Methods for minimally invasive, non-permanent occlusion of a uterine artery

Abstract

Non-permanent occlusion of the uterine arteries is sufficient to cause the demise of uterine myomata without unnecessarily exposing other tissues and anatomical structures to hypoxia attendant to prior permanent occlusion techniques. A therapeutically effective transient time of occlusion of a uterine artery to treat uterine fibroid tumors is from 1 hours to 24 hours, and preferably is at least about 4 hours. A therapeutically effective temporary time of occlusion of a uterine artery to treat uterine fibroid tumors is from 1 day (24 hours) to 7 days (168 hours), and preferably is about 4 days (96 hours). By invaginating the tissues of the vaginal wall up to or around a uterine artery, collapse of the uterine artery can be achieved without penetrating tissue of the patient.

1 . A process of treating a female patient's uterus, comprising: 
 at least partially occluding a uterine artery of the patient for a therapeutically effective time period by applying pressure to the uterine artery through a wall of a vaginal fornix of the patient; and    re-establishing blood flow through the uterine artery at the termination of said therapeutically effective time period by releasing the pressure applied to the uterine artery through vaginal wall.    
   
   
       2 . A process in accordance with  claim 1 , further comprising: 
 invaginating a portion of a vaginal wall of a patient prior to applying pressure to the uterine artery to at least partially occlude the uterine artery.    
   
   
       3 . A process in accordance with  claim 2 , wherein the invaginating a portion of the vaginal wall extends the vaginal wall adjacent to the uterine artery to be occluded.  
   
   
       4 . A process in accordance with  claim 3 , wherein invaginating a portion of the vaginal wall comprises invaginating two portions of the vaginal wall so that the vaginal wall extends adjacent to the uterine artery on opposite sides of the uterine artery.  
   
   
       5 . A process in accordance with  claim 2 , wherein invaginating a portion of the vaginal wall comprises invaginating a portion of the vaginal wall so that the vaginal wall extends under and immediately adjacent to the uterine artery.  
   
   
       6 . A process in accordance with  claim 1 , wherein occluding the uterine artery comprises collapsing said uterine artery effective to stop blood flow through said uterine artery.  
   
   
       7 . A process in accordance with  claim 6 , wherein collapsing said uterine artery comprises clamping said uterine artery.  
   
   
       8 . A process in accordance with  claim 7 , wherein clamping said uterine artery comprises bilaterally clamping said uterine artery.  
   
   
       9 . A process in accordance with  claim 6 , wherein collapsing said uterine artery comprises compressing said uterine artery between a tool on a first side of said uterine artery and an anatomical structure on a second side of said uterine artery opposite said first side of said uterine artery.  
   
   
       10 . A process in accordance with  claim 1 , wherein said therapeutically effective time period is between 1 hour and 168 hours.  
   
   
       11 . A process in accordance with  claim 1 , wherein said therapeutically effective time period is between 1 hour and 24 hours.  
   
   
       12 . A process in accordance with  claim 1 , wherein said therapeutically effective time period is between 24 hours and 168 hours.  
   
   
       13 . A process in accordance with  claim 1 , wherein said therapeutically effective time period is between 72 hours and 96 hours.  
   
   
       14 . A process in accordance with  claim 1 , wherein the therapeutically effective time period is to treat uterine fibroids.  
   
   
       15 . A process in accordance with  claim 1 , wherein the therapeutically effective time period is to treat a condition selected from the group consisting of DUB, PPH, bleeding from cesarian section surgery, and bleeding associated with myomectomy.  
   
   
       16 . A process in accordance with  claim 1 , wherein two uterine arteries are occluded for the therapeutically effective time period.  
   
   
       17 . A process useful for treating a condition of a patient having at least one uterine artery and a uterus, comprising: 
 non-invasively occluding at least one uterine artery for a therapeutically effective time period; and    removing at least a portion of a uterus of a patient.    
   
   
       18 . An assembly for treating a uterine disorder of a female patient by occluding at least in part a uterine artery thereof, comprising: 
 a) a first clamping member which has a distal section forming in part a jaw having a pressure applying clamping surface on a distal end of the jaw that is configured to invaginate vaginal tissue of the patient's vaginal fornix and that has sufficient area to occlude the patient's uterine artery when pressed against invaginated tissue of the patient's vaginal fornix;    b) a second clamping member which has a distal section forming in part a jaw having a pressure applying clamping surface on a distal end of the jaw in opposition to the pressure applying clamping surface on the distal end of the jaw of the first clamping member that is configured to invaginate vaginal tissue of the patient's vaginal fornix and that has sufficient area to occlude the patient's uterine artery when pressed against invaginate tissue of the patient's vaginal fornix;    c) a pivotal connection between the first and second clamping members at a location proximally spaced from the pressure applying surfaces of the first and second clamping members; and    d) a blood flow sensor to detect the patient's uterine artery.    
   
   
       19 . The assembly of  claim 18 , wherein the blood flow sensor is a Doppler ultrasound sensor.  
   
   
       20 . The assembly of  claim 18 , wherein the distal ends of the jaws of the first and second clamping members are configured to invaginate a vaginal wall and clamp at least a portion of said vaginal wall between jaws thereof and to at least partially occlude a uterine artery disposed therein.  
   
   
       21 . The assembly of  claim 18 , wherein the clamping members are formed at least in part of a resorbable material.  
   
   
       22 . The assembly of  claim 21 , wherein the resorbable material comprises polyglycolic acid.  
   
   
       23 . The assembly of  claim 21 , wherein the resorbable material comprises a dissolvable material selected from the group consisting of as polyvinyl alcohol and gelatin.  
   
   
       24 . The device of  claim 18  wherein the blood flow sensor is configured to verify that the patient's uterine artery is located between the jaws of the first and second clamping members.  
   
   
       25 . The device of  claim 18  wherein the first and second clamping members have tissue receiving recesses proximal to the jaws thereof.  
   
   
       26 . The assembly of  claim 18  wherein at least the first clamping member has a proximal section forming in part a manually manipulative handle configured to extend out of the patient's vagina when the device is in position to occlude the patient's uterine artery.  
   
   
       27 . The assembly of  claim 26  wherein the second clamping member has a proximal section forming in part a manually manipulative handle configured to extend out of the patient's vagina when the device is in position to occlude the patient's uterine artery.