Functional assessment and treatment catheters and methods for their use in the lung
Lung conditions are diagnosed and optionally treated using a functional assessment catheter or a functional lung assessment and treatment catheter. A flow restrictive component is initially placed in a bronchus or lung passageway upstream from a diseased lung region. The isolated lung region is then functionally assessed through the catheter, while the flow restrictive component remains in place. If the patient is a good candidate for treatment by occlusive or restrictive treatment techniques, the flow resistive component may be left in place. If the patient is not suitable for such treatment, the flow resistive component may be removed.
1. A method for treating a target lung compartment, said method comprising:
inserting a catheter having a detachable flow restrictive component connected thereto into an airway feeding the target lung compartment, the catheter having an obturator disposed in a central passage of a shaft of the catheter;
deploying the detachable flow restrictive component while remaining connected to the catheter in the airway feeding the target lung compartment, whereby the target lung compartment is isolated;
determining whether collateral ventilation exists in the target lung compartment while the detachable flow restrictive component remains deployed in the airway and connected to the catheter, wherein determining whether collateral ventilation exists comprises measuring air flow or accumulation of air from the isolated lung compartment through the catheter and detachable flow restrictive component; and
after determining whether collateral ventilation exists, detaching the detachable flow restrictive component from the catheter to leave said component in place in the airway if no significant collateral ventilation present; or removing the catheter together with the detachable flow restrictive component if significant collateral ventilation is determined to be present, wherein the determining and detaching steps are carried out in a single protocol;
the method further comprising shifting the obturator between a distally advanced position where it engages and elongates the detachable flow restrictive component to cause the component to assume a contracted configuration, and a proximally retracted position where it allows the detachable flow restrictive component to shorten and return to an expanded configuration.
2. The method of claim 1 , wherein the detachable flow restrictive component allows a restrictive flow of air into and out of the isolated lung compartment after said component has been detached from the catheter.
3. The method of claim 1 , wherein the detachable flow restrictive component fully occludes the flow of air into and out of the isolated lung compartment after said component has been detached from the catheter.
4. The method of claim 1 , further comprising actuating a release mechanism for selectively detaching the detachable flow restrictive component from a shaft of the catheter.
5. The method of claim 4 , wherein the release mechanism comprises a sleeve attached at a proximal end of the detachable flow restrictive component and an attachment ball projecting from a proximal end of the sleeve.
6. The method of claim 5 , wherein both the attachment ball and the sleeve have an internal passage which permits air flow through the release mechanism so that gases may be exchanged from a shaft of the catheter through an open aperture at a distal end of the detachable flow restrictive component for performance of a diagnostic test for collateral ventilation.
7. The method of claim 1 , wherein, in the expanded configuration, detachable flow restrictive component seals an inner wall of a lung passage and, in the contracted configuration, permits positioning within the lung passage.
8. The method of claim 1 , wherein the detachable flow restrictive component comprises an occlusive stent configured to block flow into and out of the isolated lung compartment.
9. The method of claim 8 , wherein the occlusive stent includes a temporary flow path allowing for gas exchange with the isolated lung compartment, wherein the temporary flow path is sealed when the detachable flow restrictive component is detached from the catheter.
10. The method of claim 1 , wherein the detachable flow restrictive component comprises a restrictive stent configured to allow flow into and out of the isolated lung compartment.
11. A method for treating a target lung compartment, said method comprising:
inserting a catheter having a detachable flow restrictive component connected thereto into an airway feeding the target lung compartment;
deploying the detachable flow restrictive component while remaining connected to the catheter in the airway feeding the target lung compartment, whereby the target lung compartment is isolated;
determining whether collateral ventilation exists in the target lung compartment while the detachable flow restrictive component remains deployed in the airway and connected to the catheter, wherein determining whether collateral ventilation exists comprises measuring air flow or accumulation of air from the isolated lung compartment through the catheter and detachable flow restrictive component; and
after determining whether collateral ventilation exists, detaching the detachable flow restrictive component from the catheter to leave said component in place in the airway if no significant collateral ventilation present; or removing the catheter together with the detachable flow restrictive component if significant collateral ventilation is determined to be present, wherein the determining and detaching steps are carried out in a single protocol;
the method further comprising actuating a release mechanism for selectively detaching the detachable flow restrictive component from a shaft of the catheter, wherein the release mechanism comprises a sleeve attached at a proximal end of the detachable flow restrictive component and an attachment ball projecting from a proximal end of the sleeve.
12. The method of claim 11 , wherein the detachable flow restrictive component allows a restrictive flow of air into and out of the isolated lung compartment after said component has been detached from the catheter.
13. The method of claim 11 , wherein the detachable flow restrictive component fully occludes the flow of air into and out of the isolated lung compartment after said component has been detached from the catheter.
14. The method of claim 11 , further comprising an obturator disposed in a central passage of the shaft of the catheter.
15. The method of claim 14 , further comprising shifting the obturator between a distally advanced position where it engages and elongates the detachable flow restrictive component to cause the component to assume a contracted configuration, and a proximally retracted position where it allows the detachable flow restrictive component to shorten and return to an expanded configuration.
16. The method of claim 11 , wherein both the attachment ball and the sleeve have an internal passage which permits air flow through the release mechanism so that gases may be exchanged from a shaft of the catheter through an open aperture at a distal end of the detachable flow restrictive component for performance of a diagnostic test for collateral ventilation.
17. The method of claim 11 , wherein the detachable flow restrictive component has an expanded configuration for sealing an inner wall of a lung passage and a contracted configuration to permit positioning within the lung passage.
18. The method of claim 11 , wherein the detachable flow restrictive component comprises an occlusive stent configured to block flow into and out of the isolated lung compartment.
19. The method of claim 18 , wherein the occlusive stent includes a temporary flow path allowing for gas exchange with the isolated lung compartment, wherein the temporary flow path is sealed when the detachable flow restrictive component is detached from the catheter.
20. The method of claim 11 , wherein the detachable flow restrictive component comprises a restrictive stent configured to allow flow into and out of the isolated lung compartment.