The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to medical devices for delivering a fluid to a target location, such as a diseased tissue, e.g., a tumor or the like.
Delivering fluids to treatment sites may include targeting delivery to particular tissues or a portion of a tissue, e.g., a tumor. It may be desirable for the fluid to only be delivered to the target site with minimal fluid engagement with ancillary tissue(s). For example, in oncology, the fluid may have destructive effects on tissue that would be undesirable among healthy tissue. Therefore, targeted percutaneous cannula delivery may be a desirable method of fluid delivery to the site to ensure substantially localized fluid deliver. However, such fluid delivery techniques may have complications. Although the fluid may be delivered to the site, it may be such a low viscosity that it flows and/or leeches outside of the target site upon delivery or over time after delivery. The fluid may have such a high viscosity that the dimensional parameters of the delivery cannula may not effectively deliver, deploy, disperse, or maintain flow of the fluid to the target site. The cannula and/or the target site may also be difficult for a medical professional to visualize and/or navigate for desirable fluid delivery.
Accordingly, a variety of advantageous medical outcomes addressing the above deficiencies may be realized by the devices, systems, and methods of the disclosure.
Medical devices, systems, and methods are described herein, e.g., for facilitating fluid delivery to a treatment site, such as a tumor. In one aspect, a cannula may comprise a shaft comprising a proximal end, a distal end, and a lumen. A plurality of apertures may be disposed along a delivery portion of the shaft. Each aperture may be in fluid communication with the lumen. Each aperture may extend radially from a central axis of the shaft. At least one echogenic marker may be disposed along the shaft within or adjacent to the delivery portion. A body may be disposed within the distal end of the shaft. The lumen may extend along an axial length of the shaft, and a body may be disposed within a distal end of the lumen, blocking the distal end of the lumen.
In the described and other aspects of the present disclosure, the body may comprises a pointed distal tip, a midportion having a diameter larger than the distal tip, and a proximal insertion portion having a diameter smaller than the midportion and dimensioned to fit within the distal end of the shaft. The diameter of the midportion may be greater than or equal to a diameter of the shaft. The cannula may comprise 1 to 100 apertures or more. The plurality of apertures may comprise at least one ringed pattern of apertures at a flexible portion along the shaft. The plurality of apertures may comprise at least one helical pattern of apertures along the shaft. The plurality of apertures may be circular in shape, oblong in shape, ellipsoidal in shape, rectangular in shape, or a combination thereof. The plurality of apertures may comprise at least one proximal aperture having a smaller width than a width of at least one distal aperture of the plurality of apertures. The plurality of apertures may comprise a gradual increase in width along a length of the shaft between a proximal end of the delivery portion and a distal end of the delivery portion. A width of at least one of the plurality of apertures may be about 0.254 mm±0.100 mm to about 0.381 mm±0.100 mm. An axial length of the delivery portion may range from about 1.5 cm to about 2.5 cm. The cannula may comprise one or more echogenic markers disposed adjacent a proximal end of the delivery portion and/or one or more echogenic markers disposed adjacent a distal end of the delivery portion. The cannula may comprise a plurality of echogenic markers in the form of rings disposed adjacent a proximal end of the delivery portion and/or a plurality of echogenic markers in the form of rings disposed adjacent a distal end of the delivery portion. An axial length of the at least one echogenic marker may range from about 2 mm to about 10 mm.
In one aspect, a cannula may comprise a shaft comprising a proximal end, a distal end, and a lumen therethrough. A plurality of apertures may be disposed along a delivery portion of the shaft. Each aperture may be in fluid communication with the lumen. Each aperture may extend radially from a central axis of the shaft. The plurality of apertures may be circular in shape, oblong in shape, ellipsoidal in shape, rectangular in shape, or a combination thereof. A distal marker portion may be longitudinally along the shaft distal to the delivery portion. A proximal marker portion may be along the shaft proximal to the delivery portion. A body may be disposed within the distal end of the shaft. The lumen may extend along an axial length of the shaft, and a body may be disposed within a distal end of the lumen, blocking the distal end of the lumen. The distal body may extend distally from the shaft to a gradually pointed tip.
In the described and other aspects of the present disclosure, each of the distal marker portion and the proximal marker portion may comprise a plurality of echogenic ringed grooves. The body may comprise a pointed distal tip, a midportion having a diameter larger than the distal tip, and a proximal insertion portion having a diameter smaller than the midportion and dimensioned to fit within the distal end of the shaft. A width of at least one of the plurality of apertures may be about 0.254 mm to about 0.381 mm.
In one aspect, a method of delivering a fluid disclosed herein may include inserting a cannula comprising a shaft, a lumen, and a plurality of apertures disposed along a delivery portion of the shaft into a patient. Each aperture may extend radially from a central axis of the shaft. The plurality of apertures may be circular in shape, oblong in shape, ellipsoidal in shape, rectangular in shape, or a combination thereof. Each aperture may be in fluid communication with the lumen. At least one echogenic marker may be disposed along the shaft within or adjacent to the delivery portion. At least one echogenic marker may be detected with ultrasound. The delivery portion may be positioned within a target tissue with the assistance of the at least one echogenic marker. The fluid may be delivered through the lumen and out of the plurality of apertures such that the fluid is delivered to the target tissue.
In the described and other aspects of the present disclosure, the fluid may comprise a viscosity of fluids such as solutions including water, saline and hydrogels that may vary based on composition, temperature, and concentration. The fluid may comprise a viscosity that increases as the fluid approaches a body temperature of a patient. The at least one echogenic marker may be positioned at a border of the target tissue. The fluid may be a gellable fluid. The fluid may be maintained at a temperature below about 37° C. at least until delivery. The delivery portion may be oriented along the target tissue by flexing the delivery portion. The fluid may be maintained within the target tissue for a treatment period of at least 24 hours or more.
Non-limiting examples of the present disclosure are described with reference to the accompanying figures, which are schematic and not intended to be drawn to scale. In the figures, each identical or nearly identical component illustrated is typically represented by a single numeral. For purposes of clarity, not every component is labeled in every figure, nor is every component in each embodiment of the disclosure shown where illustration is not necessary to allow those of skill in the art to understand the disclosure. In the figures:
The present disclosure is not limited to the particular embodiments described. The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting beyond the scope of the appended claims. Unless otherwise defined, all technical terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the disclosure belongs. The detailed description should be read with reference to the drawings, which are not necessarily to scale, depict illustrative embodiments, and are not intended to limit the scope of the invention.
As used herein, “proximal end” refers to the end of a device that lies closest to the medical professional along the device when introducing, removing, or exchanging the device within a patient, and “distal end” refers to the end of a device or object that lies furthest from the medical professional along the device during implantation, positioning, or delivery.
As used in this disclosure and the appended claims, the singular forms “a”, “an”, and “the” include plural referents unless the content clearly dictates otherwise. As used in this specification and the appended claims, the term “or” is generally employed in its sense including “and/or” unless the content clearly dictates otherwise.
It is noted that references in the specification to “an embodiment”, “some embodiments”, “other embodiments”, etc., indicate that the embodiment described may include one or more particular features, structures, and/or characteristics. However, such recitations do not necessarily mean that all embodiments include the particular features, structures, and/or characteristics. Additionally, when particular features, structures, and/or characteristics are described in connection with one embodiment, it should be understood that such features, structures, and/or characteristics may also be used in connection with other embodiments whether or not explicitly described unless clearly stated to the contrary.
All numeric values are herein assumed to be modified by the term “about,” whether or not explicitly indicated. The term “about”, in the context of numeric values, generally refers to a range of numbers that one of skill in the art would consider equivalent to the recited value (i.e., having the same function or result). In many instances, the term “about” may include numbers that are rounded to the nearest significant figure. Other uses of the term “about” (i.e., in a context other than numeric values) may be assumed to have their ordinary and customary definition(s), as understood from and consistent with the context of the specification, unless otherwise specified. The recitation of numerical ranges by endpoints includes all numbers within that range, including the endpoints (e.g., 1 to 5 includes 1, 1.5, 2, 2.75, 3, 3.80, 4, and 5).
Although embodiments of the present disclosure are described with specific reference to cannulas, it should be appreciated that other medical devices may be used in a variety of medical procedures. For example, a cannula described herein may instead be a catheter, or the like, and may be percutaneous or non-percutaneous.
As used herein, “fluid” may comprise one or more of a liquid, semi-liquid, super critical fluid, gas, solution, particles, drug carriers, spheres, a combination thereof, or the like. A fluid herein may comprise a viscosity that increases as its temperature increases. For example, a fluid may have a lower viscosity at a first temperature and a higher viscosity at a second temperature. For an even more specific example, a fluid may be delivered at a lower temperature within a cannula and may be deployed at a higher temperature (e.g., at least 37° C.) with a higher viscosity. Once deployed, a lower viscosity fluid may undesirably flow through and among a target site and adjacent tissue compared to a higher viscosity fluid that may desirably not flow substantially away from the target site during and/or after deployment. In some embodiments, a fluid is delivered which is a reverse thermosensitive fluid. These fluids are liquids below body temperature and viscous gels at body temperature. In various embodiments, the fluid is provided external of the body at a temperature below body temperature. The fluid may be further chilled to prolong the time the gel stays in the liquid form upon introduction into the body, in some embodiments. For example, the introduction temperature may be is about 10° C. or more below the gelation temperature of the fluid.
Although embodiments of the present disclosure are described with specific reference to oncologic fluid delivery into a tumor, it should be appreciated that embodiments herein may deliver fluid in a variety of medical treatment sites such as tissues, organs, body lumens, ducts, vessels, fistulas, cysts, and spaces (e.g., the dermis, stomach, duodenum, jejunum, small intestine, gallbladder, kidneys, pancreas, biliary trees, pancreatic trees, bladder, ureter, abscesses, walled-off pancreatic necrosis, bile ducts, etc.). Devices herein may be inserted via different access points and approaches, e.g., percutaneously, endoscopically, laparoscopically or some combination thereof.
Referring to
Referring to
A body 210 (as best illustrated in
As best illustrated in
In various embodiments, one or more dimensions of features or axial lengths along a longitudinal axis l of the cannula may be variable depending on anatomy, size of target tissue, location of target tissue, target tissue border arrangements, deliverable fluid, type or procedure, etc. The shaft 202 has a length s, e.g., about 18 in. (about 457.2 mm) for accessing a liver, but may be shorter, e.g., for accessing skin or breast tissue. For further examples, a length of a shaft may be less than about 500 mm such as about 5 mm, 10 mm 20 mm, 50 mm, 100 mm, 200 mm, 250 mm, 400 mm, etc. The shaft 202 has a gauge, e.g., about 21.5 gauge (about 0.7 mm). The distal echogenic marker 216d has an axial length d and the proximal echogenic marker 216p has an axial length p, which may be substantially similar to or different from each other, and may be, e.g., about 5 mm. A length m of the delivery portion 206 may be, e.g., about 20 mm, or about 10 mm for a 20 mm target tissue dimension. A diameter of one or more of the apertures 208 may be about 0.010 inches (about 0.254 mm) to about 0.015 inches (about 0.381 mm).
In various embodiments, a shaft may be a laser cut or otherwise machined tube. One or more features of the shaft may also be laser cut or otherwise machined, e.g., apertures, echogenic markers, lumens, pointed tips, etc. A shaft may comprise variable materials depending on parameters of a procedure such as, e.g., an epoxy such as an epoxy such as EPX 82, a polymer, carbon steel, stainless steel, nickel, gold, platinum, an alloy, a metal, a combination thereof, or the like.
In various embodiments, an echogenic marker may include one or more features that assist with visual and/or ultrasonic locating of at least a portion of a device. An echogenic marker may comprise a groove, deformation, etching, carving, or removal of material at a location of a device of interest for tracking during a procedure. An echogenic marker may include a single marker (e.g., a continuous circumferential band) or multiple markers (e.g., multiple continuous bands axially aligned with respect to each other and discontinuous with each other). One or more echogenic markers may be tracked during a procedure such as for delivery, navigating, positioning, locating anatomy, etc.
In various embodiments, radial apertures of a shaft disclosed herein may be disposed along the shaft in various patterns, e.g., arranged as helices, circumferential bands, axial lines, a combination thereof, or the like. Radial apertures of a shaft may be substantially similar to each other or vary. Radial apertures herein may comprise one or more shapes, e.g. circular, oblong, ellipsoidal, rectangular, slotted, a combination thereof, or the like. Some apertures of a shaft may have a smaller dimension and be configured to deploy a fluid while other apertures may have a larger dimension configured to deploy a fluid as well as to elastically and/or plastically deform to assist with navigation and positioning on the shaft during a procedure. In various embodiments, any number of apertures may be used, e.g., 1, 2, 4, 6, 10, 15, 20, 25, 50, 100, etc., or about 20 to about 100 or the like.
Referring to
Referring to
Embodiments of methods of delivering a fluid disclosed herein may include inserting a cannula comprising a shaft, a lumen, and a plurality of radial apertures disposed along a delivery portion of the shaft. Each radial aperture may be in fluid communication with the lumen. At least one echogenic marker may be disposed along the shaft within or adjacent to the delivery portion into a patient. At least one echogenic marker may be detected with ultrasound. The delivery portion may be positioned within a target tissue with the assistance of the at least one echogenic marker. The fluid may be delivered through the lumen and out of the plurality of apertures such that the fluid is delivered to the target tissue. The fluid may comprise a viscosity that varies with temperature, for example the fluid may increase in viscosity as temperature rises and approaches a patient body temperature. The at least one echogenic marker may be positioned at a border of the target tissue. The fluid may be a gellable fluid. The fluid may be maintained at a temperature below about 37° C. at least until delivery. The delivery portion may be oriented along the target tissue by flexing the delivery portion. The fluid may be maintained within the target tissue for a treatment period of at least 24 hours.
All of the devices and/or methods disclosed and claimed herein can be made and executed without undue experimentation in light of the present disclosure. While the devices and methods of this disclosure have been described in terms of preferred embodiments, it may be apparent to those of skill in the art that variations can be applied to the devices and/or methods and in the steps or in the sequence of steps of the method described herein without departing from the concept, spirit and scope of the disclosure. All such similar substitutes and modifications apparent to those skilled in the art are deemed to be within the spirit, scope and concept of the disclosure as defined by the appended claims.
This application claims the benefit of and priority to U.S. Provisional Patent Application Ser. No. 63/279,727, filed on Nov. 16, 2021, the disclosure of which is incorporated herein by reference.
Number | Date | Country | |
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63279727 | Nov 2021 | US |