METHODS AND DEVICES FOR PASSIVE RESIDUAL LUNG VOLUME REDUCTION AND FUNCTIONAL LUNG VOLUME EXPANSION

• US 20130296696A1
• Filed: 07/09/2013
• Published: 11/07/2013
• Est. Priority Date: 01/20/2005
• Status: Active Grant

• Current Assignee: Pulmonx Corp.
• Original Assignee: Pulmonx Corp.
• Inventors: Aljuri, Nikolai, Perkins, Rodney C., Beyhan, Niyazi
• Granted Patent: US 9,533,116 B2
• Time in Patent Office: Days
• US Class Current: 600/427
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 2017/00022 Sensing or detecting at the treatment site
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/0813 Measurement of pulmonary parameters by tracers, e.g. radioactive tracers
• CPC Class Codes: A61B 5/085 Measuring impedance of respiratory organs or lung elasticity
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 6/03 Computed tomography [CT] echo-tomography A61B8/14
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61M 16/0434 Cuffs
• CPC Class Codes: A61M 16/208 Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 2016/0027 pressure meter
• CPC Class Codes: A61M 2016/003 with a flowmeter
• CPC Class Codes: A61M 2025/1052 for temporarily occluding a vessel for isolating a sector
• CPC Class Codes: A61M 2205/3303 Using a biosensor
• CPC Class Codes: A61M 2205/3334 Measuring or controlling the flow rate
• CPC Class Codes: A61M 2205/3344 Measuring or controlling pressure at the body treatment site
• CPC Class Codes: A61M 2210/1035 Bronchi
• CPC Class Codes: A61M 2230/46 : Resistance or compliance of the lungs
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00

Abstract

The volume of a hyperinflated lung compartment is reduced by sealing a distal end of the catheter in an airway feeding the lung compartment. Air passes out of the lung compartment through a passage in the catheter while the patient exhales. A one-way flow element associated with the catheter prevents air from re-entering the lung compartment as the patient inhales. Over time, the pressure of regions surrounding the lung compartment cause it to collapse as the volume of air diminishes. Residual volume reduction effectively results in functional lung volume expansion. Optionally, the lung compartment may be sealed in order to permanently prevent air from re-entering the lung compartment.

Claims

1. A method for reducing the residual volume of a hyperinflated lung compartment, said method comprising:

sealing a distal end of a catheter in an airway feeding the lung compartment;

allowing air to be expelled from the lung compartment through a passage in the catheter while the patient is exhaling; and

blocking air from entering the lung compartment through the catheter passage while the patient is inhaling.

2. A method as in claim 1, wherein the hyperinflated lung compartment is substantially free of collateral flow from adjacent lung compartments prior to sealing the catheter distal end.

3. A method as in claim 1, wherein the hyperinflated lung compartment has collateral flow channels with one or more adjacent lung compartments prior to sealing the catheter distal end.

4. A method as in claim 3, wherein the collateral flow channels at least partially collapse as the volume of the hyperinflated lung compartment is reduced.

5. A method as in claim 1, further comprising introducing an oxygen-rich gas into the lung compartment after the volume is reduced to induce or promote absorption atelectasis.

6. A method as in claim 1, wherein reducing the residual volume of a hyperinflated lung compartment causes functional lung volume expansion of the remaining lung compartments.

7. A catheter for isolating and deflating a hyperinflated lung compartment, said catheter comprising:

a catheter body having a distal end, a proximal end, and at least one lumen extending from the distal end to the proximal end, wherein at least a distal portion of the catheter body is adapted to be advanced through the airways of the lung;

an expandable occluding member disposed near a distal end of the catheter body, wherein said occluding member is adapted to be expanded in an airway which feeds the hyperinflated lung compartment such that access to the compartment is provided only through the lumen when the occluding member is expanded; and

a one-way flow element adapted to be disposed within or in-line with the lumen so that flow in a distal-to-proximal direction is allowed and flow in a proximal-to-distal direction is inhibited or prevented.

8. A catheter as in claim 7, wherein the catheter body has a length in the range from 20 cm to 200 cm and a diameter near the distal end in the range from 0.1 mm to 10 mm.

9. A catheter as in claim 7, wherein the expandable occluding member is an inflatable balloon, cuff, or braided balloon.

10. A catheter as in claim 7, wherein the expandable occluding member has a width in the range from 1 mm to 30 mm when fully expanded.

11. A catheter as in claim 7, wherein the one-way flow element is disposed in the lumen.

12. A catheter as in claim 11, wherein the one-way flow element is disposed in the lumen near the distal end of the catheter body.

13. A catheter as in claim 7, further comprising a hub disposed on a proximal end of the catheter body.

14. A catheter as in claim 13, wherein the one-way flow element is disposed in the hub.

15. A catheter as in claim 13, wherein the hub is removable and can be attached in-line with the lumen.

16. A method for determining whether collateral ventilation of a hyperinflated lung compartment is present, said method comprising:

sealing a distal end of a catheter in an airway feeding the lung compartment;

allowing air to be expelled from the lung compartment through a passage in the catheter while the patient is exhaling;

blocking air from entering the lung compartment through the catheter passage while the patient is inhaling;

comparing an image of the lung compartment with an earlier image of the lung compartment acquired before the sealing step; and

determining whether collateral ventilation is present in the lung compartment, based on comparing the image and the earlier image.

17. A method as in claim 16, wherein the image and the earlier image are CT scans.

18. A method as in claim 16, wherein comparing the image and the earlier image comprises comparing a size of the lung compartment on the images.

19. A method as in claim 18, wherein the determining step comprises assuming collateral ventilation is present if there is no significant difference in the size of the lung compartment between the two images.

20. A method as in claim 16, further comprising advancing the catheter through a bronchoscope to position the catheter distal end in the airway before sealing.

21. A method as in claim 20, further comprising:

detaching a hub from a proximal end of the catheter;

removing the bronchoscope from the airway by sliding it proximally over the catheter, thus leaving the catheter in the airway; and

acquiring the image of the lung compartment.

22. A method as in claim 21, wherein the catheter is left in the airway from between about five minutes and about twenty-four hours before acquiring the image.

23. A method as in claim 16, wherein it is determined that there is minimal or no significant collateral ventilation of the lung compartment, the method further comprising treating the airway to permanently limit airflow into the lung compartment.