Methods for treating chronic obstructive pulmonary disease

Abstract

The methods and devices disclosed altering gaseous flow within a lung to improve the expiration cycle of individuals having Chronic Obstructive Pulmonary Disease.

1 . A method of improving gaseous flow within a diseased lung comprising the step of altering the gaseous flow paths within the lung.  
   
   
       2 . The method of  claim 1  wherein the step of altering the gaseous flow comprises the steps of: 
 selecting at least one site for collateral ventilation of the lung, and    creating at least one collateral channel in at least one of the sites.    
   
   
       3 . The method of  claim 2  further comprising the step of locating the at least one site within a portion of a natural airway of the respiratory system prior to said selecting step.  
   
   
       4 - 5 . (cancelled).  
   
   
       6 . The method of  claim 1  wherein said locating step comprises transmitting a first signal into an area of tissue, receiving a second signal, comparing said first and second signal for Doppler shifting.  
   
   
       7 . The method of  claim 6  wherein said comparing step comprises determining whether a blood vessel is present near said area of tissue.  
   
   
       8 . The method of  claim 3  wherein said locating step includes 
 (a) examining the lung using an imaging method selected from radiography, computer tomography, ultrasound, Doppler, MRI, PET and acoustic imaging to determine a location to alter the gaseous flow, and    (b) examining the lung using the non-invasive imaging method selected from radiography, computer tomography, ultrasound, doppler, MRI, PET and acoustic imaging to determine a number of collateral channels to be created.    
   
   
       9 . The method of  claim 8  further including the step of inserting a fluid into the airway to assist in ultrasound or doppler imaging.  
   
   
       10 . The method of  claim 3  further comprising the step of inserting an additive to enhance the visibility of the airway during the examining step.  
   
   
       11 . The method of  claim 3  wherein said locating step includes determining the degree of collateral ventilation between a plurality of air sacs of the lung in a region adjacent to the airway.  
   
   
       12 - 13 . (cancelled).  
   
   
       14 . The method of  claim 11  wherein said step of determining the degree of collateral ventilation includes: 
 (a) occluding a segment of the airway;    (b) adding or removing gas distally of the occluded segment; and    (c) monitoring flow or pressure distally of the occluded segment.    
   
   
       15 - 26 . (cancelled).  
   
   
       27 . The method of  claim 3  wherein the portion of the natural airway is selected from a group consisting of bronchi, upper lobe, middle lobe, lower lobe, segmental bronchi, and bronchioles.  
   
   
       28 . The method of  claim 27  wherein the step of selecting each of the sites comprises introducing a probe into a wall of the natural airway, and detecting the presence of a blood vessel.  
   
   
       29 - 33 . (cancelled).  
   
   
       34 . The method of  claim 27  wherein the step of creating at least one collateral airway comprises mechanically forming the collateral channel.  
   
   
       35 . The method of  claim 34  wherein the at least one collateral channel is mechanically formed using a process selected from dilation, cutting, piercing, and bursting.  
   
   
       36 . The method of  claim 27  wherein the step of creating at least one collateral channel comprises electrically forming the collateral channel.  
   
   
       37 - 41 . (cancelled).  
   
   
       42 . The method of  claim 27  wherein the channel comprises an opening in the wall of the airway.  
   
   
       43 - 47 . (cancelled).  
   
   
       48 . The method of  claim 27  further comprising the step of applying a glue in proximity to the at least one site for collateral ventilation.  
   
   
       49 . The method of  claim 27  further comprising the step of delivering steroids to the lung.  
   
   
       50 . The method of  claim 27  wherein the step of creating the at least one collateral channel comprises making an incision in a wall of the natural airway, placing the wall of the natural airway in tension, advancing a blunt instrument into the incision.  
   
   
       51 . (cancelled).  
   
   
       52 . The method of  claim 27  wherein the step of creating at least one collateral channel comprises inserting a conduit within a wall of the natural airway.  
   
   
       53 . The method of  claim 27  further comprising the step of inserting at least one conduit within each of the collateral channels.  
   
   
       54 . (cancelled).  
   
   
       55 . The method of  claim 53  wherein the conduit is comprised of a material selected from the group consisting of elastomers, polymers, metals, metal alloys, shape memory alloys, and shape memory polymers.  
   
   
       56 - 57 . (cancelled).  
   
   
       58 . The method of  claim 53  wherein the conduit is removable from the body.  
   
   
       59 . The method of  claim 1  where the altering step comprises collaterally ventilating the lung by forming at least one opening in a natural airway wall within said lung that is in fluid communication with lung tissue.  
   
   
       60 . (cancelled).  
   
   
       61 . The method of  claim 59  further comprising the step of placing a bioabsorbable material in the opening to maintain patency of the opening.  
   
   
       62 . (cancelled).  
   
   
       63 . The method of claim  65  wherein said preserving step comprises cooling the tissue adjacent to the opening.  
   
   
       64 - 66 . (cancelled).  
   
   
       67 . The method of  claim 1  where the altering step comprises making an inspiratory path different from an expiratory path within the lung.  
   
   
       68 - 186 . (cancelled)