SYSTEMS AND METHODS FOR SELECTIVELY INDUCING VASOCONSTRICTION TO INCREASE THERAPEUTIC UPTAKE IN TISSUE
A microcatheter is provided with a vascular spasm-inducing probe at its distal end. The spasm-inducing probe can include an electrical current, radiofrequency energy, ultrasound, chemical, or thermal modulator. When the spasm-inducing probe is activated in a vessel, the vessel narrows about the element. This permits a therapeutic agent to be delivered through the infusion lumen and out of the orifice under high pressure, while the narrowing of the vessel operates as a pseudo-valve and prevents reflux of the therapeutic agent past the narrowing of the vessel.
1 . A therapeutic system for treatment in a vessel of a patient, comprising:
a) a catheter having a proximal end and a distal end with a distal tip, a first lumen defined from the proximal end and extending to the distal tip and opening at a distal orifice passing through the distal tip; and
b) a spasm-inducing system including an activatable probe at the distal end of the catheter, which when activated is adapted to induce a narrowing spasm in the vessel.
2 . The therapeutic system of claim 1 , wherein the distal tip protrudes beyond the probe.
3 . The therapeutic system of claim 1 , further comprising at least one marker provided in association with the emitter to identify the location of the probe under imaging.
4 . The therapeutic system of claim 3 , wherein the at least one marker is radioopaque.
5 . The therapeutic system of claim 1 , further comprising a hub at the proximal end of the catheter.
6 . The therapeutic system of claim 1 , wherein the spasm-inducing system is adapted to emit radiofrequency (RF) energy at the probe.
7 . The therapeutic system of claim 1 , wherein the probe of the spasm-inducing system is adapted to emit ultrasound.
8 . The therapeutic system of claim 1 , wherein the probe of the spasm-inducing system is adapted to emit chemicals.
9 . The therapeutic system of claim 1 , wherein the probe of the spasm-inducing system is a cryogenic element.
10 . The therapeutic system of claim 1 , wherein the probe of the spasm-inducing system is a vibratory element.
11 . The therapeutic system of claim 1 , wherein the probe of the spasm-inducing system is an infrared light emitting element.
12 . The therapeutic system of claim 1 , wherein the probe of the spasm-inducing system includes bristles adapted to irritate the vessel.
13 . The therapeutic system of claim 1 , wherein the catheter defines a second lumen opening at or adjacent the probe.
14 . The therapeutic system of claim 13 , wherein the second lumen opens to disperse an infusate radially relative to the catheter.
15 . A therapeutic system for treatment in a vessel of a patient, comprising:
a) a catheter having a proximal end and a distal end with a distal tip, a first lumen defined from the proximal end and extending to the distal tip and opening at a distal orifice passing through the distal tip; and
b) a probe at the distal end of the catheter; and
c) an actuator for activating the probe, whereupon activation of the probe, the probe is adapted to cause a physical change in the vessel.
16 . The therapeutic system of claim 15 , wherein activation of the probe is adapted to cause a narrowing spasm in the vessel.
17 . The therapeutic system of claim 15 , wherein activation of the probe is adapted to cause ablation of the vessel.
18 . The therapeutic system of claim 15 , wherein the probe is adapted to emit radiofrequency (RF) energy.
19 . The therapeutic system of claim 15 , wherein the probe is adapted to emit ultrasound.
20 . The therapeutic system of claim 15 , wherein the probe is adapted to emit chemicals.
21 . The therapeutic system of claim 15 , wherein the probe is a cryogenic element.
22 . The therapeutic system of claim 15 , wherein the probe is adapted to emit microwave energy.
23 . The therapeutic system of claim 15 , wherein the probe is adapted to emit thermal energy.
24 . The therapeutic system of claim 15 , wherein the probe of the spasm-inducing system is a vibratory element.
25 . The therapeutic system of claim 15 , wherein the probe of the spasm-inducing system is an infrared light emitting element.
26 . The therapeutic system of claim 15 , wherein the probe of the spasm-inducing system includes bristles adapted to irritate the vessel.
27 . The therapeutic system of claim 15 , wherein the catheter is provided with a second lumen opening at or adjacent the probe.
28 . The therapeutic system of claim 27 , wherein the second lumen opens to disperse an infusate radially relative to the catheter.
29 . A method of therapeutic treatment comprising:
a) providing a catheter having a proximal end and a distal end with a distal tip, and a lumen extending from the proximal end to the distal end and opening at a distal orifice passing through the distal tip, the catheter provided with an actuatable probe at the distal end of the catheter;
b) advancing the distal end of the catheter into a vessel;
c) actuating the probe to cause the vessel to narrow about the probe; and
d) infusing a therapeutic agent through the lumen and out of the distal orifice into the vessel while the vessel is narrowed about the probe to a location distal of the narrowing in the vessel.
30 . The method of claim 29 , wherein the therapeutic agent is infused from the vessel toward a tumor.
31 . The method of claim 29 , wherein between the distal end of the catheter and the tumor, the vessel branches to healthy vasculature and tumor vasculature, and after activating the probe and before infusing the therapeutic agent, causing the healthy vasculature to narrow more than the tumor vasculature.
32 . The method of claim 29 , wherein the infusing comprising multiple infusions spaced apart in time.
33 . The method of claim 29 , wherein the therapeutic treatment is to treat internal bleeding.
34 . The method of claim 33 , wherein the therapeutic agent is one of a gelfoam, a glue embolic, a liquid embolic, an embolic coil, and embolic beads.
35 . The method of claim 29 , wherein the narrowed vessel constricts into contact with the probe.
36 . The method of claim 29 , further comprising:
after infusing the therapeutic agent, dilating the narrowed vessel.
37 . The method of claim 36 , wherein the dilating includes introducing a vasodilator to the narrowed vessel.
38 . A method of therapeutic treatment, comprising:
a) providing a catheter having a proximal end and a distal end with a distal tip, and a lumen extending from the proximal end to the distal end and opening at a distal orifice passing through the distal tip, the catheter provided with an actuatable probe at the distal end of the catheter;
b) advancing the distal end of the catheter into an artery feeding a tumor; and
c) actuating the probe to cause ablation of the artery feeding the tumor.