INFLATABLE SOFT PALATE SCAFFOLDING DEVICE
20200306474 ยท 2020-10-01
Inventors
- J. Christopher Flaherty (Auburndale, FL, US)
- Tai Kien (Groton, MA, US)
- John N. Irwin, III (Stamford, CT, US)
- R. Maxwell Flaherty (Auburndale, FL, US)
Cpc classification
A61M16/045
HUMAN NECESSITIES
A61M2205/0238
HUMAN NECESSITIES
International classification
Abstract
A medical device for the treatment of one or more sleep apnea disorders such as obstructive sleep apnea in a patient is provided. The device includes a scaffolding element positioned about a distal portion of an elongate shaft. The scaffolding element receives a volume of fluid to expand the scaffolding element to exert a force upon a soft palate and/or base of a tongue of a patient. The scaffolding element provides a helical breathing pathway when inserted into an airway of the patient and transitioned to an expanded state.
Claims
1. An airway scaffolding device for a patient comprising: an elongate shaft with a distal portion; a scaffolding element positioned about the distal portion of the elongate shaft, the scaffolding element configured to receive a volume of fluid to expand the scaffolding element to exert a force upon a soft palate and/or base of a tongue of the patient; a valve assembly positioned proximal to the scaffolding element; and a lumen disposed between the valve assembly and the scaffolding element, wherein the fluid is introduced through the valve assembly and travels through the lumen into the scaffolding element; wherein the scaffolding element provides a helical breathing pathway when inserted into an airway of the patient and transitioned to an expanded state via the fluid introduced through the valve assembly; and wherein the valve assembly is configured to reduce egress of fluid from the scaffolding element to maintain the scaffolding element in the expanded state.
2. The scaffolding device as claimed in at least one of the preceding claims, wherein the device comprises a single-use device.
3. The scaffolding device as claimed in at least one of the preceding claims, wherein the device comprises a multiple-use device.
4. The scaffolding device according to claim 3, wherein the device is configured to be cleaned between uses.
5. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element is configured to be expanded after insertion into the patient's airway.
6. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element comprises a balloon.
7. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element is configured to expand into a helical geometry.
8. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element is configured to be deflated prior to removal from the patient.
9. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element is configured to be removed from the patient without deflation.
10. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element is configured to be filled with a liquid.
11. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element is configured to be filled with a gas.
12. The scaffolding device according to claim 11, wherein the gas comprises air.
13. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element comprises a compliant material.
14. The scaffolding device according to claim 13, wherein the scaffolding element further comprises a non-compliant material.
15. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element comprises a non-compliant material.
16. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element comprises a material selected from the group consisting of: silicon; nylon; polyethylene; polyurethane; low-durometer polyurethane; high-durometer polyurethane; polytetrafluoroethylene (PTFE); expandable polytetrafluoroethylene (ePTFE); polyethylene terephthalate (PET); polyimide; polyether block amide; latex; and combinations thereof.
17. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element comprises a length less than or equal to 4 cm.
18. The scaffolding device according to claim 17, wherein the scaffolding element comprises a length less than or equal to 7 cm, and/or less than or equal to 10 cm.
19. The scaffolding device as claimed in at least one of the preceding claims, wherein the scaffolding element comprises a length between 1 cm and 4 cm.
20. The scaffolding device according to claim 19, wherein the scaffolding element comprises a length between 1.5 cm and 2.8 cm.
21.-107. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION OF THE DRAWINGS
[0091] Reference will now be made in detail to the present embodiments of the technology, examples of which are illustrated in the accompanying drawings. Similar reference numbers may be used to refer to similar components. However, the description is not intended to limit the present disclosure to particular embodiments, and it should be construed as including various modifications, equivalents, and/or alternatives of the embodiments described herein.
[0092] It will be understood that the words comprising (and any form of comprising, such as comprise and comprises), having (and any form of having, such as have and has), including (and any form of including, such as includes and include) or containing (and any form of containing, such as contains and contain) when used herein, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof.
[0093] It will be further understood that, although the terms first, second, third etc. may be used herein to describe various limitations, elements, components, regions, layers and/or sections, these limitations, elements, components, regions, layers and/or sections should not be limited by these terms. These terms are only used to distinguish one limitation, element, component, region, layer or section from another limitation, element, component, region, layer or section. Thus, a first limitation, element, component, region, layer or section discussed below could be termed a second limitation, element, component, region, layer or section without departing from the teachings of the present application.
[0094] It will be further understood that when an element is referred to as being on, attached, connected or coupled to another element, it can be directly on or above, or connected or coupled to, the other element, or one or more intervening elements can be present. In contrast, when an element is referred to as being directly on, directly attached, directly connected or directly coupled to another element, there are no intervening elements present. Other words used to describe the relationship between elements should be interpreted in a like fashion (e.g. between versus directly between, adjacent versus directly adjacent, etc.).
[0095] It will be further understood that when a first element is referred to as being in, on and/or within a second element, the first element can be positioned: within an internal space of the second element, within a portion of the second element (e.g. within a wall of the second element); positioned on an external and/or internal surface of the second element; and combinations of one or more of these.
[0096] As used herein, the term proximate shall include locations relatively close to, on, in and/or within a referenced component or other location.
[0097] Spatially relative terms, such as beneath, below, lower, above, upper and the like may be used to describe an element and/or feature's relationship to another element(s) and/or feature(s) as, for example, illustrated in the figures. It will be further understood that the spatially relative terms are intended to encompass different orientations of the device in use and/or operation in addition to the orientation depicted in the figures. For example, if the device in a figure is turned over, elements described as below and/or beneath other elements or features would then be oriented above the other elements or features. The device can be otherwise oriented (e.g. rotated 90 degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly.
[0098] The terms reduce, reducing, reduction and the like, where used herein, are to include a reduction in a quantity, including a reduction to zero. Reducing the likelihood of an occurrence shall include prevention of the occurrence.
[0099] The term and/or where used herein is to be taken as specific disclosure of each of the two specified features or components with or without the other. For example A and/or B is to be taken as specific disclosure of each of (i) A, (ii) B and (iii) A and B, just as if each is set out individually herein.
[0100] In this specification, unless explicitly stated otherwise, and can mean or, and or can mean and. For example, if a feature is described as having A, B, or C, the feature can have A, B, and C, or any combination of A, B, and C. Similarly, if a feature is described as having A, B, and C, the feature can have only one or two of A, B, or C.
[0101] As described herein, room pressure shall mean pressure of the environment surrounding the systems and devices of the present inventive concepts. Positive pressure includes pressure above room pressure or simply a pressure that is greater than another pressure, such as a positive differential pressure across a fluid pathway component such as a valve. Negative pressure includes pressure below room pressure or a pressure that is less than another pressure, such as a negative differential pressure across a fluid component pathway such as a valve. Negative pressure can include a vacuum but does not imply a pressure below a vacuum. As used herein, the term vacuum can be used to refer to a full or partial vacuum, or any negative pressure as described hereabove.
[0102] The term diameter where used herein to describe a non-circular geometry is to be taken as the diameter of a hypothetical circle approximating the geometry being described. For example, when describing a cross section, such as the cross section of a component, the term diameter shall be taken to represent the diameter of a hypothetical circle with the same cross sectional area as the cross section of the component being described.
[0103] The terms major axis and minor axis of a component where used herein are the length and diameter, respectively, of the smallest volume hypothetical cylinder which can completely surround the component.
[0104] It is appreciated that certain features of the inventive concepts, which are, for clarity, described in the context of separate embodiments, may also be provided in combination in a single embodiment. Conversely, various features which are, for brevity, described in the context of a single embodiment, may also be provided separately or in any suitable sub-combination. For example, it will be appreciated that all features set out in any of the claims (whether independent or dependent) can be combined in any given way.
[0105] It is to be understood that at least some of the figures and descriptions of the disclosure have been simplified to focus on elements that are relevant for a clear understanding of the inventive concepts, while eliminating, for purposes of clarity, other elements that those of ordinary skill in the art will appreciate may also comprise a portion of the inventive concepts. However, because such elements are well known in the art, and because they do not necessarily facilitate a better understanding of the inventive concepts, a description of such elements is not provided herein.
[0106] Provided herein are airway scaffolding devices for a patient, such as a patient that has issues or potential issues with sleep apnea and/or snoring. The scaffolding devices of the present inventive concepts include a balloon or other scaffolding element that can be inflated or otherwise expanded with a fluid or other flowable material (fluid herein) to assume a spiral or otherwise helical geometry (helical or spiral herein). This helical geometry includes peaks and valleys. The peaks of the helical geometry can be used to apply a force to tissue of the patient's airway, such as soft palate tissue or tissue of the tongue that otherwise would restrict the breathing of the patient (e.g. tissue that collapses into the airway during sleep). When inserted into an airway of the patient, the valleys of the helical geometry provide a helical shaped lumen, a helical breathing pathway, that supports normal, unobstructed breathing (e.g. maintains an open lumen through the airway proximate the patient's soft palate and/or base of tongue during sleep). The scaffolding devices of the present inventive concepts can be single use (e.g. disposed of after a single night's sleep), or multiple use (e.g. used for a first night's sleep, and then again one or more additional night's sleep, such as when a cleaning procedure is performed prior to repeated use).
[0107] Referring to
[0108] Referring to
[0109] Shaft 110 comprises an inflation lumen, lumen 115, which fluidly connects to balloon 150 via opening 116. Lumen 115 extends proximally within shaft 110 as shown. The length of shaft 110 and the positioning of balloon 150 on shaft 110 relative to nosepiece 120 determines the position of balloon 150 relative to the patient's airway tissue.
[0110] Shaft 110 and balloon 150 are configured to be inserted into and through a nostril of the patient (e.g. either nostril of the patient), such that balloon 150 can be positioned along all or a portion of soft palate 4. Alternatively or additionally, balloon 150 can be positioned at the base of the patient's tongue 1. Insertion and inflation of balloon 150 can open or maintain the opening of the air passageway disposed behind soft palate 4 and/or tongue 1, such as described herebelow in reference to
[0111] Shaft 110, balloon 150 and/or at least the distal portion of scaffolding device 100 form a relatively smooth surface (when balloon 150 is in a deflated state), and can include a lubricious coating and/or a friction-reduced surface to improve the comfort to the patient during insertion and/or removal of scaffolding device 100 into and/or from the patient's airway. In some embodiments, shaft 110 and/or balloon 150 comprise a material and/or coating selected from the group consisting of: a hydrophilic coating and/or material; a hydrophobic coating and/or material; a lubricant coating such as a silicone lubricant; polytetrafluoroethylene (PTFE) coating and/or material (e.g. an outer liner); and combinations of one or more of these. Distal end 119 of shaft 110 can comprise a rounded, sealed end, also configured to aid in comfort during insertion.
[0112] Scaffolding device 100 further includes a valve assembly, valve 130, which is fluidly attached to lumen 115, such that fluids can be introduced through valve 130 and into balloon 150. Valve 130 can be positioned on the proximal end of shaft 110 as shown in
[0113] Valve 130 can be further configured to be opened, such as to allow deflation of balloon 150 (e.g. to allow fluid to evacuate balloon 150) after a night's sleep and prior to removal of scaffolding device 100 from the patient. Alternatively, scaffolding device 100 can be removed from the patient with balloon 150 inflated, or at least partially inflated. In some embodiments, valve 130 is configured to be opened via compression of valve 130 (e.g. compression applied by squeezing the patient's nose which results in a compressive force applied to valve 130), to allow balloon 150 to deflate and/or fluid to be introduced through valve 130. Alternatively or additionally, valve 130 can be configured to be removed (e.g. detached from shaft 110 and/or lumen 115), such that balloon 150 can deflate.
[0114] Valve 130 can comprise a valve selected from the group consisting of: duck-bill valve; slit valve; spring-activated valve; electronically actuatable valve; one-way valve; and combinations of one or more of these. In some embodiments, valve 130 comprises a one-way valve or other valve configured to allow fluid to pass into scaffolding device 100 when a provided fluid exceeds a particular delivery pressure (e.g. exceeds a cracking pressure).
[0115] One or more components of scaffolding device 100 can be attached to one or more other components of scaffolding device 100 via one or more adhesives, such as cyanoacrylate, an ultraviolet (UV) light curable adhesive, and/or other adhesive (e.g. adhesive 35 described herebelow). For example, nosepiece 120 can be attached to shaft 110 and/or valve 130 with an adhesive; valve 130 can be attached to shaft 110 with an adhesive; and/or balloon 150 or other scaffolding element of the present inventive concepts can be attached to shaft 110 with an adhesive.
[0116] In some embodiments, scaffolding device 100 further includes a fluid delivery assembly, fill assembly 40, which can be fluidly attached (e.g. pre-attached and/or attachable) to valve 130 (e.g. via threads 131 of valve 130) and/or otherwise fluidly attached to lumen 115 (e.g. via threads on the end of shaft 110). In some embodiments, fill assembly 40 comprises a simple syringe, such as a syringe comprising a luer configured to attach to a mating luer of scaffolding device 100 (e.g. threads 131 comprising male or female mating luer threads for attachment to the syringe luer connector). Alternatively, fill assembly 40 can comprise a flexible pouch, such as fill chamber 41 shown, with a connector, connector 42, that fluidly attaches to threads 131 of valve 130 and/or a mating connector attached to lumen 115. Fill chamber 41 is filled (pre-filled or Tillable by the patient) with one or more liquids or gases, such as room air. Fill chamber 41 can include one or more resilient ribs, ribs 43 shown, which can be resiliently biased to maintain fill chamber 41 in an expanded state, such as to cause fill chamber 41 to automatically fill with room air when fill chamber 41 is unattached.
[0117] When a compressing force is applied to fill chamber 41, such as by the patient squeezing fill chamber 41, the liquids and/or gases pass through valve 130 and lumen 115 into balloon 150, such that balloon 150 expands, such as to the expanded state shown in
[0118] In some embodiments, lumen 115 is configured to slidingly receive a filament, filament 191 shown, such as a filament configured to be temporarily inserted within scaffolding device 100 (e.g. inserted within lumen 115) to temporarily increase the stiffness of scaffolding device 100 to assist in insertion of balloon 150 into the patient's airway to a location proximate soft palate 4. In some embodiments, scaffolding device 100 includes a second nosepiece 120, not shown but such as a second component for placement into the patient's other nasal valve 8 (e.g. to reduce collapse of that nasal valve).
[0119] Referring additionally to
[0120] Shaft 110 can comprise a material selected from the group consisting of: silicon; nylon; polyethylene; polyurethane; low-durometer polyurethane; high-durometer polyurethane; polytetrafluoroethylene (PTFE); expandable polytetrafluoroethylene (ePTFE); polyethylene terephthalate (PET); polyimide; polyether block amide; latex; and combinations of one, two or more of these. Alternatively or additionally, shaft 110 can comprise one or more metals (e.g. in a guidewire-like construction or other coiled arrangement), such as a metal selected from the group consisting of: stainless steel; nitinol; and combinations of one or two of these. Shaft 110 can comprise a coating, such as described herebelow.
[0121] Shaft 110 can comprise an outer diameter, D.sub.SHAFT shown, of between 0.018 and 0.300, or between 0.030 and 0.120. D.sub.SHAFT can comprise a relatively constant diameter or a varying diameter along the length of shaft 110. Shaft 110 can comprise an inner diameter (i.e. the diameter of lumen 115) of at least 0.005 or at least 0.015. Shaft 110 can comprise a length of at least 4 cm or at least 6 cm, such as a length of between 6 cm and 30 cm, between 8 cm and 20 cm, or between 10 cm and 13 cm.
[0122] Scaffolding elements of the present inventive concepts include balloon 150 of
[0123] Balloon 150 and the other scaffolding elements of the present inventive concepts can comprise a length of up to 4 cm, up to 7 cm, or up to 10 cm, such as a length of between 1 cm and 4 cm, or between 1.5 cm and 2.8 cm. Scaffolding elements of the present inventive concepts can comprise a thickness (e.g. a wall thickness prior to inflation) of at least 0.0001, 0.001, and/or 0.010. Scaffolding elements of the present inventive concepts can be positioned such that the distal end of the scaffolding element is within 10 mm of the distal end of the scaffolding device, or within 5 mm of the distal end of the scaffolding device (such as to prevent or at least reduce the likelihood of the tip of scaffolding device 100 triggering a gag reflex in the patient or otherwise causing discomfort). Scaffolding elements of the present inventive concepts can be configured to provide (e.g. when expanded) a spiral with a major diameter (D.sub.SPIRAL herein) of between 0.5 cm and 5 cm, between 1.5 cm and 2.5 cm, or between 1.7 cm and 2.0 cm. Scaffolding elements of the present inventive concepts can provide a helical breathing pathway that comprises a cross sectional area at one or more points along its length, that is at least 10%, at least 20%, at least 35%, or at least 45% of the area defined by the major diameter of the scaffolding element (when the scaffolding element is expanded into the helical geometry). For example, for an expanded scaffolding element comprising a spiral with a major diameter of 2.0 cm, which defines an area of approximately 3.14 cm.sup.2, the provided helical breathing pathway can comprise an air passageway with a cross sectional area of approximately at least 0.314 cm.sup.2, 0.628 cm.sup.2, 1.099 cm.sup.2, or 1.413 cm.sup.2, respectively, at one or more points along the length of the scaffolding element.
[0124] Balloon 150 and the other scaffolding elements of the present inventive concepts can comprise a burst pressure of at least 5 psi, at least 10 psi, at least 30 psi or at least 50 psi. The scaffolding elements of the present inventive concepts can comprise a fill volume (a volume of fluid to be introduced to achieve a full expansion) of at least 1 ml, 3 ml, 5 ml, or 7 ml. The scaffolding elements of the present inventive concepts can comprise a fill volume (a volume of fluid introduced to cause full expansion of balloon 150 or other scaffolding element) that is less than or equal to 30 ml, or less than or equal to 20 ml. The scaffolding elements of the present inventive concepts can comprise a pitch (e.g. distance between peaks 151 or valleys 152) of at least 2 mm, 4 mm, or 6 mm, or a pitch of no more than 20 mm, 15 mm, or 10 mm.
[0125] The scaffolding elements of the present inventive concepts can comprise materials, supporting elements, and/or other features, that maximize the volume of the helical breathing pathway, and/or minimize restrictions within the helical breathing pathway, when the scaffolding element is positioned within a patient airway and expanded (e.g. inflated).
[0126] In some embodiments, a scaffolding element of the present inventive concepts (e.g. balloon 150 of
[0127] Referring to
[0128] Referring to
[0129] Referring additionally to
[0130] In some embodiments, no or minimal twist is applied to tube 154 (e.g. between the proximal end and distal end of tube 154). Tube 154 can comprise an inner diameter (ID) when in its resiliently biased state (e.g. relaxed state) that is smaller than the outer diameter (OD) of the distal portion 118 of shaft 110 (the resiliently biased diameter of the distal portion 118 of shaft 110), such that tube 154 is in a stretched state after positioned about shaft 110. This stretched condition can be configured to cause tube 154 to expand into a helical geometry during inflation (e.g. obviating the need for the twisting of tube 154 to cause the helical expansion). In some embodiments, the resiliently biased ID of tube 154 is at least 30%, 40%, 50%, 60%, or 70% smaller than the resiliently biased OD of the distal portion 118 of shaft 110 about which tube 154 is positioned.
[0131] Referring to
[0132] Referring additionally to
[0133] Curing device 30 can be used to cure, harden, and/or otherwise activate adhesive 35 to fixedly attach tube 154 to the distal portion 118 of shaft 110 in the helical pattern of the applied adhesive 35. As a result of the manufacturing steps shown in
[0134] In some embodiments, adhesive 35 is applied between tube 154 and a distal portion 118 of shaft 110 without a particular pattern of application (e.g. not necessarily in a helical pattern), such as when adhesive 35 is applied over all or at least a majority of the contacting surfaces between tube 154 and shaft 110. In these embodiments, curing device 30 can be manipulated to cure only a portion of the previously applied adhesive 35, such as to create a patterned adherence between tube 154 and shaft 110 (e.g. a helically shaped pattern of adherence due to curing of a helical portion of the applied adhesive 35). For example, curing device 30 can deliver a focused curing light (e.g. a UV light used to cure a UV-curing based adhesive 35) toward the contacting portion between shaft 110 and tube 154 (with adhesive 35 previously applied) while curing device 30 is simultaneously translated and rotated about the contacting portion (e.g. by rotating curing device 30, the assembly including tube 154, or both, and simultaneously translating curing device 30, the assembly including tube 154, or both, to create a helically shaped pattern of adherence). After the curing step, the remaining uncured adhesive 35 can be removed, such as during a cleaning process including delivering a solvent (e.g. a solvent of adhesive 35) between the unadhered contacting portions between tube 154 and shaft 110.
[0135] While the manufacturing steps described in reference to
[0136] Referring to
[0137] Referring to
[0138] In some embodiments, valve 130 is configured to maintain fluid within balloon 150 or another expandable scaffolding element of the present inventive concepts at a pressure as described hereabove in reference to valve 130 of
[0139] In some embodiments, valve 130 is configured to allow fluid to pass into scaffolding device 100 without valve 130 having to be compressed. For example, an inflation device (e.g. fill assembly 40 described hereabove) can be attached to valve 130 and sufficient pressure of fluid delivery achieved to cause projections 136a-b to separate and the fluid to pass into lumen 115.
[0140] Referring to
[0141] In some embodiments, scaffolding device 100 is inserted prior to sleep, and removed and disposed of after use, often referred to as a single use device. Alternatively, scaffolding device 100 can be used for multiple sleeping periods (e.g. multiple nightly uses), such as when scaffolding device 100 is cleaned prior to a second insertion into the patient. Cleaning of scaffolding device 100 can be performed, for example, with soap and water, or with alcohol (e.g. isopropyl alcohol). In some embodiments, scaffolding device 100 is configured to be single use, multiple use, or both (e.g. at the patient's discretion).
[0142] Referring to
[0143] The above-described embodiments should be understood to serve only as illustrative examples; further embodiments are envisaged. Any feature described herein in relation to any one embodiment may be used alone, or in combination with other features described, and may also be used in combination with one or more features of any other of the embodiments, or any combination of any other of the embodiments. Furthermore, equivalents and modifications not described above may also be employed without departing from the scope of the inventive concepts, which is defined in the accompanying claims.