Systems and methods for treating aortic lesions

Abstract

Devices, systems, and methods for the localization of body lumen junctions and other intraluminal structure are disclosed. Various embodiments permit clinicians to identify and locate lesions and/or anatomical structures within a lumen and accurately place leads and/or devices within a lumen, through determining the intralumen conductance and/or cross-sectional area at a plurality of locations within the body lumen.

1 . A method for treating a lesion within an aorta, comprising the steps of:
 providing a system, comprising:
 an expandable tubular member having a first open end, a second open end, an outer surface, and a hollow interior, both the outer surface and the hollow interior extending between the first and second open ends and the expandable tubular member capable of moving between a first closed position and a second open position, 
 a catheter removably disposed within the interior of the tubular member and having a proximal end and a distal end, the distal end of the catheter for placement into a aorta, the catheter comprising a first electrode and a second electrode, each of the first and second electrodes having a proximal end and a distal end, the distal ends of the first and second electrodes located between the proximal and distal ends of the catheter, and 
 a processor connected to the first and second electrodes of the catheter, the processor capable of collecting conductance data to determine a profile of the aorta, the conductance data collected at a plurality of locations within the aorta and determined at each of the plurality of locations when the distal ends of the first and second electrodes are immersed in a fluid within the aorta; 
   delivering the catheter and the expandable tubular member to the aorta;   determining a profile of the aorta through operation of the catheter and the processor;   using the profile of the aorta to identify the location of a lesion within the aorta;   disposing at least a portion of the tubular member within the lesion; and   coupling the expandable tubular member with the aorta by moving the expandable tubular member to the second open position;   whereby the expandable tubular member provides a fluid passageway through the lesion.   
   
   
       2 . The method of  claim 1 , wherein the processor further comprises a computational program capable of detecting a bifurcation in the aorta and distinguishing the bifurcation from a lesion. 
   
   
       3 . The method of  claim 1 , wherein the profile of the aorta is determined in real time. 
   
   
       4 . The method of  claim 1 , wherein the lesion comprises an aneurysm. 
   
   
       5 . The method of  claim 1 , further comprising the step of using the profile of the aorta to identify the dimensions of the lesion. 
   
   
       6 . The method of  claim 5 , wherein the step of coupling the expandable tubular member with the aorta further comprises:
 coupling the outer surface adjacent to the first open end of the expandable tubular member to the aorta in a first location outside of the dimensions of the lesion; and   coupling the outer surface adjacent to the second open end of the expandable tubular member to the aorta in a second location outside of the dimensions of the lesion.   
   
   
       7 . The method of  claim 5 , wherein the second location is in an antegrade position relative to the first location. 
   
   
       8 . The method of  claim 1 , wherein the step of operating the system to determine a profile of the aorta further comprises the steps of:
 providing constant electrical current flow to the aorta through the catheter;   measuring a first conductance value at a first location in the aorta;   moving the catheter to a second location in the aorta;   measuring a second conductance value at a second location in the aorta;   determining a profile of the aorta based on the first conductance value of the first location and the second conductance value of the second location.   
   
   
       9 . The method of  claim 1 , wherein the fluid comprises blood. 
   
   
       10 . The method of  claim 1 , wherein the profile of the aorta comprises relative conductances. 
   
   
       11 . The method of  claim 1 , wherein the profile of the aorta comprises relative cross-sectional areas. 
   
   
       12 . The method of  claim 11 , wherein the second open position of the expandable tubular member comprises a diameter sized to the relative cross-sectional areas of the profile. 
   
   
       13 . The method of  claim 1 , wherein:
 the catheter further comprises a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes;   the fluid within the aorta comprises a first fluid having a first conductivity and a second fluid having a second conductivity; and   the conductance data is determined at each of the plurality of locations when the distal ends of the first and second electrodes are immersed in each of the first fluid and the second fluid.   
   
   
       14 . The method of  claim 13 , further comprising:
 injecting a known volume of a first solution having a first conductivity into the aorta;   injecting a second solution having a second conductivity into the aorta, wherein the second solution has a second volume and wherein the second conductivity does not equal the first conductivity;   measuring a second conductance value at the first location in the aorta;   calculating the conductance at the first location in the aorta;   measuring a first conductance value at the second location in the aorta; and   calculating the conductance at the second location in the aorta.   
   
   
       15 . The method of  claim 14 , wherein the step of determining a profile of the aorta comprises determining a profile of the aorta based on the conductance of the first location, the conductance of the second location, and the conductivities of the first and second solutions. 
   
   
       16 . The method of  claim 15 , wherein the profile of the aorta comprises cross-sectional areas of the plurality of locations. 
   
   
       17 . The method of  claim 1 , wherein:
 the catheter further comprises a third electrode and a fourth electrode, each of the third and fourth electrodes having a proximal end and a distal end, the distal ends of the third and fourth electrodes located between the proximal and distal ends of the catheter, and the proximal ends of the third and fourth electrodes coupled with the processor;   the first and the third electrodes comprise excitation electrodes and the second and the fourth electrodes comprise detection electrodes; and   the distal ends of the second and fourth electrodes are located between the distal ends of the first and the third electrodes.   
   
   
       18 . The method of  claim 1 , wherein the catheter further comprises a balloon, the balloon having a first deflated position and a second inflated position and disposed on the catheter such that when the balloon is moved between the first deflated position and the second inflated position, the balloon is capable of expanding the expandable tubular member. 
   
   
       19 . The method of  claim 18 , wherein the step of coupling the expandable tubular member with the aorta by moving the expandable tubular member to the second open position further comprises the step of moving the balloon between the first deflated position and the second inflated position. 
   
   
       20 . The method of  claim 1 , further comprising the steps of:
 removing the catheter from the expandable tubular member; and   withdrawing the catheter from the aorta.   
   
   
       21 . A kit for treating an aortic aneurysm comprising:
 an expandable tubular member having a first open end, a second open end, an outer surface, and a hollow interior, both the outer surface and the hollow interior extending between the first and second open ends and the expandable tubular member capable of moving between a first closed position and a second open position; and   a catheter removably disposed within the interior of the tubular member and having a proximal end and a distal end, the distal end of the catheter for placement into a aorta, the catheter comprising a first electrode and a second electrode, each of the first and second electrodes having a proximal end and a distal end, the distal ends of the first and second electrodes located between the proximal and distal ends of the catheter;   wherein the first and second electrodes of the catheter are capable of receiving data for determining a profile of an aorta and the first and second electrodes of the catheter are configured to be coupled with a processor for processing conductance data received from the catheter.   
   
   
       22 . The kit of  claim 21 , wherein the catheter further comprises a balloon, the balloon having a first deflated position and a second inflated position and disposed on the catheter such that when the balloon is moved between the first deflated position and the second inflated position, the balloon is capable of expanding the expandable tubular member. 
   
   
       23 . The kit of  claim 21 , wherein:
 the catheter further comprises a third electrode and a fourth electrode, each of the third and fourth electrodes having a proximal end and a distal end, the distal ends of the third and fourth electrodes located between the proximal and distal ends of the catheter, and the proximal ends of the third and fourth electrodes coupled with the processor; and   the first and the third electrodes comprise excitation electrodes and the second and the fourth electrodes comprise detection electrodes and the distal ends of the second and fourth electrodes are located between the distal ends of the first and the third electrodes.   
   
   
       24 . The kit of  claim 22 , wherein:
 the catheter further comprises a third electrode and a fourth electrode, each of the third and fourth electrodes having a proximal end and a distal end, the distal ends of the third and fourth electrodes located between the proximal and distal ends of the catheter, and the proximal ends of the third and fourth electrodes coupled with the processor; and
 the first and the third electrodes comprise excitation electrodes and the second and the fourth electrodes comprise detection electrodes and the distal ends of the second and fourth electrodes are located between the distal ends of the first and the third electrodes. 
   
   
   
       25 . The kit of  claim 21 , wherein:
 the catheter further comprises a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes; and   the catheter is capable of determining conductance data when the distal ends of the first and second electrodes are immersed in a first fluid and a second fluid.   
   
   
       26 . The kit of  claim 22 , wherein:
 the catheter further comprises a passageway for passing fluid through the catheter to the location of the distal ends of the first and second electrodes, such that fluid passing through the passageway comes in contact with the distal ends of the first and second electrodes; and   the catheter is capable of determining conductance data when the distal ends of the first and second electrodes are immersed in a first fluid and a second fluid.   
   
   
       27 . The kit of  claim 25 , further comprising:
 a syringe containing a first fluid; and   a syringe containing a second fluid.