Methods and devices for the in situ dissolution of renal calculi
View Patent ↗Methods and devices for at least reducing the mass of, if not dissolving, renal calculi in situ are provided. In the subject methods, a renal calculus is contacted, e.g. flushed, with an acidic dissolution solution in situ, where the acidic dissolution solution is a solution of a strong, inorganic acid, e.g. hydrochloric acid. In many embodiments, the renal calculus is first enclosed in an isolated local environment of a device prior contact with the dissolution solution. Also provided are novel devices and kits for practicing the subject invention.
1. A method for at least reducing the mass of a calcium comprising renal calculus, said method comprising:
introducing an elongated device into an organ of a living organism, the elongated device having at least one lumen extending therethrough;
creating an isolated local environment at the end of the elongated device and around the renal calculus by rotating an expansion device that extends from the elongated device about the longitudinal axis of the elongated device to encapsulate the renal calculus therein, wherein rotating the expansion device creates the isolated local environment by expansion of the expansion device, the expansion device comprises a single curvilinear element that initially does not create a volume for the renal calculus and then expands, via rotation, along a circumference about a central longitudinal axis to produce said isolated local environment which is characterized by having a circular cross-sectional shape in any plane normal to said longitudinal axis to create a volume for enclosing the renal calculus;
enclosing the renal calculus in the expansion device in a manner such that the renal calculus is positioned within an isolated local environment in situ and in fluid communication with the at least one lumen; and
flushing said isolated local environment with a continuous flow of hydrochloric acid dissolution solution for a period of time of ranging from about 5 to 30 minutes by introducing and removing said solution from said isolated local environment at substantially the same rate and maintaining a substantially constant pressure in said isolated local environment, said hydrochloric acid dissolution solution being hypertonic with an osmolarity of greater than 300 mosmol and having a pH of 1 or less, and the total amount of fluid passing through the isolated local environment is from about 0.5 to 2.0 liters;
wherein the dissolution fluid is removed at substantially the same rate as it is introduced such that the volume of solution and the pressure in the isolated local environment remains substantially constant, thereby minimizing traumatic impact on vessel walls of the isolated local environment.