Catheterizing body lumens
A method and related medical devices include delivering a catheter into a lumen of a subject. The catheter can include a generally tubular member having a lumen, a proximal region, and a distal region, and an inflatable member carried by a portion of the generally tubular member. The method can also include curving the portion of the generally tubular member that carries the inflatable member within the lumen of the subject, and disposing a material (e.g., an embolic material or a contrast agent) into the lumen of the generally tubular member.
1. A method for embolizing one or more branches of a portal vein for slowing or stopping blood flow to segments of a liver, the method comprising:
delivering a catheter into a branch of the portal vein of a subject, the catheter comprising:
a generally tubular member having a proximal region and a distal region, the generally tubular member defining a lumen, and
an inflatable member carried by a portion of the generally tubular member;
inflating the inflatable member to occlude the branch of the portal vein and to curve the portion of the generally tubular member that carries the inflatable member within the branch of the portal vein of the subject such that the portion of the generally tubular member that carries the inflatable member extends in a first direction generally along the branch of the portal vein of the subject;
disposing at least one first embolic material into the lumen of the generally tubular member and delivering the at least one first embolic material into the branch of the portal vein of the subject to slow or stop blood flow to a first segment of the liver and to redirect the blood flow to a second segment of the liver,
after delivering the at least one first embolic material, deflating the inflatable member,
after deflating the inflatable member, rotating the portion of the generally tubular member that carries the inflatable member within the branch of the portal vein of the subject,
after rotation, inflating the inflatable member to curve the portion of the generally tubular member that carries the inflatable member within the branch of the portal vein of the subject such that the portion of the generally tubular member that carries the inflatable member extends in a second direction generally along the branch of the portal vein of the subject, the second direction generally opposite the first direction, and then
disposing at least one second embolic material into the lumen of the generally tubular member and delivering the at least one second embolic material into the branch of the portal vein of the subject to slow or stop blood flow to the first segment of the liver and to redirect the blood flow to the second segment of the liver.
2. The method of claim 1 , wherein the at least one first embolic material is selected from the group consisting of embolic gels, embolic particles, embolic coils, and combinations thereof.
3. The method of claim 1 , wherein the at least one first embolic material comprises embolic particles.
4. The method of claim 3 , wherein the embolic particles have an arithmetic mean diameter of about 3,000 microns or less.
5. The method of claim 4 , wherein the embolic particles have the arithmetic mean diameter of about one micron or more.
6. The method of claim 1 , wherein the at least one first embolic material comprises an embolic gel.
7. The method of claim 1 , wherein the inflatable member has a wall comprising a first region having a first thickness and a second region having a second thickness that is different from the first thickness.
8. The method of claim 1 , wherein the inflatable member is eccentrically disposed on the portion of the generally tubular member that carries the inflatable member.
9. The method of claim 1 , wherein the inflatable member has a diameter of at least about five millimeters when inflated.
10. The method of claim 9 , wherein the inflatable member has the diameter of at most about 40 millimeters when inflated.
11. The method of claim 1 , wherein the method further comprises resecting a liver tissue of the subject.
12. The method of claim 1 , wherein the branch of the portal vein of the subject defines a longitudinal axis, and delivering the catheter into the branch of the portal vein of the subject comprises inserting the catheter into the branch of the portal vein of the subject along an axis that is perpendicular to the longitudinal axis.
13. The method of claim 12 , wherein the at least one first embolic material comprises embolic particles.
14. The method of claim 1 , wherein delivering the catheter into the branch of the portal vein of the subject comprises inserting the catheter through a first location in skin of the subject and inserting the catheter through a second location in the branch of the portal vein of the subject, and the second location is located at most about three millimeters from the first location.
15. The method of claim 1 , wherein curving the portion of the generally tubular member that carries the inflatable member comprises aligning the portion of the generally tubular member that carries the inflatable member with a longitudinal axis of the branch of the portal vein of the subject in the first direction; and
wherein rotating the portion of the generally tubular member that carries the inflatable member comprises aligning the portion of the generally tubular member that carries the inflatable member with the longitudinal axis of the branch of the portal vein of the subject in the second direction generally opposite the first direction.
16. A method for embolizing one or more branches of a portal vein for slowing or stopping blood flow to segments of a liver, the method comprising:
inserting a needle through a layer of skin and/or a tissue and into a branch of the portal vein of a subject such that the needle is generally perpendicular to a longitudinal axis of the branch of the portal vein;
delivering a catheter over the needle into the branch of the portal vein of the subject through the layer of skin and/or the tissue, the catheter comprising:
a generally tubular member having a proximal region and a distal region, the generally tubular member defining a lumen, and
an inflatable member carried by a portion of the generally tubular member;
inflating the inflatable member to occlude the branch of the portal vein and to curve the portion of the generally tubular member that carries the inflatable member within the branch of the portal vein of the subject such that the portion of the generally tubular member that carries the inflatable member extends in a first direction generally along the branch of the portal vein of the subject;
disposing at least one first embolic material into the lumen of the generally tubular member and delivering the at least one first embolic material into the branch of the portal vein of the subject to slow or stop the blood flow to the segments of the liver,
after delivering the at least one first embolic material, deflating the inflatable member,
after deflating the inflatable member, rotating the portion of the generally tubular member that carries the inflatable member within the branch of the portal vein of the subject,
after rotation, inflating the inflatable member to curve the portion of the generally tubular member that carries the inflatable member within the branch of the portal vein of the subject such that the portion of the generally tubular member that carries the inflatable member extends in a second direction generally along the branch of the portal vein of the subject, the second direction generally opposite the first direction, and then
disposing at least one second embolic material into the lumen of the generally tubular member and delivering the at least one second embolic material into the branch of the portal vein of the subject.
17. The method of claim 16 , wherein the at least one first embolic material is selected from the group consisting of embolic gels, embolic particles, embolic coils, and combinations thereof.
18. The method of claim 16 , wherein the at least one first embolic material comprises embolic particles.
19. The method of claim 18 , wherein the embolic particles have an arithmetic mean diameter of about 3,000 microns or less.
20. The method of claim 19 , wherein the embolic particles have the arithmetic mean diameter of about one micron or more.
21. The method of claim 16 , wherein the at least one first embolic material comprises an embolic gel.
22. The method of claim 16 , wherein the inflatable member has a wall comprising a first region having a first thickness and a second region having a second thickness that is different from the first thickness.
23. The method of claim 16 , wherein the inflatable member is eccentrically disposed on the portion of the generally tubular member that carries the inflatable member.
24. A method for treating a liver of a patient, the method comprising:
providing a catheter having a distal portion, the catheter having a balloon disposed at the distal portion;
advancing the catheter through a portal vein of the liver;
inflating the balloon;
wherein inflating the balloon curves the distal portion of the catheter and occludes the portal vein;
infusing an embolic material through the catheter into one or more branches of the portal vein to slow or stop blood flow to a first portion of the liver;
wherein infusing the embolic material through the catheter into the one or more branches of the portal vein to slow or stop the blood flow to the first portion of the liver includes redirecting the blood flow to a second portion of the liver; and
resecting the first portion of the liver.
25. The method of claim 24 , wherein redirecting the blood flow to the second portion of the liver initiates hypertrophy of the second portion of the liver.
26. The method of claim 24 , wherein redirecting the blood flow to the second portion of the liver initiates exaggerated growth of the second portion of the liver.