WO2006137051A1 - Dispositif et méthode pour positionner une substance dans un tissu - Google Patents

Dispositif et méthode pour positionner une substance dans un tissu Download PDF

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Publication number
WO2006137051A1
WO2006137051A1 PCT/IL2006/000668 IL2006000668W WO2006137051A1 WO 2006137051 A1 WO2006137051 A1 WO 2006137051A1 IL 2006000668 W IL2006000668 W IL 2006000668W WO 2006137051 A1 WO2006137051 A1 WO 2006137051A1
Authority
WO
WIPO (PCT)
Prior art keywords
tubular member
hollow tubular
tissue
elongated housing
substance
Prior art date
Application number
PCT/IL2006/000668
Other languages
English (en)
Inventor
Itzhak Kelson
Original Assignee
Ramot At Tel Aviv University Ltd.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Ramot At Tel Aviv University Ltd. filed Critical Ramot At Tel Aviv University Ltd.
Publication of WO2006137051A1 publication Critical patent/WO2006137051A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N5/1027—Interstitial radiation therapy
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3478—Endoscopic needles, e.g. for infusion
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/00234—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery
    • A61B2017/00292—Surgical instruments, devices or methods, e.g. tourniquets for minimally invasive surgery mounted on or guided by flexible, e.g. catheter-like, means
    • A61B2017/003—Steerable
    • A61B2017/00318—Steering mechanisms
    • A61B2017/00331—Steering mechanisms with preformed bends
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/065—Guide needles
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N5/00—Radiation therapy
    • A61N5/10—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy
    • A61N5/1001—X-ray therapy; Gamma-ray therapy; Particle-irradiation therapy using radiation sources introduced into or applied onto the body; brachytherapy
    • A61N5/1007—Arrangements or means for the introduction of sources into the body
    • A61N2005/1011—Apparatus for permanent insertion of sources

Definitions

  • the present invention relates to targeted delivery of a substance, and more specifically to a medical device for multiple deliveries of radioactive sources used for brachytherapy treatment of cancerous tissue.
  • brachytherapy is a form of radiation therapy in which radioactive pellets or seeds are implanted into or near the target tissue to be treated.
  • the most notable example is the case of prostate cancer, where the entire organ is actually irradiated. Complication rates with brachytherapy are minimal, and are more likely to occur in patients who have undergone transurethral resection of the prostate. Otherwise, patients who undergo transperineal implantation show excellent quality of life.
  • US Patent 6648811 to Sierocuk et. al. entitled "Brachytherapy cartridge including absorbable and autoclaveable spacer” teaches a brachytherapy seed delivery system which includes a seed cartridge comprising: a central channel, a plurality of brachytherapy seeds disposed within the central channel and a plurality of absorbable, dimensionally stable spacers disposed within the central channel.
  • This invention is further directed to a method of loading a brachytherapy seed delivery system including the steps of: providing a seed cartridge including a central channel, seeds and spacers as described above; connecting the brachytherapy seed cartridge to a brachytherapy needle including a cannula; and forcing the seeds out of the brachytherapy seed cartridge into the cannula.
  • the present invention is further directed to an improved brachytherapy method including inserting the brachytherapy needle of the brachytherapy seed delivery system recited above into a human organ; and forcing the seeds and the spacer through the cannula of the brachytherapy needle and into the human organ.
  • U.S. Patent No. 6514193 to Kaplan entitled “Method of administrating therapeutically active substance” teaches a method for administering a therapeutically active component including a non-radioactive drug to a target tissue in a subject.
  • the method includes the steps of: (a) providing a brachytherapy seed having a size and shape suitable for passing through the bore of a needle having an interior diameter of less than about 2.7 millimeters (10 gauge); (b) providing a brachytherapy implantation instrument comprising at least one brachytherapy implantation needle having a bore having an interior diameter of less than about 2.7 millimeters (10 gauge), and being adapted to accept the brachytherapy seed into the bore of the at least one brachytherapy implantation needle and deliver the accepted implantation device into a target tissue; (c) introducing the brachytherapy seed into the bore of the at least one implantation needle of the brachytherapy implantation instrument; (d) introducing at least a portion of the at least one brachytherapy implantation needle into
  • US Patent 6752753 to Hoskins et. al. entitled “Brachytherapy instrument and method” discloses a brachytherapy instrument and method for delivering therapeutic substances such as radioactive seeds, to internal organs, such as the prostate.
  • the instrument includes a needle and a stylet which are capable of reciprocating relative to one another, but which can be selectively fixed against such movement.
  • the needle is loaded with radioactive seeds, and the stylet advances the seeds to the distal end of the needle.
  • a device for targeted delivery of a substance into a tissue comprising an elongated housing having a lumen along a length of said elongated housing and a hollow tubular member capable of substance delivery, said hollow tubular member being positionable within said lumen, wherein said elongated housing and said hollow tubular member are designed such that when a portion of said hollow tubular member is positioned past an orifice of said lumen, said portion protrudes from said lumen at an angle with respect to a longitudinal axis of said elongated housing.
  • the medical device further comprising a mechanism adapted for pushing the substance through the hollow tubular member.
  • the mechanism includes a plunger being insertable into the hollow tubular member.
  • the device is configured for allowing the hollow tubular member to change an azimuthal position with respect to the tissue.
  • the elongated housing comprises a substantially tapered tip being designed for allowing introduction of said elongated housing into the tissue.
  • the tapered tip is pointed.
  • the hollow tubular member is made of a super elastic material.
  • the substance is a radioactive source.
  • the hollow tubular member is configured as an angled hollow tubular member such that the portion thereof protrudes from the lumen at an angle with respect to the longitudinal axis of the elongated housing.
  • the orifice is configured for creating the angle between the longitudinal axis and the portion.
  • the hollow tubular member further comprises a substantially pointed tip, said tip being designed for protruding through the tissue.
  • the orifice is further designed for blocking body fluids from entering into said lumen.
  • a method for targeted delivery of a substance into a tissue comprising: (a) positioning in the tissue a device comprising: (i) an elongated housing having a lumen along a length of the elongated housing; and (ii) a hollow tubular member capable of delivering the substance into the tissue; wherein the elongated housing and the hollow tubular member are designed such that when a portion of the hollow tubular member is positioned past an orifice of the lumen, the portion protrudes from the lumen at an angle with respect to a longitudinal axis of the elongated housing; (b) advancing the hollow tubular member within the elongated housing such that the portion thereof is positioned past the orifice of the lumen and in proximity to a first region of the tissue; and (c) delivering the substance to the first region of the tissue through the
  • the method further comprises changing an azymuthal position of the hollow tubular member with respect to the tissue and delivering the substance to a second region of the tissue through the hollow tubular member.
  • changing the azymuthal position of the hollow tubular member with respect to the tissue is effected by retracting the hollow tubular member, repositioning the elongated housing in the tissue and advancing the hollow tubular member within the elongated housing such that the portion of the hollow tubular member is positioned in proximity to the second region of the tissue.
  • repositioning the elongated housing in the tissue is effected by rotating the elongated housing about the longitudinal axis.
  • changing the azymuthal position of the hollow tubular member with respect to the tissue is effected by rotating the hollow tubular member about the longitudinal axis.
  • the hollow tubular member is made of a super elastic material.
  • step (b) is effected via a plunger positioned within the hollow tubular member.
  • the substance is a radioactive isotope.
  • the present invention successfully addresses the shortcomings of the presently known configurations by providing a medical device for targeted delivery of a plurality of doses to a few pre-determined points that are not co-linear, through a single penetration hole; thus minimizing damage caused to healthy tissue in the proximity of the tissue to be treated.
  • FIGs. 1 A-IB illustrate a device used for targeted delivery of a substance to a tissue, according to a preferred embodiment of the present invention
  • FIGs. 2A-2E illustrate use of the present device in a method of targeted delivery of a substance to a tissue
  • FIGs. 3A-3B illustrate the distal end of the elongated housing according to two embodiments of the present invention
  • FIGs. 4A-4B illustrate a device used for targeted delivery of a substance to a tissue, according to another embodiment of the present invention
  • FIGs. 5A-5C illustrate the use of a guiding sleeve for advancing hollow tubular member according to a preferred embodiment of the present invention
  • FIG. 6 illustrates a device for targeted positioning of a plurality of substances within a tissue according to another embodiment of the present invention
  • FIG. 7 illustrates a device for targeted positioning of a plurality of doses within a tissue according to yet another embodiment of the present invention.
  • FIG. 8 illustrates a device used for targeted delivery of a substance to a tissue, according to an additional embodiment of the present invention.
  • the present invention is of a medical device for targeted delivery of a substance into a tissue. Specifically, the device enables delivery of a substance to a number of pre-determined sites within a targeted tissue through a single penetration procedure, thus minimizing tissue damage which can result from tissue penetration.
  • the present invention describes a device designed for specifically addressing this limitation of prior art devices.
  • a device for multiple targeted delivery of a substance to a tissue examples include, but are not limited to, imaging markers such as radioactive sources, contrast agents and the like, medicaments used for treating specific tissue regions or tissue ablating substances used for region specific tissue ablation. Such substances can be delivered to any body tissue in need of treatment or ablation.
  • the substance deliverable by the present device is a flexible radioactive source that is associated with a flexible wire; that is, either the flexible wire is coated with the radioactive source or the radioactive source may be contained within a hollow flexible wire.
  • a radioactive source which can be used by the present invention include, but are not limited to, is preferably a relatively short lived radio-isotope, such as, but not limited to, Radium-223, Radium-224, Radon-219,
  • the radioactive source is preferably a relatively short lived radio-isotope, such as, but not limited to, Radium-223, Radium-224, Radon-219, Radon-220 and the like.
  • Radium 223 When Radium 223 is employed, the following decay chain is emitted therefrom:
  • Ra-223 decays, with a half-life period of 11.4 d, to Rn-219 by alpha emission;
  • Rn-219 decays, with a half-life period of 4 s, to Po-215 by alpha emission;
  • Po-215 decays, with a half-life period of 1.8 ms, to Pb-211 by alpha emission;
  • Pb-211 decays, with a half-life period of 36 m, to Bi-211 by beta emission;
  • Bi-211 decays, with a half-life period of 2.1 m, to Tl-207 by alpha emission; and Tl-207 decays, with a half-life period of 4.8 m, to stable Pb-207 by beta emission.
  • the decay chain begins with the decay of Rn-219 to Po-215, and continues to Pb-211, Bi-211, Tl-207 and Pb-207.
  • Radium 224 is employed, the following decay chain is emitted therefrom:
  • Ra-224 decays, with a half-life period of 3.7 d, to Rn-220 by alpha emission;
  • Rn-220 decays, with a half-life period of 56 s, to Po-216 by alpha emission;
  • Po-216 decays, with a half-life period of 0.15 s, to Pb-212 by alpha emission; Pb-212 decays, with a half-life period of 10.6 h, to Bi-212 by beta emission;
  • Bi-212 decays, with a half-life of Ih, to Tl-208 by alpha emission (36 % branching ratio), or to Po-212 by beta emission (64 % branching ratio);
  • Tl-208 decays, with a half-life of 3m, to stable Pb-208 by beta emission; and Po-212 decays, with a half-life of 0.3 ⁇ s, to stable Pb-208 by alpha emission.
  • the decay chain begins with the decay of Rn-220 to Po-216, and continues to Pb-212, Bi-212, Tl-208 (or Po-212) and Pb-208.
  • radioactive sources are positioned in proximity to and/or within the tissue, a plurality of short-lived atoms are released into the surrounding environment and dispersed therein by thermal diffusion and/or by convection via body fluids.
  • FIG. 1 a device for targeted delivery of a substance to the tissue, which is referred to herein as device 10.
  • Device 10 includes an elongated housing 12 having a lumen 16 running along a length thereof.
  • Device 10 further includes a hollow tubular member 14 that is positionable within lumen 16 and is designed capable of substance 20 delivery.
  • Elongated housing 12 and/or hollow tubular member 14 are designed such that when a portion 40 of hollow tubular member 14 is positioned past an orifice 42 (as seen in Figure 2C) of lumen 16, portion 40 protrudes from lumen 16 at an angle 44 with respect to a longitudinal axis 28 of elongated housing 12.
  • Elongated housing 12 is fabricated from a biocompatible and preferably rigid material such as stainless steel or Titanium.
  • Elongated housing 12 is preferably cyliiidrically shaped (i.e., round cross section) and formed as a needle; however, various cross-sectional shapes, e.g. a hexagon, an ellipse, a square and the like are also envisaged.
  • Elongated housing 12 is preferably selected of a cross sectional shape and dimensions which enable smooth translational and rotational motion within a tissue 24 following penetration thereof through hole 26.
  • Elongated housing 12 is fabricated having a length of about 1 - 15 cm and a diameter of about 0.5 - 3.0 mm.
  • elongated housing 12 is designed for penetrating easily into and through tissue 24 by having either a tapered tip 32 or a pointed tip 34 disposed at distal end 36 of elongated housing 12 (as shown in Figures 3A-3B).
  • Tapered tip 32 (or pointed tip 34) is designed for allowing non traumatic introduction of device 10 into tissue 24 thus creating penetration hole 26.
  • tapered tip 32 (or pointed tip 34) is an integral part of elongated housing; however, tapered tip 32 (or pointed tip 34) may also be attached to elongated housing 12 at its distal end 36.
  • Lumen 16 of elongated housing 12 has two or more openings, orifice 42 at or close to distal end 36 of elongated housing 12, and orifice 54 at or close to proximal end 37 of elongated housing 12.
  • Lumen 16 preferably has a diameter of about 0.4 — 3.0 mm and is configured such that hollow tubular member 14 can be positioned and moved within it.
  • Lumen 16 preferably has a circular cross section, although other cross sectional shapes such as a square or an ellipse are also contemplated herein.
  • Hollow tubular member 14 is configured for sliding and rotating within lumen 16 of elongated housing 12.
  • hollow tubular member is fabricated for protruding through tissue 24 and thus has a distal end 15 that is either tapered or pointed (see Figures 2E and 4A-5C).
  • hollow tubular member 14 is about 1- 100 cm long and has an inner diameter of about 0.4 — 3.0 mm so as to enable conduction of substance 20 (preferably radioactive material in the form of seeds) to a tissue.
  • hollow tubular member 14 and/or elongated housing 12 are designed such that a portion 40 of hollow tubular member 14 protrudes at an angle 44 from longitudinal axis 28 of elongated housing 12 when advanced out of lumen 16 through orifice 42.
  • hollow tubular member 14 can be fabricated from a super-elastic material that is angled (has a bend or a kink) in its natural state and forced straight when disposed within lumen 16.
  • a suitable material is NITESfOL.
  • hollow tubular member 14 can also be made of a shape memory polymer that can be straight at room temperature and angled at body temperature.
  • hollow tubular member 14 to angle when protruding from lumen 16 enables portion 40 to diverge from longitudinal axis 28 when free of lumen 16. Such divergence of portion 40 from longitudinal axis 28 enables a distal end 15 of hollow tubular member 14 to reach any distance which is smaller than a maximal distance 46 (designated by D in Figure IB). Furthermore, a trajectory which diverges from longitudinal axis 28 is formed as portion 40 is advanced. The trajectory is set by distal end 15 on which forces are applied on by tissue 24, and the rest of portion 40 simply follows. Moreover, hollow tubular member 14 fabricated from a super-elastic material, when retracted after positioning of the substance, returns to its pre-deployed position and shape while moving along the trajectory but in the reverse direction.
  • portion 40 is made possible by either having hollow tubular member being naturally straight; and when advanced forward it is deflected while protruding tissue 24 (as described in conjunction with Figures 4A-4B); or by having hollow tubular member 14 having a natural shape of an arc or a helix (or any other shape suitable) which is confined by inner walls of lumen 16 to be straight, and when advanced beyond orifice 42 returns to the natural shape, thus enabling distal end 15 of hollow tubular member 14 to follow the desired trajectory towards pre- determined point 22. While protrusion of portion 40, tissue 24 may apply a resisting force on distal end 15 and or on the sides of hollow tubular member 14. Having the knowledge of all forces applied enables the calculation of the trajectory portion 40 will follow, thus enabling the positioning of substance 20 at pre-determined point 22.
  • portion 40 forms an arc (part of a circle of given radius R), when it protrudes from lumen 16.
  • a substance 20 e.g. radioactive source
  • D the maximal distance D, from longitudinal axis 28, Substance 20 can reach
  • D 2R (as can be seen in Figure IB).
  • the azimuthal direction of this path is determined by the orientations of rigid elongated housing 12 around its own axis and of hollow tubular member 14 around its own axis.
  • the final placement of substance 20 in its predetermined point 22 may be effected in two ways which are further discussed herein below in conjunction with Figure 2E.
  • hollow tubular member 14 is angled by designing lumen 16 and orifice 42 of elongated housing 12 as illustrated in Figures 4A-4B. Orifice 42 is placed close to distal end 36, and lumen 16 runs straight along the proximal part of elongated housing 12 and is bent towards orifice 42 as it approaches distal end 36. Advancing hollow tubular member 14 causes it to bend according to the curved part of lumen 16 and thus angled when it is advanced past an orifice 42. In such a configuration, when portion 40 is pushed into a tissue 24, it retains an angled straight direction and thus continues to penetrate the tissue 24 along a straight line forming an angle 44 with longitudinal axis 28.
  • Hollow tubular member 14 can also be angled by a guiding sleeve 50 which is disposed within lumen 16 (see Figures 5A-5C).
  • Guiding sleeve 50 is configured such that hollow tubular member is deflected and thus angled when it is advanced past an opening 52 of guiding sleeve 50. In such a configuration, when portion 40 is pushed into a tissue 24, it retains an angled straight direction and thus continues to penetrate the tissue 24 along a straight line forming an angle 44 with longitudinal axis 28. This embodiment is further discussed below with respect to Figures 5A-5C.
  • a distal part of hollow tubular member 14 has a natural helical shape when free (as can be seen in Figure 8). Inserting hollow tubular member 14 into lumen 16 causes it to be held straight due to the forces applied by lumen walls of elongated housing 12. When hollow tubular member 14 is advanced forward such that portion 40 protrudes through orifice 42, it returns to its natural shape of a helix.
  • the super-elastic element e.g. NITINOL
  • the super-elastic element used for construction of hollow tubular member 14, return to its original shape after being subjected to the applied strain (either return to an angled shape when free of lumen 16, or return to a linear state when disposed within guiding sleeve 50).
  • device 10 is either attachable to, or further includes a delivery mechanism 18.
  • Mechanism 18 can be a simple syringe in which case hollow tubular member 14 can be adapted at a proximal end thereof for syringe attachment.
  • mechanism 18 is a plunger 48 which is disposed within hollow tubular member 14 and is designed for pushing substance 20 through and out of hollow tubular member 14 to pre-determined point 22 in a tissue 24.
  • plunger 48 is made of a super elastic material as NITINOL or a shape memory material such that it conforms and follows the shape of hollow tubular member 14.
  • Plunger 48 is preferably about 1 - 100 cm long and about 0.1 - 3 mm thick so as to fit within hollow tubular member 14.
  • FIG. 2A-2E illustrating use of device 10 in a method of targeted delivery of a substance to the tissue.
  • Figure 2 A illustrates device 10 prior to insertion into tissue 24.
  • hollow tubular member 14 is retracted and completely contained within elongated housing 12
  • mechanism 18 is also at a retracted position
  • substance 20 is at or close to distal end 15 of hollow tubular member 14.
  • Figure 2B illustrates device 10 inserted into tissue 24 through penetration hole 26.
  • mechanism 18 is still in a retracted position, thus substance 20 remains in its position within hollow tubular member 14.
  • the azimuthal position of hollow tubular member 14 is adjusted by either rotating elongated 12 about longitudinal axis 28, or by rotating hollow tubular member 14 about longitudinal axis 28, or by rotating both elongated housing 12 and hollow tubular member 14 about longitudinal axis 28.
  • Figure 2C illustrates device 10 wherein hollow tubular member 14 is advanced so that distal end 15 protrudes through orifice 42 and portion 40 diverges from longitudinal axis 28, thus creating angle 44 with longitudinal axis 28. Additionally, mechanism 18, which may be a plunger 48, is still retracted and therefore substance 20 is contained within hollow tubular member 14 at or close to distal end 15. Furthermore, distal end 15 is at proximity with pre-determined point 22.
  • Figure 2D illustrates the final step of positioning substance 20 at predetermined point 22. At this state mechanism 18 has been activated to a deployed state, thus pushing substance 20 out of hollow tubular member 14.
  • Figure 2E illustrates two manners of transferring substance 20 from distal end 15 of hollow tubular member 14 to pre-determined point 22 within the tissue.
  • mechanism 18 in this case plunger 48, is advanced forward, thus pushing substance 20 out of hollow tubular member 14.
  • mechanism 18, in this case plunger 48 is held fixed while hollow tubular member 14 is retracted with respect to plunger 48. Retraction of hollow tubular member 14 is effected until substance 20 is ejected from tubular member 14 and thus placed at pre-determined point 22.
  • substance 20 is preferably made of a solid material thus enabling it to more effectively penetrate tissue 24.
  • a plurality of doses may be inserted into hollow tubular member 14 as described hereinbelow in conjunction with Figures 6 and 7.
  • a plurality of doses may be positioned by inserting elongated housing 12 and following the steps described hereinabove. When completing the step of positioning substance 20 in pre-determined point 22, it is possible to retract hollow tubular member 14 out while holding elongated housing 12 fixed in its place, and re-inserting either the same or a new hollow tubular member 14 with a new dose of substance 20.
  • FIGS. 4A-4B illustrating a device for targeted delivery of a substance to the tissue, according to another embodiment of the present invention.
  • Orifice 42 is positioned on a side wall close to distal end 36 of elongated housing 12. Additionally, lumen 16 running along longitudinal axis 28 from the proximal end of elongated housing 12 is angled towards orifice 42.
  • hollow tubular member 14 which is initially positioned in the straight part of lumen 16, is advanced towards orifice 42.
  • Advancing hollow tubular member 14 through orifice 42 causes portion 40 to protrude in a straight line that creates an angle 44 with respect to longitudinal axis 28.
  • Advancing hollow tubular member 14 enables the positioning of substance 20 at pre-determined point 22 after activating mechanism 18.
  • FIGS 5A-5C illustrating the use of a guiding sleeve for advancing hollow tubular member according to a preferred embodiment of the present invention.
  • Guiding sleeve 50 is fabricated to fit within lumen 16 and to carry hollow tubular member 14 therewithin. By slightly retracting guiding sleeve 50 before and after the insertion of the hollow tubular member 14 into lumen 16, elongated housing 12 is effectively blocked. In this state body fluids cannot penetrate lumen 16 when its content is not there.
  • guiding sleeve 50 is in a retracted position, as can be seen in Figure 5 A, thus preventing hollow tubular member 14 to protrude through an opening 52.
  • FIG. 5B shows the combination of using guiding sleeve 50 with hollow tubular member 14 having a circular or a helical natural shape.
  • Figure 6 illustrating a device for targeted positioning of a plurality of substances within a tissue according to another embodiment of the present invention.
  • Elongated housing 12 contains more than one hollow tubular members 14A and 14B (the figure shows two, but more are possible too). Hollow tubular members 14A and 14B are arranged so that they can be advanced separately but it is possible to advance them together. Furthermore, hollow tubular members 14A and 14B are arranged so that they protrude in different directions. This configuration may be used for co-delivering doses of the same substance, or doses of different substances. For example: hollow tubular member 14A can be used for delivering radioactive seeds for brachytherapy treatment at one set of pre-determined points while hollow tubular member 14B can be used for placing a medication such as an anti inflammatory at a different set of pre-determined points.
  • Figure 7 illustrating a device for targeted positioning of a plurality of doses within a tissue according to yet another embodiment of the present invention.
  • the drawing shows a plurality of doses of a substance (indicated by 2OA, 2OB, 2OC, and 20D) arranged in a sequence and ready for positioning at a plurality of predetermined points 22A, 22B, 22C, and 22D. It is also possible to have each of plurality of doses 20A-20D being different substances to be delivered for treatment as prescribed. It is appreciated that when one dose (for example 20A) is positioned in its pre-determined point (for example 22A), the next dose (for example 20B) is pushed forward within hollow tubular member 14, being ready for positioning in the next predetermined point (for example 22B).

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Abstract

L’invention concerne un dispositif médical et une méthode pour la distribution ciblée d'une substance dans un tissu. Le dispositif comprend un logement allongé ayant une lumière le long d'une longueur du logement allongé, et un membre tubulaire creux capable de distribuer une substance. Le membre tubulaire creux est positionnable dans la lumière et, le logement allongé et le membre tubulaire creux étant conçus de façon à ce qu’une portion du membre tubulaire creux soit placée au-delà d’un orifice de la lumière, la portion dépasse donc de ladite lumière sous un angle par rapport à un axe longitudinal du logement allongé. L'appareil médical comprend en outre un mécanisme prévu pour pousser la substance à travers le membre tubulaire creux.
PCT/IL2006/000668 2005-06-20 2006-06-07 Dispositif et méthode pour positionner une substance dans un tissu WO2006137051A1 (fr)

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US69178105P 2005-06-20 2005-06-20
US60/691,781 2005-06-20
US70715005P 2005-08-11 2005-08-11
US60/707,150 2005-08-11

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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2007059397A1 (fr) * 2005-11-10 2007-05-24 Biolucent, Inc. Appareil helicoidal pour brachytherapie et procedes pour son utilisation
US11419634B2 (en) 2018-08-17 2022-08-23 Empress Medical, Inc. Causing ischemia in tumors
US11419610B2 (en) 2018-08-17 2022-08-23 Empress Medical, Inc. Device and method for passing tension member around tissue mass

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