Elongated lung volume reduction devices, methods, and systems

• US 8,632,605 B2
• Filed: 09/11/2009
• Issued: 01/21/2014
• Est. Priority Date: 09/12/2008
• Status: Expired due to Fees

• Current Assignee: Ekos LLC (Boston Scientific Corporation)
• Original Assignee: PneumRx, Inc. (Boston Scientific Corporation)
• Inventors: Thompson, David, Aronson, Nathan, Wu, Patrick, Lehrberg, David, Mathis, Mark L., Boutillette, Michael, Vasquez, Jaime
• Primary Examiner(s): Isabella, David
• Assistant Examiner(s): Sharma, Yashita
• Application Number:
  US12/558,197
• Publication Number:
  US 20100100196A1
• Time in Patent Office: 1,593 Days
• Field of Search: 623/1.11, 623/1.12, 623/1.18, 623/1.19, 623 2364- 237, 606/157, 606/158, 128/200.24, 604/506, 604/514
• US Class Current: 623/23.65
• 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 17/12104 in an air passage
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 17/12145 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/1285 for minimally invasive surgery
• 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 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/12054 Details concerning the detachment of the occluding device from the introduction device
• CPC Class Codes: A61B 2034/108 Computer aided selection or customisation of medical implants or cutting guides
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 5/087 Measuring breath flow
• CPC Class Codes: A61B 5/091 Measuring volume of inspired or expired gases, e.g. to determine lung capacity
• CPC Class Codes: A61B 5/14542 for measuring blood gases A61B5/14551 takes precedence
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 90/00 Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges protective face masks A41D13/11; surgeon's or patient's gowns or dresses A41D13/12; devices for carrying-off, for treatment of, or for carrying-over, body liquids A61M1/00
• CPC Class Codes: A61M 16/04 : Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0406 : implanted flow modifiers
• CPC Class Codes: A61M 16/0833 : T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 2205/0266 : Shape memory materials

Abstract

A lung volume reduction system is disclosed comprising an elongate implantable device adapted to be delivered to a lung airway of a patient in a delivery configuration and to change to a deployed configuration to compress lung tissue. The implant may be longer in axial length than an axial length of the target axial region in which it is deployed. Deployment may involve allowing an end of the implant to move relative to surrounding tissue while the implant is progressively deployed.

Claims

1. A method for treating a lung of a patient, the lung including an airway system having a plurality of branching airways, the method comprising:

identifying a target axial region of the airway system, the target axial region having a proximal end toward the esophagus and a distal end away from the esophagus with a length therebetween;

selecting an implant in response to the length of the target axial region such that the implant has an elongate body with a body length greater than the length of the target axial region;

advancing a distal end of the selected implant along a catheter and through the airway system toward the distal end of the target axial region;

deploying a distal portion of the implant within the target axial region so that the distal portion axially couples the elongate body of the implant to the airway system; and

withdrawing the catheter proximally relative to the axially coupled elongate body while a proximal portion of the elongate body remains along the catheter;

wherein the proximal portion of the elongate body moves distally along the catheter and distally relative to the airway toward the distal end of the axially coupled elongate body during the withdrawal of the catheter, and wherein movement of the proximal portion of the elongate body toward the distal end, laterally compresses a portion of the lung between the proximal portion and the distal portion during the withdrawal of the catheter.

2. The method of claim 1, further comprising measuring a length of the target axial region, wherein the implant is selected so that the elongate body has a length of at least 10% more than the measured target axial region.

3. The method of claim 1, wherein the length of the target axial region is measured by advancing the catheter body distally from a distal end of a bronchoscope until a distal end of the catheter body is sufficiently engaged by a surrounding lumen of the airway system to limit distal advancement, and measuring a length between the distal end of the advanced catheter and the distal end of the bronchoscope;

and

wherein the implant is deployed by advancing the distal end of the elongate body through a lumen of the catheter to adjacent the distal end of the catheter, and withdrawing the catheter proximally from the advanced implant;

wherein the elongate body of the implant is advanced axially within and from the lumen of the catheter by pushing the proximal portion of the elongate body distally within the lumen.

5. The method of claim 1, wherein the implant has a length in a range from about 110% of the length of the target axial region to about 130% of the length of the target axial region.

6. The method of claim 1, wherein the implant has a length of about 120% of the length of the target axial region.

7. The method of claim 1, wherein the implant has a length in a range from about 120 mm to about 250 mm.

9. The method of claim 1, wherein the implant comprises atraumatic surfaces disposed adjacent to the proximal end and the distal end of the elongate body so as to engage the surrounding airway system and inhibit penetration through the airway system when the elongate body compresses lung tissue between the ends from within the airway.

10. The method of claim 1, wherein the elongate body laterally compresses the portion of the lung by bending axis of the target axial region to conform to a deployed configuration of the implant.

4. A method for treating a lung of a patient, the lung including an airway system having a plurality of branching airways, the method comprising:

identifying a target axial region of the airway system, the target axial region having a proximal end toward the esophagus and a distal end away from the esophagus with a length therebetween;

selecting an implant in response to the length of the target axial region such that the implant has an elongate body with a body length greater than the length of the target axial region;

advancing a distal end of the selected implant through the airway system toward the distal end of the target axial region; and

deploying the implant within the target system so that the elongate body laterally compresses a portion of the lung;

wherein the length of the target axial region is measured by advancing the catheter body distally from a distal end of a bronchoscope until a distal end of the catheter body is sufficiently engaged by a surrounding lumen of the airway system to limit distal advancement, and measuring a length between the distal end of the advanced catheter and the distal end of the bronchoscope;

wherein the implant is deployed by advancing the distal end of the elongate body through a lumen of the catheter to adjacent the distal end of the catheter, and withdrawing the catheter proximally from the advanced implant; and

wherein the proximal end of the elongate body is disposed within a lumen of the bronchoscope when the withdrawing of the catheter is initiated, wherein the elongate body bends laterally during the withdrawing of the catheter so as to laterally compress a portion of the lung, wherein a distal released portion of the elongate body is axially coupled to the airway system while a proximal portion of the elongate body adjacent the proximal end remains within the lumen of the catheter, and wherein the proximal end of the elongate body is drawn distally during withdrawal of the catheter body, the proximal end of the implant remaining within a field of view of the bronchoscope when the implant is mechanically decoupled from the catheter and bronchoscope.

8. A method for treating a lung of a patient, the lung including an airway system having a plurality of branching airways, the method comprising:

identifying a target axial region of the airway system, the target axial region having a proximal end toward the esophagus and a distal end away from the esophagus with a length therebetween;

selecting an implant in response to the length of the target axial region such that the implant has an elongate body with a body length greater than the length of the target axial region;

advancing a distal end of the selected implant through the airway system toward the distal end of the target axial region; and

deploying the implant within a portion of the target axial region so that the elongate body laterally compresses a portion of the lung by bending the axis of target axial region toward a bent deployed configuration of the implant.