Systems and methods for treatment of fluid overload
Various systems and methods are provided for reducing pressure at an outflow of a duct, such as the thoracic duct or the lymphatic duct, for example, the right lymphatic duct. A catheter system can be configured to be at least partially implanted within a vein of a patient in the vicinity of an outflow port of a duct of the lymphatic system. The catheter system includes first and second selectively deployable restriction members each configured to be activated to at least partially occlude the vein within which the catheter is implanted and to thus restrict fluid within a portion of the vein. The catheter system includes an impeller configured to be driven by a motor to induce a low pressure zone between the restriction members by causing blood to be pumped through the catheter when the restriction members occlude the vein.
1. A method for treating edema, the method comprising:
delivering an inflow tube into a thoracic duct of a patient with edema such that a first portion of the inflow tube is positioned inside the thoracic duct and a second portion of the inflow tube is positioned in a blood vessel adjacent to the thoracic duct;
positioning an outflow tube in a jugular or subclavian vein of the patient, wherein the inflow tube and the outflow tube are in fluidic communication with a pump to provide a bypass from the thoracic duct to the jugular or subclavian vein; and
operating the pump to constantly drain fluid from the thoracic duct to the jugular or subclavian vein, thereby reducing pressure in a region of the thoracic duct and facilitating lymphatic return from the lymphatic duct to the jugular or subclavian vein.
2. The method of claim 1 , further comprising deploying a restrictor at the thoracic duct to substantially occlude the thoracic duct but for the inflow tube.
3. The method of claim 2 , wherein the restrictor comprises an inflatable balloon.
4. The method of claim 1 , further comprising automatically activating the pump to begin the constant draining in response to a measured increase in pressure.
5. The method of claim 1 , wherein the pump is implanted inside the patient.
6. The method of claim 1 , further comprising selecting the patient when the patient has acute decompensated heart failure (ADHF) and performing the method to treat acute pulmonary edema associated with the ADHF.
7. The method of claim 1 , wherein the pump is activated in responses to a measured increase in pressure at an area of the thoracic duct.
8. The method of claim 1 , wherein the outflow tube is positioned in the jugular or subclavian vein at a location upstream of the thoracic duct.
9. The method of claim 1 , wherein the pump is operated between 2 hours to 2 days to continuously pump the fluid from the thoracic duct and into the blood vessel.
10. The method of claim 1 , wherein operating the pump creates a pressure at the outlet of the thoracic duct that is between 2 and 6 mmHg.
11. The method of claim 1 , further comprising relieving lymph fluid during high venous wall tension.
12. The method of claim 11 , further comprising relieving lymph fluid during thoracic duct ostial valve closure.
13. The method of claim 1 , further comprising anchoring a portion of the inflow tube in the thoracic duct.
14. The method of claim 13 , further comprising expanding the portion of the inflow tube within the thoracic duct.
15. The method of claim 13 , further comprising funneling lymph fluid into the inflow tube.
16. The method of claim 13 , wherein the portion of the inflow tube is self-expanding.
17. The method of claim 13 , wherein the anchoring is performed using a stent-like device attached to the inflow tube that anchors the inflow tube within the thoracic duct.
18. The method of claim 17 , wherein the stent-like devices is expanded to anchor the inflow tube in the thoracic duct by pulling back a sheath, causing the stent to expand.
19. The method of claim 17 , wherein the stent-like device alleviates ostial valve closure.