Devices for maintaining patency of surgically created channels in tissue

• US 7,815,590 B2
• Filed: 07/19/2004
• Issued: 10/19/2010
• Est. Priority Date: 08/05/1999
• Status: Active Grant

• Current Assignee: Broncus Medical Incorporated
• Original Assignee: Broncus Technologies, Inc
• Inventors: Cooper, Joel D.
• Primary Examiner(s): Deak; Leslie R.
• Assistant Examiner(s): Wiest; Philip R
• Application Number:
  US10/894,876
• Publication Number:
  US 20050056292A1
• Time in Patent Office: 2,283 Days
• Field of Search: 604 401- 616, 604 8- 10, 604/20, 606 1- 3, 606/7, 606 10- 18, 606 41- 53, 606167-170, 606180-185, 623/9, 623/23.64, 623/23.65, 128/898
• US Class Current: 604/8
• CPC Class Codes: A61B 17/0644 penetrating the tissue, deformable to closed position
• CPC Class Codes: A61B 17/08 Wound clamps or clips, i.e. not or only partly penetrating the tissue suture bridges A61B17/0466; Devices for bringing together the edges of a wound
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 18/1445 at the distal end of a shaft, e.g. forceps or scissors at the end of a rigid rod
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00106 ultrasonic
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00575 for closure at remote site, e.g. closing atrial septum defects
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/1135 End-to-side connections, e.g. T- or Y-connections Y-shaped blood vessel prostheses A61F2002/065
• CPC Class Codes: A61B 2017/1139 Side-to-side connections, e.g. shunt or X-connections
• CPC Class Codes: A61B 2017/22067 Blocking; Occlusion A61B2017/22054 takes precedence
• CPC Class Codes: A61B 2017/22077 with a part piercing the tissue A61B2017/22044 takes precedence
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61B 2017/3484 Anchoring means, e.g. spreading-out umbrella-like structure
• CPC Class Codes: A61B 2018/00005 Cooling or heating of the probe or tissue immediately surrounding the probe
• 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 2018/00273 : Anchoring means for temporary attachment of a device to tissue
• CPC Class Codes: A61B 2018/00285 : Balloons
• CPC Class Codes: A61B 2018/00541 : Lung or bronchi
• CPC Class Codes: A61B 2018/1425 : Needle
• CPC Class Codes: A61B 2018/1437 : whereby the windings of the spiral touch each other such as to create a continuous surface
• CPC Class Codes: A61B 2018/1475 : Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2018/1497 : Electrodes covering only part of the probe circumference
• CPC Class Codes: A61B 2090/08021 : of the patient or his organs
• CPC Class Codes: A61B 2090/3782 : transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61F 2/02 : Prostheses implantable into the body closure means for urethra or rectum or for artificial body openings therefor A61F2/0004
• CPC Class Codes: A61F 2/20 : Epiglottis; Larynxes; Tracheae combined with larynxes or for use therewith tracheae, bronchi per se A61F2/04 ; tracheostomy tubes A61M16/0465
• CPC Class Codes: A61F 2/2412 : with soft flexible valve members, e.g. tissue valves shaped like natural valves check valves with flexible valve members in general F16K15/14
• CPC Class Codes: A61F 2/91 : made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61F 2002/043 : Bronchi
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• 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
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers

Abstract

Devices and methods for altering gaseous flow within a lung to improve the expiration cycle of an individual, particularly individuals having chronic obstructive pulmonary disease. The methods and devices create channels in lung tissue and maintain the patency of these surgically created channels in tissue. Maintaining the patency of the channels allows air to pass directly out of the lung tissue which facilitates the exchange of oxygen ultimately into the blood and/or decompresses hyper-inflated lungs.

Claims

1. A method for treating a lung, the method comprising:

selecting a treatment site in an airway of the lung;

creating a hole in an airway wall of the airway by inserting a piercing member into the airway wall;

removing the piercing member from the airway wall;

locating the hole with a balloon catheter by probing the airway wall with a guide body on the balloon catheter, where the guide body has a rounded front surface to locate the hole without dragging on the airway tissue;

inserting the guide body into the hole, where the guide body includes a resistance surface located proximal to the rounded front surface;

temporarily anchoring the balloon catheter in the hole using the resistance surface of the guide body; and

expanding the hole in the airway wall with the balloon catheter.

2. The method of claim 1, where selecting the treatment site comprises detecting the presence or absence of a blood vessel near the treatment site using ultrasound to avoid the blood vessel.

3. The method of claim 1, where the piercing member comprises an object selected from the group consisting of a needle, a cannula, a blade, a tube, and a rod.

4. The method of claim 1, where expanding the hole comprises partially expanding the hole with the balloon catheter, the method further comprising inserting an implant within the partially expanded hole.

5. The method of claim 4, further comprising fully expanding the hole by expanding the implant.

6. The method of claim 5, where expanding comprises partially expanding the hole by inserting the implant in the hole, the method further comprising fully expanding the hole by expanding the implant within the hole.

7. The method of claim 1 where selecting the treatment site comprises visually selecting the treatment site using a bronchoscope.

8. The method of claim 1, where selecting the treatment site comprises a step for determining the presence or absence of a blood vessel adjacent to the treatment site to avoid the blood vessel.

9. The method of claim 1, further comprising delivering a bio-active composition to the treatment site.

10. The method of claim 9, where the bio-active composition consists of a composition selected from the group consisting of antimetabolites, antithrobotics anticoagulants, antiplatelet agents, thorombolytics, antiproliferatives, antinflammatories, hyperplasia inhibiting agents, smooth muscle cell inhibitors, growth factors, growth factor inhibitors, cell adhesion inhibitors, cell adhesion promoters, neointimal tissue enhancing drugs, analgesics, anticonvulsives, anti-infectives, antineoplastics, histamine 2 antagonists, steroids, non-steroidal anti-inflammatories, hormones, immunomodulators, mast cell stabilizers, nucleoside analogues, respiratory agents, antihypertensives, antihistamines, ACE inhibitors, cell growth factors, nerve growth factors, anti-angiogenic agents, angiogenesis inhibitors, tissue irritants, cytotoxic agents, and metals, or a combination thereof.

11. The method of claim 9, where the bio-active composition comprises an agent selected from the group consisting of paclitaxel, rapamycin, sirolimus, everolimus, mitomycin, dactinomycin, and analogs or derivatives thereof.

12. The method of claim 9, further comprising deploying an implant into the hole.

13. The method of claim 12, where delivering the bio-active agent is carried by the implant.

14. The method of claim 1, further comprising delivering an implant to the hole using a delivery device, where the implant is visually distinct from the delivery device by color or reflection when viewed through a scope-type device, and using the visual distinction to aid in placement of the implant.

15. The method of claim 1, where the guide body comprises a shape selected from the shapes consisting of a tapered shape, rounded shape, partially-spherical shape, elliptical shape, prolate shape, cone-shape, and triangular shape.

16. The method of claim 1, where the guide body includes more than one resistance surface.

17. The method of claim 1, where the piercing member is advanceable through the guide body.

18. The method of claim 1, where the guide body includes a lumen terminating at the surface of the guide body.

19. The method of claim 1, where the front surface of the guide body comprise a distal spherical surface of the guide body and where the resistance surface comprises a proximal spherical surface of the guide body.

20. The method of claim 1, where the resistance surface is adjacent to an area of reduced diameter that allows the guide body to temporarily anchor the balloon catheter in the hole.

21. The method of claim 1, where the resistance surface comprises an area of increased surface roughness.

22. The method of claim 1, where the resistance surface increases resistance to removal of the guide body from the hole to temporarily anchor the balloon catheter in the hole.

23. A method for treating a lung, the method comprising:

selecting a treatment site in an airway of the lung;

detecting the presence or absence of a blood vessel near the treatment site to avoid the blood vessel;

creating a hole in an airway wall of the airway by inserting a piercing member into the airway wall;

locating the hole with a balloon catheter by probing the airway wall with a guide body on the balloon catheter, where the guide body has a rounded front surface to locate the hole without dragging on the airway tissue;

inserting the guide body into the hole, where the guide body includes a resistance surface located proximal to the rounded front surface;

temporarily anchoring the balloon catheter in the hole using the resistance surface of the guide body; and

expanding the hole in the airway wall with the balloon catheter.