Abstract: Methods and systems for isolating, assessing and treating lung compartments are disclosed. One or more lung compartments are accessed through an isolation catheter, oxygen rich gas is delivered to the compartments, and blood oxygen or exhaled carbon dioxide are monitored to assess lung compartment function. Diseased lung compartments may be treated using therapeutic agents delivered to the diseased compartments through the isolation catheter. Therapeutic agents include carbon monoxide, radioactive agents, chemotherapeutic agents or angiogenesis inhibitors and angiocidal agents.

Abstract: A system for delivering multiple implants into lung passageways is disclosed. The system comprises a catheter configured to receive and store a plurality of expandable implants, and an actuatable delivery tool coupled to the proximal end of the catheter. The system expels an implant of the plurality of implants with each actuation of the delivery tool. The delivery tool comprises a plunger element which extends through the catheter from the proximal to the distal end and allows the delivery tool to mechanically communicate with the implants. In one embodiment, the system comprises a spring-loaded slidable element, and a user compresses the slidable element to actuate the delivery tool. In another embodiment, the system comprises a rotation rod, and the user moves the rotation rod in a distal direction to actuate the delivery tool.

Abstract: Disclosed are various disease indications and treatment methods that benefit from selective lung region isolation. A lung region is bronchially isolated by regulating the flow of fluid to and from the lung region, such as by implanting one or more bronchial isolation devices into one or more bronchial passageways that feed air to the lung region. The bronchial isolation devices can comprise, for example, one-way valves, two-way valves, occluders or blockers, ligating clips, glues, sealants, and sclerosing agents.

Abstract: Lung volume reduction is performed in a minimally invasive manner by isolating a lung tissue segment, optionally reducing gas flow obstructions within the segment, and aspirating the segment to cause the segment to at least partially collapse. Further optionally, external pressure may be applied on the segment to assist in complete collapse. Reduction of gas flow obstructions may be achieved in a variety of ways, including over inflation of the lung, introduction of mucolytic or dilation agents, application of vibrational energy, induction of absorption atelectasis, or the like. Optionally, diagnostic procedures on the isolated lung segment may be performed, typically using the same isolation/access catheter.

Abstract: The volume of a hyperinflated lung compartment is reduced by sealing a distal end of the catheter in an airway feeding the lung compartment. Air passes out of the lung compartment through a passage in the catheter while the patient exhales. A one-way flow element associated with the catheter prevents air from re-entering the lung compartment as the patient inhales. Over time, the pressure of regions surrounding the lung compartment cause it to collapse as the volume of air diminishes. Residual volume reduction effectively results in functional lung volume expansion. Optionally, the lung compartment may be sealed in order to permanently prevent air from re-entering the lung compartment.

Abstract: The lateral flow between adjacent lung segments is occluded by blocking collateral flow channels with particles. A gas flow is established from one lung segment through the flow channels in an intermediate fibrous septum, and out through the adjacent lung segment. Particles entrained in the gas flow become lodged in the collateral flow channels to eventually block flow.

Abstract: A removal tool for an implanted device, including pulmonary stents, occlusive devices, valved devices, and flow-restrictive devices, is provided. The removal tool includes an elongate tube having a central passage, a slideable inner member within the passage, and a coupling member disposed on the distal end of the inner member. The coupling member of the removal tool includes a distal tip configured to pierce a membrane of the implanted device. The coupling member also includes a coil or a hook configured to engage a support element of the implanted device. A method of removing implanted devices is also provided. A removal tool is placed adjacent to the device, the distal end of the tool is moved to pierce its membrane, a portion of the tool engages the support member, and the distal end of the tool is retracted along with the implanted device.

Abstract: Devices for loading a collapsible implant onto a delivery catheter. In one aspect, a loading device comprises an outer tubular structure and an inner tubular structure. The outer tubular structure comprises a narrowing passage configured to receive a catheter at one end and a collapsible implant at another end. The inner tubular structure is configured to move slidably and co-axially within the outer tubular structure. The inner tubular structure comprises a carrier pin configured to move within the narrowing passage as the inner tubular structure slides into the outer tubular structure. The sliding of the inner tubular structure into the outer tubular structure causes an implant mounted on the carrier pin to collapse as the implant moves through the narrowing passage and into the distal end of a catheter.

Abstract: The present invention provides systems, methods, devices and kits for assessing the level of pulmonary disease in individual lung compartments. A lung compartment comprises a subportion of a lung, such as a lobe, a segment or a subsegment, for example. By measuring individual lung compartments, the level of disease of the pulmonary system may be more precisely defined by determining values of disease parameters reflective of individual subportions or compartments of a lung. Likewise, compartments may be separately imaged to provide further measurement information. Once individual compartments are characterized, they may be compared and ranked based on a number of variables reflecting, for example, level of disease or need for treatment. Such comparison may be aided by simultaneous display of such variables or images on a visual display. Further, the same tests may be performed on the lung as a whole or on both lungs and to determine the affect of the diseased lung compartments on the overall lung performance.

Abstract: Lung conditions are diagnosed and optionally treated using a functional assessment catheter or a functional lung assessment and treatment catheter. A flow restrictive component is initially placed in a bronchus or lung passageway upstream from a diseased lung region. The isolated lung region is then functionally assessed through the catheter, while the flow restrictive component remains in place. If the patient is a good candidate for treatment by occlusive or restrictive treatment techniques, the flow resistive component may be left in place. If the patient is not suitable for such treatment, the flow resistive component may be removed.

Abstract: Lung conditions are treated by implanting a flow restrictor in a passageway upstream from a diseased lung segment. The restrictor will create an orifice at the implantation site which inhibits air exchange with the segment to induce controlled atelectasis and/or hypoxia. Controlled atelectasis can induce collapse of the diseased segment with a reduced risk of pneumothorax. Hypoxia can promote gas exchange with non-isolated, healthy regions of the lung even in the absence of lung collapse.

Abstract: A method and system for catheter-based delivery of implants in the body. Implants can include stents, plugs, coils, baskets, filters, valves, grafts, prosthesis', drugs, drug reservoirs, biologics, or pumps. The catheter system comprises a uniquely configured grasper mechanism that allows holding the implant during the unsheathing delivery step prior to full release. With this delivery system, the implant can be unsheathed, positioned, and the position can be evaluated prior to releasing the implant from the catheter. Upon evaluation of the position of the implant, if it is found to be inaccurately placed, then removal of the implant can be done easily and without a device exchange. If the implant is found to be positioned correctly, the grasper mechanism can be actuated to release the implant from the catheter.

Abstract: A method and system for increasing the flow resistance of pathways in the lung by employing aspiration to establish an artificial convective flow current between compartments in the lung in order to entrain and deliver a clogging agent preferentially to the pathways. This treatment is performed after an area has been properly diagnosed for treatment.

Abstract: Minimally invasive systems and methods are provided for diagnosing conditions in target lung compartments. Using catheters capable of isolating the target lung compartments and measuring one or more of collateral ventilation, pressure, flow rate, and volume, conditions such as hyperinflation, compliance, gas exchange including oxygen uptake, directionality of collateral channels, blood flow, and blood flow per unit lung volume may be assessed.

Abstract: Lung volume reduction is performed in a minimally invasive manner by isolating a lung tissue segment, optionally reducing gas flow obstructions within the segment, and aspirating the segment to cause the segment to at least partially collapse. Further optionally, external pressure may be applied on the segment to assist in complete collapse. Reduction of gas flow obstructions may be achieved in a variety of ways, including over inflation of the lung, introduction of mucolytic or dilation agents, application of vibrational energy, induction of absorption atelectasis, or the like. Optionally, diagnostic procedures on the isolated lung segment may be performed, typically using the same isolation/access catheter.

Abstract: Medical methods and systems are provided for effecting lung volume reduction by selectively ablating segments of lung tissue.

Abstract: Lung volume reduction is performed in a minimally invasive manner by isolating a lung tissue segment, optionally reducing gas flow obstructions within the segment, and aspirating the segment to cause the segment to at least partially collapse. Further optionally, external pressure may be applied on the segment to assist in complete collapse. Reduction of gas flow obstructions may be achieved in a variety of ways, including over inflation of the lung, introduction of mucolytic or dilation agents, application of vibrational energy, induction of absorption atelectasis, or the like. Optionally, diagnostic procedures on the isolated lung segment may be performed, typically using the same isolation/access catheter.

Abstract: Minimally invasive methods, systems and devices are provided for qualitatively and quantitatively assessing collateral ventilation in the lungs. In particular, collateral ventilation of a target compartment within a lung of a patient is assessed by advancement of a catheter through the tracheobronchial tree to a feeding bronchus of the target compartment. The feeding bronchus is occluded by the catheter and a variety of measurements are taken with the use of the catheter in a manner which is of low risk to the patient. Examples of such measurements include but are not limited to flow rate, volume and pressure. These measurements are used to determine the presence of collateral ventilation and to quantify such collateral ventilation.

Abstract: Methods, systems and devices are provided for performing lung volume reduction in patients suffering from chronic obstructive pulmonary disease or other conditions where isolation of a lung segment or reduction of lung volume is desired. The methods are minimally invasive with instruments being introduced through the mouth (endotracheally) and rely on isolating the target lung tissue segment from other regions of the lung and occluding various lung passageways with the use of occlusal stents. The occlusal stents are delivered with the use of an occlusal stent delivery system which is loaded with the occlusal stent with the use of an occlusal stent loading system.

Abstract: Improved methods, systems and devices for occluding body passageways, particularly lung passageways. Such occlusion is achieved with occlusal stents which are particularly suited for use in performing Endobronchial Volume Reduction (EVR) in patients suffering from chronic obstructive pulmonary disease or other conditions where isolation of a lung segment or reduction of lung volume is desired. The present invention is likewise suitable for the treatment of bronchopleural fistula and potentially for other pulmonary diseases, such as hemoptysis and pneumothorax. The occlusal stents are delivered with the use of any suitable delivery system, particularly minimally invasive with instruments introduced through the mouth (endotracheally). A target lung tissue segment is isolated from other regions of the lung by deploying an occlusal stent into a target area of a lung passageway. A variety of different occlusal stent designs are provided to improve the performance and reliability of the delivered occlusal stent.