Method of gastric artery embolization
A method of bariatric embolization includes deploying an intravascular pressure modulating device at a target location, operating the pressure modulating device to reduce pressure within the fundus, and infusing an embolizing agent into the fundus. Use of the pressure modulating device prevents delivery of the embolizing agent into proximal and distal non-target vessels. The method takes advantage of unique flow and pressure dynamics of the arterial vessels in the stomach.
1. A method of delivering a therapeutic agent to a fundus of a stomach, comprising:
a) advancing a pressure reducing infusion device (PRID) to a target location distal of an esophageal artery and proximal to an artery leading to a fundus of a stomach;
b) after the PRID is at the target location, infusing a contrast agent through the PRID;
c) monitoring the contrast agent under a visualization technique;
d) from the monitoring, determining an extent of delivery of the contrast agent to vessels outside the fundus;
e) reducing the intravascular pressure distal of the PRID;
f) repeating steps b)-e) until contrast agent is delivered to vessels substantially only within the fundus; and
g) infusing therapeutic agent at the target location to treat the fundus.
2. A method according to claim 1 , wherein the therapeutic agent is infused together with additional contrast agent.
3. A method according to claim 1 , wherein the therapeutic agent is an embolization agent.
4. A method according to claim 1 , wherein the PRID is a microvalve filter device.
5. A method according to claim 4 , wherein the PRID includes,
i) a flexible outer catheter having a proximal end and a distal end,
ii) a flexible inner catheter having a proximal end and a distal end with an orifice, the inner catheter extending through and longitudinally displaceable relative to the outer catheter, and
iii) a microvalve having a proximal end and distal end, the proximal end of the microvalve coupled to the distal end of the outer catheter, and the distal end of the microvalve coupled to the inner catheter adjacent the distal end of the inner catheter, such that longitudinal displacement of the inner catheter relative to the outer catheter moves the microvalve from a non-deployed configuration to a deployed configuration, the microvalve having a proximal portion and distal portion, and a maximum diameter of the microvalve being defined between the proximal and distal portions, the proximal portion exerting an increased radial force relative to the distal portion.
6. A method according to claim 5 , wherein the distal portion of the PRID comprises a porous polymeric material defining a pore size not exceeding 500 μm.
7. A method according to claim 1 , wherein the PRID is an inflatable balloon catheter device.
8. A method of performing bariatric embolization, comprising:
a) advancing a pressure reducing infusion device (PRID) to a target location distal of an esophageal artery and proximal to an artery leading to a fundus of a stomach;
b) after the PRID is at the target location, infusing a contrast agent through the PRID;
c) monitoring the contrast agent under a visualization technique;
d) from the monitoring, determining an extent of delivery of the contrast agent to vessels outside the fundus;
e) expanding the PRID at the target location to cause a pressure drop distally of the PRID;
f) repeating steps b)-e) until contrast agent is delivered to vessels substantially only within the fundus; and
g) once it is determined that the contrast agent is delivered to vessels substantially only within the fundus, infusing embolization agent at the target location to embolize the vessels substantially only within the fundus.
9. A method according to claim 8 , wherein the embolization agent is infused together with additional contrast agent.
10. A method according to claim 8 , wherein the PRID is a microvalve filter device.
11. A method according to claim 10 , wherein the PRID includes,
i) a flexible outer catheter having a proximal end and a distal end,
ii) a flexible inner catheter having a proximal end and a distal end with an orifice, the inner catheter extending through and longitudinally displaceable relative to the outer catheter, and
iii) a microvalve having a proximal end and distal end, the proximal end of the microvalve coupled to the distal end of the outer catheter, and the distal end of the microvalve coupled to the inner catheter adjacent the distal end of the inner catheter, such that longitudinal displacement of the inner catheter relative to the outer catheter moves the microvalve from a non-deployed configuration to a deployed configuration, the microvalve having a proximal portion and distal portion, and a maximum diameter of the microvalve being defined between the proximal and distal portions, the proximal portion exerting an increased radial force relative to the distal portion.
12. A method according to claim 11 , wherein the distal portion of the PRID comprises a porous polymeric material defining a pore size not exceeding 500 μm.
13. A method according to claim 8 , wherein the PRID is an inflatable balloon catheter device.