EP-4736800-A2 - DEVICES FOR REPAIR OF A SELECTED BLOOD VESSEL OR PART THEREOF AND RAPID HEALING OF INJURED INTERNAL BODY CAVITY WALLS

EP4736800A2EP 4736800 A2EP4736800 A2EP 4736800A2EP-4736800-A2

Abstract

In some embodiments, an apparatus includes a catheter having a catheter body, a light emitter disposed at a distal end of the catheter body, and a fluid conduit coupleable to a source of fluid. The fluid conduit configured to discharge fluid from the source via the conduit and out a distal end of the catheter body. A spacing member is disposed at the distal end of the catheter body and can be moved between a collapsed configuration and an expanded configuration. In the expanded configuration, the spacing member is disposed about the light emitter. The spacing member is at least partially transmissive and/or transflective of light emitted from the light emitter. The apparatus configured to be inserted at least partially into a body lumen, to discharge fluid into the body lumen, and to emit light from the light emitter to illuminate an interior wall of the body lumen.

Inventors

LIEBER, BARUCH B.
ROSE, JOHN A.

Assignees

Prometheus Therapeutics Inc.

Dates

Publication Date: 20260506
Application Date: 20180516

Claims (15)

An apparatus, comprising: a catheter having a catheter body with a distal end and a proximal end, the distal end of the catheter body configured to be inserted at least partially into a body cavity having an interior wall; a fluid conduit disposed in the catheter body and extending from the proximal end to the distal end of the catheter body, the fluid conduit having an inlet at the proximal end and an outlet at the distal end, the fluid conduit being couplable to a fluid source and configured to discharge fluid from the fluid source via the fluid conduit and out of the distal end into the body cavity; an aspiration lumen disposed in the catheter body and extending from the proximal end to the distal end of the catheter body, the aspiration lumen being couplable to an aspiration source and configured to aspirate fluid from the body cavity; an inner body configured to be movably disposed within the fluid conduit; and a light emitter disposed on a distal tip of the inner body and configured to emit light to illuminate the interior wall.
The apparatus of claim 1, further comprising a spacing member coupled to the inner body, the spacing member configured to be disposed at the distal end of the catheter body and reconfigurable from a collapsed configuration to an expanded configuration, wherein in the expanded configuration the spacing member is disposed about the light emitter to maintain the light emitter approximately centered within the spacing member with respect to at least one axis of the spacing member, wherein the spacing member is at least partially transmissive and/or transflective of the light emitted from the light emitter.
The apparatus of claim 2, wherein the spacing member is porous to fluid dischargeable from the fluid conduit.
The apparatus of claim 1, wherein the light emitter further comprises a light scatterer having a convex end cap shape and configured such that light emitted from the light scatterer can be transmitted radially and axially through a distal end of the light scatterer.
The apparatus of claim 1, wherein the aspiration lumen and the fluid conduit are the same.
The apparatus of claim 5, further comprising a valve configured to switch the aspiration lumen and the fluid conduit from being coupled to one of the fluid source or the aspiration source.
The apparatus of claim 1, wherein the aspiration lumen is coaxial with the fluid conduit.
The apparatus of claim 1, wherein the aspiration lumen is separate from the fluid conduit.
The apparatus of claim 1, wherein the aspiration lumen is parallel to the fluid conduit.
The apparatus of claim 1, wherein the body cavity is a cavernous region, the fluid conduit being configured to discharge fluid into the cavernous region to dilute blood in the cavernous region, and the light emitter configured to emit light at a wavelength and intensity to provide a therapeutic treatment to a treatment region of the cavernous region.
The apparatus of claim 1, wherein the body cavity is a joint, the fluid conduit being configured to discharge fluid into the joint to dilute blood in the joint, and the light emitter configured to emit light at a wavelength and intensity to provide a therapeutic treatment to a treatment region of the joint.
The apparatus of claim 1, wherein the inner body includes a light conduit extending through the catheter body from the proximal end to the distal end of the catheter body, the light conduit having a proximal end optically couplable to a source of light, the light conduit configured to transmit light from the light source to the light emitter disposed at a distal end of the light conduit.
The apparatus of claim 12, further comprising the light source couplable to the proximal end of the light conduit and configured to generate light at a wavelength in the visible portion of the spectrum.
The apparatus of claim 1, further comprising an imager disposed at the distal end of the catheter and configured to image a portion of the body cavity, the imager couplable to a display on which images of the body lumen or cavity can be displayed.
The apparatus of claim 1, wherein the light emitter is configured to emit light having a power density between 5 mW/cm 2 and 5 W/cm 2 .

Description

CROSS-REFERENCE TO RELATED APPLICATIONS This application claims priority to and the benefit of U.S. Provisional Patent Application Serial No. 62/508,690, entitled "Devices and Methods for Repair of a Selected Blood Vessel or Part Thereof and Rapid Healing of Injured Internal Body Cavity Walls," filed May 19, 2017, and is a continuation application of U.S. Nonprovisional Patent Application Serial No. 15/976,199, entitled "Devices and Methods for Repair of a Selected Blood Vessel or Part Thereof and Rapid Healing of Injured Internal Body Cavity Walls," filed May 10, 2018, which claims priority to U.S. Provisional Patent Application Serial No. 62/508,690, entitled "Devices and Methods for Repair of a Selected Blood Vessel or Part Thereof and Rapid Healing of Injured Internal Body Cavity Walls," filed May 19, 2017, each of the disclosures of which is incorporated herein by reference in its entirety. TECHNICAL FIELD The present disclosure relates generally to systems, apparatus, and methods for therapeutic intervention in blood vessels and other body lumens or cavities. BACKGROUND The embodiments described herein relate generally to modulating blood flow (e.g. reduce flow rate or stop flow completely) to a selected blood vessel or part thereof. Photothrombotic occlusion has been proposed as an approach to inducing permanent clotting in arteries. This approach involves intravenous or local introduction of a photosensitizer, such as sodium fluorescin, erythrosine B, or rose bengal dye, to be absorbed onto the endothelial luminal surface of the artery. A photochemical process is initiated by light at a wavelength sufficient to excite the molecules of the photosensitizer (e.g. 510 nm to 580 nm, or higher, e.g. 830 nm). This was believed to initiate a Type II photochemical process in which the energy of excitation is transferred to molecular oxygen, a metastable, highly reactive species. In turn, the singlet oxygen was believed to initiate direct peroxidation of unsaturated fatty acids and proteins in the luminal surface, leading to structural damage, which in turn stimulates platelet adherence, followed by platelet aggregation and occlusion of the vessel. An alternative more recent mechanistic explanation of the observed photothrombosis process is that blood constituents such as multipotent stem cells and blood forming stem cells, as well as vascular wall constituents such as mesenchymal stem cells, vascular stem cells, and endothelial precursor cells, or progenitor cells, as well as differentiated cells such as fibroblasts and collagen are exposed to the effect of low level laser light that recruit cells locally and or remotely, initiate differentiation, activation and proliferation of the cells to produce the photothrombotic effect. A technique used for treating an aneurysm is to deploy a permeable mesh-like tube of biocompatible material across the neck of the aneurysm to reduce blood flow into the aneurysm, activate the platelets passing through the device into the aneurysm, and thereby promote coagulation of blood within the aneurysm. One proposed approach to treatment of aneurysms and other malformations of blood vessels combines the photothrombotic and mesh-like tube approaches. In this approach, an optical fiber tip is deployed endovascularly into the aneurysm, preceded or followed by introduction of a mesh-like tube across the neck of the aneurysm. The tip applies light energy to the interior of the aneurysm to initiate or accelerate coagulation of blood in the aneurysm. A light-energy absorbing and/or transmission agent could also be introduced into the interior of the aneurysm before using the optical fiber to apply light energy. One shortcoming of the proposed techniques is that the energy density of the light onto the wall of the blood vessel in the region to be treated (i.e. the energy per unit area of the vessel wall) cannot be well controlled to be relatively uniform, i.e. to be maintained within a range of energy density values that is high enough to be therapeutically effective and low enough not to damage the vessel wall. Thus, there is a need for a device capable of more effectively treating aneurysms or other malformations, such as arteriovenous and dural malformations, in blood vessels, for devascularizing tumors, occluding varicose and spider veins, and treating other regions and indications by creating a stable thrombus in the region of interest. SUMMARY In some embodiments, an apparatus includes a catheter having a catheter body with a distal end and a proximal end. A light emitter is disposed at the distal end of the catheter body and configured to emit light. A fluid conduit is disposed in the catheter body, extending from the proximal end to the distal end of the catheter body, and has an inlet at the proximal end of the catheter body and is coupleable to a source of fluid, and has an outlet at the distal end and is configured to discharge fluid from the source via the conduit and out of