Apparatus and method for isolated lung access

Abstract

Apparatus, systems, methods, and kits are provided for isolating a target lung segment and treating that segment, usually by drug delivery or lavage. The systems include at least a lobar or sub-lobar isolation catheter which is introduced beyond a second lung bifurcation (i.e., beyond the first bifurcation in a lobe of the lung) and which can occlude a bronchial passage at that point. An inner catheter is usually introduced through the isolation catheter and used in cooperation with the isolation catheter for delivering and/or removing drugs or washing liquids from the isolated lung region. Optionally, the inner catheter will also have an occluding member near its distal end for further isolation of a target region within the lung.

What is claimed is:  
     
         1 . An isolation catheter comprising: 
 a catheter body having a proximal end, a distal end, and a main lumen therethrough;    an expansible occlusion member disposed on the catheter body near the distal end thereof;    optical and illumination fibers disposed in the catheter body to image a region distal to the distal end of the catheter body; and    a hub attached to the proximal end of the catheter body, said hub having a connector port for at least the main lumen.    
     
     
         2 . An isolation catheter as in  claim 1 , wherein the catheter body has a length in the range from 20 cm to 90 cm, an outer diameter in the range from 2 mm to 7 mm and the main lumen has a diameter from 1 mm to 6 mm.  
     
     
         3 . An isolation catheter as in either  claim 1  or  2 , wherein the expansible occlusion member is an inflatable cuff having an expanded diameter in the range from 4 mm to 18 mm and a length in the range from 5 mm to 30 mm.  
     
     
         4 . An isolation catheter as in  claim 3 , wherein the catheter body further comprises an inflation lumen disposed to deliver and remove an inflation medium to the inflatable cuff and wherein the hub has an additional connector port for the inflation lumen.  
     
     
         5 . An isolation catheter as in either  claim 1  or  2 , wherein the catheter body further comprises a lumen disposed to direct a washing fluid over a distal tip of the optical fiber.  
     
     
         6 . An isolation lung infusion/aspiration system, said system comprising: 
 an isolation catheter according to either of claims  1  and  2 ; and    an inner catheter having a proximal end, a distal end, and a central lumen therethrough, said inner catheter being positionable within the main lumen of the sub-lobar isolation catheter to form an annular lumen within the main lumen.    
     
     
         7 . A system as in  claim 6 , wherein the hub has an additional connector port for the annular lumen.  
     
     
         8 . A system as in  claim 6 , further comprising an adaptor connectable to the hub, wherein the adaptor has a connector port for the annular lumen.  
     
     
         9 . A system as in  claim 6 , wherein the inner catheter has an outer diameter in the range from 0.5 mm to 4.5 mm, an inner diameter in the range from 0.1 mm to 3.5 mm, and a length at least 10 cm longer than the isolation catheter.  
     
     
         10 . A system as in  claim 9 , wherein the inner catheter has a length in the range from 50 cm to 200 cm.  
     
     
         11 . A system as in  claim 6 , wherein the inner catheter has an expansible occlusion member disposed near its distal end.  
     
     
         12 . A system as in  claim 11 , wherein the expansible occlusion member on the inner catheter is an inflatable cuff having an expanded diameter in the range from 4 mm to 18 mm, and a length in the range from 5 mm to 30 mm.  
     
     
         13 . A system as in  claim 11 , wherein the inner catheter further comprises an inflation lumen disposed to deliver and remove an inflation medium to the inflatable cuff on the inner catheter.  
     
     
         14 . A system as in  claim 6 , wherein the inner catheter further comprises an infusion/aspiration lumen having at least one distal port positioned proximally of the inflatable cuff on the inner catheter.  
     
     
         15 . A system as in  claim 6 , wherein the inner catheter further comprises a vibratory element near the distal end thereof.  
     
     
         16 . A system as in  claim 6 , wherein the inner catheter comprises at least two lumens which are joined near a distal end of the inner catheter and which have a common outlet port.  
     
     
         17 . An isolation catheter as in  claim 1  or  2 , further comprising a vibratory element near the distal end thereof.