Systems, devices, and methods for treating a pulmonary disorder with an agent
A medication delivery device for treatment of a pulmonary disorder in a patient includes an elongate member, an expandable member is coupled to a distal end of the elongate member, and an agent delivery portion coupled to an external surface of the expandable member. The agent delivery portion includes an agent that disrupts nerve activity.
1. A method of delivering an agent to an airway of a patient to treat a pulmonary disorder in the patient, the method comprising:
positioning a distal end of an elongate member in a treatment location in the airway of the patient, the elongate member including a medication delivery device having an expandable member, a medication delivery portion extending at least partially circumferentially about the expandable member, and a marker element positioned on the expandable member immediately adjacent to the medication delivery portion on each a proximal and distal side thereof;
at least partially expanding the expandable member;
positioning the medication delivery portion between two adjacent cartilage rings in an airway wall of the airway, wherein the medication delivery portion protrudes outwardly from immediately adjacent surfaces of the expandable member on opposing sides of the medication delivery portion; and
positioning the medication delivery portion in contact with the airway wall of the airway while the medication delivery portion is positioned entirely between the adjacent cartilage rings so that an agent coated on the medication delivery portion transfers into the airway wall to affect nerves that run along the airway so as to relieve airway obstruction in at least one airway distal to the treatment location, wherein the agent comprises ribosome-inactivating proteins (RIPs).
2. The method of claim 1 , wherein the expandable member is an inflatable balloon, and the at least partially expanding the expandable member includes at least partially filling the balloon with a fluid.
3. The method of claim 2 , wherein the positioning the medication delivery portion in contact with the airway wall includes rotating the medication delivery portion between the adjacent cartilage rings.
4. The method of claim 3 , wherein the rotating the medication delivery portion includes partially deflating the balloon, then rotating the medication delivery device using the adjacent cartilage rings as a guide, and then inflating the balloon to reposition the medication delivery portion in contact with the airway wall.
5. The method of claim 2 , wherein positioning the medication delivery portion between two adjacent cartilage rings includes viewing the medication delivery portion through the balloon with an optical element of a bronchoscope positioned proximal of the balloon.
6. The method of claim 5 , wherein viewing the medication delivery portion through the balloon includes directly coupling the optical element of the bronchoscope to a proximal portion of the balloon.
7. The method of claim 2 , wherein positioning the medication delivery portion between two adjacent cartilage rings includes viewing the marker elements adjacent the medication delivery portion through the balloon with an optical element of a bronchoscope positioned proximal of the balloon.
8. The method of claim 7 , wherein viewing the marker elements through the balloon includes directly coupling the optical element of the bronchoscope to a proximal portion of the balloon.
9. The method of claim 1 , wherein positioning a distal end of the elongate member in the treatment location includes advancing the medication delivery device through a working channel of a flexible bronchoscope.
10. The method of claim 9 , wherein the working channel of the flexible bronchoscope includes an inside diameter in the range of 1.0 mm to 6.0 mm.
11. The method of claim 1 , wherein the expandable member is a stent, and the at least partially expanding the expandable member includes expanding the stent within the airway of the patient.
12. The method of claim 11 , further comprising removing the stent from the airway following treatment.
13. The method of claim 12 , wherein removing the stent from the airway following treatment includes removing the stent between about one minute and about two years after placing the stent in the airway.
14. The method of claim 13 , wherein removing the stent from the airway following treatment includes removing the stent between about four months and eight months after placing the stent in the airway.
15. The method of claim 14 , wherein removing the stent from the airway following treatment includes removing the stent about six months after placing the stent in the airway.
16. The method of claim 11 , wherein the medication delivery portion is movable relative to the expandable member, and positioning the medication delivery portion between two adjacent cartilage rings includes moving the medication delivery portion relative to the expandable member.
17. The method of claim 11 , further comprising pressing a plurality of needles positioned on the medication delivery portion into the airway wall.
18. The method of claim 1 , wherein the expandable member is a basket, and the at least partially expanding the expandable member includes expanding the basket in the airway.
19. The method of claim 1 , wherein the medication delivery portion comprises a ring that is tethered to the expandable member.
20. The method of claim 19 , wherein the medication delivery portion comprises a film material that is tethered to the expandable member via a plurality of sutures.
21. The method of claim 1 , wherein the medication delivery portion is molded from the expandable member such that the medication delivery portion is integral with a sidewall of the expandable member.
22. A method of delivering medication to an airway of a patient to treat a pulmonary disorder in the patient, comprising:
positioning a distal end of an elongate member in a treatment location in the airway of the patient, the elongate member including a medication delivery device having an expandable member, a medication delivery portion extending at least partially circumferentially about the expandable member, and a marker element positioned on the expandable member immediately adjacent to the medication delivery portion on each a proximal and distal side thereof, wherein the medication delivery portion comprises a ring that is tethered to the expandable member, the ring having a nerve-disrupting agent coated thereon;
at least partially expanding the expandable member;
positioning the medication delivery portion between two adjacent cartilage rings in an airway wall of the airway, wherein the medication delivery portion protrudes outwardly from immediately adjacent surfaces of the expandable member on opposing sides of the medication delivery portion; and
positioning the medication delivery portion in contact with the airway wall of the airway while the medication delivery portion is positioned entirely between the adjacent cartilage rings so that the nerve-disrupting agent coated on the medication delivery portion transfers into the airway wall to affect nerves that run along the airway so as to relieve airway obstruction in at least one airway distal to the treatment location.
23. The method of claim 22 , wherein the expandable member is an inflatable balloon, and the at least partially expanding the expandable member includes at least partially filling the balloon with a fluid.
24. The method of claim 23 , wherein the positioning the medication delivery portion in contact with the airway wall includes rotating the medication delivery portion between the adjacent cartilage rings.
25. The method of claim 24 , wherein the rotating the medication delivery portion includes partially deflating the balloon, then rotating the medication delivery device using the adjacent cartilage rings as a guide, and then inflating the balloon to reposition the medication delivery portion in contact with the airway wall.
26. The method of claim 23 , wherein positioning the medication delivery portion between two adjacent cartilage rings includes viewing the medication delivery portion through the balloon with an optical element of a bronchoscope positioned proximal of the balloon.
27. The method of claim 26 , wherein viewing the medication delivery portion through the balloon includes directly coupling the optical element of the bronchoscope to a proximal portion of the balloon.
28. The method of claim 23 , wherein positioning the medication delivery portion between two adjacent cartilage rings includes viewing the marker elements adjacent the medication delivery portion through the balloon with an optical element of a bronchoscope positioned proximal of the balloon.
29. The method of claim 28 , wherein viewing the marker elements through the balloon includes directly coupling the optical element of the bronchoscope to a proximal portion of the balloon.
30. The method of claim 22 , wherein positioning a distal end of the elongate member in the treatment location includes advancing the medication delivery device through a working channel of a flexible bronchoscope.
31. The method of claim 30 , wherein the working channel of the flexible bronchoscope includes an inside diameter in the range of 1.0 mm to 6.0 mm.
32. The method of claim 22 , wherein the expandable member is a stent, and the at least partially expanding the expandable member includes expanding the stent within the airway of the patient.
33. The method of claim 32 , further comprising removing the stent from the airway following treatment.
34. The method of claim 33 , wherein removing the stent from the airway following treatment includes removing the stent between about one minute and about two years after placing the stent in the airway.
35. The method of claim 34 , wherein removing the stent from the airway following treatment includes removing the stent between about four months and eight months after placing the stent in the airway.
36. The method of claim 35 , wherein removing the stent from the airway following treatment includes removing the stent about six months after placing the stent in the airway.
37. The method of claim 22 , wherein the ring is tethered to the expandable member via a plurality of sutures.