Methods systems and kits for lung volume reduction
View Patent ↗Lung volume reduction is performed in a minimally invasive manner by isolating a lung tissue segment, optionally reducing gas flow obstructions within the segment, and aspirating the segment to cause the segment to at least partially collapse. Further optionally, external pressure may be applied on the segment to assist in complete collapse. Reduction of gas flow obstructions may be achieved in a variety of ways, including over inflation of the lung, introduction of mucolytic or dilation agents, application of vibrational energy, induction of absorption atelectasis, or the like. Optionally, diagnostic procedures on the isolated lung segment may be performed, typically using the same isolation/access catheter.
1. A method for lung volume reduction, said method comprising:
isolating a lung tissue segment;
aspirating the segment through a lung passage to cause the segment to at least partially collapse; and
implanting a barrier formed at least in part from a metal composition which expands in situ across the lung passage.
2. A method as in claim 1 , further comprising inflating the lung tissue segment to a pressure higher than its normal inflated pressure to reduce gas flow obstruction.
3. A method as in claim 2 , further comprising deflating adjacent lung regions while the lung tissue segment is inflated.
4. A method as in claim 2 , wherein inflating the lung tissue segment comprises positioning a catheter in an air passage leading into the segment, inflating a balloon on the catheter to seal the air passage, and introducing a gas through the catheter to inflate the segment.
5. A method as in claim 1 , further comprising introducing an agent to the lung tissue segment, wherein the agent clears or dilates air passages within the segment to reduce gas flow obstructions.
6. A method as in claim 5 , wherein the agent is selected from the group consisting of mucolytic agents, bronchodilators, surfactants, desiccants, solvents, necrosing agents, perfluorocarbons, and absorbents.
7. A method as in claim 5 , wherein introducing the agent comprises positioning a catheter in an air passage leading to the segment and delivering the agent through the catheter to the segment.
8. A method as in claim 1 , further comprising delivering mechanical energy to the lung segment to reduce gas flow obstructions.
9. A method as in claim 8 , wherein the mechanical energy is vibrational energy.
10. A method as in claim 8 , wherein the vibrational energy is delivered by inflating the segment with a non-compressible fluid and ultrasonically exciting the fluid to distribute ultrasonic energy throughout the segment.
11. A method as in claim 1 , wherein isolating the lung tissue segment comprises positioning a catheter in an air passage leading to the lung tissue segment and inflating a balloon on the catheter to occlude the air passage.
12. A method as in claim 11 , wherein aspirating comprises drawing gas and liquids present from the isolated lung segment through a lumen in the catheter while the balloon remains inflated.
13. A method as in claim 12 , wherein aspirating is performed at a negative pressure in the range from 2 mmHg to 50 mmHg.
14. A method as in claim 1 , wherein implanting the barrier further comprises introducing a collagen hydrogel which is not fully hydrated prior to deployment.
15. A method as in claim 1 , wherein implanting a barrier further comprises introducing an adhesive in the air passage.
16. A method as in claim 15 , wherein the adhesive includes a radiopaque tracer.
17. A method as in claim 1 , wherein aspirating the segment is performed after implanting the barrier.
18. A method as in claim 1 , wherein the barrier comprises a metal frame and an air impermeable cover.
19. A method as in claim 18 , wherein the metal frame is resilient and adapted to expand upon release from constraint.
20. A method as in claim 18 , wherein the metal frame is balloon expandable.
21. A method as in claim 1 , further comprising inducing absorption atelectasis within the lung segment prior to aspirating the segment.
22. A method as in claim 20 , wherein inducing absorption atelectasis comprises insufflating the lung segment with a high oxygen concentration gas.
23. A method as in claim 22 , wherein the high oxygen concentration is at least 50% by volume.
24. A method as in claim 22 , wherein the high oxygen concentration is at least 75% by volume.
25. A method as in claim 22 , wherein the oxygen is substantially pure.
26. A method as in claim 22 , wherein the lung is lavaged with a mixture of oxygen and a low molecular weight gas.