Systems, assemblies, and methods for treating a bronchial tree

• US 8,961,507 B2
• Filed: 04/20/2012
• Issued: 02/24/2015
• 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:
  US13/452,648
• Publication Number:
  US 20120203216A1
• Time in Patent Office: 1,040 Days
• Field of Search: 606/28, 606/34, 606/32, 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 for decreasing resistance to airflow within a bronchial tree of a subject, the method comprising:

moving an intraluminal device along a lumen of an airway of the bronchial tree, the intraluminal device comprising an expandable member and an energy emitter;

expanding the expandable member to position the energy emitter proximate to or in contact with an airway wall of a first portion of the airway; and

damaging nerves along the first portion of the airway using the energy emitter of the intraluminal device so as to impede nervous system signals transmitted along the airway from traveling past the damaged first portion to or from at higher generation airway without irreversibly damaging an inner surface of the airway wall disposed radially between the intraluminal device and the nerves.

2. The method of claim 1, wherein damaging nerves along the first portion of the airway comprises applying energy to nerve tissue along the airway wall using the energy emitter while cooling airway tissue at the inner surface of the airway wall.

3. The method of claim 2, wherein the airway tissue is cooled by circulating a cooling fluid through the intraluminal device.

4. The method of claim 3, wherein the expandable member is an inflatable balloon and the airway tissue is cooled by circulating the cooling fluid through the balloon.

5. The method of claim 4, wherein circulating the cooling fluid through the balloon concentrates heat generated by the energy emitter in outer layers of the airway wall.

6. The method of claim 4, wherein circulating the cooling fluid through the balloon allows the energy emitter to heat a single nerve trunk in an outer layer of the airway wall to a higher temperature than smooth muscle in the airway wall located radially between the single nerve trunk and the energy emitter.

7. The method of claim 4, wherein circulating the cooling fluid through the balloon includes introducing the cooling fluid into the balloon through a first opening and removing the cooling fluid through a second opening.

8. The method of claim 7, wherein the first and second openings are located at opposite ends of an interior of the balloon.

9. The method of claim 7, wherein the first opening is located at a distal end of an inflow line that extends in an interior of the balloon, and the second opening is located at a distal end of an outflow line that extends in the interior of the balloon.

10. The method of claim 9, wherein circulating the cooling fluid through the balloon inflates the balloon.

11. The method of claim 10, further comprising regulating outflow of the cooling fluid through the outflow line such that the balloon inflates until the energy emitter is brought into contact with the airway wall.

12. The method of claim 10, further comprising regulating outflow of the cooling fluid through the outflow line such that the balloon inflates until the energy emitter is brought proximate to the airway wall.

13. The method of claim 1, wherein damaging nerves along the first portion of the airway comprises destroying at least one nerve trunk at a position that is within at least one of the left and right lung root and proximate to one lung of the subject.

14. The method of claim 1, wherein damaging nerves along the first portion of the airway comprises destroying at least one nerve trunk at a position that is within a left lung or a right lung.

15. The method of claim 1, wherein damaging nerves along the first portion of the airway comprises destroying at least one nerve trunk adjacent to the airway wall without destroying at least one artery adjacent to the airway wall.

16. The method of claim 1, wherein a portion of the bronchial tree is damaged without permanently damaging smooth muscle in a wall of the airway wall.

17. The method of claim 1, wherein damaging nerves along the first portion of the airway includes damaging substantially all nerve trunks extending along a tubular section of theairway wall so as to prevent substantially all nervous system signals transmitted along the airway wall from traveling past the damaged first portion.

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

19. The method of claim 1, wherein the airway comprises a left or right main bronchus or a bronchus intermedius.

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

21. A method for decreasing resistance to airflow within the bronchial tree of a subject, the method comprising:

moving an intraluminal device along a lumen of an airway of a bronchial tree, the intraluminal device comprising an expandable member and an energy emitter, the airway having a nerve trunk in or along an outer wall thereof, the nerve trunk being capable of transmitting nervous system signals to or from a portion of a lung distal to the airway; and

damaging the nerve trunk using the intraluminal device without irreversibly damaging an inner surface of the airway wall disposed radially between the intraluminal device and the nerve trunk such that nervous system signals transmitted to or from the portion of the lung are at least partially blocked.