The present invention relates to a multifunctional catheter that can be used in photodynamic therapy to irrigate a treatment site located within a body cavity (e.g., the human maxillary sinus for treatment of chronic recurrent sinusitis), to suction waste materials from the treatment site, and to deliver a treatment composition in a generally uniform distribution pattern to the treatment site.
Chronic recurrent sinusitis (“CRS”) is an inflammatory disease of the facial sinuses and nasal passages. The National institute for Health Statistics estimates that CRS is one of the most common chronic conditions in the United States affecting an estimated 37 million Americans. See National Center for Health Statistics, NCHS, “Chronic sinusitis.” In: Summary Health Statistics for US Adults, 2002, Hyattsville, Md.: Centers for Disease Control, US Department of Health and Human Services, 2002. in clinical practice, there is a significant subpopulation of patients with CRS who remain resistant to core despite rigorous treatment regimens including surgery, allergy therapy and prolonged antibiotic therapy. The reason for treatment failure is thought to be related to the destruction of the sinus mucociliary defense by the chronic sinus infection resulting in the development of secondary antibiotic resistant microbial colonization of the sinuses and biofilm formation. Gram-negative and Gram-positive bacteria, including but not limited to, Haemophilus influenza, Streptococcus pneumonia, Staphylococcus aureus (MRSA) and multidrug resistant Pseudomonas aeruginosa are believed to cause the recalcitrant nature of persistent CRS.
Photodynamic therapy (PDT) can be used to treat various diseases involving cancer cells or microbiological pathogens. PDT is a medical treatment involving the use of a photosensitizing agent which is exposed to a specific wavelength of light to create oxygen radicals, resulting in the destruction of cancer cells, bacteria, viruses or fungi. A PDT system consists of two principal components: a photosensitizing composition and a light delivery system. The light delivery system for PDT delivers light onto the treatment site.
PDT involves the use of a photosensitizing composition that is relatively selectively concentrated in cancer cells or microbiological pathogen sites. Depending on the type of photosensitizer, the photosensitizing composition may he injected intravenously, ingested orally or applied topically. For treatment of cancer cells or microbiological pathogens within a specific body cavity area (e.g., nasal passages, maxillary and other sinuses), the photosensitizer is normally applied topically. After application, the photosensitizing composition is generally selectively retained by diseased tissue so that after a period of time, determined by the distribution kinetics of the compound, more photosensitizing composition is absorbed by the diseased tissue or microbiological pathogens than in normal tissue. The photosensitizing composition is then activated by exposure to a specific wavelength of light matching the absorption spectrum peak of the composition. This results in oxygen-derived free radical production and consequent tissue necrosis via several mechanisms including vascular constriction to the diseased tissue. Because there is less photosensitizing composition in the adjacent normal tissue, only the diseased tissue and/or microbiological pathogens undergo necrosis and the normal tissue is preserved when the correct light dose rate for that tissue is administered. The advantage of PDT over conventional treatment such as surgery, radiation and chemotherapy is its relatively selective destruction of diseased tissue or microbiological pathogens with normal tissue-preservation.
Using PDT to treat CRS requires delivery of the photosensitizing composition to the treatment site such as the maxillary sinuses which can be accomplished by using a catheter. The distribution of the photosensitizing composition onto the treatment site can have direct impact on the efficacy of the PDT treatment. PDT treatment is more effective when the photosensitizing composition is delivered by the catheter in a generally uniform distribution pattern onto the treatment site because it allows the PDT light activation of the photosensitizer to be generally uniform within the treatment site (hereinafter referred to as “generally uniform distribution pattern”). If the catheter does not provide a generally uniform distribution pattern of the photosensitizing composition within the treatment site, the treatment site may receive too much, too little or an uneven distribution of the photosensitizing composition which in torn is likely to lower the PDT efficacy.
Furthermore, it is generally desired that the treatment site be cleaned of debris or waste materials before the application of the photosensitizing composition onto the treatment site. Removal of waste materials allows the photosensitizing composition to have a better interface with the targeted cancer ceils or microbiological pathogens located at the treatment site. Accordingly, a catheter that can irrigate the treatment site with biocompatible fluids (e.g., saline, water, or the like) and aspirate the biocompatible fluids along with any waste materials located within the treatment site (hereinafter respectively referred to as “irrigation” and “aspiration”) is desired to be used before application of the photosensitizing composition onto the treatment site.
The present invention provides an improved and multifunctional catheter that provides irrigation, aspiration, arid delivery of a treatment composition (e.g., a photosensitizing composition, or other medicine) in a generally uniform distribution pattern to a treatment site located within a body cavity. This catheter is useful for many applications including but not limited to PDT treatments of desired treatment site(s) located within body cavities such as the maxillary sinuses.
The catheter of the present invention comprises a handle hub, a first tube, a second tube, a control device, a connector, and a delivery assembly comprising a third tube having a third lumen and delivery nozzles, a metal tube having a metal lumen, a fourth tube having a fourth lumen, and a delivery tip having a lip lumen. The delivery assembly includes a double lumen structure with an outer lumen and an inner lumen that is coaxial with the outer lumen and located within the outer lumen. The volume of the outer lumen is less than the volume of the inner lumen. The metal tube and the fourth tube are located within the third lumen and the outer lumen is formed by space remaining in the third lumen not occupied by the metal tube, the metal lumen, the fourth tube and the fourth lumen. The inner lumen is comprised of at least a portion of the metal lumen, at least a portion of the fourth tube, and at least a portion of the tip lumen. The distal end of the first tube is connected to the handle hub and proximate end of the first tube is connected to the connector. The connector is removably connected to a container containing a treatment composition. The distal end of the second tube is connected to the handle hub and proximate end of the second tube is connected to the control device. The control device is removably connected to a vacuum device and an irrigation fluid supply. The delivery assembly is connected to the handle hub. The control device controls irrigation and aspiration by the inner lumen of the delivery assembly when the control device is connected to the vacuum device and the irrigation fluid supply. The delivery nozzles are in communication with the outer lumen so when the connector is connected to the container, the delivery nozzles can deliver the treatment composition in a generally uniform distribution pattern to a treatment site.
The present invention also provides a method to use this multi-functional catheter comprising providing the catheter of the present invention described above; connecting the control device to the aspiration line of the vacuum device; and connecting the control device to the irrigation line of the irrigation fluid supply. The method further includes inserting the delivery assembly info a body cavity until distal portion of the delivery assembly is located at a predetermined location near a treatment site; irrigating the treatment site using the catheter wherein the control device controls the amount of irrigation fluid being delivered by the delivery assembly out of the delivery tip; and aspirating the treatment site to remove waste material using the catheter wherein the control device controls the amount of suction being delivered by the delivery assembly out of the delivery tip. The method also includes applying a treatment composition in a generally uniform distribution pattern onto a treatment site using the catheter when the connector is connected to the container and the delivery nozzles are in liquid communication with the container. Finally, the method includes removing the delivery assembly from the body cavity.
The features and inventive aspects of the present invention will become more apparent upon reading the following detailed description, claims, and drawings, of which the following is a brief description:
Referring to FIGS. 1 and 3-5, the handle hub 10 has a generally cylindrical shape constructed out of art-disclosed suitable material(s) such as plastic, polymer or the like. For example and in one exemplary embodiment, the handle hub 10 is constructed out of a thermoplastic material (e.g., Pellethane®). Grip features 46 are optionally provided on the exterior surface of the handle hub 10 in order to provide the user with better handling of the catheter 100. Label features 47 are also optionally provided on the exterior surface of the handle hub 10 in order to provide a desired location for written information (e.g., product name, trademarks patent pending disclosure, or the like). A first hub lumen 48 and a second hub lumen 50 are included and located within the handle hub 10. The handle hub 10 further includes a first proximate port 52, a second proximate port 54, and a distal port 55.
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In one exemplary embodiment, the third tube 28, the metal tube 32, and the fourth tube 36 are all coaxial and have the central axis 56 as their radical axis so that they are concentric to one another as shown in
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In the second assembly section 60 and referring to
Instead of having the proximate end of the fourth tube 36 located inside the metal lumen 34 as described above, in an alternative exemplary embodiment, the diameter of the fourth lumen 38 within the second assembly section 60 is larger than the outer diameter of the metal tube 32 so that the fourth lumen 38 within the second assembly section 60 can accommodate the distal end of the metal tube 32. Suitable art-disclosed adhesive can be optionally use to assist in the connection between the distal end of the metal tube 32 and the proximate end of the fourth tube 36. For this embodiment, the second, assembly section 60, the inner lumen 66 is the metal lumen 34 and the outer lumen 68 is formed by the interior wail of the third tube 28 (e.g., the surface wall of the third lumen 30) and the exterior wall of the fourth tube 36.
All of the connections and/or attachments discussed herein for the various components such as tubes (e.g., 12, 16, 28, 32 and 36), ports (e.g., 52, 54 and 55), connector (22), control device (20), and tip (40) can be achieved using suitable art-disclosed means, including but hot limited to, the methods described above for the connection between the distal end of the metal tube 32 and the proximate end of the fourth tube 36.
In the third assembly section 62 and referring to
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In one embodiment, the delivery tip 40 is a separate component attached to the other components of the fluid assembly 26 (e.g., the third tube 28 and the fourth tube 36). Alternatively, the delivery tip 40 and the third tube 28 are formed or constructed as a single component wherein the third lumen 30 and the tip lumen 42 are the same seamless structure,
If is optionally provided that the delivery assembly 26 is atraumatic. To assist in making the delivery assembly 26 atraumatic, the delivery tip 40 has a smooth exterior surface (e.g., each edge of the delivery tip 40 is radiused). The third assembly section 62 and the fourth assembly section 64 are constructed of suitable materials) that make them atraumatic. For example, the delivery tip 40 and the third tube 28 located within the third assembly section 62 and the fourth assembly section 64 are constructed of a suitable bendable and flexible material such as plastic, polymer, or the like. Furthermore, it is optional that the delivery tip 40 is constructed of a material that is softer than the material used for the construction of the third tube 28.
The atraumatic quality of the catheter 100 is assisted by having the metal tube 32 terminated at the second assembly section 60. The metal tube 32 provides stiffness and support to the delivery assembly 26 while allowing the delivery assembly 26 and itself (32) to maintain the ability to be flexible, bendable, and malleable. The metal tube 32 is constructed of a metal alloy in a desired thickness that provides all of these desired characteristics.
In order to maintain desired stiffness and support for the delivery assembly 26 and still allowing the delivery assembly 26 to be atraumatic, the combined length of the third assembly section 62 and the fourth assembly section 64 should be less than the combined length of the first assembly section 58 and the second assembly section 60. In fact, the combined length of the third assembly section 62 and the fourth assembly section 64 is likely to be substantially less than the length of the first assembly section 58. In one exemplary embodiment, the length of the fourth assembly section 64 ranges from about 0.08″, between about 0.05″ to about 0.2″, and between about 0.06″ and 0.15″; and the length of the third assembly section 62 ranges from about 0.5″, between about 0.3″ to about 0.8″, and between about 0.4″ to about 1″. Length as discussed herein in this specification is measured in the same direction as indicated in
The first tube 12, the second tube 16, the third tube 28, the fourth tube 36, and the deliver) tip 40 are constructed out of suitable flexible and bendable materials) such as plastic, polymers, or the like. For example, in one exemplary embodiment, the first tube 12 and the second tube 16 are constructed out of nylon while the third tube 28, the fourth tube 36, and the delivery tip 40 are all constructed out of thermoplastic material(s) (e.g., Pebax® or the like) with similar or different durometer values.
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In an alternative exemplary embodiment, the control device 20 includes art-disclosed lockable features (not shown) that allows the control device 20 to be removably connected to the irrigation line 78 as shown in FIG. 11 when irrigation is desired. The control device 20 further includes a suction lock feature 80 as shown in
In one exemplary embodiment of the catheter 100 used for PDT treatment of CRS and referring to
The metal lumen 34 within the second assembly section 60 has a diameter that is greater than the outer diameter of the fourth tube 36 within the second assembly section 60. The length of each of the components within the second assembly section 60 is 0.2″. The length of the fourth assembly section 64 is 0.09″. The length of the third assembly section 62 is 0.41″.
The distal portion of the third tube 28 includes six rows of delivery nozzles 44 with three delivery nozzles 44 in each row. Each row of the delivery nozzles 44 is spaced 0.06″ apart from the next row of delivery nozzles 44. Each of the delivery nozzles 44 within each row is rotationally 60° apart as measured from the central axis 60. The horizontal cut 70 of each of the delivery nozzles 44 is 0.11″ in length and ranges from 0.009″ to 0.012″ in width. The vertical cut 72 of each of the delivery nozzles 44 is 0.08″ in height and ranges from 0.009″ to 0.012″ in width. The horizontal cut 70 and the vertical cut 72 are centered and perpendicular in respect to each other. Measuring from the center point 74 of one of the delivery nozzles 44 to the center point 74 of its adjacent delivery nozzles 44 within the same row yield a distance of 0.28″. The delivery nozzles 44 in each row do not form a straight line with the delivery nozzles 44 located in the adjacent row instead, each delivery nozzle 44 is offset by 0.14″ (based upon measurement between the two center points 74) from each of its nearby delivery nozzle 44 located in the adjacent row. This design of the delivery nozzles 44 on the distal portion of the third tube 28 assist in delivering the treatment composition (e.g., the photosensitizing composition) in small liquid droplets (not aerosol and without assistance of gas) to the treatment site in a generally uniform distribution pattern.
The dimensions and measurements provided above for the exemplary embodiment of the catheter 100 used for PDT treatment of CRS are not intended as being exhaustive or limiting of the invention. Those skilled in the art may change the dimensions and measurements of the catheter 100 as may be best suited to the requirements of a particular use and still be within the scope of the present invention.
The present invention also provides a method of using the catheter 100 for PDT treatment of CRS The method includes providing the catheter 100 of the present invention; connecting the control device 20 to the aspiration line 76 of the vacuum device; connecting the control device 20 to the irrigation line 78 of the irrigation fluid supply; inserting the delivery assembly 26 into a body cavity (e.g., the human maxillary sinus) until the delivery tip 40 is located at a predetermined location near a treatment site; irrigating the treatment site using the catheter 100 wherein the control device 20 controls the amount of irrigation fluid being delivered by the delivery assembly 26 out of the delivery tip 40; aspirating the treatment site to remove waste material using the catheter 100 wherein the control device 20 controls the amount of suction being delivered by the delivery assembly 26 out of the delivery tip 40; applying the treatment composition in a generally uniform distribution pattern onto a treatment site using the catheter 100 when the connector 22 is connected to the container and the delivery nozzles 44 are in liquid communication with the container. Finally, the method includes removing the delivery assembly 26 from the body cavity.
The method of the present invention described above may be changed to first perform the aspiration step: follow by the irrigation step, and then another aspiration step, in fact, the aspiration and irrigation steps can be each repeated as desired during treatment.
The method of the present invention described above and the catheter 100 can also be used for other medical applications other than PDT and may be modified accordingly. Moreover, they can also be used for delivery of a desired composition to other body cavities or even inanimate cavities. For example, the catheter 100 can be sized suitably (decreasing or increasing in size) to provide a desired fit within the body cavities such as ear, vagina, lung, the entire digestive tract (e.g., throat, esophagus, stomach, intestines, rectum, or the like). In one exemplary embodiment, components of the catheter 100 described above for PDT treatment of CRS are ail proportionally reduced by 30% to 50% so the catheter 100 can be used for PDT treatment in the ear cavity.
It is understood that the present invention as described and claimed herein can be used for many additional purposes, therefore the invention is within the scope of other fields and uses and not so limited.
The explanations and illustrations presented herein are intended to acquaint others skilled in the art with the invention, its principles, and its practical application. Those skilled in the art may adapt and apply the invention in its numerous forms, as may be best suited to the requirements of a particular use. Accordingly, the specific embodiments of the present invention as set forth are not intended as being exhaustive or limiting of the invention. The scope of the invention should, therefore, be determined not with reference to the above description, but should instead be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled. The disclosures of all articles and references, including patent applications and publications, are incorporated by reference for all purposes.
This application claims file benefit of the filing date of U.S. Provisional Application Ser. No. 61/649,510 titled: “CATHETER FOR PHOTODYNAMIC THERAPY” filed on May 21, 2012, which is incorporated herein by reference for all purposes.
Number | Date | Country | |
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61649510 | May 2012 | US |