Delivery devices with coolable energy emitting assemblies

• US 8,932,289 B2
• Filed: 09/26/2011
• Issued: 01/13/2015
• Est. Priority Date: 10/27/2009
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Holaira, Inc. (Nuvaira, Inc.)
• Inventors: Dimmer, Steven C., Mayse, Martin L.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US13/245,537
• Publication Number:
  US 20120016364A1
• Time in Patent Office: 1,205 Days
• Field of Search: 606/28, 606/32, 606/42, 606/47, 606/41, 607/42, 607/98, 607/99, 607/115
• US Class Current: 606/41
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00029 open
• 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 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0262 using a circulating cryogenic fluid
• CPC Class Codes: A61N 2007/0043 intra-cavitary

Abstract

Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input.

Claims

1. A method of treating tissue in an airway of a bronchial tree of a subject, comprising:

moving an energy delivery device along a passageway in the airway, the passageway being defined by an inner surface of the airway;

delivering energy through the inner surface from the energy delivery device to damage a target region of tissue radially outward from the inner surface, the target region having a temperature profile; and

modifying the temperature profile during energy delivery such that the damaged target region has a maximum cross-sectional width at a first location which is radially separated from the inner surface of the airway relative to a longitudinal axis of the airway to maintain a protected region, in which a majority of the tissue is not permanently damaged, between the target region and the inner surface of the airway,

wherein the target region includes at least a portion of a nerve trunk extending along the airway, the energy delivery device being configured to sufficiently damage the nerve trunk to attenuate nervous system signals transmitted to a portion of the bronchial tree distally of the target region.

2. The method of claim 1, wherein the maximum cross-sectional width of the target region is located at least 2 mm radially outward from the inner surface.

3. The method of claim 1, wherein the first location is radially outward from a smooth muscle tissue region of the tissue.

4. The method of claim 1, wherein a majority of the target region is outside a region of smooth muscle tissue of the tissue.

5. The method of claim 1, wherein the airway is hyper-responsive or constricted, and wherein the energy is delivered such that any damage to the smooth muscle tissue of the airway is less than that required to substantially alter the responsiveness or constriction of the airway.

6. The method of claim 1, wherein modifying the temperature profile during energy delivery includes maintaining a protected region in which a majority of the tissue is not permanently damaged, and wherein the protected region is between the target region and the inner surface of the airway.

7. The method of claim 1 wherein maintaining the protected region comprises cooling the protected region with a cooling section of the energy delivery device while the energy is delivered.

8. The method of claim 7 wherein the cooling section comprises an inflatable member.

9. The method of claim 1, wherein delivering energy to the tissue comprises delivering the energy from a cooled electrode.

10. A method of treating tissue in an airway of a bronchial tree of a subject, comprising:

moving an energy delivery device along a passageway in the airway, the passageway being defined by an inner surface of the airway; and

delivering energy through the inner surface from the energy delivery device to damage a target region of tissue radially outward from the inner surface such that the damaged target region has a maximum cross-sectional width at a first location which is radially separated from the inner surface of the airway

wherein the target region includes at least a portion of a nerve trunk extending along the airway, the energy delivery device being configured to sufficiently damage the nerve trunk to attenuate nervous system signals transmitted to a portion of the bronchial tree distally of the target region, and

wherein the airway is hyper-responsive or constricted, and wherein the energy is delivered such that any damage to the smooth muscle tissue of the airway is less than that required to substantially alter the responsiveness or constriction of the airway.

11. The method of claim 10, wherein the maximum cross-sectional width of the target region is located at least 2 mm radially outward from the inner surface.

12. The method of claim 10, wherein the first location is radially outward from a smooth muscle tissue region of the tissue.

13. The method of claim 10, wherein a majority of the target region is outside a region of smooth muscle tissue of the tissue.

14. The method of claim 10, wherein delivering energy to the tissue comprises delivering the energy from a cooled electrode.

15. A method of treating tissue in an airway of a bronchial tree of a subject, comprising:

moving an energy delivery device along a passageway in the airway, the passageway being defined by an inner surface of the airway;

delivering energy through the inner surface from the energy delivery device to damage a target region of tissue radially outward from the inner surface such that the damaged target region has a maximum cross-sectional width at a first location which is radially separated from the inner surface of the airway, wherein the target region includes at least a portion of a nerve trunk extending along the airway, the energy delivery device being configured to sufficiently damage the nerve trunk to attenuate nervous system signals transmitted to a portion of the bronchial tree distally of the target region; and

maintaining a protected region in which a majority of the tissue is not permanently damaged, and wherein the protected region is between the target region and the inner surface of the airway.

16. The method of claim 15, wherein maintaining the protected region comprises cooling the protected region with a cooling section of the energy delivery device while the energy is delivered.

17. The method of claim 16, wherein the cooling section comprises an inflatable member.

18. The method of claim 15, wherein the maximum cross-sectional width of the target region is located at least 2 mm radially outward from the inner surface.

19. The method of claim 15, wherein the first location is radially outward from a smooth muscle tissue region of the tissue.

20. The method of claim 15, wherein a majority of the target region is outside a region of smooth muscle tissue of the tissue.

21. The method of claim 15, wherein delivering energy to the tissue comprises delivering the energy from a cooled electrode.