Systems, assemblies, and methods for treating a bronchial tree

• US 8,226,638 B2
• Filed: 09/26/2011
• Issued: 07/24/2012
• Est. Priority Date: 05/09/2008
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Innovative Pulmonary Solutions, Incorporated
• Inventors: Mayse, Martin L., Dimmer, Steven C.
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US13/245,522
• Publication Number:
  US 20120016358A1
• Time in Patent Office: 302 Days
• Field of Search: 606/28, 606/32, 607/42, 607/98, 607/99, 607/115
• US Class Current: 606/32
• 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 treating a subject, the method comprising:

damaging nerve tissue of a nerve trunk extending along an airway of a bronchial tree to attenuate nervous system signals transmitted to a portion of the bronchial tree, wherein damaging the nerve tissue comprises increasing a temperature of the nerve tissue to a first temperature while a portion of a wall of the airway is at a second temperature that is less than the first temperature, the portion of the wall is positioned radially inward from the nerve tissue at the first temperature.

2. The method of claim 1, wherein the nerve tissue is damaged while maintaining a functionality of one or more arteries extending along the airway so as to preserve a respiratory function of the portion of the bronchial tree after the nerve tissue is damaged.

3. The method of claim 1, wherein damaging the nerve tissue comprises irreversibly damaging the nerve tissue to at least partially block a transmission of nervous system signals and to cause a permanent decrease in smooth muscle tone of the portion of the bronchial tree.

4. The method of claim 1, wherein the nerve tissue is damaged without damaging to any significant extent smooth muscle in a wall of the airway.

5. The method of claim 1, wherein damaging the nerve tissue comprises:

delivering energy to the nerve tissue; and

destroying a section of the nerve tissue using the delivered energy such that the destroyed section impedes transmission of nervous system signals traveling along the nerve tissue.

6. The method of claim 1, wherein the nerve tissue is positioned along a main bronchus of the bronchial tree so as to attenuate the nervous system signals to a substantial portion of the bronchial tree distal to the main bronchus.

7. The method of claim 1, wherein the nerve tissue is generally positioned between a trachea and a lung of the subject.

8. The method of claim 1, wherein damaging the nerve tissue includes ablating nerve tissue along a right main bronchus and ablating nerve tissue along a left main bronchus.

9. The method of claim 1, further comprising:

moving a distal tip of an elongate assembly through at least a portion of a wall of the airway such that an activatable element of the elongate assembly is positioned to damage the nerve tissue when the activatable element is activated.

10. The method of claim 9, wherein the portion of the airway wall is radially between the activatable element and the nerve tissue.

11. The method of claim 1, further comprising cooling the airway wall while the nerve tissue is damaged.

12. The method of claim 11, wherein cooling comprises circulating a cooling fluid through a cooling element positioned in the airway.

13. The method of claim 12, wherein the nerve tissue is damaged using an energy delivery element positioned on or adjacent to the cooling element.