APPARATUS AND METHODS FOR ACCESSING THE LYMPHATIC SYSTEM

• US 20140243790A1
• Filed: 01/21/2014
• Published: 08/28/2014
• Est. Priority Date: 05/03/2011
• Status: Active Grant

• Current Assignee: LXS, LLC
• Original Assignee: LXS, LLC
• Inventors: Callaghan, Matthew J., Leeflang, Stephen A., Eversull, Christian S.
• Granted Patent: US 10,111,997 B2
• Time in Patent Office: Days
• US Class Current: 604/509
• CPC Class Codes: A61M 1/3496 Plasmapheresis; Leucopheresis; Lymphopheresis A61M1/3472 takes precedence
• CPC Class Codes: A61M 1/3609 Physical characteristics of the blood, e.g. haematocrit, urea
• CPC Class Codes: A61M 1/3653 Interfaces between patient blood circulation and extra-corporal blood circuit
• CPC Class Codes: A61M 1/3656 Monitoring patency or flow at connection sites; Detecting disconnections
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation
• CPC Class Codes: A61M 1/367 Circuit parts not covered by the preceding subgroups of group A61M1/3621
• CPC Class Codes: A61M 2202/0405 Lymph
• CPC Class Codes: A61M 2205/3306 Optical measuring means
• CPC Class Codes: A61M 2205/3317 Electromagnetic, inductive or dielectric measuring means
• CPC Class Codes: A61M 2230/207 hematocrit
• CPC Class Codes: A61M 2230/208 pH-value

Abstract

Systems and methods are provided for performing a medical procedure within a patient'"'"'s body that involves a thoracic duct including an ostium communicating with the patient'"'"'s venous system. An apparatus is provided that includes a catheter including proximal and distal ends and a lumen extending therebetween. An expandable sealing member is carried beyond the distal end that is expandable from a delivery condition to a deployed condition in which the sealing member defines a concave contact surface shaped for engaging a vessel wall surrounding the outlet of the thoracic duct. The sealing member includes an aspiration port in the contact surface communicating with the catheter lumen for removing fluid from the thoracic duct.

Claims

1. An apparatus for accessing a thoracic duct of a patient'"'"'s body that includes an outlet adjacent a confluence of an internal jugular vein and subclavian vein of the patient'"'"'s body, comprising:

a tubular member comprising a proximal end, a distal end sized for introduction into a patient'"'"'s vasculature, and an aspiration lumen extending between the proximal and distal ends; and

an expandable sealing member expandable from a delivery condition sized for introduction into a patient'"'"'s vasculature to a deployed condition in which the sealing member defines a concave contact surface shaped for engaging a vessel wall surrounding the outlet of the thoracic duct, the sealing member comprising an aspiration port in the contact surface communicating with the aspiration lumen for removing fluid from the thoracic duct through the aspiration port into the aspiration lumen.

2. The apparatus of claim 1, wherein the sealing member comprises a membrane including the concave contact surface and the aspiration port and a frame supporting the membrane, the frame movable between a collapsed configuration and an expanded configuration for moving the membrane between the delivery and deployed conditions.

3. The apparatus of 2, wherein the frame comprises a first arm coupled to a first end of the membrane and a second arm coupled to a second end of the membrane, the arms defining a generally “

V”

shape in the expanded configuration.

4. The apparatus of claim 3, wherein the membrane comprises opposing longitudinal edges extending between the first and second ends and defining a width of the membrane between the longitudinal edges, the membrane having a curved cross-section across the width in the deployed condition.

5. The apparatus of claim 4, wherein the membrane has a substantially uniform width along its length between the first and second ends.

6. The apparatus of claim 4, wherein an intermediate region of the membrane between the first and second ends has a width that is greater than the width at the first and second ends.

7. The apparatus of claim 3, wherein each of the first and second arms including first fixed ends coupled to the distal end of the tubular member and second free ends, and wherein the ends of the membrane are attached to the arms between the first fixed ends and the second free ends.

8. The apparatus of claim 3, wherein the first arm has a generally “

L”

shape in the expanded configuration.

9. The apparatus of claim 8, wherein the second arm is substantially straight in the expanded configuration.

10. The apparatus of claim 3, wherein the first and second arms are spaced asymmetrically relative to the distal end of the tubular member in the expanded configuration.

11. The apparatus of claim 3, further comprising a lumen extension extending between the membrane and the distal end of the tubular member and providing a fluid path between the aspiration port and the aspiration lumen.

12. The apparatus of claim 11, further comprising an expandable member on the lumen extension adjacent an inner surface of the membrane, the expandable member configured to expand and apply a distal force against the inner surface to press the outer contact surface against the vessel wall surrounding the outlet.

13. An apparatus for accessing a thoracic duct of a patient'"'"'s body that includes an outlet adjacent a confluence of an internal jugular vein and subclavian vein of the patient'"'"'s body, comprising:

a tubular member comprising a proximal end, a distal end sized for introduction into a patient'"'"'s vasculature, and an aspiration lumen extending between the proximal and distal ends;

a frame comprising first and second arms including first fixed ends coupled to the distal end of the tubular member and second free ends, the free ends movable away from one another to an expanded configuration in which the arms define a generally “

V”

shape and movable towards one another to a collapsed configuration; and

a flexible sealing member comprising opposite ends attached to the arms such that the sealing member defines an outer contact surface, the sealing member movable between a delivery condition when the arms are in the collapsed configuration for introduction into a patient'"'"'s vasculature and a deployed condition when the arms are in the expandable configuration in which the outer contact surface is shaped for engaging a vessel wall surrounding the outlet of the thoracic duct, the sealing member comprising an aspiration port in the outer contact surface communicating with the aspiration lumen for removing fluid from the thoracic duct through the aspiration port into the aspiration lumen.

14. The apparatus of claim 13, further comprising a flexible lumen extension extending between the aspiration port and the aspiration lumen.

15. The apparatus of claim 14, further comprising an expandable member on the lumen extension adjacent an inner surface of the membrane, the expandable member configured to expand and apply a distal force against the inner surface to press the outer contact surface against the vessel wall surrounding the outlet.

22. The apparatus of claim 13, wherein the first arm has a generally “

L”

shape in the expanded configuration.

23. The apparatus of claim 22, wherein the second arm is substantially straight in the expanded configuration.

16-20. -20. (canceled)

24. A method for accessing a thoracic duct of a patient'"'"'s body, comprising:

introducing a distal end of a tubular member into a patient'"'"'s vasculature with a sealing member extending distally from the distal end in a delivery condition;

advancing the tubular member until the distal end is disposed adjacent a junction of the patient'"'"'s left internal jugular vein and the patient'"'"'s left subclavian vein;

deploying the sealing member adjacent the junction such that a frame of the sealing member expands to define a generally “

V”

shape and a resilient member of the sealing member is expanded by the frame to define a concave outer contact surface oriented away from the tubular member distal end;

manipulating the tubular member to press the contact surface against a vessel wall surrounding an outlet of the thoracic duct and substantially isolate the thoracic duct from the left internal jugular vein and left subclavian vein; and

removing fluid from the thoracic duct through an aspiration port in the contact surface communicating with an aspiration lumen within the tubular member.

25-33. -33. (canceled)

34. An apparatus for accessing a thoracic duct of a patient'"'"'s body that includes an outlet adjacent a confluence of an internal jugular vein and subclavian vein of the patient'"'"'s body, comprising:

a tubular member comprising a proximal end, a distal end sized for introduction into a patient'"'"'s vasculature, and an aspiration lumen extending between the proximal and distal ends;

a frame support extending distally from the distal end and biased to a generally “

J”

shape and elastically movable to a substantially straight configuration, the frame support terminating in a frame support tip;

a flexible sealing member carried on the frame support tip and expandable from a delivery condition to a deployed condition to define a concave contact surface, the sealing member comprising an aspiration port in the contact surface; and

a flexible tubular extension extending between the sealing member and the tubular member distal end, and including a fluid path communicating between the aspiration port in the contact surface and the aspiration lumen for removing fluid from the thoracic duct through the aspiration port into the aspiration lumen.

35-37. -37. (canceled)