Various systems and methods are provided for treating pulmonary edema. In general, a pump can be configured to be implanted within a patient at risk of developing edema. The pump can be configured to pump fluid out of the patient’s lungs, e.g., out of the patient’s interstitial and alveolar spaces. The pump can be configured to be fully implanted within the patient’s body. The pump can be configured to continuously pump fluid, or the pump can be configured to be selectively actuatable in response to a trigger event. In an exemplary embodiment, the pump can include an inflow port coupled to an inflow tube in fluid communication with a lymphatic vessel of the patient, and can include an outflow port coupled to an outflow tube in fluid communication with a vein of the patient.

The disclosure relates to devices and methods for the treatment of edema using a purge-free system. The invention provides devices and methods useful for treating edema by means of an indwelling catheter that is placed in a blood vessel of a patient and used to pump blood to cause a decrease in pressure at an outlet of a lymphatic duct. The catheter pumps blood by means of an impeller but is purge-free in that the catheter does not include a system for purging or flushing catheter components with a purge fluid. The purge-free catheter avoids blood-related mechanical complications such as clotting or thrombosis by means of an impermeable sleeve or shroud that protects moving parts of the impeller drive system.

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.

Various systems and methods are provided for reducing pressure at an outflow of a duct, such as the thoracic duct or the lymphatic duct, for example, the right lymphatic duct. A catheter system can be configured to be at least partially implanted within a vein of a patient in the vicinity of an outflow port of a duct of the lymphatic system. The catheter system includes first and second selectively deployable restriction members each configured to be activated to at least partially occlude the vein within which the catheter is implanted and to thus restrict fluid within a portion of the vein. The catheter system includes an impeller configured to be driven by a motor to induce a low pressure zone between the restriction members by causing blood to be pumped through the catheter when the restriction members occlude the vein.

Various systems and methods are provided for reducing pressure at an outflow of a duct, such as the thoracic duct or the lymphatic duct, for example, the right lymphatic duct. A catheter system can be configured to be at least partially implanted within a vein of a patient in the vicinity of an outflow port of a duct of the lymphatic system. The catheter system includes first and second selectively deployable restriction members each configured to be activated to at least partially occlude the vein within which the catheter is implanted and to thus restrict fluid within a portion of the vein. The catheter system includes an impeller configured to be driven by a motor to induce a low pressure zone between the restriction members by causing blood to be pumped through the catheter when the restriction members occlude the vein.

The invention provides methods and devices that improve the flow of lymph without the use of a rotating mechanical pump. Systems and methods of the disclosure use inflatable balloons or similar restriction devices to transiently create impediments to flow in the vena cava. When those transient impediments are removed, the rush of blood to restore flow creates a localized zone of low pressure at an outlet of a lymph duct and lymph out of the lymph duct. Another episode of transient impediment is created and relieved, which encourages additional lymph flow. Using a device such as an inflatable balloon, a series of such episodes may be provided. For example, by causing about ten to twenty episodes of transient impediment and relief, lymph flow may be restored to normal rates and volumes.

An automated system and method, wherein a movement device aids in lymphatic drainage and activation of the lymphatic system by applying a skin safe medium on the skin or on or near the lymph gland(s) creating an automated repetitive drainage effect that may allow patients to be more successful at reducing and managing their swelling.

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.

Increasing the immune response to a given cancer in a patient through increasing lymphatic flow out of the cancer region, following a primary action of the cancer that loads professional antigen-presenting cells/dendritic cells (APCs/DCs) with tumor-associated antigen (TAA) from the tumor into the interstitial fluid of the cancer region. Example primary actions are radio-therapy, both stereotactic and brachytherapy using implanted seeds, proton-therapy, and chemical- or radio-pharmaceutical therapy. Intra-capillary micro-bubbles in the tumor are brought to vibrate with incident ultrasound of appropriate frequency and amplitude, producing vibrations in the extra capillary tissue that produces an outward acoustic radiation force and micro shear waves in the tissue that increases transport of the interstitial fluid. This increases an outward flow from the proximal capillaries, increasing the interstitial fluid pressure that increases lymphatic outflow including APCs/DCs with TAA to primary draining lymph nodes (DLNs).

This disclosure relates to a catheter system that for precisely positioning fluid flow restrictors within a blood vessel. In particular, this disclosure provides a catheter system that includes a sheath with a first fluid flow restrictor mounted thereto, and a catheter that is slidably disposed within the sheath and has a second fluid flow restrictor mounted thereto. Inside a blood vessel, the sheath and the catheter are separately slidable, thereby allowing the first and second fluid flow restrictors to be positioned at precise locations within the blood vessel.