US20090076622A1 — Delivery of Minimally Invasive Lung Volume Reduct…

Claim 1

Independent Claim 81 words

1 . A method for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the method comprising: advancing an implant into the lung via the airway system using a catheter body so that an elongate body of the implant extends axially along the airway; deploying the implant from the catheter so that the elongate body of the implant bends the surrounding airway and the bending of the airway compresses adjacent lung tissue.

Claim 2

Dependent Claim 81 words

1 . A method for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the method comprising: advancing an implant into the lung via the airway system using a catheter body so that an elongate body of the implant extends axially along the airway; deploying the implant from the catheter so that the elongate body of the implant bends the surrounding airway and the bending of the airway compresses adjacent lung tissue.

Claim 3

Dependent Claim 83 words

2 . The method of claim 1 , further comprising maintaining the elongate body in a delivery configuration within a lumen of the catheter prior to deploying the implant, the elongate body in the delivery configuration extending along an axis between a proximal end of the elongate body and a distal end of the elongate body, wherein the deploying of the implant comprises bending the implant between the ends so that the bending of the implant bends the airway away from the axis.

Claim 4

Dependent Claim 39 words

3 . The method of claim 2 , wherein the maintaining of the elongate body in the delivery configuration comprises restraining the elongate body within the catheter, the elongate body being biased to bend to a bent deployed configuration.

Claim 5

Dependent Claim 89 words

4 . The method of claim 3 , further comprising selecting the elongate body from among a plurality of alternative elongate bodies, the plurality of elongate bodies being allowed to bend toward the bent configuration so as to limit strain of the elongate bodies during storage and prior to the selection, and loading the selected elongate body into the catheter body by straightening the elongate body toward the axis and inserting the elongate body into the catheter so that the catheter maintains the elongate body in the delivery configuration.

Claim 6

Dependent Claim 42 words

5 . The method of claim 4 , wherein the inserting of the selected elongate body comprises loading the selected elongate body into a tubular loading cartridge and advancing the elongate body from the loading cartridge into the lumen of the catheter.

Claim 7

Dependent Claim 46 words

6 . The method of claim 5 , further comprising attaching the loading cartridge to the catheter so that a lumen of the loading cartridge is coaxial with the lumen of the catheter, and so that the loading cartridge is axially affixed relative to the catheter.

Claim 8

Dependent Claim 84 words

7 . The method of claim 6 , wherein a distal end of the loading cartridge is affixed to a proximal hub of the catheter so that the lumen of the loading cartridge extends smoothly to the lumen of the catheter, and further comprising pushing the elongate body from within the attached loading catheter to within the catheter with a pusher, wherein the pusher effects deployment of the implant from a distal end of the catheter by extending the pusher through the loading cartridge.

Claim 9

Dependent Claim 36 words

8 . The method of claim 3 , further comprising axially restraining the proximal end of the elongate body within the lung and withdrawing the catheter proximally from over the distal end of the elongate body.

Claim 10

Dependent Claim 66 words

9 . The method of claim 1 , further comprising grasping the proximal end of the elongate body using a grasper extending distally within the catheter before deploying of the implant, wherein the grasper grasps the implant during and after deployment, determining that the deployment of the implant is less than ideal, and retrieving the implant back into a lumen of the catheter using the grasper.

Claim 11

Dependent Claim 51 words

10 . The method of claim 9 , wherein the retrieving of the implant comprising tensioning the grasper proximally and pushing the catheter distally so that the catheter straightens the elongate body of the implant axially within the airway so as to facilitate withdrawing the implant axially from the airway system.

Claim 12

Dependent Claim 94 words

11 . The method of claim 1 , further comprising steering a guidewire during advancement of the guidewire by rotating the guidewire so as to orient a tip of the guidewire, absorbing impacts between the tip of the guidewire and the airway with a bumper disposed on the tip of the guidewire, ending advancement of the guidewire when a cross-section of the airway induces engagement between the airway and the guidewire, measuring a length of the airway using the guidewire, advancing the catheter over the guidewire and removing the guidewire before advancing the implant.

Claim 13

Dependent Claim 112 words

12 . The method of claim 1 , further comprising advancing the catheter body using a guidewire receivable by a lumen of the catheter, a tip of the guidewire angling from an axis of the guidewire proximal of the tip so as to facilitate steering, wherein the guidewire has a cross-section significantly smaller than a lumen of the catheter, and wherein a dilator atraumatically expands openings of the airway system as the catheter advances distally, the dilator tapering radially outwardly proximally of the guidewire tip between a distal end of the catheter and the tip of the guidewire, and further comprising withdrawing the dilator proximally from the catheter before deploying the implant.

Claim 14

Dependent Claim 41 words

13 . The method of claim 1 , further comprising deploying the catheter and advancing the catheter body distally under guidance of a remote imaging modality, and without optical imaging of at least a distal portion of the implant during deployment.

Claim 15

Dependent Claim 53 words

14 . The method of claim 2 , further comprising advancing the catheter body into the lung using a bronchoscope, advancing a distal end of the catheter distally beyond a viewing field of the bronchoscope, and deploying at least the distal portion of the implant distally beyond the viewing field of the bronchoscope.

Claim 16

Dependent Claim 49 words

15 . The method of claim 1 , further comprising advancing a guidewire distally of the catheter toward a distal end of the airway system, the guidewire having indicia of lengths to the distal end of the guidewire, and selecting a length of the elongate body using the indicia.

Claim 17

Dependent Claim 21 words

16 . The method of claim 15 , wherein the indicia comprise radiopaque markings along a distal length of the guidewire.

Claim 18

Dependent Claim 100 words

17 . A method for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the method comprising: advancing a distal end of a guidewire distally within the airway system, the guidewire having indicia of lengths to the distal end of the guidewire; selecting an implant length using the indicia; advancing an implant having the selected length into the lung via the airway system so that an elongate body of the implant extends axially along the airway; deploying the implant so that the implant compresses adjacent lung tissue from within the airway.

Claim 19

Dependent Claim 100 words

17 . A method for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the method comprising: advancing a distal end of a guidewire distally within the airway system, the guidewire having indicia of lengths to the distal end of the guidewire; selecting an implant length using the indicia; advancing an implant having the selected length into the lung via the airway system so that an elongate body of the implant extends axially along the airway; deploying the implant so that the implant compresses adjacent lung tissue from within the airway.

Claim 20

Dependent Claim 125 words

18 . A system for treating a lung of a patient, the lung having an airway system including an airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; and an implant releasable and supportable by the catheter near the distal end so that when the distal end is advanced to the airway the implant extends axially along the airway in a delivery configuration, an elongate body of the implant deployable from the delivery configuration to a deployed configuration within the airway by bending of the elongate body so as to bend the surrounding airway and so that the bending of the airway compresses adjacent lung tissue.

Claim 21

Dependent Claim 125 words

18 . A system for treating a lung of a patient, the lung having an airway system including an airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; and an implant releasable and supportable by the catheter near the distal end so that when the distal end is advanced to the airway the implant extends axially along the airway in a delivery configuration, an elongate body of the implant deployable from the delivery configuration to a deployed configuration within the airway by bending of the elongate body so as to bend the surrounding airway and so that the bending of the airway compresses adjacent lung tissue.

Claim 22

Dependent Claim 114 words

19 . The system of claim 18 , wherein the catheter is laterally flexible and has a lumen extending proximally of the distal end, the lumen releasably receiving the elongate body during insertion so as to maintain the elongate body in the delivery configuration prior to deploying the implant, the elongate body in the delivery configuration extendable along an axis between a proximal end of the elongate body and a distal end of the elongate body, wherein deploying of the implant from the delivery configuration to the deployed configuration comprises bending of the implant between the ends such that the bending of the implant is configured to bend the airway away from the axis.

Claim 23

Dependent Claim 39 words

20 . The system of claim 19 , wherein the elongate body is biased to bend to a bent deployed configuration, the lumen maintaining the elongate body in the delivery configuration by restraining the elongate body within the catheter.

Claim 24

Dependent Claim 75 words

21 . The system of claim 20 , further comprising a plurality of alternatively selectable implants, each implant comprising an elongate body and being released toward the bent configuration so as limit strain of the elongate body during storage, each implant being loadable into the catheter by straightening the associated elongate body toward the axis and inserting the elongate body into the lumen so that the catheter maintains the elongate body in the delivery configuration.

Claim 25

Dependent Claim 67 words

22 . The system of claim 21 , further comprising a tubular loading cartridge having a proximal end and a distal end, the loading cartridge releasably receiving a selected elongate body from among the plurality of elongate bodies, the loading cartridge being coupleable to the catheter body so that the selected elongate body is advanceable from within the loading cartridge distally into the lumen of the catheter.

Claim 26

Dependent Claim 105 words

23 . The system of claim 22 , wherein a distal end of the loading cartridge is affixable to a proximal hub of the catheter so that a lumen of the loading cartridge extends smoothly to the lumen of the catheter, and further comprising a pusher axially movable within the loading cartridge and the catheter so as to push the elongate body from within the attached loading catheter to within the catheter, the pusher having a pusher surface distally engageable against the implant and a shaft extending proximally from the pusher surface to facilitate deployment of the implant from the distal end of the catheter.

Claim 27

Dependent Claim 62 words

24 . The system of claim 18 , further comprising a grasper extending distally along the catheter, the grasper axially coupling to the implant so as to facilitate retrieving the implant into a lumen of the catheter when the elongate body is distal of the catheter, the grasper articulatable from the proximal end of the catheter so as release the elongate body.

Claim 28

Dependent Claim 64 words

25 . The system of claim 24 , wherein the tensioning the grasper proximally and pushing the catheter distally effects retrieving of the implant when the elongate body is distal of the catheter and the grasper is axially coupled to the grasper, the catheter straightening the elongate body of the implant axially so as to facilitate withdrawing the implant axially from the airway system.

Claim 29

Dependent Claim 107 words

26 . The system of claim 18 , further comprising: a guidewire extendable distally through a lumen of the catheter for advancing the catheter body through the airway system, a steering tip of the guidewire angling from an axis of the catheter, the guidewire having a cross-section significantly smaller than a lumen of the catheter; and a dilator advanceable distally through the lumen of the catheter so that the dilator is disposed axially between the guidewire tip and the distal end of the catheter, the dilator tapering radially outwardly proximally of the guidewire tip to atraumatically expand openings of the airway system as the catheter advances distally.

Claim 30

Dependent Claim 31 words

27 . The system of claim of claim 26 , further comprising one or more radiopaque markers positionable adjacent the distal end of the catheter to facilitate positioning of the implant.

Claim 31

Dependent Claim 61 words

28 . The system of claim 18 , further comprising a bronchoscope having a proximal end, a distal end, and a lumen therebetween, an image signal transmitter, the distal end of the catheter receivable into the lumen and advanceable distally beyond a viewing field of the bronchoscope so as to deploy the implant distally beyond the viewing field of the bronchoscope.

Claim 32

Dependent Claim 48 words

29 . The system of claim 28 , further comprising a guidewire advanceable distally through a lumen of the catheter to a distal end of the airway, the guidewire having indicia of a distal length of the guidewire between the catheter and a distal end of the guidewire.

Claim 33

Dependent Claim 22 words

30 . The system of claim 29 , wherein the indicia comprise radiopaque scale markings along the distal length of the guidewire.

Claim 34

Dependent Claim 133 words

31 . A system for treating a lung of a patient, the lung having an airway system including an airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; an implant positionable near the distal end of the catheter, the implant deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway; and a grasper extendable distally along the catheter to the implant, the grasper, when axially coupled with the implant, facilitating recapturing the implant in a lumen of the catheter when the implant is distal of the catheter, the grasper articulatable from the proximal end of the catheter so as to axially release the implant.

Claim 35

Dependent Claim 133 words

31 . A system for treating a lung of a patient, the lung having an airway system including an airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; an implant positionable near the distal end of the catheter, the implant deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway; and a grasper extendable distally along the catheter to the implant, the grasper, when axially coupled with the implant, facilitating recapturing the implant in a lumen of the catheter when the implant is distal of the catheter, the grasper articulatable from the proximal end of the catheter so as to axially release the implant.

Claim 36

Dependent Claim 134 words

32 . A system for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the implant deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; and a grasper extendable distally from near the proximal end of the catheter along the catheter to the implant, the grasper articulatable from the proximal end of the catheter so as to axially release the implant; the grasper, when axially coupled with the implant, facilitating recapturing the implant in a lumen of the catheter when the implant is distal of the catheter.

Claim 37

Dependent Claim 134 words

32 . A system for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the implant deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; and a grasper extendable distally from near the proximal end of the catheter along the catheter to the implant, the grasper articulatable from the proximal end of the catheter so as to axially release the implant; the grasper, when axially coupled with the implant, facilitating recapturing the implant in a lumen of the catheter when the implant is distal of the catheter.

Claim 38

Dependent Claim 129 words

33 . A system for treating a lung of a patient, the lung having an airway system including an airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; an implant positionable near the distal end of the catheter, the implant having an elongate body deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway; and an elongate measurement body extendable distally along the catheter, the measurement body having indicia of a distal length of the measurement body between the catheter and a distal end of the measurement body suitable for selecting a length of the elongate body of the implant.

Claim 39

Dependent Claim 129 words

33 . A system for treating a lung of a patient, the lung having an airway system including an airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; an implant positionable near the distal end of the catheter, the implant having an elongate body deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway; and an elongate measurement body extendable distally along the catheter, the measurement body having indicia of a distal length of the measurement body between the catheter and a distal end of the measurement body suitable for selecting a length of the elongate body of the implant.

Claim 40

Dependent Claim 147 words

34 . A system for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the implant having an elongate body deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; an implant positionable near the distal end of the catheter, the implant having an elongate body deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway; and an elongate measurement body extendable distally along the catheter, the measurement body having indicia of a distal length of the measurement body suitable for selecting a length of the elongate body of the implant.

Claim 41

Dependent Claim 147 words

34 . A system for delivering an implant to a lung of a patient, the lung having an airway system including an airway, the implant having an elongate body deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway, the system comprising: an elongate catheter body having a proximal end and a distal end, the distal end being advanceable through the airway system to the airway; an implant positionable near the distal end of the catheter, the implant having an elongate body deployable from a delivery configuration to a deployed configuration so as to compress adjacent lung tissue from within the airway; and an elongate measurement body extendable distally along the catheter, the measurement body having indicia of a distal length of the measurement body suitable for selecting a length of the elongate body of the implant.

Delivery of Minimally Invasive Lung Volume Reduction Devices

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