Abstract: A method of assessing a lung compartment of a patient may involve: advancing a diagnostic catheter into a lung airway leading to a first sub-compartment of the lung compartment; inflating an occluding member disposed on the diagnostic catheter to form a seal with a wall of the airway and thus isolate the first sub-compartment; introducing a diagnostic gas into the first sub-compartment; and recording a perfusion value of the diagnostic gas within the first sub-compartment.

Abstract: Methods and systems for targeting, accessing and diagnosing diseased lung compartments are disclosed. The method comprises introducing a diagnostic catheter with an occluding member at its distal end into a lung segment via an assisted ventilation device; inflating the occluding member to isolate the lung segment; and performing a diagnostic procedure with the catheter while the patient is ventilated. The proximal end of the diagnostic catheter is configured to be attached to a console. The method may also comprise introducing the diagnostic catheter into the lung segment; inflating the occluding member to isolate the lung segment; and monitoring blood oxygen saturation. The method may further comprise introducing the diagnostic catheter into the lung segment; determining tidal flow volume in the lung segment; determining total lung capacity of the patient; and determining a flow rank value based on the tidal flow volume of the lung segment and the total lung capacity.

Abstract: A method of diagnosing an air leak in a lung compartment of a patient may include: advancing a diagnostic catheter into an airway leading to the lung compartment; inflating an occluding member on the catheter to form a seal with a wall of the airway and thus isolate the lung compartment; measuring air pressure within the lung compartment during multiple breaths, using the diagnostic catheter; displaying the measured air pressure as an air pressure value on a console coupled with the diagnostic catheter; and determining whether an air leak is present in the lung compartment based on the displayed air pressure value during the multiple breaths.

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: An obturator for a bronchial tube or tubule of a human or animal lung includes a blocking element (92) and a securing element (90). The blocking element serves to seal the tube or tubule against the passage of fluid past the obturator when the obturator is disposed in a bronchial tube or tubule. The securing element serves to retain the blocking element in position. The blocking element comprises a substantially cylindrical plug of biocompatible, resiliently deformable closed-cell foamed plastics material, such as PVC. The securing element includes a stent having barbs (98) to engage and retain the blocking element. The stent also has anchors (100) to retain the stent in a bronchial tube or tubule. A method of treatment of emphysema or other lung conditions or diseases in human or animal patients comprises placing an obturator in a bronchial tube or tubule of the patient so as to seal the tube or tubule against the passage of fluid past the obturator.

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: 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: 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: A method for determining lung function in a patient is disclosed, in which a multi-lumen catheter with an expandable occluding element at its end is used to isolate a targeted lung compartment, and respiratory characteristics at the targeted lung compartment are measured over multiple respiratory cycles. The relation between various characteristics of the respiratory cycle is used to determine compliance of lung tissue within the targeted lung compartment.

Abstract: A method of determining potential treatment sites in a diseased lung is disclosed, in which an assessment catheter is introduced into a lung passageway. The catheter has a distal portion comprising an occluding member and a proximal portion configured to operatively mate with an external console. The catheter is used to identify one or more assessment sites within the airways of the lung. At each assessment site, at least one physiological, anatomical or biological characteristic is determined. A characteristic score for each assessment site is calculated based on a predetermined algorithm; and a treatment is determined based on the scores of the assessment sites. The algorithm takes into account several parameters including the disease characteristics as well as the number and proximity of each assessment site to at least one of the diseased regions. The method envisages treatment of emphysema, asthma or bronchopleural leak.

Abstract: A method for assessing lung function in a patient is disclosed. The method comprises isolating a lung compartment. Thereafter, in one embodiment, an inhaled gas of known composition is introduced into the lung and compared to the composition of the exhaled gas. Alternatively, accumulated CO2 content is measured within the isolated lung compartment over time, and compared to a baseline CO2 content. Alternatively, a change in pressure of an isolated lung compartment may be monitored. Alternatively, the magnitude of the range of CO2 values in an isolated lung compartment can be compared to a predetermined threshold. Any of the results obtained via these alternative embodiments may be used to determine lung function.

Abstract: Minimally invasive methods, systems and devices are provided for 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 airway of the target compartment. The feeding airway is occluded by the catheter and the opening and closing of a one-way valve coupled with the catheter is observed. If the valve ceases opening and closing over time, this may indicate that significant collateral ventilation into the target compartment is absent. If the valve continues to open and close over time, significant collateral ventilation into the compartment may be present. Based on the collateral ventilation assessment, a treatment plan may be generated.

Abstract: Devices systems and methods are disclosed for preventing or inhibiting secretions from entering the lumen of a functional assessment catheter for the lungs, or removing collected secretions. The catheter comprises an expandable element, a cover, or an internal component configured to prevent or inhibit secretion flow into the lumen. The catheter alternatively or additionally comprises a distal end configured to facilitate air flow, absorb secretions or repel secretions away from the catheter tip. The catheter alternatively or additionally comprises an internal element such as a coilable wire, or an obturator configured to prevent secretions from being drawn into the lumen, or to actively remove the secretions. The catheter alternatively or additionally comprises an element to dry, aerate or aspirate the lung passageways.

Abstract: Disclosed are methods and devices for regulating fluid flow to and from a region of a patient's lung, such as to achieve a desired fluid flow dynamic to a lung region during respiration and/or to induce collapse in one or more lung regions. Pursuant to an exemplary procedure, an identified region of the lung is targeted for treatment. The targeted lung region is then bronchially isolated to regulate airflow into and/or out of the targeted lung region through one or more bronchial passageways that feed air to the targeted lung region.

Abstract: A method and system for increasing the flow resistance of collateral 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 collateral pathways. The method may sometimes be performed after lung has been assessed for the presence of collateral pathways.

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: Methods and systems for lung volume reduction of a patient are described. The methods include implanting a flow control device in a bronchial passageway of the lung. The flow control device regulates fluid flow through the bronchial passageway and includes a valve protector that at least partially surrounds a valve member. The valve protector has sufficient rigidity to maintain the shape of the valve member against compression.

Abstract: Disclosed is a sizing device for sizing an inside diameter of a lung passageway. The device includes an elongate shaft configured for positioning in the lung passageway and a sizing element at the distal end of the shaft. The sizing element defines a range of transverse dimensions that correspond to a range of transverse dimensions suitable for use with a predetermined set of bronchial isolation devices. The device is used to determine the suitability of a bronchial isolation device for use in the lung passageway prior to using a separate delivery catheter to deliver the bronchial isolation device into the lung passageway.

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: 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.