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: Disclosed is an assembly for loading a bronchial flow control device into a container, such as into a delivery catheter. The assembly includes a funnel housing and a puller housing that mate with one another. The funnel housing defines a funnel-shaped loading cavity that receives a flow control device and that gradually reduces in size moving in a first direction. The puller housing is removably attached to the funnel housing and is also removably attachable to a bronchial flow control device that can be positioned in the loading cavity. The puller housing pulls the bronchial flow control device in the first direction through the funnel housing to gradually contract the bronchial flow control device into a compressed state of reduced size relative to the expanded size.

Abstract: Devices, methods, and systems are provided for loading an implantable device into a container. One aspect of the loading system contains a loader element with a loading tunnel that is configured to gradually contract an implantable device into a compressed state of reduced size relative to an expanded state as the implantable device travels through the loading tunnel.

Abstract: Systems, methods and devices for performing pulmonary procedures, and in particular treating lung disease. A flow control element includes a valve that prevents airflow in the inhalation direction but permits airflow in the exhalation direction. The flow control element is guided to and positioned at the site by a bronchoscope that is introduced into the patient's trachea and used to view the lungs during delivery of the flow control element. The valve may include one, two or more valve elements, and it may be collapsible for easier delivery. A source of vacuum or suction may be used to increase the amount of fluid withdrawn from the lung tissue. A device for measuring hollow structures, such as bronchioles, and a device for removing a previously-placed flow control element are disclosed as well.

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: Disclosed is a flow control device for a bronchial passageway. The device can includes a valve member that regulates fluid flow through the flow control device, a frame coupled to the valve member, and a membrane attached to the frame. At least a portion of the flow control device forms a seal with the interior wall of the bronchial passageway when the flow control device is implanted in the bronchial passageway. The membrane forms a fluid pathway from the seal into the valve member to direct fluid flowing through the bronchial passageway into the valve member.

Abstract: Disclosed is a method of regulating fluid flow for a targeted lung region. The method comprises injecting a therapeutic agent into the targeted lung region. The therapeutic agent induces a reaction in lung tissue of the targeted lung region or in a collateral pathway to the lung region to reduce collateral fluid flow into the targeted lung region. In one aspect, the method additionally comprises deploying a bronchial isolation device in the direct pathway to regulate fluid flow to the targeted lung region through the direct pathway. The therapeutic agent can comprise, for example, a sclerosing agent that induces a reaction that causes sclerosis in the lung tissue.

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: Devices, systems, and methods for measuring the diameter of an airway in a human or animal subject are disclosed. The device comprises a flexible catheter body having a proximal end and a distal end. Flexible sizing elements are disposed along and extend approximately orthogonally from the catheter body. The sizing elements have different heights from one another and are configured to fit through the working channel of a bronchoscope. Devices, systems, and methods for redirecting airflow through a lung airway are also disclosed. The method comprises introducing into the airway a catheter comprising a distal end, a proximal end and an elongated portion therebetween, wherein the distal end comprises an airway closing mechanism, and wherein the proximal end comprises an actuator to actuate the airway closing mechanism; and actuating the airway closing mechanism to at least partially close the airway.

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: 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: 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: 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: 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.