Systems and methods for performing medical procedures involving accessing the lymphatic system

Abstract

System and methods are provided for treating a patient that include a delivery device sized for introduction into a target site within a patient's body, a source of one or more therapeutic and/or diagnostic agents coupled to the delivery device, and a tubular member sized for introduction into the patient's vasculature to isolate the thoracic duct. Once the thoracic duct is isolated, fluid may be removed from the thoracic duct, e.g., to prevent the agents that transit from the target site into the thoracic duct from entering the patient's vasculature, and/or to modulate flow through the thoracic duct to modulate concentration and/or resident time of the agents at the target site. The one or more agents may include particles sized for preferential transit into the lymphatic system.

1 . A system for treating a patient, comprising:
 a delivery device sized for introduction into a target treatment site within a patient's body;   a source of one or more agents coupled to the delivery device, the one or more agents comprising particles sized for preferential transit into the lymphatic system; and   a tubular member comprising a proximal end, a distal end sized for introduction into the patient's body into a thoracic duct, an expandable member on the distal end for substantially sealing the thoracic duct from the patient's venous system, and a lumen extending between the proximal and distal ends for removing fluid from the thoracic duct including the particles transiting into the thoracic duct.   
     
     
         2 . The system of  claim 1 , wherein the delivery device comprises a needle and the source of agents comprising a syringe barrel coupled to the needle, the one or more agents housed within the syringe barrel. 
     
     
         3 . The system of  claim 1 , wherein the particles have an outer cross-section larger than about thirty nanometers (30 nm). 
     
     
         4 . The system of  claim 3 , wherein the particles have an outer cross-section smaller than about one hundred nanometers (100 nm). 
     
     
         5 . The system of  claim 1 , wherein the one or more agents comprise a chemotherapy agent encapsulated within a lipid membrane. 
     
     
         6 . The system of  claim 1 , further comprising an external system communicating with the tubular member lumen to analyze the removed fluid to detect the presence of the one or more agents in the removed fluid, thereby identifying when the one or more agents have transited into the thoracic duct. 
     
     
         7 . The system of  claim 6 , further comprising an infusion device for returning the removed fluid into the patient's body before the one or more agents have been detected in the removed fluid. 
     
     
         8 . The system of  claim 7 , wherein the external system further comprises one of a separator and a filter for removing the one or more agents from the removed fluid, the infusion device configured to return the remaining fluid into the patient's body after removing the one or more agents. 
     
     
         9 . The system of  claim 1 , further comprising a controller communicating with the tubular member lumen for controlling a flow rate of fluid removed from the thoracic duct to control a resident time of the one or more agents from the target treatment site. 
     
     
         10 . A system for treating a patient, comprising:
 a delivery device sized for introduction into a target treatment site within a patient's body;   a source of one or more agents coupled to the delivery device, the one or more agents comprising particles sized for preferential transit into the lymphatic system;   a tubular member comprising a proximal end, a distal end sized for introduction into the patient's body into a thoracic duct, an expandable member on the distal end for substantially sealing the thoracic duct from the patient's venous system, and a lumen extending between the proximal and distal ends for removing fluid from the thoracic duct including the particles transiting into the thoracic duct; and   a controller communicating with the tubular member lumen for modulating fluid flow through the thoracic duct to modulate one or both of resident time and concentration of the one or more agents delivered into the target treatment site.   
     
     
         11 - 22 . (canceled) 
     
     
         23 . A method for minimizing system exposure to one or more therapeutic or diagnostic agents, comprising:
 locally introducing the one or more agents into a patient's body; and   subsequently collecting or removing lymphatic fluid from the patient's thoracic duct.   
     
     
         24 . The method of  claim 23 , wherein the one or more agents are sized for preferential uptake by the patient's lymphatic system, the method further comprising isolating the thoracic duct to prevent the one or more agents that transit into the thoracic duct from entering the patient's venous system. 
     
     
         25 . A method for modulating one or both of residence time and concentration of one or more therapeutic or diagnostic agents, comprising:
 delivering the one or more agents locally into a target site within a patient's body; and   modulating flow of fluid through the patient's thoracic duct.   
     
     
         26 . The method of  claim 25 , wherein the one or more agents are sized for preferential uptake by the patient's lymphatic system. 
     
     
         27 . The method of  claim 25 , wherein the one or more agents have an outer cross-section larger than about thirty nanometers (30 nm). 
     
     
         28 . The method of  claim 25 , wherein the one or more agents have an outer cross-section smaller than about one hundred nanometers (100 nm). 
     
     
         29 . The method of  claim 25 , wherein the one or more agents comprise a chemotherapy agent encapsulated within a lipid membrane. 
     
     
         30 . The method of  claim 25 , further comprising isolating the thoracic duct to prevent the one or more agents that transit into the thoracic duct from entering the patient's venous system. 
     
     
         31 - 65 . (canceled)