Methods for treating airways

• US 8,181,656 B2
• Filed: 02/23/2006
• Issued: 05/22/2012
• Est. Priority Date: 06/10/1998
• Status: Expired due to Fees

• Current Assignee: Boston Scientific Scimed, Inc. (Boston Scientific Corporation)
• Original Assignee: Asthmatx, Inc. (Boston Scientific Corporation)
• Inventors: Danek, Christopher J., Biggs, Michael, Loomas, Bryan E., Laufer, Michael D., Kaplan, Gary S., Shriner, Kelly M.
• Primary Examiner(s): Matthews, William H.
• Application Number:
  US11/361,564
• Publication Number:
  US 20060137698A1
• Time in Patent Office: 2,280 Days
• Field of Search: 128/898, 606/41, 606/46, 607/42
• US Class Current: 128/898
• CPC Class Codes: A61B 17/22004 using mechanical vibrations, e.g. ultrasonic shock waves A61B17/225 takes precedence
• CPC Class Codes: A61B 17/24 for use in the oral cavity, larynx, bronchial passages or nose for medical inspection of cavities or tubes in the body A61B1/00; Tongue scrapers
• CPC Class Codes: A61B 18/00 Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body eye surgery A61F9/007; ear surgery A61F11/00
• CPC Class Codes: A61B 18/08 by means of electrically-heated probes
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 2017/00115 with audible or visual output
• CPC Class Codes: A61B 2017/00292 mounted on or guided by flexible, e.g. catheter-like, means
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/22062 to be filled with liquid
• CPC Class Codes: A61B 2017/242 for bronchial passages
• CPC Class Codes: A61B 2018/00083 low, i.e. electrically insulating
• 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 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00654 with individual control of each of a plurality of energy emitting elements
• CPC Class Codes: A61B 2018/00666 using a threshold value
• CPC Class Codes: A61B 2018/00678 upper
• CPC Class Codes: A61B 2018/00761 : Duration
• CPC Class Codes: A61B 2018/00791 : Temperature
• CPC Class Codes: A61B 2018/00797 : measured by multiple temperature sensors
• CPC Class Codes: A61B 2018/00803 : with temperature prediction
• CPC Class Codes: A61B 2018/044 : the surgical action being effected by a circulating hot fluid
• CPC Class Codes: A61B 2018/046 : in liquid form
• CPC Class Codes: A61B 2018/1807 : using light other than laser radiation
• CPC Class Codes: A61B 2090/3614 : using optical fibre
• CPC Class Codes: A61M 2025/0096 : being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 2210/1039 : Lungs
• CPC Class Codes: A61M 25/0043 : characterised by structural features
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61N 1/3601 : of respiratory organs
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body

Abstract

This relates to treating an asthmatic lung and more particularly, relates to advancing a treatment device into the lung and treating the lung with the device. This also includes additional steps of treating the airway wall, applying energy or heat to the airway wall in an asthmatic lung.

Claims

1. In a patient diagnosed with asthma, a method for locating and treating one or more treatment sites within an airway of the lung of the patient, the method comprising:

applying a diagnostic electrical stimulation to the lung;

locating treatment sites in a plurality of airways of the lung by evaluating a reaction to the diagnostic electrical stimulation;

positioning a treatment device at the located treatment sites in the airways; and

thermally altering the treatment sites via the treatment device to alter the airways in a manner that reduces the ability of the lung to produce a symptom of asthma.

2. The method of claim 1 where applying energy comprises selecting a modality from the group consisting of radio frequency, heat, ultrasound, radiant, laser, or microwave.

3. The method of claim 1, where electrically stimulating the lung comprises exposing airway tissue to an electrical field stimulation.

4. The method of claim 1, where locating the treatment sites comprises use of a non-invasive imaging technique.

5. The method of claim 4, where the non-invasive imaging technique comprises a technique selected from the group consisting of a bronchogram, magnetic resonance imaging, computed tomography, radiography, and ventilation perfusion scans.

6. The method of claim 1, where locating the treatment site by evaluating comprises visually evaluating the effect of the stimulating step on the airway using a bronchoscope with a visualization system.

7. The method of claim 1, where locating the treatment site by evaluating comprises measuring pressure changes in the airway before and after the stimulating step.

8. The method of claim 7, where measuring pressure changes comprises measuring pressure changes within the entire lung.

9. The method of claim 8, where measuring pressure changes comprises measuring pressure changes within an airway or alveolar sac.

10. The method of claim 1, wherein locating the treatment sites comprises measuring the electrical properties of the tissue before and after the stimulating step.

11. The method of claim 1, where applying energy further comprises adjusting a treatment parameter based upon the results of the evaluating the reaction.

12. The method of claim 11, where the treatment parameter comprises a duration of treatment, an intensity of treatment, a temperature, an amount of tissue, and a depth of treatment.

13. The method of claim 1, where locating the treatment sites comprises evaluating a reaction selected from the group consisting of an increase in the resistance to airflow within the lung, constriction of airways within the lung, inflammation of airway tissue, irritation of airway tissue, increase edema of the airway, and increased mucus plugging of the airway.

14. The method of claim 1, further comprising testing the lung for a pre-treatment pulmonary value prior to applying energy to the treatment site.

15. The method of claim 14, where the pulmonary values comprise a value selected from the group consisting of forced expiratory volume, forced vital capacity, forced expiratory flow, maximum flow, peak expiratory flow rate, functional residual capacity, residual volume, and total lung capacity.

16. The method of claim 14, where stimulating the lungs occurs prior to the act of testing the lung for a pre-treatment pulmonary value.

17. The method of claim 16, further comprising testing the lung for a post-treatment pulmonary value.

18. The method of claim 1, further comprising sub-mucosal sensing of the energy during the treating act.

19. The method of claim 18, where the sub-mucosal sensing is invasive and measures temperature, impedance, and/or blood flow.

20. The method of claim 18, where the sub-mucosal sensing is non-invasive and comprises infra-red sensing.

21. The method of claim 1 wherein applying the diagnostic electrical stimulation comprises producing at least one artificially induced symptom of reversible obstructive pulmony disease.