System and method for selective pressure-controlled therapeutic delivery
A treatment system includes a guide sheath, and a catheter provided with a pressure-controlled element. The pressure-control element preferably includes an expanded configuration adapted to extend across a small feeder vessel branching from the splenic vein. The pressure-control element is positioned with the feeder vessel, and a therapeutic agent is delivered under pressure directly into the feeder vessel, where it is forced to penetrate deep into tissue. Pressure responsive elements for monitoring intravascular pressure are also provided to time delivery of the therapeutic agent for maximum uptake by the target organ. Methods for treating tissues and organs via vascular pathways are provided.
1. A method for delivering a therapeutic agent for treatment of a solid tumor in a target organ, the target organ in fluid communication with a vein in a patient, the method comprising:
a) introducing a treatment system into the vein of the patient, the treatment system comprising a microvalve comprising a filamentary braid coated with a polymeric filter comprising pores, the microvalve movable between a collapsed configuration for delivery through the vein, and an expanded configuration adapted to extend across the vein;
b) advancing the microvalve into the vein in the collapsed configuration, the vein subject to a systemic venous pressure on a distal side of the microvalve; then
c) expanding the microvalve into the expanded configuration to block flow within the vein in a distal to proximal direction past the microvalve; and
d) injecting the therapeutic agent at a first pressure, distal of the microvalve and into the vein to cause the therapeutic agent to flow through the vein and into the target organ at a pressure higher than the systemic venous pressure, wherein a pressure of the injected therapeutic agent generates a net increase in fluid pressure in the vein of 10 mmHg to 200 mmHg above the systemic venous pressure.
2. The method according to claim 1 , wherein:
the first pressure is below 300 psi.
3. The method according to claim 1 , wherein:
the microvalve is dynamic such that the microvalve automatically expands to the expanded configuration and contracts to a smaller configuration in response to fluid pressure within the vein on proximal and distal sides of the microvalve, wherein in the smaller configuration the microvalve is not adapted to block flow within the vein.
4. The method according to claim 3 , wherein:
the microvalve is located on a catheter, the catheter comprising a proximal end, a distal end, a first lumen extending between the proximal and distal ends and having a distal orifice, and the microvalve located at the distal end, proximal of the distal orifice.
5. The method according to claim 1 , wherein:
the treatment system further comprises is a static occlusion element.
6. The method according to claim 5 , wherein:
the static occlusion element is a balloon.
7. The method according to claim 4 , wherein:
the proximal end of the catheter comprises an implantable injection port, and
further comprising implanting the implantable injection port in the patient and injecting a bolus of a second agent, such that the injecting the therapeutic agent and the injecting the bolus of the second agent both occur through the implanted injection port.
8. The method according to claim 1 , wherein:
the therapeutic agent comprises one of a radio-embolization agent and a biologic agent.
9. The method according to claim 1 , wherein:
the therapeutic agent is a biologic agent selected from the group consisting of one of CAR-T cells, CAR-NK cells, TCR-R cells, TCR-NK cells, B-cells, and a combination of two or more of the cells.
10. The method according to claim 1 , wherein:
the therapeutic agent comprises one or more of a biologic cell, a checkpoint inhibitor, and an oncolytic virus.
11. The method according to claim 1 , wherein:
the target organ is one of the pancreas, the kidneys, and the liver.
12. The method according to claim 1 , wherein:
the vein is a portal vein or a feeder vessel extending therefrom.
13. The method according to claim 1 , wherein:
the vein is a splenic vein or a feeder vessel extending therefrom.
14. A method for delivering a therapeutic agent under pressure to a target organ for treatment of a solid tumor in the target organ, the target organ in fluid communication with a vein in a patient, the method comprising:
a) introducing a treatment system into the vein of the patient, the treatment system comprising a microvalve comprising a filamentary braid coated with a polymeric filter comprising pores, the microvalve movable between a collapsed configuration for delivery through the vein, and an expanded configuration adapted to extend across the vein;
b) advancing the microvalve in the collapsed configuration into the vein, wherein the vein is subject to a systemic venous pressure on a distal side of the microvalve; then
c) expanding the microvalve into the expanded configuration across the vein to block flow within the vein in a distal to proximal direction past the microvalve; and
d) injecting the therapeutic agent at a first pressure below 300 psi to exit distal of the microvalve and into the vein to cause the therapeutic agent to flow through the vein at a pressure higher than the systemic venous pressure and into the target organ, the therapeutic agent comprising a biologic agent selected from the group consisting of one of CAR-T cells, CAR-NK cells, TCR-R cells, TCR-NK cells, B-cells, and a combination of two or more of the cells.
15. The method according to claim 14 , wherein:
the target organ is one of the pancreas, the kidneys, and the liver.
16. The method according to claim 14 , wherein:
the vein is a portal vein or a feeder vessel extending therefrom.
17. The method according to claim 14 , wherein:
the vein is a splenic vein or a feeder vessel extending therefrom.
18. A method for delivering a therapeutic agent under pressure to a target organ for treatment of a solid tumor in the target organ, the target organ in fluid communication with a vein in a patient, the method comprising:
a) introducing a treatment system into the vein of the patient, the treatment system comprising a microvalve comprising a filamentary braid coated with a polymeric filter comprising pores, the microvalve movable between a collapsed configuration for delivery through the vein, and an expanded configuration adapted to extend across the vein;
b) advancing the microvalve in the collapsed configuration into the vein, wherein the vein is subject to a systemic venous pressure on a distal side of the microvalve; then
c) expanding the microvalve into the expanded configuration across the vein to block flow within the vein in a distal to proximal direction past the microvalve; and
d) injecting the therapeutic agent at a first pressure below 300 psi to exit distal of the microvalve and into the vein to cause the therapeutic agent to flow through the vein at a pressure higher than the systemic venous pressure and into the target organ, the therapeutic agent comprising one or more of a biologic cell, a checkpoint inhibitor, and an oncolytic virus.
19. The method according to claim 18 , wherein:
the target organ is one of the pancreas, the kidneys, and the liver.
20. The method according to claim 18 , wherein:
the vein is a portal vein or a feeder vessel extending from the portal vein.
21. The method according to claim 18 , wherein:
the vein is a splenic vein or a feeder vessel extending from the splenic vein.
22. A method for delivering a therapeutic agent under pressure to a target organ for treatment of a solid tumor in the target organ, the target organ in fluid communication with one or more vessels in a patient, the method comprising:
a) introducing a treatment system into a vessel of the patient in fluid communication with the target organ, the treatment system comprising a microvalve comprising a filamentary braid coated with a polymeric filter comprising pores, the microvalve having shape memory to an expanded configuration adapted to extend across the vessel;
b) advancing the microvalve into the vessel, wherein the vessel is subject to a systemic venous pressure on a distal side of the microvalve; then
c) expanding the microvalve across the vessel to block flow within the vessel in a distal to proximal direction past the microvalve;
d) injecting the therapeutic agent at a first pressure below 300 psi to exit distal of the microvalve and into the vessel to cause the therapeutic agent to flow through the vessel at a pressure higher than the systemic venous pressure and into the target organ, the therapeutic agent comprising a biologic agent selected from the group consisting of one of CAR-T cells, CAR-NK cells, TCR-R cells, TCR-NK cells, β-cells, and a combination of two or more of the cells; and
e) injecting a bolus of a second fluid different than the therapeutic agent at a second pressure at or above 300 psi, the second fluid entering the vessel and forcing the therapeutic agent to flow deeper through the vessel to therapeutically treat the solid tumor in the target organ with the therapeutic agent.
23. The method of claim 22 , wherein the target organ is not located within an extremity.
24. A method for delivering a therapeutic agent under pressure to a target organ for treatment of a solid tumor in the target organ, the target organ in fluid communication with one or more vessels in a patient, the method comprising:
a) introducing a treatment system into a vessel of the patient in fluid communication with the target organ, the treatment system comprising a microvalve comprising a filamentary braid coated with a polymeric filter comprising pores, the microvalve having shape memory to an expanded configuration adapted to extend across the vessel;
b) advancing the microvalve into the vessel, wherein the vessel is subject to a systemic venous pressure on a distal side of the microvalve; then
c) expanding the microvalve across the vessel to block flow within the vessel in a distal to proximal direction past the microvalve;
d) injecting the therapeutic agent at a first pressure below 300 psi to exit distal of the microvalve and into the vessel to cause the therapeutic agent to flow through the vessel at a pressure higher than the systemic venous pressure and into the target organ, the therapeutic agent comprising one or more of a biologic cell, a checkpoint inhibitor, and an oncolytic virus; and
e) injecting a bolus of a second fluid different than the therapeutic agent at a second pressure at or above 300 psi, the second fluid entering the vessel and forcing the therapeutic agent to flow deeper through the vessel to therapeutically treat the solid tumor in the target organ with the therapeutic agent.
25. The method of claim 24 , wherein the target organ is not located within an extremity.