Minimally invasive lung volume reduction devices, methods, and systems

• US 8,668,707 B2
• Filed: 09/14/2012
• Issued: 03/11/2014
• Est. Priority Date: 03/13/2006
• Status: Expired due to Fees

• Current Assignee: EKOS Corporation (Boston Scientific Corporation)
• Original Assignee: PneumRx, Inc. (Boston Scientific Corporation)
• Inventors: Thompson, David, Aronson, Nathan, Wu, Patrick, Lehrberg, David, Mathis, Mark L., Boutillette, Michael, Vasquez, Jaime
• Primary Examiner(s): Anderson, Gregory
• Application Number:
  US13/618,986
• Publication Number:
  US 20130102887A1
• Time in Patent Office: 543 Days
• Field of Search: 606/151, 606/157, 623/23.65
• US Class Current: 606/157
• CPC Class Codes: A61B 1/044 for absorption imaging
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 17/12031 complete occlusion
• CPC Class Codes: A61B 17/12104 in an air passage
• CPC Class Codes: A61B 17/12131 characterised by the type of occluding device
• CPC Class Codes: A61B 17/1214 Coils or wires
• CPC Class Codes: A61B 17/12145 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 17/1215 comprising additional materials, e.g. thrombogenic, having filaments, having fibers, being coated
• CPC Class Codes: A61B 17/12172 having a pre-set deployed three-dimensional shape methods of manufacturing A61B2017/00526
• CPC Class Codes: A61B 2017/00477 Coupling A61B2017/0046 takes precedence
• CPC Class Codes: A61B 2017/00809 Lung operations
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• CPC Class Codes: A61B 2017/12054 Details concerning the detachment of the occluding device from the introduction device
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/485 involving fluorescence X-ray imaging
• CPC Class Codes: A61B 90/00 Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges protective face masks A41D13/11; surgeon's or patient's gowns or dresses A41D13/12; devices for carrying-off, for treatment of, or for carrying-over, body liquids A61M1/00
• CPC Class Codes: A61B 90/02 Devices for expanding tissue, e.g. skin tissue implements for holding wounds open, surgical tractors A61B17/02; implantable mammary prosthesis A61F2/12; dilators A61M29/00
• CPC Class Codes: A61F 2002/043 : Bronchi
• CPC Class Codes: A61F 2002/046 : Tracheae
• CPC Class Codes: A61M 16/04 : Tracheal tubes catheters in general A61M25/00
• CPC Class Codes: A61M 16/0406 : implanted flow modifiers
• CPC Class Codes: A61M 16/0833 : T- or Y-type connectors, e.g. Y-piece
• CPC Class Codes: A61M 16/208 : Non-controlled one-way valves, e.g. exhalation, check, pop-off non-rebreathing valves
• CPC Class Codes: A61M 2205/0266 : Shape memory materials
• CPC Class Codes: A61M 2205/32 : with radio-opaque indicia
• CPC Class Codes: A61M 37/0069 : Devices for implanting pellets, e.g. markers or solid medicaments for introducing of radioactive sources for interstitial radiation therapy, i.e. brachytherapy A61N5/1027

Abstract

A lung volume reduction system is disclosed comprising an implantable device adapted to be delivered to a lung airway of a patient in a delivery configuration and to change to a deployed configuration to bend the lung airway. The invention also discloses a method of bending a lung airway of a patient comprising inserting a device into the airway in a delivery configuration and bending the device into a deployed configuration, thereby bending the airway.

Claims

1. A system for treating a patient having a lung with an airway and a portion of the lung offset eccentrically from the airway, the system comprising:

a delivery catheter having a proximal end and a distal end with a delivery lumen therebetween, the distal end of the delivery catheter configured to be inserted distally into the airway;

an implant having a proximal end and a distal end and an elongate body therebetween, the implant configured to be delivered to the airway in a delivery configuration in the delivery lumen of the delivery catheter, the implant further configured to be deployed within the airway with the elongate body extending along a region of the airway from the delivery configuration to a deployed configuration, the elongate body of the deployed configuration of the implant configured to selectively compress the portion of the lung offset eccentrically from the airway and disposed between the proximal end and the distal end of the implant.

2. The system of claim 1 further comprising an imaging system for imaging the delivery catheter and the implant as the implant is being delivered and deployed to the airway of the lung.

3. The system of claim 2 wherein the imaging system comprises a bronchoscope having an elongate bronchoscope insertion tube, the insertion tube extending from a proximal working head to a distal end with a working channel therebetween, the working channel configured for receiving the delivery catheter, and the bronchoscope further having a scope oriented distally so as to acquire an image from within the airway distally of a distal end of the elongate insertion tube.

4. The system of claim 2 wherein the imaging system comprises an x-ray guidance system.

5. The system of claim 4 wherein the x-ray guidance system comprises one of a fluoroscopy system and a computed tomography system.

6. The system of claim 1 wherein the local compression of the portion of the lung between the proximal and distal end of the implant increases tension in another portion of the lung.

7. The system of claim 1 wherein the local compression of the portion of the lung between the proximal and distal end of the implant increases an elastic recoil of another portion of the lung.

8. The system of claim 1 wherein the local compression of the portion of the lung between the proximal and distal end of the implant increases a volume of another portion of the lung.

9. The system of claim 8 wherein the deployed configuration of the implant is similar to the seam of baseball.

10. The system of claim 1 wherein the local compression of the portion of the lung between the proximal and distal end of the implant decreases a volume of the compressed portion of the lung.

11. The system of claim 1 wherein the implant comprises a spring material configured to return the implant to the deployed configuration.

12. The system of claim 1 wherein the implant comprises a tubular member, the tubular member including one or more notches and a pull-wire within a lumen of the tubular member, the pull-wire configured to be actuated by a user to activate the implant from the delivery configuration to the deployed configuration.

13. The system of claim 1, wherein the implant is configured to be delivered and deployed to a single airway and wherein the implant is configured to selectively compress the portion of the lung offset eccentrically from the single airway.

14. A method for treating a patient having a lung with an airway and a lung portion offset eccentrically from the airway, the method comprising:

delivering an implant in a delivery configuration, within a delivery lumen of a delivery catheter, into the airway of the lung, the implant having a proximal end and a distal end and an elongate body therebetween;

deploying the implant from the delivery lumen of the delivery catheter to the portion of the lung, the implant being deployed from the delivery configuration to a deployed configuration within the lung; and

wherein the elongate body of the deployed implant extends along a region of the airway and wherein the elongate body of the deployed implant selectively compresses the portion of the lung offset eccentrically from the airway between the proximal end and the distal end of the implant.

15. The method of claim 14 further comprising visualizing the delivery and deployment of the implant to verify the positioning of the implant to determine whether the implant is in a desired position.

16. The method of claim 15, wherein the visualizing the delivery and deployment of the implant is performed by a bronchoscope having an elongate bronchoscope insertion tube, the insertion tube extending from a proximal working head to a distal end with a working channel therebetween, the working channel configured for receiving the delivery catheter, and the bronchoscope further having a scope oriented distally so as to acquire an image from within the airway distally of a distal end of the elongate insertion tube.

17. The method of claim 15, wherein the implant comprises a tubular member, the tubular member including one or more notches and a pull-wire within a lumen of the tubular member;

and further comprising;

actuating the pull-wire to activate the implant from the delivery configuration to the deployed configuration.

18. The method of claim 14, wherein the imaging system comprises an x-ray guidance system.

19. The method of claim 18, wherein the x-ray guidance system comprises one of a fluoroscopy system and a computed tomography system.

20. The method of claim 14, wherein the local compression of the portion of the lung between the proximal and distal end of the implant increases tension in a second portion of the lung.

21. The method of claim 20, wherein the compressed portion of the lung comprises a diseased portion of the lung and wherein the second portion of the lung comprises a healthy portion of the lung.

22. The method of claim 14, wherein the local compression of the portion of the lung between the proximal and distal end of the implant increases an elastic recoil of a second portion of the lung.

23. The method of claim 22, wherein the compressed portion of the lung comprises a healthy portion of the lung.

24. The method of claim 14, wherein the local compression of the portion of the lung between the proximal and distal end of the implant increases a volume of a second portion of the lung.

25. The method of claim 24, wherein the implant is deployed to a first lung and the second portion of the lung comprises a second lung.

26. The method of claim 14, wherein the implant comprises a spring material configured to naturally return the implant to the deployed configuration.

27. The method of claim 14, wherein the implant is delivered and deployed into a single airway of the lung and wherein the compressed portion of the lung is offset eccentrically from the single airway.

28. A method for treating a patient having a lung with an airway, the method comprising:

deploying an implant with an elongate body within the airway of the lung from a delivery configuration to a deployed configuration, the elongate body of the deployed implant extending along a region of the airway and configured to locally compress a portion of the lung offset eccentrically from the airway and disposed directly between a proximal end and a distal end of the implant; and

the deployed implant allowing air or fluid to pass through the airway therepast.

29. The method of claim 28, wherein the implant is deployed to a diseased portion of the lung.

30. The method of claim 29, wherein the local compression of the diseased portion of the lung moves a diaphragm up so as to enable a lung cavity to operate more effectively.

31. The method of claim 28, wherein the implant is deployed into a single airway of the lung and wherein the compressed portion of the lung is offset eccentrically from the single airway.