SELF-EXPANDABLE TUBE AND METHOD OF USE

Abstract

The invention relates to a self-expandable tube having a catheter body with a double lumen in which one lumen allows for suctioning or decompression and another lumen for a feeding tube. A self-expandable portion collects secretions above the expandable portion or in the anatomical lumen and a suction source coupled to the self-expandable tube removes the secretions as is disclosed herein.

Claims

1. A self-expandable tube comprising: an elongate catheter body with a proximal end and a distal end having an expandable section, the catheter body including at least two lumens that span a longitudinal length of the catheter body; and an outer sheath surrounding the catheter body and constraining the expandable section, the outer sheath being movable to release constraint on the expandable section.

2. The self-expandable tube of claim 1, wherein the outer sheath has one or more openings passing there through.

3. The self-expandable tube of claim 2, wherein the one or more openings form a porosity on the outer sheath between 50% and 99%, between 60% and 89%, or between 70% and 79%.

4. The self-expandable tube of claim 1, wherein the catheter body is configured to be bendable along a longitudinal axis without collapsing or obstructing the double lumen.

5. The self-expandable tube of claim 4, wherein the catheter body is configured to be bendable along a bend angle between 0-45 degrees from the longitudinal axis.

6. The self-expandable tube of claim 4, wherein the catheter body is configured to be bendable along a bend angle between 5-35 degrees from the longitudinal axis.

7. The self-expandable tube of claim 4, wherein the catheter body is configured to be bendable along a bend angle between 10-25 degrees from the longitudinal axis.

8. The self-expandable tube of claim 1, wherein the catheter body further comprises proximal ports and distal ports communicating with at least one of the at least two of a plurality of lumens.

9. The self-expandable tube of claim 1, wherein the proximal ports further comprises a seal configured to prevent fluid backflow through the proximal ports.

10. The self-expandable tube of claim 1, wherein the expandable section has a contracted state having a diameter between 2-3 mm and has an expanded state having a diameter between 12-14 mm.

11. The self-expandable tube of claim 1, wherein the expandable section comprises a single biocompatible material and formed as a single monolithic or unitary element.

12. The self-expandable tube of claim 1, wherein the expandable section comprises plural elements joined to each other.

13. The self-expandable tube of claim 1, wherein the expandable section comprises plural biocompatible materials joined as a composite.

14. The self-expandable tube of claim 1, wherein the expandable section further comprises at least one of a plurality of reinforcing members.

15. The self-expandable tube of claim 14, wherein the at least one of a plurality of reinforcing members further comprise a plurality of reinforcing members circumferentially arrayed about the expandable section, each of the plurality of reinforcing members extending distally from a proximal region of the expandable section.

16. The self-expandable tube of claim 15, wherein each of the plurality of reinforcing members further comprise an elastic, shape memory or superelastic member joined to the expandable section.

17. The self-expandable tube of claim 15, wherein each of the plurality of reinforcing members further comprises a thickened region of the expandable section.

18. A self-expandable tube comprising: an elongate catheter body with a proximal end and a distal end having an expandable section, the catheter body including at least two lumens that span a longitudinal length of the catheter body; an outer sheath surrounding the catheter body and constraining the expandable section, the outer sheath being movable to release constraint on the expandable section; and at least one of a plurality of reinforcing members associated with the expandable section circumferentially arrayed about the expandable section and extending distally from a proximal region of the expandable section.

19. The self-expandable tube of claim 18, wherein each of the plurality of reinforcing members further comprise an elastic, shape memory or superelastic member joined to the expandable section.

20. The self-expandable tube of claim 18, wherein each of the plurality of reinforcing members further comprises a thickened region of the expandable section.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0007] In the accompanying figures, like elements are identified by like reference numerals among the several preferred embodiments of the present invention.

[0008] FIG. 1 is an enlarged cross-sectional view of one embodiment of the Self-Expandable, Tube.

[0009] FIG. 2 is a diagrammatic view of a proximal portion of the Self-Expandable Tube as used with a patient.

[0010] FIG. 3 is a schematic view of one embodiment of the Self-Expandable Tube disposed within a patient.

DETAILED DESCRIPTION OF THE INVENTION

[0011] The foregoing and other features and advantages of the invention are apparent from the following detailed description of exemplary embodiments, read in conjunction with the accompanying drawings. The detailed description and drawings are merely illustrative of the invention rather than limiting, the scope of the invention being defined by the appended claims and equivalents thereof.

[0012] Generally speaking, the Self-Expandable Tube 100 will be placed in the distal third of the esophagus and will expand to the vessel size of the esophagus preventing secretions from the stomach to reflux into the oropharynx and/or lungs. Alternatively, the Self-Expandable Tube 100 may be placed in other locations within the esophagus or other locations within any anatomical lumen. For example, the Self-Expandable Tube 100 may be used within the digestive system, circulatory system, etc. The Self-Expandable Tube 100 creates a seal around the esophagus that will significantly decrease aspiration and potential pneumonias. In one embodiment, the Self-Expandable Tube 100 has a first lumen 120 that allows the placement of a smaller feeding tube 122 in the distal stomach and/or post pyloric area. These feeding tubes are used in almost all the patients requiring mechanical ventilation and critical care support. The anatomical lumen may be an interior of a vessel, such as the central space in an artery or vein through which blood flows, the interior of the gastrointestinal tract, the pathways of the bronchi in the lungs, the interior of renal tubules and urinary collecting ducts, the pathways of the female genital tract, starting with a single pathway of the vagina, splitting up in two lumens in the uterus, both of which continue through the fallopian tubes. The self-expandable tube 100 may be used in connection with a filter system, such as the one described in U.S. Pat. Nos. 8,668,712, 8,613,753, and 8,777,977.

[0013] As shown in FIG. 1, the Self-Expandable Tube 100 includes a catheter body 110 including a self-expandable portion 140 located on the distal end of the catheter body 110. The catheter body 110 includes a first lumen 120 and a second lumen 130 that span the longitudinal length of the catheter body 110. An outer sheath 160 surrounds at least a portion of the longitudinal length of the catheter body 110, and the outer sheath 160 includes a plurality of openings 170 traversing the thickness of the outer sheath 160. Preferably, the plurality of openings 170 are substantially positioned on the distal end of the outer sheath 160 and communicate with a space 162 between the catheter body 110 and the outer sheath 160 to allow fluid to flow therebetween and suctioned to the proximal portion of the Self-Expandable Tube 100. The catheter body 110 and the outer sheath 160 may include a generally tubular configuration, although other polygonal or elliptical configurations are envisioned as well. The proximal portion of the outer sheath 160 is operably coupled to a vacuum or suction source, as shown in FIG. 2, to remove secretions accumulated above the self-expandable portion 140 by suctioning the secretions into the space 162. The first lumen 120 may be operably coupled with a feeding tube 122 that traverses the length of the first lumen 120 through the self-expandable portion 140 and into the distal stomach or post-pyloric area, as shown in FIG. 3. The second lumen 130 may be operably coupled with a suctioning or decompression tube 132 that allows for the suctioning or decompression through the self-expandable portion 140 and into the stomach, as shown in FIG. 3. In one embodiment, the lumens 120, 130 may be bendable along their longitudinal axis to allow for the curvature or bending of the esophagus or other lumen. In one embodiment, the lumens 120, 130 may bend at an angle of between about 0-45 degrees from the longitudinal axis, alternatively, between about 5-35 degrees from the longitudinal axis, alternatively, between about 10-25 degrees from the longitudinal axis. In one embodiment, the feeding tube 122 and the suctioning tube 132 are operably coupled within the same catheter body 110 and operate by way of the first lumen 120 operably coupled to a first distal port 124 and the second lumen 130 operably coupled to a second distal port 134, as shown in FIG. 3. The proximal ports 121 and 131 of the first and second lumens 120, 130 may be sized as to receive the feeding tube 122 and the suction tube 132 and allow longitudinal movement therebetween. Optionally, there may be a seal on the proximal ports 121, 131 to prevent back flow of gastric contents, air, or gas. The second lumen 130 may be larger than the first lumen 120, as to provide the suctioning and clearing of any aspirated materials in the anatomical lumen, such as the gastric contents of the stomach for example. The first lumen 120 may include a first one way valve 180 that allows air to flow distally but prevents fluids from flowing proximally. The second lumen 130 may include a second one way valve 182 that allows air to flow distally but prevents fluids from flowing proximally. The first and second one way valves 180, 182 may be positioned along the length of the first and second lumens 120, 130. Additional valves may be placed along the longitudinal length of the inner lumens 120, 130. Alternatively, the valves may be placed along the distal end of the inner lumens 120, 130 as to be in proximity to the lower esophageal sphincter if acid reflux should be an issue and to prevent vomiting. The expandable portion 140 expands to the size of the anatomical lumen and can be compressed or expanded following contractions and relaxations of the anatomical lumen. The self-expandable portion 140 may have appropriate dimensions in length, diameter, or in its cross-sectional expansive shape, all of which depend on the patient criteria or the anatomy of the anatomical lumen. In one embodiment, the Self-Expandable Tube 100 is inserted into the esophagus and the self-expandable portion 140 is positioned above the lower esophageal sphincter. For purposes of example only, one set of dimensions for the self-expandable portion 140 includes a contracted state that may be between 2-3 mm in diameter, and can expand to the size of the esophagus, which may between 12-14 mm in diameter. In alternative embodiments, the self-expandable portion 140 may expand in order to accommodate a wide variety of variances in anatomical structures.

[0014] In one embodiment, the distal end of the outer sheath 160 may abut with the self-expandable portion 140 in the expanded state, as shown in FIG. 1. In another embodiment, the distal end of the outer sheath 160 may be sealed against the catheter body proximal to the self-expandable portion 140. In one embodiment, the outer sheath 160 may conceal the self-expandable portion 140 in the contracted state and the outer sheath 160 may be moved proximally as to expose the contracted self-expandable portion 140 to allow for self-expansion to the expanded state.

[0015] The self-expandable portion 140 is preferably fabricated of a biocompatible material, such as silicone or biocompatible metal, which is suitable for use in an anatomical lumen. The self-expandable portion 140 may be fabricated using a single material, wherein the seal is formed as a single monolithic or unitary element, or of plural joined elements formed of the same biocompatible material, such a stent or mesh structure. Alternatively, the self-expandable portion 140 may be fabricated of plural biocompatible materials and may be joined as a composite. In either construct of the self-expandable portion 140, but more preferably, in the case of a composite construction of the self-expandable portion 140, at least one reinforcing member 138 is operably associated with the self-expandable portion 140 to facilitate movement of the self-expandable portion 140 between its diametrically collapsed and diametrically expanded positions. In accordance with the illustrated embodiments, plural reinforcing members 138 are associated with the self-expandable portion 140 and extend longitudinally along the self-expandable portion 140 in a radially spaced apart relationship relative to each other. The at least one reinforcing member 138 may be coupled to the self-expandable portion 140 on either its luminal or abluminal surfaces, or may be embedded within self-expandable portion 140 such that it resides at least partially within a wall thickness of the self-expandable portion 140. Alternatively, the at least one reinforcing member 138 may comprise a relatively thickened region, such as a rib or a pattern or ribs, of the same material employed in fabricating the self-expandable portion 140. The at least one self-expandable portion 140 is preferably an elastic, shape memory or super-elastic material, such as stainless steel, silicone, nitinol, chromium-molybdenum alloys, or similar materials. In this manner the self-expandable portion 140 is self-expanding upon being released from a constraining sheath or covering, such as the self-expandable tube 100. For purposes of this application, when reference is made to self-expandable portion 140, such reference is intended to be inclusive of the at least one reinforcing member 138, where appropriate. Those of ordinary skill in the art will understand that the at least one reinforcing member 138 may or may not be necessary, depending upon the construction and materials employed in fabricating the self-expandable portion 140, in order to provide for either expansion or collapse, or to facilitate or aid in apposition or sealing of the self-expandable portion 140 against the anatomical lumen. The self-expansion may be achieved by a shape memory metal or polymer, which transitions to the larger expanded state upon a present condition, such as temperature, pressure, and the like.

[0016] When in its diametrically expanded position, the self-expandable portion 140 is intended to achieve the size of the anatomical lumen while exerting low pressure against the anatomical lumen wall, thereby inhibiting passage of secretions beyond the self-expandable portion 140 to areas of the esophagus proximal the self-expandable portion 140 and improving clearance from secretions deposited proximal of the self-expandable portion 140. The self-expandable portion 140 also reduces the likelihood of unintended fluid passage through the esophagus. In some embodiments, the self-expandable portion 140 may include at least one radiopaque or fluoroscopic marker to facilitate imaging the position of the self-expandable portion 140 after placement. The self-expandable portion 140 may take on any appropriate shape, for instance, the self-expandable portion 140 can be substantially elongated, substantially rounded or substantially horseshoe shape in transverse cross section. In longitudinal aspect, self-expandable portion 140 preferably has an elongate generally tubular shape with a rounded taper at a proximal end thereof that connects with the distal end of the catheter body 110. In one embodiment, the shape of the self-expandable portion 140 may be dictated by airway anatomy, by compatibility with the cough mechanism and by a need to reduce the likelihood of aspiration of secretions. In some embodiments, a distal portion of the self-expandable portion 140, sometimes measuring about 2 to about 3 mm in axial length, may be everted to afford a smoother circumferential surface area for tissue engagement. Everting a distal portion of the self-expandable portion 140 may reduce potential tissue growth around the self-expandable portion 140, and possibly facilitate advancement of the inner lumens 120, 130 with reduced risk of trauma to the patient.

[0017] To further facilitate introduction and maneuvering of the Self-Expandable Tube 100, portions of the catheter body 110 and the outer sheath 160 may be comprised of different materials having different physical and/or material properties. For example, proximal portions of the catheter body 110 and outer sheath 160 may be stiffer and more rigid than distal portions of the catheter body 110 and outer sheath 160. This construction may ease the advancement of the Self-Expandable Tube 100 in the patient with reduced deformation or curving of the catheter body 110 and outer sheath 160. Further, the relatively softer and more malleable material comprising the distal portions of the catheter body 110 and outer sheath 160 may allow for deformation or compression of distal ends of the catheter body 110 and outer sheath 160, and also may be more accommodating to the operator.

[0018] As shown in FIG. 2, the Self-Expandable Tube 100, including catheter body 110 and outer sheath 160, is prepared for insertion into a patient to prevent secretions from the lower GI into the patient's oropharynx and/or lungs. Positioning marks may be placed on the catheter body 110 to indicate the relative positions of the catheter body 110 and the outer sheath 160 and whether the Self-Expandable Tube 100 is above the lower esophageal sphincter but below the lungs. A first positioning mark 200 and a second positioning mark 210 indicate the status of the self-expandable portion 140. Specifically, the first positioning mark 200 is provided distally to indicate that the self-expandable portion 140 is in the contracted state, and the second positioning mark 210 is provided proximally to indicate that the self-expandable portion 140 is expanded. The outer sheath 160 may include a coupling for a vacuum source 164 that suctions the secretions accumulated above the self-expandable portion 140. The proximal portion of the catheter body 110 may include a hub portion 220 for stopping the distal movement of the catheter body 110. The proximal portions of the feeding tube 122 and the suction tube 132 are operably coupled with the proximal portion of the catheter body 110.

[0019] As shown in FIG. 3, the Self-Expandable Tube 100, including catheter body 110 and outer sheath 160 in an alternative embodiment whereby the catheter body 110 extends through the expandable portion 140, the stomach portion, and past the post-pyloric area. The catheter body 110 includes the first lumen 120 and the second lumen 130; however, the first lumen 120 includes a first distal port 124 that is located in the post-pyloric stomach area, and the second lumen 130 includes a second distal port 134 that is located in the stomach area. The expandable portion 140 expands in the distal third of the esophagus to the vessel size of the esophagus preventing secretions from the stomach to reflux into the oropharynx and/or lungs by way of the openings in the outer sheath 160. The second lumen 130 that allows the placement of a smaller feeding tube in the distal stomach and/or post pyloric area. A method of using the Self-Expandable Tube 100 comprises the steps of coupling a catheter body 110 to a self-expandable portion 140 on a distal end of the catheter body 110, the catheter body 110 including a first lumen 120 and second lumen 130 spanning the longitudinal length of the catheter body 110. The first lumen 120 coupling with a tube 122 that traverses the length of the first lumen 120 and through the self-expandable portion 140 and the second lumen 130 coupling with a suction or decompression tube 132 that traverses the length of the second lumen 130 and through the self-expandable portion 140. Creating a sealing membrane by expanding the self-expandable portion 140 to the size of the anatomical lumen. An outer sheath 160 surrounding the longitudinal length of the catheter body 110 including a plurality of openings 170 traversing the outer sheath 160 allowing suctioning from secretions accumulated above the self-expandable portion 140 and the anatomical lumen to travel to the proximal portion of the outer sheath 160. Coupling the proximal portion of the outer sheath 160 to a vacuum or suction source 164 to remove the secretions above the expandable portion 140 and the anatomical lumen by suctioning the secretions through the space 162. The plurality of openings 170 may include a porosity along the outer diameter of the outer sheath 160. Porosity may be varied as to achieve optimum flow through the outer sheath 160 as to not disrupt the portions of the esophagus or stomach or other anatomical lumens in which the outer sheath 160 is disposed. Porosity may also be measured as to the percentage of pores occupying the area of the outer sheath 160. In one embodiment, the porosity may be between 50% and 99%, alternatively, between 60%-89%, alternatively between 70%-79% as to achieve the optimum flow through. The porosity may be increased by further stretching of the outer sheath 160 along the anatomical lumen or esophagus. Additionally, a stretch ratio may be selected for the outer sheath 160 as adjusted to the flow rate in a particular anatomical lumen. For example, the stretching ratio of the outer sheath 160 may be between 1.5 and 10 from the area of the initial outer sheath to the area of the outer sheath 160 stretched in the longitudinal or transverse direction. The outer sheath 160 may include a porosity to achieve a flow rate between 1.0-1000 mL/cm or for a water entry pressure of 0-350 psi selected to a specific vein or artery.

[0020] While the invention has been described in connection with various embodiments, it will be understood that the invention is capable of further modifications. This application is intended to cover any variations, uses or adaptations of the invention following, in general, the principles of the invention, and including such departures from the present disclosure as, within the known and customary practice within the art to which the invention pertains. Those of skill in the art will understand that obvious variations in construction, materials, dimensions or properties may be made without departing from the scope of the invention which is intended to be limited only by the claims appended hereto.