CA2401331A1 - Methods and devices for use in performing pulmonary procedures - Google Patents

Methods and devices for use in performing pulmonary procedures Download PDF

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Publication number
CA2401331A1
CA2401331A1 CA002401331A CA2401331A CA2401331A1 CA 2401331 A1 CA2401331 A1 CA 2401331A1 CA 002401331 A CA002401331 A CA 002401331A CA 2401331 A CA2401331 A CA 2401331A CA 2401331 A1 CA2401331 A1 CA 2401331A1
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Canada
Prior art keywords
valve
carried out
pulmonary
providing step
patient
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Granted
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CA002401331A
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French (fr)
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CA2401331C (en
Inventor
Mark Deem
Bernard H. Andreas
Sunmi Chew
Antony J. Fields
Ronald French
Hanson S. Gifford, Iii
Ronald R. Hundertmark
Alan R. Rapacki
Douglas S. Sutton
Peter M. Wilson
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Pulmonx Corp
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Individual
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Publication of CA2401331C publication Critical patent/CA2401331C/en
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Classifications

    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16K—VALVES; TAPS; COCKS; ACTUATING-FLOATS; DEVICES FOR VENTING OR AERATING
    • F16K15/00—Check valves
    • F16K15/14—Check valves with flexible valve members
    • F16K15/144—Check valves with flexible valve members the closure elements being fixed along all or a part of their periphery
    • F16K15/147—Check valves with flexible valve members the closure elements being fixed along all or a part of their periphery the closure elements having specially formed slits or being of an elongated easily collapsible form
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A—HUMAN NECESSITIES
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    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12099—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder
    • A61B17/12104—Occluding by internal devices, e.g. balloons or releasable wires characterised by the location of the occluder in an air passage
    • A—HUMAN NECESSITIES
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    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B17/12131—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device
    • A61B17/12168—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure
    • A61B17/12172—Occluding by internal devices, e.g. balloons or releasable wires characterised by the type of occluding device having a mesh structure having a pre-set deployed three-dimensional shape
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2476—Valves implantable in the body not otherwise provided for
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91—Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
    • A61P11/00—Drugs for disorders of the respiratory system
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
    • A61B17/12022—Occluding by internal devices, e.g. balloons or releasable wires
    • A61B2017/1205—Introduction devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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    • A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
    • A61B17/221—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions
    • A61B2017/2215—Gripping devices in the form of loops or baskets for gripping calculi or similar types of obstructions having an open distal end
    • A—HUMAN NECESSITIES
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    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
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    • A61B2090/061—Measuring instruments not otherwise provided for for measuring dimensions, e.g. length
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/24—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body
    • A61F2/2403—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with pivoting rigid closure members
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/2412—Heart valves ; Vascular valves, e.g. venous valves; Heart implants, e.g. passive devices for improving the function of the native valve or the heart muscle; Transmyocardial revascularisation [TMR] devices; Valves implantable in the body with soft flexible valve members, e.g. tissue valves shaped like natural valves
    • A61F2/2418—Scaffolds therefor, e.g. support stents
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A—HUMAN NECESSITIES
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    • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
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    • A—HUMAN NECESSITIES
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2220/005—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements using adhesives
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S128/00—Surgery
    • Y10S128/912—Connections and closures for tubes delivering fluids to or from the body

Abstract

An implantable flow control element is provided which prevents air from entering an isolated portion of a patient's lung. The element may permit air to escape from the isolated portion so that the element acts like a valve. Systems for implanting pulmonary devices are also provided.

Claims (99)

1. A method of controlling air flow in a pulmonary passageway, comprising the steps of:
providing a flow control element having a valve;
advancing the flow control element through a patient's pulmonary system;
releasing the flow control element at a pulmonary site to isolate a portion of the patient's lung, the valve permitting air flow in an expiratory direction and preventing air flow in an inspiratory direction.
2. The method of claim 1, wherein:
the providing step is carried out with the valve having first and second lips which engage one another when the valve is in a closed position.
3. The method of claim 2, wherein:
the providing step is carried out with the first lip being stiffer than the second lip, the first lip biasing the second lip toward the closed position.
4. The method of claim 2, wherein:
the providing step is carried out with the first and second lips being curved when viewed from an end of the lips
5. The method of claim 2, wherein:
the providing step is carried out with the first and second lips forming a duckbill valve.
6. The method of claim 2, wherein:
the providing step is carried out with the first and second lips forming a heimlich valve.
7. The method of claim 1, wherein:
the providing step is carried out with the flow control element having a valve body with a sealing portion which seals against the wall of the pulmonary passageway.
8. The method of claim 7, wherein:

the releasing step is carried out with the sealing portion sealing against the wall of the pulmonary passageway until an opening pressure differential is achieved wherein the sealing portion opens to permit air to pass in the same direction as the valve.
9. The method of claim 7, wherein:
the providing step is carried out with the sealing portion being made of a resilient material.
10. The method of claim 7, wherein:
the providing step is carried out with the sealing portion being a ring.
11. The method of claim 10, wherein:
the providing step is carried out with at least two rings.
12. The method of claim 1 l, wherein:
the rings have different sizes to seal different size locations.
13. The method of claim 7, wherein:
the providing step is carried out with the ring having a helical shape.
14. The method of claim 13, further comprising the step of:
rotating the valve so that the ring anchors the device.
15. The method of claim 1, wherein:
the providing step is carried out with flow control element having a body mounted to an expandable support structure.
16. The method of claim 15, wherein:

the providing step is carried out with the support structure having an exposed portion not covered by the body.
17. The method of claim 1, wherein:
the providing step is carried out with the flow control element having a plurality of flexible bristles extending from the outer surface;
the releasing step is carried out with the bristles engaging the wall of the pulmonary passageway.
18. The method of claim 17, wherein:

the releasing step is carried out with the bristles being angled to preferentially anchor the valve relative to forces exerted in an expiratory direction.
19. The method of claim 17, wherein:
the providing step is carried out with at least 10 bristles.
20. The method of claim 1, wherein:
the advancing step is carried out with the flow control element being in a collapsed condition; and the releasing step is carried out with the flow control element expanding toward an expanded condition.
21. The method of claim 1, wherein:
the providing step is carried out with the valve being a valve selected from the group consisting of poppet, ball, duckbill, heimlich, flap and leaflet.
22. The method of claim 1, wherein:
the providing step is carried out with the valve having a valve structure;
the releasing step being carried out so that the valve structure cooperates with a portion of the wall of the passageway, the valve structure being positioned against the portion of the wall in a closed position and being spaced apart from the wall when in an open position.
23. The method of claim 22, wherein:
the providing step is carried out with the valve structure being a resilient portion positioned against the wall.
24. The method of claim 22, wherein:
the providing step is carried out with the valve structure being a ring.
25. The method of claim 22, wherein:
the providing step is carried out with the valve structure being formed by a number of independent sections which each have an open position and a closed position.
26. The method of claim 1, wherein:
the providing step is carried out with the valve being generally conical.
27. The method of claim 1, wherein:
the providing step is carried out with the flow control element having a body, the body being integrally formed with the valve.
28. The method of claim 1, wherein:
the providing step is carried out with the body being made of a resilient material.
29. The method of claim 1, wherein:
the providing step is carried out with the valve having a support structure with the valve mounted to the support structure.
30. The method of claim 1, wherein:
the providing step is carried out with the flow control element having a large end and a small end.
31. The method of claim 1, wherein:
the providing step is carried out with the valve being a slit valve.
32 . The method of claim 31, wherein:
the providing step is carried out with the valve being generally conical.
33. The method of claim 1, wherein:
the providing step is carried out with a sealant on an exterior surface of the flow control element.
34. The method of claim 33, wherein:
the providing step is carried out with the sealant being an adhesive which seals a space between the flow control element and pulmonary wall.
35. The method of claim 33, wherein:
the providing step is carried out with the sealant being a flowable substance which conforms to the shape of the pulmonary site.
36. The method of claim 1, wherein:
the providing step is carried out with the valve having first and second lips and reinforcing elements extending along lateral edges of the lips.
37. The method of claim 1, wherein:
the providing step is carried out with the valve opening upon a pressure differential of no more than 10 inches water.
38. The method of claim 1, wherein:
the providing step is carried out with the valve opening upon a pressure differential of no more than 5 inches water.
39. The method of claim 1, wherein:
the providing step is carried out with the valve opening upon a pressure differential of no more than 1 inch water.
40. A device for controlling air flow in a pulmonary passageway, comprising:
a body;
a valve coupled to the body, the valve configured to prevent air from entering an isolated portion of the patient's lung but permitting expiratory air to pass through the valve.
41. The device of claim 40, wherein:
the body is expandable from a collapsed position to an expanded position
42. The device of claim 40, wherein:
the valve opens upon a pressure differential of no more than 10 inch water.
43. The device of claim 40, wherein:
the valve opens upon a pressure differential of no more than 5 inch water.
44. The device of claim 40, wherein:
the valve opens upon a pressure differential of no more than 1 inch water.
45. The device of claim 40, wherein:
the valve has a first lip and a second lip, the first and second lips engaging one another when the valve is in a closed position.
46 . The device of claim 45, wherein:

the first lip being stiffer than the second lip, the first lip biasing the second lip toward the closed position.
47 . The device of claim 45, wherein:
the first and second lips form a duckbill valve.
48. The device of claim 45, wherein:
the first and second lips form a heimlich valve.
49. The device of claim 40, wherein:
the body has a sealing portion which seals against the wall of the pulmonary passageway.
50. The device of claim 49, wherein:
the sealing portion seals against the wall of the pulmonary passageway until an opening pressure differential is achieved wherein the sealing portion becomes spaced apart from the wall to permit air to pass in the same direction as the valve.
51. The device of claim 49, wherein:
the sealing portion is made of a resilient material.
52. The device of claim 49, wherein:
the sealing portion is a ring.
53. The device of claim 52; wherein:
the sealing portion has a plurality of rings.
54. The device of claim 53, wherein:
the rings have different sizes so that they seal different size locations.
55. The device of claim 52, wherein:
the sealing portion has a helical ring.
56. The device of claim 52, wherein:
the sealing portion has a frustoconical surface.
57. The device of claim 40, wherein:
the body includes an expandable support structure.
58. The device of claim 40, wherein:
the body is made of an elastomeric material.
59. The device of claim 57, wherein:
the body covers only part of the expandable support structure.
60. The device of claim 40, wherein:
the valve is integrally formed with the body.
61. The device of claim 40, wherein the body has at least 10 bristles.
62. The device of claim 49, wherein;
the sealing portion is deflectable to permit the passage of air in an expiratory direction.
63. The device of claim 40, wherein:
the valve is selected from the group consisting of poppet, ball, duckbill, heimlich, flap and leaflet.
64. The device of claim 40, wherein:
the valve is formed by a number of independent sections which each have an open position and a closed position.
65. The device of claim 64, wherein:
the independent sections are configured to form a valve with a portion of the wall of the pulmonary passageway, the independent sections engaging the wall in a closed position and being spaced apart from the wall in an open position.
66. The device of claim 40, wherein:
the valve is generally conical.
67. The device of claim 40, wherein:
the valve has a slit.
68. The device of claim 40, wherein:
the body has a support structure with the valve mounted to the support structure.
69. The device of claim 68, wherein:
the body is coupled to the support structure with at least one connection, the connection being contained within an opening in the support structure so that the connection is free to move within the opening.
70. The device of claim 68, wherein:
the support structure is tapered to be larger at one end.
71. The device of claim 40, further comprising:
a sealant on an exterior surface of the device.
72. The device of claim 71, wherein:
the sealant is an adhesive.
73 . The device of claim 71, wherein:
the sealant is a flowable substance which conforms to the pulmonary site.
74. A method of delivering a blocking element into the pulmonary system, the method comprising the steps of:
providing a blocking element coupled to a delivery element;
advancing the blocking element through a patient's lungs to a location in a patient's pulmonary system;
expanding an expandable member to occlude a pulmonary passageway;
withdrawing air from the patient's lungs after the expanding step; and releasing the blocking element from the delivery element at a pulmonary site to isolate a portion of the patient's lungs, the blocking element preventing air from entering the isolated portion of the lung through the pulmonary site.
75. The method of claim 74, wherein:
the releasing step is carried out with the expandable member expanded.
76. The method of claim 74, wherein:
the providing step is carried out with the blocking element permitting air flow in the opposite direction so that the blocking element acts like a valve; and the releasing step is carried out with the blocking element preventing air flow in an inhalation direction but permitting air flow in an exhalation direction.
77. The method of claim 74, wherein:
the expanding step is carried out with the expandable member being part of the delivery element.
78. The method of claim 74, wherein:
the withdrawing step is carried out by withdrawing air through the delivery element to remove air from the isolated part of the patient's lung.
79. The method of claim 74, wherein:
the releasing step is carried out before the withdrawing step.
80. The method of claim 74, wherein;
the releasing step is carried out after the withdrawing step.
81. A system for delivering an element into the pulmonary system, comprising:
a delivery element having a first lumen; and a pulmonary element releasably coupled to the delivery element, the pulmonary element and delivery element being configured for intrapulmonary delivery, the pulmonary element at least blocking air flow into an isolated portion of a patient's lung.
82. The system of claim 81, further comprising:
a source of vacuum coupled to the first lumen.
83. The system of claim 81, wherein:
the delivery element has an expandable member mounted thereto for occluding a pulmonary passageway.
84. The system of claim 81, wherein:
the delivery element has a second lumen, the expandable member being a balloon which is coupled to the second lumen for inflating the balloon.
85. The system of claim 81, wherein:
the pulmonary element is a valve which permits air flow in one direction and blocks air flow in the other direction.
86. The system of claim 81, wherein:

the pulmonary element is mounted within the first lumen.
87 . The system of claim 86, wherein:
the first lumen has an enlarged distal end, the pulmonary element being positioned in the enlarged portion of the first lumen.
88 . The system of claim 81, further comprising:
a source of fluid coupled to the first lumen.
89. The system of claim 88, wherein:
the source of fluid contains a fluid selected from the group consisting of therapeutic agent, antibiotic, saline, sealant and adhesive.
90. A method of treating the lung, comprising the steps of:
advancing a device through an intrapulmonary path to a blocking element, the blocking element being previously implanted in a patient's lung for isolating a portion of a patient's lung;
performing a procedure with the device on the isolated portion of the patient's lung, the device extending through the previously implanted blocking element;
and removing the device after the performing step, wherein the blocking element prevents air flow in the inhalation direction after the device has been removed.
91. The method of claim 90, wherein:
the advancing, performing and removing steps are carried out with the blocking element preventing air flow in an inspiratory direction but permitting air flow in an expiratory direction.
92. The method of claim 90, wherein:
the performing step is carried out by applying suction through a lumen in the device.
93. The method of claim 92, wherein:
the performing step is carried out to remove air from the isolated portion of the lung.
94. The method of claim 90, wherein:

the performing step is carried out by delivering a therapeutic substance to the isolated portion of the lung through a lumen in the device.
95. The method of claim 94, further comprising the step of:
removing material from the isolated portion of the lung after the performing step.
96. The method of claim 90, further comprising the step of:
expanding an expandable member to occlude a pulmonary location.
97. The method of claim 90, wherein:
the advancing step is carried out with the blocking element sealing around the device when the device is positioned therein.
98. A device for blocking flow in one direction through a pulmonary passageway, comprising:
a valve body having an expandable metal structure, the expandable metal structure having a covered portion and an exposed portion, the exposed portion forming anchoring elements which anchor the valve body to a location in a patient's pulmonary passageway; and at least one valve coupled to the valve body for permitting air flow in one direction and at least substantially preventing air flow in the other direction.
99. The valve structure of claim 98, wherein:
the exposed portion of the metal structure forms v-shaped anchoring elements.
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US20060174870A1 (en) 2006-08-10
US7165548B2 (en) 2007-01-23
US20040016435A1 (en) 2004-01-29
WO2001066190A3 (en) 2003-08-21
AU2001243416B2 (en) 2006-05-11
AU4341601A (en) 2001-09-17
JP2006314816A (en) 2006-11-24
EP1359978A2 (en) 2003-11-12
CA2401331C (en) 2010-07-27
US6840243B2 (en) 2005-01-11
WO2001066190A2 (en) 2001-09-13
US6679264B1 (en) 2004-01-20
US20030192551A1 (en) 2003-10-16
DE60144491D1 (en) 2011-06-01
JP3881242B2 (en) 2007-02-14
US8357139B2 (en) 2013-01-22
US7662181B2 (en) 2010-02-16
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US20010037808A1 (en) 2001-11-08
ATE506103T1 (en) 2011-05-15

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