US20040134487A1 - Methods and devices for use in performing pulmonary procedures - Google Patents

Methods and devices for use in performing pulmonary procedures Download PDF

Info

Publication number
US20040134487A1
US20040134487A1 US10/704,023 US70402303A US2004134487A1 US 20040134487 A1 US20040134487 A1 US 20040134487A1 US 70402303 A US70402303 A US 70402303A US 2004134487 A1 US2004134487 A1 US 2004134487A1
Authority
US
United States
Prior art keywords
valve
flow control
control element
lung
flow
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10/704,023
Inventor
Mark Deem
Bernard Andreas
Sunmi Chew
Antony Fields
Ronald French
Hanson Gifford
Ronald Hundertmark
Alan Rapacki
Douglas Sutton
Peter Wilson
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Emphasys Medical Inc
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Assigned to EMPHASYS MEDICAL, INC. reassignment EMPHASYS MEDICAL, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: THE FOUNDRY, LLC.
Application filed by Individual filed Critical Individual
Priority to US10/704,023 priority Critical patent/US20040134487A1/en
Assigned to FOUNDRY, LLC, THE reassignment FOUNDRY, LLC, THE ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: SUTTON, DOUGLAS, DEEM, MARK E., FRENCH, RONALD, GIFFORD III, HANSON S.
Publication of US20040134487A1 publication Critical patent/US20040134487A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • FMECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16KVALVES; TAPS; COCKS; ACTUATING-FLOATS; DEVICES FOR VENTING OR AERATING
    • F16K15/00Check valves
    • F16K15/14Check valves with flexible valve members
    • F16K15/144Check valves with flexible valve members the closure elements being fixed along all or a part of their periphery
    • F16K15/147Check valves with flexible valve members the closure elements being fixed along all or a part of their periphery the closure elements having specially formed slits or being of an elongated easily collapsible form
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12104Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in an air passage
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2476Valves implantable in the body not otherwise provided for
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00Drugs for disorders of the alimentary tract or the digestive system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61PSPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00Drugs for disorders of the respiratory system
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205Introduction devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/06Measuring instruments not otherwise provided for
    • A61B2090/061Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2403Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with pivoting rigid closure members
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/24Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418Scaffolds therefor, e.g. support stents
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02Prostheses implantable into the body
    • A61F2/04Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2002/043Bronchi
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0008Fixation appliances for connecting prostheses to the body
    • A61F2220/0016Fixation appliances for connecting prostheses to the body with sharp anchoring protrusions, e.g. barbs, pins, spikes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2220/00Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2220/0025Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • YGENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10STECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00Surgery
    • Y10S128/912Connections and closures for tubes delivering fluids to or from the body

Definitions

  • the present invention relates generally to methods and devices for use in performing pulmonary procedures, and more particularly, procedures for treating various diseases of the lungs.
  • Pulmonary diseases such as emphysema and chronic obstructive pulmonary disease (COPD) reduce the ability of one or both lungs to fully expel air during the exhalation phase of the breathing cycle.
  • the diseased lung tissue is less elastic than healthy lung tissue, which is one factor that prevents full exhalation of air.
  • the diseased portion of the lung does not fully recoil due to the tissue being less elastic. Consequently, the diseased (e.g., emphysematic) lung tissue exerts a relatively low driving force, which results in the diseased lung expelling less air volume than a healthy lung.
  • the reduced air volume exerts less force on the airway which allows the airway to close before all air has been expelled, another factor that prevents full exhalation.
  • hyper-expanded lung tissue occupies more of the pleural space than healthy lung tissue. In most cases, a portion of the lung is diseased while the remaining part is healthy and therefore still able to efficiently carry out oxygen exchange. By taking up more of the pleural space, the hyper-expanded lung tissue reduces the amount of space available to accommodate the healthy, functioning lung tissue. As a result, the hyper-expanded lung tissue causes inefficient breathing due to its own reduced functionality and because it adversely affects the functionality of adjacent healthy tissue.
  • Lung reduction surgery is a conventional method of treating lung diseases such as emphysema.
  • a diseased portion of the lung is surgically removed which makes more of the pleural space available to accommodate the functioning, healthy portion of the lung.
  • the lung is typically accessed through a median stemotomy or small lateral thoracotomy.
  • a portion of the lung, typically the upper lobe of each lung, is freed from the chest wall and then resected, e.g., by a stapler lined with bovine pericardium to reinforce the lung tissue adjacent the cut line and also to prevent air or blood leakage.
  • the chest is then closed and tubes are inserted to remove air and fluid from the pleural cavity.
  • the conventional surgical approach is relatively traumatic and invasive, and, like most surgical procedures, is not a viable option for all patients.
  • More recently proposed treatments include the use of devices that employ RF or laser energy to cut, shrink or fuse diseased lung tissue.
  • Another lung volume reduction device utilizes a mechanical structure that is used to roll the lung tissue into a deflated, lower profile mass that is permanently maintained in a compressed condition.
  • open surgical, minimally invasive and endobronchial approaches have all been proposed.
  • Another proposed device (disclosed in publication no. WO 98/48706) is positioned at a location in the lung to block airflow and isolate a part of the lung.
  • the publication states that the occlusion device is introduced through an endobronchial delivery device, and is resiliently deformable in order to provide a complete seal against airflow.
  • the invention provides a method for treating a patient's lung.
  • the method includes steps of selecting a hollow structure in a patient's lung, the hollow structure defining a pathway for conducting fluid flow in at least first and second directions, and allowing fluid flow within the pathway in the first direction while controlling fluid flow in the second direction.
  • the invention provides a method for treating a patient's lung.
  • This method includes steps of providing a valve which allows fluid flow in a first direction and limits fluid flow in a second direction, and positioning the valve at a desired location in a lung of a patient with the first direction corresponding to an exhalation direction and the second direction corresponding to an inhalation direction.
  • the invention provides a method for treating a patient's lung that includes steps of providing a flow control element that limits fluid flow in at least one direction, positioning the flow control element at a location in a lung of a patient with the one direction substantially corresponding to an inhalation direction, and removing the flow control element after a period of time.
  • the invention provides a method for treating a patient's lung, the method comprising steps of selecting a hollow structure in a patient's lung, the hollow structure defining a pathway for conducting fluid flow in at least first and second directions, applying suction to draw fluid through the pathway in the first direction, and substantially preventing fluid flow through the pathway in the second direction.
  • the invention provides a system for treating a patient's lung.
  • the system includes a flow control element sized and configured to be positioned in a hollow structure located in a patient's lung, the flow control element including a valve member that permits fluid flow in a first direction while substantially preventing fluid flow in a second direction.
  • a delivery device is sized and configured to be guided to and positioned in or adjacent the hollow structure, and the flow control element is removably mounted on the delivery device.
  • This valve may be a poppet, ball, duckbill, heimlick, flat or leaflet valve.
  • the invention provides a system for treating a patient's lung.
  • the system includes a measuring device for determining the approximate size of a hollow structure in a patient's lung, and a flow control element sized and configured to be positioned in a hollow structure located in a patient's lung, wherein the flow control element allows fluid flow in a first direction but substantially prevents fluid flow in a second direction.
  • the invention provides a system for treating a patient's lung.
  • This system includes a flow control element sized and configured to be positioned in a hollow structure located in a patient's lung, wherein the flow control element allows fluid flow in a first direction but substantially prevents fluid flow in a second direction, and a removal device for removing the flow control element from the hollow structure subsequent to positioning the flow control element in the hollow structure.
  • a blocking element is coupled to a delivery element.
  • the blocking element is advanced to a location in a patient's lung.
  • An expandable member is expanded to occlude a pulmonary passageway and air is then withdrawn from the lung.
  • the blocking element is released to block air flow into the isolated portion of the lung.
  • the blocking element may also be a valve.
  • the expandable member may be carried by the delivery element or by a separate element.
  • a device is advanced through the blocking element after implantation of the blocking element.
  • a procedure such as delivery or evacuation of fluids or liquids, may then be performed with the device.
  • the device is then removed with the blocking element again preventing air from passing in the inhalation direction.
  • the blocking element may also be a valve which permits air flow in an expiratory direction.
  • FIG. 1 is an elevation view schematically showing a system constructed according to one embodiment of the invention, the system being used to perform a pulmonary procedure on a patient;
  • FIG. 2 is an enlarged elevation view of the lungs of the patient shown in FIG. 1 along with the system of the invention
  • FIG. 3 is an enlarged elevation view, in section, of a flow control element forming part of the system shown in FIG. 2, wherein the flow control element allows fluid flow in a first direction but blocks fluid flow in a second direction;
  • FIG. 4 is an enlarged elevation view, in section, of an alternative flow control element that allows fluid flow in a first direction but blocks fluid flow in a second direction;
  • FIG. 5 is an enlarged elevation view, in section, of another alternative flow control element
  • FIG. 6 is an enlarged elevation view, in section, of still another alternative flow control element
  • FIG. 7 is a perspective view of an introducer constructed according to another embodiment of the invention.
  • FIG. 8 is an enlarged perspective view of a portion of the introducer shown in FIG. 7;
  • FIG. 9 is a perspective view of a delivery device constructed according to another embodiment of the invention for delivering a flow control element to a selected location in a patient's lung;
  • FIG. 10 is a perspective view of a measuring device constructed according to another embodiment of the invention for determining the size of a hollow structure prior to disposing a flow control element in the structure;
  • FIG. 11 is a perspective view of a removal device constructed according to another embodiment of the invention for removing a flow control element that has already been positioned in a hollow structure.
  • FIG. 12 is a side view of another flow control element.
  • FIG. 13 is another side view of the flow control element of FIG. 12.
  • FIG. 14 is a cross-sectional view of the flow control element of FIG. 12.
  • FIG. 15 is an alternative cross-sectional view of the flow control element of FIG. 12.
  • FIG. 16 is an isometric view of the flow control element of FIG. 12 altered to have a tapered shape.
  • FIG. 17 shows another flow control element.
  • FIG. 18 is an end view of the flow control element of FIG. 17.
  • FIG. 19 shows another flow control element.
  • FIG. 20 shows still another flow control element.
  • FIG. 21 is a side view of another flow control element.
  • FIG. 22 is a cross-section of FIG. 21 along line A-A.
  • FIG. 23 is a longitudinal cross-section of FIG. 21.
  • FIG. 24 is an alternative embodiment of the flow control device of FIG. 21.
  • FIG. 25 is a cross-section of FIG. 24 along line B-B.
  • FIG. 26 shows another flow control element with a flap valve in a closed position.
  • FIG. 27 shows the flap valve of FIG. 26 in an open position.
  • FIG. 28 shows a slit valve in a closed position.
  • FIG. 29 shows the slit valve in an open position.
  • FIG. 30 shows a flow control element with bristles.
  • FIG. 31 is a cross-sectional view of a ball valve.
  • FIG. 32 is a cross-sectional view of a poppet valve.
  • FIG. 33 shows a leaftlet valve
  • FIG. 34 is a cross-section of the leaflet valve of FIG. 33.
  • FIG. 35 shows another flap valve.
  • FIG. 36 is a cross-sectional view of the flap valve of FIG. 35.
  • FIG. 37 shows still another flap valve.
  • FIG. 38 is a cross-sectional view of the flap valve of FIG. 36.
  • FIG. 39 shows a system for performing pulmonary procedures.
  • FIG. 40 is a cross-sectional view of the distal end of the system of FIG. 39.
  • FIG. 41 illustrates access of the isolated portion of the lung through the flow control element of the present invention.
  • FIG. 42 shows a device passing through the flow control element of FIGS. 12 - 15 with the valve sealing around the device.
  • the present invention provides methods and devices for performing pulmonary procedures, for example, treating various lung diseases such as emphysema and COPD.
  • a flow control element that allows fluid flow in a first direction and controls fluid flow in a second direction.
  • fluid means gas, liquid, or a combination of a gas(es) and liquid(s).
  • controlled fluid flow means that the flow is altered in some manner, i.e., the flow is not unimpeded in the second direction.
  • the specific manner in which fluid flow is controlled in the second direction depends on the construction of the flow control element.
  • the flow control element may, for example, completely block, substantially block, limit, meter or regulate fluid flow in the second direction by a valve or other suitable structure.
  • the flow control element when positioned in a hollow structure in a patient's body, such as a bronchiole in one of the lungs, the flow control element is oriented to allow flow in the exhalation direction but prevent fluid flow in the inhalation direction.
  • the flow control element has a valve member that opens during exhalation in order to deflate or decompress the isolated lung portion distal to the flow control element. This maintains the diseased tissue in a decompressed state which prevents further hyper-expansion of the tissue.
  • the invention also permits slow decompression of the lung tissue over a short or extended period of time.
  • the invention thus may be used to prevent fluid being drawn into one or more portion of a patient's lung.
  • a portion of the lung may be deflated by applying gentle suction (via the flow control element) to the hyper-expanded tissue without collapsing the walls of the narrow airways surrounded by diseased tissue.
  • the suction draws air, liquid, mucous, etc., out of the lung portion to evacuate the diseased tissue.
  • FIG. 1 is a schematic view showing a system 10 constructed according to one embodiment of the invention for carrying out a pulmonary procedure on the lung L of a patient P.
  • the system 10 is exemplary only and includes a bronchoscope 12 having a steering mechanism schematically indicated at 14 , a shaft 16 , and a port 18 which provides access to one or more working channels of the bronchoscope.
  • FIG. 1 shows a delivery device 20 constructed according to the invention.
  • the delivery device 20 is shown positioned in the bronchoscope 12 in order to deliver a flow control element 22 .
  • the bronchoscope 12 has been passed into the patient's trachea T and guided into the right bronchus 24 .
  • the delivery device 20 is then manipulated with respect to the bronchoscope 12 via steering mechanism 14 to control placement of the flow control element 22 .
  • the delivery device 20 is movable within a bronchoscope working channel 26 (FIG. 8) and is guided into the desired location in the hollow structure, which in this case is a bronchiole 28 .
  • the bronchiole 28 feeds an upper lobe U of the lung L which represents a diseased lung portion.
  • the delivery device 20 is placed through the side port 18 and into the working channel 26 , the distal end 30 of the delivery device 20 is moved out of the working channel, and the flow control element 22 is secured in position in the bronchiole 28 .
  • FIG. 2 is an enlarged view of the patient's lungs L shown in FIG. 1 after the introducer 12 and delivery device 20 have been removed, the flow control element 22 being left in the bronchiole 28 .
  • the flow control element 22 shown in more detail in FIG. 3, is in the form of a valve with a valve member 32 supported by a ring 34 .
  • FIG. 2 also illustrates a second flow control element 22 A placed in a bronchiole 28 A that feeds a lower lobe LL of the lung.
  • the flow control element 22 A includes a valve member 32 A and a support ring 34 A and reduces or prevents fluid from being inhaled into the hyper-expanded tissue of the lower lobe LL. It will be understood that any number of flow control elements may be used in a given procedure.
  • valve member 32 is a duckbill-type valve and has two flaps defining an opening 36 .
  • the valve member 32 is shown in a flow-preventing orientation in FIG. 3 with the opening 36 closed.
  • the valve member 32 is configured to allow fluid flow in a first direction (along arrow A) while controlling fluid flow in a second direction (along arrow B).
  • fluid flow in the direction of arrow B is controlled by being completely blocked by valve member 32 .
  • the first and second directions in which fluid flow is allowed and controlled, respectively, are preferably opposite or substantially opposite each other, for example, as shown in the Figures. It will be appreciated, though, that the invention may be practiced with the first and second directions different but not opposite each other.
  • valve member 32 of the flow control element 22 controls fluid flow by completely blocking such flow in the second direction.
  • valve member 32 effectively functions as a one-way valve.
  • Alternative embodiments of the invention utilize flow control elements that controls fluid flow in the second direction without completely blocking such flow.
  • FIG. 4 shows an exemplary flow control element 38 constructed according to an alternative embodiment of the invention that limits, but does not block, fluid flow in at least one direction.
  • the flow control element 38 comprises a valve member 40 supported by a ring 42 .
  • the valve member 40 is preferably a duckbill-type valve having a similar construction to that of the valve member 32 , except that the flaps 44 are formed, secured, oriented or otherwise configured to maintain a flow opening 46 when in their flow-controlling (as opposed to flow-allowing) orientation.
  • the opening 46 is sized and configured to achieve desired flow characteristics through the flow control element 38 .
  • FIG. 4 shows only one way to achieve limited fluid flow in a given direction.
  • the specific manner in which flow control is obtained may vary according to the invention, e.g., by varying the number, size, shape or position of the flow openings on the flow control element.
  • the flow control element may be constructed to provide a pumping action that aids in moving gas or liquid within a hollow structure, such as a bronchiole.
  • a mechanical pumping action is produced that may be used to move the gas or liquid to further deflate the isolated region of the lung.
  • FIG. 5 shows an exemplary flow control element 50 constructed according to this embodiment and including a pair of valve members 52 , 54 supposed in series by a ring 56 .
  • the valve members 52 , 54 each include a pair of flaps defining a valve opening (the valve members being shown in their closed, fluid flow blocking orientation in FIG. 5).
  • a chamber 58 is defined between the valve members 52 , 54 and produces a pumping effect on the fluid flowing through the flow control element 50 .
  • the chamber would collapse and expand with movement of the bronchiole (or other hollow structure in which it is inserted) to pump fluid from the diseased lung tissue.
  • the valve member 54 is coupled to a bellows 60 to enhance the pumping action and/or to control the amount of force needed to open the valve member.
  • the wall 62 defining the chamber 58 is secured to the ring 56 so that the chamber 58 occupies the entire interior of the ring 56 .
  • the flow control element 50 may have a different configuration wherein the chamber 58 is defined by an air pocket located within the wall 62 . This may prevent fluid collecting in the chamber 58 .
  • a power-driven pump may be used to draw fluid out of the lungs, e.g., a miniature batter-powered electric pump, or pumps that use physical or chemical characteristics, e.g., a change in air temperature, presence of an additional gas or liquid, change in pH, etc., to generate pumping force that evacuates air and mucous.
  • FIG. 6 shows yet another alternative flow control element 70 including a valve member 72 comprising a pair of flaps defining an opening, and ring 74 supporting the valve member 72 .
  • the valve member 72 is a duckbill-type valve that permits fluid flow in a first direction but prevents flow in a second direction.
  • the ring 74 in this embodiment comprises a stent 76 having struts 78 to enhance fixation of the flow control element 70 in the hollow body structure (not shown).
  • the valve member 72 may be attached to the stent 76 by any suitable means, e.g., molded to the stent, suture, fasteners, adhesives, etc.
  • the stent 76 is movable between collapsed and expanded (FIG.
  • the flow control element 70 including stent 76 may be collapsed and held in a sheath for delivery through a relatively small space, for example, the working channel of a bronchoscope.
  • a bronchoscope has a diameter of about 6 or 7 mm, while the working channel has a diameter of about 2 or 3 mm.
  • Utilizing a collapsible flow control element may also be useful in introducing the flow control element through an small opening formed in the patient's thorax.
  • FIGS. 7 and 8 show in detail the bronchoscope 12 and the flow control element delivery device 20 described above in connection with FIG. 1.
  • the bronchoscope 12 has an eyepiece 80 which is used to visualize the trachea and the various pathways of the lung during deployment of the flow control element 22 .
  • the bronchoscope 12 may be provided with a camera/recorder, an aspiration/irrigation system, or other auxiliary features.
  • the steering mechanism 14 may comprise cables that move the distal tip of the bronchoscope shaft 16 over a desired angular range, for example, 0° through 180°.
  • FIG. 8 shows the distal portion 30 of the bronchoscope 12 including the working channel 26 (which communicates with the side port 18 ), one or more fiber optic light guides 81 , and a lens 82 for transmitting images to the eyepiece 80 .
  • FIG. 9 shows the delivery device 20 to include a handle 84 , an actuator 86 , a support shaft 87 and a sheath 88 .
  • the delivery device 20 will be described in connection with delivering the flow control element 70 of FIG. 6, although it will be understood that it may be used to deliver alternative flow control elements.
  • the flow control element 70 and in particular the stent 76 , is collapsed to a low profile orientation and then mounted on the shaft 87 .
  • the sheath 88 is moved distally from the position shown in FIG. 9 until it covers the stent body 76 (and the valve member 72 , if desired) to maintain the flow control element 70 collapsed.
  • the shaft 87 and sheath 88 are then passed into the side port 18 and working channel 26 of the bronchoscope 12 and guided to a desired location in the lung.
  • the actuator 86 is used to remove the sheath 88 from the flow control element 70 which allows the stent 76 to expand.
  • Stent 76 is preferably formed of a self-expanding material, e.g., nitinol. In this case the flow control element 70 immediately expands and engages the tissue upon retraction of sheath 88 .
  • the stents could rely on a mechanism such as a balloon or heat activation to expand in use.
  • the flow control element of the invention may be guided to and positioned at a desired location in the pulmonary system, such as the bronchiole 28 shown in FIGS. 1 and 2, by various delivery devices or systems.
  • a desired location in the pulmonary system such as the bronchiole 28 shown in FIGS. 1 and 2
  • various delivery devices or systems For example, guidewire-based systems, introducer sheaths, cannulae or catheters, etc., may be used to deliver the treatment element in a minimally invasive manner.
  • the above-described method for using a bronchoscope to introduce the flow control element may be modified by placing an introducer sheath over the bronchoscope. The sheath provides access should the bronchoscope need to be removed from patient's body, for example, in order to place a different size flow control element.
  • FIG. 10 shows somewhat schematically an exemplary device for determining the size of a hollow structure in a patient's body, for example, a bronchiole in a lung.
  • the device 90 includes a housing 92 , shaft 94 , positioning element, 96 and measuring elements 98 .
  • the measuring elements 98 have tips 100 that are moved into contact with the wall of the hollow structure, such as the inner surface of a bronchiole (not shown).
  • the device 90 is calibrated so that when tips 100 of measuring elements 98 engage the wall of the bronchiole the indicator 102 displays the approximate size of the bronchiole.
  • An electrical coupling 104 powers the device 90 .
  • the positioning element 96 is optional and may be used to fix the position of the measuring elements 98 within the bronchiole so as to obtain more precise measurement.
  • the illustrated element 96 is an inflatable balloon, although other elements could be used to center and hold the shaft 96 within the bronchiole. Any suitable means may be used for ensuring that the measuring elements 98 do in fact contact the bronchiole wall in order to provide a true reading.
  • the measuring elements 98 may be moved distally (to the right in FIG. 10) until a visual indicator indicates that the tips 100 are in contact with tissue. Alternatively, a change in electrical resistance may be used to confirm contact between the measuring elements 98 and tissue.
  • the device 90 is merely representative of the various means that may be used to determine the size of a hollow body structure.
  • the shaft 94 of the measuring device 90 is passed through the bronchoscope working channel 26 and delivered to the site.
  • the device 90 is then operated as described above to determine the approximate size of the bronchiole.
  • the degree of precision with which the size of the hollow structure is measured will depend on the procedure being performed and user preference.
  • the device 90 is removed from working channel 26 , and delivery device 20 is inserted into the channel to deploy the flow control element in the bronchiole.
  • a flow control element it may in some instances be necessary or desirable to remove a flow control element from a hollow structure in which it has been deployed.
  • placement of a flow control element for a given period of time effects beneficial results on the diseased lung tissue.
  • the time during which the diseased tissue is deflated and decompressed may allow the tissue to regain some elasticity as a result of being temporarily inactive. After the tissue has regained some or all of its elasticity, it would be better to remove the flow control element and allow the tissue to function efficiently.
  • the flow control element is preferably not removed before the tissue has a sufficient chance to recover.
  • FIG. 11 shows a device 110 comprising a handle 112 , an actuator 114 , a shaft 116 and one or more removal components 118 .
  • the components 118 preferably have tips 120 configured to grasp a flow control element in order to remove the element from surrounding tissue.
  • the shaft 116 of the device 110 is passed into a patient's trachea (not shown) and is guided to the previously-deployed flow control element; for example, the shaft 116 may be introduced through the working channel of a bronchoscope in the same manner as the delivery device 20 .
  • the removal components 118 are preferably collapsed within shaft 116 while the shaft is guided to the site. The components 118 are then extended into contact with the wall of the bronchiole. The tips 120 are used to grasp and remove the flow control element from the bronchiole.
  • the flow control element of the invention is secured in position in the hollow structure, such as bronchiole 28 , so as to remain in place during breathing.
  • the exterior of the flow control element may be configured along all or part of its exterior to aid in fixing the element in place, for instance, as schematically indicated by reference numeral 48 in FIGS. 3 and 4.
  • the fixation structure 48 may comprise adhesives, tissue growth-inducing substances, fasteners, staples, clips, suture, stents, balloons, Dacron® sleeves, sintered, etched, roughened, barbed or alternatively treated surfaces, etc.
  • Placement of a flow control element constructed according to the invention in a patient's pulmonary system achieves several benefits.
  • the element when deployed in the bronchiole 28 as shown in FIGS. 1 and 2, the element shows exhalation but prevents inhalation.
  • the flow control element 22 thus limits or prevents the inhalation of additional fluid into the diseased lung portion. This is beneficial because it prevents further enlargement of the hyper-expanded tissue, which in turn maintains more room in the pleural space for healthy lung tissue.
  • the flow control element 22 also allows any air being naturally exhaled by the patient (as well as any liquid, if present) to exit the lung, thereby deflating or compressing the tissue.
  • the fluid is preferably permitted to flow unimpeded from the lung, but it may instead be metered or regulated in order to control deflation.
  • FIGS. 12 - 16 another flow control element 22 is shown.
  • the flow control element 22 serves as a blocking element 122 which blocks air in the inhalation direction.
  • the blocking element 122 may also have a valve 124 which permits air flow in an exhalation direction but prevents air flow in the inhalation direction.
  • the valve 124 may be any suitable valve such as any of the valves described herein.
  • FIGS. 13 and 16 show the valve 124 having a first lip 126 and a second lip 128 which engage one another in the closed position.
  • the term valve as used herein may also refer to a check valve which permits flow in one direction but prevents flow in the other direction.
  • valves described herein are used with various aspects of the invention, other aspects of the invention may be practiced by blocking flow in both directions.
  • the devices and methods for accessing the isolated part of the lung may be used with devices which block air flow in both directions.
  • flow in the exhalation direction may be regulated in another manner as described herein rather than simply with the valve.
  • the flow control element 22 has an expandable support structure 130 .
  • the support structure 130 is metallic and preferably a superelastic material such as nitinol.
  • the support structure 130 is formed by cutting, etching or otherwise removing material from a tube to form openings 132 as is generally known in the art of forming small, metallic tubes such as stents.
  • the support structure 130 may be made in any other suitable manner and with other suitable materials.
  • the support structure 130 may be a nitinol tube which is laser cut to have six diamond-shaped openings 132 .
  • the flow control element 22 has a body 134 coupled to the support structure 130 .
  • the body is preferably molded silicone or urethane but may be any other suitable material.
  • the valve 124 is mounted to the body 134 and may be integrally formed with the body 134 as described below.
  • the body 134 may be attached to the support structure 130 in any suitable manner.
  • the body 134 may be positioned in the support structure 130 and an end 136 averted over an end 138 of the support structure 130 .
  • the everted end 136 is attached to the rest of the body 134 through the openings 132 in the support structure 130 at connections 140 with an adhesive, adhesive rivet, heat weld or any other suitable method.
  • An advantage of coupling the body 134 to the support structure 130 with the connections 140 is that the support structure 130 and body 134 may collapse and expand somewhat independently since the connections 140 are free to move in the openings 132 .
  • the flow control element 22 may also have a sealing portion 142 which forms a seal with the wall of the pulmonary passage.
  • the sealing portion 142 may be attached to the body 134 separately (FIG. 14) or may be integrally formed with the body 134 and valve 124 (FIG. 15).
  • An advantage of the flow control element 22 is that a substantial portion of the element 22 , such as the body 134 and valve 124 , are integrally formed.
  • the valve 124 , valve body 134 and sealing portion 142 are all integrally formed.
  • the sealing portion 142 extends around the valve 124 but is not coupled directly to the valve 124 so that the valve 124 is not subjected to forces exerted on or by the sealing portion 142 .
  • the sealing portion 142 extends from a tube 144 positioned around the valve 124 .
  • the sealing portion 142 forms a ring 146 around the body 134 .
  • the ring 146 is made of a resilient, elastomeric material which improves sealing with the wall of the pulmonary passage.
  • the ring 146 may have any suitable shape such as straight, tapered, angled or could have frustoconical surface 143 which angles the ring 146 .
  • the sealing portion 142 preferably has at least two sealing portions 142 , and preferably three, which each have a different diameter to seal with different size passages. In this manner, the device may be used within a given size range.
  • the ring 142 also may be designed to deflect to permit exhalation air to pass.
  • valve 124 will, of course, open to permit air to escape, however, the pressure force on the valve 124 can be reduced if the sealing portion 142 also opens to permit further venting of the isolated portion of the lung.
  • various other structures may also be used to provide valves which cooperate with the wall of the pulmonary passageway to permit venting of the isolated area.
  • the body 134 is coupled to the support structure 130 to provide an exposed part 135 of the support structure 130 which helps to anchor the device.
  • the term exposed part shall mean a part of the support structure 130 not covered by the body 134 .
  • the exposed part 135 may be covered by another material so long as it is not covered by the body 134 .
  • the exposed part 135 of the support structure 130 may form anchoring elements 148 which anchor the support structure 130 .
  • the anchoring elements 148 are preferably v-shaped to improve anchoring.
  • the anchoring elements 148 may also be barbs or the like.
  • the flow control device 22 may also be angled, tapered or flared so that one end 151 is larger than the other 149 .
  • any other shape, such as a cylinder or tube flared at both ends may be used without departing from many aspects of the invention.
  • the element 22 has a valve 150 which has first and second lips 152 , 154 which engage one another in a closed position.
  • the first lip 152 is preferably stiffer than the second lip 154 so that the first lip 152 biases the second lip 154 closed.
  • the first lip 152 may be made stiffer than the second lip 154 in any manner such as by using a thicker layer of the same material, a stiffer material for the first lip, or by simply adhering or attaching a stiffener 156 to the first lip 152 .
  • the first and second lips 152 , 154 are preferably formed by a tube of material with the stiffener 156 attached to one side to form the first lip 152 .
  • the first and second lips 152 , 154 are also preferably curved as shown in FIG. 18.
  • the element 22 is preferably made of molded silicone or urethane although any other suitable material may be used.
  • the valve 150 also has reinforcing elements 155 at the lateral edges to further support the lips 152 , 154 .
  • the valve 150 may, of course, have either the elements 155 or stiffener 156 .
  • the sealing portion 142 is not shown for clarity, the sealing portion 142 may also be provided.
  • FIG. 19 another flow control element 22 is shown wherein the same or similar reference number show the same or similar structure.
  • the flow control element 22 has the valve 124 and a number of sealing portions 142 .
  • the valve 124 , sealing portion 142 and body 134 are integrally formed of a resilient material such as molded silicone or urethane.
  • a resilient material such as molded silicone or urethane.
  • the flow control element 22 may also have reinforcing element 158 such as a helical coil 160 .
  • the flow control element 22 has a sealing portion 142 which has a helical shape.
  • the element 22 is rotated so that the helical shape of the sealing portion 142 engages the wall to anchor the element 22 .
  • any of the flow control elements of the present invention may also be used with a sealant 162 , such as an adhesive, which seals and/or anchors the device.
  • a sealant 162 such as an adhesive, which seals and/or anchors the device.
  • the sealant 162 is positioned on the exterior of the device between the sealing portions 142 .
  • the sealant 162 is preferably a viscous substance which is applied to the exterior surface of the device before introduction.
  • the sealant 162 may be an adhesive which also helps to anchor the device.
  • the use of the sealant 162 may be used with any of the devices described herein.
  • the flow control element 22 has a support structure 164 which anchors a valve 166 .
  • the structure 164 has anchoring elements 168 , preferably two, on each side of the valve 166 .
  • the anchoring element 168 are formed by two wires attached together.
  • any other suitable structure may be used for the structure 164 such as a stent-like structure or an expandable ring with barbs.
  • the valve 164 cooperates with the wall of the pulmonary passageway to vent the isolated area.
  • the valve 164 is generally conical, however, any other shape may be used.
  • the valve 164 may engage the pulmonary wall with a number of different configurations without departing from the scope of the invention, thus, the following preferred embodiments do not limit the scope of the invention.
  • the valve 164 is elastic and yields to permit expiratory air to pass between the valve and the wall of the passageway. Referring to FIG. 22, the valve 164 is thinner near an end engaging the wall W so that the end of the valve 164 is more flexible.
  • FIGS. 24 and 25 still another device is shown wherein the same or similar reference numbers refer to the same or similar structure.
  • the device has a valve 170 with a number of sections 172 with each section 172 forming a seal with the wall of the pulmonary passage.
  • the sections 172 are separated by wires 174 which provide a resilient structure.
  • the device may be formed with any number of the sections 172 forming a valve structure 173 with the wall of the pulmonary passage.
  • FIGS. 26 and 27 still another flow control element 22 is shown wherein the same or similar reference numbers refer to the same or similar structure.
  • the element 22 has a flap valve 174 which opens to permit expiratory air to pass.
  • the valve 174 is also generally conical.
  • the term generally conical as used herein means that the cone may diverge from a cone in that the walls may be slightly curved, have a number of sections or a seam, flap or fold while still being generally cone-shaped.
  • FIGS. 28 and 29 still another valve is shown having a slit or seam 178 which opens to permit expiratory air to pass.
  • the slit or seam 178 may also be oriented and configured like a slit valve without departing from the scope of the invention.
  • the device has the valve 124 but may have any other suitable valve.
  • the device has flexible bristles 180 , preferably more than 10, 20 or even 30 bristles 180 , which anchor the device in the pulmonary passageway.
  • the bristles 180 are preferably angled to resist forces in the expiratory direction so that pressure forces, such as forces developed during coughing, cannot dislodge the device.
  • the bristles 180 may be used with the sealant 162 to provide an airtight seal.
  • FIG. 31 still another flow control element 22 is shown which includes a sealing element 182 , such s a ball 184 , biased toward the closed position to form a ball valve 183 .
  • the sealing element 182 is biased with a spring 186 although any other biasing element may be used.
  • the device has a body 188 with the sealing portion 142 .
  • the body 188 has an opening 190 through which air may pass when the sealing element 182 opens.
  • FIG. 32 still another device is shown which has a blocking element 185 rather than the ball 184 of FIG. 31 to form a poppet valve 187 .
  • FIGS. 33 and 34 still another flow control element 22 is shown.
  • the device has a valve 186 which has at least three leaflets 188 which engage one another in the closed position.
  • FIG. 35 and 36 still another device is shown having a flap valve 190 .
  • the flap valve 190 deflects to permit expiratory air to pass.
  • the flap 190 is preferably made of an elastomeric material.
  • the flap 190 is attached to a support strut 192 extending across an open end 194 of the body 196 .
  • the body 196 has the sealing portion 142 which is preferably formed by ribs extending around the body 196 .
  • FIGS. 37 and 38 another flap valve 198 is shown.
  • the flap valve 198 is attached to the body at hinge 199 .
  • the system 200 is, of course, useful for delivering any of the devices described herein or any other suitable device.
  • the system 200 includes a delivery element 202 having a first lumen 204 and a second lumen 206 .
  • the delivery element 202 also has an expandable member 208 , such as a balloon 210 , which is coupled to the second lumen 206 for inflating the balloon 210 with a source of inflation fluid or gas 212 .
  • the device is loaded into the end of the delivery element 202 and a pusher 214 may be used to move the device, such as the device of FIGS. 12 - 16 , out of the delivery element 202 .
  • the first lumen 204 has an enlarged end which forms a capsule 215 which contains the device.
  • the element 202 may also be advanced over a guidewire 217 or the like in a conventional manner.
  • the delivery element 202 may also be used to remove air, and even fluid if necessary, from the isolated portion of the lung.
  • the expandable member 208 is expanded to isolate a portion of the lung and suction is applied to deflate the lung.
  • the isolated portion of the lung may be deflated with the device contained within the delivery element 202 or may be deflated after delivery of the device.
  • An advantage of using the valves of the present invention is that air can be drawn through the valve even after the valve has been deployed. Referring to FIG. 40, the valve 124 also may remain operational even when in the collapsed position. Thus, the isolated portion of the lung may also be suctioned when the device is contained in the first lumen.
  • the second lumen 206 of the delivery element 202 may be substantially independent of the outer wall of the delivery element 202 so that the stiffness of the device is reduced as compared to an integrally formed multi-lumen device.
  • the second lumen 206 is formed by a separate tube 209 passing through the first lumen 204 .
  • the delivery element 202 has an outer diameter which is 80-120%, more preferably 90-110%, of the minimum placement size of the device.
  • the isolated portion of the lung may be accessed after implantation of a device for subsequent medical treatments.
  • the valve may be penetrated with the delivery device 202 , or similar device, to deliver and/or evacuate gas or liquid.
  • the device is coupled to a source of fluid 211 , such as an antibiotic or antisurfactant, which is delivered and, if necessary, evacuated from the lung.
  • a gas such as an antibiotic gas, may also be delivered from a source of gas 213 to the isolated area to reach distal portions of the isolated area.
  • the device 202 may be coupled to a vacuum source 215 for deflating the isolated portion or evacuating mucous or other fluids from the isolated portion of the lung.
  • a valve 216 is provided for selectively coupling the first lumen 204 to any of the source of fluid 211 , gas 213 or vacuum 215 .
  • the device 202 may form a tight seal with the valve 124 so that the isolated portion remains deflated during the procedure.
  • the device 202 may have the expandable element 208 , such as the balloon 210 , for occluding the pulmonary passageway on either side of the valve 124 to achieve isolation at any particular location in the pulmonary passageway distal or proximal to the valve 124 .
  • An advantage of the present invention is that the isolated portion may be deflated after implantation of the valve without penetrating the valve.
  • the device may be positioned proximal to the valve and the expandable element expanded to occlude the pulmonary passageway. Suction is then applied through the device so that a low pressure area develops between the valve and occluding member. When the pressure differential is large enough, the valve will open to vent and deflate the isolated portion of the lung. This process can be continued in a controlled manner until the desired amount of deflations is achieved or when a target pressure has been reached. When suction is stopped, the valve will close to isolate part of the lung.
  • the delivery device may also be used as a diagnostic tool.
  • the balloon may be deflated momentarily so that the isolated area between the balloon and valve increases in pressure. If the pressure decreases after the balloon is inflated again it may indicate that the valve is not sealing properly since the air may be passing around or through the valve and into the isolated portion.
  • An alternative diagnostic would be to pressurize the space between the valve and expandable member. The pressure response can then be monitored to determine if the valve provides an adequate seal.
  • the devices and valves of the present invention provide the ability to prevent inflation of diseased areas of the lung while also permitting venting of these portions of the lung.
  • the valves preferably open with a relatively small pressure differential across the valve.
  • the valves preferably open with a pressure differential of no more than 10 inches water more preferably no more than 5 inches water and most preferably no more than 1 inch water.
  • the valves and valve elements of the present invention may open with relatively small pressure differentials, the valves and valve elements may also have higher opening pressures.
  • the valves may also be designed to open only for high pressure events such as coughing.
  • the opening pressure, or differential pressure is at least 25 inches water but still no more than 120 inches water.
  • coughing may be induced to increase the driving force and respiratory pressure to vent the isolated portions of the lung.
  • the flow control elements of the invention permit the diseased tissue to gradually deflate, either under the patient's own power or by applying relatively gentle suction for a given period of time.
  • the suction may be applied intermittently or continuously by any suitable means.
  • a suction catheter could be passed through the flow control element in the bronchiole and into the distal tissue.
  • the flow control element for example, a valve member, would preferably seal around the catheter in order to prevent fluid moving distally past the valve.
  • the invention thus provides significant benefits as it permits fluid to be evacuated from the alveoli without collapsing the floppy walls of the narrow airways leading to them, problem with common lung diseases such as emphysema and COPD, as discussed above. Accordingly, the invention facilitates removal of more fluid from the diseased lung tissue than prior art approaches, the effect of which is more plural space available to the healthy lung tissue.
  • using the invention to deflate the diseased lung tissue for a selected period of time., e.g., one month, may have beneficial results on the tissue by temporarily removing it from the respiratory circuit.
  • the flow control element is preferably removed before the tissue begins to necrose, but is left in place a sufficiently long enough time that the tissue will not revert to its floppy, toneless state when the element is removed.
  • some possible substances with which the invention may be used include gene therapy or angiogenesis factors for lung repair or re-establishment of tissue elasticity; growth factors; anti-growth or anti-angiogenesis factors (or substances to cause necrosis or apoptosis) to prevent re-establishment of air and blood flow; antibiotics to prevent infection; anti-inflammatory agents including steroids and cortisones; sclerosing drugs or materials to promote rapid healing, for example, to allow earlier removal of the flow control element; agents for absorbing remaining fluids; and sealing substances for enhancing isolation of the diseased tissue.
  • the portion of the lung being treated may de deflated over time through repeated natural inhalation and exhalation with the flow control element in place.
  • a vacuum source may be coupled to the flow control element to draw fluid out of the diseased tissue in the manner discussed above. This deflation of the diseased portion may be performed alone or in conjunction with delivering biological substances.
  • the pressures used to suction the lung portion are preferably low to avoid collapsing the walls of the narrow airways.
  • the flow control element comprises a valve
  • the valve may comprise an annulus or support ring formed of any suitable metal or synthetic material, with the valve member being formed of silicone, natural rubber, latex, polyurethane, polytetrafluoroethylene, a thermoplastic elastomer, tissue, etc.
  • the valve member may be integral with the support ring or it may be a separate member attached thereto by suitable means, e.g., suture, adhesives, mechanical fasteners. If the flow control element comprises a stent with a valve prior art attachment methods may be used. For example, see U.S. Pat. No. 5, 954,766, the content of which is incorporated herein in reference.
  • the specific characteristics of the flow control element may be varied depending on the particular application. It may be desirable to provide multiple flow control elements with valve members that require different exhale pressures to open, for example, in order to allow treatment of patients who generate different exhalation pressures.
  • the different flow control elements could be provided in a kit and be distinguished from each other based on required opening force, size, material, etc.
  • the kit could include a color or other coding system to indicate these factors.
  • the flow control elements of the invention are preferably constructed so as to require a relatively low opening force in order to allow fluid flow in the first direction.
  • Emphysema patients typically exhale a small quantity of low-pressure fluid.
  • the invention preferably allows any such fluid to escape via the flow control element in the hollow structure.
  • the flow control element is designed to open and allow flow in the first direction in response to any positive pressure generated by the patient.
  • the flow control element will open to allow fluid to escape the tissue. It will nonetheless be recognized that the particular force required to open the flow control element may be varied depending on exhalation pressures associated with the intended patient population.
  • inventive devices may include removable or detachable components, and may comprise disposable or reusable components, or a combination of disposable and reusable components.
  • inventive devices may be practiced with one or more of the steps specifically illustrated and described herein modified or omitted.
  • the invention is not limited to treating lung diseases as is shown in the Figures, although that is a preferred application.
  • the invention may be used in any pulmonary or non-pulmonary procedure in which it is desirable to allow fluid flow in a first direction and control fluid flow in a second, different direction within a hollow structure.
  • a minimally invasive, endobronchial approach is shown in the Figures, other approaches may used, for example, an open surgical procedure using a median stemotomy, a minimally invasive procedure using a mini thoracotomy, or a still less invasive procedure using one or more ports or openings in the thorax, etc.

Abstract

An implantable flow control element is provided which prevents air from entering an isolated portion of a patient's lung. The element may permit air to escape from the isolated portion so that the element acts like a valve. Systems for implanting pulmonary devices are also provided.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • This is a continuation of U.S. application Ser. No. 09/797,910, filed on Mar. 2, 2001, which is a continuation-in-part of U.S. application Ser. No. 09/519,735 filed Mar. 4, 2000, the full disclosures of which are incorporated herein by reference.[0001]
  • BACKGROUND OF THE INVENTION
  • 1. Field of the Invention [0002]
  • The present invention relates generally to methods and devices for use in performing pulmonary procedures, and more particularly, procedures for treating various diseases of the lungs. [0003]
  • 2. Description of the Background Art [0004]
  • Pulmonary diseases such as emphysema and chronic obstructive pulmonary disease (COPD) reduce the ability of one or both lungs to fully expel air during the exhalation phase of the breathing cycle. The diseased lung tissue is less elastic than healthy lung tissue, which is one factor that prevents full exhalation of air. During breathing, the diseased portion of the lung does not fully recoil due to the tissue being less elastic. Consequently, the diseased (e.g., emphysematic) lung tissue exerts a relatively low driving force, which results in the diseased lung expelling less air volume than a healthy lung. The reduced air volume exerts less force on the airway which allows the airway to close before all air has been expelled, another factor that prevents full exhalation. [0005]
  • The problem is further compounded by the diseased, less elastic tissue that surrounds the very narrow airways that lead to the alveoli (the air sacs where oxygen-carbon dioxide exchange occurs). This tissue has les tone than healthy tissue and is typically unable to maintain the narrow airways open until the end of the exhalation cycle. This traps air in the lungs and exacerbates the already-inefficient breathing cycle. The trapped air causes the tissue to become hyper-expanded and no longer able to effect efficient oxygen-carbon dioxide exchange. Applying suction to these narrow airways (a procedure proposed in the literature for deflating the diseased portion of the lung) may collapse the airways due to the surrounding diseased tissue, thereby preventing successful fluid removal. [0006]
  • In addition, hyper-expanded lung tissue occupies more of the pleural space than healthy lung tissue. In most cases, a portion of the lung is diseased while the remaining part is healthy and therefore still able to efficiently carry out oxygen exchange. By taking up more of the pleural space, the hyper-expanded lung tissue reduces the amount of space available to accommodate the healthy, functioning lung tissue. As a result, the hyper-expanded lung tissue causes inefficient breathing due to its own reduced functionality and because it adversely affects the functionality of adjacent healthy tissue. [0007]
  • Lung reduction surgery is a conventional method of treating lung diseases such as emphysema. A diseased portion of the lung is surgically removed which makes more of the pleural space available to accommodate the functioning, healthy portion of the lung. The lung is typically accessed through a median stemotomy or small lateral thoracotomy. A portion of the lung, typically the upper lobe of each lung, is freed from the chest wall and then resected, e.g., by a stapler lined with bovine pericardium to reinforce the lung tissue adjacent the cut line and also to prevent air or blood leakage. The chest is then closed and tubes are inserted to remove air and fluid from the pleural cavity. The conventional surgical approach is relatively traumatic and invasive, and, like most surgical procedures, is not a viable option for all patients. [0008]
  • More recently proposed treatments include the use of devices that employ RF or laser energy to cut, shrink or fuse diseased lung tissue. Another lung volume reduction device utilizes a mechanical structure that is used to roll the lung tissue into a deflated, lower profile mass that is permanently maintained in a compressed condition. As for the type of procedure used, open surgical, minimally invasive and endobronchial approaches have all been proposed. Another proposed device (disclosed in publication no. [0009] WO 98/48706) is positioned at a location in the lung to block airflow and isolate a part of the lung. The publication states that the occlusion device is introduced through an endobronchial delivery device, and is resiliently deformable in order to provide a complete seal against airflow.
  • The search for new and better treatments underscores the drawbacks associated with existing pulmonary procedures. Accordingly, there is a need in the art for improved methods and devices for performing pulmonary procedures, and in particular, treating lung diseases such as emphysema. [0010]
  • SUMMARY OF THE INVENTION
  • In one embodiment the invention provides a method for treating a patient's lung. The method includes steps of selecting a hollow structure in a patient's lung, the hollow structure defining a pathway for conducting fluid flow in at least first and second directions, and allowing fluid flow within the pathway in the first direction while controlling fluid flow in the second direction. [0011]
  • In another embodiment the invention provides a method for treating a patient's lung. This method includes steps of providing a valve which allows fluid flow in a first direction and limits fluid flow in a second direction, and positioning the valve at a desired location in a lung of a patient with the first direction corresponding to an exhalation direction and the second direction corresponding to an inhalation direction. [0012]
  • In another embodiment the invention provides a method for treating a patient's lung that includes steps of providing a flow control element that limits fluid flow in at least one direction, positioning the flow control element at a location in a lung of a patient with the one direction substantially corresponding to an inhalation direction, and removing the flow control element after a period of time. [0013]
  • In another embodiment the invention provides a method for treating a patient's lung, the method comprising steps of selecting a hollow structure in a patient's lung, the hollow structure defining a pathway for conducting fluid flow in at least first and second directions, applying suction to draw fluid through the pathway in the first direction, and substantially preventing fluid flow through the pathway in the second direction. [0014]
  • In another embodiment the invention provides a system for treating a patient's lung. The system includes a flow control element sized and configured to be positioned in a hollow structure located in a patient's lung, the flow control element including a valve member that permits fluid flow in a first direction while substantially preventing fluid flow in a second direction. A delivery device is sized and configured to be guided to and positioned in or adjacent the hollow structure, and the flow control element is removably mounted on the delivery device. This valve may be a poppet, ball, duckbill, heimlick, flat or leaflet valve. [0015]
  • In another embodiment the invention provides a system for treating a patient's lung. The system includes a measuring device for determining the approximate size of a hollow structure in a patient's lung, and a flow control element sized and configured to be positioned in a hollow structure located in a patient's lung, wherein the flow control element allows fluid flow in a first direction but substantially prevents fluid flow in a second direction. [0016]
  • In another embodiment the invention provides a system for treating a patient's lung. This system includes a flow control element sized and configured to be positioned in a hollow structure located in a patient's lung, wherein the flow control element allows fluid flow in a first direction but substantially prevents fluid flow in a second direction, and a removal device for removing the flow control element from the hollow structure subsequent to positioning the flow control element in the hollow structure. [0017]
  • In another embodiment, a blocking element is coupled to a delivery element. The blocking element is advanced to a location in a patient's lung. An expandable member is expanded to occlude a pulmonary passageway and air is then withdrawn from the lung. The blocking element is released to block air flow into the isolated portion of the lung. The blocking element may also be a valve. The expandable member may be carried by the delivery element or by a separate element. [0018]
  • In still another embodiment, a device is advanced through the blocking element after implantation of the blocking element. A procedure, such as delivery or evacuation of fluids or liquids, may then be performed with the device. The device is then removed with the blocking element again preventing air from passing in the inhalation direction. The blocking element may also be a valve which permits air flow in an expiratory direction.[0019]
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is an elevation view schematically showing a system constructed according to one embodiment of the invention, the system being used to perform a pulmonary procedure on a patient; [0020]
  • FIG. 2 is an enlarged elevation view of the lungs of the patient shown in FIG. 1 along with the system of the invention; [0021]
  • FIG. 3 is an enlarged elevation view, in section, of a flow control element forming part of the system shown in FIG. 2, wherein the flow control element allows fluid flow in a first direction but blocks fluid flow in a second direction; [0022]
  • FIG. 4 is an enlarged elevation view, in section, of an alternative flow control element that allows fluid flow in a first direction but blocks fluid flow in a second direction; [0023]
  • FIG. 5 is an enlarged elevation view, in section, of another alternative flow control element; [0024]
  • FIG. 6 is an enlarged elevation view, in section, of still another alternative flow control element; [0025]
  • FIG. 7 is a perspective view of an introducer constructed according to another embodiment of the invention; [0026]
  • FIG. 8 is an enlarged perspective view of a portion of the introducer shown in FIG. 7; [0027]
  • FIG. 9 is a perspective view of a delivery device constructed according to another embodiment of the invention for delivering a flow control element to a selected location in a patient's lung; [0028]
  • FIG. 10 is a perspective view of a measuring device constructed according to another embodiment of the invention for determining the size of a hollow structure prior to disposing a flow control element in the structure; and [0029]
  • FIG. 11 is a perspective view of a removal device constructed according to another embodiment of the invention for removing a flow control element that has already been positioned in a hollow structure. [0030]
  • FIG. 12 is a side view of another flow control element. [0031]
  • FIG. 13 is another side view of the flow control element of FIG. 12. [0032]
  • FIG. 14 is a cross-sectional view of the flow control element of FIG. 12. [0033]
  • FIG. 15 is an alternative cross-sectional view of the flow control element of FIG. 12. [0034]
  • FIG. 16 is an isometric view of the flow control element of FIG. 12 altered to have a tapered shape. [0035]
  • FIG. 17 shows another flow control element. [0036]
  • FIG. 18 is an end view of the flow control element of FIG. 17. [0037]
  • FIG. 19 shows another flow control element. [0038]
  • FIG. 20 shows still another flow control element. [0039]
  • FIG. 21 is a side view of another flow control element. [0040]
  • FIG. 22 is a cross-section of FIG. 21 along line A-A. [0041]
  • FIG. 23 is a longitudinal cross-section of FIG. 21. [0042]
  • FIG. 24 is an alternative embodiment of the flow control device of FIG. 21. [0043]
  • FIG. 25 is a cross-section of FIG. 24 along line B-B. [0044]
  • FIG. 26 shows another flow control element with a flap valve in a closed position. [0045]
  • FIG. 27 shows the flap valve of FIG. 26 in an open position. [0046]
  • FIG. 28 shows a slit valve in a closed position. [0047]
  • FIG. 29 shows the slit valve in an open position. [0048]
  • FIG. 30 shows a flow control element with bristles. [0049]
  • FIG. 31 is a cross-sectional view of a ball valve. [0050]
  • FIG. 32 is a cross-sectional view of a poppet valve. [0051]
  • FIG. 33 shows a leaftlet valve. [0052]
  • FIG. 34 is a cross-section of the leaflet valve of FIG. 33. [0053]
  • FIG. 35 shows another flap valve. [0054]
  • FIG. 36 is a cross-sectional view of the flap valve of FIG. 35. [0055]
  • FIG. 37 shows still another flap valve. [0056]
  • FIG. 38 is a cross-sectional view of the flap valve of FIG. 36. [0057]
  • FIG. 39 shows a system for performing pulmonary procedures. [0058]
  • FIG. 40 is a cross-sectional view of the distal end of the system of FIG. 39. [0059]
  • FIG. 41 illustrates access of the isolated portion of the lung through the flow control element of the present invention. [0060]
  • FIG. 42 shows a device passing through the flow control element of FIGS. [0061] 12-15 with the valve sealing around the device.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
  • The present invention provides methods and devices for performing pulmonary procedures, for example, treating various lung diseases such as emphysema and COPD. One preferred embodiment of the invention provides a flow control element that allows fluid flow in a first direction and controls fluid flow in a second direction. As used herein, fluid means gas, liquid, or a combination of a gas(es) and liquid(s). In addition, controlled fluid flow, as used herein, means that the flow is altered in some manner, i.e., the flow is not unimpeded in the second direction. The specific manner in which fluid flow is controlled in the second direction depends on the construction of the flow control element. The flow control element may, for example, completely block, substantially block, limit, meter or regulate fluid flow in the second direction by a valve or other suitable structure. [0062]
  • As an example, when positioned in a hollow structure in a patient's body, such as a bronchiole in one of the lungs, the flow control element is oriented to allow flow in the exhalation direction but prevent fluid flow in the inhalation direction. The flow control element has a valve member that opens during exhalation in order to deflate or decompress the isolated lung portion distal to the flow control element. This maintains the diseased tissue in a decompressed state which prevents further hyper-expansion of the tissue. The invention also permits slow decompression of the lung tissue over a short or extended period of time. [0063]
  • The invention thus may be used to prevent fluid being drawn into one or more portion of a patient's lung. According to another aspect of the invention, a portion of the lung may be deflated by applying gentle suction (via the flow control element) to the hyper-expanded tissue without collapsing the walls of the narrow airways surrounded by diseased tissue. The suction draws air, liquid, mucous, etc., out of the lung portion to evacuate the diseased tissue. It will be recognized that these and other aspects of the invention may be practiced independently or in conjunction with each other. [0064]
  • FIG. 1 is a schematic view showing a system [0065] 10 constructed according to one embodiment of the invention for carrying out a pulmonary procedure on the lung L of a patient P. It should initially be noted that suitable systems, methods or devices outside of those specifically described herein may be used to practice the invention. As such, the system 10 is exemplary only and includes a bronchoscope 12 having a steering mechanism schematically indicated at 14, a shaft 16, and a port 18 which provides access to one or more working channels of the bronchoscope.
  • FIG. 1 shows a [0066] delivery device 20 constructed according to the invention. The delivery device 20 is shown positioned in the bronchoscope 12 in order to deliver a flow control element 22. The bronchoscope 12 has been passed into the patient's trachea T and guided into the right bronchus 24. The delivery device 20 is then manipulated with respect to the bronchoscope 12 via steering mechanism 14 to control placement of the flow control element 22. With reference to FIGS. 1 and 7-9, the delivery device 20 is movable within a bronchoscope working channel 26 (FIG. 8) and is guided into the desired location in the hollow structure, which in this case is a bronchiole 28. For purposes of explanation, the bronchiole 28 feeds an upper lobe U of the lung L which represents a diseased lung portion. The delivery device 20 is placed through the side port 18 and into the working channel 26, the distal end 30 of the delivery device 20 is moved out of the working channel, and the flow control element 22 is secured in position in the bronchiole 28.
  • FIG. 2 is an enlarged view of the patient's lungs L shown in FIG. 1 after the [0067] introducer 12 and delivery device 20 have been removed, the flow control element 22 being left in the bronchiole 28. The flow control element 22, shown in more detail in FIG. 3, is in the form of a valve with a valve member 32 supported by a ring 34. It should be noted that FIG. 2 also illustrates a second flow control element 22A placed in a bronchiole 28A that feeds a lower lobe LL of the lung. The flow control element 22A includes a valve member 32A and a support ring 34A and reduces or prevents fluid from being inhaled into the hyper-expanded tissue of the lower lobe LL. It will be understood that any number of flow control elements may be used in a given procedure.
  • Referring to FIG. 3, which shows the [0068] flow control element 22 in detail, the valve member 32 is a duckbill-type valve and has two flaps defining an opening 36. The valve member 32 is shown in a flow-preventing orientation in FIG. 3 with the opening 36 closed. The valve member 32 is configured to allow fluid flow in a first direction (along arrow A) while controlling fluid flow in a second direction (along arrow B). In this embodiment, fluid flow in the direction of arrow B is controlled by being completely blocked by valve member 32. The first and second directions in which fluid flow is allowed and controlled, respectively, are preferably opposite or substantially opposite each other, for example, as shown in the Figures. It will be appreciated, though, that the invention may be practiced with the first and second directions different but not opposite each other.
  • As noted above, the [0069] valve member 32 of the flow control element 22 controls fluid flow by completely blocking such flow in the second direction. As such, the valve member 32 effectively functions as a one-way valve. Alternative embodiments of the invention utilize flow control elements that controls fluid flow in the second direction without completely blocking such flow.
  • FIG. 4 shows an exemplary [0070] flow control element 38 constructed according to an alternative embodiment of the invention that limits, but does not block, fluid flow in at least one direction. The flow control element 38 comprises a valve member 40 supported by a ring 42. The valve member 40 is preferably a duckbill-type valve having a similar construction to that of the valve member 32, except that the flaps 44 are formed, secured, oriented or otherwise configured to maintain a flow opening 46 when in their flow-controlling (as opposed to flow-allowing) orientation. The opening 46 is sized and configured to achieve desired flow characteristics through the flow control element 38.
  • When the [0071] flow control element 38 is in its flow-allowing orientation (not shown), the flaps 44 spread apart and allow essentially unimpeded fluid flow out of the diseased lung portion. When the flow control element 38 is in its flow-controlling orientation, as shown in FIG. 4, the flaps move together to define opening 46 which allows a predetermined amount of fluid to be inhaled into the lung portion. This is in contrast to flow control element 22 which blocks fluid flow into the lung when in a flow-controlling orientation. It will of course be recognized that FIG. 4 shows only one way to achieve limited fluid flow in a given direction. The specific manner in which flow control is obtained may vary according to the invention, e.g., by varying the number, size, shape or position of the flow openings on the flow control element.
  • According to another aspect of the invention, the flow control element may be constructed to provide a pumping action that aids in moving gas or liquid within a hollow structure, such as a bronchiole. For instance, when the lung distorts during inhalation and/or exhalation, a mechanical pumping action is produced that may be used to move the gas or liquid to further deflate the isolated region of the lung. FIG. 5 shows an exemplary [0072] flow control element 50 constructed according to this embodiment and including a pair of valve members 52, 54 supposed in series by a ring 56. The valve members 52, 54 each include a pair of flaps defining a valve opening (the valve members being shown in their closed, fluid flow blocking orientation in FIG. 5). A chamber 58 is defined between the valve members 52, 54 and produces a pumping effect on the fluid flowing through the flow control element 50. The chamber would collapse and expand with movement of the bronchiole (or other hollow structure in which it is inserted) to pump fluid from the diseased lung tissue.
  • The [0073] valve member 54 is coupled to a bellows 60 to enhance the pumping action and/or to control the amount of force needed to open the valve member. The wall 62 defining the chamber 58 is secured to the ring 56 so that the chamber 58 occupies the entire interior of the ring 56. The flow control element 50 may have a different configuration wherein the chamber 58 is defined by an air pocket located within the wall 62. This may prevent fluid collecting in the chamber 58. In addition, a power-driven pump may be used to draw fluid out of the lungs, e.g., a miniature batter-powered electric pump, or pumps that use physical or chemical characteristics, e.g., a change in air temperature, presence of an additional gas or liquid, change in pH, etc., to generate pumping force that evacuates air and mucous.
  • FIG. 6 shows yet another alternative [0074] flow control element 70 including a valve member 72 comprising a pair of flaps defining an opening, and ring 74 supporting the valve member 72. The valve member 72 is a duckbill-type valve that permits fluid flow in a first direction but prevents flow in a second direction. The ring 74 in this embodiment comprises a stent 76 having struts 78 to enhance fixation of the flow control element 70 in the hollow body structure (not shown). The valve member 72 may be attached to the stent 76 by any suitable means, e.g., molded to the stent, suture, fasteners, adhesives, etc. The stent 76 is movable between collapsed and expanded (FIG. 6) orientations to enable easy delivery and deployment. That is, the flow control element 70 including stent 76 may be collapsed and held in a sheath for delivery through a relatively small space, for example, the working channel of a bronchoscope. (A typical bronchoscope has a diameter of about 6 or 7 mm, while the working channel has a diameter of about 2 or 3 mm.) Utilizing a collapsible flow control element may also be useful in introducing the flow control element through an small opening formed in the patient's thorax.
  • FIGS. 7 and 8 show in detail the [0075] bronchoscope 12 and the flow control element delivery device 20 described above in connection with FIG. 1. The bronchoscope 12 has an eyepiece 80 which is used to visualize the trachea and the various pathways of the lung during deployment of the flow control element 22. The bronchoscope 12 may be provided with a camera/recorder, an aspiration/irrigation system, or other auxiliary features. The steering mechanism 14 may comprise cables that move the distal tip of the bronchoscope shaft 16 over a desired angular range, for example, 0° through 180°. FIG. 8 shows the distal portion 30 of the bronchoscope 12 including the working channel 26 (which communicates with the side port 18), one or more fiber optic light guides 81, and a lens 82 for transmitting images to the eyepiece 80.
  • FIG. 9 shows the [0076] delivery device 20 to include a handle 84, an actuator 86, a support shaft 87 and a sheath 88. For purposes of illustration, the delivery device 20 will be described in connection with delivering the flow control element 70 of FIG. 6, although it will be understood that it may be used to deliver alternative flow control elements. The flow control element 70, and in particular the stent 76, is collapsed to a low profile orientation and then mounted on the shaft 87. The sheath 88 is moved distally from the position shown in FIG. 9 until it covers the stent body 76 (and the valve member 72, if desired) to maintain the flow control element 70 collapsed. (This position of the sheath is omitted for clarity.) The shaft 87 and sheath 88 are then passed into the side port 18 and working channel 26 of the bronchoscope 12 and guided to a desired location in the lung. The actuator 86 is used to remove the sheath 88 from the flow control element 70 which allows the stent 76 to expand. Stent 76 is preferably formed of a self-expanding material, e.g., nitinol. In this case the flow control element 70 immediately expands and engages the tissue upon retraction of sheath 88. Alternatively, the stents could rely on a mechanism such as a balloon or heat activation to expand in use.
  • The flow control element of the invention may be guided to and positioned at a desired location in the pulmonary system, such as the [0077] bronchiole 28 shown in FIGS. 1 and 2, by various delivery devices or systems. For example, guidewire-based systems, introducer sheaths, cannulae or catheters, etc., may be used to deliver the treatment element in a minimally invasive manner. The above-described method for using a bronchoscope to introduce the flow control element may be modified by placing an introducer sheath over the bronchoscope. The sheath provides access should the bronchoscope need to be removed from patient's body, for example, in order to place a different size flow control element.
  • The invention is preferably carried out by first determining the approximate size of the target lumen, i.e., the hollow structure in which the flow control element will be placed. FIG. 10 shows somewhat schematically an exemplary device for determining the size of a hollow structure in a patient's body, for example, a bronchiole in a lung. The [0078] device 90 includes a housing 92, shaft 94, positioning element, 96 and measuring elements 98. The measuring elements 98 have tips 100 that are moved into contact with the wall of the hollow structure, such as the inner surface of a bronchiole (not shown). The device 90 is calibrated so that when tips 100 of measuring elements 98 engage the wall of the bronchiole the indicator 102 displays the approximate size of the bronchiole. An electrical coupling 104 powers the device 90.
  • The [0079] positioning element 96 is optional and may be used to fix the position of the measuring elements 98 within the bronchiole so as to obtain more precise measurement. The illustrated element 96 is an inflatable balloon, although other elements could be used to center and hold the shaft 96 within the bronchiole. Any suitable means may be used for ensuring that the measuring elements 98 do in fact contact the bronchiole wall in order to provide a true reading. The measuring elements 98 may be moved distally (to the right in FIG. 10) until a visual indicator indicates that the tips 100 are in contact with tissue. Alternatively, a change in electrical resistance may be used to confirm contact between the measuring elements 98 and tissue. It should be noted that the device 90 is merely representative of the various means that may be used to determine the size of a hollow body structure.
  • In use, the [0080] shaft 94 of the measuring device 90 is passed through the bronchoscope working channel 26 and delivered to the site. The device 90 is then operated as described above to determine the approximate size of the bronchiole. The degree of precision with which the size of the hollow structure is measured will depend on the procedure being performed and user preference. After determining the size of the bronchiole the device 90 is removed from working channel 26, and delivery device 20 is inserted into the channel to deploy the flow control element in the bronchiole.
  • It may in some instances be necessary or desirable to remove a flow control element from a hollow structure in which it has been deployed. As an example, it may be the case that placement of a flow control element for a given period of time effects beneficial results on the diseased lung tissue. The time during which the diseased tissue is deflated and decompressed may allow the tissue to regain some elasticity as a result of being temporarily inactive. After the tissue has regained some or all of its elasticity, it would be better to remove the flow control element and allow the tissue to function efficiently. The flow control element, however, is preferably not removed before the tissue has a sufficient chance to recover. [0081]
  • Accordingly, the invention also provides methods and devices for removing a flow control element from a hollow structure such as a bronchiole in a patient's body. FIG. 11 shows a [0082] device 110 comprising a handle 112, an actuator 114, a shaft 116 and one or more removal components 118. The components 118 preferably have tips 120 configured to grasp a flow control element in order to remove the element from surrounding tissue. The shaft 116 of the device 110 is passed into a patient's trachea (not shown) and is guided to the previously-deployed flow control element; for example, the shaft 116 may be introduced through the working channel of a bronchoscope in the same manner as the delivery device 20. The removal components 118 are preferably collapsed within shaft 116 while the shaft is guided to the site. The components 118 are then extended into contact with the wall of the bronchiole. The tips 120 are used to grasp and remove the flow control element from the bronchiole.
  • The flow control element of the invention is secured in position in the hollow structure, such as [0083] bronchiole 28, so as to remain in place during breathing. The exterior of the flow control element may be configured along all or part of its exterior to aid in fixing the element in place, for instance, as schematically indicated by reference numeral 48 in FIGS. 3 and 4. The fixation structure 48 may comprise adhesives, tissue growth-inducing substances, fasteners, staples, clips, suture, stents, balloons, Dacron® sleeves, sintered, etched, roughened, barbed or alternatively treated surfaces, etc.
  • Placement of a flow control element constructed according to the invention in a patient's pulmonary system achieves several benefits. With reference to the illustrated [0084] flow control element 22, when deployed in the bronchiole 28 as shown in FIGS. 1 and 2, the element shows exhalation but prevents inhalation. The flow control element 22 thus limits or prevents the inhalation of additional fluid into the diseased lung portion. This is beneficial because it prevents further enlargement of the hyper-expanded tissue, which in turn maintains more room in the pleural space for healthy lung tissue. The flow control element 22 also allows any air being naturally exhaled by the patient (as well as any liquid, if present) to exit the lung, thereby deflating or compressing the tissue. The fluid is preferably permitted to flow unimpeded from the lung, but it may instead be metered or regulated in order to control deflation.
  • Referring to FIGS. [0085] 12-16, another flow control element 22 is shown. The flow control element 22 serves as a blocking element 122 which blocks air in the inhalation direction. The blocking element 122 may also have a valve 124 which permits air flow in an exhalation direction but prevents air flow in the inhalation direction. The valve 124 may be any suitable valve such as any of the valves described herein. For example, FIGS. 13 and 16 show the valve 124 having a first lip 126 and a second lip 128 which engage one another in the closed position. The term valve as used herein may also refer to a check valve which permits flow in one direction but prevents flow in the other direction. Although the valves described herein are used with various aspects of the invention, other aspects of the invention may be practiced by blocking flow in both directions. For example, the devices and methods for accessing the isolated part of the lung may be used with devices which block air flow in both directions. Finally, flow in the exhalation direction may be regulated in another manner as described herein rather than simply with the valve.
  • The [0086] flow control element 22 has an expandable support structure 130. The support structure 130 is metallic and preferably a superelastic material such as nitinol. The support structure 130 is formed by cutting, etching or otherwise removing material from a tube to form openings 132 as is generally known in the art of forming small, metallic tubes such as stents. Of course, the support structure 130 may be made in any other suitable manner and with other suitable materials. As an example, the support structure 130 may be a nitinol tube which is laser cut to have six diamond-shaped openings 132.
  • The [0087] flow control element 22 has a body 134 coupled to the support structure 130. The body is preferably molded silicone or urethane but may be any other suitable material. The valve 124 is mounted to the body 134 and may be integrally formed with the body 134 as described below. The body 134 may be attached to the support structure 130 in any suitable manner. For example, the body 134 may be positioned in the support structure 130 and an end 136 averted over an end 138 of the support structure 130. The everted end 136 is attached to the rest of the body 134 through the openings 132 in the support structure 130 at connections 140 with an adhesive, adhesive rivet, heat weld or any other suitable method. An advantage of coupling the body 134 to the support structure 130 with the connections 140 is that the support structure 130 and body 134 may collapse and expand somewhat independently since the connections 140 are free to move in the openings 132.
  • The [0088] flow control element 22 may also have a sealing portion 142 which forms a seal with the wall of the pulmonary passage. The sealing portion 142 may be attached to the body 134 separately (FIG. 14) or may be integrally formed with the body 134 and valve 124 (FIG. 15). An advantage of the flow control element 22 is that a substantial portion of the element 22, such as the body 134 and valve 124, are integrally formed. In the embodiment of FIG. 15, the valve 124, valve body 134 and sealing portion 142 are all integrally formed. The sealing portion 142 extends around the valve 124 but is not coupled directly to the valve 124 so that the valve 124 is not subjected to forces exerted on or by the sealing portion 142. The sealing portion 142 extends from a tube 144 positioned around the valve 124.
  • The sealing [0089] portion 142 forms a ring 146 around the body 134. The ring 146 is made of a resilient, elastomeric material which improves sealing with the wall of the pulmonary passage. The ring 146 may have any suitable shape such as straight, tapered, angled or could have frustoconical surface 143 which angles the ring 146. The sealing portion 142 preferably has at least two sealing portions 142, and preferably three, which each have a different diameter to seal with different size passages. In this manner, the device may be used within a given size range. The ring 142 also may be designed to deflect to permit exhalation air to pass. During coughing, for example, the valve 124 will, of course, open to permit air to escape, however, the pressure force on the valve 124 can be reduced if the sealing portion 142 also opens to permit further venting of the isolated portion of the lung. As will be explained below, various other structures may also be used to provide valves which cooperate with the wall of the pulmonary passageway to permit venting of the isolated area.
  • The [0090] body 134 is coupled to the support structure 130 to provide an exposed part 135 of the support structure 130 which helps to anchor the device. The term exposed part shall mean a part of the support structure 130 not covered by the body 134. Of course, the exposed part 135 may be covered by another material so long as it is not covered by the body 134. The exposed part 135 of the support structure 130 may form anchoring elements 148 which anchor the support structure 130. The anchoring elements 148 are preferably v-shaped to improve anchoring. Of course, the anchoring elements 148 may also be barbs or the like. Referring to FIG. 16, the flow control device 22 may also be angled, tapered or flared so that one end 151 is larger than the other 149. Of course, any other shape, such as a cylinder or tube flared at both ends, may be used without departing from many aspects of the invention.
  • Referring to FIGS. 17 and 18, another [0091] flow control element 22 is shown wherein the same or similar reference numbers refer to the same or similar structure. The element 22 has a valve 150 which has first and second lips 152, 154 which engage one another in a closed position. The first lip 152 is preferably stiffer than the second lip 154 so that the first lip 152 biases the second lip 154 closed. The first lip 152 may be made stiffer than the second lip 154 in any manner such as by using a thicker layer of the same material, a stiffer material for the first lip, or by simply adhering or attaching a stiffener 156 to the first lip 152. The first and second lips 152, 154 are preferably formed by a tube of material with the stiffener 156 attached to one side to form the first lip 152. The first and second lips 152, 154 are also preferably curved as shown in FIG. 18. The element 22 is preferably made of molded silicone or urethane although any other suitable material may be used. The valve 150 also has reinforcing elements 155 at the lateral edges to further support the lips 152, 154. The valve 150 may, of course, have either the elements 155 or stiffener 156. Although the sealing portion 142 is not shown for clarity, the sealing portion 142 may also be provided.
  • Referring to FIG. 19, another [0092] flow control element 22 is shown wherein the same or similar reference number show the same or similar structure. The flow control element 22 has the valve 124 and a number of sealing portions 142. The valve 124, sealing portion 142 and body 134 are integrally formed of a resilient material such as molded silicone or urethane. Of course, various other constructions may be used with the flow control element 22 without departing from the scope of the invention. The flow control element 22 may also have reinforcing element 158 such as a helical coil 160.
  • Referring to FIG. 20, still another [0093] flow control element 22 is shown wherein the same or similar reference numbers refer to the same or similar structure. The flow control element 22 has a sealing portion 142 which has a helical shape. In one method of implanting the device, the element 22 is rotated so that the helical shape of the sealing portion 142 engages the wall to anchor the element 22.
  • Any of the flow control elements of the present invention may also be used with a [0094] sealant 162, such as an adhesive, which seals and/or anchors the device. Referring to FIG. 20, the sealant 162 is positioned on the exterior of the device between the sealing portions 142. The sealant 162 is preferably a viscous substance which is applied to the exterior surface of the device before introduction. The sealant 162 may be an adhesive which also helps to anchor the device. The use of the sealant 162 may be used with any of the devices described herein.
  • Referring to FIGS. [0095] 21-23, still another flow control element 22 is shown wherein the same or similar reference numbers refer to the same or similar structure. The flow control element 22 has a support structure 164 which anchors a valve 166. The structure 164 has anchoring elements 168, preferably two, on each side of the valve 166. The anchoring element 168 are formed by two wires attached together. Of course, any other suitable structure may be used for the structure 164 such as a stent-like structure or an expandable ring with barbs.
  • The [0096] valve 164 cooperates with the wall of the pulmonary passageway to vent the isolated area. The valve 164 is generally conical, however, any other shape may be used. The valve 164 may engage the pulmonary wall with a number of different configurations without departing from the scope of the invention, thus, the following preferred embodiments do not limit the scope of the invention. The valve 164 is elastic and yields to permit expiratory air to pass between the valve and the wall of the passageway. Referring to FIG. 22, the valve 164 is thinner near an end engaging the wall W so that the end of the valve 164 is more flexible.
  • Referring to FIGS. 24 and 25, still another device is shown wherein the same or similar reference numbers refer to the same or similar structure. The device has a [0097] valve 170 with a number of sections 172 with each section 172 forming a seal with the wall of the pulmonary passage. The sections 172 are separated by wires 174 which provide a resilient structure. The device may be formed with any number of the sections 172 forming a valve structure 173 with the wall of the pulmonary passage.
  • Referring to FIGS. 26 and 27, still another [0098] flow control element 22 is shown wherein the same or similar reference numbers refer to the same or similar structure. The element 22 has a flap valve 174 which opens to permit expiratory air to pass. The valve 174 is also generally conical. The term generally conical as used herein means that the cone may diverge from a cone in that the walls may be slightly curved, have a number of sections or a seam, flap or fold while still being generally cone-shaped.
  • Referring to FIGS. 28 and 29, still another valve is shown having a slit or [0099] seam 178 which opens to permit expiratory air to pass. The slit or seam 178 may also be oriented and configured like a slit valve without departing from the scope of the invention.
  • Referring to FIG. 30, still another [0100] flow control element 22 is shown in which the same or similar reference numbers refer to the same or similar structure. The device has the valve 124 but may have any other suitable valve. The device has flexible bristles 180, preferably more than 10, 20 or even 30 bristles 180, which anchor the device in the pulmonary passageway. The bristles 180 are preferably angled to resist forces in the expiratory direction so that pressure forces, such as forces developed during coughing, cannot dislodge the device. The bristles 180 may be used with the sealant 162 to provide an airtight seal.
  • Referring to FIG. 31, still another [0101] flow control element 22 is shown which includes a sealing element 182, such s a ball 184, biased toward the closed position to form a ball valve 183. The sealing element 182 is biased with a spring 186 although any other biasing element may be used. The device has a body 188 with the sealing portion 142. The body 188 has an opening 190 through which air may pass when the sealing element 182 opens. Referring to FIG. 32, still another device is shown which has a blocking element 185 rather than the ball 184 of FIG. 31 to form a poppet valve 187.
  • Referring to FIGS. 33 and 34, still another [0102] flow control element 22 is shown. The device has a valve 186 which has at least three leaflets 188 which engage one another in the closed position. Referring to FIG. 35 and 36, still another device is shown having a flap valve 190. The flap valve 190 deflects to permit expiratory air to pass. The flap 190 is preferably made of an elastomeric material. The flap 190 is attached to a support strut 192 extending across an open end 194 of the body 196. The body 196 has the sealing portion 142 which is preferably formed by ribs extending around the body 196. Referring to FIGS. 37 and 38, another flap valve 198 is shown. The flap valve 198 is attached to the body at hinge 199.
  • Referring to FIGS. 39 and 40, another [0103] system 200 for deploying a device to a pulmonary location is shown. The system 200 is, of course, useful for delivering any of the devices described herein or any other suitable device. The system 200 includes a delivery element 202 having a first lumen 204 and a second lumen 206. The delivery element 202 also has an expandable member 208, such as a balloon 210, which is coupled to the second lumen 206 for inflating the balloon 210 with a source of inflation fluid or gas 212. The device is loaded into the end of the delivery element 202 and a pusher 214 may be used to move the device, such as the device of FIGS. 12-16, out of the delivery element 202. The first lumen 204 has an enlarged end which forms a capsule 215 which contains the device. The element 202 may also be advanced over a guidewire 217 or the like in a conventional manner.
  • The [0104] delivery element 202 may also be used to remove air, and even fluid if necessary, from the isolated portion of the lung. The expandable member 208 is expanded to isolate a portion of the lung and suction is applied to deflate the lung. The isolated portion of the lung may be deflated with the device contained within the delivery element 202 or may be deflated after delivery of the device. An advantage of using the valves of the present invention is that air can be drawn through the valve even after the valve has been deployed. Referring to FIG. 40, the valve 124 also may remain operational even when in the collapsed position. Thus, the isolated portion of the lung may also be suctioned when the device is contained in the first lumen. The second lumen 206 of the delivery element 202 may be substantially independent of the outer wall of the delivery element 202 so that the stiffness of the device is reduced as compared to an integrally formed multi-lumen device. The second lumen 206 is formed by a separate tube 209 passing through the first lumen 204. In another aspect of the invention, the delivery element 202 has an outer diameter which is 80-120%, more preferably 90-110%, of the minimum placement size of the device.
  • Referring now to FIGS. 39, 41 and [0105] 42, the isolated portion of the lung may be accessed after implantation of a device for subsequent medical treatments. For example, the valve may be penetrated with the delivery device 202, or similar device, to deliver and/or evacuate gas or liquid. The device is coupled to a source of fluid 211, such as an antibiotic or antisurfactant, which is delivered and, if necessary, evacuated from the lung. A gas, such as an antibiotic gas, may also be delivered from a source of gas 213 to the isolated area to reach distal portions of the isolated area. Finally, the device 202 may be coupled to a vacuum source 215 for deflating the isolated portion or evacuating mucous or other fluids from the isolated portion of the lung. A valve 216 is provided for selectively coupling the first lumen 204 to any of the source of fluid 211, gas 213 or vacuum 215.
  • Referring to FIG. 42, the [0106] device 202 may form a tight seal with the valve 124 so that the isolated portion remains deflated during the procedure. Alternatively, the device 202 may have the expandable element 208, such as the balloon 210, for occluding the pulmonary passageway on either side of the valve 124 to achieve isolation at any particular location in the pulmonary passageway distal or proximal to the valve 124.
  • An advantage of the present invention is that the isolated portion may be deflated after implantation of the valve without penetrating the valve. The device may be positioned proximal to the valve and the expandable element expanded to occlude the pulmonary passageway. Suction is then applied through the device so that a low pressure area develops between the valve and occluding member. When the pressure differential is large enough, the valve will open to vent and deflate the isolated portion of the lung. This process can be continued in a controlled manner until the desired amount of deflations is achieved or when a target pressure has been reached. When suction is stopped, the valve will close to isolate part of the lung. [0107]
  • After deployment of the valve, the delivery device, or other suitable device, may also be used as a diagnostic tool. For example, the balloon may be deflated momentarily so that the isolated area between the balloon and valve increases in pressure. If the pressure decreases after the balloon is inflated again it may indicate that the valve is not sealing properly since the air may be passing around or through the valve and into the isolated portion. An alternative diagnostic would be to pressurize the space between the valve and expandable member. The pressure response can then be monitored to determine if the valve provides an adequate seal. [0108]
  • The devices and valves of the present invention provide the ability to prevent inflation of diseased areas of the lung while also permitting venting of these portions of the lung. The valves preferably open with a relatively small pressure differential across the valve. For example, the valves preferably open with a pressure differential of no more than 10 inches water more preferably no more than 5 inches water and most preferably no more than 1 inch water. Although the valves and valve elements of the present invention may open with relatively small pressure differentials, the valves and valve elements may also have higher opening pressures. For example, the valves may also be designed to open only for high pressure events such as coughing. For such valves, the opening pressure, or differential pressure, is at least 25 inches water but still no more than 120 inches water. In accordance with a method of the present invention, coughing may be induced to increase the driving force and respiratory pressure to vent the isolated portions of the lung. [0109]
  • The flow control elements of the invention permit the diseased tissue to gradually deflate, either under the patient's own power or by applying relatively gentle suction for a given period of time. The suction may be applied intermittently or continuously by any suitable means. For example, a suction catheter could be passed through the flow control element in the bronchiole and into the distal tissue. The flow control element, for example, a valve member, would preferably seal around the catheter in order to prevent fluid moving distally past the valve. [0110]
  • The invention thus provides significant benefits as it permits fluid to be evacuated from the alveoli without collapsing the floppy walls of the narrow airways leading to them, problem with common lung diseases such as emphysema and COPD, as discussed above. Accordingly, the invention facilitates removal of more fluid from the diseased lung tissue than prior art approaches, the effect of which is more plural space available to the healthy lung tissue. [0111]
  • In addition, as noted above, using the invention to deflate the diseased lung tissue for a selected period of time., e.g., one month, may have beneficial results on the tissue by temporarily removing it from the respiratory circuit. The flow control element is preferably removed before the tissue begins to necrose, but is left in place a sufficiently long enough time that the tissue will not revert to its floppy, toneless state when the element is removed. Stated otherwise, it may be possible to use the invention as a means for repairing (rather than removing or obliterating) diseased lung tissue, either by controlling the fluid flow in the lung tissue or by controlling the fluid flow in combination with delivering one or more substances. [0112]
  • For example, some possible substances with which the invention may be used include gene therapy or angiogenesis factors for lung repair or re-establishment of tissue elasticity; growth factors; anti-growth or anti-angiogenesis factors (or substances to cause necrosis or apoptosis) to prevent re-establishment of air and blood flow; antibiotics to prevent infection; anti-inflammatory agents including steroids and cortisones; sclerosing drugs or materials to promote rapid healing, for example, to allow earlier removal of the flow control element; agents for absorbing remaining fluids; and sealing substances for enhancing isolation of the diseased tissue. [0113]
  • The portion of the lung being treated may de deflated over time through repeated natural inhalation and exhalation with the flow control element in place. Alternatively or additionally, a vacuum source may be coupled to the flow control element to draw fluid out of the diseased tissue in the manner discussed above. This deflation of the diseased portion may be performed alone or in conjunction with delivering biological substances. The pressures used to suction the lung portion are preferably low to avoid collapsing the walls of the narrow airways. [0114]
  • In the embodiments in which the flow control element comprises a valve, it may be formed of various materials and may be constructed in various manners. As an example, the valve may comprise an annulus or support ring formed of any suitable metal or synthetic material, with the valve member being formed of silicone, natural rubber, latex, polyurethane, polytetrafluoroethylene, a thermoplastic elastomer, tissue, etc. The valve member may be integral with the support ring or it may be a separate member attached thereto by suitable means, e.g., suture, adhesives, mechanical fasteners. If the flow control element comprises a stent with a valve prior art attachment methods may be used. For example, see U.S. Pat. No. 5, 954,766, the content of which is incorporated herein in reference. [0115]
  • The specific characteristics of the flow control element may be varied depending on the particular application. It may be desirable to provide multiple flow control elements with valve members that require different exhale pressures to open, for example, in order to allow treatment of patients who generate different exhalation pressures. The different flow control elements could be provided in a kit and be distinguished from each other based on required opening force, size, material, etc. The kit could include a color or other coding system to indicate these factors. [0116]
  • The flow control elements of the invention are preferably constructed so as to require a relatively low opening force in order to allow fluid flow in the first direction. Emphysema patients typically exhale a small quantity of low-pressure fluid. The invention preferably allows any such fluid to escape via the flow control element in the hollow structure. As such, the flow control element is designed to open and allow flow in the first direction in response to any positive pressure generated by the patient. Put another way, as long as some pressure differential exists between the distal lung tissue and the proximal portion of the bronchiole, the flow control element will open to allow fluid to escape the tissue. It will nonetheless be recognized that the particular force required to open the flow control element may be varied depending on exhalation pressures associated with the intended patient population. [0117]
  • It will be appreciated that features of the various preferred embodiments of the invention may be used independently or in conjunction with one another, while the illustrated methods and devices may be modified or combined in whole or in part. The inventive devices may include removable or detachable components, and may comprise disposable or reusable components, or a combination of disposable and reusable components. Likewise, it will be understood that the invention may be practiced with one or more of the steps specifically illustrated and described herein modified or omitted. [0118]
  • It should also be recognized that the invention is not limited to treating lung diseases as is shown in the Figures, although that is a preferred application. The invention may be used in any pulmonary or non-pulmonary procedure in which it is desirable to allow fluid flow in a first direction and control fluid flow in a second, different direction within a hollow structure. Finally, it will be understood that although a minimally invasive, endobronchial approach is shown in the Figures, other approaches may used, for example, an open surgical procedure using a median stemotomy, a minimally invasive procedure using a mini thoracotomy, or a still less invasive procedure using one or more ports or openings in the thorax, etc. [0119]
  • The preferred embodiments of the invention are described above in detail for the purpose of setting forth a complete disclosure and for sake of explanation and clarity. It will be readily understood that the scope of the invention defined by the appended claims will encompass numerous changes and modifications. [0120]

Claims (24)

What is claimed is:
1. A device for controlling air flow in a pulmonary passageway, comprising:
a body;
a one-way valve coupled to the body, the valve configured to prevent air from entering an isolated portion of the patient's lung but permitting expiratory air to pass through the valve, wherein the valve opens upon a pressure differential of no more than 10 inch water.
2. A device as defined in claim 1, wherein the valve opens upon a pressure differential of no more than 5 inch water.
3. A device as defined in claim 1, wherein the valve opens upon a pressure differential of no more than 1 inch water.
4. A device as defined in claim 1, wherein the body has a sealing portion which seals against the wall of the pulmonary passageway.
5. A device as defined in claim 4, wherein the sealing portion is deflectable to permit the passage of air in an expiratory direction.
6. A device as defined in claim 4, wherein the sealing portion is a ring.
7. A device as defined in claim 4, wherein the sealing portion is made of a resilient material.
8. A device as defined in claim 1, wherein the body includes an expandable support structure.
9. A device as defined in claim 1, wherein the body is made of an elastomeric material.
10. A device as defined in claim 8, wherein the body covers only part of the expandable support structure.
11. A device as defined in claim 1, wherein the valve is integrally formed with the body.
12. A device as defined in claim 1, wherein the valve has a first lip and a second lip, the first and second lips engaging one another when the valve is in a closed position, and wherein the first and second lips form a duckbill valve.
13. A device for controlling air flow in a pulmonary passageway, comprising:
a body;
a one-way valve coupled to the body, the valve configured to prevent air from entering an isolated portion of the patient's lung but permitting expiratory air to pass through the valve, wherein a pressure differential of 10 inch water or less opens the valve.
14. A device as defined in claim 13, wherein a pressure differential of 5 inch water or less opens the valve.
15. A device as defined in claim 13, wherein a pressure differential of 1 inch water or less opens the valve.
16. A device as defined in claim 13, wherein the body has a sealing portion which seals against the wall of the pulmonary passageway.
17. A device as defined in claim 16, wherein the sealing portion is deflectable to permit the passage of air in an expiratory direction.
18. A device as defined in claim 16, wherein the sealing portion is a ring.
19. A device as defined in claim 16, wherein the sealing portion is made of a resilient material.
20. A device as defined in claim 13, wherein the body includes an expandable support structure.
21. A device as defined in claim 13, wherein the body is made of an elastomeric material.
22. A device as defined in claim 20, wherein the body covers only part of the expandable support structure.
23. A device as defined in claim 13, wherein the valve is integrally formed with the body.
24. A device as defined in claim 13, wherein the valve has a first lip and a second lip, the first and second lips engaging one another when the valve is in a closed position, and wherein the first and second lips form a duckbill valve.
US10/704,023 2000-03-04 2003-11-06 Methods and devices for use in performing pulmonary procedures Abandoned US20040134487A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
US10/704,023 US20040134487A1 (en) 2000-03-04 2003-11-06 Methods and devices for use in performing pulmonary procedures

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US09/519,735 US6679264B1 (en) 2000-03-04 2000-03-04 Methods and devices for use in performing pulmonary procedures
US09/797,910 US6694979B2 (en) 2000-03-04 2001-03-02 Methods and devices for use in performing pulmonary procedures
US10/704,023 US20040134487A1 (en) 2000-03-04 2003-11-06 Methods and devices for use in performing pulmonary procedures

Related Parent Applications (1)

Application Number Title Priority Date Filing Date
US09/797,910 Continuation US6694979B2 (en) 2000-03-04 2001-03-02 Methods and devices for use in performing pulmonary procedures

Publications (1)

Publication Number Publication Date
US20040134487A1 true US20040134487A1 (en) 2004-07-15

Family

ID=24069559

Family Applications (8)

Application Number Title Priority Date Filing Date
US09/519,735 Expired - Lifetime US6679264B1 (en) 2000-03-04 2000-03-04 Methods and devices for use in performing pulmonary procedures
US09/797,910 Expired - Lifetime US6694979B2 (en) 2000-03-04 2001-03-02 Methods and devices for use in performing pulmonary procedures
US10/419,508 Expired - Lifetime US6840243B2 (en) 2000-03-04 2003-04-18 Methods and devices for use in performing pulmonary procedures
US10/419,654 Abandoned US20030192551A1 (en) 2000-03-04 2003-04-18 Methods and devices for use in performing pulmonary procedures
US10/630,473 Expired - Lifetime US7165548B2 (en) 2000-03-04 2003-07-29 Methods and devices for use in performing pulmonary procedures
US10/704,023 Abandoned US20040134487A1 (en) 2000-03-04 2003-11-06 Methods and devices for use in performing pulmonary procedures
US11/395,396 Expired - Lifetime US7662181B2 (en) 2000-03-04 2006-03-30 Methods and devices for use in performing pulmonary procedures
US12/264,849 Expired - Lifetime US8357139B2 (en) 2000-03-04 2008-11-04 Methods and devices for use in performing pulmonary procedures

Family Applications Before (5)

Application Number Title Priority Date Filing Date
US09/519,735 Expired - Lifetime US6679264B1 (en) 2000-03-04 2000-03-04 Methods and devices for use in performing pulmonary procedures
US09/797,910 Expired - Lifetime US6694979B2 (en) 2000-03-04 2001-03-02 Methods and devices for use in performing pulmonary procedures
US10/419,508 Expired - Lifetime US6840243B2 (en) 2000-03-04 2003-04-18 Methods and devices for use in performing pulmonary procedures
US10/419,654 Abandoned US20030192551A1 (en) 2000-03-04 2003-04-18 Methods and devices for use in performing pulmonary procedures
US10/630,473 Expired - Lifetime US7165548B2 (en) 2000-03-04 2003-07-29 Methods and devices for use in performing pulmonary procedures

Family Applications After (2)

Application Number Title Priority Date Filing Date
US11/395,396 Expired - Lifetime US7662181B2 (en) 2000-03-04 2006-03-30 Methods and devices for use in performing pulmonary procedures
US12/264,849 Expired - Lifetime US8357139B2 (en) 2000-03-04 2008-11-04 Methods and devices for use in performing pulmonary procedures

Country Status (8)

Country Link
US (8) US6679264B1 (en)
EP (1) EP1359978B1 (en)
JP (2) JP3881242B2 (en)
AT (1) ATE506103T1 (en)
AU (2) AU2001243416B2 (en)
CA (1) CA2401331C (en)
DE (1) DE60144491D1 (en)
WO (1) WO2001066190A2 (en)

Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040077987A1 (en) * 1998-02-13 2004-04-22 Ventrica, Inc., Corporation Of Delaware Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication
US20040154621A1 (en) * 2000-03-04 2004-08-12 Deem Mark E. Methods and devices for use in performing pulmonary procedures
US20050016530A1 (en) * 2003-07-09 2005-01-27 Mccutcheon John Treatment planning with implantable bronchial isolation devices
US20050145253A1 (en) * 2001-10-11 2005-07-07 Emphasys Medical, Inc., A Delaware Corporation Bronchial flow control devices and methods of use
US7036509B2 (en) 2003-12-04 2006-05-02 Emphasys Medical, Inc. Multiple seal port anesthesia adapter
US20090012626A1 (en) * 2006-03-13 2009-01-08 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US20100070050A1 (en) * 2008-09-12 2010-03-18 Pneumrx, Inc. Enhanced Efficacy Lung Volume Reduction Devices, Methods, and Systems
US7771472B2 (en) 2004-11-19 2010-08-10 Pulmonx Corporation Bronchial flow control devices and methods of use
US7798147B2 (en) 2001-03-02 2010-09-21 Pulmonx Corporation Bronchial flow control devices with membrane seal
US7814912B2 (en) 2002-11-27 2010-10-19 Pulmonx Corporation Delivery methods and devices for implantable bronchial isolation devices
US8206684B2 (en) 2004-02-27 2012-06-26 Pulmonx Corporation Methods and devices for blocking flow through collateral pathways in the lung
US8251067B2 (en) 2001-03-02 2012-08-28 Pulmonx Corporation Bronchial flow control devices with membrane seal
US8474460B2 (en) 2000-03-04 2013-07-02 Pulmonx Corporation Implanted bronchial isolation devices and methods
US8512360B2 (en) 1998-02-13 2013-08-20 Medtronic, Inc. Conduits for use in placing a target vessel in fluid communication with source of blood
US8721734B2 (en) 2009-05-18 2014-05-13 Pneumrx, Inc. Cross-sectional modification during deployment of an elongate lung volume reduction device
US8740921B2 (en) 2006-03-13 2014-06-03 Pneumrx, Inc. Lung volume reduction devices, methods, and systems
US9211181B2 (en) 2004-11-19 2015-12-15 Pulmonx Corporation Implant loading device and system
US9402633B2 (en) 2006-03-13 2016-08-02 Pneumrx, Inc. Torque alleviating intra-airway lung volume reduction compressive implant structures
US10390838B1 (en) 2014-08-20 2019-08-27 Pneumrx, Inc. Tuned strength chronic obstructive pulmonary disease treatment

Families Citing this family (310)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7992572B2 (en) 1998-06-10 2011-08-09 Asthmatx, Inc. Methods of evaluating individuals having reversible obstructive pulmonary disease
US7027869B2 (en) * 1998-01-07 2006-04-11 Asthmatx, Inc. Method for treating an asthma attack
US6488673B1 (en) * 1997-04-07 2002-12-03 Broncus Technologies, Inc. Method of increasing gas exchange of a lung
US6634363B1 (en) * 1997-04-07 2003-10-21 Broncus Technologies, Inc. Methods of treating lungs having reversible obstructive pulmonary disease
US7425212B1 (en) * 1998-06-10 2008-09-16 Asthmatx, Inc. Devices for modification of airways by transfer of energy
US5954766A (en) 1997-09-16 1999-09-21 Zadno-Azizi; Gholam-Reza Body fluid flow control device
US7921855B2 (en) * 1998-01-07 2011-04-12 Asthmatx, Inc. Method for treating an asthma attack
US7892229B2 (en) 2003-01-18 2011-02-22 Tsunami Medtech, Llc Medical instruments and techniques for treating pulmonary disorders
US8016823B2 (en) * 2003-01-18 2011-09-13 Tsunami Medtech, Llc Medical instrument and method of use
US8181656B2 (en) 1998-06-10 2012-05-22 Asthmatx, Inc. Methods for treating airways
US20070123958A1 (en) * 1998-06-10 2007-05-31 Asthmatx, Inc. Apparatus for treating airways in the lung
US7198635B2 (en) 2000-10-17 2007-04-03 Asthmatx, Inc. Modification of airways by application of energy
US6328689B1 (en) 2000-03-23 2001-12-11 Spiration, Inc., Lung constriction apparatus and method
US6679264B1 (en) 2000-03-04 2004-01-20 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US8251070B2 (en) 2000-03-27 2012-08-28 Asthmatx, Inc. Methods for treating airways
US6514290B1 (en) 2000-03-31 2003-02-04 Broncus Technologies, Inc. Lung elastic recoil restoring or tissue compressing device and method
US20030164168A1 (en) * 2000-05-18 2003-09-04 Shaw David Peter Bronchiopulmonary occulsion devices and lung volume reduction methods
US6722360B2 (en) 2000-06-16 2004-04-20 Rajiv Doshi Methods and devices for improving breathing in patients with pulmonary disease
US20020147462A1 (en) * 2000-09-11 2002-10-10 Closure Medical Corporation Bronchial occlusion method and apparatus
US7104987B2 (en) * 2000-10-17 2006-09-12 Asthmatx, Inc. Control system and process for application of energy to airway walls and other mediums
US6527761B1 (en) * 2000-10-27 2003-03-04 Pulmonx, Inc. Methods and devices for obstructing and aspirating lung tissue segments
US20060135947A1 (en) * 2000-10-27 2006-06-22 Pulmonx Occlusal stent and methods for its use
US9433457B2 (en) 2000-12-09 2016-09-06 Tsunami Medtech, Llc Medical instruments and techniques for thermally-mediated therapies
US7549987B2 (en) 2000-12-09 2009-06-23 Tsunami Medtech, Llc Thermotherapy device
US6896692B2 (en) 2000-12-14 2005-05-24 Ensure Medical, Inc. Plug with collet and apparatus and method for delivering such plugs
US6890343B2 (en) 2000-12-14 2005-05-10 Ensure Medical, Inc. Plug with detachable guidewire element and methods for use
US8083768B2 (en) 2000-12-14 2011-12-27 Ensure Medical, Inc. Vascular plug having composite construction
US6623509B2 (en) 2000-12-14 2003-09-23 Core Medical, Inc. Apparatus and methods for sealing vascular punctures
US6846319B2 (en) 2000-12-14 2005-01-25 Core Medical, Inc. Devices for sealing openings through tissue and apparatus and methods for delivering them
US20020112729A1 (en) * 2001-02-21 2002-08-22 Spiration, Inc. Intra-bronchial obstructing device that controls biological interaction with the patient
US7011094B2 (en) * 2001-03-02 2006-03-14 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US20040074491A1 (en) * 2001-03-02 2004-04-22 Michael Hendricksen Delivery methods and devices for implantable bronchial isolation devices
JP4409123B2 (en) * 2001-07-19 2010-02-03 オリンパス株式会社 Medical obturator
US6743259B2 (en) * 2001-08-03 2004-06-01 Core Medical, Inc. Lung assist apparatus and methods for use
US6994706B2 (en) 2001-08-13 2006-02-07 Minnesota Medical Physics, Llc Apparatus and method for treatment of benign prostatic hyperplasia
US6645205B2 (en) 2001-08-15 2003-11-11 Core Medical, Inc. Apparatus and methods for reducing lung volume
US20030050648A1 (en) * 2001-09-11 2003-03-13 Spiration, Inc. Removable lung reduction devices, systems, and methods
US6790237B2 (en) * 2001-10-09 2004-09-14 Scimed Life Systems, Inc. Medical stent with a valve and related methods of manufacturing
US6592594B2 (en) * 2001-10-25 2003-07-15 Spiration, Inc. Bronchial obstruction device deployment system and method
US20030127090A1 (en) * 2001-11-14 2003-07-10 Emphasys Medical, Inc. Active pump bronchial implant devices and methods of use thereof
US8444636B2 (en) 2001-12-07 2013-05-21 Tsunami Medtech, Llc Medical instrument and method of use
US20030154988A1 (en) * 2002-02-21 2003-08-21 Spiration, Inc. Intra-bronchial device that provides a medicant intra-bronchially to the patient
US20060235432A1 (en) * 2002-02-21 2006-10-19 Devore Lauri J Intra-bronchial obstructing device that controls biological interaction with the patient
US6929637B2 (en) * 2002-02-21 2005-08-16 Spiration, Inc. Device and method for intra-bronchial provision of a therapeutic agent
WO2003075796A2 (en) * 2002-03-08 2003-09-18 Emphasys Medical, Inc. Methods and devices for inducing collapse in lung regions fed by collateral pathways
US20030181922A1 (en) 2002-03-20 2003-09-25 Spiration, Inc. Removable anchored lung volume reduction devices and methods
WO2003079944A1 (en) * 2002-03-20 2003-10-02 Spiration, Inc. Removable anchored lung volume reduction devices and methods
US20030216769A1 (en) * 2002-05-17 2003-11-20 Dillard David H. Removable anchored lung volume reduction devices and methods
US20030195385A1 (en) * 2002-04-16 2003-10-16 Spiration, Inc. Removable anchored lung volume reduction devices and methods
US20030212412A1 (en) * 2002-05-09 2003-11-13 Spiration, Inc. Intra-bronchial obstructing device that permits mucus transport
US20040039250A1 (en) * 2002-05-28 2004-02-26 David Tholfsen Guidewire delivery of implantable bronchial isolation devices in accordance with lung treatment
US7096536B2 (en) * 2002-06-07 2006-08-29 Illinois Tool Works Inc Hinge apparatus with check mechanism
US7166120B2 (en) * 2002-07-12 2007-01-23 Ev3 Inc. Catheter with occluding cuff
US20040010209A1 (en) * 2002-07-15 2004-01-15 Spiration, Inc. Device and method for measuring the diameter of an air passageway
US20040059263A1 (en) * 2002-09-24 2004-03-25 Spiration, Inc. Device and method for measuring the diameter of an air passageway
US20100158795A1 (en) * 2008-06-12 2010-06-24 Pulmonx Methods and systems for assessing lung function and delivering therapeutic agents
DE60329625D1 (en) * 2002-11-27 2009-11-19 Pulmonx Corp INTRODUCTION FOR IMPLANTABLE BRONCHIAL INSULATION DEVICES
US20040210248A1 (en) * 2003-03-12 2004-10-21 Spiration, Inc. Apparatus, method and assembly for delivery of intra-bronchial devices
US7100616B2 (en) * 2003-04-08 2006-09-05 Spiration, Inc. Bronchoscopic lung volume reduction method
US8082921B2 (en) * 2003-04-25 2011-12-27 Anthony David Wondka Methods, systems and devices for desufflating a lung area
US7811274B2 (en) 2003-05-07 2010-10-12 Portaero, Inc. Method for treating chronic obstructive pulmonary disease
US20040226556A1 (en) 2003-05-13 2004-11-18 Deem Mark E. Apparatus for treating asthma using neurotoxin
US7426929B2 (en) 2003-05-20 2008-09-23 Portaero, Inc. Intra/extra-thoracic collateral ventilation bypass system and method
ATE481057T1 (en) 2003-05-28 2010-10-15 Cook Inc VALVE PROSTHESIS WITH VESSEL FIXING DEVICE
US7533667B2 (en) * 2003-05-29 2009-05-19 Portaero, Inc. Methods and devices to assist pulmonary decompression
US7252086B2 (en) * 2003-06-03 2007-08-07 Cordis Corporation Lung reduction system
US7377278B2 (en) 2003-06-05 2008-05-27 Portaero, Inc. Intra-thoracic collateral ventilation bypass system and method
US7682332B2 (en) * 2003-07-15 2010-03-23 Portaero, Inc. Methods to accelerate wound healing in thoracic anastomosis applications
US7153324B2 (en) 2003-07-31 2006-12-26 Cook Incorporated Prosthetic valve devices and methods of making such devices
US7533671B2 (en) * 2003-08-08 2009-05-19 Spiration, Inc. Bronchoscopic repair of air leaks in a lung
US20050103340A1 (en) * 2003-08-20 2005-05-19 Wondka Anthony D. Methods, systems & devices for endobronchial ventilation and drug delivery
US20050059862A1 (en) * 2003-09-12 2005-03-17 Scimed Life Systems, Inc. Cannula with integrated imaging and optical capability
AU2004216569B2 (en) * 2003-09-30 2009-12-24 Ethicon Endo-Surgery, Inc. Multi-angled duckbill seal assembly
US8034032B2 (en) 2003-09-30 2011-10-11 Ethicon Endo-Surgery, Inc. Multi-angled duckbill seal assembly
US8579892B2 (en) 2003-10-07 2013-11-12 Tsunami Medtech, Llc Medical system and method of use
US7361183B2 (en) 2003-10-17 2008-04-22 Ensure Medical, Inc. Locator and delivery device and method of use
US8852229B2 (en) 2003-10-17 2014-10-07 Cordis Corporation Locator and closure device and method of use
US20050178389A1 (en) * 2004-01-27 2005-08-18 Shaw David P. Disease indications for selective endobronchial lung region isolation
EP2368525B1 (en) * 2004-03-08 2019-09-18 Pulmonx, Inc Implanted bronchial isolation devices
US7775968B2 (en) * 2004-06-14 2010-08-17 Pneumrx, Inc. Guided access to lung tissues
US20050288702A1 (en) * 2004-06-16 2005-12-29 Mcgurk Erin Intra-bronchial lung volume reduction system
WO2006002396A2 (en) * 2004-06-24 2006-01-05 Calypso Medical Technologies, Inc. Radiation therapy of the lungs using leadless markers
WO2006014567A2 (en) 2004-07-08 2006-02-09 Pneumrx, Inc. Pleural effusion treatment device, method and material
US7766891B2 (en) * 2004-07-08 2010-08-03 Pneumrx, Inc. Lung device with sealing features
US20060030863A1 (en) * 2004-07-21 2006-02-09 Fields Antony J Implanted bronchial isolation device delivery devices and methods
US20060047291A1 (en) * 2004-08-20 2006-03-02 Uptake Medical Corporation Non-foreign occlusion of an airway and lung collapse
US7906124B2 (en) * 2004-09-18 2011-03-15 Asthmatx, Inc. Inactivation of smooth muscle tissue
US7949407B2 (en) 2004-11-05 2011-05-24 Asthmatx, Inc. Energy delivery devices and methods
WO2006052940A2 (en) * 2004-11-05 2006-05-18 Asthmatx, Inc. Medical device with procedure improvement features
US20070093802A1 (en) * 2005-10-21 2007-04-26 Danek Christopher J Energy delivery devices and methods
ES2645340T3 (en) 2004-11-16 2017-12-05 Uptake Medical Technology Inc. Lung treatment device
WO2006055047A2 (en) * 2004-11-18 2006-05-26 Mark Adler Intra-bronchial apparatus for aspiration and insufflation of lung regions distal to placement or cross communication and deployment and placement system therefor
US8220460B2 (en) * 2004-11-19 2012-07-17 Portaero, Inc. Evacuation device and method for creating a localized pleurodesis
US7398782B2 (en) * 2004-11-19 2008-07-15 Portaero, Inc. Method for pulmonary drug delivery
US20060118126A1 (en) * 2004-11-19 2006-06-08 Don Tanaka Methods and devices for controlling collateral ventilation
EP1816945B1 (en) 2004-11-23 2019-08-21 PneumRx, Inc. Steerable device for accessing a target site
WO2006063339A2 (en) * 2004-12-08 2006-06-15 Ventus Medical, Inc. Respiratory devices and methods of use
US9833354B2 (en) 2004-12-08 2017-12-05 Theravent, Inc. Nasal respiratory devices
US8061357B2 (en) * 2004-12-08 2011-11-22 Ventus Medical, Inc. Adhesive nasal respiratory devices
US10610228B2 (en) 2004-12-08 2020-04-07 Theravent, Inc. Passive nasal peep devices
US7806120B2 (en) * 2004-12-08 2010-10-05 Ventus Medical, Inc. Nasal respiratory devices for positive end-expiratory pressure
US7824366B2 (en) * 2004-12-10 2010-11-02 Portaero, Inc. Collateral ventilation device with chest tube/evacuation features and method
US20080228137A1 (en) * 2007-03-12 2008-09-18 Pulmonx Methods and devices for passive residual lung volume reduction and functional lung volume expansion
US8496006B2 (en) 2005-01-20 2013-07-30 Pulmonx Corporation Methods and devices for passive residual lung volume reduction and functional lung volume expansion
US11883029B2 (en) 2005-01-20 2024-01-30 Pulmonx Corporation Methods and devices for passive residual lung volume reduction and functional lung volume expansion
US8876791B2 (en) 2005-02-25 2014-11-04 Pulmonx Corporation Collateral pathway treatment using agent entrained by aspiration flow current
US8088144B2 (en) 2005-05-04 2012-01-03 Ensure Medical, Inc. Locator and closure device and method of use
US8926654B2 (en) 2005-05-04 2015-01-06 Cordis Corporation Locator and closure device and method of use
US20070032785A1 (en) * 2005-08-03 2007-02-08 Jennifer Diederich Tissue evacuation device
US8104474B2 (en) * 2005-08-23 2012-01-31 Portaero, Inc. Collateral ventilation bypass system with retention features
US9265605B2 (en) * 2005-10-14 2016-02-23 Boston Scientific Scimed, Inc. Bronchoscopic lung volume reduction valve
US8545530B2 (en) * 2005-10-19 2013-10-01 Pulsar Vascular, Inc. Implantable aneurysm closure systems and methods
BRPI0617652A2 (en) 2005-10-19 2011-08-02 Pulsar Vascular Inc methods and systems for endovascular incision and repair of tissue and lumen defects
US20070186933A1 (en) * 2006-01-17 2007-08-16 Pulmonx Systems and methods for delivering flow restrictive element to airway in lungs
US7406963B2 (en) * 2006-01-17 2008-08-05 Portaero, Inc. Variable resistance pulmonary ventilation bypass valve and method
US20070203396A1 (en) * 2006-02-28 2007-08-30 Mccutcheon John G Endoscopic Tool
US8136526B2 (en) * 2006-03-08 2012-03-20 Pulmonx Corporation Methods and devices to induce controlled atelectasis and hypoxic pulmonary vasoconstriction
US7691151B2 (en) 2006-03-31 2010-04-06 Spiration, Inc. Articulable Anchor
US7829986B2 (en) * 2006-04-01 2010-11-09 Stats Chippac Ltd. Integrated circuit package system with net spacer
WO2007132449A2 (en) * 2006-05-11 2007-11-22 Yossi Gross Implantable respiration therapy device
EP2026723B1 (en) 2006-05-23 2018-11-21 Theravent, Inc. Nasal respiratory devices
GB0610171D0 (en) 2006-05-23 2006-06-28 Robitaille Jean Pierre Valved nasal canula
US8690938B2 (en) * 2006-05-26 2014-04-08 DePuy Synthes Products, LLC Occlusion device combination of stent and mesh with diamond-shaped porosity
EP2032213A4 (en) * 2006-06-07 2014-02-19 Theravent Inc Nasal devices
US20090145441A1 (en) * 2007-12-06 2009-06-11 Rajiv Doshi Delayed resistance nasal devices and methods of use
US20110203598A1 (en) * 2006-06-07 2011-08-25 Favet Michael L Nasal devices including layered nasal devices and delayed resistance adapters for use with nasal devices
US7654264B2 (en) 2006-07-18 2010-02-02 Nellcor Puritan Bennett Llc Medical tube including an inflatable cuff having a notched collar
WO2008027293A2 (en) * 2006-08-25 2008-03-06 Emphasys Medical, Inc. Bronchial isolation devices for placement in short lumens
US8342182B2 (en) 2006-08-28 2013-01-01 Pulmonx Corporation Functional assessment and treatment catheters and methods for their use in the lung
US7931647B2 (en) 2006-10-20 2011-04-26 Asthmatx, Inc. Method of delivering energy to a lung airway using markers
US7993323B2 (en) 2006-11-13 2011-08-09 Uptake Medical Corp. High pressure and high temperature vapor catheters and systems
US8585645B2 (en) * 2006-11-13 2013-11-19 Uptake Medical Corp. Treatment with high temperature vapor
US8240309B2 (en) * 2006-11-16 2012-08-14 Ventus Medical, Inc. Adjustable nasal devices
US7985254B2 (en) 2007-01-08 2011-07-26 David Tolkowsky Endobronchial fluid exhaler devices and methods for use thereof
GB0701315D0 (en) * 2007-01-24 2007-03-07 Smiths Group Plc Medico-surgical devices
US20080221582A1 (en) * 2007-03-05 2008-09-11 Pulmonx Pulmonary stent removal device
TW200836781A (en) * 2007-03-07 2008-09-16 Ventus Medical Inc Nasal devices
EP1967178A1 (en) * 2007-03-07 2008-09-10 Raffinerie Notre Dame - Orafti S.A. Fructan-based epilatory compositions
WO2008111070A2 (en) * 2007-03-12 2008-09-18 David Tolkowsky Devices and methods for performing medical procedures in tree-like luminal structures
US8137302B2 (en) * 2007-03-12 2012-03-20 Pulmonx Corporation Methods and systems for occluding collateral flow channels in the lung
US8163034B2 (en) * 2007-05-11 2012-04-24 Portaero, Inc. Methods and devices to create a chemically and/or mechanically localized pleurodesis
US7931641B2 (en) * 2007-05-11 2011-04-26 Portaero, Inc. Visceral pleura ring connector
US20080281151A1 (en) * 2007-05-11 2008-11-13 Portaero, Inc. Pulmonary pleural stabilizer
US20080287878A1 (en) * 2007-05-15 2008-11-20 Portaero, Inc. Pulmonary visceral pleura anastomosis reinforcement
US20080283065A1 (en) * 2007-05-15 2008-11-20 Portaero, Inc. Methods and devices to maintain patency of a lumen in parenchymal tissue of the lung
US8062315B2 (en) 2007-05-17 2011-11-22 Portaero, Inc. Variable parietal/visceral pleural coupling
US20080295829A1 (en) * 2007-05-30 2008-12-04 Portaero, Inc. Bridge element for lung implant
US8235983B2 (en) * 2007-07-12 2012-08-07 Asthmatx, Inc. Systems and methods for delivering energy to passageways in a patient
ATE556667T1 (en) 2007-08-23 2012-05-15 Aegea Medical Inc UTERUS THERAPY DEVICE
US8136230B2 (en) * 2007-10-12 2012-03-20 Spiration, Inc. Valve loader method, system, and apparatus
US8043301B2 (en) * 2007-10-12 2011-10-25 Spiration, Inc. Valve loader method, system, and apparatus
US10182712B2 (en) * 2007-10-12 2019-01-22 Beth Israel Deaconess Medical Center, Inc. Catheter guided endotracheal intubation
US8322335B2 (en) * 2007-10-22 2012-12-04 Uptake Medical Corp. Determining patient-specific vapor treatment and delivery parameters
WO2009055410A1 (en) * 2007-10-22 2009-04-30 Uptake Medical Corp. Determining patient-specific vapor treatment and delivery parameters
US8020700B2 (en) 2007-12-05 2011-09-20 Ventus Medical, Inc. Packaging and dispensing nasal devices
AU2009212689A1 (en) * 2008-02-01 2009-08-13 Ventus Medical, Inc. CPAP interface and backup devices
US8483831B1 (en) 2008-02-15 2013-07-09 Holaira, Inc. System and method for bronchial dilation
WO2009105432A2 (en) * 2008-02-19 2009-08-27 Portaero, Inc. Devices and methods for delivery of a therapeutic agent through a pneumostoma
US8475389B2 (en) * 2008-02-19 2013-07-02 Portaero, Inc. Methods and devices for assessment of pneumostoma function
US8336540B2 (en) * 2008-02-19 2012-12-25 Portaero, Inc. Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US9924992B2 (en) * 2008-02-20 2018-03-27 Tsunami Medtech, Llc Medical system and method of use
US10245098B2 (en) 2008-04-29 2019-04-02 Virginia Tech Intellectual Properties, Inc. Acute blood-brain barrier disruption using electrical energy based therapy
US10702326B2 (en) 2011-07-15 2020-07-07 Virginia Tech Intellectual Properties, Inc. Device and method for electroporation based treatment of stenosis of a tubular body part
US10238447B2 (en) 2008-04-29 2019-03-26 Virginia Tech Intellectual Properties, Inc. System and method for ablating a tissue site by electroporation with real-time monitoring of treatment progress
US9598691B2 (en) 2008-04-29 2017-03-21 Virginia Tech Intellectual Properties, Inc. Irreversible electroporation to create tissue scaffolds
US11254926B2 (en) 2008-04-29 2022-02-22 Virginia Tech Intellectual Properties, Inc. Devices and methods for high frequency electroporation
US11272979B2 (en) 2008-04-29 2022-03-15 Virginia Tech Intellectual Properties, Inc. System and method for estimating tissue heating of a target ablation zone for electrical-energy based therapies
US10117707B2 (en) 2008-04-29 2018-11-06 Virginia Tech Intellectual Properties, Inc. System and method for estimating tissue heating of a target ablation zone for electrical-energy based therapies
US9198733B2 (en) 2008-04-29 2015-12-01 Virginia Tech Intellectual Properties, Inc. Treatment planning for electroporation-based therapies
US10448989B2 (en) 2009-04-09 2019-10-22 Virginia Tech Intellectual Properties, Inc. High-frequency electroporation for cancer therapy
US10272178B2 (en) 2008-04-29 2019-04-30 Virginia Tech Intellectual Properties Inc. Methods for blood-brain barrier disruption using electrical energy
US9283051B2 (en) 2008-04-29 2016-03-15 Virginia Tech Intellectual Properties, Inc. System and method for estimating a treatment volume for administering electrical-energy based therapies
US8992517B2 (en) 2008-04-29 2015-03-31 Virginia Tech Intellectual Properties Inc. Irreversible electroporation to treat aberrant cell masses
US9867652B2 (en) 2008-04-29 2018-01-16 Virginia Tech Intellectual Properties, Inc. Irreversible electroporation using tissue vasculature to treat aberrant cell masses or create tissue scaffolds
EP2662046B1 (en) 2008-05-09 2023-03-15 Nuvaira, Inc. Systems and assemblies for treating a bronchial tree
US8721632B2 (en) 2008-09-09 2014-05-13 Tsunami Medtech, Llc Methods for delivering energy into a target tissue of a body
US20090308398A1 (en) * 2008-06-16 2009-12-17 Arthur Ferdinand Adjustable resistance nasal devices
US8579888B2 (en) 2008-06-17 2013-11-12 Tsunami Medtech, Llc Medical probes for the treatment of blood vessels
ES2879278T3 (en) 2008-09-05 2021-11-22 Pulsar Vascular Inc Systems to support or occlude a physiological opening or cavity
US9561068B2 (en) 2008-10-06 2017-02-07 Virender K. Sharma Method and apparatus for tissue ablation
US9561066B2 (en) 2008-10-06 2017-02-07 Virender K. Sharma Method and apparatus for tissue ablation
US10064697B2 (en) 2008-10-06 2018-09-04 Santa Anna Tech Llc Vapor based ablation system for treating various indications
US10695126B2 (en) 2008-10-06 2020-06-30 Santa Anna Tech Llc Catheter with a double balloon structure to generate and apply a heated ablative zone to tissue
EP2341859B1 (en) 2008-10-06 2017-04-05 Virender K. Sharma Apparatus for tissue ablation
MX2011001507A (en) * 2008-11-04 2011-04-05 Unomedical As A closed respiratory suction system.
US20100160906A1 (en) * 2008-12-23 2010-06-24 Asthmatx, Inc. Expandable energy delivery devices having flexible conductive elements and associated systems and methods
US8347881B2 (en) * 2009-01-08 2013-01-08 Portaero, Inc. Pneumostoma management device with integrated patency sensor and method
US11284931B2 (en) * 2009-02-03 2022-03-29 Tsunami Medtech, Llc Medical systems and methods for ablating and absorbing tissue
US8518053B2 (en) * 2009-02-11 2013-08-27 Portaero, Inc. Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US11638603B2 (en) 2009-04-09 2023-05-02 Virginia Tech Intellectual Properties, Inc. Selective modulation of intracellular effects of cells using pulsed electric fields
US11382681B2 (en) 2009-04-09 2022-07-12 Virginia Tech Intellectual Properties, Inc. Device and methods for delivery of high frequency electrical pulses for non-thermal ablation
US8361041B2 (en) 2009-04-09 2013-01-29 University Of Utah Research Foundation Optically guided feeding tube, catheters and associated methods
US9060922B2 (en) 2009-04-09 2015-06-23 The University Of Utah Optically guided medical tube and control unit assembly and methods of use
FR2944201B1 (en) * 2009-04-14 2011-06-10 Novatech Sa BRONCHIC SHUTTER WITH VALVE
US8903488B2 (en) 2009-05-28 2014-12-02 Angiodynamics, Inc. System and method for synchronizing energy delivery to the cardiac rhythm
US9895189B2 (en) 2009-06-19 2018-02-20 Angiodynamics, Inc. Methods of sterilization and treating infection using irreversible electroporation
JP5731512B2 (en) 2009-09-04 2015-06-10 パルサー バスキュラー インコーポレイテッド System and method for sealing an anatomical opening
ES2560671T3 (en) * 2009-09-21 2016-02-22 Arnold Wolfovich Levin Device for the treatment of conditions associated with the lung
CN102639077B (en) 2009-10-27 2015-05-13 赫莱拉公司 Delivery devices with coolable energy emitting assemblies
US8900223B2 (en) * 2009-11-06 2014-12-02 Tsunami Medtech, Llc Tissue ablation systems and methods of use
US20110108041A1 (en) * 2009-11-06 2011-05-12 Elliot Sather Nasal devices having a safe failure mode and remotely activatable
US8911439B2 (en) * 2009-11-11 2014-12-16 Holaira, Inc. Non-invasive and minimally invasive denervation methods and systems for performing the same
EP4111995A1 (en) 2009-11-11 2023-01-04 Nuvaira, Inc. Device for treating tissue and controlling stenosis
US9161801B2 (en) * 2009-12-30 2015-10-20 Tsunami Medtech, Llc Medical system and method of use
US8425455B2 (en) 2010-03-30 2013-04-23 Angiodynamics, Inc. Bronchial catheter and method of use
US8579964B2 (en) 2010-05-05 2013-11-12 Neovasc Inc. Transcatheter mitral valve prosthesis
US8875711B2 (en) 2010-05-27 2014-11-04 Theravent, Inc. Layered nasal respiratory devices
WO2012021597A2 (en) * 2010-08-10 2012-02-16 Boston Scientific Scimed, Inc. Stent delivery system with integrated camera
US9943353B2 (en) 2013-03-15 2018-04-17 Tsunami Medtech, Llc Medical system and method of use
WO2012042287A1 (en) * 2010-09-29 2012-04-05 Arnold Wolfovich Levin Device for the treatment of lung associated conditions
US20120095369A1 (en) 2010-10-15 2012-04-19 Teixeira Scott M System and Method for Sampling Device for Bodily Fluids
ES2912362T3 (en) 2010-11-09 2022-05-25 Aegea Medical Inc Method of placement and apparatus for delivering steam to the uterus
CN102133136A (en) * 2011-01-28 2011-07-27 于军 Biological power duplex valve device and charging and discharging method
US9554897B2 (en) 2011-04-28 2017-01-31 Neovasc Tiara Inc. Methods and apparatus for engaging a valve prosthesis with tissue
US9308087B2 (en) 2011-04-28 2016-04-12 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US8795241B2 (en) 2011-05-13 2014-08-05 Spiration, Inc. Deployment catheter
US10004510B2 (en) 2011-06-03 2018-06-26 Pulsar Vascular, Inc. Systems and methods for enclosing an anatomical opening, including shock absorbing aneurysm devices
ES2656328T3 (en) 2011-06-03 2018-02-26 Pulsar Vascular, Inc. Aneurism devices with additional anchoring mechanisms and associated systems
US8839791B2 (en) 2011-06-22 2014-09-23 Breathe Technologies, Inc. Ventilation mask with integrated piloted exhalation valve
US9486602B2 (en) 2011-06-22 2016-11-08 Breathe Technologies, Inc. Ventilation mask with integrated piloted exhalation valve and method of ventilating a patient using the same
US9038634B2 (en) 2011-06-22 2015-05-26 Breathe Technologies, Inc. Ventilation mask with integrated piloted exhalation valve
FR2978345B1 (en) * 2011-07-25 2013-08-30 Charam Khosrovaninejad SURGICAL DEVICE FOR ANCHOR CONTROL IN INTESTINES.
US9078665B2 (en) 2011-09-28 2015-07-14 Angiodynamics, Inc. Multiple treatment zone ablation probe
US9730830B2 (en) 2011-09-29 2017-08-15 Trudell Medical International Nasal insert and cannula and methods for the use thereof
EP3735916A1 (en) 2011-10-05 2020-11-11 Pulsar Vascular, Inc. Devices for enclosing an anatomical opening
CN104135960B (en) 2011-10-07 2017-06-06 埃杰亚医疗公司 A kind of uterine therapy device
WO2013120082A1 (en) 2012-02-10 2013-08-15 Kassab Ghassan S Methods and uses of biological tissues for various stent and other medical applications
US9259229B2 (en) 2012-05-10 2016-02-16 Pulsar Vascular, Inc. Systems and methods for enclosing an anatomical opening, including coil-tipped aneurysm devices
US9345573B2 (en) 2012-05-30 2016-05-24 Neovasc Tiara Inc. Methods and apparatus for loading a prosthesis onto a delivery system
EP2854682B1 (en) 2012-06-04 2021-06-23 Boston Scientific Scimed, Inc. Systems for treating tissue of a passageway within a body
JP5891119B2 (en) * 2012-06-21 2016-03-22 テルモ株式会社 Exhalation resistance device
WO2014018153A1 (en) 2012-07-24 2014-01-30 Boston Scientific Scimed, Inc. Electrodes for tissue treatment
WO2014066081A1 (en) 2012-10-24 2014-05-01 Cook Medical Technologies Llc Anti-reflux prosthesis
US9272132B2 (en) 2012-11-02 2016-03-01 Boston Scientific Scimed, Inc. Medical device for treating airways and related methods of use
US9283374B2 (en) 2012-11-05 2016-03-15 Boston Scientific Scimed, Inc. Devices and methods for delivering energy to body lumens
AU2013355303B2 (en) 2012-12-04 2017-12-14 Mallinckrodt Hospital Products IP Limited Cannula for minimizing dilution of dosing during nitric oxide delivery
US9795756B2 (en) 2012-12-04 2017-10-24 Mallinckrodt Hospital Products IP Limited Cannula for minimizing dilution of dosing during nitric oxide delivery
US9398933B2 (en) 2012-12-27 2016-07-26 Holaira, Inc. Methods for improving drug efficacy including a combination of drug administration and nerve modulation
EP2752170B1 (en) * 2013-01-08 2017-02-22 Cook Medical Technologies LLC Multi valve anti-reflux prosthesis
EP3964151A3 (en) 2013-01-17 2022-03-30 Virender K. Sharma Apparatus for tissue ablation
US9888956B2 (en) 2013-01-22 2018-02-13 Angiodynamics, Inc. Integrated pump and generator device and method of use
AU2014214700B2 (en) 2013-02-11 2018-01-18 Cook Medical Technologies Llc Expandable support frame and medical device
US9434977B2 (en) 2013-02-27 2016-09-06 Avent, Inc. Rapid identification of organisms in bodily fluids
US10821729B2 (en) 2013-02-28 2020-11-03 Hewlett-Packard Development Company, L.P. Transfer molded fluid flow structure
US11426900B2 (en) 2013-02-28 2022-08-30 Hewlett-Packard Development Company, L.P. Molding a fluid flow structure
EP2961614B1 (en) 2013-02-28 2020-01-15 Hewlett-Packard Development Company, L.P. Molded print bar
KR101886590B1 (en) * 2013-02-28 2018-08-07 휴렛-팩커드 디벨롭먼트 컴퍼니, 엘.피. Molded fluid flow structure
US20140276051A1 (en) * 2013-03-13 2014-09-18 Gyrus ACM, Inc. (d.b.a Olympus Surgical Technologies America) Device for Minimally Invasive Delivery of Treatment Substance
CN105189122B (en) 2013-03-20 2017-05-10 惠普发展公司,有限责任合伙企业 Molded die slivers with exposed front and back surfaces
US9572665B2 (en) 2013-04-04 2017-02-21 Neovasc Tiara Inc. Methods and apparatus for delivering a prosthetic valve to a beating heart
US10188510B2 (en) 2013-05-03 2019-01-29 Cormatrix Cardiovascular, Inc. Prosthetic tissue valves
US10188509B2 (en) 2013-05-03 2019-01-29 Cormatrix Cardiovascular, Inc. Prosthetic tissue valves
US9814618B2 (en) 2013-06-06 2017-11-14 Boston Scientific Scimed, Inc. Devices for delivering energy and related methods of use
US9308078B2 (en) 2013-07-19 2016-04-12 Boston Scientific Scimed, Inc. Medical device, system, and method for regulating fluid flow in bronchial passageways
EP3708104A1 (en) 2013-08-09 2020-09-16 Boston Scientific Scimed, Inc. Expandable catheter and related methods of manufacture and use
US9782211B2 (en) 2013-10-01 2017-10-10 Uptake Medical Technology Inc. Preferential volume reduction of diseased segments of a heterogeneous lobe
KR20160145068A (en) * 2014-04-16 2016-12-19 사노피 에스에이 Sealing member for a medical device
JP6594901B2 (en) 2014-05-12 2019-10-23 バージニア テック インテレクチュアル プロパティース インコーポレイテッド Selective modulation of intracellular effects of cells using pulsed electric fields
JP6534385B2 (en) * 2014-05-19 2019-06-26 学校法人 名城大学 Stent
WO2015179666A1 (en) 2014-05-22 2015-11-26 Aegea Medical Inc. Systems and methods for performing endometrial ablation
US10179019B2 (en) 2014-05-22 2019-01-15 Aegea Medical Inc. Integrity testing method and apparatus for delivering vapor to the uterus
ES2755370T3 (en) * 2014-07-18 2020-04-22 Ethicon Inc Devices to control the size of the emphysematous bulla
EP3169247B1 (en) 2014-07-18 2020-05-13 Ethicon, Inc. Mechanical retraction via tethering for lung volume reduction
US10485604B2 (en) 2014-12-02 2019-11-26 Uptake Medical Technology Inc. Vapor treatment of lung nodules and tumors
WO2016100325A1 (en) 2014-12-15 2016-06-23 Virginia Tech Intellectual Properties, Inc. Devices, systems, and methods for real-time monitoring of electrophysical effects during tissue treatment
US10531906B2 (en) 2015-02-02 2020-01-14 Uptake Medical Technology Inc. Medical vapor generator
GB2550099B (en) 2015-03-24 2020-09-02 Gyrus Acmi Inc Airway stent
US9592138B1 (en) 2015-09-13 2017-03-14 Martin Mayse Pulmonary airflow
EP3383266B1 (en) * 2015-11-30 2021-08-11 Materialise N.V. Computer-implemented method of providing a device for placement in an airway passage
CN108882981B (en) 2016-01-29 2021-08-10 内奥瓦斯克迪亚拉公司 Prosthetic valve for preventing outflow obstruction
CN114983553A (en) 2016-02-19 2022-09-02 埃杰亚医疗公司 Method and apparatus for determining the integrity of a body cavity
GB2563540B (en) 2016-03-25 2021-11-03 Gyrus Acmi Inc Valve planning tool
US11331140B2 (en) 2016-05-19 2022-05-17 Aqua Heart, Inc. Heated vapor ablation systems and methods for treating cardiac conditions
WO2018013359A1 (en) * 2016-07-11 2018-01-18 Cormatrix Cardiovascular, Inc. Prosthetic tissue valves
WO2018013361A1 (en) * 2016-07-11 2018-01-18 Cormatrix Cardiovascular, Inc. Prosthetic tissue valves
US11419490B2 (en) * 2016-08-02 2022-08-23 Covidien Lp System and method of using an endoscopic catheter as a port in laparoscopic surgery
KR20190059921A (en) 2016-09-30 2019-05-31 늄알엑스, 인코퍼레이티드 Guide wire
US11529224B2 (en) 2016-10-05 2022-12-20 Pulmonx Corporation High resistance implanted bronchial isolation devices and methods
US10758333B2 (en) 2016-10-05 2020-09-01 Pulmonx Corporation High resistance implanted bronchial isolation devices and methods
US10905492B2 (en) 2016-11-17 2021-02-02 Angiodynamics, Inc. Techniques for irreversible electroporation using a single-pole tine-style internal device communicating with an external surface electrode
WO2018090148A1 (en) 2016-11-21 2018-05-24 Neovasc Tiara Inc. Methods and systems for rapid retraction of a transcatheter heart valve delivery system
US20200008711A1 (en) 2017-03-17 2020-01-09 SPIRATION, INC., d/b/a OLYMPUS RESPIRATORY AMERICA Airway sizing apparatus
US11129673B2 (en) 2017-05-05 2021-09-28 Uptake Medical Technology Inc. Extra-airway vapor ablation for treating airway constriction in patients with asthma and COPD
WO2019036810A1 (en) 2017-08-25 2019-02-28 Neovasc Tiara Inc. Sequentially deployed transcatheter mitral valve prosthesis
US11344364B2 (en) 2017-09-07 2022-05-31 Uptake Medical Technology Inc. Screening method for a target nerve to ablate for the treatment of inflammatory lung disease
EP3678721A1 (en) 2017-09-08 2020-07-15 Vapotherm, Inc. Birfurcated cannula device
US11350988B2 (en) 2017-09-11 2022-06-07 Uptake Medical Technology Inc. Bronchoscopic multimodality lung tumor treatment
USD845467S1 (en) 2017-09-17 2019-04-09 Uptake Medical Technology Inc. Hand-piece for medical ablation catheter
US11419658B2 (en) 2017-11-06 2022-08-23 Uptake Medical Technology Inc. Method for treating emphysema with condensable thermal vapor
US11607537B2 (en) 2017-12-05 2023-03-21 Virginia Tech Intellectual Properties, Inc. Method for treating neurological disorders, including tumors, with electroporation
US11490946B2 (en) 2017-12-13 2022-11-08 Uptake Medical Technology Inc. Vapor ablation handpiece
US11311329B2 (en) 2018-03-13 2022-04-26 Virginia Tech Intellectual Properties, Inc. Treatment planning for immunotherapy based treatments using non-thermal ablation techniques
US11925405B2 (en) 2018-03-13 2024-03-12 Virginia Tech Intellectual Properties, Inc. Treatment planning system for immunotherapy enhancement via non-thermal ablation
WO2019232432A1 (en) 2018-06-01 2019-12-05 Santa Anna Tech Llc Multi-stage vapor-based ablation treatment methods and vapor generation and delivery systems
US11737872B2 (en) 2018-11-08 2023-08-29 Neovasc Tiara Inc. Ventricular deployment of a transcatheter mitral valve prosthesis
US11653927B2 (en) 2019-02-18 2023-05-23 Uptake Medical Technology Inc. Vapor ablation treatment of obstructive lung disease
CA3135753C (en) 2019-04-01 2023-10-24 Neovasc Tiara Inc. Controllably deployable prosthetic valve
CA3136334A1 (en) 2019-04-10 2020-10-15 Neovasc Tiara Inc. Prosthetic valve with natural blood flow
US11439402B2 (en) 2019-04-18 2022-09-13 Clearstream Technologies Limited Embolization devices and methods of manufacturing the same
EP3958750A1 (en) * 2019-04-22 2022-03-02 Eolo Medical Inc. Devices for the treatment of pulmonary disorders with implantable valves
WO2020236931A1 (en) 2019-05-20 2020-11-26 Neovasc Tiara Inc. Introducer with hemostasis mechanism
CN114144144A (en) 2019-06-20 2022-03-04 内奥瓦斯克迪亚拉公司 Low-profile prosthetic mitral valve
US11583650B2 (en) * 2019-06-28 2023-02-21 Vapotherm, Inc. Variable geometry cannula
BR112022001231A2 (en) * 2019-07-24 2022-04-05 Quest Medical Inc Filtered vacuum discharge vent valve
EP4034211B1 (en) 2019-09-26 2023-12-27 Vapotherm, Inc. Internal cannula mounted nebulizer
WO2022026270A1 (en) * 2020-07-28 2022-02-03 Pulmonx Corporation High resistance implanted bronchial isolation devices and methods
CN113288019B (en) * 2021-05-14 2024-02-13 宁波海泰科迈医疗器械有限公司 Access component for cleaning endoscope lens in real time and application method thereof
CN113244481B (en) * 2021-05-25 2022-07-05 吉林大学 Split type piezoelectricity driven intelligent insulin pastes
WO2023091619A1 (en) * 2021-11-18 2023-05-25 Maracaja Luiz Selective lobe delivery of therapeutics and apparatus for interventional bronchoscopy
CN115531038B (en) * 2022-09-26 2023-06-16 中日友好医院(中日友好临床医学研究所) One-way valve for bronchus

Citations (91)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2832078A (en) * 1956-10-17 1958-04-29 Battelle Memorial Institute Heart valve
US2981254A (en) * 1957-11-12 1961-04-25 Edwin G Vanderbilt Apparatus for the gas deflation of an animal's stomach
US3320972A (en) * 1964-04-16 1967-05-23 Roy F High Prosthetic tricuspid valve and method of and device for fabricating same
US3445916A (en) * 1967-04-19 1969-05-27 Rudolf R Schulte Method for making an anatomical check valve
US3657744A (en) * 1970-05-08 1972-04-25 Univ Minnesota Method for fixing prosthetic implants in a living body
US3671979A (en) * 1969-09-23 1972-06-27 Univ Utah Catheter mounted artificial heart valve for implanting in close proximity to a defective natural heart valve
US3788327A (en) * 1971-03-30 1974-01-29 H Donowitz Surgical implant device
US3874388A (en) * 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
US4014318A (en) * 1973-08-20 1977-03-29 Dockum James M Circulatory assist device and system
US4084268A (en) * 1976-04-22 1978-04-18 Shiley Laboratories, Incorporated Prosthetic tissue heart valve
US4086665A (en) * 1976-12-16 1978-05-02 Thermo Electron Corporation Artificial blood conduit
US4212463A (en) * 1978-02-17 1980-07-15 Pratt Enoch B Humane bleeder arrow
US4218782A (en) * 1977-05-25 1980-08-26 Biocoating Anpartsselskab Heart valve prosthesis and method for the production thereof
US4250873A (en) * 1977-04-26 1981-02-17 Richard Wolf Gmbh Endoscopes
US4339831A (en) * 1981-03-27 1982-07-20 Medtronic, Inc. Dynamic annulus heart valve and reconstruction ring
US4732152A (en) * 1984-12-05 1988-03-22 Medinvent S.A. Device for implantation and a method of implantation in a vessel using such device
US4759758A (en) * 1984-12-07 1988-07-26 Shlomo Gabbay Prosthetic heart valve
US4795449A (en) * 1986-08-04 1989-01-03 Hollister Incorporated Female urinary incontinence device
US4808183A (en) * 1980-06-03 1989-02-28 University Of Iowa Research Foundation Voice button prosthesis and method for installing same
US4819664A (en) * 1984-11-15 1989-04-11 Stefano Nazari Device for selective bronchial intubation and separate lung ventilation, particularly during anesthesia, intensive therapy and reanimation
US4830003A (en) * 1988-06-17 1989-05-16 Wolff Rodney G Compressive stent and delivery system
US4832680A (en) * 1986-07-03 1989-05-23 C.R. Bard, Inc. Apparatus for hypodermically implanting a genitourinary prosthesis
US4846836A (en) * 1988-10-03 1989-07-11 Reich Jonathan D Artificial lower gastrointestinal valve
US4850999A (en) * 1980-05-24 1989-07-25 Institute Fur Textil-Und Faserforschung Of Stuttgart Flexible hollow organ
US4852568A (en) * 1987-02-17 1989-08-01 Kensey Nash Corporation Method and apparatus for sealing an opening in tissue of a living being
US4934999A (en) * 1987-07-28 1990-06-19 Paul Bader Closure for a male urethra
US4990151A (en) * 1988-09-28 1991-02-05 Medinvent S.A. Device for transluminal implantation or extraction
US5116360A (en) * 1990-12-27 1992-05-26 Corvita Corporation Mesh composite graft
US5116564A (en) * 1988-10-11 1992-05-26 Josef Jansen Method of producing a closing member having flexible closing elements, especially a heart valve
US5123919A (en) * 1991-11-21 1992-06-23 Carbomedics, Inc. Combined prosthetic aortic heart valve and vascular graft
US5306234A (en) * 1993-03-23 1994-04-26 Johnson W Dudley Method for closing an atrial appendage
US5382261A (en) * 1992-09-01 1995-01-17 Expandable Grafts Partnership Method and apparatus for occluding vessels
US5392775A (en) * 1994-03-22 1995-02-28 Adkins, Jr.; Claude N. Duckbill valve for a tracheostomy tube that permits speech
US5409019A (en) * 1992-10-30 1995-04-25 Wilk; Peter J. Coronary artery by-pass method
US5411552A (en) * 1990-05-18 1995-05-02 Andersen; Henning R. Valve prothesis for implantation in the body and a catheter for implanting such valve prothesis
US5411507A (en) * 1993-01-08 1995-05-02 Richard Wolf Gmbh Instrument for implanting and extracting stents
US5413599A (en) * 1988-09-20 1995-05-09 Nippon Zeon Co., Ltd. Medical valve apparatus
US5417226A (en) * 1994-06-09 1995-05-23 Juma; Saad Female anti-incontinence device
US5445626A (en) * 1991-12-05 1995-08-29 Gigante; Luigi Valve operated catheter for urinary incontinence and retention
US5486154A (en) * 1993-06-08 1996-01-23 Kelleher; Brian S. Endoscope
US5499995A (en) * 1994-05-25 1996-03-19 Teirstein; Paul S. Body passageway closure apparatus and method of use
US5500014A (en) * 1989-05-31 1996-03-19 Baxter International Inc. Biological valvular prothesis
US5645519A (en) * 1994-03-18 1997-07-08 Jai S. Lee Endoscopic instrument for controlled introduction of tubular members in the body and methods therefor
US5645565A (en) * 1995-06-13 1997-07-08 Ethicon Endo-Surgery, Inc. Surgical plug
US5649906A (en) * 1991-07-17 1997-07-22 Gory; Pierre Method for implanting a removable medical apparatus in a human body
US5660175A (en) * 1995-08-21 1997-08-26 Dayal; Bimal Endotracheal device
US5755770A (en) * 1995-01-31 1998-05-26 Boston Scientific Corporatiion Endovascular aortic graft
US5855601A (en) * 1996-06-21 1999-01-05 The Trustees Of Columbia University In The City Of New York Artificial heart valve and method and device for implanting the same
US5855597A (en) * 1997-05-07 1999-01-05 Iowa-India Investments Co. Limited Stent valve and stent graft for percutaneous surgery
US5855587A (en) * 1996-06-13 1999-01-05 Chon-Ik Hyon Hole forming device for pierced earrings
US5910144A (en) * 1998-01-09 1999-06-08 Endovascular Technologies, Inc. Prosthesis gripping system and method
US5944738A (en) * 1998-02-06 1999-08-31 Aga Medical Corporation Percutaneous catheter directed constricting occlusion device
US6009614A (en) * 1998-04-21 2000-01-04 Advanced Cardiovascular Systems, Inc. Stent crimping tool and method of use
US6020380A (en) * 1998-11-25 2000-02-01 Tap Holdings Inc. Method of treating chronic obstructive pulmonary disease
US6022312A (en) * 1995-05-05 2000-02-08 Chaussy; Christian Endosphincter, set for releasable closure of the urethra and method for introduction of an endosphincter into the urethra
US6027508A (en) * 1996-10-03 2000-02-22 Scimed Life Systems, Inc. Stent retrieval device
US6027525A (en) * 1996-05-23 2000-02-22 Samsung Electronics., Ltd. Flexible self-expandable stent and method for making the same
US6051022A (en) * 1998-12-30 2000-04-18 St. Jude Medical, Inc. Bileaflet valve having non-parallel pivot axes
US6068635A (en) * 1998-03-04 2000-05-30 Schneider (Usa) Inc Device for introducing an endoprosthesis into a catheter shaft
US6068638A (en) * 1995-10-13 2000-05-30 Transvascular, Inc. Device, system and method for interstitial transvascular intervention
US6077291A (en) * 1992-01-21 2000-06-20 Regents Of The University Of Minnesota Septal defect closure device
US6083255A (en) * 1997-04-07 2000-07-04 Broncus Technologies, Inc. Bronchial stenter
US6168614B1 (en) * 1990-05-18 2001-01-02 Heartport, Inc. Valve prosthesis for implantation in the body
US6174323B1 (en) * 1998-06-05 2001-01-16 Broncus Technologies, Inc. Method and assembly for lung volume reduction
US6183520B1 (en) * 1996-08-13 2001-02-06 Galt Laboratories, Inc. Method of maintaining urinary continence
US6190381B1 (en) * 1995-06-07 2001-02-20 Arthrocare Corporation Methods for tissue resection, ablation and aspiration
US6200333B1 (en) * 1997-04-07 2001-03-13 Broncus Technologies, Inc. Bronchial stenter
US6206918B1 (en) * 1999-05-12 2001-03-27 Sulzer Carbomedics Inc. Heart valve prosthesis having a pivot design for improving flow characteristics
US6234996B1 (en) * 1999-06-23 2001-05-22 Percusurge, Inc. Integrated inflation/deflation device and method
US6240615B1 (en) * 1998-05-05 2001-06-05 Advanced Cardiovascular Systems, Inc. Method and apparatus for uniformly crimping a stent onto a catheter
US6245102B1 (en) * 1997-05-07 2001-06-12 Iowa-India Investments Company Ltd. Stent, stent graft and stent valve
US6247471B1 (en) * 1999-07-08 2001-06-19 Essex Pb&R Corporation Smoke hood with oxygen supply device and method of use
US6258100B1 (en) * 1999-08-24 2001-07-10 Spiration, Inc. Method of reducing lung size
US6270527B1 (en) * 1998-10-16 2001-08-07 Sulzer Carbomedics Inc. Elastic valve with partially exposed stent
US20020007831A1 (en) * 2000-07-19 2002-01-24 Davenport Paul W. Method for treating chronic obstructive pulmonary disorder
US20020026233A1 (en) * 2000-08-29 2002-02-28 Alexander Shaknovich Method and devices for decreasing elevated pulmonary venous pressure
US20020062120A1 (en) * 1999-07-02 2002-05-23 Pulmonx Methods, systems, and kits for lung volume reduction
US20020077696A1 (en) * 1997-09-16 2002-06-20 Gholam-Reza Zadno-Azizi Body fluid flow control device
US20020077593A1 (en) * 1999-10-21 2002-06-20 Pulmonx Apparatus and method for isolated lung access
US20020087153A1 (en) * 1999-08-05 2002-07-04 Broncus Technologies, Inc. Devices for creating collateral channels
US20020111619A1 (en) * 1999-08-05 2002-08-15 Broncus Technologies, Inc. Devices for creating collateral channels
US20020111620A1 (en) * 2001-02-14 2002-08-15 Broncus Technologies, Inc. Devices and methods for maintaining collateral channels in tissue
US20020112729A1 (en) * 2001-02-21 2002-08-22 Spiration, Inc. Intra-bronchial obstructing device that controls biological interaction with the patient
US6440164B1 (en) * 1999-10-21 2002-08-27 Scimed Life Systems, Inc. Implantable prosthetic valve
US20030018344A1 (en) * 2001-07-19 2003-01-23 Olympus Optical Co., Ltd. Medical device and method of embolizing bronchus or bronchiole
US20030018327A1 (en) * 2001-07-20 2003-01-23 Csaba Truckai Systems and techniques for lung volume reduction
US20030050648A1 (en) * 2001-09-11 2003-03-13 Spiration, Inc. Removable lung reduction devices, systems, and methods
US20030083671A1 (en) * 2001-10-25 2003-05-01 Spiration, Inc. Bronchial obstruction device deployment system and method
US6558318B1 (en) * 1993-02-22 2003-05-06 Heartport, Inc. Endoscopic retraction method
US6679264B1 (en) * 2000-03-04 2004-01-20 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US6699231B1 (en) * 1997-12-31 2004-03-02 Heartport, Inc. Methods and apparatus for perfusion of isolated tissue structure

Family Cites Families (158)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US75170A (en) * 1868-03-03 Improvement in the manufacture of soap
US16435A (en) * 1857-01-20 Sawing-machine
US52344A (en) * 1866-01-30 Alfbed w
US37808A (en) * 1863-03-03 Improvement in dumping-tubs
US112729A (en) * 1871-03-14 Improvement in dress-swords
US77593A (en) * 1868-05-05 Samuel f
US95209A (en) * 1869-09-28 Improved medical extract
US56274A (en) * 1866-07-10 Improvement in cotton-seed planters
US77696A (en) * 1868-05-05 Improvement in corn-harvesters
US62120A (en) * 1867-02-19 Smith dtar
US192550A (en) * 1877-06-26 Ifviprovefvlewt in steam-piston valves
US25132A (en) * 1859-08-16 Eotary movement
US87153A (en) * 1869-02-23 eaton
US111619A (en) * 1871-02-07 Improvement in saws
US138165A (en) * 1873-04-22 Improvement in boat-detaching apparatus
US51799A (en) * 1866-01-02 Improvement in sashes and frames for windows
US75169A (en) * 1868-03-03 Richard kitson
US111620A (en) * 1871-02-07 Improvement in devices for enlarging wells
US41906A (en) * 1864-03-15 Improvement in grain-weighers
US3709227A (en) * 1970-04-28 1973-01-09 Scott And White Memorial Hospi Endotracheal tube with positive check valve air seal
US3822720A (en) * 1971-03-04 1974-07-09 Noyce R Flow control assembly
US3794036A (en) * 1972-08-02 1974-02-26 R Carroll Pressure regulated inflatable cuff for an endotracheal or tracheostomy tube
US3901272A (en) * 1974-01-04 1975-08-26 Ford Motor Co Unidirectional flow control valve
US4056854A (en) 1976-09-28 1977-11-08 The United States Of America As Represented By The Department Of Health, Education And Welfare Aortic heart valve catheter
US4222126A (en) 1978-12-14 1980-09-16 The United States Of America As Represented By The Secretary Of The Department Of Health, Education & Welfare Unitized three leaflet heart valve
SU852321A1 (en) 1979-10-02 1981-08-07 Второй Московский Ордена Ленинагосударственный Медицинский Ин-Ститут Им. H.И.Пирогова Method of treating acute purulent diseases of lungs and pleura of children
US4302854A (en) 1980-06-04 1981-12-01 Runge Thomas M Electrically activated ferromagnetic/diamagnetic vascular shunt for left ventricular assist
US4477930A (en) 1982-09-28 1984-10-23 Mitral Medical International, Inc. Natural tissue heat valve and method of making same
FR2543834B1 (en) 1983-04-07 1985-08-23 Descartes Universite Rene VARIABLE GEOMETRY PROBE FOR MEASURING RADIAL CONSTRAINTS IN A SPHINCTER OF A LIVING ORGANISM
US4710192A (en) 1985-12-30 1987-12-01 Liotta Domingo S Diaphragm and method for occlusion of the descending thoracic aorta
SU1371700A1 (en) 1986-02-21 1988-02-07 МВТУ им.Н.Э.Баумана Prosthesis of heart valve
SU1593651A1 (en) 1987-07-07 1990-09-23 1-Й Московский Медицинский Институт Им.И.М.Сеченова Artery prosthesis
US4879998A (en) * 1987-08-28 1989-11-14 Litton Systems, Inc. Balanced exhalation valve for use in a closed loop breathing system
US4774942A (en) * 1987-08-28 1988-10-04 Litton Systems, Inc. Balanced exhalation valve for use in a closed loop breathing system
US5010892A (en) 1988-05-04 1991-04-30 Triangle Research And Development Corp. Body lumen measuring instrument
US4877025A (en) * 1988-10-06 1989-10-31 Hanson Donald W Tracheostomy tube valve apparatus
US4968294A (en) 1989-02-09 1990-11-06 Salama Fouad A Urinary control valve and method of using same
US5800339A (en) 1989-02-09 1998-09-01 Opticon Medical Inc. Urinary control valve
JPH02255122A (en) * 1989-03-29 1990-10-15 Terumo Corp Gas flow valve
US5352240A (en) 1989-05-31 1994-10-04 Promedica International, Inc. Human heart valve replacement with porcine pulmonary valve
US5562608A (en) * 1989-08-28 1996-10-08 Biopulmonics, Inc. Apparatus for pulmonary delivery of drugs with simultaneous liquid lavage and ventilation
US5137024A (en) * 1989-10-06 1992-08-11 Terumo Kabushiki Kaisha Gas flow valve and sphygmomanometer air-feeding/discharging apparatus using the same
US5061274A (en) 1989-12-04 1991-10-29 Kensey Nash Corporation Plug device for sealing openings and method of use
US5271385A (en) 1990-03-29 1993-12-21 United States Surgical Corporation Abdominal cavity organ retractor
US5158548A (en) * 1990-04-25 1992-10-27 Advanced Cardiovascular Systems, Inc. Method and system for stent delivery
IT1247037B (en) 1991-06-25 1994-12-12 Sante Camilli ARTIFICIAL VENOUS VALVE
US5161524A (en) 1991-08-02 1992-11-10 Glaxo Inc. Dosage inhalator with air flow velocity regulating means
US5151105A (en) 1991-10-07 1992-09-29 Kwan Gett Clifford Collapsible vessel sleeve implant
US5662713A (en) 1991-10-09 1997-09-02 Boston Scientific Corporation Medical stents for body lumens exhibiting peristaltic motion
US5643317A (en) 1992-11-25 1997-07-01 William Cook Europe S.A. Closure prosthesis for transcatheter placement
DK0621015T3 (en) 1993-04-23 1998-12-21 Schneider Europ Gmbh Stent but a cover layer of an elastic material as well as a method of applying this layer to the stent
WO1994026175A1 (en) 1993-05-06 1994-11-24 Vitaphore Corporation Embolization device
US5366478A (en) 1993-07-27 1994-11-22 Ethicon, Inc. Endoscopic surgical sealing device
US5957672A (en) 1993-11-10 1999-09-28 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Blood pump bearing system
US5453090A (en) 1994-03-01 1995-09-26 Cordis Corporation Method of stent delivery through an elongate softenable sheath
US5683451A (en) 1994-06-08 1997-11-04 Cardiovascular Concepts, Inc. Apparatus and methods for deployment release of intraluminal prostheses
US5642730A (en) * 1994-06-17 1997-07-01 Trudell Medical Limited Catheter system for delivery of aerosolized medicine for use with pressurized propellant canister
US6312407B1 (en) 1995-06-05 2001-11-06 Medtronic Percusurge, Inc. Occlusion of a vessel
US5697968A (en) 1995-08-10 1997-12-16 Aeroquip Corporation Check valve for intraluminal graft
US5653231A (en) * 1995-11-28 1997-08-05 Medcare Medical Group, Inc. Tracheostomy length single use suction catheter
DE19547538C2 (en) 1995-12-20 1999-09-23 Ruesch Willy Ag Instrument for use in interventional flexible tracheoscopy / bronchoscopy
EP1011889B1 (en) 1996-01-30 2002-10-30 Medtronic, Inc. Articles for and methods of making stents
US5885228A (en) 1996-05-08 1999-03-23 Heartport, Inc. Valve sizer and method of use
US6050972A (en) 1996-05-20 2000-04-18 Percusurge, Inc. Guidewire inflation system
JP3690815B2 (en) 1996-05-20 2005-08-31 メドトロニック パークサージ インコーポレイテッド Small section catheter
US6152909A (en) 1996-05-20 2000-11-28 Percusurge, Inc. Aspiration system and method
US6325777B1 (en) 1996-05-20 2001-12-04 Medtronic Percusurge, Inc. Low profile catheter valve and inflation adaptor
WO1998000840A1 (en) 1996-06-28 1998-01-08 Samsung Electronics Co., Ltd. Thin film magnetic head tip and manufacturing method therefor
IT1284108B1 (en) 1996-07-04 1998-05-08 Carlo Rebuffat SURGICAL PRESIDIUM FOR THE TREATMENT OF PULMONARY EMPHYSEMA
US6077295A (en) 1996-07-15 2000-06-20 Advanced Cardiovascular Systems, Inc. Self-expanding stent delivery system
US5893867A (en) 1996-11-06 1999-04-13 Percusurge, Inc. Stent positioning apparatus and method
AU6688398A (en) 1997-03-06 1998-09-22 Percusurge, Inc. Intravascular aspiration system
US5851232A (en) 1997-03-15 1998-12-22 Lois; William A. Venous stent
DE19715698C2 (en) 1997-04-15 2000-10-05 Konrad Engel Lithotrypsy probe for a ureteroscope for mechanical destruction of ureter stones
GB2324729B (en) * 1997-04-30 2002-01-02 Bradford Hospitals Nhs Trust Lung treatment device
US5957949A (en) 1997-05-01 1999-09-28 World Medical Manufacturing Corp. Percutaneous placement valve stent
US6162245A (en) 1997-05-07 2000-12-19 Iowa-India Investments Company Limited Stent valve and stent graft
US6007575A (en) 1997-06-06 1999-12-28 Samuels; Shaun Laurence Wilkie Inflatable intraluminal stent and method for affixing same within the human body
US5957919A (en) 1997-07-02 1999-09-28 Laufer; Michael D. Bleb reducer
DE19731894C1 (en) 1997-07-24 1999-05-12 Storz Karl Gmbh & Co Endoscopic instrument for performing endoscopic interventions or examinations and endoscopic instruments containing such an endoscopic instrument
US5984965A (en) 1997-08-28 1999-11-16 Urosurge, Inc. Anti-reflux reinforced stent
US6254642B1 (en) 1997-12-09 2001-07-03 Thomas V. Taylor Perorally insertable gastroesophageal anti-reflux valve prosthesis and tool for implantation thereof
US5976174A (en) 1997-12-15 1999-11-02 Ruiz; Carlos E. Medical hole closure device and methods of use
US6141855A (en) 1998-04-28 2000-11-07 Advanced Cardiovascular Systems, Inc. Stent crimping tool and method of use
US6493589B1 (en) 1998-05-07 2002-12-10 Medtronic, Inc. Methods and apparatus for treatment of pulmonary conditions
RU2140211C1 (en) 1998-10-28 1999-10-27 Российская медицинская академия последипломного образования Министерства здравоохранения Российской Федерации Method of surgical treatment of patients with pathology of respiratory organs complicated with pulmonary hemorrhages
DE19906191A1 (en) 1999-02-15 2000-08-17 Ingo F Herrmann Mouldable endoscope for transmitting light and images with supplementary device has non-round cross section along longitudinal section for inserting in human or animal body opening
ATE398888T1 (en) 1999-03-05 2008-07-15 Seiko Epson Corp CORRECTING DEVICE FOR IMAGE DATA, CORRECTING METHOD FOR IMAGE DATA, CARRIER ON WHICH AN IMAGE DATA CORRECTION PROGRAM IS RECORDED.
EP1143864B1 (en) 1999-08-05 2004-02-04 Broncus Technologies, Inc. Methods and devices for creating collateral channels in the lungs
US6235026B1 (en) 1999-08-06 2001-05-22 Scimed Life Systems, Inc. Polypectomy snare instrument
US6610043B1 (en) 1999-08-23 2003-08-26 Bistech, Inc. Tissue volume reduction
US6416554B1 (en) 1999-08-24 2002-07-09 Spiration, Inc. Lung reduction apparatus and method
US6328689B1 (en) 2000-03-23 2001-12-11 Spiration, Inc., Lung constriction apparatus and method
ES2272225T3 (en) 1999-08-24 2007-05-01 Spiration, Inc. LUNG VOLUME REDUCTION KIT.
US6454702B1 (en) 1999-10-14 2002-09-24 Scimed Life Systems, Inc. Endoscope and endoscopic instrument system having reduced backlash when moving the endoscopic instrument within a working channel of the endoscope
US6402754B1 (en) 1999-10-20 2002-06-11 Spiration, Inc. Apparatus for expanding the thorax
US6911032B2 (en) 1999-11-18 2005-06-28 Scimed Life Systems, Inc. Apparatus and method for compressing body tissue
US6458153B1 (en) 1999-12-31 2002-10-01 Abps Venture One, Ltd. Endoluminal cardiac and venous valve prostheses and methods of manufacture and delivery thereof
JP2003514616A (en) 1999-11-24 2003-04-22 グリースハーバー ウント コンパニー アーゲー シャフハウゼン Apparatus for improving the outflow of aqueous humor in a living eye
US6510846B1 (en) 1999-12-23 2003-01-28 O'rourke Sam Sealed back pressure breathing device
US6458076B1 (en) * 2000-02-01 2002-10-01 5 Star Medical Multi-lumen medical device
WO2001056512A1 (en) 2000-02-02 2001-08-09 Snyders Robert V Artificial heart valve
US20030070683A1 (en) * 2000-03-04 2003-04-17 Deem Mark E. Methods and devices for use in performing pulmonary procedures
US6450976B2 (en) 2000-03-10 2002-09-17 Accumed Systems, Inc. Apparatus for measuring the length and width of blood vessels and other body lumens
IL135371A (en) 2000-03-30 2006-10-31 Roie Medical Technologies Ltd Resectoscope
JP4716594B2 (en) 2000-04-17 2011-07-06 オリンパス株式会社 Endoscope
US6471638B1 (en) 2000-04-28 2002-10-29 Origin Medsystems, Inc. Surgical apparatus
US20030164168A1 (en) 2000-05-18 2003-09-04 Shaw David Peter Bronchiopulmonary occulsion devices and lung volume reduction methods
WO2001087166A2 (en) 2000-05-18 2001-11-22 Cook Urological Inc. Medical device handle
US6722360B2 (en) 2000-06-16 2004-04-20 Rajiv Doshi Methods and devices for improving breathing in patients with pulmonary disease
US6951568B1 (en) 2000-07-10 2005-10-04 Origin Medsystems, Inc. Low-profile multi-function vessel harvester and method
US6921361B2 (en) 2000-07-24 2005-07-26 Olympus Corporation Endoscopic instrument for forming an artificial valve
US6719752B2 (en) 2000-08-31 2004-04-13 Pentax Corporation Endoscopic treatment instrument
US6719763B2 (en) 2000-09-29 2004-04-13 Olympus Optical Co., Ltd. Endoscopic suturing device
US6499995B1 (en) 2000-10-04 2002-12-31 Dann A. Schwartz Phosphorescent dental appliance and method of construction
US6527761B1 (en) 2000-10-27 2003-03-04 Pulmonx, Inc. Methods and devices for obstructing and aspirating lung tissue segments
US6716226B2 (en) 2001-06-25 2004-04-06 Inscope Development, Llc Surgical clip
US6997931B2 (en) 2001-02-02 2006-02-14 Lsi Solutions, Inc. System for endoscopic suturing
JP3939158B2 (en) 2001-02-06 2007-07-04 オリンパス株式会社 Endoscope device
US7011094B2 (en) 2001-03-02 2006-03-14 Emphasys Medical, Inc. Bronchial flow control devices and methods of use
US7798147B2 (en) 2001-03-02 2010-09-21 Pulmonx Corporation Bronchial flow control devices with membrane seal
US6503272B2 (en) 2001-03-21 2003-01-07 Cordis Corporation Stent-based venous valves
US20020177847A1 (en) 2001-03-30 2002-11-28 Long Gary L. Endoscopic ablation system with flexible coupling
JP4261814B2 (en) 2001-04-04 2009-04-30 オリンパス株式会社 Tissue puncture system
US6958076B2 (en) 2001-04-16 2005-10-25 Biomedical Research Associates Inc. Implantable venous valve
US6808491B2 (en) 2001-05-21 2004-10-26 Syntheon, Llc Methods and apparatus for on-endoscope instruments having end effectors and combinations of on-endoscope and through-endoscope instruments
KR100393548B1 (en) 2001-06-05 2003-08-02 주식회사 엠아이텍 Stent
US6977918B2 (en) 2001-06-29 2005-12-20 Nokia Corp. Method and apparatus for processing a signal received in a high data rate communication system
US6491706B1 (en) 2001-07-10 2002-12-10 Spiration, Inc. Constriction device including fixation structure
US6824509B2 (en) 2001-07-23 2004-11-30 Olympus Corporation Endoscope
EP1434615B1 (en) * 2001-10-11 2007-07-11 Emphasys Medical, Inc. Bronchial flow control device
WO2003033044A2 (en) 2001-10-12 2003-04-24 Applied Medical Resources Corporation High flow stone basket system
JP3772107B2 (en) 2001-10-12 2006-05-10 オリンパス株式会社 Endoscope system
US20030127090A1 (en) 2001-11-14 2003-07-10 Emphasys Medical, Inc. Active pump bronchial implant devices and methods of use thereof
DE50100883D1 (en) 2001-11-27 2003-12-04 Storz Karl Gmbh & Co Seal for an endoscope
US7081097B2 (en) 2002-01-04 2006-07-25 Vision Sciences, Inc. Endoscope sheath assemblies having an attached biopsy sampling device
US6740030B2 (en) 2002-01-04 2004-05-25 Vision Sciences, Inc. Endoscope assemblies having working channels with reduced bending and stretching resistance
WO2003075796A2 (en) * 2002-03-08 2003-09-18 Emphasys Medical, Inc. Methods and devices for inducing collapse in lung regions fed by collateral pathways
US7261728B2 (en) 2002-03-15 2007-08-28 Ethicon Endo-Surgery, Inc. Biopsy forceps device and method
US20030181922A1 (en) * 2002-03-20 2003-09-25 Spiration, Inc. Removable anchored lung volume reduction devices and methods
US6878149B2 (en) 2002-03-25 2005-04-12 Acueity, Inc. Apparatus and method for intraductal abalation
US20040039250A1 (en) 2002-05-28 2004-02-26 David Tholfsen Guidewire delivery of implantable bronchial isolation devices in accordance with lung treatment
EP1524942B1 (en) 2002-07-26 2008-09-10 Emphasys Medical, Inc. Bronchial flow control devices with membrane seal
DE60329625D1 (en) 2002-11-27 2009-11-19 Pulmonx Corp INTRODUCTION FOR IMPLANTABLE BRONCHIAL INSULATION DEVICES
US7814912B2 (en) 2002-11-27 2010-10-19 Pulmonx Corporation Delivery methods and devices for implantable bronchial isolation devices
US7100616B2 (en) * 2003-04-08 2006-09-05 Spiration, Inc. Bronchoscopic lung volume reduction method
DE602004023350D1 (en) 2003-04-30 2009-11-12 Medtronic Vascular Inc Percutaneous inserted provisional valve
US20050016530A1 (en) 2003-07-09 2005-01-27 Mccutcheon John Treatment planning with implantable bronchial isolation devices
US7036509B2 (en) 2003-12-04 2006-05-02 Emphasys Medical, Inc. Multiple seal port anesthesia adapter
US20050178389A1 (en) 2004-01-27 2005-08-18 Shaw David P. Disease indications for selective endobronchial lung region isolation
US8206684B2 (en) 2004-02-27 2012-06-26 Pulmonx Corporation Methods and devices for blocking flow through collateral pathways in the lung
EP2368525B1 (en) 2004-03-08 2019-09-18 Pulmonx, Inc Implanted bronchial isolation devices
US20060030863A1 (en) * 2004-07-21 2006-02-09 Fields Antony J Implanted bronchial isolation device delivery devices and methods
US6951571B1 (en) 2004-09-30 2005-10-04 Rohit Srivastava Valve implanting device
US7771472B2 (en) * 2004-11-19 2010-08-10 Pulmonx Corporation Bronchial flow control devices and methods of use
US7806120B2 (en) * 2004-12-08 2010-10-05 Ventus Medical, Inc. Nasal respiratory devices for positive end-expiratory pressure
US20070203396A1 (en) * 2006-02-28 2007-08-30 Mccutcheon John G Endoscopic Tool
WO2008027293A2 (en) * 2006-08-25 2008-03-06 Emphasys Medical, Inc. Bronchial isolation devices for placement in short lumens

Patent Citations (97)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2832078A (en) * 1956-10-17 1958-04-29 Battelle Memorial Institute Heart valve
US2981254A (en) * 1957-11-12 1961-04-25 Edwin G Vanderbilt Apparatus for the gas deflation of an animal's stomach
US3320972A (en) * 1964-04-16 1967-05-23 Roy F High Prosthetic tricuspid valve and method of and device for fabricating same
US3445916A (en) * 1967-04-19 1969-05-27 Rudolf R Schulte Method for making an anatomical check valve
US3671979A (en) * 1969-09-23 1972-06-27 Univ Utah Catheter mounted artificial heart valve for implanting in close proximity to a defective natural heart valve
US3657744A (en) * 1970-05-08 1972-04-25 Univ Minnesota Method for fixing prosthetic implants in a living body
US3788327A (en) * 1971-03-30 1974-01-29 H Donowitz Surgical implant device
US3874388A (en) * 1973-02-12 1975-04-01 Ochsner Med Found Alton Shunt defect closure system
US4014318A (en) * 1973-08-20 1977-03-29 Dockum James M Circulatory assist device and system
US4084268A (en) * 1976-04-22 1978-04-18 Shiley Laboratories, Incorporated Prosthetic tissue heart valve
US4086665A (en) * 1976-12-16 1978-05-02 Thermo Electron Corporation Artificial blood conduit
US4250873A (en) * 1977-04-26 1981-02-17 Richard Wolf Gmbh Endoscopes
US4218782A (en) * 1977-05-25 1980-08-26 Biocoating Anpartsselskab Heart valve prosthesis and method for the production thereof
US4212463A (en) * 1978-02-17 1980-07-15 Pratt Enoch B Humane bleeder arrow
US4850999A (en) * 1980-05-24 1989-07-25 Institute Fur Textil-Und Faserforschung Of Stuttgart Flexible hollow organ
US4808183A (en) * 1980-06-03 1989-02-28 University Of Iowa Research Foundation Voice button prosthesis and method for installing same
US4339831A (en) * 1981-03-27 1982-07-20 Medtronic, Inc. Dynamic annulus heart valve and reconstruction ring
US4819664A (en) * 1984-11-15 1989-04-11 Stefano Nazari Device for selective bronchial intubation and separate lung ventilation, particularly during anesthesia, intensive therapy and reanimation
US4732152A (en) * 1984-12-05 1988-03-22 Medinvent S.A. Device for implantation and a method of implantation in a vessel using such device
US4759758A (en) * 1984-12-07 1988-07-26 Shlomo Gabbay Prosthetic heart valve
US4832680A (en) * 1986-07-03 1989-05-23 C.R. Bard, Inc. Apparatus for hypodermically implanting a genitourinary prosthesis
US4795449A (en) * 1986-08-04 1989-01-03 Hollister Incorporated Female urinary incontinence device
US4852568A (en) * 1987-02-17 1989-08-01 Kensey Nash Corporation Method and apparatus for sealing an opening in tissue of a living being
US4934999A (en) * 1987-07-28 1990-06-19 Paul Bader Closure for a male urethra
US4830003A (en) * 1988-06-17 1989-05-16 Wolff Rodney G Compressive stent and delivery system
US5413599A (en) * 1988-09-20 1995-05-09 Nippon Zeon Co., Ltd. Medical valve apparatus
US4990151A (en) * 1988-09-28 1991-02-05 Medinvent S.A. Device for transluminal implantation or extraction
US4846836A (en) * 1988-10-03 1989-07-11 Reich Jonathan D Artificial lower gastrointestinal valve
US5116564A (en) * 1988-10-11 1992-05-26 Josef Jansen Method of producing a closing member having flexible closing elements, especially a heart valve
US5500014A (en) * 1989-05-31 1996-03-19 Baxter International Inc. Biological valvular prothesis
US6168614B1 (en) * 1990-05-18 2001-01-02 Heartport, Inc. Valve prosthesis for implantation in the body
US5411552A (en) * 1990-05-18 1995-05-02 Andersen; Henning R. Valve prothesis for implantation in the body and a catheter for implanting such valve prothesis
US5116360A (en) * 1990-12-27 1992-05-26 Corvita Corporation Mesh composite graft
US5649906A (en) * 1991-07-17 1997-07-22 Gory; Pierre Method for implanting a removable medical apparatus in a human body
US5123919A (en) * 1991-11-21 1992-06-23 Carbomedics, Inc. Combined prosthetic aortic heart valve and vascular graft
US5445626A (en) * 1991-12-05 1995-08-29 Gigante; Luigi Valve operated catheter for urinary incontinence and retention
US6077291A (en) * 1992-01-21 2000-06-20 Regents Of The University Of Minnesota Septal defect closure device
US5382261A (en) * 1992-09-01 1995-01-17 Expandable Grafts Partnership Method and apparatus for occluding vessels
US5409019A (en) * 1992-10-30 1995-04-25 Wilk; Peter J. Coronary artery by-pass method
US5411507A (en) * 1993-01-08 1995-05-02 Richard Wolf Gmbh Instrument for implanting and extracting stents
US6558318B1 (en) * 1993-02-22 2003-05-06 Heartport, Inc. Endoscopic retraction method
US5306234A (en) * 1993-03-23 1994-04-26 Johnson W Dudley Method for closing an atrial appendage
US5486154A (en) * 1993-06-08 1996-01-23 Kelleher; Brian S. Endoscope
US5645519A (en) * 1994-03-18 1997-07-08 Jai S. Lee Endoscopic instrument for controlled introduction of tubular members in the body and methods therefor
US5392775A (en) * 1994-03-22 1995-02-28 Adkins, Jr.; Claude N. Duckbill valve for a tracheostomy tube that permits speech
US5499995A (en) * 1994-05-25 1996-03-19 Teirstein; Paul S. Body passageway closure apparatus and method of use
US5499995C1 (en) * 1994-05-25 2002-03-12 Paul S Teirstein Body passageway closure apparatus and method of use
US5417226A (en) * 1994-06-09 1995-05-23 Juma; Saad Female anti-incontinence device
US5755770A (en) * 1995-01-31 1998-05-26 Boston Scientific Corporatiion Endovascular aortic graft
US6022312A (en) * 1995-05-05 2000-02-08 Chaussy; Christian Endosphincter, set for releasable closure of the urethra and method for introduction of an endosphincter into the urethra
US6190381B1 (en) * 1995-06-07 2001-02-20 Arthrocare Corporation Methods for tissue resection, ablation and aspiration
US5645565A (en) * 1995-06-13 1997-07-08 Ethicon Endo-Surgery, Inc. Surgical plug
US5660175A (en) * 1995-08-21 1997-08-26 Dayal; Bimal Endotracheal device
US6068638A (en) * 1995-10-13 2000-05-30 Transvascular, Inc. Device, system and method for interstitial transvascular intervention
US6027525A (en) * 1996-05-23 2000-02-22 Samsung Electronics., Ltd. Flexible self-expandable stent and method for making the same
US5855587A (en) * 1996-06-13 1999-01-05 Chon-Ik Hyon Hole forming device for pierced earrings
US5855601A (en) * 1996-06-21 1999-01-05 The Trustees Of Columbia University In The City Of New York Artificial heart valve and method and device for implanting the same
US6183520B1 (en) * 1996-08-13 2001-02-06 Galt Laboratories, Inc. Method of maintaining urinary continence
US6027508A (en) * 1996-10-03 2000-02-22 Scimed Life Systems, Inc. Stent retrieval device
US6083255A (en) * 1997-04-07 2000-07-04 Broncus Technologies, Inc. Bronchial stenter
US6200333B1 (en) * 1997-04-07 2001-03-13 Broncus Technologies, Inc. Bronchial stenter
US5855597A (en) * 1997-05-07 1999-01-05 Iowa-India Investments Co. Limited Stent valve and stent graft for percutaneous surgery
US6245102B1 (en) * 1997-05-07 2001-06-12 Iowa-India Investments Company Ltd. Stent, stent graft and stent valve
US20020077696A1 (en) * 1997-09-16 2002-06-20 Gholam-Reza Zadno-Azizi Body fluid flow control device
US20020095209A1 (en) * 1997-09-16 2002-07-18 Gholam-Reza Zadno-Azizi Body fluid flow control device
US6699231B1 (en) * 1997-12-31 2004-03-02 Heartport, Inc. Methods and apparatus for perfusion of isolated tissue structure
US6280464B1 (en) * 1998-01-09 2001-08-28 Endovascular Technologies, Inc. Prosthesis gripping system and method
US5910144A (en) * 1998-01-09 1999-06-08 Endovascular Technologies, Inc. Prosthesis gripping system and method
US5944738A (en) * 1998-02-06 1999-08-31 Aga Medical Corporation Percutaneous catheter directed constricting occlusion device
US6068635A (en) * 1998-03-04 2000-05-30 Schneider (Usa) Inc Device for introducing an endoprosthesis into a catheter shaft
US6009614A (en) * 1998-04-21 2000-01-04 Advanced Cardiovascular Systems, Inc. Stent crimping tool and method of use
US6240615B1 (en) * 1998-05-05 2001-06-05 Advanced Cardiovascular Systems, Inc. Method and apparatus for uniformly crimping a stent onto a catheter
US6174323B1 (en) * 1998-06-05 2001-01-16 Broncus Technologies, Inc. Method and assembly for lung volume reduction
US6270527B1 (en) * 1998-10-16 2001-08-07 Sulzer Carbomedics Inc. Elastic valve with partially exposed stent
US6020380A (en) * 1998-11-25 2000-02-01 Tap Holdings Inc. Method of treating chronic obstructive pulmonary disease
US6051022A (en) * 1998-12-30 2000-04-18 St. Jude Medical, Inc. Bileaflet valve having non-parallel pivot axes
US6206918B1 (en) * 1999-05-12 2001-03-27 Sulzer Carbomedics Inc. Heart valve prosthesis having a pivot design for improving flow characteristics
US6234996B1 (en) * 1999-06-23 2001-05-22 Percusurge, Inc. Integrated inflation/deflation device and method
US20020062120A1 (en) * 1999-07-02 2002-05-23 Pulmonx Methods, systems, and kits for lung volume reduction
US6247471B1 (en) * 1999-07-08 2001-06-19 Essex Pb&R Corporation Smoke hood with oxygen supply device and method of use
US20020111619A1 (en) * 1999-08-05 2002-08-15 Broncus Technologies, Inc. Devices for creating collateral channels
US20020087153A1 (en) * 1999-08-05 2002-07-04 Broncus Technologies, Inc. Devices for creating collateral channels
US6258100B1 (en) * 1999-08-24 2001-07-10 Spiration, Inc. Method of reducing lung size
US20020077593A1 (en) * 1999-10-21 2002-06-20 Pulmonx Apparatus and method for isolated lung access
US6440164B1 (en) * 1999-10-21 2002-08-27 Scimed Life Systems, Inc. Implantable prosthetic valve
US6840243B2 (en) * 2000-03-04 2005-01-11 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US6679264B1 (en) * 2000-03-04 2004-01-20 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US6694979B2 (en) * 2000-03-04 2004-02-24 Emphasys Medical, Inc. Methods and devices for use in performing pulmonary procedures
US20020007831A1 (en) * 2000-07-19 2002-01-24 Davenport Paul W. Method for treating chronic obstructive pulmonary disorder
US20020026233A1 (en) * 2000-08-29 2002-02-28 Alexander Shaknovich Method and devices for decreasing elevated pulmonary venous pressure
US20020111620A1 (en) * 2001-02-14 2002-08-15 Broncus Technologies, Inc. Devices and methods for maintaining collateral channels in tissue
US20020112729A1 (en) * 2001-02-21 2002-08-22 Spiration, Inc. Intra-bronchial obstructing device that controls biological interaction with the patient
US20030018344A1 (en) * 2001-07-19 2003-01-23 Olympus Optical Co., Ltd. Medical device and method of embolizing bronchus or bronchiole
US20030018327A1 (en) * 2001-07-20 2003-01-23 Csaba Truckai Systems and techniques for lung volume reduction
US20030050648A1 (en) * 2001-09-11 2003-03-13 Spiration, Inc. Removable lung reduction devices, systems, and methods
US6592594B2 (en) * 2001-10-25 2003-07-15 Spiration, Inc. Bronchial obstruction device deployment system and method
US20030083671A1 (en) * 2001-10-25 2003-05-01 Spiration, Inc. Bronchial obstruction device deployment system and method

Cited By (44)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8512360B2 (en) 1998-02-13 2013-08-20 Medtronic, Inc. Conduits for use in placing a target vessel in fluid communication with source of blood
US20040077987A1 (en) * 1998-02-13 2004-04-22 Ventrica, Inc., Corporation Of Delaware Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication
US7993356B2 (en) 1998-02-13 2011-08-09 Medtronic, Inc. Delivering a conduit into a heart wall to place a coronary vessel in communication with a heart chamber and removing tissue from the vessel or heart wall to facilitate such communication
US20040154621A1 (en) * 2000-03-04 2004-08-12 Deem Mark E. Methods and devices for use in performing pulmonary procedures
US8474460B2 (en) 2000-03-04 2013-07-02 Pulmonx Corporation Implanted bronchial isolation devices and methods
US8251067B2 (en) 2001-03-02 2012-08-28 Pulmonx Corporation Bronchial flow control devices with membrane seal
US7798147B2 (en) 2001-03-02 2010-09-21 Pulmonx Corporation Bronchial flow control devices with membrane seal
US7854228B2 (en) 2001-10-11 2010-12-21 Pulmonx Corporation Bronchial flow control devices and methods of use
US20050145253A1 (en) * 2001-10-11 2005-07-07 Emphasys Medical, Inc., A Delaware Corporation Bronchial flow control devices and methods of use
US7814912B2 (en) 2002-11-27 2010-10-19 Pulmonx Corporation Delivery methods and devices for implantable bronchial isolation devices
US20050016530A1 (en) * 2003-07-09 2005-01-27 Mccutcheon John Treatment planning with implantable bronchial isolation devices
US7036509B2 (en) 2003-12-04 2006-05-02 Emphasys Medical, Inc. Multiple seal port anesthesia adapter
US8206684B2 (en) 2004-02-27 2012-06-26 Pulmonx Corporation Methods and devices for blocking flow through collateral pathways in the lung
US7771472B2 (en) 2004-11-19 2010-08-10 Pulmonx Corporation Bronchial flow control devices and methods of use
US9211181B2 (en) 2004-11-19 2015-12-15 Pulmonx Corporation Implant loading device and system
US9872755B2 (en) 2004-11-19 2018-01-23 Pulmonx Corporation Implant loading device and system
US11083556B2 (en) 2004-11-19 2021-08-10 Pulmonx Corporation Implant loading device and system
US8388682B2 (en) 2004-11-19 2013-03-05 Pulmonx Corporation Bronchial flow control devices and methods of use
US9402633B2 (en) 2006-03-13 2016-08-02 Pneumrx, Inc. Torque alleviating intra-airway lung volume reduction compressive implant structures
US9402632B2 (en) 2006-03-13 2016-08-02 Pneumrx, Inc. Lung volume reduction devices, methods, and systems
US8157837B2 (en) 2006-03-13 2012-04-17 Pneumrx, Inc. Minimally invasive lung volume reduction device and method
US8157823B2 (en) 2006-03-13 2012-04-17 Pneumrx, Inc. Lung volume reduction devices, methods, and systems
US20090012626A1 (en) * 2006-03-13 2009-01-08 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US8668707B2 (en) 2006-03-13 2014-03-11 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US10226257B2 (en) 2006-03-13 2019-03-12 Pneumrx, Inc. Lung volume reduction devices, methods, and systems
US8740921B2 (en) 2006-03-13 2014-06-03 Pneumrx, Inc. Lung volume reduction devices, methods, and systems
US8888800B2 (en) 2006-03-13 2014-11-18 Pneumrx, Inc. Lung volume reduction devices, methods, and systems
US8932310B2 (en) 2006-03-13 2015-01-13 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US10188397B2 (en) 2006-03-13 2019-01-29 Pneumrx, Inc. Torque alleviating intra-airway lung volume reduction compressive implant structures
US9782558B2 (en) 2006-03-13 2017-10-10 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US8142455B2 (en) 2006-03-13 2012-03-27 Pneumrx, Inc. Delivery of minimally invasive lung volume reduction devices
US8282660B2 (en) 2006-03-13 2012-10-09 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US9402971B2 (en) 2006-03-13 2016-08-02 Pneumrx, Inc. Minimally invasive lung volume reduction devices, methods, and systems
US9474533B2 (en) 2006-03-13 2016-10-25 Pneumrx, Inc. Cross-sectional modification during deployment of an elongate lung volume reduction device
US20100100196A1 (en) * 2008-09-12 2010-04-22 Pneumrx, Inc. Elongated Lung Volume Reduction Devices, Methods, and Systems
US9192403B2 (en) 2008-09-12 2015-11-24 Pneumrx, Inc. Elongated lung volume reduction devices, methods, and systems
US20100070050A1 (en) * 2008-09-12 2010-03-18 Pneumrx, Inc. Enhanced Efficacy Lung Volume Reduction Devices, Methods, and Systems
US10058331B2 (en) 2008-09-12 2018-08-28 Pneumrx, Inc. Enhanced efficacy lung volume reduction devices, methods, and systems
US9173669B2 (en) 2008-09-12 2015-11-03 Pneumrx, Inc. Enhanced efficacy lung volume reduction devices, methods, and systems
US10285707B2 (en) 2008-09-12 2019-05-14 Pneumrx, Inc. Enhanced efficacy lung volume reduction devices, methods, and systems
US8632605B2 (en) 2008-09-12 2014-01-21 Pneumrx, Inc. Elongated lung volume reduction devices, methods, and systems
US8721734B2 (en) 2009-05-18 2014-05-13 Pneumrx, Inc. Cross-sectional modification during deployment of an elongate lung volume reduction device
US10350048B2 (en) 2011-09-23 2019-07-16 Pulmonx Corporation Implant loading device and system
US10390838B1 (en) 2014-08-20 2019-08-27 Pneumrx, Inc. Tuned strength chronic obstructive pulmonary disease treatment

Also Published As

Publication number Publication date
US6840243B2 (en) 2005-01-11
AU2001243416B2 (en) 2006-05-11
EP1359978A4 (en) 2008-05-07
CA2401331C (en) 2010-07-27
WO2001066190A2 (en) 2001-09-13
US20030192550A1 (en) 2003-10-16
US20060174870A1 (en) 2006-08-10
US8357139B2 (en) 2013-01-22
EP1359978A2 (en) 2003-11-12
US20040016435A1 (en) 2004-01-29
US20030192551A1 (en) 2003-10-16
WO2001066190A3 (en) 2003-08-21
JP3881242B2 (en) 2007-02-14
CA2401331A1 (en) 2001-09-13
JP2004504867A (en) 2004-02-19
US7662181B2 (en) 2010-02-16
US7165548B2 (en) 2007-01-23
EP1359978B1 (en) 2011-04-20
US6679264B1 (en) 2004-01-20
DE60144491D1 (en) 2011-06-01
ATE506103T1 (en) 2011-05-15
JP2006314816A (en) 2006-11-24
US6694979B2 (en) 2004-02-24
US20010037808A1 (en) 2001-11-08
AU4341601A (en) 2001-09-17
US20090114226A1 (en) 2009-05-07

Similar Documents

Publication Publication Date Title
US6904909B2 (en) Methods and devices for use in performing pulmonary procedures
US6694979B2 (en) Methods and devices for use in performing pulmonary procedures
AU2001243416A1 (en) Methods and devices for use in performing pulmonary procedures
US6837906B2 (en) Lung assist apparatus and methods for use
US7011094B2 (en) Bronchial flow control devices and methods of use
EP1434615B1 (en) Bronchial flow control device
US20040089306A1 (en) Devices and methods for removing bronchial isolation devices implanted in the lung
US20210169632A1 (en) Methods and devices for trans-bronchial airway bypass

Legal Events

Date Code Title Description
AS Assignment

Owner name: EMPHASYS MEDICAL, INC., CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:THE FOUNDRY, LLC.;REEL/FRAME:014886/0006

Effective date: 20000814

AS Assignment

Owner name: FOUNDRY, LLC, THE, CALIFORNIA

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:DEEM, MARK E.;GIFFORD III, HANSON S.;FRENCH, RONALD;AND OTHERS;REEL/FRAME:014886/0001;SIGNING DATES FROM 20000621 TO 20000622

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION