Devices, Treatments, and Methods for Restoring Tissue Elastic Recoil - Patent application

Abstract

In consideration of the extensive tissue damage experienced by patients with advanced COPD, pulmonary treatment devices, systems, and methods of use are provided that provide treatments designed specifically to treat the particularly compromised lung tissue present in these patients. These treatments reduce trapped air volume, tension the lung tissue, and improve lung elastic recoil. In particular, various embodiments of invertible pulmonary treatment devices are provided. The devices are made of shape-memory material, allowing the devices to be expanded under tension and then recoil back toward their original relaxed or resting shape. In these embodiments, portions of the devices are invertible. Thus, each device is capable of storing energy, at least when inverted, which is utilized to continuously tension the lung as the device relaxes toward its original shape.

Description

[Technical Field]

[0001] (CROSS-REFERENCE TO RELATED APPLICATIONS) This application claims the benefit of U.S. Provisional Patent No. 62 / 945,510 (Attorney Docket No. 52086-707.101), filed December 9, 2019, the entire contents of which are incorporated herein by reference. [Background technology]

[0002] Chronic obstructive pulmonary disease (COPD) is a common, progressive, and debilitating lung disease that often leads to death. COPD patients are diagnosed with either emphysema, chronic bronchitis, or, more commonly, a combination of both. Symptoms of COPD include persistent coughing, especially one that produces excess mucus, shortness of breath (especially during exercise), wheezing during breathing, a barrel chest deformity, and chest muscle tension due to chest expansion associated with the barrel chest deformity. End-stage COPD presents with symptoms more closely related to slow, persistent suffocation, as the disease ultimately nearly completely blocks any outflow of gas from the lungs. While such symptoms may begin as a minor disruption to daily life, they often lead to difficulty speaking or even basic breathing. COPD reduces oxygen and carbon dioxide gas exchange, leading to circulatory problems such as low oxygen levels in the blood, brain, and heart muscle. This adversely affects mental alertness and contributes to an extremely rapid heartbeat due to increased strain on the heart.

[0003] According to the National Institutes of Health, COPD is the third leading cause of death in the United States. The American Lung Association reports that more than 11 million people in the United States have been diagnosed with COPD. However, approximately 24 million more people have the disease and may not know it. Worldwide, COPD affects approximately 65 million people.

[0004] COPD can occur in people who suffer from an inherited genetic condition called alpha-1 antitrypsin deficiency (A1AT deficiency) and from breathing air under environmental conditions such as air pollution and polluted air in less-than-ideal work environments. However, COPD most commonly occurs in people over the age of 40 with a history of smoking. Cigarette smoke contains over 4,000 different chemicals, many of which are toxic. Both the smoke inhaled by the smoker (through the filter) and the smoke emitted from the hot end are toxic. There are three major components that pose a health risk: tar, nicotine, and carbon monoxide. Tar settles in the lungs and stimulates a series of changes that lead to obstructive pulmonary disease and lung cancer. Nicotine, an additive in cigarettes, also stimulates the nervous system, reduces arteriolar diameter, releases adrenaline, and increases heart rate and blood pressure. Nicotine also increases the viscosity of blood platelets, which increases the risk of blood clots. Carbon monoxide binds irreversibly to hemoglobin so that oxygen is effectively unable to bind. This causes strain on the heart muscle, which must beat harder to provide the same amount of oxygen.

[0005] Cigarette smoke and secondhand smoke travel down through the trachea and into the bronchial tubes. The toxic smoke then travels into the bronchioles, which contain small clusters of air sacs known as alveoli. Within the alveoli are capillaries. In healthy individuals, oxygen travels through the alveoli into the capillaries and bloodstream during inhalation, allowing oxygen-rich blood to be distributed to the rest of the body via the arterial system. Simultaneously, carbon dioxide is transported from the blood, along the venous pathway, into the capillaries and into the alveoli during exhalation so that it can be removed from the body. This process is known as gas exchange. The elasticity of healthy air sacs allows this exchange to occur during the lung volume changes that accompany the breathing cycle. However, smoke inhalation ultimately destroys this elasticity and the lung tissue itself.

[0006] The effects of cigarette smoke on pulmonary elastin are remarkably complex, affecting many aspects of connective tissue metabolism. Cigarette smoke inhalation causes the accumulation of alveolar phagocytes within the respiratory bronchi, which appear pigmented and metabolically and morphologically activated. Activated phagocytes secrete chemoattractants and secretagogues for neutrophils and are capable of secreting metalloproteases and α1 antiproteases capable of digesting elastin. The end result is a cluster of numerous neutrophils and phagocytes, ready to release significant amounts of elastases at sites where the earliest signs of centrilobular emphysema are detected. This is visible on lung x-rays as small pockets of dissolved tissue known as alveoli. Additionally, alveolar phagocytes and cigarette smoke are rich sources of oxidants. One potential effect of these oxidants could be to oxidize the methionine residues found in the active sites of α1 protease inhibitors. This is demonstrated by selective chemical oxidation, which results in relatively ineffective inhibitors that associate with elastase approximately 2,000 times more slowly than the native protein. This leads to oxidative damage to lung cells and cellular components such as lipids, cofactors, and nucleic acids. Endogenous antioxidant systems in the lung, such as ceruloplasmin, vitamin C, or peptide methionine sulfoxide reductase, are adversely affected by cigarette smoke, reducing the lung's defenses against oxidation. The elastin maturation process is impaired by cigarette smoke.

[0007] Such damage affects the walls between the alveolar sacs. As the air sacs weaken, they break open or "melt," creating one air sac instead of many smaller ones. The total surface area of ​​the air sacs is reduced, which reduces the amount of gas that can be exchanged across the air sac walls. These gases are transported across the thin air sac membrane surface using the process of diffusion. By reducing the mass of the air sacs, the total surface area of ​​the sacs is limited, reducing gas exchange. This makes it more difficult for capillaries to absorb enough oxygen and for the body to expel carbon dioxide, making breathing progressively more difficult. In addition, the air sacs lose their elasticity and recoil, making it more difficult to expel air. The walls of the airways become thickened and swollen, while producing more mucus than normal, which can clog the airways and lead to air sacs. Thickening and mucus plugging are the chronic bronchitis components of COPD. All of these factors contribute to the symptoms of COPD.

[0008] Another common COPD symptom is air entrapment, which causes dysfunction and lobar and lung hyperinflation. The reduced volume achieved by the lungs after exhalation is determined by the balance of forces between inward elastic recoil pressure, i.e., the inward pulling tension of lung tissue that lifts the diaphragm, and outward recoil pressure, i.e., the outward pulling of the chest wall. The lungs are suspended in an expanded state between the chest wall and the lung's outer membrane due to negative pressure or vacuum. This vacuum expands the lungs and keeps them pinned to the chest wall. Because the lungs are held in a nearly expanded state, the internal lung tissue (parenchyma) is stressed under tension (generating lung elastic resistance to stretching, commonly referred to as lung elastic recoil). This tension draws airways radially outward throughout the lungs, helping to hold them open and allowing air to be squeezed out of the lungs during the expiratory breathing cycle. During exhalation, the diaphragm muscles relax, and the internal elastic recoil of the lungs lifts the diaphragm and lung bed, reducing lung volume and squeezing air out of the lungs. During inhalation, the diaphragm muscles contract, drawing the diaphragm downward, increasing lung volume and drawing air back into the lungs. Static hyperinflation occurs when, due to elastin breakdown, the lungs exert little recoil pressure to counter the recoil pressure of the chest wall. This results in a recoil force equilibrium at a higher-than-normal resting volume. In other words, there is little recoil, and therefore the diaphragm cannot lift as much, reducing the lung's ability to expel air. This produces a chronic increase in lung volume, also known as increased total lung capacity (TLC). Dynamic hyperinflation occurs when air is taken into the lungs after each breath due to an imbalance between inspired and expired volumes. This most commonly occurs during exercise, when inspiration is more efficient than expiration. With each breath, hyperinflation increases. The ability to exhale completely depends on airflow limitation and the time available for expiration. Both types of air intake cause 1) gas congestion in the lungs, preventing new oxygen from being inhaled, 2) retention of CO2 and blood flow within the lungs (hypoxemia), and 3) collapse of the better-functioning lobes, making them unable to inhale or exhale.This last phenomenon occurs because entrapment often occurs in the location with the most lung tissue destruction (the region with the greatest reduction in recoil). As more air is entrapped in this area and the lobe hyperinflates, it expands into areas where tissue is better preserved and still performing well, but the added pressure of the inflated tissue restricts airflow in and out of healthier areas.

[0009] Eventually, the enzymes destroy and eliminate airway and alveolar tissue. Large pores form within the alveolar bed, forming alveoli and alveoli. Alveoli are small, subpleural, thin-walled air pockets no larger than 1–2 cm in diameter. Their walls are less than 1 mm thick. If they rupture, they allow air to escape into the pleural space between the lung and chest wall, which usually uses a vacuum to expand the lung and keep it pinned to the chest wall, resulting in spontaneous pneumothorax or lung collapse. Alveoli, like alveoli, are cystic air spaces or pockets with imperceptible walls (less than 1 mm). The difference between alveoli and alveoli is generally considered their size, with a diameter of approximately 2 cm being the dividing line. Over time, alveoli can coalesce to form alveoli.

[0010] Smoking cessation remains an important therapeutic intervention for COPD. A step-by-step management approach includes: Stage I (mild obstruction): Short-acting bronchodilators as needed Stage II (moderate obstruction): short-acting bronchodilators, long-acting bronchodilators, cardiopulmonary rehabilitation as needed Stage III (severe obstruction): short-acting bronchodilators as needed, long-acting bronchodilators, cardiopulmonary rehabilitation, in case of repeated exacerbations, inhaled glucocorticoids Stage IV (very severe obstruction or moderate obstruction with evidence of chronic respiratory failure): Interventions such as short-acting bronchodilators as needed, long-acting bronchodilators, cardiopulmonary rehabilitation, in case of repeated exacerbations, inhaled glucocorticoids, long-term oxygen therapy (if criteria are met), lung transplantation, lung volume reduction surgery (LVRS), or implantable therapeutic devices.

[0011] Lung volume reduction surgery (LVRS) is a surgical procedure to remove diseased emphysematous lung tissue. This surgery removes up to one-third of the lung and attempts to remove non-gas-exchanging portions of the lung. It is intended to remove sections of dysfunctional tissue that can no longer exchange gases to and from the bloodstream. It also aims to remove blood vessels (the vessels that run through portions of the lung where gas cannot be exchanged) that would otherwise exchange less oxygenated blood with high levels of CO2 back to the heart and circulatory system. However, this surgery presents patients with a high risk of surgical-related morbidity and mortality. Patients who are already struggling to breathe due to the disease further suffer from severe orthopedic trauma due to the sternotomy, which presents difficulties in recovering these patients from general anesthesia. LVRS-related mortality and morbidity are common outcomes, as published in the National Emphysema Treatment Trial (NETT) report. NETT was a multicenter, randomized, controlled clinical trial that compared the effectiveness of lung volume reduction surgery (LVRS) plus medical management with rehabilitation with medical management with rehabilitation in 1,218 patients with severe emphysema.

[0012] LVRS is performed using a long, simple resection to remove a large portion of lung volume. Therefore, it is not discriminatory in the tissue removed. LVRS also removes portions of the remaining intact lung that would otherwise exchange gas. This reduces the lung volume through which the patient needs to exchange gas. LVRS is also ineffective for homogeneous disease, the type that most COPD patients suffer from. In homogeneous disease, the disease is uniformly spread throughout all lobes, without a discrete target lung volume that can be sacrificed to improve lung elastic recoil. Homogeneous patients require therapy because they suffer from insufficient lung volume for gas exchange. Removing more lung tissue merely reduces that volume. Therefore, surgery actually worsens these patients' breathing ability.

[0013] Various implantable therapeutic devices have been developed to help treat patients with COPD. One such device is the endobronchial valve. The endobronchial valve is a minimally invasive alternative to lung volume reduction surgery (LVRS). The endobronchial valve is designed to replicate the effects of that procedure without requiring an incision by allowing most of the diseased lobes of the lung to be pneumatically blocked so that air can be evacuated and collapse the treated lobe. An endobronchial valve is typically a small, one-way valve that is implanted so that when the patient exhales, air can flow out of the lobe through the valve, but when the patient inhales, the valve closes, blocking air from entering the lobe. Thus, a set of implanted endobronchial valves can help empty air from the lobe itself. Although this has been shown to be beneficial in treating a very small subset of patients with heterogeneous emphysema, such endobronchial valves suffer from some of the same limitations as LVRS. While successful in collapsing the lobes in homogeneous patients, endobronchial valves reduce their already inadequate lung capacity. Homogeneous disease is the type that most COPD patients suffer from. Therefore, the valve may actually impair these patients' ability to breathe. Another limitation of the valve is the fact that approximately 80% of patients exhibit additional flow pathways that connect into the lobes in addition to the main airway tree typically depicted in anatomical textbooks. Although the valve is designed to block flow within the airways, in the majority of patients, complete blockage or complete air pressure isolation can never be achieved, and the lobes never collapse. Often, alternative flow pathways are generated by enzymatic destruction due to the disease itself. This is particularly true in heterogeneous patients, where tissue damage is concentrated.

[0014] A similar type of therapy involves endoscopic volume reduction using a pulmonary sealant. A pulmonary sealant foam is deposited within the peripheral airways and alveoli, which polymerizes and acts as a tissue glue on the pulmonary lining to seal the target area and cause durable, irreversible absorbable atelectasis or collapse of lung tissue. Such treatment with a biological sealant produces irreversible changes in atelectatic tissue. The biological sealant is delivered to the alveolar compartment as a separate liquid component via a dual-lumen catheter passed through the instrument channel of a flexible bronchoscope. A common side effect after foam sealant application is a systemic, flu-like inflammatory reaction, accompanied by transient fever, cough, bronchospasm, chest pain, leukocytosis, fatigue, and elevated C-reactive protein levels. This side effect is sometimes self-limiting and resolves spontaneously within 24 to 96 hours. In some cases, the inflammation can cause long-term morbidity and even death. Other severe pulmonary side effects within six months after the procedure include recurrent COPD exacerbations, pneumonia, bronchitis, and hemoptysis. Over a period of several weeks, the treated lung area will begin to atrophy, reducing lung volume through atelectasis. However, such treatments again ultimately suffer from some of the same limitations as LVRS. In particular, lung sealants destroy lung tissue and reduce lung volume, and therefore they are not effective against homogenous disease, the type that most COPD patients suffer from. Thus, these techniques actually worsen these patients' ability to breathe.

[0015] Endobronchial coils are another type of therapeutic device developed to help treat COPD patients and act as a minimally invasive alternative to lung volume reduction surgery (LVRS). Endobronchial coils are nitinol devices implanted bronchoscopy under fluoroscopic guidance. The coils are straightened so they can be passed through the bronchoscope into the airway for deployment. They are then pushed out of the catheter and allowed to return to their preprogrammed shape, bending the airway into which they were deployed. The device bends the airway, compressing adjacent tissue and causing a small lung volume reduction effect. As the coils return to their original double-loop shape within the airway, targeted pockets of lung tissue are compressed between the coil features, replicating the effects of LVRS in minimally invasive treatments. Multiple coils implanted throughout the lobe attempt to achieve mechanical volume reduction. However, such bending and folding of the airway increases resistance to gas flow, preventing the airway from flowing efficiently to exchange gas. The bending also compresses tissue by permanently ceasing movement in portions of the lung volume, preventing those portions from efficiently contributing to gas exchange. Thus, limited inspiration and expiration exist within those regions, reducing the patient's breathing capacity. Additionally, the coil design and dimensions provide a very small contact area, which produces high pressure and compressive stress on the lung tissue. This potentially allows for a "cheese-wire" cutting effect, limiting the time that treatment remains effective, even if initial results are positive. The coil is robust enough to bend thick, collagenous airways with substantial walls that will not be easily abraded or suffer device-related tissue erosion or migration. However, due to the nature of the disease and enzymatic destruction in COPD patients, substantial thick-walled airways are largely absent beyond fourth-generation airways in patients with the degree of disease critical to requiring this type of intervention.Typical disease-related tissue destruction leaves only a thin, weakened area of ​​tissue within the area of ​​contact with the coil, which can only accelerate the "cheese-wire cutting" effect, which can substantially reduce the potential for treatment success. Additionally, blood vessels run parallel to most lung airways and are comparable in size to the airways. Bending tortuous central airways (generations 2-4) is not recommended because the blood vessels can easily become entrapped or ruptured. Because the patient's entire cardiac output is routed through the lungs and these vessels, the use of such coils on these airways would pose extreme risks to the patient.

[0016] Devices such as endobronchial coils and endobronchial valves, which are mechanical structures, suffer from fatigue-related failure due to the numerous respiratory cycles these products endure and the nature of the bending that lung airways present to these devices. To clear mucus, the airways compress flat during coughing, reducing the cross-sectional area of ​​the airway, which increases the velocity of expelled gas, which increases the effectiveness of the coughing event in clearing unwanted material from the lungs. Device failure often occurs where metal or rigid biocompatible materials are placed within the lungs, where coughing presents repeated high-force bending and airway collapse to the device. Another cause of device failure is tissue inflammation and granulation buildup in the airway wall tissue and the formation of bacterial colonies, which are commonly found on polymers implanted within the lung. Most devices previously proposed to treat COPD to date contain one or more design flaws that result in granulation tissue formation or bacterial colonization that is nearly impossible to remove or otherwise treat.

[0017] Therefore, additional treatment options are desirable, especially for the treatment of homogeneous COPD, where LVRS is particularly ineffective and potentially harmful. Such treatment options should avoid blocking, rendering non-functional, or removing segments of the lung in the manner of LVRS. In addition, such treatment options should avoid harmful compression of tissue. Compression of lung tissue can compress and block blood vessels, leading to tissue necrosis and cell death, which in turn causes chronic air leaks and eventual lung collapse due to the breakdown of the vacuum seal between the lung and the chest wall. Such treatment options should also be suitable for patients with end-stage COPD. These patients typically do not have any anatomically normal airways beyond the fourth generation, an anatomical structure consisting of severely weakened and destroyed alveolar tissue that continues to deteriorate. An ideal solution would be a device fabricated using materials and methods that minimize the potential for bacterial colonization and granulation tissue formation within the airways. At least some of these objectives will be met by the present invention. Summary of the Invention [Means for solving the problem]

[0018] The present invention relates generally to medical systems, devices and methods, and more particularly to treating patients suffering from COPD. Similarly, the present invention relates to the following numbered clauses:

[0019] In addition, the present invention relates to the following aspects:

[0020] In one aspect of the invention, the lung treatment devices, methods, and systems contained herein treat COPD and COPD symptoms by applying a bridge to lung tissue in patients who have been diagnosed with emphysema and have been determined to exhibit lung tissue destruction ranging from zero to 70% volume of destroyed tissue, preferably at least 30% destruction, as determined by calculating the percent of destroyed low-density lung volume tissue present in CT images with a Hounsfield Units score of 850 (HU) or higher.

[0021] In another aspect of the invention, the pulmonary treatment devices, methods, and systems contained herein treat COPD and COPD symptoms by stretching lung tissue in a patient who has been diagnosed with emphysema, while the patient has also been determined to be sufficiently air-loaded such that the retained residual volume is determined to be between 100% and 400% of normal, but most preferably, the residual volume is determined to be greater than 175% of normal for the patient's gender, age, and height.

[0022] In another aspect of the present invention, lung treatment devices, methods, and systems contained herein treat COPD and COPD symptoms by stretching lung tissue in patients who have been diagnosed with emphysema and whose volume of damaged lung tissue, defined as the volume of low-density tissue in each lobe greater than 850 (HU), falls within the range of zero to 70% within each lobe, but preferably greater than 30%. Treatment can be performed in each of the four major lobes of the lung, in a single or separate procedure.

[0023] In another aspect of the invention, the pulmonary treatment devices, methods, and systems contained herein treat COPD and COPD symptoms by compressing lung tissue as the tissue is torqued to wrap and rotate around an implant device that is secured to the lung tissue such that the lung tissue is pulled downward against the device and then anchored to another portion of the lung tissue, preventing the implant from back-rotating and allowing the lung tissue to not unwind from the implant.

[0024] In another aspect of the present invention, the pulmonary treatment devices, methods, systems, and structures contained herein, which may be considered implant systems, treat COPD and COPD symptoms by spanning lung tissue, reducing lung volume, and producing at least one of the following measurable physiological changes to improve breathing in COPD patients: 1) Elevate the diaphragm against the reference rib cage 2) Measure the diaphragmatic lift relative to a reference rib location while the patient maintains exhalation as a result of treatment. 3) Elevate the base of at least one lung toward the patient's upper chest 4) Reduce coughing 5) Reduces mucus production 6) Reduces coughing caused by trapped air and mucus 7) Reduces the feeling of glottal closure 8) Increases a patient's ability to clear mucus from the lungs 9) Increases arterial blood oxygen levels in the bloodstream 10) Increases the percentage of arterial blood oxygen in the bloodstream 11) Reduces arterial CO2 levels in the bloodstream 12) Reduces the percentage of arterial CO2 in the bloodstream 13) Increase mobility as measured by the current standard 6-minute walk test 14) Increase the number of meters a patient can walk within 6 minutes 15) Increases pulmonary airway diameter as measured using high-resolution CT 16) Increases airway diameter 17) Increases lung empty volume during expiration 18) Increases airway lumen diameter 19) Provides radial outward support to the airway 20) Assists in reducing lung volume during exhalation 21) Reduce the volume of at least one lung 22) Reduce leaf volume 23) Reduces the volume of both lungs 24) Reduces lung volume 25) Reduces TLC in the lung pairs 26) Perform tissue compression 27) Compressing tissue within the lobe 28) Remove loose tissue in the lungs 29) Restore lung tissue elastic recoil to physiological capacity for lung expansion pressures of 2-200cm*H2O 30) Increases lung elastic recoil 31) Decreases lung compliance 32) Changing the shape of the pressure-volume curve generated by measuring patient respiration 33) Increase the area within the pressure-volume curve that describes the patient's breathing 34) Comparing inspiratory and expiratory data and displacing gaps as seen using post-processed CT images 35) Delay airway closure during expiration by comparing pre- versus post-treatment airway volumes of similar regions within the lung using post-processed CT image data. 36) Reduces lung volume 37) Reduce airway resistance 38) Reduce the volume of one or more lungs in a patient 39) Reduce inspiratory effort using pulse transit time or respiratory inductance plethysmography methods 40) Reduce dynamic hyperinflation as measured by CT, 6-minute walk test, or plethysmography 41) Reduces post-expiratory lung volume 42) Reduce functional residual capacity 43) Reduce the incidence of respiratory failure 44) Increase the time between COPD exacerbation events 45) Increases the time the airway remains open during expiration 46) Increases forced expiratory volume in 1 second (FEV1) 47) Increase forced vital capacity (FVC) 48) Increases the FEV1 / FVC ratio 49) Reduces mood swings 50) Reduces pressure on the heart 51) Reduces pressure on the coronary arteries 52) Reduces blood pressure 53) Reduces pulmonary hypertension 54) Reduces hypertension in the blood vessels supplying the heart muscle 55) Reduces systolic and / or diastolic blood pressure 56) Reduces heart rate 57) Reduces systolic blood pressure 58) Increases the ejection fraction of the heart 59) Reduces pulmonary artery pressure 60) Reduce lung tissue density (from 800 to 810-1,000 HU (Hounsfield Units)) 61) Make lung tissue density more uniform (adjust lobar differences in mean lobar density to 1-200 Hounsfield units) 62) Increase forced expiratory volume during expiration 63) Reduce residual volume left in the lungs during and after expiration (RV) 64) Reduces the amount of gas trapped in the lungs during and after expiration 65) Reduces the amount of gas trapped in the lobe during and after expiration 66) Increase tidal expiratory volume change during tidal breathing at rest 67) Increase inspiratory reserve volume during tidal breathing at rest 68) Decrease the patient's respiratory rate 69) Decrease the patient's heart rate 70) Increase the patient's cardiac ejection fraction 71) Decrease the patient's total lung capacity 72) Decreases lung compliance 73) Decrease compliance within a lobe or region of lung tissue 74) Increases lung tissue compliance uniformity between the upper and lower lobes 75) Increase lung tissue compliance uniformity between lobes within a patient 76) Increases interlobar lung tissue compliance uniformity 77) Decreases inspiratory effort 78) Decrease total lung capacity (TLC) 79) Reduce the RV / TLC ratio 80) Increases intralobar airway volume during inspiration 81) Increases intralobar airway volume during expiration 82) Reduces intralobar differences in lung airway volume during respiration 83) Increase the total blood volume in the patient's lungs or lobes by administering a treatment 84) Reduces the local blood volume in severely compromised lung tissue and reduces the amount of reduced oxygenated blood that mixes with normal blood in patients with emphysema 85) Increases the change in lobar volume between the inspiratory and expiratory breathing cycles 86) Reduces the amount of air trapped in the lobe after exhalation 87) Reduces lung expiratory volume after treatment 88) Increase the volume of one or more lobes during inspiration 89) Increases volume within the distal airways in one or more lobes 90) Increases the volume within the central airways in one or more lobes 91) Reduces central airway impedance within one or more lobes 92) Reduce impedance within one or both lungs 93) Reduce resistance to flow within one or more lobes 94) Reduces resistance to flow in one or more lungs 95) Increase vascular density within one or more lobes 96) Increases the number of blood vessels per liter of lobar volume 97) Increases the volume of the airway wall within one or more lobes 98) Increases airway wall volume within the central airways of one or more lobes 99) Decrease the percentage of damaged tissue per liter of lung volume within one or more lobes 100) Maintaining airway patency longer and increasing the rate of aerosol transport within one or more lobes 101) Maintaining airway patency longer and increasing local concentrations of aerosol-delivered drugs within one or more lobes 102) Measure one or more fissures that move more than 2 mm, indicating a change in lobar volume 103) Measure one or more gaps that move more than 2 mm relative to the chest wall ribs, indicating a change in lung volume 104) Reduce the percentage of low-attenuating lung tissue within one or more lobes 105) Reduce the amount of low-attenuating lung tissue within one or more lobes 106) Reduce the percentage of low-density tissue of 950 HU or higher within one or more lobes 107) Reduce the amount of low-density tissue of 950 HU or higher in one or more lobes

[0025] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal end that is effectively attached to lung tissue that has been degraded by enzymatic destruction.

[0026] In another aspect of the invention, a pulmonary treatment device is provided that includes a pulmonary treatment device with proximal and distal ends that anchor to an airway within the lung.

[0027] In another aspect of the invention, a pulmonary treatment device is provided, comprising a pulmonary treatment device with a distal end attached to tissue, the distal end consisting primarily of alveoli.

[0028] In another aspect of the present invention, a pulmonary treatment device is provided, comprising a treatment device, method, or system for tensioning lung tissue, parenchyma, alveoli, tissue with enzyme damage, distended, relaxed, or stretched tissue.

[0029] In another aspect of the present invention, a pulmonary treatment device is provided, comprising a pulmonary treatment device produced from a rounded wire shaft material that presents minimal sharp edges to the soft tissue within the lung that would otherwise cause granulation tissue to form.

[0030] In another aspect of the present invention, a COPD treatment device is provided that includes a pulmonary treatment device produced from a rounded wire shaft material with a distal end and a proximal end, while at least the distal or proximal end is formed to create a blunt atraumatic end without the benefit of a remolded material.

[0031] In another aspect of the present invention, a COPD treatment device is provided that includes a pulmonary treatment device produced from a rounded wire shaft material with a distal end, a proximal end, and a central section, wherein the distal end is connected to the central section and the proximal end is connected to the central section without the benefit of a connection for joining the components.

[0032] In another aspect of the present invention, a COPD treatment device is provided that comprises a pulmonary treatment device that is manufactured and coated with an antibacterial coating, such as silver or some other material that repels bacteria.

[0033] In one aspect of the present invention, a lung treatment device is provided comprising an elongated shaft coiled in a helical shape around a longitudinal axis to form a tissue retraction end, an extendable central section, and a stabilizing end, wherein the tissue retraction end includes at least one loop that is curved at least partially around the longitudinal axis and configured to engage free damaged alveolar sac tissue, and the stabilizing end includes at least one loop that is curved at least partially around the longitudinal axis and configured to engage a lung passage proximal to the free damaged alveolar sac tissue, the extendable central section being configured to extend along the longitudinal axis while the tissue retraction end engages the free damaged alveolar sac tissue such that the free damaged alveolar sac tissue is retracted toward the lung passage, and the stabilizing end seats within the lung passage in a manner that maintains the free damaged alveolar sac tissue in the retracted position.

[0034] In another aspect of the present invention, a device for treating a lung is provided that includes a tissue engaging end configured to engage freed damaged alveolar sac tissue and a stabilizing end configured to engage a lung passageway proximal to the freed damaged alveolar sac tissue, the device being configured to re-tension a portion of the lung by drawing the tissue engaging end toward the stabilizing end seated within the lung passageway and maintaining such drawing with a recoil force.

[0035] In another aspect of the present invention, a lung treatment device for treating a lung is provided, the lung treatment device including a tissue-attracting distal end, a stabilizing proximal end, and a resilient central section, wherein at least a portion of the device is configured to be positioned around the exterior of a bronchoscope in a configuration suitable for advancement into the lung, wherein at least a portion of the tissue-attracting end, a portion of the central section, or a portion of the stabilizing end is configured to at least partially circulate around the longitudinal axis of the bronchoscope during advancement into the lung and is configured to displace lung tissue, the extendable central section is configured to be extended, while the tissue-attracting end is anchored to the lung tissue to allow the lung tissue to be drawn toward the central section of the device, and the stabilizing end is seated within the lung tissue in such a manner that the lung tissue at the proximal end of the treatment device is drawn toward the central section of the treatment device after the bronchoscope is removed from the lung.

[0036] In another aspect of the present invention, a lung treatment device for treating a lung is provided, comprising a tissue retracting end configured to be anchored to lung tissue and a stabilizing proximal end configured to be anchored to lung tissue proximal to the tissue to which the tissue retracting end is anchored, the device being configured to re-tension a portion of the lung by retracting the tissue retracting end toward the stabilizing end seated within the lung.

[0037] In another aspect of the present invention, a lung treatment device for treating a lung is provided, comprising a tissue retracting end configured to be anchored to lung tissue and a stabilizing proximal end configured to be anchored to lung tissue proximal to the tissue to which the tissue retracting end is anchored, the device being configured to re-tension a portion of the lung by drawing the tissue to which the tissue retracting end is anchored toward the tissue to which the stabilizing end is anchored within the lung.

[0038] In another aspect of the present invention, a pulmonary treatment device for treating a lung is provided, comprising a tissue retracting end configured to be anchored to lung tissue and a stabilizing proximal end configured to be anchored to lung tissue proximal to the tissue to which the tissue retracting end is anchored, the device being configured to re-tension a portion of the lung by pulling the tissue to which the tissue engaging end is anchored toward the tissue to which the stabilizing end is anchored within the lung, and a central section of the pulmonary treatment device configured to maintain a patent lumen through the pulmonary treatment device.

[0039] In another aspect of the invention, a lung treatment device for treating a lung is provided, the lung treatment device comprising a tissue retracting end configured to be anchored to lung tissue and a stabilizing proximal end configured to be anchored to lung tissue proximal to the tissue to which the tissue retracting end is anchored, the device being configured to be advanced into the lung and then extended to a longer configuration before anchoring the tissue retracting end to the tissue and before anchoring the proximal stabilizing end to the tissue, to more effectively re-tension a portion of the lung by pulling the tissue engaging end toward the stabilizing end that is anchored to the tissue within the lung.

[0040] In another aspect of the present invention, a lung treatment device is provided comprising an elongated shaft coiled in a helical shape around a longitudinal axis to form a tissue retraction end, an extendable central section, and a stabilizing end, wherein the tissue retraction end includes at least one loop configured to engage free damaged alveolar sac tissue or a wall of an airway, the stabilizing end being at least partially curved around the longitudinal axis and including at least one loop configured to engage the lung passage proximal to the free damaged alveolar sac tissue, the extendable central section being configured to extend along the longitudinal axis while the tissue retraction end engages the free damaged alveolar sac tissue such that the free damaged alveolar sac tissue is retracted toward the lung passage and the stabilizing end seats the free damaged alveolar sac tissue within the lung passage in a manner that maintains the free damaged alveolar sac tissue in the retracted position.

[0041] In another aspect of the present invention, a pulmonary treatment device is provided that includes an implant made of a polymer or metal that behaves at least partially in an elastic manner and that is shaped to form tissue retraction anchor ends, an extendable central section, and a stabilizing end, wherein the tissue retraction ends can be advanced distally, extending the extendable central section with an increased length and elastically strained, after which the tissue retraction ends may be deployed to anchor or anchor to a wall of the airway, the stabilizing end including at least one loop that is at least partially curved about a longitudinal axis and configured to engage a lung passageway proximal to the central section, and the extendable central section is configured to provide an elastic recoil force that spans the lung tissue, provides luminal patency, maintains support for the stent within the airway, and prevents airway collapse while the tissue retraction ends and the proximal stabilizing end are retracted toward each other.

[0042] In another aspect of the invention, a pulmonary treatment device is provided that reduces the length of airway segments and improves lung elastic recoil.

[0043] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be mounted on the exterior of a bronchoscope during delivery to a location within the lungs.

[0044] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be advanced into the lung in a length-unconstrained configuration, allowing the system to be flexible while being delivered along a tortuous path. Most of these devices are delivered to the upper lobes, typically requiring the scope and device to be navigated through at least one small radius bend within the lung.

[0045] In another aspect of the invention, a pulmonary treatment device is provided that can be advanced into the lung under unstressed conditions, and the delivery system can allow the device to be flexible while being delivered along a tortuous path.

[0046] In another aspect of the present invention, a pulmonary treatment device for treating the lungs is provided that is unstressed to allow the delivery system to be as flexible as possible while being delivered along a tortuous path, allowing the device length to be extended or shortened.

[0047] In another aspect of the invention, a pulmonary treatment device is provided that is configured so that its length can be extended or shortened prior to deployment of the device in the lung and stressing the lung tissue.

[0048] In another aspect of the present invention, a pulmonary treatment device is provided that can be configured to be advanced to a treatment site within the lung along a tortuous path and configured in a flexible, unstressed condition that allows the length to be unconstrained, but can be configured to be elongated at the treatment site before being deployed and distorting lung tissue.

[0049] In another aspect of the invention, a pulmonary treatment device is provided that can be advanced to a treatment location within the lung along a tortuous path, configured in a flexible, unstressed condition but configured to store strain energy that can be strained to a longer configuration and applied to lung tissue after deployment of the treatment device.

[0050] In another aspect of the invention, a pulmonary treatment device is provided that can be advanced into the lung, and the device length can be adjusted to change length after a portion of the device is placed in contact with lung tissue.

[0051] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a spring coil central section.

[0052] In another aspect of the invention, a pulmonary treatment device is provided with an unconstrained central lumen and constrained distal anchor features by retracting a delivery device component from the central lumen of the treatment device.

[0053] In another aspect of the present invention, a pulmonary treatment device is provided that includes a central longitudinal axis, a distal end, a proximal end, and a lumen extending coaxially along the central longitudinal axis, configured to be guided by a guidewire advanced through the lumen along the central longitudinal axis.

[0054] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be guided by a bronchoscope and advanced through the lumen along the central longitudinal axis, the pulmonary treatment device comprising a central longitudinal axis, a distal end, a proximal end, and a lumen extending coaxially along the central longitudinal axis.

[0055] In another aspect of the invention, a pulmonary treatment device is provided that includes distal and proximal anchors and a central section that can be stretched and store fully elastic strain energy within the central section.

[0056] In another aspect of the present invention, a pulmonary treatment device is provided that includes distal and proximal anchors and a central section that allow the device to be stretched and store fully elastic strain energy within the treatment device before being coupled to lung tissue.

[0057] In another aspect of the invention, a pulmonary treatment device is provided that includes a tissue-retracting distal end, a stabilizing proximal end, and a central section that is capable of being stretched and storing fully elastic strain energy.

[0058] In another aspect of the present invention, a pulmonary treatment device is provided that includes a tissue-pulling distal end, a stabilizing proximal end, and a central section that can be stretched and store full elastic strain energy before the device is coupled to the lung tissue and causes length compression of the lung tissue.

[0059] In another aspect of the present invention, a lung treatment device is provided that includes a tissue-pulling distal end, a stabilizing proximal end, and a central section, wherein the stabilizing proximal end can be stretched and store fully elastic strain energy after being seated in lung tissue.

[0060] In another aspect of the present invention, a pulmonary treatment device is provided that includes a distal end, a proximal end, and a central section that can be deployed within the lung and stretched to store fully elastic strain energy so that tension can be restored within the lung tissue.

[0061] In another aspect of the present invention, a pulmonary treatment device is provided that includes a distal end, a proximal end, and a central section that can be deployed within the lung and stretched to store full elastic strain energy so as to restore lung elastic recoil within the lung.

[0062] In another aspect of the invention, a pulmonary treatment device is provided that includes a proximal end, a distal end, and a central section, wherein the central section is cylindrical and the proximal end is configured to be flared.

[0063] In another aspect of the invention, a pulmonary treatment device is provided that includes a proximal end, a distal end, and a central section, where the central section is configured to be tapered such that the diameter varies along the length of the central section of the device.

[0064] In another aspect of the invention, a pulmonary treatment device is provided that includes a proximal end, a distal end, and a central section, where the distal end is configured to include a spring element that can be restrained by an exterior surface of a bronchoscope.

[0065] In another aspect of the invention, a pulmonary treatment device is provided, wherein the device includes a proximal end, a distal end, and a central section configured with a spring element that can be expanded to a larger diameter by a balloon.

[0066] In another aspect of the invention, a pulmonary treatment device is provided that is mounted around the exterior of a bronchoscope and configured to increase tension within lung tissue during delivery to a location within the lung.

[0067] In another aspect of the invention, a pulmonary treatment device is provided having a distal anchor, a proximal anchor, and a central section that can be stretched to store elastic strain energy and span lung tissue.

[0068] In another aspect of the invention, a pulmonary treatment device is provided that is configured with a distal anchor, a proximal anchor, and a central section made from a single wire shaft and that can be advanced into the lung under unstressed conditions to allow the system to be flexible while being delivered along a tortuous path.

[0069] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a central section made from a continuous wire shaft.

[0070] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a central section that are made from a single element, without any connecting joints to join features of the device.

[0071] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the treatment device configured to be stretched, store elastic strain energy, and span lung tissue, and comprising at least one weld for connecting features of the device.

[0072] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the treatment device configured to be stretched, store elastic strain energy, and span lung tissue, and comprising at least one crimped sleeve for connecting features of the device.

[0073] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the treatment device configured to be stretched, store elastic strain energy, and span lung tissue, and comprising at least one glued joint for connecting features of the device.

[0074] In another aspect of the invention, a pulmonary treatment device is provided that is made from a continuous wire shaft, while the wire shaft end is terminated to a blunt atraumatic tip.

[0075] In another aspect of the invention, a pulmonary treatment device is provided that is fabricated from a continuous wire shaft, while at least one wire shaft end is recast to form a blunt, atraumatic tip.

[0076] In another aspect of the present invention, a pulmonary treatment device is provided that is made from a continuous wire shaft that is delivered while at least partially surrounding a bronchoscope, and at least one wire shaft end is recast to form a ball-shaped tip.

[0077] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal end, a proximal end, and a central section, the treatment device being fabricated from one or more wire shaft components, with at least one proximal end or one distal end or both ends being remolded to form a ball-shaped blunt tip.

[0078] In another aspect of the present invention, a lung treatment device is provided having a distal end, a proximal end, and a central section, the treatment device being configured to be delivered at least partially mounted on the outside of a bronchoscope, and at least one of the proximal end or one of the distal end or both ends being remolded to be shaped into a ball-shaped blunt tip.

[0079] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the treatment device configured to be stretched, store elastic strain energy, and span lung tissue, while the distal end is fused to form a blunt ball end.

[0080] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be stretched, store elastic strain energy, and span lung tissue, while the distal end is fused to form a blunt ball end.

[0081] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the treatment device configured to be elongated, store elastic strain energy, and span lung tissue, while the distal end is fused to form a blunt tip.

[0082] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be stretched, store elastic strain energy, and be capable of spanning lung tissue, while the distal end is fused to form a blunt tip.

[0083] In another aspect of the present invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the treatment device configured to be stretched, store elastic strain energy, and span lung tissue, while the distal end has material joined thereto to form an atraumatic end.

[0084] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be stretched, store elastic strain energy, and span lung tissue, while the distal end has material joined thereto to form an atraumatic end.

[0085] In another aspect of the present invention, a lung treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the device configured to be advanced into the lung in a delivery configuration in which it is unstressed and extends or shortens the length of the device, the device configured to be stretched, store elastic strain energy, and be anchored to the lung tissue such that the lung tissue is stretched in the delivery treatment configuration.

[0086] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a central section that can be delivered to a treatment site in a delivery configuration and acted upon lung tissue in the treatment configuration. In the delivery configuration, the device can be advanced into the lung in the absence of stresses that would otherwise lengthen or shorten the device, and in the treatment configuration, the device can be elongated, store elastic strain energy, and beneficially stretch the lung tissue.

[0087] In another aspect of the invention, a pulmonary treatment device is provided comprising a distal anchor, a proximal anchor, and a central section, the device configured to be stretched and store elastic strain energy such that the distal anchor is anchored to a location within the lung and the proximal anchor is anchored to a proximal location within the lung away from the location of the distal anchor, the elastic strain energy being allowed to reduce the distance between the distal anchor and the proximal anchor, bringing the distal and proximal anchors closer together within the lung.

[0088] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a central section that can be delivered to a treatment site in a delivery configuration and caused to act on lung tissue in the treatment configuration, where the device is elongated and can store elastic strain energy, and where the device can use the elastic strain energy to shorten the device and beneficially stretch the lung tissue.

[0089] In another aspect of the present invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a central section that can be delivered to a treatment site in a delivery configuration and acted upon lung tissue in the treatment configuration. In the delivery configuration, the device can be mounted around the exterior of a bronchoscope, and in the treatment configuration, the device can benefit from the use of pneumatic pressure to shorten the device and advantageously tension the lung tissue. Foreshortening may be accomplished by using a balloon to pneumatically expand the device diameter while allowing device foreshortening to shorten the device and cause lung tissue tensioning.

[0090] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal anchor, a proximal anchor, and a central section that can be delivered to a treatment site in a delivery configuration and acted upon lung tissue in the treatment configuration. In the delivery configuration, the device can be mounted around the exterior of a bronchoscope, and in the treatment configuration, the device can benefit from the use of hydraulic pressure to shorten the device and advantageously tension it against lung tissue.

[0091] In another aspect of the invention, a pulmonary treatment device is provided that can be advanced to a treatment site within the lung along a tortuous path, configured in a flexible unstressed condition that allows its length to remain unchanged from its unstressed state, but configured to be elongated at the treatment site before being deployed to distort lung tissue.

[0092] In another aspect of the invention, a pulmonary treatment device is provided that can be advanced to a treatment site within the lung along a tortuous path, configured under a flexible condition so that its length remains unchanged from its unstressed state, but configured to be stretched at the treatment site before being deployed and distorting lung tissue.

[0093] In another aspect of the present invention, a pulmonary treatment device is provided that is configured under flexible conditions so that its length remains unchanged from its unstressed state, but that can be advanced to a treatment location within the lung along a tortuous path, configured to shorten in an unassisted manner after being deployed within the tissue and, advantageously, stretching across the lung tissue.

[0094] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within tissue and, advantageously, to stretch across lung tissue and then shorten in an unassisted manner, under flexible conditions, and that can be advanced to a treatment location within the lung along a tortuous path.

[0095] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a distal end, a proximal end, and a central section that can be deployed within tissue and, advantageously, advanced to a treatment location within the lung along a tortuous path that is configured to shorten in an unassisted manner after stretching across the lung tissue.

[0096] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a distal end, a proximal end, and a central section that can be advanced to a treatment location within the lung along a tortuous path, configured to be stretched, store elastic strain energy, and advantageously stretch lung tissue and then shorten in an unassisted manner.

[0097] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a distal anchor, a proximal anchor, and a central section that can be advanced to a treatment location within the lung along a tortuous path, configured to be stretched, store elastic strain energy, and advantageously stretch lung tissue and then shorten in an unassisted manner.

[0098] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a distal anchor that anchors at a first location within the lung, a proximal anchor that anchors at a second location within the lung remote from the first location, and a central section that is connected to the proximal and distal anchors, wherein the device is configured to be advanced to a treatment location within the lung along a tortuous path, and the central section is configured to be elongated before the proximal and distal anchors are deployed and, advantageously, stretched across lung tissue.

[0099] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a distal anchor that anchors at a first location within the lung, a proximal anchor that anchors at a second location within the lung remote from the first location, and a central section connected to the proximal and distal anchors, wherein the device is configured to be advanced to a treatment location within the lung along a tortuous path, and the central section is configured to shorten after the proximal and distal anchors are deployed and, advantageously, stretch across lung tissue.

[0100] In another aspect of the present invention, a lung treatment device is provided that is configured with a distal anchor that anchors at a first location within the lung, a proximal anchor that anchors at a second location within the lung remote from the first location, and a central section that is connected to the proximal and distal anchors, the device being configured to be mounted around the outside of a bronchoscope so that it can be advanced at least in part along a tortuous path to a treatment location within the lung, and the central section being configured to shorten after the proximal and distal anchors are deployed and, advantageously, stretched across lung tissue.

[0101] In another aspect of the present invention, a lung treatment device is provided that is configured with a distal anchor that anchors at a first location within the lung, a proximal anchor that anchors at a second location within the lung remote from the first location, and a central section that is connected to the proximal and distal anchors, the device being configured to be mounted around the outside of a bronchoscope so that it can be advanced at least in part along a tortuous path to a treatment location within the lung, and the central section being configured to shorten after the proximal and distal anchors are deployed and, advantageously, stretched across lung tissue.

[0102] In another aspect of the present invention, a lung treatment device is provided that is configured with a distal anchor that anchors at a first location within the lung, a proximal anchor that anchors at a second location within the lung remote from the first location, and a central section that is connected to the proximal and distal anchors, the device being configured to be mounted around the exterior of a bronchoscope so that it can be advanced at least in part to a treatment location within the lung along a tortuous path, and the central section being configured to be shortened after the proximal and distal anchors are deployed and, advantageously, stretched across lung tissue.

[0103] In another aspect of the present invention, a pulmonary treatment device is provided that acts in a stent-like manner to maintain pulmonary airway patency and straighten the airway pathway between its proximal and distal ends.

[0104] In another aspect of the invention, a pulmonary treatment device is provided that acts in a stent-like manner to support the airway, open the airway lumen, and act as a tensioning device along the longitudinal axis of the airway.

[0105] In another aspect of the invention, a pulmonary treatment device is provided that is advanceable into the lung in an unstrained state.

[0106] In another aspect of the invention, a pulmonary treatment device is provided that is advanceable into the lung while maintaining a non-extended length.

[0107] In another aspect of the present invention, a pulmonary treatment device is provided that at least partially surrounds a bronchoscope used to deliver the pulmonary treatment device.

[0108] In another aspect of the invention, a pulmonary treatment device is beneficially provided with a distal anchor feature configured to hold the distal anchor from deployment using a bronchoscope shaft while the device is advanced into the lung.

[0109] In another aspect of the invention, a pulmonary treatment device is provided that is configured to surround a bronchoscope, such that scope shaft strength is beneficially used to modify treatment device dimensions.

[0110] In another aspect of the present invention, a pulmonary treatment device is provided that can be extended by advancing a bronchoscope.

[0111] In another aspect of the present invention, a pulmonary treatment device is provided that can be extended by advancing a bronchoscope.

[0112] In another aspect of the present invention, a pulmonary treatment device is provided that can be extended by retracting the bronchoscope.

[0113] In another aspect of the present invention, a pulmonary treatment device is provided that can be extended by retracting a bronchoscope guide sleeve.

[0114] In another aspect of the invention, a pulmonary treatment device is provided that is configured to initially deploy a proximal end to engage tissue before being extended to enhance lung elastic recoil.

[0115] In another aspect of the invention, a pulmonary treatment device is provided whereby the device can be advanced into the lung in an unstrained state and extended or shortened from a zero strain length, whereby the device length can be increased using delivery system components at the treatment site before any portion of the device is released from the delivery system.

[0116] In another aspect of the invention, a pulmonary treatment device is provided that can be retracted and extended after partial deployment.

[0117] In another aspect of the invention, a pulmonary treatment device is provided whose distal end can be retracted and extended after deployment.

[0118] In another aspect of the invention, a pulmonary treatment device is provided that can be tensioned along its longitudinal axis, but the device length is maintained after deployment of the distal end.

[0119] In another aspect of the invention, a pulmonary treatment device is provided in which the distal end can be longitudinally tensioned after deployment to draw the distal end and adjacent lung tissue more proximally.

[0120] In another aspect of the invention, a pulmonary treatment device is provided with flared ends (the end diameter is larger than the central section) for treating emphysema.

[0121] In another aspect of the invention, a pulmonary treatment device is provided that acts in a stent-like manner with flared ends (end diameter is larger than the central body) for treating emphysema.

[0122] In another aspect of the present invention, a pulmonary treatment device is provided that spans lung tissue and can be deployed in all anatomical lumens within the lung, whether anatomical, disease-created, or device-generated, as shown as RB1-LB10 on a conventional airway chart.

[0123] In another aspect of the invention, a pulmonary treatment device is provided that acts in a stent-like manner and is delivered by advancing a bronchoscope.

[0124] In another aspect of the invention, a pulmonary treatment device is provided that is delivered by advancing a catheter (without the use of a scope) to stent lung tissue.

[0125] In another aspect of the invention, a pulmonary treatment device is provided for stenting lung tissue, the device being delivered by guiding a bronchoscope into position using a guidewire.

[0126] In another aspect of the invention, a pulmonary treatment device is provided for stenting lung tissue, the device being delivered by guiding a catheter into position using a guidewire.

[0127] In another aspect of the invention, a pulmonary treatment device is provided that straightens airways.

[0128] In another aspect of the invention, a pulmonary treatment device is provided that straightens two or more airways simultaneously.

[0129] In another aspect of the invention, a lung treatment device is provided that straightens two or more airways while pushing them laterally closer together.

[0130] In another aspect of the invention, a pulmonary treatment device is provided that pushes two or more airways together, creating lung tissue tension.

[0131] In another aspect of the present invention, a pulmonary treatment device is provided that compresses two or more airways together to cause any one of the beneficial changes listed above as items (1)-(107) above.

[0132] In another aspect of the invention, a pulmonary treatment device is provided that straightens airways while shortening their length.

[0133] In another aspect of the invention, a pulmonary treatment device is provided that displaces lung tissue closer to the trachea.

[0134] In another aspect of the invention, a pulmonary treatment device is provided that retracts tissue away from the pleura.

[0135] In another aspect of the invention, a pulmonary treatment device is provided that displaces lung tissue closer to the heart.

[0136] In another aspect of the invention, a pulmonary treatment device is provided that pushes two or more airways together, displacing lung tissue closer to the trachea. In another aspect of the invention, a pulmonary treatment device is provided that pushes two or more airways together, retracting tissue away from the pleura.

[0137] In another aspect of the invention, a pulmonary treatment device is provided that pushes two or more airways together, displacing lung tissue closer to the heart.

[0138] In another aspect of the invention, a pulmonary treatment device is provided that shortens airway length while spanning tissue distal to its distal end.

[0139] In another aspect of the invention, a pulmonary treatment device is provided that is tensioned while supporting airway patency.

[0140] In another aspect of the invention, a pulmonary treatment device is provided that is tensioned while supporting airway patency between its ends.

[0141] In another aspect of the invention, a pulmonary treatment device is provided that stent lung tissue while providing support to keep the airway open and also providing tension within the longitudinal axis of the airway.

[0142] In another aspect of the invention, a pulmonary treatment device is provided that is sufficiently elastic to change dimensions during breathing.

[0143] In another aspect of the invention, a pulmonary treatment device is provided that comprises a curved shape that spans lung tissue and maintains a fixed length as measured following a curved path before and after deployment.

[0144] In another aspect of the invention, a pulmonary treatment device is provided that straightens an airway while allowing gas to flow therethrough in at least one direction.

[0145] In another aspect of the invention, a pulmonary treatment device is provided that deploys into an airway while also straightening a gas flow path through the airway in which the pulmonary treatment device is deployed.

[0146] In another aspect of the invention, a pulmonary treatment device is provided that includes a distal end that is designed to couple to low-density lung tissue, known to have a density greater than 800 HU.

[0147] In another aspect of the invention, a pulmonary treatment device is provided that comprises an optimized design with a high tissue contact area to reduce lung tissue stress.

[0148] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue distal to the pulmonary treatment device, shortening the length of the airway occupied by the pulmonary treatment device.

[0149] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue distal to the pulmonary treatment device, shortening the length of the airway occupied by the pulmonary treatment device, supporting the airway wall and maintaining airway patency.

[0150] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue distal to the pulmonary treatment device while the device length is increased as tension is applied to the device.

[0151] In another aspect of the invention, a pulmonary treatment device is provided that includes an anchor that spans lung tissue while the device length is increased as the proximal end of the device is moved closer to the trachea.

[0152] In another aspect of the invention, a pulmonary treatment device is provided that includes an anchor that spans lung tissue while the device length is increased as a portion of the device is moved closer to the trachea.

[0153] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue longitudinally along an axis occupied by the device while also supporting the airway walls and maintaining airway patency.

[0154] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue to reduce elastic recoil adjacent the airway that the pulmonary treatment device occupies.

[0155] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue distal or proximal to the device to support the airway wall and maintain airway patency.

[0156] In another aspect of the invention, a pulmonary treatment device is provided that straightens at least a portion of an airway wall.

[0157] In another aspect of the invention, a stretched pulmonary treatment device is provided that includes at least one end that forms a circular shape.

[0158] In another aspect of the invention, a stretched pulmonary treatment device is provided that includes at least one end that forms a helical shape.

[0159] In another aspect of the invention, a stretching pulmonary treatment device is provided that includes at least one end that penetrates lung tissue.

[0160] In another aspect of the invention, a stretching pulmonary treatment device is provided that includes at least one end that deploys in a self-contacting configuration.

[0161] In another aspect of the invention, a tensioning pulmonary treatment device is provided that includes at least one end that does not compress tissue.

[0162] In another aspect of the present invention, a tensioned pulmonary treatment device is provided that has an axisymmetric design.

[0163] In another aspect of the invention, a tension lung treatment device is provided that changes lung volume sufficiently to displace the heart laterally.

[0164] In another aspect of the invention, a pulmonary treatment device is provided that stents lung tissue and provides longitudinal tension while holding at least a portion of the airway lumen open.

[0165] In another aspect of the invention, a pulmonary treatment device is provided that includes a proximal or distal end that straightens as tension is applied to the device during deployment.

[0166] In another aspect of the present invention, a lung tissue tensioning pulmonary treatment device is provided that does not compress tissue.

[0167] In another aspect of the present invention, a pulmonary tissue tensioning pulmonary treatment device is provided that selectively tensions tissue regions.

[0168] In another aspect of the invention, a lung tissue tensioning pulmonary treatment device is provided that increases tension in lung tissue to a uniform magnitude.

[0169] In another aspect of the invention, a pulmonary treatment device is provided that tensions lung tissue in one portion of the lung while relieving tension in another portion of the same lung.

[0170] In another aspect of the present invention, a pulmonary treatment device is provided that is delivered in a delivery configuration and deployed in a deployed configuration, and that includes a proximal end, a distal end, and a central section connected to the proximal and distal ends, and that is configured with a delivery length in the delivery configuration and a deployed length that is longer than the delivery length.

[0171] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue so as to be compliant during breathing.

[0172] In another aspect of the invention, a pulmonary treatment device is provided that spans and stretches lung tissue during the inhalation portion of the breathing cycle.

[0173] In another aspect of the invention, a pulmonary treatment device is provided that spans lung tissue and contracts to a shorter length during the exhalation portion of the breathing cycle.

[0174] In another aspect of the present invention, a COPD treatment device is provided that extends during the inspiratory portion of the breathing cycle.

[0175] In another aspect of the present invention, a COPD treatment device is provided that shortens during the exhalation portion of the respiratory cycle.

[0176] In another aspect of the present invention, there is provided a COPD treatment device acting as a stent device comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a shape-memory material having a temperature at or near normothermia and exhibiting a shape-recovery transition temperature within a temperature range below normothermia such that after placement within the lung, the member expands radially and contracts longitudinally, thereby firmly anchoring at least a portion of the member to lung tissue.

[0177] In another aspect of the present invention, there is provided a COPD treatment device acting as a stent device comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a shape-memory material having a temperature at or near normal body temperature, the shape-recovery transition temperature being below normal body temperature such that after placement within the lung, the member expands radially and contracts longitudinally, thereby at least a portion of the member straightening the lung airway.

[0178] In another aspect of the present invention, a COPD treatment device is provided comprising a helically wound coil spring, the spring having a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a shape-memory material having a temperature at or near normothermia and exhibiting a shape-recovery transition temperature within a temperature range below normothermia such that after placement within the lung, the member expands radially and contracts longitudinally, thereby at least a portion of the member straightening the lung airway.

[0179] In another aspect of the present invention, there is provided a COPD treatment device acting as a stent device comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a shape-memory material having a temperature at or near normal body temperature, the shape-recovery transition temperature being below normal body temperature such that after placement within the lung, the member expands radially and contracts longitudinally, thereby spanning at least a portion of the member across lung tissue.

[0180] In another aspect of the present invention, there is provided a COPD treatment device acting as a helically wound coil spring comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a shape-memory material having a temperature at or near normothermia and exhibiting a shape-recovery transition temperature below normothermia such that after placement within the lung, the member expands radially and contracts longitudinally, thereby at least a portion of the member spanning lung tissue.

[0181] In another aspect of the present invention, a COPD treatment device acting as a stent device is provided, comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermia and exhibiting a shape recovery transition temperature within a temperature range below normothermia such that after placement within the lung, the member radially expands and longitudinally contracts, thereby spanning at least a portion of the member across lung tissue.

[0182] In another aspect of the present invention, there is provided a COPD treatment device acting as a helically wound coil spring comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermia and exhibiting a shape recovery transition temperature below normothermia such that after placement within the lung, the member expands radially and contracts longitudinally, thereby spanning at least a portion of the member across lung tissue.

[0183] In another aspect of the present invention, a COPD treatment device is provided that acts as a stent device, comprising a proximal end, a distal end, and a central section joining the ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermia and exhibiting a shape recovery transition temperature within a temperature range below normothermia such that after placement within the lung, the member contracts longitudinally, thereby spanning at least a portion of the member across lung tissue.

[0184] In another aspect of the present invention, a COPD treatment device acting as a stent device is provided, comprising a proximal end, a distal end, and a central section joining the ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermic body temperature, the material exhibiting a shape recovery transition temperature within a temperature range below normothermic body temperature such that after placement within the lung, the member contracts longitudinally such that at least a portion of the member spans the lung tissue while the distal end is configured to anchor to free lung tissue.

[0185] In another aspect of the present invention, a COPD treatment device is provided comprising a helically wound coil spring comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermia and exhibiting a shape recovery transition temperature within a temperature range below normothermia such that after placement within the lung, the member contracts longitudinally such that at least a portion of the member spans lung tissue.

[0186] In another aspect of the present invention, a COPD treatment device is provided comprising a helically wound coil spring comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermic body temperature, the material exhibiting a shape recovery transition temperature within a temperature range below normothermic body temperature such that after placement within the lung, the member contracts longitudinally such that at least a portion of the member spans lung tissue while a distal end is configured to anchor within the free lung tissue.

[0187] In another aspect of the present invention, a COPD treatment device is provided that includes a helically wound coil spring comprising a tubular-shaped member having first and second open ends and a lumen extending therethrough, the member being sized for placement within a lung airway, the member being comprised of a nitinol material having a temperature at or near normothermic body temperature, the material exhibiting a shape recovery transition temperature within a temperature range below normothermic body temperature such that after placement within the lung, the member contracts longitudinally such that at least a portion of the member spans the lung tissue while a proximal end is configured to anchor within the reinforcing lung tissue.

[0188] In another aspect of the present invention, a COPD treatment device is provided, comprising a first coiled end, a second coiled end, and a lumen extending therethrough, the device being sized for placement within a lung airway, the device being comprised of a nitinol material having a temperature at or near normothermia and exhibiting a shape recovery transition temperature within a temperature range below normothermia such that after placement within the lung, the device contracts longitudinally such that at least a portion of the device spans lung tissue.

[0189] In another aspect of the present invention, an airway straightening COPD treatment device is provided that includes a single helical component with an arc length that does not change during deployment.

[0190] In another aspect of the present invention, a COPD treatment device is provided that does not cause lung volume reduction.

[0191] In another aspect of the present invention, a COPD treatment device is provided that causes minimal lung volume reduction.

[0192] In another aspect of the present invention, a COPD treatment device is provided that does not cause lung volume compression.

[0193] In another aspect of the present invention, a COPD treatment device is provided that causes minimal lung volume compression.

[0194] In another aspect of the present invention, a COPD treatment device is provided that does not cause lung tissue compression.

[0195] In another aspect of the present invention, a COPD treatment device is provided that causes minimal lung tissue compression.

[0196] In another aspect of the present invention, a COPD treatment device is provided that includes a resilient stent device for straightening a lung airway, the stent device including a wire formed into multiple bends, generally forming a helical shape having a longitudinal axis, that is extended before being detached from a delivery system and that applies longitudinal tension to lung tissue in a patient when the stent device is positioned within the airway.

[0197] In another aspect of the present invention, a COPD treatment device is provided that includes a medical device for straightening a lung airway, the medical device including a tissue retraction end, a stabilizing end, and a tether extending between the tissue retraction end and the stabilizing end, the device configured such that a distance between the ends measured along the tether is fixed and maintained after release from a delivery device, but the distance between the ends can be extended by moving the delivery device prior to releasing the medical device from the delivery device.

[0198] In another aspect of the present invention, a COPD treatment device is provided that spans lung tissue and includes a tension indicator feature.

[0199] In another aspect of the present invention, a COPD treatment device is provided that spans lung tissue and includes a displacement indicator feature.

[0200] In another aspect of the present invention, a COPD treatment device is provided that straightens airways in the lungs and includes a tension indicator feature.

[0201] In another aspect of the present invention, a COPD treatment device is provided that straightens airways in the lungs and includes a displacement indicator feature.

[0202] In another aspect of the present invention, a COPD treatment device is provided that straightens airways within the lungs when tension is applied to lung tissue.

[0203] In another aspect of the present invention, a COPD treatment device is provided that expands airways within the lungs when the device is used to apply tension to lung tissue.

[0204] In another aspect of the present invention, a COPD treatment device is provided comprising a medical device for straightening a lung airway, the medical device comprising a tissue retraction end, a stabilizing end, and a tether extending between the tissue retraction end and the stabilizing end, while the tether is shaped to form a coil, and the coil is straightened as the distance between the tissue retraction end and the stabilizing end of the device is extended.

[0205] In another aspect of the present invention, a COPD treatment device is provided that includes a medical device made from a single continuous length of plastic, metal, tubing, wire, or extrusion, the medical device having a tissue-retracting end, a stabilizing end, and a tether joining the two ends, the medical device being used to span lung tissue.

[0206] In another aspect of the invention, a COPD treatment device is provided comprising a first portion having a first bearing surface and defining a first local axis, the first portion of the treatment device configured to engage the first bearing surface with a first portion of an airway, the treatment device further comprising a second portion coupled to the first portion of the treatment device, the second portion of the treatment device having a second bearing surface and defining a second local axis, the second portion of the treatment device configured to engage the second bearing surface with a second portion of the airway, the second portion of the airway being axially spaced from the first portion of the airway, wherein in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the airway, urging it into a more coaxial orientation about the second local axis, and the second portion of the treatment device presses against the second portion of the airway, urging it into a more coaxial orientation about the first local axis, thereby straightening a path through the airway in contact with the first and second portions of the treatment device.

[0207] In another aspect of the present invention, a COPD treatment device is provided comprising a first portion having a structure with a center of gravity defining a first local axis and a first bearing surface, the first portion of the treatment device configured to engage the first bearing surface with a first portion of the airway, the treatment device further comprising a second portion coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity defining a second local axis and a second bearing surface, the second portion of the treatment device configured to engage the first bearing surface with a first portion of the airway. The treatment device is configured to engage the second portion and the second bearing surface, the second portion of the airway being axially spaced from the first portion of the airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the airway, urging it into a more coaxial orientation about the second local axis, and the second portion of the treatment device presses against the second portion of the airway, urging it into a more coaxial orientation about the first local axis, thereby straightening a path through the airway in contact with the first and second portions of the treatment device.

[0208] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising: a first portion having a structure with a center of gravity defining a first local axis and a first bearing surface, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the airway; a second portion coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity defining a second local axis and a second bearing surface, the second portion of the treatment device The second portion of the treatment device is configured to engage a second bearing surface with a second portion of the airway, the second portion of the airway being axially spaced from the first portion of the airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the airway, urging it into a more coaxial orientation about the second local axis, and the second portion of the treatment device presses against the second portion of the airway, urging it into a more coaxial orientation about the first local axis, thereby straightening a path through the airway in contact with the first and second portions of the treatment device.

[0209] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising a first portion having a first bearing surface and defining a first local axis, the first portion of the treatment device configured to engage the first bearing surface with a first portion of the first airway, the treatment device further comprising a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device engaging the second bearing surface. a second portion of the treatment device configured to engage a second portion of the first airway with the second bearing surface and defining a second local axis, the second portion of the airway being axially spaced from the first portion of the first airway; a third portion coupled to the second portion of the treatment device and having a third bearing surface and defining a third local axis, the third portion of the treatment device configured to engage a third bearing surface with the first portion of the second airway; a fourth portion (which may be another tissue retracting end) coupled to the third portion of the treatment device and configured to engage a third bearing surface with the first portion of the second airway; a fourth portion of the treatment device having a fourth bearing surface and defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis; the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation relative to the fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation relative to the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device.

[0210] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a center of gravity that defines a second local axis. a second portion of the treatment device having a structure, the second portion of the treatment device configured to engage the second bearing surface with a second portion of the first airway, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure, with a center of gravity defining a third local axis, the third portion of the treatment device configured to engage the third bearing surface with the first portion of the second airway, and a fourth portion (which can be another distal end) of the third portion of the treatment device a fourth portion of the treatment device coupled to the lung, the fourth portion of the treatment device having a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway. , urging it into a more coaxial orientation about the first local axis, thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device.

[0211] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity that defines a second local axis; a second portion of the treatment device having a second bearing surface configured to engage a second portion of the first airway with the second bearing surface, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure with a center of gravity defining a third local axis; the third portion of the treatment device having a third bearing surface configured to engage a first portion of the second airway with the third bearing surface; a fourth portion (which can be another distal end) coupled to the third portion of the treatment device; The portion has a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis. , thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device, while the first and second portions of the treatment device, in their deployed configuration within the lung,The third and fourth portions of the treatment device are urged closer to each other.

[0212] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity that defines a second local axis; a second portion of the treatment device having a second bearing surface configured to engage a second portion of the first airway with the second bearing surface, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure with a center of gravity defining a third local axis; the third portion of the treatment device having a third bearing surface configured to engage a first portion of the second airway with the third bearing surface; a fourth portion (which can be another distal end) coupled to the third portion of the treatment device; The portion has a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis. , thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device, while the first and second portions of the treatment device, in their deployed configuration within the lung,The third and fourth portions of the treatment device are urged closer together, while the treatment device, in its deployed configuration within the lung, increases tension within the lung tissue.

[0213] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity that defines a second local axis; a second portion of the treatment device having a second bearing surface configured to engage a second portion of the first airway with the second bearing surface, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure with a center of gravity defining a third local axis; the third portion of the treatment device having a third bearing surface configured to engage a first portion of the second airway with the third bearing surface; a fourth portion (which can be another distal end) coupled to the third portion of the treatment device; The portion has a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis. , thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device, while the first and second portions of the treatment device, in their deployed configuration within the lung,The second and third portions of the treatment device are connected by a resilient spring material while the third and fourth portions of the treatment device are urged closer together.

[0214] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity that defines a second local axis; a second portion of the treatment device having a second bearing surface configured to engage a second portion of the first airway with the second bearing surface, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure with a center of gravity defining a third local axis; the third portion of the treatment device having a third bearing surface configured to engage a first portion of the second airway with the third bearing surface; a fourth portion (which can be another distal end) coupled to the third portion of the treatment device; The portion has a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis. , thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device, while the first and second portions of the treatment device, in their deployed configuration within the lung,The third and fourth portions of the treatment device are urged closer to the second and third portions of the treatment device, while the second and third portions of the treatment device are connected by a resilient spring material, and at least one of the portions of the treatment device is covered with a jacket to increase the area that engages with a portion of the airway.

[0215] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity that defines a second local axis; a second portion of the treatment device having a second bearing surface configured to engage a second portion of the first airway with the second bearing surface, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure with a center of gravity defining a third local axis; the third portion of the treatment device having a third bearing surface configured to engage a first portion of the second airway with the third bearing surface; a fourth portion (which can be another distal end) coupled to the third portion of the treatment device; The portion has a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis. , thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device, while the first and second portions of the treatment device, in their deployed configuration within the lung,The second and third portions of the treatment device are urged closer to the third and fourth portions of the treatment device, while the second and third portions of the treatment device are connected by a resilient spring material, while at least one of the portions of the treatment device is covered with a jacket and increases the area over which it engages with a portion of the airway, while the first and fourth portions of the treatment device are covered with a jacket and increase the area over which it engages with the first portion of the first airway and the second portion of the second airway.

[0216] In another aspect of the invention, a pulmonary treatment device is provided that is configured to be deployed within one or more airways of a patient's lungs to treat the patient's lungs, the treatment device comprising: a first portion having a first bearing surface having a structure with a center of gravity that defines a first local axis, the first portion of the treatment device configured to engage the first bearing surface with the first portion of the first airway; a second portion (which may be part of a proximal V-clip) coupled to the first portion of the treatment device, the second portion of the treatment device having a structure with a center of gravity that defines a second local axis; a second portion of the treatment device having a second bearing surface configured to engage a second portion of the first airway with the second bearing surface, the second portion of the first airway being axially spaced from the first portion of the first airway and coupled to a third portion, the second portion of the treatment device having a structure with a center of gravity defining a third local axis; the third portion of the treatment device having a third bearing surface configured to engage a first portion of the second airway with the third bearing surface; a fourth portion (which can be another distal end) coupled to the third portion of the treatment device; The portion has a fourth bearing surface having a structure with a center of gravity defining a fourth local axis, the fourth portion of the treatment device configured to engage the fourth bearing surface with a second portion of the second airway, the second portion of the second airway being axially spaced from the first portion of the second airway, and in a deployed configuration within the lung, the first portion of the treatment device presses against the first portion of the first airway, urging it into a more coaxial orientation with respect to the second local axis within the first airway, and the second portion of the treatment device presses against the second portion of the first airway, urging it into a more coaxial orientation with respect to the first local axis. , thereby straightening a path through the first airway in contact with the first and second portions of the treatment device, the third portion of the treatment device presses against the first portion of the second airway, urging it into a more coaxial orientation about a fourth local axis within the second airway, and the fourth portion of the treatment device presses against the second portion of the second airway, urging it into a more coaxial orientation about the third local axis, thereby straightening a path through the second airway in contact with the third and fourth portions of the treatment device, while the first and second portions of the treatment device, in their deployed configuration within the lung,The second and third portions of the treatment device are urged closer to the third and fourth portions of the treatment device, while the second and third portions of the treatment device are connected by a resilient spring material, while at least one of the portions of the treatment device is covered with a jacket selected from a material, defined herein as a jacket material, to increase the area over which it engages with a portion of the airway, while the first and fourth portions of the treatment device are covered with a jacket to increase the area over which it engages with the first portion of the first airway and the second portion of the second airway.

[0217] In another aspect of the invention, a pulmonary treatment device is provided that is configured with an outer covering to increase the area that engages with lung tissue.

[0218] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a covering made from the materials enumerated herein, defined as a covering material, to increase the area that engages with lung tissue.

[0219] In another aspect of the invention, a pulmonary treatment device is provided that is configured with an outer covering to increase the area that engages with lung tissue.

[0220] In another aspect of the invention, a pulmonary treatment device is provided that is configured with a covering made from a polymer to increase the area that engages with lung tissue.

[0221] In another aspect of the invention, a pulmonary treatment device is provided that is configured with an outer covering made from a polymeric material that modulates the release rate of a therapeutic drug.

[0222] In another aspect of the present invention, a pulmonary treatment device is provided that is configured with a covering made from a polymeric material that modulates the release rate of a therapeutic drug, while the therapeutic drug reduces the rate of wound healing, tissue remodeling, inflammation, development of granulation tissue, or a combination thereof.

[0223] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device including an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue and provide benefits associated with increasing lung tension.

[0224] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device including an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue to provide benefits associated with increasing lung tension, and the elongated body configured to elute a therapeutic drug.

[0225] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue to provide benefits associated with increasing lung tension, and the elongated body configured to elute a therapeutic drug, the therapeutic drug configured to locally reduce a wound healing rate.

[0226] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue to provide benefits associated with increasing lung tension, and the elongated body configured to elute a therapeutic drug, the therapeutic drug configured to locally reduce tissue remodeling.

[0227] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue to provide benefits associated with increasing lung tension, and the elongated body configured to elute a therapeutic drug, the therapeutic drug configured to locally reduce inflammation.

[0228] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue to provide benefits associated with increasing lung tension, and the elongated body configured to elute a therapeutic drug, the therapeutic drug configured to reduce granulation tissue formation.

[0229] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway to straighten a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension in lung tissue to provide benefits associated with increasing lung tension, and the elongated body configured to elute a therapeutic drug, the therapeutic drug configured to reduce hyperplasia.

[0230] In another aspect of the present invention, a pulmonary treatment device is provided that is configured to be deployed within an airway of a patient's lung to treat the patient's lung, the treatment device comprising an elongated body having a proximal end and a distal end, the elongated body configured to transition between a delivery configuration and a deployed configuration, the deployed configuration of the elongated body applying force to the airway and straightening a portion of the airway axially spaced between the proximal and distal ends of the treatment device to reduce airflow resistance within the lung, the elongated body configured to increase tension within lung tissue to provide benefits associated with increasing lung tension, the elongated body configured to elute a therapeutic drug, the elongated body comprising a polymeric material that regulates the release of the therapeutic drug.

[0231] In another aspect of the present invention, a method for treating a lung is provided that includes deploying an implantable pulmonary treatment device in an airway of the lung, the treatment device comprising an elongated body having a proximal end and a distal end that can be repositioned, the distal end of the elongated body being deployed to anchor to lung tissue, the proximal end of the elongated body being deployed to an initial position to anchor to lung tissue in a repositionable manner, and the proximal end being repositioned to a position farther from the distal end of the treatment device than the initial deployed position of the proximal end so as to urge the elongated body and the airway into a more linear configuration.

[0232] In another aspect of the present invention, a method for treating a lung is provided, comprising deploying an implantable pulmonary treatment device in an airway of the lung, the treatment device comprising an elongated body having a proximal end and a distal end that can be repositioned, the distal end of the elongated body being deployed to anchor to lung tissue, the proximal end of the elongated body being deployed to an initial position to anchor to lung tissue in a repositionable manner, the proximal end being repositioned to a position farther from the distal end of the treatment device than the initial deployed position of the proximal end so as to urge the elongated body and the airway into a more linear configuration, the elongated body of the treatment device being configured to tension the lung tissue and provide benefits associated with increasing lung tension.

[0233] In another aspect of the present invention, a method for treating a lung is provided, comprising deploying an implantable pulmonary treatment device in an airway of the lung, the treatment device comprising an elongated body having a proximal end and a distal end that can be repositioned, the distal end of the elongated body being deployed to anchor to lung tissue, the proximal end of the elongated body being deployed to an initial position to anchor to lung tissue in a repositionable manner, the proximal end being repositioned to a position farther from the distal end of the treatment device than the initial deployed position of the proximal end so as to urge the elongated body and the airway into a more linear configuration, the elongated body of the treatment device being configured to increase tension in the lung tissue along a directional vector between the treatment device and the chest wall.

[0234] In another aspect of the present invention, a method for treating a lung is provided, comprising deploying a pulmonary treatment device in an airway of the lung, the treatment device comprising an elongated body having a proximal end and a distal end that can be repositioned, the distal end of the elongated body being deployed to anchor to lung tissue, the proximal end of the elongated body being deployed to an initial position to anchor to lung tissue in a repositionable manner, the proximal end being repositioned to a position farther from the distal end of the treatment device than the initial deployed position of the proximal end so as to urge the elongated body and the airway into a more linear configuration, and the elongated body of the treatment device being configured to increase tension on lung tissue between the treatment device and the chest wall.

[0235] In another aspect of the present invention, a method for treating a lung is provided, comprising deploying a pulmonary treatment device into an airway of the lung, the treatment device comprising an elongated body having a proximal end and a distal end that can be repositioned, the distal end of the elongated body being deployed to anchor to lung tissue, the proximal end of the elongated body being deployed to an initial position to anchor to lung tissue in a repositionable manner, the proximal end being repositioned to a position farther from the distal end of the treatment device than the initial deployed position of the proximal end so as to urge the elongated body and the airway into a more linear configuration, and the elongated body of the treatment device being configured to elute a therapeutic drug.

[0236] In another aspect of the invention, a method for treating a lung is provided, comprising: deploying a tissue engaging end of a pulmonary treatment device into loosened damaged alveolar sac tissue distal to a pulmonary passageway; retracting the tissue engaging end toward the pulmonary passageway so that a portion of the lung associated with the loosened damaged alveolar sac tissue is re-tensioned; and seating a stabilizing end of the pulmonary treatment device within the pulmonary passageway to maintain re-tensioning of the portion of the lung.

[0237] In another aspect of the invention, a method for treating a lung is provided, comprising providing a pulmonary treatment device with a proximal end configured to be a stabilizing end, a distal end configured to be a tissue retracting end, and a resilient central section connected to the stabilizing end and the tissue retracting end, and a delivery device configured to seat the stabilizing end of the pulmonary treatment device within a lung passageway; applying a force to stress the resilient central section of the treatment device such that it is distorted to a longer length and the distal tissue retracting end of the pulmonary treatment device is advanced further within the lung; securing the tissue engaging end of the treatment device to the lung; and then removing the delivery device, allowing the resilient central section to stent the lumen of the lung passageway while applying a compressive stress on lung tissue near the treatment device and stretching a portion of the lung adjacent the treatment device.

[0238] In another aspect of the invention, a method is provided for reducing the distance between two intrapulmonary locations and increasing tension at a location within the lung that is not between the two locations, the method including the steps of providing a device with at least two anchors capable of being stretched and storing elastic recoil strain energy and an elastic central section, anchoring the first anchors to a first location within the lung, stretching the central section to store elastic recoil strain energy, anchoring the second anchor to a second location away from the first location, and enabling the central section to use the stored elastic recoil strain energy to reduce the distance between the first and second anchored locations, thereby decreasing the distance between the two locations and increasing tension at the location within the lung that is not between the two anchored locations.

[0239] In another aspect of the invention, a method is provided for reducing the distance between two intrapulmonary locations and increasing tension at a location within the lung that is not between the two locations, the method including the steps of providing a device with at least two anchors capable of storing elastic recoil strain energy and an elastic central section, anchoring the first anchor to a first location within the lung and anchoring a second anchor to a second location away from the first location, and reducing the distance between the anchored first location and the anchored second location, thereby decreasing the distance between the two locations and increasing tension at the location within the lung that is not between the two anchored locations.

[0240] In another aspect of the invention, a method is provided for reducing the distance between two intrapulmonary locations and increasing tension at a location within the lung that is not between the two locations, the method including the steps of providing a device with at least two anchors and an elastic central section capable of storing elastic recoil strain energy, anchoring the first anchor to a first location within the lung and anchoring the second anchor to a second location away from the first location, and reducing the distance between the first and second anchored locations to decrease the distance between the two locations and use the stored elastic recoil strain energy to increase tension at the location within the lung that is not between the two anchored locations.

[0241] Another aspect of the present invention provides a method for treating a lung, comprising: advancing a delivery device into a lung airway, the delivery device comprising a bronchoscope, a deployment sleeve, and a guidewire; advancing the treatment device through the lung airway until the stabilized or proximal end of the treatment device is seated within the lung airway, whereby the user continues to advance the unstabilized proximal end portion of the treatment device until the central section is extended or lengthened; and deploying a tissue anchoring feature at the distal end of the lung treatment device, allowing the elastic central section of the treatment device to draw lung tissue toward the center of the elastic central section, increasing tension within the adjacent lung tissue. After removing the delivery system, lung elastic recoil tension will be increased within the lung. By performing this method of treatment, one end of the treatment device is anchored to lung tissue, the treatment device is extended, storing strain energy and allowing the device to fully elastically extend, and the distal portion is then anchored to lung tissue. After removing the bronchoscope and associated delivery system components, such as the guidewire and deployment sleeve, the pulmonary treatment device utilizes stored strain energy to recover to its original unstressed length, which causes the portion of the lung associated with the distal or free damaged alveolar sac tissue to retract, and the seated stabilizing end of the pulmonary treatment device is drawn into the lung tissue, drawing the tissue engaging end toward the lung passageway to maintain retraction of the majority of the lung. The elastic central section of the treatment device may be configured to improve lung tension while stenting the lung airway as airway tissue in contact with the elastic central section compresses over time, which may facilitate enabling luminal collapse during breathing. The elastic central section of the treatment device may be made from laser-cut tubing or coiled or braided wire.

[0242] In another aspect of the invention, a guidewire, deployment sleeve, and bronchoscope guide sleeve are used to advance and deploy a pulmonary treatment device, 1) seating a proximal anchor of the treatment device, described as the stabilizing end of the treatment device, 2) advancing a distal anchor structure, defined as the tissue retracting end portion of the treatment device, such that a central section of the treatment device is stretched in a fully reversible elastic manner, 3) the bronchoscope is removed while the deployment sleeve applies a compressive force to the tissue retracting end portion of the treatment device, maintaining the extended length of the central section, and 4) removing the bronchoscope causes the tissue retracting end to retract. A method is provided for activating the attached anchor feature, thus securing the distal portion of the treatment device to the lung tissue, while 5) the guidewire, deployment sleeve, and bronchoscope are completely removed from the lung, 6) allowing the elastic recoil properties of the lung treatment device to re-tension the area of ​​freed damaged alveolar sac tissue, 7) pulling the distal and proximal ends of the treatment device closer together, 8) reducing lung compliance, and 9) maintaining re-tensioning of the area of ​​freed damaged alveolar sac tissue and improving the radial outward force on the airways, thus reducing or eliminating the symptoms of COPD.

[0243] In another aspect of the invention, a method for treating a lung is provided, comprising: advancing a pulmonary treatment system to a treatment site, the pulmonary treatment system comprising a delivery system element with a distal end and a proximal end and a pulmonary treatment device configured to at least partially surround the delivery system element while the system is used to treat a patient; extending the treatment device; and deploying the device within the lung and spanning lung tissue.

[0244] In another aspect of the invention, a method is provided for treating a lung, comprising: advancing a pulmonary treatment system to a treatment site, the pulmonary treatment system comprising a delivery system element with a distal end, a proximal end, and a length greater than twice the maximum lateral dimension of the element; and a pulmonary treatment device configured to at least partially surround the delivery system element while the system is advanced into the patient; stretching the treatment device; and deploying the device within the lung to enhance lung elastic recoil.

[0245] In another aspect of the invention, a method for treating a lung is provided, comprising: advancing a pulmonary treatment system comprising a delivery system element with a distal end, a proximal end, and a length greater than twice the maximum lateral dimension of the element; and a pulmonary treatment device configured to at least partially surround the delivery system element while the system is advanced into the patient and deliver the treatment device to a treatment location within the lung; extending the treatment device; and deploying the device into the lung and drawing lung tissue toward the center of gravity of the treatment device.

[0246] In another aspect of the invention, a method for treating a lung is provided, comprising the steps of advancing a pulmonary treatment system comprising a delivery system element with a distal end, a proximal end, and a length greater than twice the maximum lateral dimension of the element, and an implantable pulmonary treatment device configured to at least partially surround the delivery system element while the system is advanced into the patient and deliver the treatment device to a treatment location within the lung; elongating the treatment device; and deploying the treatment device within the lung and, beneficially, stressing tissue within the lung.

[0247] In another aspect of the invention, a method is provided for treating a lung, comprising advancing a pulmonary treatment system comprising a delivery system cannula with a distal end, a proximal end, and a length that is twice as long as a maximum lateral dimension of the cannula, and a pulmonary treatment device configured to at least partially enclose the delivery system cannula while the system is advanced into the patient, deliver a treatment device to a treatment location within the lung, embed the treatment device within the lung, improve lung elastic recoil, and reduce symptoms of COPD.

[0248] In another aspect of the invention, a method for treating a lung is provided that includes advancing a pulmonary treatment system comprising a delivery system cannula with a distal end, a proximal end, and a length that is twice as long as a maximum lateral dimension of the cannula, and a pulmonary treatment device configured to at least partially surround the delivery system cannula while the system is advanced into the patient, deliver a treatment device to a treatment location within the lung, elongate the treatment device, deploy the treatment device within the lung, and span the lung tissue.

[0249] In another aspect of the invention, a method for treating a lung is provided, comprising advancing a pulmonary treatment system comprising a bronchoscope with a distal end, a proximal end, and a length that is two times longer than a maximum lateral dimension of a working length portion of the bronchoscope, and a pulmonary treatment device configured to at least partially enclose the bronchoscope while the system is advanced into a patient, deliver a treatment device to a treatment location within the lung, expand the treatment device, and implant it within the lung to treat COPD.

[0250] In another aspect of the invention, a lung treatment method is provided for treating a lung, the method including providing a bronchoscope with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retraction end, a proximal tissue stabilization end, and a central section. The treatment device is configured to at least partially surround the bronchoscope while the system is advanced into a patient to deliver the treatment device to the lung. The method includes anchoring the tissue retraction end to a first location, anchoring the tissue stabilization end to a second location spaced from the first location, and reducing the distance between the first and second locations to increase tension in a portion of the lung not between the first and second locations.

[0251] In another aspect of the invention, a lung treatment method is provided that includes providing a bronchoscope with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retraction end, a proximal tissue stabilization end, and a central section configured to store elastic strain energy. Additionally, the treatment device is configured to at least partially surround the bronchoscope while the system is advanced into the patient, delivering the treatment device to the lung. The method includes anchoring the tissue retraction end to a first location, anchoring the tissue stabilization end to a second location spaced from the first location, and allowing the stored elastic strain energy to reduce the distance between the first and second locations, increasing tension in a portion of the lung not between the first and second locations.

[0252] In another aspect of the invention, a lung treatment method is provided that includes providing a bronchoscope with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retraction end, a proximal tissue stabilization end, and a central section configured to be capable of storing elastic strain energy. The method includes anchoring the tissue retraction end to a first location, anchoring the tissue stabilization end to a second location remote from the first location, and allowing the stored elastic strain energy to reduce the distance between the first and second locations, increasing tension in a portion of the lung not between the first and second locations.

[0253] In another aspect of the invention, a lung treatment method is provided that includes providing an elongated delivery system shaft with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retracting end, a proximal tissue stabilizing end, and a central section configured to be capable of storing elastic strain energy. The method includes anchoring the tissue retracting end to a first location, anchoring the tissue stabilizing end to a second location remote from the first location, and allowing the stored elastic strain energy to reduce the distance between the first and second locations, increasing tension in a portion of the lung not between the first and second locations.

[0254] In another aspect of the invention, a lung treatment method is provided that includes providing an elongated delivery system shaft with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retraction end, a proximal tissue stabilization end, and a central section configured to be capable of storing elastic strain energy. Additionally, the lung treatment device is configured to at least partially surround the elongated delivery system shaft. The method includes anchoring the tissue retraction end to a first location and anchoring the tissue stabilization end to a second location spaced from the first location, and allowing the stored elastic strain energy to reduce the distance between the first and second locations, increasing tension in a portion of the lung not between the first and second locations.

[0255] In another aspect of the invention, a lung treatment method is provided that includes providing an elongated delivery system shaft with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retraction end, a proximal tissue stabilization end, and a central section configured to store elastic strain energy. Additionally, the treatment device is configured to at least partially surround the elongated delivery system shaft. The method includes anchoring the tissue retraction end to a first location, anchoring the tissue stabilization end to a second location spaced from the first location, and reducing the distance between the first and second locations to increase tension in a portion of the lung not between the first and second locations.

[0256] In another aspect of the invention, a lung treatment method is provided that includes providing an elongated delivery system shaft with a distal end, a proximal end, and a length greater than 5 inches, and a lung treatment device with a distal tissue retracting end, a proximal tissue stabilizing end, and a central section configured to store elastic strain energy. The method includes anchoring the tissue retracting end to a first location, anchoring the tissue stabilizing end to a second location spaced from the first location, and reducing the distance between the first and second locations to increase tension in a portion of the lung not between the first and second locations.

[0257] In another aspect of the present invention, a method of lung treatment is provided that includes providing a lung treatment device, a bronchoscope, and a bronchoscope guide sleeve, wherein the treatment device is configured with a proximal end, a distal end, and a central section incorporating a lumen extending through the treatment device proximal end and central section along a central axis between the distal end and the proximal end, the bronchoscope guide sleeve is configured with a lumen extending through the entire length of the bronchoscope guide sleeve along a central axis between the proximal end, the distal end, and the proximal end, and the bronchoscope is configured to be advanced through the bronchoscope guide sleeve and through the proximal end and central section of the treatment device to allow the length of the lung treatment device to be extended or shortened by sliding the bronchoscope guide sleeve attached to the lung treatment device along the axis of the coaxial bronchoscope. Furthermore, when the distal end of the treatment device is anchored to a first location within the lung and the proximal end of the treatment device is anchored to a second location within the lung that is away from the first location, the treatment device is shortened, reducing the distance between the two locations within the lung and increasing tension in an area within the lung that is not between the two locations.

[0258] In another aspect of the present invention, a pulmonary treatment method is provided, including providing a pulmonary treatment device, a bronchoscope, and a bronchoscope guide sleeve, wherein the pulmonary treatment device is configured with a proximal end, a distal end, and a central section. The treatment device is capable of being stretched and storing elastic strain energy. The treatment device may also be attached to the bronchoscope and the bronchoscope guide sleeve. The bronchoscope guide sleeve is configured with a proximal end, a distal end, and a lumen extending therethrough along its longitudinal axis. The bronchoscope is configured to be advanced through the bronchoscope guide sleeve and through the treatment device, allowing the pulmonary treatment device length to be extended or shortened by sliding the bronchoscope guide sleeve along the axis of the coaxial bronchoscope. Further, the distal end of the treatment device is anchored to a first location within the lung and the proximal end of the treatment device is anchored to a second location within the lung that is away from the first location, and the treatment device is shortened, reducing the distance between the two locations within the lung that is not between the first anchoring location and the second anchoring location, and increasing tension in an area within the lung.

[0259] In another aspect of the present invention, a method of treating lungs is provided, including providing a lung treatment device, a bronchoscope, and a bronchoscope guide sleeve, wherein the treatment device is configured with a proximal end, a distal end, and a central section. The treatment device is capable of being stretched and storing elastic strain energy. The treatment device may also be attached to the bronchoscope and the bronchoscope guide sleeve. The bronchoscope guide sleeve is configured with a proximal end, a distal end, and a lumen extending therethrough along its longitudinal axis. The bronchoscope is configured to be advanced through the bronchoscope guide sleeve and through the treatment device, allowing the treatment device length to be extended or shortened by sliding the bronchoscope guide sleeve along the axis of the coaxial bronchoscope. Further, the treatment device is elongated, storing elastic strain energy, the distal end is anchored to a first location within the lung, the treatment device proximal end is anchored to a second location within the lung that is away from the first location, and the treatment device is shortened, reducing the distance between the two locations within the lung and increasing tension in an area within the lung that is not between the first and second anchoring locations.

[0260] In another aspect of the present invention, a method of treating lungs is provided, including providing a lung treatment device, a bronchoscope, and a bronchoscope guide sleeve, wherein the treatment device is configured with a proximal end, a distal end, and a central section. The treatment device is capable of being stretched and storing elastic strain energy. The treatment device may also be attached to the bronchoscope and the bronchoscope guide sleeve. The bronchoscope guide sleeve is configured with a proximal end, a distal end, and a lumen extending therethrough along its longitudinal axis. The bronchoscope is configured to be advanced through the bronchoscope guide sleeve and through the lung treatment device, allowing the length of the lung treatment device to be extended or shortened by sliding the bronchoscope guide sleeve along the axis of the coaxial bronchoscope. Further, the treatment device is stretched and stores elastic strain energy, the distal end is anchored to a first location within the lung, and the lung treatment device proximal end is anchored to a second location within the lung that is away from the first location, and the stored elastic strain energy is allowed to shorten the lung treatment device, reducing the distance between the two locations within the lung and increasing tension in an area within the lung that is not between the first anchoring location and the second anchoring location.

[0261] In another aspect of the invention, a method of treating a lung is provided that includes deploying a tissue-retracting end of a lung treatment device into an airway at a location distal to the bifurcation from a length of the lung treatment device, retracting a non-deployed portion of the device proximally, and then deploying a stabilizing end at the bifurcation.

[0262] In another aspect of the invention, a method of lung treatment is provided that includes deploying a tissue retracting end of a lung treatment device into an airway at a location distal to a stabilizing end target location relative to the length of the device, retracting a non-deployed portion of the device proximally, and then deploying the stabilizing end at the proximal stabilizing end target location.

[0263] In another aspect of the invention, a method of treating lungs is provided that includes deploying a tissue-retracting end of a lung treatment device into an airway at a location distal to the bifurcation along the length of the device, deploying the remainder of the device, and then tensioning the stabilizing end of the device and placing the stabilizing end at the airway opening or bifurcation.

[0264] In another aspect of the invention, a method of lung treatment is provided that includes deploying a tissue-retracting end of a lung treatment device into an airway at a location distal to a stabilizing end target location relative to the length of the device, deploying the remainder of the device, and then tensioning the stabilizing end of the device to place the stabilizing end at the stabilizing end target location.

[0265] In another aspect of the invention, a method of pulmonary treatment is provided that includes deploying a tissue-retracting end of a pulmonary treatment device into an airway at a location distal to a bifurcation from a length of the pulmonary treatment device, deploying the remainder of the pulmonary treatment device, and then tensioning a portion of the pulmonary treatment device to allow the stabilizing end to be placed at an airway opening or bifurcation.

[0266] In another aspect of the present invention, a method of pulmonary treatment is provided that includes deploying a tissue retracting end of a pulmonary treatment device into an airway at a location distal to a stabilizing end target location relative to a length of the pulmonary treatment device, deploying the remainder of the pulmonary treatment device, and then tensioning a portion of the pulmonary treatment device to allow the stabilizing end to be placed at the stabilizing end target location.

[0267] In another aspect of the present invention, a lung treatment method is provided that includes the steps of disposing a shape memory alloy medical device within a human lung so that the device is at substantially body temperature, wherein the shape memory alloy medical device exhibits reversible stress-induced or strain-induced martensite at body temperature and straightens the lung airways, and the method further includes the steps of deforming the medical device to a deformed shape that is different from its final shape, constraining the deformed shape of the medical device by applying a constraint mechanism, positioning the medical device and the constraint mechanism within the lung, and removing the constraint mechanism to allow the device to recover from the deformed shape to its final shape.

[0268] In another aspect of the present invention, a lung treatment method is provided, comprising the steps of: disposing a shape memory alloy medical device within a human lung so that the device is substantially at body temperature, wherein the shape memory alloy medical device exhibits reversible stress-induced or strain-induced martensite at body temperature and straightens the lung airways; the method further comprises the steps of: transforming the medical device to a deformed shape different from its final shape; constraining the deformed shape of the medical device by applying a constraint mechanism; positioning the medical device and the constraint mechanism within the lung; and removing the constraint mechanism, allowing the device to recover from the deformed shape to its final shape, thereby spanning the lung tissue.

[0269] In another aspect of the present invention, a method of treating lungs is provided, comprising delivering to the lung a resilient medical device having a distal end, a proximal end, and a connected central section, anchoring at least a portion of the distal end to a first position within the lung, displacing at least a portion of the proximal end to a position away from the anchored at least a portion of the distal end, and anchoring at least a portion of the proximal end to a second position within the lung, thereby spanning the lung tissue.

[0270] In another aspect of the present invention, a method of lung treatment is provided that includes delivering to the lung a resilient medical device having a distal end, a proximal end, and a connected central section, anchoring at least a portion of the distal end to a first position within the lung, displacing at least a portion of the proximal end to a position away from the anchored at least a portion of the distal end, and anchoring at least a portion of the proximal end to a second position within the lung, thereby spanning the lung tissue while the step of displacing the proximal end includes the step of lengthening the device.

[0271] In another aspect of the present invention, a method of treating lungs is provided, comprising delivering to the lung a resilient medical device having a distal end, a proximal end, and a connected central section, anchoring at least a portion of the distal end to a first position within the lung, displacing at least a portion of the proximal end to a position away from the anchored at least a portion of the distal end, tensioning the device, and anchoring at least a portion of the proximal end to a second position within the lung, thereby tensioning the device against lung tissue.

[0272] In another aspect of the present invention, a method of lung treatment is provided that includes straightening a lung airway by delivering a resilient medical device to a lung, the resilient medical device having a distal end, a proximal end, and a connected central section, anchoring at least a portion of the distal end to a first position within the lung, displacing at least a portion of the proximal end to a position away from the anchored at least a portion of the distal end to straighten the lung airway, and anchoring at least a portion of the proximal end to a second position within the lung.

[0273] In another aspect of the present invention, a method of treating a lung is provided, comprising delivering to a lung a resilient medical device having a distal end, a proximal end, and a connected central section, anchoring at least a portion of the distal end to a first position within a lung airway, displacing at least a portion of the proximal end to a position away from the anchored at least a portion of the distal end to bridge the lung airway, and anchoring at least a portion of the proximal end to a second position within another lung airway, thereby spanning the lung airway.

[0274] In another aspect of the present invention, a method of treating a lung is provided, comprising delivering to a lung a resilient medical device having a distal end, a proximal end, and a connected central section, anchoring at least a portion of the distal end at a first position within a lung airway, displacing at least a portion of the proximal end to a position away from the anchored at least a portion of the distal end so as to span the lung airway, and anchoring at least a portion of the proximal end to a second position within another at least a portion of the same lung airway, thereby spanning the lung airway.

[0275] In another aspect of the present invention, a lung treatment method is provided that includes steps of tensioning lung tissue without causing lung volume reduction, the steps including delivering to the lung an elastic medical device having a distal end, a proximal end, and a connected central section; anchoring at least a portion of the distal end to a first position within the lung; displacing at least a portion of the proximal end to a position within the lung that is separate from the anchored at least a portion of the distal end, stretching the central section of the device; and anchoring at least a portion of the proximal end to a separate position within the lung while all adjacent lung tissue is tensioned and the lung tissue is not compressed to cause lung volume reduction.

[0276] In another aspect of the present invention, a lung treatment method is provided that includes steps of tensioning lung tissue without causing lung volume reduction, the steps including delivering to the lung an elastic medical device having a distal end, a proximal end, and a connected central section; anchoring at least a portion of the proximal end to a first position within the lung; displacing a portion of the distal end to a position within the lung that is away from the anchored at least a portion of the proximal end, stretching the central section of the device; and anchoring at least a portion of the distal end to a remote position within the lung while all adjacent lung tissue is tensioned and the lung tissue is not compressed to cause lung volume reduction.

[0277] In another aspect of the present invention, a lung treatment method is provided that includes deploying a resilient airway straightening medical device having an elongated body and at least one end that can be attached to lung tissue, attaching the end to at least a portion of the lung, and pulling the device to draw the lung tissue toward the attached end and straighten a portion of the lung airway.

[0278] In another aspect of the present invention, a lung treatment method is provided that includes deploying a resilient airway straightening medical device having an elongated body and at least one end that can be attached to lung tissue, attaching the end to at least a portion of the lung, and retracting the device to retract the lung tissue and straighten a portion of the lung airway without causing lung volume reduction or tissue compression at the attached end.

[0279] In another aspect of the present invention, a method of treating lungs is provided, comprising deploying a resilient airway straightening medical device comprising an elongated body and at least one end configured to be attached to lung tissue, attaching the end to at least a portion of the lung, and retracting the device to draw the lung tissue toward the attached end and straighten a portion of the lung airway.

[0280] In another aspect of the present invention, a pulmonary treatment method is provided that includes deploying a pulmonary treatment device from a delivery device into a pulmonary airway, the pulmonary treatment device having a tissue-retracting end, a stabilizing end, and a tether extending between the elastic tissue-retracting end and the stabilizing end, the device configured such that before releasing the pulmonary treatment device from the delivery device, the distance between the ends is increased and then the ends are attached to the lung tissue.

[0281] In another aspect of the present invention, a method of treating a lung is provided, comprising deploying a lung treatment device from a delivery device into a lung airway, the lung treatment device comprising a tissue retracting end, a stabilizing end, and a tether extending between the resilient tissue retracting end and the stabilizing end, the device being configured such that before releasing the lung treatment device from the delivery device, the distance between the ends is increased so that the ends are attached to the lung airway, thereby straightening the lung airway.

[0282] In another aspect of the present invention, a method of pulmonary treatment is provided, comprising deploying a pulmonary treatment device from a delivery device into a pulmonary airway, the pulmonary treatment device comprising a tissue retracting end, a stabilizing end, and a tether extending between the elastic tissue retracting end and the stabilizing end, the device being configured such that the distance between the ends is increased, the ends are attached to lung tissue, and the pulmonary treatment device is released from the delivery device to increase tension between the ends.

[0283] In another aspect of the present invention, a pulmonary treatment method is provided that includes deploying a pulmonary treatment device from a delivery device into a pulmonary airway, the pulmonary treatment device having a tissue retracting end, a stabilizing end, and a tether extending between the elastic tissue retracting end and the stabilizing end, the device configured such that before releasing the pulmonary treatment device from the delivery device, the distance between the ends is increased and the ends are attached to the lung tissue, allowing the tissue to maintain the increased distance.

[0284] In another aspect of the present invention, a lung treatment method is provided that includes a step of improving respiratory efficiency in a patient with lungs having an airway, the method including a step of advancing a treatment device distally through the airway into a portion of the patient's lung while the treatment device is in a delivery configuration, the treatment device having a proximal end and a distal end; and a step of deploying the treatment device within the portion of the lung by transitioning the treatment device from the delivery configuration to a deployed configuration, the deployed configuration of the treatment device comprising at least two helical segments with a transition segment disposed between the at least two helical segments, the transition segment being configured to straighten lung tissue disposed between the at least two helical segments when the device is in a second configuration.

[0285] In another aspect of the present invention, a lung treatment method is provided that includes a step of improving respiratory efficiency in a patient with lungs having an airway, the method including a step of advancing a treatment device distally through the airway into a portion of the patient's lung while the treatment device is in a delivery configuration, the treatment device having a proximal end and a distal end; and a step of deploying the treatment device within the portion of the lung by transitioning the treatment device from the delivery configuration to a deployed configuration, the deployed configuration of the treatment device comprising at least two helical segments with a transition segment disposed between the at least two helical segments, the distal end being configured to straighten lung tissue that is disposed distal to the at least two helical segments when the treatment device is transitioned to the deployed configuration.

[0286] In another aspect of the present invention, a lung treatment method is provided that includes a step of improving respiratory efficiency in a patient with lungs having an airway, the method including a step of advancing a treatment device distally through the airway into a portion of the patient's lung while the treatment device is in a delivery configuration, the treatment device having a proximal end and a distal end; and a step of deploying the treatment device within the portion of the lung by transitioning the treatment device from the delivery configuration to a deployed configuration, the deployed configuration of the treatment device comprising at least two helical segments with a transition segment disposed between the at least two helical segments, the distal end being configured to straighten lung tissue that is disposed distal to the at least two helical segments when the treatment device is transitioned to the deployed configuration.

[0287] In another aspect of the present invention, a lung treatment method is provided that includes a step of improving respiratory efficiency in a patient with lungs having an airway, the method including the steps of: advancing a treatment device distally through the airway into a portion of the patient's lung while the treatment device is in a delivery configuration, the treatment device having a proximal end and a distal end; and deploying the treatment device within the portion of the lung by transitioning the treatment device from the delivery configuration to a deployed configuration, the deployed configuration of the treatment device comprising at least two helical sections with a transition section disposed between the at least two helical sections, the distal end being configured to straighten lung tissue that is disposed distal to the distal end when the treatment device is transitioned to the deployed configuration and the proximal end is repositioned more proximal to the deployed distal end.

[0288] In another aspect of the present invention, a system for treating lungs is provided, comprising: a delivery device having a proximal end, a distal end, and a lumen therethrough, the distal end being configured to be advanced through the tracheobronchial tree of the lung to an area of ​​free, damaged alveolar sac tissue; a pulmonary treatment device advanceable through the lumen of the delivery device, the pulmonary treatment device including a tissue retracting end and a stabilizing end; and a deployment element removably attached to the pulmonary treatment device and insertable into the lumen of the delivery device, wherein the delivery device and deployment element together 1) deploy the tissue retracting end into the area of ​​free, damaged alveolar sac tissue while maintaining attachment of the pulmonary treatment device to the deployment element; 2) retract the deployed tissue retracting end to re-tension the area of ​​free, damaged alveolar sac tissue; and 3) deploy the stabilizing end within the lung passageway to maintain re-tensioning of the area of ​​free, damaged alveolar sac tissue.

[0289] In another aspect of the invention, there is provided a delivery device having a proximal end, a distal end, and a lumen therethrough, the distal end being configured to be advanced through the tracheobronchial tree of the lung to an airway within the lung; a deployment sleeve having a distal end, a proximal end, and a lumen therethrough, the deployment sleeve being sized to be advanced through the delivery device lumen; a guidewire that may be passed through the lumen of the deployment sleeve; and a guidewire mounted around the exterior of the delivery device in a configuration that enables the system to be advanced through the trachea and into the lung airways and passageways. A system for treating a lung is provided, comprising a pulmonary treatment device having a distal tissue retracting end, a proximal stabilizing end, and a central section spring element, the pulmonary treatment device being configured to be advanced such that the proximal stabilizing end is wedged into lung tissue, a delivery device being configured to continue advancing an unstabilized portion of the treatment device such that the central section spring element is strained to a longer state, and a deployment sleeve being advanced and held against the distal end of the treatment device to hold it in place within the patient while the delivery device is removed. The system includes a guidewire configured to hold the treatment device in coaxial alignment with the delivery device lumen. The delivery device may be a bronchoscope.

[0290] In another aspect of the invention, a system for treating the lungs of a COPD patient is provided, comprising a delivery system element with a distal end, a proximal end, and a lung treatment device configured to at least partially surround the delivery system element while the system is being used to treat the patient.

[0291] In another aspect of the invention, a system for treating the lungs of a COPD patient is provided, comprising: a delivery system element with a distal end, a proximal end, and a length that is greater than twice the maximum lateral dimension of the element; and a pulmonary treatment device configured to at least partially surround the delivery system element while the system is advanced into the patient.

[0292] In another aspect of the invention, a system for treating the lungs of a COPD patient is provided, comprising: a delivery system element with a distal end, a proximal end, and a length that is greater than twice the maximum lateral dimension of the element; and a pulmonary treatment device configured to at least partially surround the delivery system element while the system is advanced into the patient and deliver the treatment device to a treatment location within the lung.

[0293] In another aspect of the invention, a system for treating the lungs of a COPD patient is provided, comprising: a delivery system element with a distal end, a proximal end, and a length that is greater than twice the maximum lateral dimension of the element; and a pulmonary treatment device configured to at least partially surround the delivery system element while the system is advanced into the patient and deliver the treatment device to a treatment location within the lung.

[0294] In another aspect of the present invention, a system for treating the lungs of a COPD patient is provided, comprising a delivery system cannula with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the cannula, and a pulmonary treatment device configured to at least partially surround the delivery system cannula while the system is advanced into the patient and deliver the treatment device to a treatment location within the lung, while the pulmonary treatment device is implanted within the lung to improve lung elastic recoil.

[0295] In another aspect of the present invention, a system for treating a lung is provided comprising a delivery system cannula with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the cannula, and a pulmonary treatment device configured to at least partially surround the delivery system cannula while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung while the treatment device is implanted within the lung and spans lung tissue.

[0296] In another aspect of the present invention, a system for treating the lungs is provided, comprising a bronchoscope with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the working length of the bronchoscope, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung, while the treatment device is implanted within the lung to treat COPD.

[0297] In another aspect of the present invention, a system for treating the lungs is provided, comprising a bronchoscope with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the working length of the bronchoscope, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung, while the treatment device is implanted within the lung to treat symptoms associated with COPD.

[0298] In another aspect of the present invention, a system for treating the lungs is provided, comprising a bronchoscope with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the working length of the bronchoscope, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver a treatment device to a treatment location within the lung, while the treatment device is implanted within the lung to produce one or more of the beneficial changes in the patient listed herein above.

[0299] In another aspect of the present invention, a system for treating the lungs is provided, comprising a bronchoscope with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the working length of the bronchoscope, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung, while the treatment device is elongated prior to implantation within the lung to produce one or more of the beneficial changes in the patient listed herein above.

[0300] In another aspect of the present invention, a system for treating the lungs is provided, comprising a bronchoscope with a distal end, a proximal end, and a length that is twice as long as the maximum lateral dimension of the working length of the bronchoscope, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung while the treatment device is stretched, stores elastic strain energy, and releases it within the tissue, resulting in one or more of the beneficial changes in the patient listed herein above.

[0301] In another aspect of the present invention, a system for treating the lungs is provided comprising a bronchoscope with a distal end, a proximal end, and a lumen extending therethrough, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung while the treatment device is elongated, stores elastic strain energy, and releases it within the tissue to produce one or more of the beneficial changes in the patient listed herein above.

[0302] In another aspect of the present invention, a system for treating the lungs is provided, comprising a bronchoscope with a distal end, a proximal end, and a lumen extending therethrough, and a pulmonary treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver the treatment device to a treatment location within the lung while the treatment device is stretched and stores elastic strain energy, which is used to stretch the lung tissue.

[0303] In another aspect of the present invention, a system for treating a lung is provided, comprising: a bronchoscope with a distal end, a proximal end, and a lumen extending therethrough; a lung treatment device configured to at least partially surround the bronchoscope while the system is advanced into a patient and deliver a treatment device to a treatment location within the lung; and a bronchoscope guide sleeve with a distal end, a proximal end, and a lumen configured to allow the bronchoscope to be advanced through the bronchoscope guide sleeve, while the treatment device is stretched by the bronchoscope guide sleeve and bronchoscope, storing elastic strain energy within the treatment device and used to stretch the lung tissue.

[0304] In another aspect of the present invention, a system for treating lungs is provided, comprising a lung treatment device, a bronchoscope, and a bronchoscope guide sleeve, wherein the treatment device is configured with a proximal end, a distal end, a central section, and a lumen extending through the treatment device proximal end and central section along a central axis between the distal end and the proximal end, and the bronchoscope guide sleeve is configured with a lumen extending through the entire length of the bronchoscope guide sleeve along a central axis between the proximal end, the distal end, and the open distal end and the proximal end, and the bronchoscope is configured to be advanced through the bronchoscope guide sleeve and through the proximal end and central section of the lung treatment device, such that the treatment device length may be adjusted by sliding the bronchoscope guide sleeve along the axis of the coaxial bronchoscope.

[0305] In another aspect of the present invention, there is provided a system for treating a lung, comprising an assembly for straightening a portion of a lung airway, the assembly comprising:

[0306] The device includes a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung.

[0307] In another aspect of the present invention, there is provided a system for treating a lung, comprising an assembly for straightening a portion of a lung airway, the assembly comprising:

[0308] The instrument comprises a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, wherein the delivery device is a bronchoscope.

[0309] In another aspect of the present invention, there is provided a system for treating a lung, comprising an assembly for straightening a portion of a lung airway, the assembly comprising:

[0310] The device comprises a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, wherein the delivery device is a tube.

[0311] In another aspect of the present invention, a system for treating a lung is provided, comprising an assembly for straightening a portion of a lung airway, the assembly comprising a straightening element, a first end configured for anchoring to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for anchoring to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, wherein the straightening element is tensioned after at least one end is deployed.

[0312] In another aspect of the present invention, a system for treating a lung is provided, comprising an assembly for straightening a portion of a lung airway, the assembly comprising a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, while the straightening element and the end are more coaxial while they are delivered to the airway before being released from the delivery device.

[0313] In another aspect of the present invention, a system for treating a lung is provided, comprising an assembly for straightening a portion of a lung airway, the assembly comprising a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, wherein the first end is a deformable spring.

[0314] In another aspect of the present invention, a system for treating a lung is provided, comprising an assembly for straightening a portion of a lung airway, the assembly comprising a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, wherein the second end is a deformable spring.

[0315] In another aspect of the present invention, a system for treating a lung is provided, comprising an assembly for straightening a portion of a lung airway, the assembly comprising a straightening element, a first end configured for fixation to a first portion of the lung, the first end to which the straightening element is attached, a second end configured for fixation to a second portion of the lung, the second end to which the straightening element is attached, and a delivery device for delivering the first end to the first portion of the lung and the second end to the second portion of the lung, wherein the straightening element is a spiral.

[0316] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung.

[0317] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising: a first straightening element having a first end for attachment to a first airway within the lung; a second straightening element having a second end for attachment to a second airway within the lung; a connector connecting the first straightening element to the second straightening element; and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, wherein the delivery device is a bronchoscope.

[0318] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, wherein the delivery device is a tube.

[0319] In another aspect of the present invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, wherein the first straightening element is tensioned after at least one end is deployed.

[0320] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, while the first straightening element and the first end are more coaxial while they are delivered to the airways before being released from the delivery device.

[0321] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, while the second straightening element and the second end are more coaxial while being delivered to the airways before being released from the delivery device.

[0322] In another aspect of the present invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, wherein the first tissue retracting end is a deformable spring.

[0323] In another aspect of the present invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, wherein the first straightening element is a spiral.

[0324] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, wherein the second straightening element is a spiral.

[0325] In another aspect of the present invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, while the connector connecting the first straightening element to the second straightening element is a V-shaped spring.

[0326] In another aspect of the present invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung, while the connector connecting the first straightening element to the second straightening element is a V-shaped spring.

[0327] In another aspect of the invention, a system for straightening more than one lung airway is provided, the assembly comprising a first straightening element having a first end for attachment to a first airway within the lung, a second straightening element having a second end for attachment to a second airway within the lung, a connector connecting the first straightening element to the second straightening element, and a delivery device for delivering the first end to the first airway within the lung and the second end to the second airway within the lung; additionally, more components may be included for use in straightening a third, fourth, fifth, or sixth airway with a single device.

[0328] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply a straightening force on the lung airway, the implantable device including a proximal end, a distal end, and a transition section connecting the two ends including at least one helical loop structure, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable length constraint and the second configuration configured such that a distance between a start and end of at least one of the helical loop structures is increased to straighten the airway.

[0329] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that the distance between the beginning and end of the same helical loop structure can be elastically strained to a greater extent to apply tension to the lung tissue.

[0330] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that the distance between the beginning and end of the same helical loop structure can be elastically strained to a greater extent to apply tension to the lung tissue, at least one of the ends comprising a circular helical section when the implantable device is in the second configuration.

[0331] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a greater distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, and both of the ends comprise circular helical sections when the implantable device is in the second configuration.

[0332] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising: an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends, the transition section including at least one helical loop structure with a helical loop beginning and ending; the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a greater distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue; and the implantable device further comprising an outer covering, the outer covering being made of a metal (e.g., stainless steel, titanium, nitinol, nickel, cobalt chromium, or a combination thereof) or a polymer (e.g., polycarbonate urethane, polytetrafluoroethylene (PTFE), ethylene tetrafluoroethylene (ETFE)).Fluorinated ethylene propylene (FEP), polyimide film (e.g., Kapton®), polyimide, polyether ether ketone (PEEK), polyethylene, ethylene vinyl acetate (EVA) (also known as poly(ethylene vinyl acetate) (PEVA)), polypropylene, polyvinyl alcohol (PVA), polyurethane, nylon, polyether block amide (PEBA), acrylonitrile butadiene styrene (ABS), polybutyrate, butyrate, polyethylene terephthalate (PET), polysulfone (PES), ethylene tetrafluoroethylene (ETFE), polyvinylidene fluoride (PVDF), thermoplastic polyethylene The implantable device comprises an outer covering (which can be metal, plastic, coating, coil, or extrusion made from a variety of materials such as polyurethane elastomers (e.g., Pellethane®), aliphatic polyether-based thermoplastic polyurethanes (TPUs) (e.g., Tecoflex®), metallocenes, or combinations thereof) that covers a portion of the implantable device, the outer covering being configured to reduce erosion into the airway by the deployed implantable device (by maximizing the bearing area in contact with tissue to greater than 9.81E-7 square inches of bearing area per linear inch of the implantable device).

[0333] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends, the transition section including at least one helical loop structure with a helical loop beginning and ending, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, and an outer covering covering the at least one helical section.

[0334] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and ending, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, and an outer jacket covering the distal end of the implantable device.

[0335] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends, the transition section including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the distal end of the implantable device configured to couple with the airway.

[0336] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, and the proximal end of the implantable device is atraumatic.

[0337] A method for treating a patient's lungs is provided, the lungs including a lung passage system having a first lung passage elongated axial region with an associated first local lung passage central axis and a second lung passage elongated axial region with an associated second local lung passage central axis, the method including: axially introducing an elongated body of an implant system into the lung passage system such that a proximal portion of the elongated body is disposed within the first axial lung passage region and a distal implant portion of the elongated body is disposed within the second axial lung passage region; and spanning a lung tissue volume located distal to at least one of the lung passage axial regions by bending the elongated body between the proximal and distal portions to urge a first local lung passage axis of the first lung passage axial region laterally toward the second lung passage axial region while the proximal and distal portions of the elongated body extend axially into the first and second lung passage axial regions, respectively.

[0338] A method for treating a patient's lungs is provided, the lungs including a lung passage system having a first lung passage elongated axial region with an associated first local lung passage central axis and a second lung passage elongated axial region with an associated second local lung passage central axis, the method including: axially introducing an elongated body of an implant system into the lung passage system such that a proximal portion of the elongated body is disposed within the first axial lung passage region and a distal implant portion of the elongated body is disposed within the second axial lung passage region; and tensioning a lung tissue volume by releasing strain energy previously stored within the elongated body to urge a first local lung passage axis of the first lung passage axial region laterally toward the second lung passage axial region while proximal and distal portions of the elongated body, at least partially disposed distal to at least one of the lung passage axial regions, extend into the first and second lung passage axial regions, respectively.

[0339] A method is provided for treating a patient's lung, the lung including a lung passage system having a first lung passage elongated axial region with an associated first local lung passage central axis and a second lung passage elongated axial region with an associated second local lung passage central axis, the method including: axially introducing an elongated body of an implant system into the lung passage system such that a proximal portion of the elongated body is disposed within the first axial lung passage region and a distal implant portion of the elongated body is disposed within the second axial lung passage region; and, while the proximal and distal portions of the elongated body extend axially into the first and second lung passage axial regions, respectively, tensioning a lung tissue volume by releasing strain energy previously stored within the elongated body to urge a first local lung passage axis of the first lung passage axial region laterally toward the second lung passage axial region.

[0340] A method is provided for treating a patient's lung, the lung including a lung passage system having a first lung passage elongated axial region with an associated first local lung passage central axis and a second lung passage elongated axial region with an associated second local lung passage central axis, the method including: axially introducing an elongated body of an implant system into the lung passage system such that a proximal portion of the elongated body is positioned within the first axial lung passage region and a distal implant portion of the elongated body is positioned within the second axial lung passage region; and spanning the lung tissue volume by rotating the elongated body.

[0341] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a greater distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the proximal end of the implantable device comprising one or more features selected from the following: a ball, a loop, a detachable connection, a threaded hole or shaft, a friction-fit taper or hole that is reversibly coupled to the delivery system.

[0342] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and ending, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a greater distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the implantable device being fabricated from a metal alloy containing nickel and titanium.

[0343] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a greater distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the implantable device being fabricated from a stainless steel alloy.

[0344] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the implantable device being fabricated from a steel alloy containing chromium.

[0345] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and ending, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the implantable device being fabricated from an alloy containing cobalt.

[0346] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends including at least one helical loop structure with a helical loop beginning and ending, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, the second configuration configured such that the distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the stabilizing end including more helical loops than the tissue retracting end when the implantable device is in the second configuration.

[0347] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends, the transition section including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, the second configuration configured such that a greater distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the tissue retracting end comprising less than one loop when the implantable device is in the second configuration.

[0348] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends, the transition section including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, and the second configuration configured such that a distance between the beginning and end of the same helical loop structure can be elastically strained to apply tension to the lung tissue, the helical section transitioning into the proximal end through a bend disposed between a proximal portion and the proximal end of the helical section when the device is in the second configuration, the bend being disposed between the proximal portion and the proximal end of the helical section such that when the proximal end is repositioned more proximal to the proximal portion of the helical section, the helical section is straightened.

[0349] In another aspect of the present invention, a lung airway straightening system for improving respiratory efficiency in a patient with an airway is provided, the system comprising an implantable device configured to apply tension on lung tissue, the implantable device including a proximal stabilizing end, a distal tissue retracting end, and a transition section connecting the two ends, the transition section including at least one helical loop structure with a helical loop beginning and end, the device further having a first delivery configuration and a second deployed configuration, the first configuration of the implantable device corresponding to a deliverable condition and a finite distance between the beginning and end of at least one of the helical loop structures, the second configuration configured to be elastically strained over a longer distance between the beginning and end of the same helical loop structure to apply tension to the lung tissue, the implant comprising a spring element, the implant constrained in the delivery configuration during delivery, and the implant configured to naturally recover from the constrained delivery configuration to the deployed configuration during deployment.

[0350] In another aspect of the invention, a lung tensioning device is provided that tensions lung tissue using the application of a rotational motion that causes the implant to pivot after a portion of the implant engages the tissue.

[0351] In another aspect of the present invention, a lung tensioning device is provided that tensions lung tissue using the application of a combination of rotational and longitudinal translational motions, where the implant is rotated and longitudinal translational motions are applied to the implant after a portion of the implant engages tissue.

[0352] These and other embodiments are described in further detail in the following description taken in conjunction with the accompanying drawings. The present invention provides, for example, the following. (Item 1) 1. A pulmonary treatment device for treating a lung, comprising: at least one tissue retractor element having a shape configured to grasp lung tissue; an anchoring element having a shape configured to anchor within a pulmonary passageway of the lung, the tissue retraction element opposing the anchoring element along a longitudinal axis when the pulmonary treatment device is in a tensioned configuration; at least one everting element, the at least one everting element being disposed between the at least one tissue retracting element and the anchoring element when the pulmonary treatment device is in the extended configuration, the at least one everting element moving the at least one tissue retracting element between the at least one everting element and the anchoring element as the pulmonary treatment device transitions toward the relaxed configuration; A device comprising: (Item 2) 2. The device of claim 1, wherein the pulmonary treatment device is formed from a continuous shaft. (Item 3) 3. The device of claim 2, wherein the continuous shaft is made of shape memory wire. (Item 4) 4. The device of any of items 2-3, wherein the at least one tissue retraction element comprises two tissue retraction elements, each formed from an opposite end of the continuous shaft. (Item 5) Item 5. The device of item 4, wherein the at least one everting element comprises two everting elements, each formed from a portion of the continuous shaft adjacent to one of the two tissue retraction elements. (Item 6) Item 6. The device of item 5, wherein the anchoring element is formed from a portion of the continuous shaft between the two everting elements. (Item 7) 7. The device of claim 6, further comprising an attachment feature formed from a portion of the continuous shaft forming the anchoring element. (Item 8) 10. A device according to any of the preceding items, wherein the at least one tissue retracting element has a shape configured to penetrate into the lung tissue upon deployment to grasp the lung tissue. (Item 9) 10. A device according to any of the preceding items, wherein each of the at least one tissue retraction elements has a helical shape that, upon deployment, threads into the lung tissue to grasp the tissue. (Item 10) The device of any of the preceding items, wherein each of the at least one tissue retraction elements, upon deployment, wraps around an axis generally perpendicular to the longitudinal axis. (Item 11) 10. The device of claim 1, wherein the at least one inversion element, when in the relaxed configuration, wraps around a vertical axis that is generally perpendicular to the longitudinal axis. (Item 12) Item 12. The device of item 11, wherein the at least one tissue retraction element, when in the relaxed configuration, is displaced from both the vertical axis and the longitudinal axis and wraps around a horizontal axis that is generally perpendicular thereto. (Item 13) Item 13. The device of item 12, wherein the horizontal axis is at least 1 mm from the vertical axis. (Item 14) 14. The device according to any of items 12-13, wherein the horizontal axis is at least 1 mm from the vertical axis. (Item 15) 10. The device of claim 1, wherein the at least one everting element forms a first circular cross-section when in the relaxed configuration, and the at least one tissue retraction element forms a second circular cross-section when in the relaxed configuration, the first circular cross-section lying in a plane perpendicular to the second circular cross-section. (Item 16) 10. The device of claim 1, wherein the at least one tissue retraction element comprises two tissue retraction elements, each having a helical winding that points away from one another. (Item 17) 2. The device of claim 1, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements having a different length. (Item 18) 10. The device of claim 1, wherein the at least one inversion element comprises at least two concentric loops. (Item 19) 10. The device of claim 1, wherein the at least one inverting element resides in a plane in the relaxed configuration, while the anchoring element resides above the plane in the relaxed configuration, and the at least one tissue retraction element resides below the plane in the relaxed configuration. (Item 20) The device of any of the preceding items, wherein the at least one everting element has a lower elastic modulus than the at least one tissue retraction element. (Item 21) 10. The device of claim 1, wherein the anchoring element has a loop-like shape upon deployment so as to apply at least partially a circumferential force within the lung passageway. (Item 22) 10. The device of any of the preceding items, wherein the anchoring element forms a loop around the longitudinal axis. (Item 23) 10. The device of any of the preceding items, wherein the anchoring element comprises an attachment feature that forms a loop. (Item 24) Item 24. The device of item 23, wherein the loop is formed around an axis perpendicular to the longitudinal axis. (Item 25) The device of any of the preceding items, wherein the lung tissue comprises damaged lung tissue, unsupported lung tissue, alveoli, free tissue, and / or tissue having small or large alveoli. (Item 26) 1. An introducer for delivering a pulmonary treatment device, comprising: a tube having a distal end and a proximal end, the tube configured to load the pulmonary treatment device; a plunger comprising an elongated member configured to be inserted into a proximal end of the tube, the elongated member having a coupling element near a distal end thereof configured to releasably couple to the pulmonary treatment device; a sheath configured to cover the coupling element within the tube prior to actuation of the coupling element to maintain coupling of the coupling element with the pulmonary treatment device; and an actuator coupled to the plunger configured to, upon actuation, advance a portion of the coupling element beyond the sheath to release the pulmonary treatment device; An introducer comprising: (Item 27) Item 27. The introducer of item 26, wherein the coupling element comprises a hook shape with a cutout. (Item 28) Item 28. The introducer of item 27, wherein the cutout has an angle that allows the pulmonary treatment device to slide out of the hook shape when the cutout is exposed from the sheath. (Item 29) 27. The introducer of claim 26, wherein the sheath is made of polyetheretherketone. (Item 30) 30. An introducer according to any of items 26-29, wherein the actuator is configured to advance a portion of the coupling member a predetermined distance upon actuation. (Item 31) 31. The introducer of claim 30, wherein the actuator comprises a push button that advances a portion of the coupling member the predetermined distance while the push button is depressed. (Item 32) Item 32. The introducer of item 31, wherein the push button has a length proportional to the distance the plunger moves upon actuation. (Item 33) 33. An introducer according to any of paragraphs 31-32, wherein the push button begins to advance after receiving a force of at least 5 pounds. (Item 34) 34. An introducer according to any one of items 31-33, wherein the push button is movable in only one direction. (Item 35) 35. The introducer of any of items 26-34, wherein a portion of the coupling element remains advanced beyond the sheath after actuation in a locked configuration. (Item 36) 36. An introducer according to any of items 26-35, wherein the tube is made of a perfluoroalkoxyalkane. (Item 37) 37. An introducer according to any of items 26-36, wherein the tube includes a distal fitting configured to mate with a catheter. (Item 38) Item 38. The introducer of item 37, wherein the distal fitting is configured to mate with the catheter in a manner that allows passage of the pulmonary treatment device from the tube to the catheter. (Item 39) Item 39. The introducer of item 38, wherein the plunger is configured to push the pulmonary treatment device through the tube and into the catheter. (Item 40) Item 40. The introducer of item 39, wherein the plunger is configured to push the pulmonary treatment device through the catheter and out the distal end of the catheter. (Item 41) 41. The introducer of any of items 26-40, wherein the distance between the distal joint and the coupling element is 150-170 mm prior to advancement of the plunger to retract the pulmonary treatment device. (Item 42) 1. A system for delivering a pulmonary treatment device, comprising: An introducer, the introducer comprising: a tube having a proximal end and a distal end, the tube configured to house the pulmonary treatment device; a plunger comprising an elongated member configured to be inserted into a proximal end of the tube, the elongated member having a coupling element near a distal end thereof configured to releasably couple to the pulmonary treatment device; an actuator coupled to the plunger configured to release the pulmonary treatment device; an introducer comprising: a catheter comprising a shaft having a proximal end and a distal end, the proximal end of the shaft configured to mate with the distal end of the introducer; A system comprising: (Item 43) Item 43. The system of item 42, wherein the shaft is sized and configured to be advanced through a working lumen of a bronchoscope. (Item 44) 44. The system according to any one of items 42-43, wherein the shaft is made of polyether block amide. (Item 45) 45. The system of any of items 42-44, wherein the plunger, when engaged, is configured to push the pulmonary treatment device through the tube and into the catheter. (Item 46) Item 46. The system of item 45, wherein the plunger is configured to push the pulmonary treatment device through the catheter and out of the distal end of the catheter. (Item 47) Item 47. The system of item 46, wherein the plunger is configured to push the pulmonary treatment device through the catheter and completely out of the distal end of the catheter without actuating release of the pulmonary treatment device. (Item 48) Item 48. The system of item 47, wherein the introducer further comprises a sheath configured to cover the coupling element within the tube prior to actuation of the coupling element so as to maintain coupling of the coupling element with the pulmonary treatment device. (Item 49) Item 49. The system of item 48, wherein an actuator coupled to the plunger is configured to, upon actuation, advance a portion of the coupling element beyond the sheath to release the pulmonary treatment device. (Item 50) Item 50. The system of item 49, wherein the coupling element comprises a hook shape with a cutout. (Item 51) Item 51. The system of item 50, wherein the cutout has an angle that allows the pulmonary treatment device to slide out of the hook shape when the cutout is exposed from the sheath. (Item 52) 52. The system of any of items 49-51, wherein the actuator is configured to advance a portion of the coupling member a predetermined distance upon actuation. (Item 53) Item 53. The system of item 52, wherein the actuator comprises a push button that advances a portion of the coupling member the predetermined distance while the push button is depressed. (Item 54) Item 54. The system of item 53, wherein the push button has a length proportional to the distance the plunger moves upon actuation. (Item 55) 55. The system of any of items 53-54, wherein the push button begins to advance after receiving a force of at least 5 pounds. (Item 56) 56. The system of any of items 53-55, wherein the push button is movable in only one direction. (Item 57) 57. The system of any of items 53-56, wherein a portion of the coupling element remains advanced beyond the sheath after actuation in a locked configuration. (Item 58) 58. The system of any of items 42-57, further comprising a guidewire configured to pass through the catheter. (Item 59) Item 59. The system of item 58, wherein the guidewire has a plurality of markers positioned therealong to indicate the distance at which the guidewire emerges from the distal end of the catheter. (Item 60) 60. The system of claim 59, wherein the marker is made of a material that is visible using visualization techniques through the patient's body. (Item 61) 61. A system according to any of items 59-60, wherein at least some of the plurality of markers are positioned along the proximal end of the guidewire. (Item 62) 61. The system of any of items 59-60, wherein a first section of the guidewire extends distally from the distal end of the catheter, while a second section of the guidewire extends proximally from the proximal end of the catheter, and wherein a portion of the plurality of markers is positioned along the first section and another portion of the plurality of markers is positioned along the second section. (Item 63) Item 63. The system of item 62, wherein the spacing of the markers within the portion is proportional to the spacing of the markers within the other portion. (Item 64) 64. The system of any of items 58-63, wherein the guidewire is configured to extend at least 250 mm from the distal end of the catheter. (Item 65) 65. The system of any of items 42-64, wherein the catheter is configured to move in conjunction with the plunger while coupled to the tube to expose the pulmonary treatment device. (Item 66) Item 66. The system of item 65, wherein movement of the catheter in conjunction with the plunger is incrementally increased to incrementally expose the pulmonary treatment device. (Item 67) 1. A pulmonary treatment device, comprising: at least one tissue retractor element having a shape configured to grasp lung tissue; an anchoring element having a shape configured to anchor within a pulmonary passageway of the lung, the tissue retraction element opposing the anchoring element along a longitudinal axis when the pulmonary treatment device is in a tensioned configuration; at least one everting element, the at least one everting element being disposed between the at least one tissue retracting element and the anchoring element when the pulmonary treatment device is in the extended configuration, the at least one everting element moving the at least one tissue retracting element between the at least one everting element and the anchoring element as the pulmonary treatment device transitions toward the relaxed configuration; A lung treatment device comprising: 67. The system of any of items 42-66, further comprising: (Item 68) Item 68. The system of item 67, wherein the pulmonary treatment device is formed from a continuous shaft. (Item 69) Item 69. The system of item 68, wherein the continuous shaft is made of shape memory wire. (Item 70) 70. The system of any of items 68-69, wherein the at least one tissue retraction element comprises two tissue retraction elements, each formed from an opposite end of the continuous shaft. (Item 71) Item 71. The system of item 70, wherein the at least one everting element comprises two everting elements, each of the two everting elements formed from a portion of the continuous shaft adjacent to one of the two tissue retraction elements. (Item 72) Item 72. The system of item 71, wherein the anchoring element is formed from a portion of the continuous shaft between the two everting elements. (Item 73) Item 73. The system of item 72, further comprising an attachment feature formed from a portion of the continuous shaft forming the anchoring element. (Item 74) 74. The system of any of items 67-73, wherein the at least one tissue attracting element has a shape configured to penetrate into the lung tissue upon deployment to grasp the lung tissue. (Item 75) 75. The system of any of items 67-74, wherein each of the at least one tissue retracting elements has a helical shape that, upon deployment, threads into the lung tissue to grasp the tissue. (Item 76) 76. The system of any of items 67-75, wherein each of the at least one tissue retraction elements, upon deployment, wraps around an axis generally perpendicular to the longitudinal axis. (Item 77) 77. The system of any of items 67-76, wherein the at least one inversion element, when in the relaxed configuration, wraps around a vertical axis that is generally perpendicular to the longitudinal axis. (Item 78) 78. The system of any of items 67-77, wherein the at least one tissue retraction element, when in the relaxed configuration, is displaced from both the vertical axis and the longitudinal axis and wraps around a horizontal axis that is generally perpendicular thereto. (Item 79) Item 79. The system of item 78, wherein the horizontal axis is at least 1 mm from the vertical axis. (Item 80) Item 79. The system of item 78, wherein the horizontal axis is at least 1 mm from the vertical axis. (Item 81) 81. The system of any of items 67-80, wherein the at least one everting element forms a first circular cross-section when in the relaxed configuration, and the at least one tissue retraction element forms a second circular cross-section when in the relaxed configuration, the first circular cross-section lying in a plane perpendicular to the second circular cross-section. (Item 82) 82. The system of any of items 67-81, wherein the at least one tissue retraction element comprises two tissue retraction elements, each having a helical winding that points away from each other. (Item 83) 83. The system of any of items 67-82, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements having a different length. (Item 84) 84. The system of any of items 67-83, wherein the at least one inversion element comprises at least two concentric loops. (Item 85) 85. The system of any of items 67-84, wherein the at least one inverting element resides in a plane in the relaxed configuration, while the anchoring element resides above the plane in the relaxed configuration and the at least one tissue retraction element resides below the plane in the relaxed configuration. (Item 86) 86. The system of any of items 67-85, wherein the at least one inverting element has a lower elastic modulus than the at least one tissue retraction element. (Item 87) 87. The system of any of items 67-86, wherein the anchoring element has a loop-like shape upon deployment so as to apply at least partially a circumferential force within the lung passageway. (Item 88) 88. The system of any of items 67-87, wherein the anchoring element forms a loop around the longitudinal axis. (Item 89) 89. The system of any of items 67-88, wherein the anchoring element comprises an attachment feature that forms a loop. (Item 90) Item 90. The system of item 89, wherein the loop is formed around an axis perpendicular to the longitudinal axis. (Item 91) 91. The system of any of items 67-90, wherein the lung tissue comprises damaged lung tissue, unsupported lung tissue, alveoli, free tissue, and / or tissue with small or large alveoli. (Item 92) The pulmonary treatment device comprises: at least one tissue retraction element having a shape that recoils to a curved configuration about a first axis; an inversion element having a shape that recoils into a curved configuration about a second axis perpendicular to the first axis; a tethering element having a shape that recoils to a curved configuration about a third axis perpendicular to both the first and second axes; 67. The system of any of items 42-66, comprising: (Item 93) The pulmonary treatment device comprises: an anchoring element having a shape configured to anchor within a pulmonary passageway of the lung, the pulmonary passageway having a luminal axis; at least one tissue retractor element having a shape configured to grasp lung tissue, the at least one tissue retractor element being aligned with the luminal axis during deployment of the at least one tissue retractor element; at least one everting element that moves the at least one tissue retraction element out of alignment with the lumen axis as the at least one everting element recoils toward a relaxed configuration; and 67. The system of any of items 42-66, comprising: (Item 94) 1. A pulmonary treatment device for treating a lung, comprising: at least one tissue retraction element having a shape that recoils to a curved configuration about a first axis; an inversion element having a shape that recoils into a curved configuration about a second axis perpendicular to the first axis; a tethering element having a shape that recoils to a curved configuration about a third axis perpendicular to both the first and second axes; A device comprising: (Item 95) Item 95. The device of item 94, wherein the pulmonary treatment device is formed from a continuous shaft. (Item 96) Item 96. The device of item 95, wherein the continuous shaft is made of shape memory wire. (Item 97) 97. The device of any of items 95-96, wherein the at least one tissue retraction element comprises two tissue retraction elements, each formed from an opposite end of the continuous shaft. (Item 98) Item 98. The device of item 97, wherein the at least one everting element comprises two everting elements, each of the two everting elements formed from a portion of the continuous shaft adjacent to one of the two tissue retraction elements. (Item 99) Item 99. The device of item 98, wherein the anchoring element is formed from a portion of the continuous shaft between the two everting elements. (Item 100) 100. The device of claim 99, further comprising an attachment feature formed from a portion of the continuous shaft forming the anchoring element. (Item 101) 101. The device of any of items 94-100, wherein the at least one tissue retraction element has a shape configured to penetrate into the lung tissue as it recoils to the curved configuration. (Item 102) 102. The device of any of items 94-101, wherein each of the at least one tissue retraction elements has a helical shape that threads into the tissue as it recoils to the curved configuration. (Item 103) 103. The device of any of items 94-102, wherein the first axis is at least 1 mm from the second axis. (Item 104) 104. The device of any of items 94-103, wherein the first axis is at least 1 mm from the third axis. (Item 105) 105. The device of any of items 94-104, wherein the at least one everting element forms a first circular cross-section when in the relaxed configuration, and the at least one tissue retraction element forms a second circular cross-section when in the relaxed configuration, the first circular cross-section lying in a plane perpendicular to the second circular cross-section. (Item 106) 106. The device of any of items 94-105, wherein the at least one tissue retraction element comprises two tissue retraction elements, each having a helical winding that points away from each other. (Item 107) 107. The device of any of items 94-106, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements having a different length. (Item 108) 108. The device of any of items 94-107, wherein the at least one inverting element comprises at least two concentric loops. (Item 109) 109. The device of any of items 94-108, wherein the at least one everting element resides in a plane in the relaxed configuration, while the anchoring element resides above the plane in the relaxed configuration, and the at least one tissue retraction element resides below the plane in the relaxed configuration. (Item 110) 109. The device of any of items 94-109, wherein the at least one inverting element has a lower elastic modulus than the at least one tissue retraction element. (Item 111) 111. The device of any of items 94-110, wherein the anchoring element has a loop-like shape upon deployment so as to apply at least partially a circumferential force within the lung passageway. (Item 112) 112. The device of any of items 94-111, wherein the anchoring element comprises an attachment feature that forms a loop. (Item 113) Item 113. The device of item 112, wherein the loop is formed around an axis perpendicular to the third axis. (Item 114) 1. A pulmonary treatment device for treating a lung, comprising: an anchoring element having a shape configured to anchor within a pulmonary passageway of the lung, the pulmonary passageway having a luminal axis; at least one tissue retractor element having a shape configured to grasp lung tissue, the at least one tissue retractor element being aligned with the luminal axis during deployment of the at least one tissue retractor element; at least one everting element that moves the at least one tissue retraction element out of alignment with the lumen axis as the at least one everting element recoils toward a relaxed configuration; and A device comprising: (Item 115) Item 115. The device of item 114, wherein the pulmonary treatment device is formed from a continuous shaft. (Item 116) Item 116. The device of item 115, wherein the continuous shaft is made of shape memory wire. (Item 117) 117. The device of any of items 115-116, wherein the at least one tissue retraction element comprises two tissue retraction elements, each formed from an opposite end of the continuous shaft. (Item 118) Item 118. The device of item 117, wherein the at least one everting element comprises two everting elements, each of the two everting elements formed from a portion of the continuous shaft adjacent to one of the two tissue retraction elements. (Item 119) Item 119. The device of item 118, wherein the anchoring element is formed from a portion of the continuous shaft between the two everting elements. (Item 120) Item 120. The device of item 119, further comprising an attachment feature formed from a portion of the continuous shaft forming the anchoring element. (Item 121) 121. The device of any of items 114-120, wherein the at least one tissue retracting element has a shape configured to penetrate into the lung tissue upon deployment to grasp the lung tissue. (Item 122) 122. A device according to any of items 114-121, wherein each of the at least one tissue retraction elements has a helical shape that, upon deployment, threads into the lung tissue to grasp the tissue. (Item 123) 123. The device of any of items 114-122, wherein each of the at least one tissue retraction elements, upon deployment, wraps around an axis generally perpendicular to the luminal axis. (Item 124) 124. The device of any of items 114-123, wherein the at least one everting element, when in the relaxed configuration, wraps around a vertical axis that is generally perpendicular to the luminal axis. (Item 125) Item 125. The device of item 124, wherein the at least one tissue retraction element, when in the relaxed configuration, is displaced from both the vertical axis and the luminal axis and wraps around a horizontal axis that is generally perpendicular thereto. (Item 126) Item 126. The device of item 125, wherein the horizontal axis is at least 1 mm from the vertical axis. (Item 127) 127. The device of any of items 114-126, wherein the at least one everting element forms a first circular cross-section when in the relaxed configuration, and the at least one tissue retraction element forms a second circular cross-section when in the relaxed configuration, the first circular cross-section lying in a plane perpendicular to the second circular cross-section. (Item 128) 128. The device of any of items 114-127, wherein the at least one tissue retraction element comprises two tissue retraction elements, each having a helical winding that points away from each other. (Item 129) 129. The device of any of items 114-128, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements having a different length. (Item 130) 130. The device of any of items 114-129, wherein the at least one inversion element comprises at least two concentric loops. (Item 131) 131. The device of any of items 114-130, wherein the at least one inverting element resides in a plane in the relaxed configuration, while the anchoring element resides above the plane in the relaxed configuration, and the at least one tissue retraction element resides below the plane in the relaxed configuration. (Item 132) 132. The device of any of items 114-131, wherein the at least one inverting element has a lower elastic modulus than the at least one tissue retraction element. (Item 133) 133. The device of any of items 114-132, wherein the anchoring element has a loop-like shape upon deployment so as to apply at least partially a circumferential force within the lung passageway. (Item 134) 134. The device of any of items 114-133, wherein the anchoring element forms a loop around the luminal axis. (Item 135) 135. The device of any of items 114-134, wherein the anchoring element comprises an attachment feature that forms a loop. (Item 136) Item 136. The device of item 135, wherein the loop is formed around an axis perpendicular to the luminal axis. (Item 137) 1. A method of treating a lung, comprising: deploying at least one tissue attracting element of the pulmonary treatment device into the lung tissue; deploying an eversion element of the pulmonary treatment device such that the eversion element is in an everted position; deploying a proximal anchor to a location within the pulmonary passageway to anchor the pulmonary treatment device within the pulmonary passageway while maintaining the everting element in the everted position; A method comprising: (Item 138) Item 138. The method of item 137, wherein deploying the at least one tissue retraction element comprises releasing the at least one tissue retraction element to move the at least one tissue retraction element toward a preformed shape. (Item 139) Item 139. The method of item 138, wherein the preformed shape is configured to penetrate into the lung tissue to grip the lung tissue. (Item 140) Item 139. The method of item 138, wherein the preformed shape has a helical shape that upon deployment, threads into the lung tissue to grip the tissue. (Item 141) Item 138. The method of item 137, wherein the pulmonary treatment device has a longitudinal axis, and wherein each of the at least one tissue retraction elements, upon deployment, wraps around an axis generally perpendicular to the longitudinal axis. (Item 142) Item 138. The method of item 137, wherein the lung tissue in which the at least one tissue retracting element is deployed is at least 5 mm from a location within the lung passageway. (Item 143) Item 138. The method of item 137, wherein the lung tissue in which the at least one tissue retracting element is deployed is 30-50 mm from the pleura of the lung. (Item 144) Item 138. The method of item 137, further comprising retracting the pulmonary treatment device prior to deploying the proximal anchor such that the at least one tissue retraction element displaces at least a portion of the lung tissue. (Item 145) Item 145. The method of item 144, wherein the movement of at least a portion of the lung tissue applies tension to the lung. (Item 146) Item 145. The method of item 144, further comprising retracting the pulmonary treatment device prior to deploying the proximal anchor to move the at least one tissue retraction element proximally at least 5 mm. (Item 147) Item 145. The method of item 144, further comprising retracting the pulmonary treatment device prior to deploying the proximal anchor such that the pulmonary treatment device stores energy within the eversion element. (Item 148) Item 148. The method of claim 147, wherein the step of retracting the lung treatment device extends the everting element. (Item 149) Item 145. The method of item 144, further comprising maintaining the attachment of the pulmonary treatment device to the delivery device after deploying the proximal anchor. (Item 150) Item 149. The method of item 149, further comprising adjusting the position of the pulmonary treatment device after deployment of the proximal anchor. (Item 151) Item 149. The method of item 149, further comprising the step of reloading the pulmonary treatment device into the delivery device after deploying the proximal anchor. (Item 152) Item 152. The method of item 151, further comprising repeating the deploying step after the reloading step. (Item 153) 138. The method of claim 137, wherein the lung tissue comprises damaged lung tissue, unsupported lung tissue, alveoli, free tissue, and / or tissue with small or large alveoli. (Item 154) 1. A method for delivering a pulmonary treatment device to the lung, comprising: advancing a distal end of a catheter through, past, and into tissue, wherein the pulmonary treatment device is housed within the distal end of the catheter; exposing at least one tissue retraction element of the pulmonary treatment device from the distal end of the catheter such that the at least one tissue retraction element is deployed into the damaged tissue; exposing an eversion element of the pulmonary treatment device from the distal end of the catheter such that the eversion element is in an everted position; exposing a proximal anchor of the pulmonary treatment device from the distal end of the catheter so as to deploy the proximal anchor within the pulmonary passageway while maintaining the everting element in the everted position; A method comprising: (Item 155) Item 155. The method of item 154, further comprising the step of coupling an introducer to the proximal end of the catheter prior to the exposing step, wherein the pulmonary treatment device is housed within the distal end of the introducer. (Item 156) Item 156. The method of item 155, further comprising advancing the pulmonary treatment device from the introducer into the catheter. (Item 157) Item 157. The method of item 156, wherein the introducer comprises a plunger having an elongated member extending into the catheter, and advancing the pulmonary treatment device comprises pushing the pulmonary treatment device with the elongated member. (Item 158) Item 158. The method of item 157, wherein the plunger includes a coupling member at a distal end of the elongate member, the coupling member being coupled to the pulmonary treatment device during advancement of the pulmonary treatment device. (Item 159) Item 159. The method of item 158, wherein the introducer includes a sheath extending over at least a portion of the coupling member to maintain coupling between the pulmonary treatment device and the coupling member, further comprising exposing at least a portion of the coupling member and extending the sheath thereover from the distal end of the catheter. (Item 160) Item 159. The method of item 159, further comprising the step of exposing at least a portion of the coupling member and causing the sheath to extend out of the distal end of the catheter, and then repositioning at least a portion of the coupling member and causing the sheath to extend within and over the distal end of the catheter. (Item 161) Item 159. The method of item 159, wherein at least a portion of the coupling member has a cutout that receives a portion of the proximal anchor, further comprising the step of advancing the elongate member to position the cutout beyond the sheath and releasing the proximal anchor. (Item 162) Item 162. The method of item 161, wherein the plunger includes a mechanism for advancing the extension member, further comprising the step of actuating the mechanism. (Item 163) Item 163. The method of item 162, wherein the actuating the mechanism includes depressing a push button. (Item 164) Item 164. The method of item 163, wherein the push button is movable a predetermined distance, and depressing the push button advances the extension member proportionally along the predetermined distance. (Item 165) Item 164. The method of item 163, wherein the push button is locked after reaching the predetermined distance, further comprising the step of depressing the push button until the push button is locked. (Item 166) 155. The method of claim 154, wherein the lung tissue comprises damaged lung tissue, unsupported lung tissue, alveoli, free tissue, and / or tissue with small or large alveoli. (Item 167) 1. A method for delivering a pulmonary treatment device to the lung, comprising: advancing a distal end of a guidewire through the pulmonary passageway and into tissue beyond the pulmonary passageway; advancing a distal end of a catheter over the guidewire so that a distal tip of the catheter is positioned within the pulmonary passageway; determining a distance from a distal end of the guidewire to a distal end of the catheter; selecting a pulmonary treatment device based on the determined distance; delivering the pulmonary treatment device to the lung; A method comprising: (Item 168) Item 168. The method of item 167, wherein advancing the distal end of the guidewire comprises advancing the distal end of the guidewire until the distal end of the catheter reaches the pleura. (Item 169) Item 168. The method of item 167, further comprising the step of retracting the guidewire from the pleura 30-50 mm. (Item 170) Item 168. The method of item 167, wherein the guidewire comprises a plurality of markers, and determining the distance comprises visualizing at least a portion of the plurality of markers. (Item 171) Item 171. The method of item 170, wherein the plurality of markers are positioned along a proximal end of the guidewire, and determining the distance includes visualizing at least a portion of the plurality of markers along the proximal end of the guidewire. (Item 172) Item 171. The method of item 170, wherein the plurality of markers are positioned along a distal end of the guidewire, and determining the distance includes visualizing at least a portion of the plurality of markers along the distal end of the guidewire. (Item 173) Item 171. The method of item 170, wherein a first portion of the plurality of markers is positioned along a distal end of the guidewire and a second portion of the plurality of markers is positioned along a proximal end of the guidewire, and determining the distance includes visualizing the second portion indicative of the first portion. (Item 174) Item 168. The method of claim 167, wherein selecting the pulmonary treatment device includes selecting a pulmonary treatment device in an extended configuration having a length corresponding to the distance. (Item 175) Item 175. The method of claim 174, wherein the pulmonary treatment device is pre-loaded in an introducer in the extended configuration, and selecting the pulmonary treatment device includes selecting the introducer in which the pulmonary treatment device is pre-loaded. (Item 176) The step of delivering the pulmonary treatment device comprises: advancing a distal end of the catheter through the pulmonary passageway and beyond the pulmonary passageway into tissue, wherein the pulmonary treatment device is retracted within the distal end of the catheter; exposing at least one tissue retraction element of the pulmonary treatment device from the distal end of the catheter such that the at least one tissue retraction element is deployed into the tissue; exposing an eversion element of the pulmonary treatment device from the distal end of the catheter such that the eversion element is in an everted position; exposing a proximal anchor of the pulmonary treatment device from the distal end of the catheter so as to deploy the proximal anchor within the pulmonary passageway while maintaining the everting element in the everted position; Item 168. The method according to Item 167, comprising: (Item 177) 1. A pulmonary treatment device for treating a lung, comprising: at least one tissue retractor element having a shape configured to grasp lung tissue; at least one everting element configured to evert under tension; an anchoring element configured to anchor the pulmonary treatment device; A device comprising: (Item 178) 1. A pulmonary treatment device for treating a lung, comprising: a tissue retractor element having a shape configured to engage the first and second airways to retract the first and second airways toward each other; device. (Incorporated by reference)

[0353] All publications, patents, and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication, patent, or patent application was specifically and individually indicated to be incorporated by reference. [Brief explanation of the drawings]

[0354] The novel features of the invention are set forth with particularity in the appended claims. A better understanding of the features and advantages of the present invention will be obtained by reference to the following detailed description that sets forth illustrative embodiments, in which the principles of the invention are utilized, and the accompanying drawings.

[0355] [Figure 1] FIG. 1 illustrates the lungs of a healthy patient.

[0356] [Figure 2] Figures 2-3 illustrate damaged lung tissue. [Figure 3] Figures 2-3 illustrate damaged lung tissue.

[0357] [Figure 4] FIG. 4 illustrates a cross-sectional slice under computed tomography (CT) of the lungs of a patient with COPD.

[0358] [Figure 5] FIG. 5 illustrates the lungs of a patient with advanced COPD.

[0359] [Figure 6] FIG. 6 illustrates an embodiment of a pulmonary treatment device comprising an elongated shaft that is coiled into a helical shape and forms a tissue-gathering end, a stabilizing end, and an extendable central section therebetween.

[0360] [Figure 7] FIG. 7 illustrates an embodiment of a pulmonary treatment device that expands along its longitudinal axis.

[0361] [Figure 8] FIG. 8 illustrates a pulmonary treatment device delivered by a delivery device configured to be advanced to an area of ​​loose, damaged alveolar sac tissue.

[0362] [Figure 9] FIG. 9 illustrates retraction of the deployment elements, straightening and extending the surrounding airway.

[0363] [Figure 10] FIG. 10 illustrates a pulmonary treatment device that is left in place to maintain retraction of the lungs.

[0364] [Figure 11] FIG. 11 illustrates the positioning of three pulmonary treatment devices within a patient's lungs.

[0365] [Figure 12] FIG. 12 illustrates multiple pulmonary treatment devices positioned within both lungs of a patient.

[0366] [Figure 13] FIG. 13 illustrates an embodiment of the tissue retracting end of a pulmonary treatment device.

[0367] [Figure 14] FIG. 14 illustrates a top view of the embodiment of FIG.

[0368] [Figure 15] FIG. 15 illustrates another embodiment of the tissue retracting end of a pulmonary treatment device.

[0369] [Figure 16] FIG. 16 illustrates a top view of the embodiment of FIG.

[0370] [Figure 17] FIG. 17 illustrates an embodiment of the tissue retracting end of a pulmonary treatment device having multiple loops.

[0371] [Figure 18] FIG. 18 illustrates a top view of the embodiment of FIG.

[0372] [Figure 19] FIG. 19 illustrates another embodiment of the tissue retracting end of a pulmonary treatment device.

[0373] [Figure 20] FIG. 20 illustrates a top view of the embodiment of FIG.

[0374] [Figure 21] FIG. 21 illustrates an embodiment of a tissue retracting end in which the shaft extends along a longitudinal axis through an extendable central section and then gradually bends radially outward distal to the extendable central section.

[0375] [Figure 22] FIG. 22 illustrates a top view of the embodiment of FIG.

[0376] [Figure 23] FIG. 23 illustrates an embodiment of a tissue gathering end where at least one of the loops of the tissue gathering end crosses over at least a portion of another loop.

[0377] [Figure 24] FIG. 24 illustrates a top view of the embodiment of FIG.

[0378] [Figure 25] FIG. 25 illustrates an embodiment of a pulmonary treatment device having an extendable central section connecting the tissue retraction end and the stabilization end.

[0379] [Figure 26] FIG. 26 illustrates an embodiment of a pulmonary treatment device having an attachment feature located distal to the stabilizing end.

[0380] [Figure 27] 27A-27D illustrate exemplary tips suitable for either the distal tip or the proximal tip.

[0381] [Figure 28] 28A-28D illustrate an exemplary method of forming the tip of FIGS. 27A-27D.

[0382] [Figure 29] 29A-29D illustrate an exemplary tip having an attachment feature.

[0383] [Figure 30] FIG. 30 illustrates an embodiment of the device, which is comprised of a shaft with a hollow tube.

[0384] [Figure 31] 31A-31B illustrate an embodiment of a bronchoscope used as a delivery device for delivering a pulmonary treatment device.

[0385] [Figure 32] FIG. 32 illustrates an embodiment of an introducer with a pre-loaded pulmonary treatment device.

[0386] [Figure 33] FIG. 33 illustrates another embodiment of an introducer having a pre-loaded pulmonary treatment device.

[0387] [Figure 34]FIG. 34 illustrates a pre-loaded introducer advanceable into the working channel port of a bronchoscope.

[0388] [Figure 35] FIG. 35 illustrates the tip of the insertion cord of a bronchoscope positioned within damaged tissue of a patient's lung.

[0389] [Figure 36] 36-37 illustrate an embodiment in which two devices are joined using a joining device. [Figure 37] 36-37 illustrate an embodiment in which two devices are joined using a joining device.

[0390] [Figure 38] FIG. 38 illustrates an embodiment of a delivery system for delivering a pulmonary treatment device of the present invention.

[0391] [Figure 39] FIG. 39 illustrates an embodiment of a pulmonary treatment device deliverable by the system of FIG. 38 and having flared stabilizing ends.

[0392] [Figure 40] FIG. 40 illustrates the treatment device of FIG. 39 mounted on the delivery system of FIG.

[0393] [Figure 41] FIG. 41 illustrates deployment of the treatment device within the target airway by advancing the delivery system so that the extendable central section expands and elongates the treatment device while pushing the tissue retracting ends further along the target airway.

[0394] [Figure 42] FIG. 42 illustrates the beginning stages of decoupling the device from the delivery system, with the tissue retraction end being unloaded from the bronchoscope.

[0395] [Figure 43] FIG. 43 illustrates a further step of decoupling the device from the delivery system, where the deployment sleeve and guidewire are removed from the bronchoscope, allowing the tissue retracting end to fully engage the wall of the airway.

[0396] [Figure 44] FIG. 44 illustrates retraction and removal of the delivery device from the pulmonary anatomy, leaving behind the treatment device.

[0397] [Figure 45] FIG. 45 illustrates the treatment device after the stored elastic strain energy stored within at least a central section of the treatment device has forced the device to shorten and elastically recover closer to its original pre-stretched length.

[0398] [Figure 46] FIG. 46 illustrates another embodiment of a delivery system for delivery of a therapeutic device, the delivery system comprising a bronchoscope having a bronchoscope body and an insertion cord, a guidewire, a deployment sleeve, and a guide sleeve.

[0399] [Figure 47] FIG. 47 illustrates an embodiment of a treatment device that is releasably mounted onto the delivery system of FIG. [Figure 48] FIG. 48 illustrates the elongation of the extendable central section due to retraction of the stabilizing ends by the guide sleeve and clasp features.

[0400] [Figure 49] FIG. 49 illustrates another embodiment of a treatment device having tissue retraction ends and an extendable central section, which is similar to the device of FIG. 39; however, in this embodiment, the stabilization ends are different.

[0401] [Figure 50]FIG. 50 illustrates the treatment device of FIG. 49 loaded onto a delivery system.

[0402] [Figure 51] FIG. 51 illustrates the deployment of the tissue retracting end of the treatment device of FIG. 49 into the airway.

[0403] [Figure 52] FIG. 52 illustrates the extension of the central section of the treatment device of FIG. 49 by retracting a guide sleeve having a tether extending therethrough that is removably attached to the extension loop of the device.

[0404] [Figure 53] FIG. 53 illustrates anchoring of the stabilizing end of the treatment device of FIG. 49 by retracting the bronchoscope from the device.

[0405] [Figure 54] FIG. 54 illustrates the treatment device of FIG. 49 after the tethers have been cut and removed, thereby allowing the central section to recoil toward its natural configuration over time.

[0406] [Figure 55] FIG. 55 illustrates the elastic recoil of the treatment device of FIG. 54 supporting airway trees A, B, C, D, E, and F under tension.

[0407] [Figure 56] FIG. 56 illustrates an alternative method of treating a patient in which a pulmonary treatment device is deployed within the pulmonary anatomy and then subsequently expanded.

[0408] [Figure 57] FIG. 57 illustrates an embodiment of a treatment device that is collapsible to a small profile for optional delivery through a lumen within a delivery device.

[0409] [Figure 58]FIG. 58 illustrates the treatment device of FIG. 57 in a collapsed configuration mounted on a guidewire.

[0410] [Figure 59A] FIG. 59A illustrates the treatment device in an unstressed configuration.

[0411] [Figure 59B] FIG. 59B illustrates the treatment device and delivery system within the lung, with the treatment device partially deployed within the lung.

[0412] [Figure 60] FIG. 60 illustrates a treatment device and delivery system while the treatment device is partially deployed within the lung and the tissue retracting end of the treatment device is rotated to apply torque to and tension the lung tissue.

[0413] [Figure 61] FIG. 61 illustrates a treatment device deployed within the lung after the tissue retraction end is rotated, applying torque and tension to the lung tissue, and the tethering end is deployed within another airway branch, maintaining twisting and lung tissue tension.

[0414] [Figure 62] 62A-62D illustrate a treatment device and delivery system with sequential deployment steps including a rotational motion applied to the tissue retracting end and deployment of the anchoring end to maintain tissue retraction, rotation, and tension.

[0415] [Figure 63] 63A-63C illustrate embodiments of treatment devices with various tissue retraction and anchoring element geometries.

[0416] [Figure 64] FIG. 64 illustrates an embodiment of a treatment device with tissue retraction elements that cross across the longitudinal axis of the device.

[0417] [Figure 65] FIG. 65 illustrates an embodiment of a treatment device made from two ribbon strips that are joined together.

[0418] [Figure 66] FIG. 66 illustrates an embodiment of a treatment device that is crimped together.

[0419] [Figure 67] FIG. 67 illustrates an embodiment of a treatment device with curved tissue retraction elements.

[0420] [Figure 68] FIG. 68 illustrates an embodiment of a treatment device with interlocking tissue retraction and anchoring elements.

[0421] [Figure 69] FIG. 69 illustrates an embodiment of a treatment device with a strain relief section that stores energy during deployment.

[0422] [Figure 70] 70A-70B illustrate an embodiment of a treatment device comprised of a tube with slots or cuts along at least a portion of its length to increase the bearing area against tissue.

[0423] [Figure 71] 71A-71C illustrate alternative designs for increasing the device bearing area on tissue.

[0424] [Figure 72] FIG. 72 illustrates an embodiment of a treatment device with an expandable anchoring element design.

[0425] [Figure 73] FIG. 73 illustrates an embodiment of a treatment device with hooks as anchoring elements.

[0426] [Figure 74]FIG. 74 illustrates an embodiment of a treatment device with a stent as the anchoring element.

[0427] [Figure 75] FIG. 75 illustrates an embodiment of a treatment device segment made from two spliced ​​wires.

[0428] [Figure 76] 76A-76B illustrate embodiments of attachment end configurations of treatment devices.

[0429] [Figure 77] FIG. 77 illustrates an embodiment of a socketed attachment end of a treatment device.

[0430] [Figure 78] FIG. 78 illustrates an embodiment of a threaded attachment end of a treatment device.

[0431] [Figure 79] FIG. 79 illustrates an embodiment of a treatment device with interlocking attachment ends.

[0432] [Figure 80] FIG. 80 illustrates an embodiment of the attachment end of the treatment device that is controlled by forceps.

[0433] [Figure 81] FIG. 81 illustrates an embodiment of a treatment device with a stent anchoring element.

[0434] [Figure 82-1] 82A-82B illustrate an embodiment of a treatment device made from a single wire shaft.

[0435] [Figure 82-2] 82C-82D illustrate additional embodiments of pulmonary treatment devices having tissue retraction elements and anchoring elements.

[0436] [Figure 82-3] 82E-82G illustrate steps in an exemplary method of deploying a torque-based pulmonary treatment device such as that illustrated in FIGS. 82A-82D.

[0437] [Figure 83-1] 83A-83I illustrate an embodiment of a treatment device being deployed within lung tissue. [Figure 83-2] 83A-83I illustrate an embodiment of a treatment device being deployed within lung tissue.

[0438] [Figure 84] 84A-84E illustrate an embodiment of a dual tissue retractor element treatment device and components.

[0439] [Figure 85] FIG. 85 illustrates an embodiment of a treatment device and delivery system inserted into the airway.

[0440] [Figure 86] FIG. 86 illustrates an embodiment of a tissue retraction element of a treatment device deployed through an airway wall.

[0441] [Figure 87] FIG. 87 illustrates an embodiment of a treatment device being rotated to rotate and tension tissue.

[0442] [Figure 88] FIG. 88 illustrates an embodiment of the central section of a treatment device being deployed from a catheter.

[0443] [Figure 89] FIG. 89 illustrates an embodiment of the tethering end of a treatment device being deployed at an airway opening.

[0444] [Figure 90]FIG. 90 illustrates an embodiment of a treatment device decoupled from the control device of the delivery system.

[0445] [Figure 91] 91A-91D illustrate design details of an embodiment of the torque application tool and connection.

[0446] [Figure 92] FIG. 92 illustrates steps of a method embodiment, including basic treatment steps, that utilize torque to affect tissue.

[0447] [Figure 93] FIG. 93 illustrates an example of two treatment devices deployed into adjacent airways.

[0448] [Figure 94] FIG. 94 illustrates steps of an embodiment of a method for deploying two treatment devices in a bifurcating airway.

[0449] [Figure 95] FIG. 95 illustrates steps of an embodiment of a method for deploying a treatment device while seeking anatomical feedback.

[0450] [Figure 96] FIG. 96 illustrates steps of an embodiment of a method for deploying a therapeutic device while seeking physiological feedback.

[0451] [Figure 97] 97A-97C illustrate an embodiment of a surgically placed, torsion-based treatment device.

[0452] [Figure 98] FIG. 98 illustrates the treatment device of FIG. 97A being surgically deployed.

[0453] [Figure 99]99A-99D illustrate an embodiment of a distal tip having a twisted end.

[0454] [Figure 100] FIG. 100 illustrates an embodiment of a torque-based pulmonary treatment device prepared for pre-loading into an introducer.

[0455] [Figure 101] FIG. 101 illustrates the device pre-loaded into the introducer of FIG. 100 and prepared for advancement into the catheter.

[0456] [Figure 102] FIG. 102 illustrates the distal tip of the catheter of FIG. 101 advanced beyond the distal tip of the bronchoscope and the initiation steps of deployment of the device.

[0457] [Figure 103] FIG. 103 illustrates the exposure of the anchoring elements for anchoring the device.

[0458] [Figure 104] FIG. 104 illustrates the expansion of the anchoring element.

[0459] [Figure 105] FIG. 105 illustrates the release of the device, which is left as an implant.

[0460] [Figure 106] FIG. 106 illustrates an embodiment of such a pulmonary treatment device comprising a clip having a first arm and a second arm.

[0461] [Figure 107A] 107A-107C illustrate the clip embodiment of FIG. 106 in use. [Figure 107B] 107A-107C illustrate the clip embodiment of FIG. 106 in use. [Figure 107C]107A-107C illustrate the clip embodiment of FIG. 106 in use.

[0462] [Figure 108] FIG. 108 illustrates multiple clips used to treat a target location having multiple airway branches from an airway ostium.

[0463] [Figure 109] FIG. 109 illustrates an exemplary treatment of multiple target locations within the lung, each comprising a single airway ostium to a triple-bifurcated airway.

[0464] [Figure 110] FIG. 110 illustrates an embodiment of a clip having a proximal end that includes a strain relief loop.

[0465] [Figure 111] FIG. 111 illustrates an embodiment of a clip having a proximal end that includes a strain relief loop and arms that are curved rather than straight.

[0466] [Figure 112] 112A-112B illustrate a branching airway with intertwined blood vessels and an embodiment of a clip with a gap.

[0467] [Figure 113] FIG. 113 illustrates an embodiment of a clip having arms with various curves, some of which are symmetrical about a longitudinal axis and some of which are not.

[0468] [Figure 114] FIG. 114 illustrates an embodiment of a clip having a magnet.

[0469] [Figure 115] FIG. 115 illustrates an embodiment of a clip having sharp tips at the ends of the arms.

[0470] [Figure 116] FIG. 116 illustrates an embodiment of a clip with a blunt tip and spring loaded for strain relief.

[0471] [Figure 117] FIG. 117 illustrates an embodiment of a clip being delivered with the use of a delivery device.

[0472] [Figure 118] FIG. 118 illustrates the clip of FIG. 117 fully deployed within the bifurcation.

[0473] [Figure 119] 119-121 illustrate embodiments of clips in which the arms have different lengths and / or shapes from one another. [Figure 120] 119-121 illustrate embodiments of clips in which the arms have different lengths and / or shapes from one another. [Figure 121] 119-121 illustrate embodiments of clips in which the arms have different lengths and / or shapes from one another.

[0474] [Figure 122] FIG. 122 illustrates the clip of FIG. 121 positioned on a bifurcation.

[0475] [Figure 123] FIG. 123 illustrates an embodiment of a delivery device having a deployment device that is coupleable to a clip in a manner that allows for the transmission of torque to the clip by rotation of the deployment device.

[0476] [Figure 124] FIG. 124 provides a close-up view of an embodiment of a deployment device that can be coupled to a clip in a manner that allows for the transfer of torque.

[0477] [Figure 125]FIG. 125 illustrates an embodiment of a deployment device having a spiral-shaped window.

[0478] [Figure 126] FIG. 126 illustrates an embodiment of a deployment device similar to FIG. 124, however, where barbed wires make up the proximal and distal ends.

[0479] [Figure 127] FIG. 127 illustrates an embodiment of a reversible pulmonary treatment device emerging from a delivery device.

[0480] [Figure 128] FIG. 128 illustrates an embodiment of a reversible pulmonary treatment device similar to that illustrated in FIG.

[0481] [Figure 129] FIG. 129 illustrates another embodiment of a reversible pulmonary treatment device.

[0482] [Figure 130] FIG. 130 illustrates yet another embodiment of a reversible pulmonary treatment device.

[0483] [Figure 131] FIG. 131 illustrates a branched lung passageway comprising a first airway extending into damaged tissue with a delivery device positioned therein.

[0484] [Figure 132] FIG. 132 illustrates an initial step in the process of deployment of an invertible pulmonary treatment device, with the distal tip emerging from the distal end of the delivery device.

[0485] [Figure 133] FIG. 133 illustrates a tissue retractor element extending into the damaged tissue and a retaining element gripping the damaged tissue.

[0486] [Figure 134] FIG. 134 illustrates an invertible pulmonary treatment device being retracted such that the tissue retraction elements are inverted.

[0487] [Figure 135] FIG. 135 illustrates an embodiment of an anchoring element that is deployed by retraction of the delivery device, and optionally, the bronchoscope.

[0488] [Figure 136] FIG. 136 illustrates an embodiment of a reversible pulmonary treatment device decoupled from the delivery device, revealing the attachment features.

[0489] [Figure 137A] FIG. 137A illustrates another embodiment of a reversible pulmonary treatment device.

[0490] [Figure 137B] FIG. 137B illustrates a variation of the embodiment of FIG. 137A in which the everting elements curve radially outward, away from the longitudinal axis and from each other.

[0491] [Figure 138] FIG. 138 provides a side view of the reversible pulmonary treatment device of FIG. 137A.

[0492] [Figure 139] 139A-139D illustrate an embodiment of a delivery system for a reversible pulmonary treatment device.

[0493] [Figure 140] FIG. 140 illustrates the insertion cord tip of a bronchoscope inserted into a lung passageway, with the distal end of the catheter extending a short distance from the bronchoscope and the guidewire extending into the pulmonary anatomy.

[0494] [Figure 141]FIG. 141 illustrates the catheter being advanced further into the working channel of the bronchoscope so that the distal end of the catheter is further advanced.

[0495] [Figure 142] FIG. 142 illustrates a catheter inserted into the working channel of a bronchoscope so that its proximal end emerges from the working channel.

[0496] [Figure 143] FIG. 143 illustrates an embodiment of a reversible pulmonary treatment device that reaches the distal end of a catheter.

[0497] [Figure 144] FIG. 144 illustrates an embodiment of a reversible pulmonary treatment device as it further emerges from the catheter.

[0498] [Figure 145] FIG. 145 illustrates further advancement of the tissue retractor element into the damaged tissue, the pre-curve bending the distal tip proximally.

[0499] [Figure 146] FIG. 146 illustrates the advancement of the tissue retractor element even further into the damaged tissue, causing the pre-curve to bend the distal tip back around in a distal direction.

[0500] [Figure 147] FIG. 147 illustrates the emergence of the everting element from the distal end of the catheter.

[0501] [Figure 148] FIG. 148 illustrates the catheter and plunger being pulled together in the proximal direction.

[0502] [Figure 149] FIG. 149 illustrates the anchoring element being released from the plunger.

[0503] [Figure 150] FIG. 150 illustrates the inverted element recovering towards its original pre-formed shape.

[0504] [Figure 151] FIG. 151 illustrates the inverted element fully retracted to its original pre-formed shape. DETAILED DESCRIPTION OF THE INVENTION

[0505] Detailed Description of the Invention Specific embodiments of the disclosed devices, delivery systems, and methods will now be described with reference to the drawings. Nothing in this detailed description is intended to imply that any particular component, feature, or step is essential to the invention. (anatomical changes in COPD)

[0506] Figure 1 illustrates a patient's healthy lung L. As shown, the lung L includes the tracheobronchial tree, which is the anatomical and functional section of the respiratory system that transports air from the larger upper airways to the lung parenchyma. It consists of the trachea T ​​and various intrapulmonary airways, including the bronchi, bronchioles, and peripheral bronchioles. The trachea and bronchi have cartilaginous walls, which make them thick and fibrous, allowing them to remain patent during breathing. The bronchi undergo multiple divisions, ultimately giving rise to the peripheral bronchioles, which, by definition, lack cartilage. The most distal respiratory bronchioles and alveoli are where gases are exchanged in and out of the bloodstream.

[0507] The trachea T, also known as the zero-generation airway, extends distally 10–12 cm and then divides into the right and left main bronchi MB, commonly referred to as first-generation airways. The left main bronchus MB (shown in Figure 1) is approximately 5 cm long. The main bronchus MB divides into the lobar bronchi LB (secondary or second-generation airways) and then into the segmental bronchi SB (tertiary or third-generation airways). Subsegmental airways (fourth-generation airways) branch from the segmental airways, which then connect to numerous subsegmental segments found in each lobar segment. The bronchi undergo multiple divisions (average 23) along the bronchial tree. The initial 16–17th-generation bronchi constitute the conducting zone of the airway and are not normally involved in gas exchange in healthy lungs. However, as COPD progresses, particularly with emphysema, many of the traditional pathways, approximately beyond the fourth generation, are generally destroyed and collateral pathways are formed that allow gas to communicate and become incorporated into areas within the lung that can no longer exchange gas as well as into alveolar tissue within the lung that can exchange gas.

[0508] As the bronchi divide into smaller airways, the respiratory epithelial cells undergo histological changes, giving rise to the peripheral bronchioles. The 17th-19th generation bronchioles constitute the transition zone. These bronchioles enter pyramidal-shaped lobes, separated from each other by thin septa, and their apex is directed toward the hilum, which contains five to seven terminal bronchioles. The last two to three generations of bronchioles contain several alveoli within their walls and constitute the respiratory zone. The lung area distal to the terminal bronchioles is called the acini. The final division is called the respiratory bronchioles, which further branch into multiple alveolar ducts. Alveoli, the functional units of the respiratory system, begin to appear at the level of the respiratory bronchioles. This is where the majority of gas exchange occurs. It is important to note that the majority of healthy lung volume is composed of alveolar tissue. A network of airways branches from the trachea through various parts of the lungs, supplying a volume of oxygen and expelling carbon dioxide from alveoli, which are located nearly everywhere within the lungs. Only a small volume of the lungs is occupied by the airway tree and the arterial network, which transports blood from the right side of the heart through the lungs to the left side of the heart.

[0509] In a healthy lung L, intrapulmonary airways are held open by tension t (indicated by the line with the facing arrow) between the airways and the chest wall CW. The elastic properties of healthy connective lung tissue and alveolar tissue communicate tension. Tension is required to hold the airways open during normal breathing because the airways experience higher external pressure relative to internal air pressure during the expiratory breathing cycle. Without this radially outward lung elastic recoil tension holding the airways open, the airways would collapse during exhalation, which would not allow air to exit the lungs. The lung L is suspended in an expanded state due to the negative pressure or vacuum between the chest wall CW and the lung's outer membrane, i.e., the pleura PL of the lung L. As a person inhales, the chest wall CW and ribs R are expanded by the chest wall muscles CWM, and the diaphragm muscle D contracts, causing the diaphragm to descend and the diaphragmatic arch DA to contract, expanding the lung L and its volume. By expanding the volume, negative pressure is created within the alveoli, which draws fresh oxygen into the airways and alveoli. Such expansion stresses the internal lung tissue with increased tension, which distends the airways and increases lung elastic recoil. This increased lung elastic recoil significantly improves alveolar and airway contraction during exhalation. This ability to stretch and undergo ultimate elastic strain extension, along with its ability to fully recoil back to its original shape, is made possible by a fibrous protein called elastin. Elastin fibers are present in virtually all vertebrate tissues but are found abundantly only in a few structures, such as arteries, some ligaments, and the lung. In these organs, elastin accounts for a significant percentage of the total protein.

[0510] In many respects, elastin is a perfectly designed protein for its role in normal lung function. Its unusual amino acid composition and lysine-derived crosslinks provide elastin fibers with excellent extensibility and recoil properties. They also confer chemical stability to the fibers, making them susceptible to some proteolytic enzymes and chemical insults. A complication arises in conjunction with this inherent stability: mature elastin has an extremely low turnover rate. Once the delicate architecture of the structural alveolar wall is constructed and the continuum of connective tissue fibers is established, the components are intended to remain in that configuration. After the fetal and early perinatal periods of lung development, if the original architecture is destroyed, the ability to initiate new, structurally correct alveoli is absent.

[0511] The introduction of cigarette smoke and other pollutants signals phagocytes and neutrophils to respond. As neutrophils degranulate and release their enzymes, an imbalance exists between the finely regulated ratio of elastase to antiprotease, which perpetuates the destruction of lung tissue and lung elasticity. Any damage sustained by alveolar elastin that is not repaired accelerates the inevitable dehiscence of the alveolar walls. If the damage is perpetuated, as in the case of cigarette smoke, the alveolar walls slowly dehiscence, leaving lungs with significantly enlarged air spaces and no elastic recoil. Coalescence of the damage leaves structural gaps in the tissue, further reducing the lung's ability to maintain tissue integrity and lung elastic recoil.

[0512] Figures 2-3 illustrate this change in lung composition. As alveolar sacs are destroyed, large open spaces called alveoli, large alveoli, and giant alveoli form, which can exceed several centimeters in length, width, or length. Alveoli are small, subpleural, thin-walled, air-containing spaces no larger than 1-2 cm in diameter. Their walls are less than 1 mm thick. Alveoli, like small alveoli, are cystic air spaces with imperceptible walls (less than 1 mm). The difference between small and large alveoli is generally considered their size, with the border being approximately 2 cm in diameter. Over time, small alveoli can coalesce to form large or giant alveoli. While Figure 2 illustrates the damage typically seen in patients with early-stage severe emphysema, Figure 3 shows a more typical appearance of an end-stage emphysema patient, who typically experience a 30% annual mortality rate. 4 illustrates cross-sectional slices obtained using computed tomography (CT) of the lungs of a patient with COPD. CT is a non-invasive, painless procedure that uses low-dose X-ray images to visualize lung tissue. As shown, much of the lung parenchyma has been destroyed, and the majority of the lung now consists primarily of air pockets, small alveoli, and alveoli.

[0513] Figure 5 illustrates the lung L of a patient with advanced COPD. As in most COPD patients, this example shows homogeneous destruction of the lung parenchyma. This can be easily identified by the fact that similar amounts of damage are present in the upper, middle, and lower portions of the lung. If only the uppermost portion of the lung is damaged, it would be considered a lung with predominant damage in the upper lobe. Predominant damage in the lower portion would be predominant in the lower lobe. While some patients may present with heterogeneous disease, with one lung predominantly in the upper lobe and the other predominantly in the lower lobe, most heterogeneous patients present with upper lobe damage in both lungs or lower lobe damage in both lungs. Over 60% to 75% of all patients present with homogeneous disease, with a nearly uniform distribution of damage throughout the entire lung volume. Visible damage in some patients may not be readily visible even with high-resolution CT images, where the image slice thickness is less than 1.0 mm. However, most patients exhibit damage that can be easily recognized in these images, such as the pocket BU shown in Figure 5. Beyond the fourth-generation airways, there is widespread tissue destruction, with diffuse small alveoli (BL) and large alveoli (BU) filling the lung L area. Thus, end-stage COPD patients often lack any anatomically normal airways beyond the fourth-generation airways. This finding is based on a review of thousands of 3D-reconstructed computed tomography files obtained to study the lungs of patients with severe emphysema. While basic medical and specialized pulmonology teachings indicate that medium- to small-collagen-walled airways are preserved in patients with end-stage emphysema, this is simply not the case. CT reconstructions, typically referred to as post-processed CT files, provide more than simply two-dimensional visual images of cross-sectional slices of the lung. These detailed images of the body's internal structures can be reconstructed (post-processed) in a 3D format, and thus tissue density and density variations can reveal lung tissue conditions, anatomical boundaries, and physiological data and dimensions. This data can be analyzed to summarize anatomical and physiological changes such as airway lumen diameter and volume changes during breathing. Post-processing can also be used to measure the volume and density of blood vessels that remain intact within the injured lung.This is particularly useful for determining overall gas exchange activity within a lobe or region of the lung. Areas of lung tissue that do not efficiently take in gases or otherwise exchange oxygen and CO2 undergo a regulatory effect, vasoconstriction, which prevents blood from flowing without being properly prepared for return to the vascular system. Using post-processing software, it is possible to me...

Claims

1. 1. A pulmonary treatment device for treating a lung, comprising: at least one tissue retractor having a shape configured to grasp lung tissue; a proximal portion having a shape configured to be positioned within a pulmonary passageway of the lung, the tissue retraction element opposing the proximal portion along a longitudinal axis when the pulmonary treatment device is in a stretched configuration; at least one everting element disposed between the at least one tissue retraction element and the proximal portion when the pulmonary treatment device is in the extended configuration, the at least one everting element moving at least a portion of the at least one tissue retraction element between the at least one everting element and the proximal portion as the pulmonary treatment device transitions toward a relaxed configuration; wherein the at least one everting element forms a first circular cross-section when in the relaxed configuration and the at least one tissue retraction element forms a second circular cross-section when in the relaxed configuration, the first circular cross-section lying in a plane perpendicular to the second circular cross-section.

2. The device of claim 1 , wherein the pulmonary treatment device is formed from a continuous shaft.

3. The device of claim 2 , wherein the continuous shaft is made of shape memory wire.

4. The device of any of claims 2 to 3, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements being formed from an opposite end of the continuous shaft.

5. 5. The device of claim 4, wherein the at least one everting element comprises two everting elements, each of the two everting elements formed from a portion of the continuous shaft adjacent one of the two tissue retraction elements.

6. The device of claim 5 , wherein the proximal portion comprises an anchoring element, the anchoring element being formed from a portion of the continuous shaft between the two everting elements.

7. The device of claim 6 , further comprising an attachment feature formed from a portion of the continuous shaft forming the anchoring element.

8. The device of any of claims 1 to 7, wherein the at least one tissue retracting element has a shape configured to penetrate into the lung tissue upon deployment so as to grasp the lung tissue.

9. The device of any of claims 1 to 8, wherein at least one of the at least one tissue retracting elements has a helical shape that upon deployment, threads into the lung tissue to grasp the lung tissue.

10. The device of any of claims 1 to 9, wherein at least one of the at least one tissue retraction elements upon deployment wraps about an axis generally perpendicular to the longitudinal axis.

11. The device of any of claims 1 to 10, wherein the at least one inverting element, when in the relaxed configuration, wraps around a vertical axis substantially perpendicular to the longitudinal axis.

12. The device of claim 11 , wherein the at least one tissue retraction element, when in the relaxed configuration, is displaced from both the vertical axis and the longitudinal axis and wraps around a horizontal axis that is generally perpendicular to both the vertical axis and the longitudinal axis.

13. The device of claim 12 , wherein the horizontal axis is at least 1 mm from the vertical axis.

14. A device according to any of claims 12 to 13, wherein the horizontal axis is at least 1 mm from the vertical axis.

15. The device according to any of claims 1 to 14, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements having a helical shaped winding that winds away from each other.

16. The device of any of claims 1 to 15, wherein the at least one tissue retraction element comprises two tissue retraction elements, each of the two tissue retraction elements having a different length.

17. The device of any preceding claim, wherein the at least one inversion element comprises at least two concentric loops.

18. The device of any one of claims 1 to 17, wherein the at least one inverting element resides in a plane in the relaxed configuration, while the anchoring element resides above the plane in the relaxed configuration, and the at least one tissue retracting element resides below the plane in the relaxed configuration.

19. The device of any preceding claim, wherein the at least one everting element has a lower elastic modulus than the at least one tissue retraction element.

20. 20. The device of any of claims 1-19, wherein the proximal portion comprises an anchoring element, the anchoring element having a loop-like shape upon deployment so as to apply an at least partially circumferential force within the lung passageway.

21. The device of any of claims 1 to 20, wherein the proximal portion comprises an anchoring element, the anchoring element forming a loop around the longitudinal axis.

22. The device of any preceding claim, wherein the proximal portion comprises an anchoring element, the anchoring element comprising an attachment feature forming a loop.

23. The device of claim 22 , wherein the loop is formed about an axis perpendicular to the longitudinal axis.

24. The device of any of claims 1 to 23, wherein the lung tissue comprises damaged lung tissue, unsupported lung tissue, alveoli, free tissue, and / or tissue having small or large alveoli.

25. The device of claim 2 , wherein the continuous shaft has a first end and a second end, the first end and the second end being parallel to each other when the pulmonary treatment device is in a relaxed configuration.

26. The device of claim 25 , wherein the first and second ends are parallel to a longitudinal axis of the pulmonary treatment device when the pulmonary treatment device is in a relaxed configuration.

27. 3. The device of claim 2, wherein the everting element comprises at least one preformed curve in the continuous shaft, the at least one everting element moving the at least a portion of the at least one tissue retracting element between the at least one everting element and the proximal portion as the continuous shaft relaxes toward the at least one preformed curve.

Images