Tissue volume reduction

• US 20010051799A1
• Filed: 04/20/2001
• Published: 12/13/2001
• Est. Priority Date: 08/23/1999
• Status: Active Grant

• Current Assignee: Pulmonx Pulmonx
• Original Assignee: Edward P. Ingenito
• Inventors: Ingenito, Edward P.
• Granted Patent: US 6,682,520 B2
• Time in Patent Office: Days
• US Class Current: 604/516
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• 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 17/12136 Balloons
• CPC Class Codes: A61B 17/12186 liquid materials adapted to be injected
• CPC Class Codes: A61B 2017/00495 for two-component glue
• CPC Class Codes: A61K 2300/00 Mixtures or combinations of active ingredients, wherein at least one active ingredient is fully defined in groups A61K31/00 - A61K41/00
• CPC Class Codes: A61K 38/1825 Fibroblast growth factor [FGF]
• CPC Class Codes: A61K 38/1841 Transforming growth factor [TGF]
• CPC Class Codes: A61K 38/1858 Platelet-derived growth factor [PDGF]
• CPC Class Codes: A61K 38/363 Fibrinogen
• CPC Class Codes: A61K 38/4833 Thrombin (3.4.21.5)
• CPC Class Codes: A61K 45/06 Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• CPC Class Codes: A61P 11/00 Drugs for disorders of the respiratory system

Abstract

Devices, compositions, and methods for achieving non-surgical lung volume reduction (e.g., bronchoscopic lung volume reduction (BLVR)) are described. BLVR can be carried out by collapsing a region of the lung, adhering one portion of the collapsed region to another, and promoting fibrosis in or around the adherent tissue.

Claims

1. A method for reducing lung volume in a patient, the method comprising

(a) advancing a bronchoscope into a region of the lung targeted for reduction;

and

(b) introducing material into the targeted region through the bronchoscope to reduce the volume of the targeted region.

2. The method of

claim 1

, wherein the material introduced through the bronchoscope induces collapse of the targeted region;

promotes adhesion between one collapsed portion of the lung and another; and

promotes fibrosis in or around the collapsed region of the lung.

3. The method of

claim 2

, wherein the material comprises fibrin or fibrinogen.

4. The method of

claim 3

, wherein the material further comprises a polypeptide growth factor.

5. The method of

claim 4

, wherein the polypeptide growth factor is a fibroblast growth factor or a transforming growth factor beta-like (TGFβ

-like) polypeptide.

6. The method of

claim 1

, wherein, prior to introducing material into the targeted region, the region is collapsed by blocking air flow into or out of the region.

7. A method for performing lung volume reduction, the method comprising:

(a) collapsing a region of the lung;

(b) adhering one portion of the collapsed region to another; and

(c) promoting fibrosis in or around the collapsed region of the lung.

8. The method of

claim 7

, wherein the method is performed using a bronchoscope.

9. The method of

claim 7

, wherein collapsing a region of the lung is achieved by administering a substance that increases the surface tension of fluids lining the alveoli in the targeted region.

10. The method of

claim 9

, wherein the substance is fibrinogen.

11. The method of

claim 10

, wherein the substance is fibrin.

12. The method of

claim 7

, wherein collapsing a region of the lung is achieved by blocking air flow into or out of the targeted region.

13. The method of

claim 7

, wherein adhering one portion of the collapsed region to another is achieved by administering fibrinogen and a fibrinogen activator.

14. The method of

claim 13

, wherein the fibrinogen activator is thrombin.

15. The method of

claim 13

, wherein the fibrinogen comprises 3-12% fibrinogen.

16. The method of

claim 15

, wherein the fibrinogen comprises approximately 10% fibrinogen.

17. The method of

claim 7

, wherein adhering one portion of the collapsed region to another is achieved by administering fibrin.

18. The method of

claim 7

, wherein promoting fibrosis in or around the collapsed region of the lung is achieved by administering a polypeptide growth factor.

19. The method of

claim 18

, wherein the polypeptide growth factor is a fibroblast growth factor (FGF).

20. The method of

claim 18

, wherein the FGF is basic fibroblast growth factor (bFGF).

21. The method of

claim 18

, wherein the polypeptide growth factor is transforming growth factor-beta (TGF-β

).

22. The method of

claim 13

, further comprising administration of factor XIIIa transglutaminase.

23. The method of

claim 17

, further comprising administration of factor XIIIa transglutaminase.

24. The method of

claim 7

, further comprising reducing the risk of infection by administration of an antibiotic.

25. The method of

claim 24

, wherein the antibiotic is administered together with fibrinogen, fibrin, or a fibrinogen activator.

26. The method of

claim 7

, further comprising, prior to collapsing a region of the lung, inflating the region with absorbable gas.

27. The method of

claim 26

, wherein the absorbable gas is at least 90% oxygen.

28. A physiologically acceptable composition comprising a polypeptide growth factor and

(a) fibrinogen or

(b) a fibrin monomer or

(c) a fibrinogen activator.

29. The composition of

claim 28

, wherein the polypeptide growth factor is a fibroblast growth factor (FGF).

30. The composition of

claim 29

, wherein the FGF is basic fibroblast growth factor (bFGF) or a biologically active fragment thereof.

31. The composition of

claim 28

, wherein the polypeptide growth factor is transforming growth factor-beta (TGF-β

).

32. The composition of

claim 28

, wherein the fibrin monomer is a fibrin I monomer, a fibrin II monomer, a des BB fibrin monomer, or any mixture or combination thereof.

33. The composition of

claim 28

, wherein the fibrinogen activator is thrombin.

34. The composition of

claim 28

, further comprising an antibiotic.

35. A device for performing lung volume reduction, the device comprising a bronchoscope having a working channel and a catheter that can be inserted into the working channel.

36. The device of

claim 35

, wherein the catheter comprises multiple lumens.

37. The device of

claim 35

, wherein the catheter comprises an inflatable balloon.

38. A device for performing lung volume reduction, the device comprising a catheter having a plurality of lumens and a container for material having a plurality of chambers, the chambers of the container being connectable to the lumens of the catheter.

39. The device of

claim 38

, wherein the catheter comprises two lumens and the container comprises two chambers.

40. The device of

claim 38

, further comprising an injector.

41. The device of

claim 38

, further comprising a bronchoscope having a working chamber comparable in size and shape to the size and shape of the catheter.

42. A catheter comprising an inflatable balloon and dual lumens.