Ureteral and Bladder Catheters and Methods of Inducing Negative Pressure to Increase Renal Perfusion

Abstract

A ureteral catheter includes a drainage lumen having a proximal portion configured to be positioned in at least a portion of a patient's urethra and/or bladder and a distal portion configured to be positioned in a patient's kidney, renal pelvis, and/or in the ureter adjacent to the renal pelvis. The distal portion includes a retention portion for maintaining positioning of the distal portion of the drainage lumen. The retention portion includes a plurality of sections, each section having one or more openings on a sidewall of the retention portion for permitting fluid flow into the drainage lumen. A total area of openings of a first section of the plurality of sections is less than a total area of openings of an adjacent second section of the plurality of sections. The second section is closer to a distal end of the drainage lumen than the first section.

1 . The ureteral catheter of  claim 54 ,
 wherein the retention portion comprises a plurality of sections, each section comprising one or more of the plurality of openings on the sidewall of the retention portion for permitting fluid flow into the drainage lumen,   wherein a total area of openings of a first section of the plurality of sections is less than a total area of openings of an adjacent second section of the plurality of sections, the second section being closer to a distal end of the drainage lumen than the first section.   
     
     
         2 . The ureteral catheter of  claim 54 , wherein a proximal portion of the drainage lumen is essentially free of or free of openings. 
     
     
         3 . The ureteral catheter of  claim 54 , wherein a proximal portion of the drainage lumen is configured to extend outside of the patient's body. 
     
     
         4 - 6 . (canceled) 
     
     
         7 . The ureteral catheter of  claim 54 , wherein the retention portion further comprises:
 at least one first coil having a first diameter; and   at least one second coil having a second diameter, the first diameter being less than the second diameter, the second coil being closer to the distal end of the drainage lumen than the first coil.   
     
     
         8 . (canceled) 
     
     
         9 . (canceled) 
     
     
         10 . The ureteral catheter of  claim 54 , wherein the sidewall comprises a radially inwardly facing side and a radially outwardly facing side, and wherein a total area of the openings on the radially inwardly facing side is greater than a total area of the openings on the radially outwardly facing side. 
     
     
         11 . The ureteral catheter of  claim 54 , wherein the sidewall comprises a radially inwardly facing side and a radially outwardly facing side, and wherein one or more of the plurality of openings are disposed on the radially inwardly facing side, and wherein the radially outwardly facing side is essentially free of openings. 
     
     
         12 - 16 . (canceled) 
     
     
         17 . The ureteral catheter of  claim 1 , wherein the sections are of equal length. 
     
     
         18 - 21 . (canceled) 
     
     
         22 . The ureteral catheter of  claim 1 , wherein a total area of the one or more openings of a section increases for sections closer to a distal end of the retention portion. 
     
     
         23 - 35 . (canceled) 
     
     
         36 . The ureteral catheter of  claim 1 , wherein the second section comprises more openings than the first section. 
     
     
         37 - 53 . (canceled) 
     
     
         54 . A ureteral catheter, comprising:
 a drainage lumen comprising a proximal portion configured to be positioned in at least a portion of a patient's urethra and/or bladder and a distal portion configured to be positioned in a patient's kidney, renal pelvis, and/or in the ureter adjacent to the renal pelvis, the distal portion comprising a retention portion for maintaining positioning of the distal portion of the drainage lumen, the retention portion comprising a proximal end, a distal end, and a plurality of openings on a sidewall of the retention portion for permitting fluid flow into the drainage lumen,   wherein an area of an opening of the plurality of openings which is closer to a proximal end of the retention portion is less than an area of an opening of the plurality of openings which is closer to the distal end of the retention portion.   
     
     
         55 - 56 . (canceled) 
     
     
         57 . A system for inducing negative pressure in a portion of a urinary tract of a patient, the system comprising:
 at least one ureteral catheter according to  claim 54 ; and   a negative pressure source in fluid communication with the drainage lumen of the at least one ureteral catheter, the negative pressure source being configured for inducing a positive and/or a negative pressure in a portion of the urinary tract of the patient to draw fluid into the drainage lumen through the openings of the retention portion.   
     
     
         58 - 62 . (canceled) 
     
     
         63 . The system of  claim 57 , further comprising:
 one or more physiological sensors associated with the patient, the physiological sensors being configured to provide information representative of at least one physical parameter to a controller for the negative pressure source to adjust an operating parameter of the negative pressure source based, at least in part, on the information received from the one or more sensors to increase or decrease vacuum pressure in the drainage lumen of the at least one ureteral catheter to adjust flow of urine through the drainage lumen.   
     
     
         64 . The system of  claim 57 , comprising a first ureteral catheter configured to be placed in a first kidney, renal pelvis, and/or in the ureter adjacent to the renal pelvis of the patient and a second ureteral catheter configured to be placed in a second kidney, renal pelvis, and/or in the ureter adjacent to the renal pelvis of the patient,
 wherein the negative pressure source is configured to apply negative pressure independently to the first ureteral catheter and the second ureteral catheter such that the pressure in each catheter can be the same or different from the other catheter.   
     
     
         65 . (canceled) 
     
     
         66 . The ureteral catheter of  claim 54 , wherein an area of a proximal most opening of the plurality of openings is less than an area of a more distal opening of the plurality of openings closer to the distal end of the retention portion. 
     
     
         67 . The ureteral catheter of  claim 54 , wherein an area of an opening of the plurality of openings towards the distal end of the retention portion is greater than an area of an adjacent opening of the plurality of openings towards the proximal end of the retention portion. 
     
     
         68 . The ureteral catheter of  claim 54 , wherein a shape of each opening of the plurality of openings is independently selected from one or more of circles, triangles, rectangles, and squares. 
     
     
         69 . The ureteral catheter of  claim 54 , wherein the retention portion comprises a coil. 
     
     
         70 . The ureteral catheter of  claim 54 , wherein the sidewall of the retention portion comprises a radially inwardly facing side and a radially outwardly facing side, wherein at least one opening of the plurality of openings is disposed on the inwardly facing side of the retention portion.