Method and apparatus for mitigating acute reoxygenation injury during percutaneous coronary intervention

Abstract

A system and methods are described for improving the management of ischemic cardiac tissue during acute coronary syndromes. The system combines a catheter-based sub-system which allows for simultaneous balloon dilation of a coronary artery and infusion of a carefully controlled perfusate during percutaneous coronary intervention. The system allows for modulation of levels of oxygen at the time of percutaneous intervention. In addition, catheters and systems are provided for administration of fluids with modified oxygen content during an intervention that incorporate upstream flow control members to compartmentalize the perfusion of the target coronary artery and the remainder of the heart.

The invention claimed is: 
     
         1 . A reperfusion system for treating a patient undergoing an interventional procedure in which a blood flow to a tissue has been reduced comprising:
 a vascular perfusion catheter defining an infusion lumen, and having an exterior surface and an occluding member, the occluding member mounted on the exterior surface;   a treatment catheter dimensioned to be threaded through the infusion lumen of the vascular perfusion catheter: and   an oxygenation controller in fluid communication with the infusion lumen.   
     
     
         2 . The system of  claim 1 , wherein the treatment catheter is an angioplasty catheter. 
     
     
         3 . The system of  claim 1 , wherein the oxygenation controller includes a pump for forcing a perfusate through the vascular perfusion catheter, a perfusate oxygen modulator for controlling the oxygen level within the perfusate, and a controller configured to change the oxygenation level within the perfusate intentionally from a first oxygenation level to at least a second oxygenation level, the second oxygenation level being different from the first to control the oxygen level within the perfusate. 
     
     
         4 . The system of  claim 1 , wherein the treatment catheter has a treatment portion and the treatment catheter has sufficient length such that the treatment portion can be threaded past the occluding member of the vascular perfusion catheter. 
     
     
         5 . The system of  claim 4 , wherein the treatment portion is an angioplasty balloon. 
     
     
         6 . The system of  claim 1 , further including a guidewire having a tip with a sensor attached thereto. 
     
     
         7 . The system of  claim 6 , wherein the guidewire interacts with the vascular perfusion catheter to place the vascular perfusion catheter in the interventional procedure. 
     
     
         8 . The system of  claim 1 , further including a guidewire having a tip with a probe attached thereto. 
     
     
         9 . The system of  claim 8 , wherein the guidewire interacts with the vascular perfusion catheter to place the vascular perfusion catheter in the interventional procedure. 
     
     
         10 . The system of  claim 1 , wherein the treatment catheter is a stent catheter.