Partial aortic occlusion devices and methods for cerebral perfusion augmentation

• US 8,888,740 B2
• Filed: 01/10/2011
• Issued: 11/18/2014
• Est. Priority Date: 04/24/2001
• Status: Expired due to Fees

• Current Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Original Assignee: Zoll Circulation Incorporated (Asahi Kasei Corporation)
• Inventors: Barbut, Denise R., Keith, Peter T., Berhow, Steven W., St. Germain, Jon P.
• Primary Examiner(s): Price, Nathan R
• Application Number:
  US12/987,849
• Publication Number:
  US 20110106132A1
• Time in Patent Office: 1,408 Days
• Field of Search: 604/101.01, 604/101.02, 604/101.03, 604/101.05, 604/96.01, 604/503, 604/505, 604/507, 604/508, 604/915, 604/916, 604/919, 604/539, 606/192, 606/193, 606/194
• US Class Current: 604/101.01
• CPC Class Codes: A61B 17/12036 partial occlusion
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12045 double occlusion, e.g. during anastomosis
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/12145 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/1219 expandable in contact with liquids
• CPC Class Codes: A61B 2017/22054 with two balloons
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/4076 Diagnosing or monitoring particular conditions of the nervous system A61B5/4821, A61B5/4824 take precedence
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61F 2002/068 Modifying the blood flow model, e.g. by diffuser or deflector
• CPC Class Codes: A61F 2007/126 for invasive application, e.g. for introducing into blood vessels
• CPC Class Codes: A61F 7/12 Devices for heating or cooling internal body cavities
• CPC Class Codes: A61M 2025/0002 with a pressure sensor at the distal end
• CPC Class Codes: A61M 2025/0034 characterized by elements which are assembled, connected or fused, e.g. splittable tubes, outer sheaths creating lumina or separate cores making of catheters A61M25/0009
• 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 general flow characteristics A61M2206/10
• CPC Class Codes: A61M 2025/0081 Soft tip
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2210/127 : Aorta
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 2230/30 : Blood pressure A61M2230/04 takes precedence
• 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 25/003 : characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves catheter tips A61M25/0067
• CPC Class Codes: A61M 25/0032 : characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts
• 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 25/0069 : Tip not integral with tube
• CPC Class Codes: A61M 25/0074 : Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/008 : Strength or flexibility characteristics of the catheter tip
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/0662 : Guide tubes
• CPC Class Codes: A61M 25/1011 : Multiple balloon catheters

Abstract

Methods are provided for partial aortic obstruction for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially obstruct aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. Partial obstruction of a vessel can be accomplished by a device comprising an elongate catheter and a distally mounted expandable member. The expandable member may comprise one or two balloons. Other medical devices, such as an angioplasty, stent, or atherectomy catheter, can be inserted distal the expandable member to provide therapeutic intervention.

Claims

1. A method for increasing cerebral blood flow, comprising the steps of:

inserting a catheter into a descending aorta, the catheter having a proximal end, a distal end, a first inflatable balloon mounted on the distal end, and a second inflatable balloon mounted on the distal end proximal the first inflatable balloon;

locating the first inflatable balloon upstream from a takeoff of renal arteries;

locating the second inflatable balloon downstream from the takeoff of the renal arteries; and

inflating and maintaining an inflated state of the second inflatable balloon to partially occlude blood flow in the descending aorta during systole and diastole, wherein cerebral blood flow is increased.

2. The method of claim 1, wherein the second inflatable balloon is adjusted in volume to achieve a desired blood pressure gradient from one side to the other of the second inflatable balloon, while maintaining partial occlusion of the aorta.

3. The method of claim 2, further comprising the step of inflating and maintaining an inflated state of the first inflatable balloon to partially occlude blood flow in the aorta during systole and diastole.

4. The method of claim 3, wherein the first balloon is adjusted in volume to achieve a desired blood pressure gradient from one side to the other of said balloon, while maintaining partial occlusion of the aorta.

5. The method of claim 4, further comprising the step of inflating and maintaining the first and second balloons for at least 30 minutes.

6. The method of claim 5, further comprising the step of inflating and maintaining the first and second balloons for at least one hour.

7. The method of claim 1, wherein the second inflatable balloon is inflated to provide 50% or greater occlusion of the cross-sectional area of the descending aorta.

8. The method of claim 7, wherein the second inflatable balloon is inflated to provide 56% or greater occlusion of the cross-sectional area of the descending aorta.

9. The method of claim 8, wherein the second inflatable balloon is inflated to provide 64% or greater occlusion of the cross-sectional area of the descending aorta.

10. The method of claim 9, wherein the second inflatable balloon is inflated to provide 71% or greater occlusion of the cross-sectional area of the descending aorta.

11. The method of claim 10, wherein the second inflatable balloon is inflated to provide 76% or greater occlusion of the cross-sectional area of the descending aorta.

12. The method of claim 11, wherein the second inflatable balloon is inflated to provide 83% or greater occlusion of the cross-sectional area of the descending aorta.

13. The method of claim 12, wherein the second inflatable balloon is inflated to provide 91% or greater occlusion of the cross-sectional area of the descending aorta.

14. The method of claim 1, further comprising the step of inflating and maintaining an inflated state of the first inflatable balloon to partially occlude blood flow in the aorta during systole and diastole.

15. The method of claim 14, wherein the first balloon is adjusted in volume to achieve a desired blood pressure gradient from one side to the other of said balloon, while maintaining partial occlusion of the aorta.

16. The method of claim 14, further comprising the step of inflating and maintaining the first and second balloons for at least 30 minutes.

17. The method of claim 16, further comprising the step of inflating and maintaining the first and second balloons for at least 1 hour.

18. The method of claim 14, wherein the first inflatable balloon is inflated to provide 50% or greater occlusion of the cross-sectional area of the descending aorta.

19. The method of claim 18, wherein the first inflatable balloon is inflated to provide 56% or greater occlusion of the cross-sectional area of the descending aorta.

20. The method of claim 19, wherein the first inflatable balloon is inflated to provide 64% or greater occlusion of the cross-sectional area of the descending aorta.

21. The method of claim 20, wherein the first inflatable balloon is inflated to provide 71% or greater occlusion of the cross-sectional area of the descending aorta.

22. The method of claim 21, wherein the first inflatable balloon is inflated to provide 76% or greater occlusion of the cross-sectional area of the descending aorta.

23. The method of claim 22, wherein the first inflatable balloon is inflated to provide 83% or greater occlusion of the cross-sectional area of the descending aorta.

24. The method of claim 23, wherein the first inflatable balloon is inflated to provide 91% or greater occlusion of the cross-sectional area of the descending aorta.