portion of the bronchial tree comprises outputting energy from the intraluminal device to ablate the nerve tissue while cooling a portion of the intraluminal device to cool the wall of the airway to inhibit damage to the smooth muscle in the wall of the airway.

10. The method of claim 8, wherein at least partially denervating the portion of the bronchial tree comprises applying radiofrequency energy to nerve tissue of a nerve trunk extending along an outside surface of the airway to damage the nerve tissue while cooling the airway using a cooling member of the intraluminal device.

11. The method of claim 8, wherein at least partially denervating the portion of the bronchial tree includes damaging at least one nerve trunk extending along an exterior of the airway.

12. The method of claim 8, wherein at least partially denervating the portion of the bronchial tree causes a decrease of airway smooth muscle tone in portions of the bronchial tree distal to a section of the airway treated by the intraluminal device.

13. The method of claim 8, wherein at least partially denervating the portion of the bronchial tree includes damaging nerve tissue at a treatment site to cause a sufficient decrease of airway smooth muscle tone so as to substantially increase airflow into and out of the portions of the bronchial tree distal to the treatment site.

14. A method of treating a lung comprising:

positioning an intraluminal device in a lumen of an airway of a bronchial tree; and

damaging a section of nerve tissue at a treatment site along the airway using the intraluminal device to substantially prevent nervous system signals from traveling to a higher generation airway of the bronchial tree distally of the treatment site whereby resistance to airflow in the bronchial tree distally of the treatment site is decreased.

15. The method of claim 14, wherein damaging the section of nerve tissue comprises delivering energy from the intraluminal device positioned in the airway proximal the treatment site.

16. The method of claim 14, wherein damaging the section of nerve tissue comprises damaging nerve tissue positioned between a trachea and a lung through which the bronchial branches extend.

17. The method of claim 14, further comprising:

damaging a nerve trunk extending along an exterior wall of a main bronchus to damage the section of nerve tissue.

18. The method of claim 14, further comprising:

cooling airway tissue near the treatment site while damaging the section of nerve tissue.

19. The method of claim 18, wherein cooling comprises circulating a fluid through the intraluminal device contacting the airway to cool the wall of the airway while the nerve tissue is damaged.

20. The method of claim 14, further comprising:

cooling a radiofrequency electrode of the intraluminal device while radiofrequency energy outputted by the radiofrequency electrode damages a nerve trunk extending along an outside wall of the airway.