Device and methods for transvascular tumor embolization
A method of embolizing a tumor includes advancing a distal end of a device having a catheter body and an occlusion structure to a target tumor site within a blood vessel of a body. The occlusion structure is activated within the blood vessel, and a real time pressure measurement in the vascular space distal to the activated occlusion structure is monitored. The method further includes waiting for a pressure drop in the vascular space distal to the activated occlusion structure and for the pressure drop to cause a blood flow reversal in branch vessels antegrade to the occlusion. An embolic substance is injected from the distal end of the delivery device to permit the reversed blood flow to carry the embolic substance into the vasculature of the target tumor and the device is withdrawn from the body. Other catheter assemblies and methods of use are also disclosed.
1. A method of embolizing a tumor, the method comprising:
advancing a distal end of a device including a catheter body and an occlusion structure to a target tumor site within a blood vessel of a body, wherein the device comprises a catheter extension that extends axially beyond a distal end of the catheter body, wherein the catheter extension comprises an outer diameter less than an outer diameter of the catheter body, wherein a nose piece is adapted to the catheter extension, and wherein the occlusion structure comprises an inflatable balloon disposed on the catheter extension in a pocket between the distal end of the catheter body and a proximal end of the nose piece such that the inflatable balloon has an outer diameter approximately equal to the outer diameter of the catheter body when the inflatable balloon in disposed in the pocket in a deflated state;
activating the occlusion structure within the blood vessel;
monitoring a real time pressure measurement in the vascular space distal to the activated occlusion structure;
waiting for a pressure drop in a vascular space distal to the activated occlusion structure and for the pressure drop to cause a blood flow reversal in branch vessels antegrade to the occlusion;
injecting an embolic substance from the distal end of the delivery device to permit the reversed blood flow to carry the embolic substance into the vasculature of the target tumor; and
withdrawing the device from the body.
2. The method of claim 1 , further comprising a step of signaling a procedural endpoint based on the monitoring of the pressure measurement.
3. The method of claim 2 , wherein the signaling of the procedural endpoint occurs when a predetermined pressure is reached in the vascular space distal to the activated occlusion structure.
4. The method of claim 3 , wherein the predetermined pressure is a predetermined percentage of an un-occluded systolic pressure.
5. The method of claim 4 , wherein the predetermined percentage is in the range of about 50% to 100%.
6. The method of claim 1 , wherein the occlusion structure comprises an inflatable balloon.
7. The method of claim 6 wherein the balloon is provided with a plurality of channels that extend from a proximal end to a distal end of the balloon, the channels configured to provide fluid communication between a proximal surface of the balloon and a distal surface of the balloon.
8. The method of claim 7 , wherein the channels are offset from a central longitudinal axis of the balloon and are equally spaced about the circumference of the catheter to provide symmetrical blood bypass through the balloon.
9. The method of claim 7 , wherein the balloon comprises valves configured to affect fluid flow through the channels.