Delivery devices with coolable energy emitting assemblies

Abstract

Systems, delivery devices, and methods to treat to ablate, damage, or otherwise affect tissue. The treatment systems are capable of delivering a coolable ablation assembly that ablates targeted tissue without damaging non-targeted tissue. The coolable ablation assembly damages nerve tissue to temporarily or permanently decrease nervous system input.

What is claimed is: 
     
         1 . A pulmonary treatment apparatus for treatment of target tissue in an airway of a subject, comprising:
 an elongated shaft having proximal and distal ends, an inflow lumen and an outflow lumen extending between the proximal and distal ends;   an ablation assembly configured to be positioned in the airway and coupled to the distal end of the shaft, the ablation assembly including an expandable member, a fluid delivery conduit, and one or more energy emitters coupled to the fluid delivery conduit, the fluid delivery conduit and the expandable member being fluidly coupled to the inflow lumen and the outflow lumen,   wherein the ablation assembly is movable from a delivery configuration in which the one or more energy emitters are configured to be delivered into the airway via a delivery device, to a deployed configuration in which the conduit and the one or more energy emitters radially project from a surface of the expandable member such that, when positioned in the airway, each of the one or more energy emitters is configured to engage a wall of the airway in at least one intercartilagenous space extending between adjacent cartilaginous rings of the airway, and the expandable member is configured to engage the wall of the airway both distally and proximally of each of the one or more energy emitters;   wherein the apparatus is configured for circulation of fluid through the ablation assembly via the inflow and outflow lumens so as to cool the expandable member and the one or more energy emitters such that a portion of the surface of the wall is cooled sufficiently to reduce damage to airway tissue disposed between the one or more energy emitters and the target tissue, while the one or more energy emitters deliver energy to the target tissue to create one or more lesions extending along a circumference of the airway within the at least one intercartilagenous space.   
     
     
         2 . The pulmonary treatment apparatus of  claim 1 , further comprising:
 a source of energy coupled to the one or more energy emitters and configured to deliver energy thereto such that one or more lesions are created in target tissue spaced radially outwardly from the surface of the wall of the airway; and   a cooling system fluidly coupled to the inflow lumen and configured to deliver the fluid to the ablation assembly so as to cool the expandable member and the one or more energy emitters.   
     
     
         3 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters comprise a single elongated electrode. 
     
     
         4 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters comprise a plurality of circumferentially spaced apart electrodes. 
     
     
         5 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters form a helical configuration. 
     
     
         6 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters comprise a pair of bipolar electrodes. 
     
     
         7 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters comprise a plurality of axially and circumferentially spaced-apart electrodes. 
     
     
         8 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters comprise a first portion positionable in a first intercartilagenous space and a second portion positionable in a second intercartilagenous space when the first portion is positioned in the first intercartilagenous space. 
     
     
         9 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters are configured to deliver RF energy to the airway wall. 
     
     
         10 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters are configured to deliver microwave energy to the airway wall. 
     
     
         11 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters are configured to deliver ultrasound energy to the airway wall. 
     
     
         12 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters are movable from the delivery configuration to the deployed configuration by the expandable member. 
     
     
         13 . The pulmonary treatment apparatus of  claim 1 , wherein the expandable member is configured to engage and cool airway tissue adjacent to the surface of the airway wall engaged by the one or more energy emitters. 
     
     
         14 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters include an electrode coupled to the fluid delivery conduit. 
     
     
         15 . The pulmonary treatment apparatus of  claim 14 , wherein the electrode is a collapsible electrode. 
     
     
         16 . The pulmonary treatment apparatus of  claim 1 , wherein the one or more energy emitters include an electrode comprised of a conductive foil, film, or coating. 
     
     
         17 . The pulmonary treatment apparatus of  claim 1 , wherein a first end of the fluid delivery conduit is directly coupled to the distal end of the elongate shaft, a second end of the fluid delivery conduit is coupled to a distal end of the expandable member, and a proximal end of the expandable member is also directly coupled to the distal end of the elongate shaft such that the fluid flows serially through the fluid delivery conduit and the expandable member. 
     
     
         18 . The pulmonary treatment apparatus of  claim 17 , wherein the first end of the fluid delivery conduit is coupled to the inflow lumen, and the proximal end of the expandable member is coupled to the outflow lumen such that the fluid flows serially through the fluid delivery conduit and then the expandable member. 
     
     
         19 . The pulmonary treatment apparatus of  claim 1 , wherein the expandable member is optically coupleable to a viewing device of the delivery device such that the one or more energy emitters is viewable through the expandable member. 
     
     
         20 . A treatment apparatus for treatment of target tissue in a body lumen of a subject, comprising:
 an elongated shaft having proximal and distal ends, an inflow lumen and an outflow lumen extending between the proximal and distal ends;   an ablation assembly configured to be positioned in the body lumen and coupled to the distal end of the shaft, the ablation assembly including an expandable member, a fluid delivery conduit, and one or more energy emitters coupled to the fluid delivery conduit, the fluid delivery conduit and the expandable member being fluidly coupled to the inflow lumen and the outflow lumen,   wherein the ablation assembly is movable from a collapsed configuration to a deployed configuration in which the conduit and the one or more energy emitters radially project from a surface of the expandable member such that, when positioned in the body lumen, each of the one or more energy emitters is configured to engage a wall of the body lumen, and the expandable member is configured to engage the wall of the body lumen both distally and proximally of each of the one or more energy emitters;   wherein the apparatus is configured for circulation of fluid through the ablation assembly via the inflow and outflow lumens so as to cool the expandable member and the one or more energy emitters so as to protect non tissue disposed between the one or more energy emitters and the target tissue, while the one or more energy emitters deliver energy to the target tissue.