Method and apparatus for intra-aortic substance delivery to a branch vessel

• US 8,585,678 B2
• Filed: 03/07/2008
• Issued: 11/19/2013
• Est. Priority Date: 09/20/2002
• Status: Active Grant

• Current Assignee: AngioDynamics, Inc.
• Original Assignee: AngioDynamics, Inc.
• Inventors: Elkins, Jeffrey M., Valencia, Aurelio, Patel, Samir R., Aboytes, Ricardo, Goodson, Harry B., Ball, Craig A.
• Primary Examiner(s): Sirmons, Kevin C
• Assistant Examiner(s): GILBERT, ANDREW M
• Application Number:
  US12/044,230
• Publication Number:
  US 20080154236A1
• Time in Patent Office: 2,083 Days
• Field of Search: 604/500, 604/507, 604/508, 604/284
• US Class Current: 604/508
• 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 2025/105 having a balloon suitable for drug delivery, e.g. by using holes for delivery, drug coating or membranes
• 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 25/0041 pre-formed, e.g. specially adapted to fit with the anatomy of body channels urethral catheters A61F2/04
• CPC Class Codes: A61M 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/0071 Multiple separate lumens multiple separate lumens throughout the catheter A61M25/0026
• CPC Class Codes: A61M 25/0074 Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/0075 Valve means
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 39/06 Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof

Abstract

A renal flow system injects a volume of fluid agent into a location within an abdominal aorta in a manner that flows bi-laterally into each of two renal arteries via their respectively spaced ostia along the abdominal aorta wall. A local injection assembly includes two injection members, each having an injection port that couples to a source of fluid agent externally of the patient. The injection ports may be positioned with an outer region of blood flow along the abdominal aorta wall perfusing the two renal arteries. A flow isolation assembly may isolate flow of the injected agent within the outer region and into the renals. The injection members are delivered to the location in a first radially collapsed condition, and bifurcate across the aorta to inject into the spaced renal ostia. A delivery catheter for upstream interventions is used as a chassis to deliver a bilateral local renal injection assembly to the location within the abdominal aorta.

Claims

1. A method of delivering fluid into the right and left renal arteries of a patient in conjunction with a radiographic contrast material administration procedure, comprising:

administering a radiographic contrast material to the patient;

placing a localized bifurcated drug delivery system within an abdominal aorta of the patient;

wherein the localized bifurcated drug delivery system comprises a first sub-catheter and a second sub-catheter extending distally from a bifurcation location;

maneuvering the first sub-catheter of the localized drug delivery system from the abdominal aorta into the right renal artery of the patient;

maneuvering the second sub-catheter of the localized drug delivery system from the abdominal aorta into the left renal artery of the patient;

delivering an amount of fluid through the localized drug delivery system;

passing a first portion of the amount of fluid through the first sub-catheter and into the right renal artery;

passing a second portion of the amount of fluid through the second sub-catheter and into the left renal artery; and

simultaneously performing an interventional procedure on the patient such that the interventional procedure and the localized drug delivery are performed through a single percutaneous access.

2. The method of claim 1, wherein the-interventional procedure comprises performing a diagnostic procedure on the patient while the localized drug delivery system is disposed within the abdominal aorta of the patient.

3. The method of claim 1, wherein the interventional procedure is performed on the patient while the first fluid portion and the second fluid portion are passed into the right renal artery and left renal artery, respectively.

4. The method of claim 1, wherein the single percutaneous access comprises a femoral artery access.

5. The method of claim 1, wherein the first portion and the second portion of the amount of fluid are passed into the right renal artery and left renal artery, respectively, simultaneously.

6. The method of claim 1, wherein the fluid comprises a vasodilator.

7. The method of claim 6, wherein the vasodilator comprises a member selected from the group consisting of papavarine, fenoldopam mesylate, a calcium-channel blocker, atrial natriuretic peptide (ANP), acetylcholine, nifedipine, nitroglycerine, nitroprusside, adenosine, dopamine, and theophylline.

8. The method of claim 1, wherein the fluid comprises an antioxidant.

9. The method of claim 8, wherein the antioxidant comprises acetylcysteine.

10. The method of claim 1, wherein the fluid comprises a diuretic.

11. The method of claim 10, wherein the diuretic comprises a member selected from the group consisting of mannitol and furosemide.

12. The method of claim 1, wherein the patient exhibits a rise in serum creatinine of more than 25% or an absolute rise in serum creatinine of 0.5 mg/dl within 48 hours.

13. The method of claim 1, wherein the surgical intervention comprises a member selected from the group consisting of an angioplasty, a coronary procedure, artery bypass, a valve repair, and a valve replacement.

14. A method of delivering fluid into the right and left renal arteries of a patient in conjunction with a cardiac procedure, comprising:

performing the cardiac procedure on the patient;

placing a localized drug delivery system within an abdominal aorta of the patient;

maneuvering a first sub-catheter of the localized drug delivery system from the abdominal aorta into the right renal artery of the patient;

maneuvering a second sub-catheter of the localized drug delivery system from the abdominal aorta into the left renal artery of the patient;

wherein the first sub-catheter and the second-sub catheter extend bilaterally from a bifurcation location at a distal end of the localized drug delivery system;

delivering an amount of fluid through the localized drug delivery system;

wherein the cardiac procedure is performed simultaneously on the patient through a single percutaneous access.

15. The method of claim 14, wherein the cardiac procedure comprises an angiography.

16. A method of delivering fluid into the right and left renal arteries of a patient comprising:

placing a localized drug delivery system within an abdominal aorta of the patient, the localized drug delivery system comprising a bifurcated catheter having a first sub-catheter in fluid communication with a second sub-catheter;

maneuvering a first sub-catheter of the localized drug delivery system from the abdominal aorta through a right renal ostia, and into the right renal artery of the patient;

maneuvering a second sub-catheter of the localized drug delivery system from the abdominal aorta through a left renal ostia, and into the left renal artery of the patient;

delivering an amount of fluid through the localized drug delivery system while allowing an amount of blood to flow through the abdominal aorta of the patient from a location upstream of the right and left ostia along the abdominal aorta to a location downstream of the right and left ostia;

passing a first portion of the amount of fluid through the first sub-catheter and into the right renal artery; and

passing a second portion of the amount of fluid through the second sub-catheter and into the left renal artery; and

simultaneously performing cardiac procedure on the patient.

17. The method of claim 16, wherein the cardiac procedure comprises performing a coronary procedure on the patient.

18. The method of claim 16, wherein the cardiac procedure is performed on the patient while the first fluid portion and the second fluid portion are passed into the right renal artery and the left renal artery, respectively.

19. The method of claim 16, wherein the cardiac procedure and localized drug delivery is performed on the patient through a single percutaneous access.