System and method for site specific therapy

Abstract

A system, including catheter apparatus, and related method for performing site specific therapy. The catheter apparatus can include one or more semipermeable microcatheters for use in performing site specific microdialysis. The system and method are particularly suited for use in addressing cerebral edema by affecting the osmolar relationship between fluids making up the brain tissue. Also disclosed is an apparatus having a delivery/recovery mechanism in the form of a pump reservoir and one or more catheters in the form of semipermeable microcatheters, for use in delivering and/or recovering fluid to and/or from a tissue site or for performing tissue engineering outside of the body. The apparatus can be used in a method to perform site specific microtherapy, including for the treatment of avascular necrosis, compartment syndrome, cerebral edema, and to improve skin flap survival in the course of reconstructive surgery.

1 . A system for performing site specific therapy of a tissue site exhibiting tissue swelling, the system comprising an apparatus comprising: (a) one or more catheters comprising one or more semipermeable microcatheters, the catheter(s) adapted to be positioned within the tissue site, and (b) a delivery and/or recovery mechanism for employing the catheter(s) to control the movement of bulk fluids and/or active fluid components within or between tissue portions or adjacent tissues in a manner that achieves a therapeutic effect. 
     
     
         2 . A system according to  claim 1  wherein the tissue swelling includes impaired interstitial circulation, and the system is adapted to recover water and permeant solutes from the tissue site. 
     
     
         3 . A system according to  claim 2  wherein the tissue site comprises a solid tumor. 
     
     
         4 . A system according to  claim 2  wherein the fluid movement is used to effect the movement of biologically active molecules. 
     
     
         5 . A system according to  claim 3  wherein the tissue site comprises an anatomic location or organ within the body containing one or more fluids in latent or actual fluid communication. 
     
     
         6 . A system according to  claim 1  wherein the apparatus is used for the deliberate and controlled movement of fluids and/or the active fluid components, within or between tissue portions or adjacent tissues. 
     
     
         7 . A system according to  claim 6  wherein such fluid movement is used to effect the movement of agents between adjacent healthy and diseased portions of the same tissue. 
     
     
         8 . A system according to  claim 6  wherein the apparatus comprises microfibril technology to remove fluid, solutes, or specific agents from the tissue site. 
     
     
         9 . A system according to  claim 6  wherein the system can be used for the infusion of therapeutic agents and the corresponding removal of tissue fluids. 
     
     
         10 . A system according to  claim 6  wherein the system can be used to provide artificial microcirculation for replicating, repairing, or augmenting circulation within the tissue site. 
     
     
         11 . A system according to  claim 1 , wherein the system is used to deliver toxic agents directly to a tissue site. 
     
     
         12 . A system according to  claim 1 , wherein the system is used for the delivery of poorly diffusible molecules to the interstitum. 
     
     
         13 . A system according to  claim 1 , wherein the apparatus is used to treat inflammation in a fixed tissue space. 
     
     
         14 . A system according to  claim 1  wherein the system is adapted for tissues having an inadequate local tissue microcirculatory system to perfuse the tissue. 
     
     
         15 . A method for performing site specific therapy of a tissue site exhibiting swelling, the method comprising the steps of providing a system according to  claim 1 , and using the system to deliver toxic agents directly to a tissue site. 
     
     
         16 . A method for performing site specific therapy of a tissue site exhibiting swelling, the method comprising the steps of providing a system according to  claim 1 , and using the system for the delivery of poorly diffusible molecules to the interstitum. 
     
     
         17 . A method for performing site specific therapy of a tissue site exhibiting swelling, the method comprising the steps of providing a system according to  claim 1 , and using the system for the infusion of therapeutic agents and the corresponding removal of tissue fluids. 
     
     
         18 . A method for performing site specific therapy of a tissue site exhibiting swelling, the method comprising the steps of providing a system according to  claim 1 , and using the system to provide artificial microcirculation for replicating, repairing, or augmenting circulation within the tissue site. 
     
     
         19 . A method according to  claim 18 , wherein the tissue swelling includes impaired interstitial circulation, and the system is adapted to recover water and permeant solutes from the tissue site. 
     
     
         20 . A method according to  claim 19  wherein the tissue site comprises a solid tumor.