Delivery devices with coolable energy emitting assemblies

• US 9,675,412 B2
• Filed: 10/31/2014
• Issued: 06/13/2017
• Est. Priority Date: 10/27/2009
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Holaira, Inc. (Nuvaira, Inc.)
• Inventors: Dimmer, Steven C., Mayse, Martin L.
• Primary Examiner(s): GIULIANI, THOMAS ANTHONY
• Application Number:
  US14/529,335
• Publication Number:
  US 20150051597A1
• Time in Patent Office: 956 Days
• Field of Search: 606 47, 606 41, 607 99
• CPC Class Codes: A61B 1/2676 Bronchoscopes
• CPC Class Codes: A61B 18/1485 having a short rigid shaft for accessing the inner body through natural openings
• 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 2017/320069 for ablating tissue
• CPC Class Codes: A61B 2018/00011 with fluids
• CPC Class Codes: A61B 2018/00017 with gas
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• 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 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0262 using a circulating cryogenic fluid
• CPC Class Codes: A61N 2007/0043 intra-cavitary

Abstract

Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input. The coolable ablation assembly delivers energy through an inner surface of an airway to damage a target region of tissue such that the damaged target region has a maximum cross-sectional width radially separated from the inner surface of the airway.

Claims

1. A treatment system for treating a bronchial tree of a subject, comprising:

a delivery device, including;

an energy emitter configured to deliver energy through an inner surface of an airway to damage a target region of tissue located radially outward from the inner surface such that the damaged target region has a maximum cross-sectional width at a first location which is radially separated from the inner surface of the airway;

a cooling section configured to contain a coolant and allow circulation of the coolant within for cooling tissue between the energy emitter and the target region; and

an elongate shaft through which the coolant is capable of flowing to the cooling section and the energy emitter, wherein the cooling section is coupled directly to a distal end of the shaft,

wherein the energy emitter is coupled to a channel, the channel being coupled directly to the distal end of the shaft at a proximal end of the channel, the channel being fluidly coupled directly to a distal end of the cooling section at a distal end of the channel, and through which the coolant is capable of flowing to cool a tissue-contacting portion of the energy emitter when the energy emitter outputs energy, and wherein an elongate portion of the energy emitter extends circumferentially about the cooling section.

2. The treatment system of claim 1, wherein the cooling section is configured to cool tissue both proximal and distal of the energy emitter.

3. The treatment system of claim 1, wherein the cooling section comprises an inflatable member.

4. The treatment system of claim 3, wherein the elongate shaft has a first lumen in fluid communication with the channel and a second lumen in fluid communication with a chamber of the inflatable member of the delivery device, wherein the channel is in communication with the chamber to allow the coolant to flow serially through the channel and the inflatable member.

5. The treatment system of claim 1, wherein the energy emitter is configured to permanently damage a nerve trunk at the target region to attenuate nervous system signals transmitted to a portion of the bronchial tree distally of the target region.

6. The treatment system of claim 1, wherein the energy emitter is configured to deliver the energy such that the first location is outside a smooth muscle region of the airway.

7. The treatment system of claim 1, wherein the energy emitter is configured to deliver the energy such that the first location is at least about 2 mm from the inner surface.

8. A treatment system for treating a subject, comprising:

an elongate shaft through which a coolant is capable of flowing, the elongate shaft having an inflow lumen and an outflow lumen; and

an intraluminal energy delivery device coupled to the elongate shaft, the delivery device including;

an energy emitter assembly including an electrode configured to output energy to ablate targeted tissue of a bronchial tree, and a conduit directly coupled to one of the inflow lumen and the outflow lumen of the shaft, and to which the electrode is coupled, wherein the coolant is capable of flowing directly from the elongate shaft through the conduit so as to cool a tissue-contacting portion of the energy emitter assembly; and

a deployable element movable from a collapsed state to an expanded state to bring the tissue-contacting portion of the energy emitter assembly into contact with an airway wall of the bronchial tree, wherein an elongate portion of the energy emitter assembly extends circumferentially about the deployable element in the expanded state, the deployable element comprising an inflatable balloon directly coupled to the other of the inflow lumen and the outflow lumen of the shaft and including a cooling section, the conduit being in fluid communication with the cooling section, the inflatable balloon being configured to contain coolant and allow circulation of the coolant within, and the cooling section being movable into contact with the airway wall so as to cool tissue adjacent to the tissue-contacting portion of the energy emitter assembly when energy is being outputted therefrom, wherein the intraluminal energy delivery device is configured to deliver energy to damage a target region of tissue separated from the tissue-contacting portion of the energy emitter assembly such that the damaged target region has a maximum cross-sectional width at a first depth separate from the tissue-contacting portion of the energy emitter assembly.

9. The treatment system of claim 8, wherein the delivery device is configured to deliver energy such that the maximum cross-sectional width of the target region is at a depth of at least 2 mm from the tissue-contacting portion of the energy emitter assembly.

10. The treatment system of claim 8, wherein the delivery device is further configured such that the first depth is deeper than a region of smooth muscle tissue in the tissue.

11. The treatment system of claim 8, wherein the delivery device is configured to output energy to damage tissue such that most of the damaged tissue is outside of a region of smooth muscle tissue of the airway wall.

12. The treatment system of claim 8, wherein the target region is located such that any permanent damage to smooth muscle tissue of an airway of the subject is less than that required to substantially alter the responsiveness or constriction of the airway.

13. The treatment system of claim 8, wherein at least a portion of the conduit is configured to wrap around a portion of a surface of the deployable element when in the expanded state.