AMFİZEM MEMBRANE STENTİ

Abstract

The invention relates to an emphysema membrane stent (1) used in the endoscopic treatment of emphysema, which does not cause irreversible damage, can be easily removed when desired, does not require replacement, is easy to apply and can be repeated when desired, and is used in lung diseases.

Description

-1- TARIFF EMPHYSEMA MEMBRANE STENT Technical Area The present invention relates to stent structures used in lung diseases. The invention is particularly useful for the endoscopic treatment of emphysema that causes irreversible damage. non-existent, easily removable when desired, requiring no replacement, production Low-cost, easy-to-apply, and repeatable emphysema membrane 10 It is related to the stent. State of the Art Emphysema is the destruction of the alveoli in the lungs, either congenital or acquired. subsequently, air accumulates in the form of balloons of varying sizes. It is the emergence of their accumulated wealth. Emphysema areas cause loss of lung function in two ways. Firstly... due to the loss occurring in the lung areas that become nonfunctional, the second one is 20 Lung areas that have ballooned in shape depending on their size, unlike other normal areas. Emphysema results from the loss of function caused by applying pressure to certain areas. Medical treatment has no effect in its treatment. Emphysema patients eventually need a lung transplant. Lung 25 Until the transplantation stage, we provide emphysema patients with what we call bridging therapies. Temporary volume reduction support treatments are needed. These treatments may involve surgery or... These are endoscopic volume reduction treatments. Patients usually undergo surgical treatment around 30, depending on the severity of their general condition. They prefer endoscopic volume reduction therapy because it is not feasible for them. -2- Also, in some cases, especially those that cannot be surgically removed Endoscopic volume reduction therapies are generally preferred in centriacinary emphysema. is being done. Some known endobronchial volume reduction therapies, such as valve therapy, 5 The effect lasts for six months, and the valves, which are very expensive, need to be replaced. The method called coiling is irreversible and can lead to vascular complications. Therefore, its use is banned in some Western countries. In addition to these, we may also see steam and adhesives, which are still in the experimental stage. These methods can be counted among the endoscopic treatments of emphysema. All of these In such circumstances, the need to develop new techniques arises. In application number CN219148053 (U), unidirectional ventilation is recommended for the treatment of emphysema. The implanted valve structure with this function is described. The technique mentioned is used in emphysema. with an implanted valve that has a one-way ventilation function for treatment It is related and belongs to the technical field of medical instruments. An implanted valve is a woven material. It has a support structure and a cylindrical head section close to the pulmonary alveolus, and It includes a tail portion away from the pulmonary alveolus, and the outer diameter of the head portion is 20 cm. It is larger than that portion. However, new techniques for endoscopic treatment of emphysema. Improvements are needed. In conclusion, endoscopic treatment of emphysema can cause irreversible damage. not included, can be easily removed when desired, does not require replacement, production 25 a new technique that is low cost, easy to implement, and repeatable when needed Improvements are becoming necessary. -3- Explanation of the Purposes of the Discovery Based on the current state of the art, the aim of the invention is to improve existing structures. The goal is to eliminate these problems and develop an emphysema membrane stent. Another aim of the invention is to provide endoscopic treatment for irreversible emphysema. The goal is to develop a stent structure that does not cause damage. Another purpose of the invention is to provide a comfortable, on-demand solution for endoscopic treatment of emphysema. The goal is to develop a stent that can be removed in some way and does not require replacement. 10 Another aim of the invention is to provide an easily applicable endoscopic treatment for emphysema. It is the development of a new stent that can be replicated when needed. Another aim of the invention is to develop 15 methods that could be effective for endoscopic treatment of emphysema. It is the development of membrane stents. In order to achieve the aforementioned goals, technology, with its significant technical advantages, An emphysema membrane stent that surpasses known capabilities has been developed. Explaining the Figures Figure 1; A representative application of the invention showing the structure of an emphysema membrane stent and These are the drawings that illustrate the process. Figure 2; A representative application of the invention with one, two, three, 25 different membrane structures. Top views of four, five, six, or seven-chambered emphysema membrane stents. These are drawings. Figure 3; A representative application of the invention with an emphysema membrane stent in the right upper lobe. These are drawings of anterior subsegment treatment. Figure 4; A representative application of the invention: emphysema membrane stent placed 30° distal to the bronchus. These are diagrams illustrating two different membrane operating principles. -4- Figure 5; A representative application of the invention showing the quadruple stent feet and foot projections. and drawings of the movement mechanism. Figure 6; A representative application of the invention showing the six-legged stent feet and foot projections. and drawings of the movement mechanism. Figure 7; A representative application of the invention showing the movable stent feet, foot 5 These are drawings of its protrusions and movement mechanism. Reference Numbers Detailed Explanation of the Discovery The invention is used in the treatment of lung diseases, specifically for the endoscopic treatment of emphysema. 15 that does not cause irreversible damage and can be easily removed when desired. Emphysema that does not require modification, is easy to administer, and can be repeated when desired. It is related to membrane stent (1). As shown in Figure 1; emphysema membrane stent (1), stent distal (2), distal aspirated air (3), foot protrusions (4), flexible bronchoscope (5), balloon (6), 20 1 Emphysema Membrane Stent 9 Membrane original orientation 2 Stent distal 10 Emphysematous right upper lobe 3 Air aspirated from the distal end 11. Upper right, treated for emphysema. lob 4 Foot protrusions 12. Right lung affected by atelectasis upper lobe apical segment Flexible bronchoscope 13. Right lung affected by atelectasis upper lobe posterior segment 6 Balloon 14. Right lung affected by atelectasis upper lobe anterior subsegment 7 Intermembrane space 15 Distal bronchus 8 Membrane reverse side 16 Membrane -5- intermembrane space (7), reverse direction of the membrane (8), original direction of the membrane (9), Memban (16) is shown. As can be seen in Figure 2; one, two, three, four or different membrane (16) structures Drawings of top views of the emphysema membrane stent with more chambers (1) 5 It has been given. Atelectasis is the collapse of part of the lung or one lung entirely. The result is that it cannot expand sufficiently and thus loses its function. Atelectasis In this case, lung parenchyma containing less air forms. This treatment procedure 10 As a result, atelectasis develops, causing loss of function due to air accumulation, and The ballooned lung, which was pressing on the adjacent lung, was deactivated, and The other lung areas that were relieved were able to regain their normal function. It is possible. In Figure 3, the right upper lobe (10) with emphysema and the lung image with emphysema treatment. The right upper lobe (11) is shown. The right lung upper lobe that has undergone atelectasis. apical segment (12), posterior segment of the right lung upper lobe that was subjected to atelectasis (13), right lung upper lobe anterior subsegment with atelectasis (14) It is shown. 20 In Figure 4, the distal bronchus (15) on the emphysema membrane stent (1), inside The movement of the membrane (16) is shown. Figure 5 shows the quadruple stent feet, foot projections, and movement mechanism. 25 This is shown in Figure 6, which illustrates the feet, foot projections, and movement of the six-stent structure. The mechanism is shown. In Figure 7, the movable stent feet are shown positioned on the foot. The protrusions and movement mechanism are shown. Emphysema Membrane Stent (1), Silicone or Polyurethane or any other inert 30 It can be made from an elastic material. Membranes (16) are inside the stent that will block the stent. It is laid in two, three, or four layers in the region. -6- Emphysema Membrane Stent (1), segment bronchi or smaller subsegment to the bronchi or lobar bronchi or to the main bronchi as appropriate to the purpose It is even capable of being installed. Two sheets in the middle made of silicone or polyurethane or another inert elastic material. or three-leaf or four-leaf or more-leaf membranes (16) or conical, with a hole in the middle, or other geometric shapes, between or in the middle It is an elastic structure with a potential or actual gap or opening. Depending on the diameter of the bronchus in which it will be placed, tubes of different diameters and different types of tubes are used. Leaf membranes are of various sizes (16) or conical or have different geometric structures. An elastic tube made of silicone, polyurethane, or another inert material. a thin bronchoscope, aspiration cannula, or transbronchial needle is inserted in the middle and 15 the lung that is emptied when air is drawn back out after being aspirated There is no air leakage in this section. Membranes (16) that will prevent air from entering during the aspiration process There are leaf membranes (16) designed in this way. Among the membranes (16), 20 to prevent air entry during aspiration, around the catheter or around the bronchoscope or around the cannulas used for aspiration or a balloon (6) or membrane (16) that blocks it may be placed on it. The membrane (16) or balloon (6) that will act as this blocking membrane (16), 25 an adjacent structure on the bronchoscope, cannula, or catheter used for aspiration A membrane that can be found in pieces or used as a separate piece. (16) or balloon (6) or in the form of various geometric structures. By entering the emphysematous subsegment through these membranes (16), the segment or 30 Air is evacuated from the subsegment. Atelectasis of the emphysematous lung segment. -7- The discharge is ensured. The procedure is performed under fluoroscopy or directly with a bronchoscope without fluoroscopy. That can also be done. Emphysematous area in a lung segment, subsegment, or lobe after being deflated, cannula or catheter or transbronchial needle or bronchoscope 5 After withdrawal, the procedure is performed by lowering the blocking membrane (16) or balloon (6) on it. It can be terminated. This process allows air to refill the treated area of ​​the lung afterwards. It can be repeated in this case. The procedure can be performed under fluoroscopy or directly without fluoroscopy. 10 It can be done. Before the procedure, mucosal tissue was injected into the patient's segmental bronchus with a Karakoca COPD Balloon (6). resection is performed, thereby allowing secretion to develop and the implanted device to interact with the secretion. Blockage is prevented. 15 Before the whole bronchial system is treated with COPD balloon (6) up to the distal bronchus. It can be cleaned. Emphysema membrane stent (1) with the aid of rigid or flexible bronchoscope (5) It gets stuck in the bronchus. 20 The emphysematous segment is deflated by aspirating the air inside. The patient undergoes CT scans every two months. The procedure is monitored, and if emphysema recurs, the same process is repeated. Patient preparation is as follows: 25 CT scan, SFT (Sphere Aspiration Test), V / P (Visual Pulmonary Test) Scintigraphy, Routine Consultations, TOBI or COLISTIN for at least four weeks. with inhalation therapy before the procedure, preoperative antibiotics and antibiotics performing anti-inflammatory treatment, mucosal resection with COPD Balloon (6) It is in this form. Emphysema Membrane Stent (1), made of silicone or polyurethane or other inert material The stent is made of a material with a cylindrical, conical, or other geometric shape, and its length is 10- -8- 15-20 mm; diameter 2-3-4-5-6 or other sizes and diameters, outside the stent. There are foot protrusions (4) at different intervals and in different geometric shapes, and these The protrusions function to allow the stent to adhere to the bronchial cartilage. The lengths, diameters and geometric shapes of these foot projections (4) vary in size and 5 They can be in various forms. One or more of these can be located at different points between the head and end of the stent. Multiple membranes (16) may be found. The membranes (16) inside the stent are different. They may have been placed in those dimensions. The membranes inside the stent (16) can have different shapes. These membranes 10 (16) two-sided or centrally opening membranes or multi-layered membranes (6) It can be opened as [this option]. Through the membranes (16) with a bronchoscope or cannula or transbronchial needle When passing through, the membrane (16) openings should face into the bronchus, i.e., distally, in the direction 15 During the procedure, the membrane opening is placed outside the bronchus with the help of a balloon (6) after the procedure. that is, it will shift in the opposite direction so that it will face proximal or to the balloon (6) It can return to its original shape directly through its own stretching properties without needing any further intervention. an opening between membranes (16) which can be returned to their original direction by mechanical action. will not happen or the leaves may sit on top of each other or push against each other 20 There will be a potential gap that opens up. The stent's opening can be conical, cylindrical, or otherwise shaped for insertion. It is designed in geometric shapes. Inside the stent, in two, three, or four stages. These chambers will contain air pockets through which air aspirated from the bronchi will pass via the cannula. 25 to prevent air from re-entering and to create a barrier when pulling It will function. Through a thin bronchoscope with a channel inside the tube, visualization is performed or aspiration cannulas are used. or aspiration is performed using transbronchial needles. The procedure is necessary if 30 in this case, under single lung ventilation using a double lumen endotracheal tube or the withdrawal procedure will be performed under total anesthesia by stopping the airflow -9- thus, the lung segment from which air is removed by aspiration during the procedure, or air directly into the subsegment, lobe, or the entire lung during the procedure His departure will be prevented. Emphysema membrane stents (1) are one of the important complications of other stents. It was developed to prevent migration. Emphysema membrane stents (1) into the bronchi It was developed for situations where the correct diameter cannot be measured after insertion. Emphysema membrane stents (1) migration of stents in case of inability to obtain precise measurements It was developed to prevent the need for stent replacement in such cases. The feet of emphysema membrane stents (1), the foot projections (4) are fixed or 10 It is mobile and can be opened to increase the height of the legs when needed. It has been developed. Emphysema membrane stents (1) are placed in the bronchus by changing the stent wall thickness. It was developed for adjusting the diameters of the fittings. 15 Emphysema membrane stents (1), stent wall is uniform or uneven throughout. It is designed to be of a certain thickness and to be homogeneous or not. Emphysema membrane stents (1) are available with varying stent wall thicknesses. Emphysema membrane stents (1) are designed with movable 20 in the stent wall. stent foot, foot protrusions (4), stent with its own thickness when folded in the opposite direction It will be converted to the sum of the wall thicknesses. Emphysema Membrane Stents (1) have diameters of 2-3-4-5….20 mm or other diameters. It is possible. Emphysema Membrane Stents (1) prevent slippage from the bronchi 25 feet that will obstruct, foot protrusions (4) fixed or foldable movable it could be. Movable foot projections (4) on Emphysema Membrane Stents (1) By rotating the stents, they open and thus increase the height of the foot protrusions (4) 30 It is possible. -10- After inserting the Emphysema Membrane Stent (1) into the bronchus over the bronchoscope with a bronchoscope or a balloon to be inserted (6) or with forceps in the opposite direction by turning the feet, move the foot protrusions (4) and open them to the other side It is folded to ensure it fits snugly against the bronchial wall. After the Emphysema Membrane Stent (1) is placed on the bronchial wall, the bronchoscope Air aspiration is stopped and the bronchoscope is used while the stent remains attached to the wall. It is removed. The invention relates to an emphysema membrane stent (1) used in lung diseases, 10 Its feature is that it does not cause irreversible damage for endoscopic treatment of emphysema. Emphysema that can be easily removed when desired and does not require replacement. to form a membrane stent (1) into segment bronchi or smaller into the subsegmental bronchi or lobar bronchi or as appropriate to its purpose The trunk, which can be placed even in the main bronchi, has at least one membrane in the inner middle of the trunk (16) 15 and / or at least one support outside the stent for the stent to adhere to the bronchial cartilage. It is characterized by having a protrusion (4) or protrusions. The body is made of silicone, polyurethane, or any other inert elastic material. It contains. The inner part of the body has a silicone or polyurethane or other inert elastic material in the middle. 20 material with two leaves, three leaves, four leaves or more leaves It contains membranes (16). An elastic tube made of silicone, polyurethane, or another inert material. a thin bronchoscope or aspiration cannula in the middle of the body or 25 When air is aspirated using a transbronchial needle and then withdrawn, it returns to its original position. membranes that prevent air from escaping into the evacuated lung chamber (16) includes. 30 membranes (16) that will prevent air entry during the aspiration process leaf membranes designed in this way (16), among the membranes (16) to prevent air entry during aspiration, around the catheter or -11- around the bronchoscope or around the cannulas used for aspiration or contains a balloon (6) or membrane (16) that blocks it. Emphysema is placed in the relevant bronchus with the help of a rigid or flexible bronchoscope (5). Includes membrane stent (1). Single or multi-leaf with bilateral or central opening feature 5 It contains a membrane (16). A conical or cylindrical, geometrically shaped stent designed for insertion into the body. The opening of the stent draws out air aspirated from the bronchi through the cannula. 10 that function to prevent air from re-entering and create a barrier. two, three, or four or more air chambers, tube-shaped casing by visualization through a thin bronchoscope with a channel inside, or through aspiration cannulas or Aspiration is performed using transbronchial needles, the procedure is necessary. in this case, under single lung ventilation using a double lumen endotracheal tube or by stopping the airflow under total anesthesia and performing the withdrawal procedure, the procedure takes 15 minutes. to the lung segment or subsegment from which air is removed by aspiration during the procedure or prevents air from going directly to the lobe or the entire lung during the procedure It contains a membrane (16) that forms air chambers. By modifying the stent wall thickness, the diameters that sit in the bronchus are adjusted, 20 The stent wall will be of uniform or uneven thickness throughout and will be homogeneous. or a movable stent leg located in the stent wall, configured in such a way that it will not be present, When the foot protrusions (4) are folded in the opposite direction, their own thickness and the stent wall transforming into the sum of its thickness, preventing migration, after being placed in the bronchi It can be used in situations where the correct diameter cannot be measured, and precise measurements cannot be taken. 25 In cases of stent migration, stent replacement can be avoided. made of silicone, polyurethane, or another inert material to allow passage The body is in the form of an elastic tube, fixed or movable, and can be extended in length as needed. Includes stent feet or foot protrusions (4) that can increase. After inserting the bronchoscope into the bronchus, the bronchoscope or the tube is inserted into it. by inserting a balloon (6) or by turning the feet in the opposite direction with forceps, -12- by moving and unfolding the foot projections (4) and folding them to the other side, to the bronchial wall With the stent securely positioned and attached to the wall, the bronchoscope is withdrawn. It includes a detachable body that can be fixed in place.

Claims

-13- REQUESTS 1. The invention relates to an emphysema membrane stent (1) used in lung diseases. Its characteristic feature is that it causes irreversible damage for endoscopic treatment of emphysema. 5 that are not present, can be easily removed when desired, and do not require replacement. To form an emphysema membrane stent (1), - to the segment bronchi or smaller subsegment bronchi or lobes into the bronchi or, as appropriate for the purpose, even into the main bronchi. mountable body, - at least one membrane in the inner middle of the body (16) and / or 10 - At least one foot projection outside the stent is required for the stent to adhere to the bronchial cartilage. (4) or is characterized by a protrusion.

2. The emphysema membrane stent (1) conforming to Request 1 is characterized by: 15 made of silicone or polyurethane or any other inert elastic material It contains a body.

3. The emphysema membrane stent (1) conforming to Request 1 is characterized by: - The inner part of the body, in the middle, is made of silicone or polyurethane or another inert elastic material. two-leaf, three-leaf, four-leaf or more of material It contains leafy membranes (16).

4. The emphysema membrane stent (1) conforming to Request 1 is characterized by: - an elastic tube made of silicone, polyurethane, or another inert material. a thin bronchoscope or aspiration cannula in the middle of the body or 25 when air is aspirated by inserting a transbronchial needle and then withdrawn to prevent air from escaping into the lung section that has been evacuated It contains membranes (16) that provide -14- 5. The emphysema membrane stent (1) conforming to Request 1 is characterized by: - air entry during aspiration between membranes (16) leaf membranes designed to block (16), - To prevent air from entering between the membranes (16) during aspiration. around the catheter or around the bronchoscope or for aspiration purposes 5 balloons (6) that block around or on the cannulas used or It contains a membrane (16).

6. The emphysema membrane stent (1) conforming to Request 1 is characterized by:  10 inserted into the relevant bronchus with the help of a rigid or flexible bronchoscope (5) It contains an emphysema membrane stent (1).

7. The emphysema membrane stent (1) conforming to Request 1 is characterized by: - single or multi-layered membrane with bilateral or central opening feature (16) It includes. 15 8. The emphysema membrane stent (1) conforming to Request 1 is characterized by: - conical or cylindrical, geometrically shaped, designed to have an inlet on the body. stent mouthpiece, - Air aspirated from the bronchi inside the stent is drawn out of the cannula again 20 It functions to prevent air from entering and to create a barrier. two or three or more stages of air chambers, – by visualizing through a thin bronchoscope with a channel inside the tube-shaped body, or aspiration using aspiration cannulas or transbronchial needles if necessary, a double-lumen endotracheal tube (25) is used. using air under single lung ventilation or total anesthesia by stopping the flow and performing a withdrawal procedure, and by aspirating during the process. to the lung segment or subsegment or lobe from which air has been evacuated or air that prevents air from going directly to the entire lung during the procedure It contains a membrane (16) that forms its chambers. 30 -15- 9. The emphysema membrane stent (1) conforming to Request 1 is characterized by: - By modifying the stent wall thicknesses, the diameters that sit in the bronchus can be increased. as adjusted, the stent wall has a thickness that is uniform or uneven throughout, and 5 in the stent wall, structured to be homogeneous or non-homogeneous. The movable stent foot, fixed or foot protrusions (4) are located in the opposite direction. When folded, it becomes the sum of its own thickness and the thickness of the stent wall. migratory devices, once placed in the bronchi, cannot be accurately measured. Stents can be used in situations where precise measurements cannot be taken. To avoid stent replacement in case of migration, 10 an elastic tube made of silicone or polyurethane or another inert material body in the form of, - A fixed or mobile stent that can be extended to increase its length when needed. It includes feet or foot protrusions (4).

10. The emphysema membrane stent (1) conforming to Claim 1 has the following characteristics: - After inserting the bronchoscope into the bronchus, either with the bronchoscope or inside it... by inserting a balloon (6) or by turning it in the opposite direction with forceps by moving and unfolding the feet, foot protrusions (4) and folding them to the other side Once firmly seated against the bronchial wall, the stent remains attached to the wall for 20 days. The bronchoscope contains a body that is fixed in position after being withdrawn.

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