Devices and systems for lung treatment
Devices, systems, and methods for measuring the diameter of an airway in a human or animal subject are disclosed. The device comprises a flexible catheter body having a proximal end and a distal end. Flexible sizing elements are disposed along and extend approximately orthogonally from the catheter body. The sizing elements have different heights from one another and are configured to fit through the working channel of a bronchoscope. Devices, systems, and methods for redirecting airflow through a lung airway are also disclosed. The method comprises introducing into the airway a catheter comprising a distal end, a proximal end and an elongated portion therebetween, wherein the distal end comprises an airway closing mechanism, and wherein the proximal end comprises an actuator to actuate the airway closing mechanism; and actuating the airway closing mechanism to at least partially close the airway.
1 . A method for selecting a size of a pulmonary implant to be implanted in an airway in a human or animal subject, the method comprising:
inserting a bronchoscope into the airway;
advancing an elongate airway measuring device through a channel in the bronchoscope to expose within the airway a distal end of the measuring device and first and second fixed length flexible sizing elements disposed near the distal end and extending approximately orthogonally relative to a longitudinal axis of the measuring device, wherein the sizing elements have different heights from one another; wherein the first fixed length flexible sizing element comprises two fixed length flexible tabs disposed approximately opposite one another across the longitudinal axis and extending approximately orthogonally relative to the longitudinal axis, and wherein the second fixed length flexible sizing element comprises two fixed length flexible tabs disposed approximately opposite one another across the longitudinal axis and extending approximately orthogonally relative to the longitudinal axis; wherein each orthogonally extending fixed length flexible tab has a single attachment to an elongate body of the measuring device; and
confirming that the size of pulmonary implant is correct for the airway, wherein confirming comprises observing, using the bronchoscope, the first fixed length flexible sizing element in relation to a wall forming the airway and the second fixed length flexible sizing element in relation to the wall forming the airway.
2 . The method of claim 1 , wherein confirming that the size of pulmonary implant is correct for the airway comprises observing that the first fixed length flexible sizing element is not touching the wall forming the airway and the second fixed length flexible element is touching the wall forming the airway.
3 . The method of claim 1 , further comprising: observing that both the distal end and the sizing elements of the measuring device are located within the airway; and confirming, based on the observation of the distal end and sizing elements, that the airway is long enough for the pulmonary implant to be implanted therein.
4 . The method of claim 1 , wherein the pulmonary implant comprises an endobronchial valve.
5 . The method of claim 1 , wherein the pulmonary implant comprises a plug-forming substance or sealant.
6 . The method of claim 1 , wherein the pulmonary implant is an expandable pulmonary implant, and wherein the height of the first fixed length flexible sizing element corresponds to a maximum diameter of the pulmonary implant in a deployed configuration, and the height of the second fixed length flexible sizing element corresponds to a minimum diameter of the pulmonary implant in the deployed configuration.
7 . The method of claim 1 , wherein the first and second fixed length flexible sizing elements are disposed proximally along the measuring device relative to the distal end, and wherein a distance between the distal end and the first and second fixed length flexible sizing elements corresponds to a length of the pulmonary implant.
8 . The method of claim 1 , wherein the measuring device further comprises a depth marker configured to indicate the pulmonary implant is too long for the airway if the depth marker is proximal to a proximal end of the airway and configured to indicate the pulmonary implant fits the airway if the depth marker is located within the airway when the distal end of the measuring device contacts a branch of the airway.
9 . The method of claim 8 , wherein the depth marker is located proximal to the first and second fixed length flexible sizing elements.
10 . The method of claim 1 , further comprising collapsing the first and second fixed length flexible sizing elements along a side of said measuring device during the advancement through the channel of the bronchoscope.
11 . The method of claim 10 , further comprising expanding the first and second fixed length flexible sizing elements once they are exposed within the airway.
12 . A method of redirecting airflow through a lung airway, the method comprising:
advancing an elongate airway measuring device through a channel in a bronchoscope to expose within the airway a distal end of the measuring device and first and second fixed length flexible sizing elements disposed near the distal end and extending approximately orthogonally relative to a longitudinal axis of the measuring device, wherein the sizing elements have different heights from one another; wherein the first fixed length flexible sizing element comprises two fixed length flexible tabs disposed approximately opposite one another across the longitudinal axis and extending approximately orthogonally relative to the longitudinal axis, and wherein the second fixed length flexible sizing element comprises two fixed length flexible tabs disposed approximately opposite one another across the longitudinal axis and extending approximately orthogonally relative to the longitudinal axis; wherein each orthogonally extending fixed length flexible tab has a single attachment to an elongate body of the measuring device;
confirming a size of an airway closing mechanism is correct for the lung airway, wherein confirming comprises observing, using the bronchoscope, the first fixed length flexible sizing element in relation to a wall forming the lung airway and the second fixed length flexible sizing element in relation to the wall forming the lung airway;
introducing into the airway a catheter having a proximal end, a distal end, and the airway closing mechanism at or near the distal end; and
using an actuator at or near the proximal end of the catheter to activate the airway closing mechanism to at least partially close the airway.
13 . The method of claim 12 , further comprising: assessing multiple portions of a lung to determine whether one or more of the portions have collateral ventilation channels between them; and choosing the lung airway from among multiple airways based on a determination that a portion of the lung being fed by the lung airway does not have collateral ventilation.
14 . The method of claim 12 , wherein the airway closing mechanism comprises an endobronchial valve.
15 . The method of claim 12 , wherein the airway closing mechanism comprises a plug-forming substance or sealant.
16 . The method of claim 12 , wherein the airway closing mechanism is an expandable pulmonary implant, and wherein the height of the first fixed length flexible sizing element corresponds to a maximum diameter of the pulmonary implant in a deployed configuration, and the height of the second fixed length flexible sizing element corresponds to a minimum diameter of the pulmonary implant in the deployed configuration.
17 . The method of claim 12 , wherein the first and second fixed length flexible sizing elements are disposed proximally along the measuring device relative to the distal end, and wherein a distance between the distal end and the first and second fixed length flexible sizing elements corresponds to a length of the airway closing mechanism.
18 . The method of claim 12 , wherein the measuring device further comprises a depth marker configured to indicate the airway closing mechanism is too long for the airway if the depth marker is proximal to a proximal end of the airway and configured to indicate the airway closing mechanism fits the airway if the depth marker is located within the airway when the distal end of the measuring device contacts a branch of the airway.
19 . The method of claim 18 , wherein the depth marker is located proximal to the first and second fixed length flexible sizing elements.
20 . The method of claim 12 , further comprising collapsing the first and second fixed length flexible sizing elements along a side of said measuring device during the advancement through the channel of the bronchoscope, and expanding the first and second fixed length flexible sizing elements once they are exposed within the lung airway.