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 locating a site in an airway in a lung for the creation of at least one collateral channel, the method comprising: 
 examining an area of the lung for collateral ventilation in the lung.    
   
   
       2 . The method of  claim 1  further comprising delivering an agent to the lung for assessing the degree of collateral ventilation.  
   
   
       3 . The method of  claim 2  where the agent is non-harmful gas.  
   
   
       4 . The method of  claim 3  where the gas is Xenon.  
   
   
       5 . A method of improving gaseous flow within a diseased lung comprising: 
 altering the gaseous flow paths within the lung;    locating at least one region within a portion of a natural airway of the respiratory system for altering gaseous flow where locating comprises:    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.    
   
   
       6 . The method of  claim 5  further including the step of inserting a fluid into the airway to assist in ultrasound or doppler imaging.  
   
   
       7 . The method of  claim 5  further comprising the step of inserting an additive to enhance the visibility of the airway during the examining step.  
   
   
       8 . The method of  claim 5  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.  
   
   
       9 . The method of  claim 8  wherein said step of determining the degree of collateral ventilation includes: 
 (a) forcing a volume of a gas through the airway and into the air sacs;    (b) reducing pressure in the airway after the forcing step;    (c) determining the reduction in a diameter of the airway as a result of the reduced pressure.    
   
   
       10 . The method of  claim 9  further including the step of occluding a segment of the airway and wherein said steps of reducing pressure and determining the reduction in diameter are performed distally of the occluded segment.  
   
   
       11 . The method of  claim 8  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.    
   
   
       12 . The method of  claim 8  wherein said step of determining the degree of collateral ventilation includes: 
 (a) forcing a volume of a gas within the lung near to the airway; and    (b) measuring pressure, flow, or return volume of the gas within the airway, wherein said measuring step is performed after said forcing step.    
   
   
       13 . The method of  claim 12  further including the step of occluding a segment of the airway and wherein said measuring step is performed distally of the occluded segment.  
   
   
       14 . The method of  claim 12  wherein said forcing step comprises forcing the gas through a wall of the airway directly into the air sacs.  
   
   
       15 . The method of  claim 14  further comprising the step of measuring the difference between the forced volume and the return volume to determine the degree of collateral ventilation.  
   
   
       16 . A method of evaluating an individual having a diseased lung as a candidate for a procedure to create collateral channels within an airway of the individual, said method comprising the steps of: 
 (a) performing pulmonary function tests on the individual to obtain at least one pulmonary function value;    (b) comparing the at least one pulmonary function to a corresponding predetermined pulmonary function value;    (c) assigning a rating to the individual based upon said comparing step; and    (d) evaluating the individual based upon the rating.    
   
   
       17 . The method of  claim 16  wherein the pulmonary function value is selected from a group consisting of FEV (forced expiratory volume), FVC (forced vital capacity), FEF (forced expiratory flow), Vmax (maximum flow), PFER (peak expiratory flow rate), FRC (functional residual capacity), RV (residual volume), TLC (total lung capacity), or a combination thereof.  
   
   
       18 . The method of  claim 16  further comprising the step of obtaining clinical information from the individual, and wherein said assigning step further includes accounting for the clinical information to assign the rating.  
   
   
       19 . The method of  claim 16  further comprising the step of using imaging to identify an amount of the lung that is hyper-inflated, and wherein said assigning step further includes accounting for the amount of the lung that is hyper-inflated to assign the rating.  
   
   
       20 . A method of determining the effectiveness of a procedure to improve gaseous flow within a diseased lung, said method comprising the steps of: 
 (a) performing pulmonary function tests on the individual to obtain at least one pulmonary function value;    (b) creating collateral channels within the lung;    (c) performing post procedure pulmonary function tests on the individual to obtain at least one post-procedure pulmonary function value; and    (d) obtaining clinical information from the individual;    (e) comparing the pulmonary function value with the post-procedure pulmonary function value to determine the effect of creating collateral ventilation; and    (f) evaluating the comparing step with the clinical information to assess the effectiveness of the procedure to improve gaseous flow within the diseased lung.    
   
   
       21 . The method of  claim 20  wherein the pulmonary function value is selected from a group consisting of FEV (forced expiratory volume), FVC (forced vital capacity), FEF (forced expiratory flow), Vmax (maximum flow), PFER (peak expiratory flow rate), FRC (functional residual capacity), RV (residual volume), TLC (total lung capacity), or a combination thereof.