Systems, assemblies, and methods for treating a bronchial tree

• US 8,821,489 B2
• Filed: 04/20/2012
• Issued: 09/02/2014
• Est. Priority Date: 05/09/2008
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Holaira, Inc. (Nuvaira, Inc.)
• Inventors: Mayse, Martin L., Dimmer, Steven C.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US13/452,660
• Publication Number:
  US 20120209296A1
• Time in Patent Office: 865 Days
• Field of Search: 606/28, 606/32, 606/34, 606/41, 607/42, 607/98, 607/99, 607/113, 607/115
• 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 of treating a subject comprising:

positioning a treatment device at a treatment site within a first airway of the subject, wherein at least one nerve trunk runs along the first airway and carries nervous system signals to or from a second airway that is a higher generation airway of the first airway; and

damaging the nerve trunk using the treatment device sufficiently to inhibit transmission of the nervous system signals past the treatment site such that airway resistance in the higher generation airway is reduced.

2. The method of claim 1 wherein the nerve trunk is closer to an exterior surface of an airway wall of the first airway than to an interior surface of the airway wall of the first airway.

3. The method of claim 1 wherein the nerve trunk is disposed along an exterior surface of an airway wall of the first airway.

4. The method of claim 1 wherein the nerve trunk is radially outside a smooth muscle layer of the first airway.

5. The method of claim 1 further comprising inhibiting damage to airway tissue disposed radially between the treatment device and the nerve trunk.

6. The method of claim 5 wherein the inhibiting damage step comprises cooling the airway tissue using the treatment device.

7. The method of claim 6 wherein the cooling step comprises absorbing heat from the airway tissue with a cooling element on the treatment device.

8. The method of claim 6 wherein the treatment device comprises an energy emitter for delivering energy to the nerve trunk.

9. The method of claim 1 wherein the airway resistance in the higher generation airway is reduced without delivering energy in the higher generation airway.

10. The method of claim 1 wherein the first airway is between a trachea and a lung of the subject.

11. The method of claim 10 wherein the first airway comprises a left or right main bronchus or a bronchus intermedius.

12. The method of claim 1 wherein the first airway is a first generation airway located outside of the left and right lungs.

13. The method of claim 1 wherein airway resistance in the higher generation airway is reduced by reducing airway inflammation in the higher generation airway.

14. A method of treating a subject comprising:

delivering energy so as to damage nerve tissue at a first site along a first airway of the subject such that nervous system signals traveling through the nerve tissue are blocked sufficiently to reduce airway resistance in a second airway that is a higher generation airway of the first airway.

15. The method of claim 14 wherein the nerve tissue is closer to an exterior surface of a wall of the first airway than to an interior surface of the wall of the first airway.

16. The method of claim 14 wherein the nerve tissue is disposed along an exterior surface of a wall of the first airway.

17. The method of claim 14 wherein the nerve tissue is radially outside a smooth muscle layer of the first airway.

18. The method of claim 14 wherein the nerve tissue is damaged using a treatment device positioned in the first airway, the method further comprising inhibiting damage to airway tissue disposed radially between the treatment device and the nerve tissue.

19. The method of claim 18 wherein the inhibiting damage step comprises cooling the airway tissue using the treatment device.

20. The method of claim 19 wherein the cooling step comprises absorbing heat from the airway tissue with a cooling element on the treatment device.

21. The method of claim 19 wherein the treatment device comprises an energy emitter for delivering energy to the nerve tissue.

22. The method of claim 14 wherein the first airway is between a trachea and a lung of the subject.

23. The method of claim 22 wherein the first airway comprises a left or right main bronchus or a bronchus intermedius.

24. The method of claim 14 wherein the first airway is a first generation airway located outside of the left and right lungs.

25. The method of claim 14 wherein airway resistance in the higher generation airway is reduced by reducing airway inflammation in the higher generation airway.