Method and apparatus for treatment of intracranial hemorrhages

Abstract

An ultrasound catheter with fluid delivery lumens, fluid evacuation lumens and a light source is used for the treatment of intracerebral hemorrhages. After the catheter is inserted into a blood clot in the brain, a lytic drug can be delivered to the blood clot via the fluid delivery lumens while applying ultrasonic energy to the treatment site. As the blood clot is dissolved, the liquefied blood clot can be removed by evacuation through the fluid evacuation lumens.

What is claimed is: 
     
         1 . A method for treating a blood clot resulting from an intracranial hemorrhage comprising:
 forming a hole in a patient's skull;   positioning at least a portion of a treatment portion of a catheter of into the blood clot;   delivering a therapeutic compound to the blood clot through a fluid delivery lumen in the catheter;   activating an ultrasound element in a treatment portion of the catheter; and   evacuating a fluid around the treatment portion into the elongate tubular body.   
     
     
         2 . The method of  claim 1 , wherein the therapeutic compound is a thrombolytic compound. 
     
     
         3 . The method of  claim 1 , wherein the catheter comprises an external ventricular drainage catheter. 
     
     
         4 . The method of  claim 3 , further comprising inserting an ultrasound catheter into the external ventricular drainage catheter. 
     
     
         5 . The method of  claim 3 , further comprising inserting an ultrasound catheter alongside the external ventricular drainage catheter. 
     
     
         6 . The method of  claim 3 , wherein the activating an ultrasound element in a treatment portion of the catheter comprising activating ultrasound radiating members incorporated in to external ventricular drainage catheter. 
     
     
         7 . The method of  claim 1 , further comprising measuring the pressure within the treatment portion of the catheter with a pressure sensor located within the treatment portion. 
     
     
         8 . The method of  claim 1 , wherein the treatment catheter is positioned within the blood clot with fluoroscopic, magnetic resonance, neuronavigation, and/or computed tomography visualization. 
     
     
         9 . The method of  claim 1 , wherein the positioning the at least portion of a treatment portion of an catheter into the blood clot comprises positioning the catheter extravascularly. 
     
     
         10 . A method for treating a blood clot in a patient comprising:
 advancing a ultrasound catheter into an external ventricular drainage (EVD) catheter; and   transmitting ultrasound energy with the ultrasound catheter.   
     
     
         11 . The method of  claim 10 , further comprising delivering a fluid comprising a thrombolytic drug into the external ventricular drainage (EVD). 
     
     
         12 . The method of  claim 10 , comprising transmitting ultrasound energy at a frequency between about 20 kHz and about 20 MHz. 
     
     
         13 . The method of  claim 12 , wherein a blood clot is positioned outside the external ventricular drainage (EVD) catheter. 
     
     
         14 . The method of  claim 12 , wherein the ultrasound radiating member is incorporated in to external ventricular drainage catheter. 
     
     
         15 . A method for treating a blood clot in a patient comprising:
 forming a hole in a patient's skull;   advancing an external ventricular drainage (EVD) catheter through the hole to into a target in a patient's brain;   advancing a ultrasound catheter into the external ventricular drainage (EVD) catheter; and   transmitting ultrasound energy from the ultrasound catheter.   
     
     
         16 . The method of  claim 15 , comprising transmitting ultrasound energy at a frequency between about 20 kHz and about 20 MHz. 
     
     
         17 . The method of  claim 16  wherein the hole is a burr hole. 
     
     
         18 . The method of  claim 16 , further comprising inserting the external ventricular drainage (EVD) catheter into an introducer sheath. 
     
     
         19 . The method of  claim 16 , wherein the external ventricular drainage (EVD) catheter is advanced into the ventricles of the patient's brain. 
     
     
         20 . The method of  claim 16 , further comprising inserting the ultrasound catheter through a proximal end of the external ventricular drainage (EVD) catheter. 
     
     
         21 . The method of  claim 16 , further comprising delivering a therapeutic compound to the external ventricular drainage (EVD) catheter. 
     
     
         22 . The method of  claim 21 , wherein the therapeutic compound is a thrombolytic compound. 
     
     
         23 . The method of  claim 16 , wherein the ultrasound catheter has multiple ultrasound elements. 
     
     
         24 . The method of  claim 16 , wherein clot outside the wherein the external ventricular drainage (EVD) is dissolved. 
     
     
         25 . The method of  claim 24 , withdrawing the dissolved blood clot through the external ventricular drainage (EVD) is dissolved. 
     
     
         26 . The method of  claim 16 , wherein an ultrasound radiating member of the ultrasound catheter extends past a distal tip of the external ventricular drainage (EVD) catheter. 
     
     
         27 . The method of  claim 15 , wherein the external ventricular drainage (EVD) catheter is positioned within the blood clot with fluoroscopic, magnetic resonance, neuronavigation, and/or computed tomography visualization. 
     
     
         28 . The method of  claim 15 , wherein a stylet positioned in the external ventricular drainage (EVD) when advancing an external ventricular drainage (EVD) catheter into the patient's brain. 
     
     
         29 . The method of  claim 24 , further comprising removing the stylet. 
     
     
         30 . The method of  claim 15 , wherein the target is a blood clot.