Fluid delivery systems and methods for treatment

Abstract

To provide systems and associated methods for delivering a cooled fluid during treatment of a patient.SOLUTION: A treatment system 17 includes a fluid cooling supply system 12 for chilling and delivering liquid coolant to a patient. The fluid cooling supply system 12 includes a cooling device and a heat exchanger device. The heat exchanger device is biased to the cooling device and is in fluid communication with a treatment device in a patient. The fluid cooling supply system includes at least one biasing mechanism to provide a given biasing force between the heat exchanger device and the cooling device to effectuate and improve heat transfer. The liquid coolant may be circulated through an energy delivery device positioned in an airway of a patient to preserve tissue.SELECTED DRAWING: Figure 1

Description

[Technical field]

[0001] (Related Applications) This application was filed on March 13, 2013, and is incorporated herein by reference in its entirety. This application claims the benefit of U.S. Provisional Patent Application No. 61 / 779,371, filed on Oct. 13, 2006.

[0002] (Technical field) The present invention generally relates to a system and related techniques for delivering chilled fluid during patient treatment. How to do it. [Background technology]

[0003] (background) Description of Related Art Some conventional medical procedures involve delivering chilled liquids directly to the body. For example, chilled fluids can cool organs, such as the brain, and increase blood flow to protect them from damage. The mixture may be fed into the stream.

[0004] Other conventional medical procedures involve the injection of chilled liquid into devices used to treat the human body. For example, some particularly effective treatments for pulmonary diseases include, e.g., Systems, Assemblies, and Methods for Treating the Bronchial Tree No. 8,088,127, entitled "Methods for Treating a Bronchial Tree," and U.S. Patent No. 8,088,127, entitled "Cold Delivery Devices With Coolable Energy Emission Assemblies No. 2011 / 0152855, entitled "Ultra-low-noise Energy Emitting Assemblies" In one exemplary procedure described in these documents, a pulmonary treatment system includes The method delivers energy to damage nerve trunks that extend along the patient's airway. In an example, energy is delivered to a coolable energy emitter assembly and simultaneously To avoid or limit the destruction of the target tissue, the chilled fluid is introduced into the energy emitter assembly. The energy emitter assembly is then cooled by the ionizing radiation.

[0005] Conventional coolant delivery systems typically deliver coolant from a container to a patient and / or treatment device. Depending on the type of treatment being performed, a conventional coolant delivery system is used. The stem can be equipped with a relatively large reservoir that can hold as much as five gallons of coolant. The cooling liquid is supplied to the thermal treatment catheter from the large container. In most cases, the coolant is simply maintained at room temperature. A closed loop system where the fluid is pumped into the device, circulated through the device in the patient, and returned to the reservoir. Yes. Summary of the Invention [Problem to be solved by the invention]

[0006] (overview) Delivering coolant to a patient's treatment site during a procedure presents the practitioner with several challenges. For example, for a desired interval during a treatment session, Maintaining a desired temperature (or temperature range) at a treatment site within a patient can be difficult. This is particularly true from the point at which the fluid is cooled and delivered to the patient to treat tissue. This is due to heat loss that may have occurred up to that point.

[0007] Conventional coolant supply systems rely on a single source of cooling fluid to be delivered to a treatment device positioned within a patient. To provide a sufficiently compact and efficient closed loop system that allows for control of the temperature and pressure of the liquid It has been recognized that conventional coolant supply systems can be expensive. This may require extensive and time-consuming sterilization between different patient procedures. In addition, conventional cooling liquid supply systems are difficult to meet the requirements of the size of the insertion device, the treatment area, and the like. The temperature at the site, duration of the treatment, requirements regarding the controllability of the system, and the patient's Due to other requirements that may be specific to a particular procedure, certain procedures, such as the pulmonary procedures discussed above, may require additional testing. It is recognized that there may be cases where the device is not ideal for use during a particular procedure. [Means for solving the problem]

[0008] According to one aspect of the present disclosure, a treatment system includes a fluid cooling supply system for treatment of a patient. The system includes a cooling system for cooling the fluid and delivering the cooled fluid to an energy The fluid cooling supply system is configured to circulate through a treatment device, such as a delivery device. The system includes (or is connected to) a fluid container having a fluid or coolant contained therein. The fluid cooling supply system may be a thermal processor for heat treating the fluid. The heat exchanger may include a cooling device having a cooling rate. or a cooling device that is biased with a given force to cause heat transfer from the fluid moving therethrough. The heat exchanger may include a thermally conductive surface and a cartridge. and a fluid passage extending through the cartridge. At least a portion of the fluid passage in the cartridge is adjacent to the thermally conductive surface. The fluid passage allows for the passage of the fluid during thermal processing of the fluid by the cooling device. Thus, when the cartridge is coupled to the cooling device, the thermally conductive surface and the thermal plate are The plates are biased against each other to cool the cartridge by operating the cooling device. extracting heat from a fluid contained within the fluid passage; and providing the cooled fluid for treatment. The drug may be delivered to a patient for treatment.

[0009] In one embodiment, the heat exchange cartridge is coupled to a plate having a thermally conductive surface. A flexible, preferably disposable, thermoformed tray. The flexible thermoformed tray is a tray When coupled to the plate, the recessed serpentine structure defines a fluid passageway. The section includes an inlet port for coupling to an inlet supply line, and a second end of the passageway includes an outlet port. The recessed serpentine structure has an outlet port for coupling to an inlet supply line. The residence time is determined based on the desired residence time of the fluid in the cartridge, the residence time being determined by the flow rate of the fluid and the and the desired temperature change of the fluid from the inlet to the outlet of the cartridge.

[0010] In another embodiment, the heat exchanger is a device for transferring heat from a fluid contained within or moving through the bag. A valve that is removably coupled to the cooling device with a given biasing force to effect thermal conduction from the valve. The bag is positioned between the cooling device and the plate. The bag can be removably coupled to the cooling device by a plate or the bag can be or other mounting devices to achieve the desired fluid temperature. A common mechanism for creating such adequate heat transfer is the given energization of the heat exchanger to the cooling device. For this reason, the bag is secured to a clamp, plate with fasteners or other suitable means. The cooling device can be energized by a device such as a The bag may include a fluid passageway that extends through the bag and meanders throughout the bag. A portion of the bag is disposed adjacent to a cooling device, and by operating the cooling device, and a cooling device attached to the bag to draw heat from the fluid contained within the fluid passage of the bag. and the cooled fluid can be delivered to the patient for treatment.

[0011] The fluid cooling delivery system includes a pump that delivers and / or circulates a volume of fluid to a patient. To regulate the amount of heat transfer and fluid volume and pressure delivered to the patient, To achieve this, at least one controller can be coupled to the cooling device and the pump. The body cooling supply system may also include a supply path and a return path, the paths being connected together. The supply path may include a line or tube or fluid pathway. In the fluid container, the fluid is passed through a heat exchanger cartridge to cool the fluid, which is then processed. The return path is within the patient to a treatment device for cooling at the placement site. The treatment device is the starting point, and the return path is for continuous circulation of the fluid through the system. This allows the fluid container, the supply tube and the return tube to be traversed back to the fluid container. The tube, the fluid passages of the cartridge, and the treatment device are all in fluid communication with each other. Therefore, the cooling device requires a pump to circulate the cooling fluid through the entire system while the patient is being treated. Cool the fluid.

[0012] As can be appreciated in any aspect of the present disclosure, a fluid cooling supply system includes: It can be a closed loop system or an open loop system. In a closed loop system, the flow The fluid is continuously fed from and returned to the fluid reservoir for recirculation. In this system, fluid is delivered from a fluid container to the treatment device and then circulated through the treatment device. It is discarded after ringing.

[0013] With respect to certain components of the fluid cooling supply system introduced above, several aspects According to the present invention, the fluid container may be a bag or other device capable of holding a fluid. In a closed loop system, the fluid container has a supply port for providing fluid and a supply port for dispensing fluid through the system. and a return port for receiving fluid once circulated through the collapsible bag (e.g., saline). (such as an IV bag used to hold and deliver saline or other fluids). The use of a pumpable bag advantageously allows fluid to be pumped from a fluid container through the system. The resulting fluid flow depending on whether the pumping is forward or reverse. It can respond to pressure changes.

[0014] In some embodiments, the fluid container is connected to a closed loop system via a coaxial bag spike assembly. The coaxial double spike has a lumen within the lumen of the female luer. A hypotube may be provided for insertion through the inner passageway and the outer passageway. The assembly defines a coaxial arrangement of fluid paths. A bag spike adapter with two ports for connecting to the inner and outer passages For example, the inner passage may be in fluid communication with a return line and the outer passage may be in fluid communication with a supply line. In an alternative embodiment, the outer passage is in fluid communication with the return line and the inner passage is in fluid communication with the return line. The side passage is in fluid communication with the supply line. Thus, the coaxial bag spike assembly Separate supply spikes by allowing bodies to flow in and out of the fluid container simultaneously This eliminates the need for a return spike and allows standard commercial IV bags to be used as coolant containers. It can also be used as a vessel.

[0015] The cooling device is a device that uses the effect of the fluid when the heat exchanger is coupled to the thermal plate. A thermoelectric cooler (hereafter referred to as a thermoelectric cooler) has a thermal plate for efficient heat transfer. The cooling device may be any suitable cooling device, such as a TEC (transducer-assisted cooling chamber). TECs are well known in the art. As is known, heat transfer devices are commonly used to cool equipment and control the amount of heat transfer from a material or fluid. TECs use the Peltier effect (or thermoelectric effect) to create a Therefore, a typical TEC consists of multiple p The device is equipped with a "hot plate" and a "cold plate" that have n-type and n-type semiconductors. When a voltage is applied across the semiconductor, the TEC changes from a cold plate to a hot plate. The heat is conducted away from the hotplate by, for example, a heat sink and a fan. Therefore, the cooling device of the present disclosure preferably comprises a flow meter housed in a cartridge. A thermal (cold) pump that is energized against a heat exchanger cartridge to remove heat from the body. A TEC with a rated current. The cooling of the fluid may be achieved using other cooling devices or systems, such as other cooling systems that include a heat exchanger. It will be appreciated that other methods may be used to achieve the same results.

[0016] The pump is configured to supply and circulate the chilled fluid through the treatment device. The pump may be further configured to regulate the volume and pressure of fluid passing through the system. In some embodiments, the pump is connected adjacent to the cooling device and the cartridge. A peristaltic pump is a device that comes into contact with a fluid to maintain its sterility. It has the ability to draw and push fluid through a tube without touching it. In one example, The pump draws fluid through the cartridge with negative pressure and pumps the fluid through the cartridge with positive pressure. A supply between the heat exchanger cartridge and the patient to supply chilled fluid to the device. In this way, the cartridge is positioned below the Positioning the pump in the stream provides several advantages. The resulting negative pressure in the ridges allows for a more precise selection of cartridge materials and design. This allows for more flexibility in the design of the cartridge. This results in increased heat transfer from the fluid during system operation. The positive pressure supplied to the energy delivery device is at least 80 psi and the fluid is at least 10 p.s.i. The fluid is returned from the treatment device to the fluid container and / or cartridge at a pressure of si or less, but the system The pressure in the system may vary beyond these values ​​depending on system and patient requirements. It is possible.

[0017] In some embodiments, the pump operates the system at a flow rate of between 70 milliliters per minute and 160 milliliters per minute. The fluid is configured to circulate through the nozzle, but the flow rate does not vary beyond such range. Preferably, the flow rate is 100 milliliters per minute. The pump is configured to deliver chilled fluid to the treatment device at a pressure between 25 psi and 150 psi. However, the flow rate may vary beyond such range. Preferably, the pressure is between 80 psi and 100 psi. It is.

[0018] In some embodiments, the pump includes a forward gear and a reverse gear. Reverse the flow of fluid through the system to remove gas from the system before or during patient treatment. The system is adapted to remove gas or bubbles from the system, thereby preventing interference during the procedure. This allows for fluid delivery without the need for a separate pump, maximizing cooling of the fluid within the cartridge. An inlet positioned substantially perpendicular to the horizontal and positioned in the upper portion of the cartridge. and an outlet port located in the lower portion of the cartridge. This configuration can be used to reverse the flow of fluid through the system by reversing the pump direction. In particular, the gas is removed from the fluid passages of the cartridge. The fluid rises vertically through the ridge and finally enters the fluid container for dissipation. The forward gear of the pump is then engaged to deliver chilled fluid during patient treatment. Even during normal forward operation of the pump, gases that may be present in the cartridge may be present. The body may have a tendency to rise upwards due to the particular arrangement and configuration of the cartridge. can.

[0019] In some embodiments, the fluid passage comprises a transition portion between a first sidewall and a second sidewall of the fluid passage. The at least one corner is adjacent to the at least one corner during operation of the system. configured to prevent air bubbles from being trapped near or adjacent to the at least one corner. The corner has a radius or chamfer at the transition between the first and second side walls of the passage. In addition, the fluid passage may have rounded upper and lower corners of the cross-sectional profile. These features reduce the cross-sectional area of ​​the fluid passages. This prevents air bubbles from getting trapped in the corners due to the vertical orientation of the cartridge. It can help overcome surface tension.

[0020] In one embodiment, the heat exchanger cartridge comprises a first plate and a second plate bonded together. The first plate is made of copper, aluminum and / or stainless steel. The thermally conductive surface is preferably made of copper, more preferably Most of the time, the material is made of plated or anodized metals, such as anodized aluminum or silver-plated copper. The second plate includes a thermal insulator, such as a polymer or plastic, and has at least one of the fluid passages. The serpentine groove defines a portion of the inner wall of the inner wall of the fluid. The serpentine groove defines a portion of the inner wall of the inner wall of the fluid. , and may have a substantially flat profile relative to the thermal plate. an input port coupled to a fluid container for supplying a fluid; and an output port coupled to the device. The cartridge and the output port are in fluid communication with the fluid passage and the treatment device. The ridge includes a variable volume reservoir contained within the cartridge, and fluid is dispensed from the variable volume reservoir. In such a manner that the information is only drawn from this source and not from any other source. The fluid may then be circulated through the treatment device and then discarded (open loop system). The fluid may be pumped through the inlet of the variable volume vessel (closed loop system) or the fluid may be returned to the inlet of the variable volume vessel (closed loop system). In some embodiments, the return fluid passage extends through a portion of the cartridge, At least a portion of the return fluid passage is disposed adjacent to the heat transfer surface, and the fluid in the return fluid passage is adapted to be recirculated. The fluid is then pre-cooled before being returned to the fluid container for storage.

[0021] In one embodiment, the fluid cooling supply system is sufficiently spaced between the cartridge and the cooling device. At least one biasing mechanism may be provided for providing a given biasing force. The biasing mechanism is positioned to removably couple the cartridge to the cooling device. The at least one magnet may be provided by a cooling device. and a thermal plate that is magnetically coupleable to at least one corresponding magnet adjacent to the thermal plate of the thermal sensor. or may be magnetically coupleable to a magnetically attractable element of a cooling device. At least one biasing mechanism may be positioned at opposing ends of the cartridge. The thermal plate may include two pairs of magnets, each of which has a corresponding pair of magnets adjacent to the thermal plate. A corresponding pair of magnets can be coupled to a thermal plate of a cooling device. The thermal plate can be fixed to a biasing frame that is fixed to the outer periphery of the thermal plate. The corresponding pairs of magnets in the biasing frame can extend around the magnets in the cartridge. The cartridge is fitted to a pair of the thermal expansion cartridges and can be attracted to the pair of the thermal expansion cartridges. As a result of utilizing naturally occurring means and mechanisms, Most or all of the surface area of ​​the thermally conductive surface of the cartridge is exposed to the cooling device at a given bias force. The thermal plate of the chair is energized over most or all of its surface area during cooling of the fluid. The heat transfer mechanism effectively and efficiently transfers heat from the fluid to the

[0022] In some aspects of the present disclosure, the cooling system may provide a sufficient amount of force to the cooling device. Acts to bias the cartridge and functions to create and improve heat transfer from the fluid In particular, the available TEC is limited by the amount of heat flux that can be dissipated by the TEC. Because of this, the desired heat transfer of the fluid is somewhat limited in some applications. is known to be somewhat inefficient compared to other cooling devices, so cartridge Other aspects such as the design of the pump and the configuration of other components in the system, such as the location of the pump, It is important to reduce the efficiency of the system by using the Due to the nature of the surface materials, the thermally conductive surfaces of the cartridge and the thermal plate of the cooling device It is important that there is sufficient force between the thermal plate and the heat conductive surface. Under the microscope, the copper and ceramic surfaces are usually Even if the surface is smooth, if sufficient pressure is not applied and maintained during heat transfer, It exhibits numerous ridges and valleys that can affect the thermal conductivity between materials. Increase face-to-face contact between biased surfaces to efficiently cool fluids during patient treatment Thus, an effective means and various mechanisms for properly biasing the cartridge against the cooling device are provided. Such improved surface contact ultimately reduces heat loss in the system. The fluid temperature is reduced, thereby providing a constant and controllable fluid temperature to a treatment device within the patient. This is particularly important when operating a cooling system during a lung procedure, which may require certain At intervals of 0.5-100° C., a constant fluid temperature and a constant fluid temperature are maintained for a specified duration during the treatment session. It requires pressure.

[0023] In one embodiment, the cartridge is press-fitted to improve heat transfer and reduce heat loss. Thus, the cartridge can be formed and provided in a rest configuration. When the cooling device is separated from the seat, it is in a first state (prestressed) and is connected to the cooling device. The first state can be manufactured to be in a second state when the cooling device is connected to the cooling device. The cartridge is formed to have a convex outer shape relative to the thermal plate of the vice. and having the lateral arc of the cartridge extend from the left side to the right side of the cartridge. Therefore, when the cartridge is engaged with the thermal plate, (i.e., by utilizing pairs of magnets on the left and right sides of the cartridge), The convex shape and force of the stone causes the magnets on the side of the cartridge to "flatten" the cartridge's outline. The thermally conductive surface of the cartridge is essentially flush with the thermal plate. This prestressed configuration provides a flat profile that the cartridge can withstand. This tends to prevent slight "buckling" which can result in increased cooling for the machine. This results in a recessed cartridge that is not fully or properly biased. The prestressed construction provides greater face-to-face contact between the thermally conductive surface and the thermal plate. This results in improved heat transfer while reducing heat loss in the system. This is because, when the cooling system is running during a patient treatment, this particular lung treatment At certain intervals, a constant fluid temperature and This is particularly important since the pump requires constant fluid pressure.

[0024] Install the heat exchanger cartridge for patient treatment and remove the heat exchanger cartridge from the cooling system. In some embodiments, the method includes removing a heat exchanger. The cartridge is then urged against a thermal plate of a cooling device. Cartridges and cooling devices having the same or similar features as those discussed in the The method includes removing the heat exchanger cartridge from the cooling device, may be performed after treatment of one or more patients or treatment sessions. and biasing the heat exchanger cartridge against a thermal plate of the cooling device. The step of biasing the cartridge may involve engaging a magnet or other biasing mechanism such that a given biasing force is applied to the cartridge. and adding a heat exchanger to the cartridge to provide efficient heat transfer from the fluid. In a preferred configuration, the biasing force is at least 10 pounds of force, and is preferably at least 10 pounds. The preferred range is from 100 to 60 pounds of force, although a given biasing force may vary beyond such values ​​and ranges. The biasing force provided by the magnet urges the thermally conductive surface of the cartridge toward the cooling device. Due to the magnet configuration, the cooling device The biasing of the cartridge against the seat is automatic, and the cartridge is connected to the cooling device. The cartridges are then positioned in approximately the same location on the cartridge holder as each alternate cartridge. , maintaining consistency of position of all replaceable cartridges coupled to the cooling device; Therefore, the cartridge may be damaged during repeated use of the system and replacement cartridges may be used. One advantage of the system is that it provides consistency in the efficiency of cooling the fluid. to deliver fluid to a patient prior to removing the heat exchanger cartridge from the cooling device. The method can further include pumping the mixture through a heat exchanger cartridge. , a treatment device (e.g., an energy The method may further include providing chilled fluid to a delivery device.

[0025] In another aspect, a fluid cooling supply system includes a thermal plate for cooling a fluid. a cooling device for cooling the thermal plate and a disposable heat exchanger cover removably coupled to the thermal plate; a cartridge and a heat conducting member for conducting heat from the fluid contained within the cartridge; and at least one biasing mechanism coupled to the cooling device. The cartridge may include a first plate and a second plate coupled to one another. The first plate has a thermally conductive surface such as copper, aluminum and / or stainless steel, and the second plate has a thermally conductive surface such as copper, aluminum and / or stainless steel. The second plate is made of a thermal insulating material such as polymer, ABS, nylon or polycarbonate. The plate 2 is similar to the cartridge discussed in reference to the magnetically attractable cartridge. , a serpentine channel defining the fluid passageway. In one configuration, the cartridge comprises: An upper angled surface and a corresponding lower angled surface received within the front plate for biasing the cooling device. The cartridge has angled side surfaces for easy removal and replacement of the cartridge. The cartridge may be provided with a handle at the end thereof. A number of recesses may be provided for improved heat transfer of the fluid through the device.

[0026] The cartridge may include a fluid reservoir for delivering fluid through the system. The fluid reservoir may be entirely contained within the cartridge, with the fluid reservoir being located on an exterior portion of the cartridge. The second plate may then be coupled to the cartridge. The fluid reservoir in this embodiment includes a second fluid reservoir positioned in the upper portion of the second fluid reservoir. The fluid may be a collapsible bag positioned within the cavity of the plate. The fluid may be delivered from a fluid container to a treatment device and returned to the fluid container in a closed loop system. The fluid container may be removed from the cart or disposed of as waste in an open loop system. The components and components for setting up and operating the system are located within the Ridge itself. This provides the advantage of reducing the number of steps and procedures required to install the device, thereby reducing the risk of incorrect installation of non-sterile components. The risk of human error due to use is reduced, ensuring the sterility of fluids. It also provides cooling during operation, as opposed to providing room temperature fluid from an external fluid container. An additional benefit is that the device cools the fluid within the container.

[0027] The at least one biasing mechanism includes a first biasing mechanism for engaging the cartridge with the cooling device. and a second position for disconnecting the cartridge from the cooling device. As discussed further in this disclosure, the biasing mechanism ( By providing a cam system or the like, surface-to-surface contact between the cartridge and the cooling device can be achieved. In order to increase the thermal conductivity of the cartridge, a sufficient force is applied to the thermal plate of the cooling device. This provides an effective means of properly biasing the thermally conductive surface of the edge. The front plate is coupled to a front surface of a housing that contains the cooling device. The front plate and the cartridge work together to bias the cartridge against the thermal plate. The cartridge is supported on the thermal plate of the cooling device. The front plate is sized to slidably receive the cartridge. The slot in the front plate can have a slot formed between the upper and lower biasing surfaces. The upper and lower biasing surfaces are not parallel to the thermal plate, The upper and lower angled surfaces of the cartridge can be accommodated. Therefore, the slot has a trapezoidal cross-sectional outline that corresponds to the trapezoidal cross-sectional outline of the cartridge. Therefore, the cartridge can be inserted without the cam system being disengaged (or locked). When the cartridge is unlocked, it may be slidably receivable within the slot in the front plate. When the cartridge is positioned in the slot, the cam system urges the cartridge toward the cooling device. to apply a given biasing force to the fluid during operation of the system. Cooling can occur.

[0028] In some configurations, the cam system includes a cam lever and at least one cam lobe. a camshaft having a cartridge; an actuating member coupled to the cartridge; and at least one actuating device that can be coupled to the cam lever. It can be attached directly to the shaft or dynamically connected to the camshaft. The configuration results in four cam lobes along the length of the camshaft, spaced apart from each other. However, the four cam lobes may be a single cam lobe or cam device. corresponding to the positions of the cam lobes, and are coupled to the actuating member adjacent to each of the cam lobes. There can be four actuating devices positioned. The four actuating devices are actuated by a cam lever. When the camshaft is rotated by moving from a disengaged to an engaged state, The actuator is actuated downward by the respective cam lobe. having a lower working surface that can be formed at an angle that can correspond to the angle of the prescription surface; This allows the upper angled surface of the cartridge to be moved by engaging a cam system. This biases the lower actuation surface against the surface, thereby causing the slot and cartridge Due to the trapezoidal profile and angle of the lower working surface, the cartridge is advanced slightly downward. The trapezoidal shape of the slot and cartridge The contour of the shape and the angle of the lower working surface together provide the desired contact when the cam system is engaged. The applied biasing force tends to bias the cartridge laterally against the cooling device.

[0029] Method for mounting replaceable heat exchanger cartridges on a cooling device using a cam system The method includes actuating a cam system into an engaged state to activate a cooling device. The method may include biasing the cartridge against the vice. and actuating the cartridge to a disengaged state to release the biasing force on the cartridge. The method includes removing the cartridge and replacing the cartridge with a replacement cartridge. This replacement cartridge is used during the patient procedure to The system can be used to power the cooling device.

[0030] In another embodiment, the at least one biasing mechanism is coupled to the cooling device by a hinge. and biasing the hinged door toward a closed position, thereby providing a gap between the hinged door and the cooling surface of the cooling device. In this embodiment, the cartridge may be held in place by a hinged door. On the door and / or on the facing surface of the cooling device to provide a good interface between the cartridge and the cooling device. In one embodiment, the carburette may be provided with sufficient force to increase the surface-to-surface contact between the carburette and ... The cooling device must be installed to ensure that the cartridge is inserted in an orientation that allows normal operation. a key or keys defined in at least one side edge of the cartridge for alignment with one or more keys of the cartridge; The cartridge can be configured to have one or more notches that are inserted into the cartridge.

[0031] According to some aspects of the present disclosure, a method of cooling a fluid for treatment of a patient is provided. The method involves drawing the coolant through a heat exchanger at negative pressure to chill the coolant. The method may include positioning the treatment device within the patient's bronchus and and providing a coolant to the treatment device to transfer heat from the patient to the treatment device. The method provides a coolant supply from a reservoir and returns the fluid to the reservoir in a closed loop system. Alternatively, the method may include removing fluid from a patient in an open loop system. after transferring heat to the cooling system, dispensing coolant from the reservoir and discarding the fluid. The method can include supplying fluid to the treatment device with a positive pressure. a control device coupled to the coolant device to adjust the amount of heat transfer from the coolant; adjusting the volume of fluid delivered for treatment of the patient using a controller coupled to the may include.

[0032] According to some aspects of the present disclosure, a method of cooling a fluid for treatment of a patient is provided. The method includes positioning a heat exchanger relative to a cooling device. It may include some or all of the cartridge features discussed in the disclosure. The method includes positioning the heat exchanger in a substantially vertical orientation so that gas rises through the heat exchanger. The method may include positioning a pump below the heat exchanger and determining whether the heat exchanger is in a closed state. Reverse flow of fluid through the heat exchanger to substantially remove gas from the exchanger and system. The method may include pumping with a gas such as that discussed in this disclosure. and further comprising some or all of the steps of providing the cooled fluid to the patient. can be done.

[0033] In some aspects according to the present disclosure, a system for treating a patient is provided. The system uses negative pressure to chill the fluid and deliver the chilled fluid to the patient with positive pressure. A fluid cooling supply device configured to draw fluid through the heat exchanger. The fluid cooling supply device may include a cooling device, a pump, a control device, a housing, and a front end. The plate may include some or all of the features discussed in this disclosure. Similarly, the heat exchanger may be one of several of the cartridge features discussed in this disclosure. The system may include a fluid cooling supply device positioned within the patient. The fluid cooling supply device may include an energy delivery device coupled to the cooling system. The heated fluid is circulated through an energy delivery device to deliver energy during a patient treatment. The energy delivery device is adapted to deliver energy to a target tissue of a patient. The energy delivery device may include electrodes adapted to deliver energy. The cooling member may include a cooling member disposed adjacent to the electrode. The cooling member may include a fluid cooling supply. The electrode and the cooling section may be configured to allow circulation of fluid from the supply device. The material is disposed adjacent to the wall of the patient's airway and provides for delivery of energy to the electrodes and cooling element. The circulation of cooled fluid in the brain damages nerve tissue and preserves the tissue while allowing the patient to breathe. The system is located at the bottom of the cooling device and is - Providing a pump configured to circulate fluid through the delivery device at positive pressure. The method can include any of the methods discussed in this disclosure for providing chilled fluid to a patient. The method may further include some or all of the steps for:

[0034] In some aspects of the present disclosure, the fluid cooling supply system (or other components described in the present disclosure) The temperature of the fluid delivered (by any other system and method described herein) is determined by the energy delivery. The device may be provided at a given temperature or range at the location of the delivery device or other treatment device. The temperature of the energy delivery device should be maintained below 20°C during the patient's treatment. In a preferred arrangement, the temperature at the energy delivery device is maintained at The temperature is maintained at 20°C to -5°C during patient treatment. The temperature in the device is maintained at 5°C to -2°C during the patient treatment. The temperature may vary beyond these ranges depending on the needs of the user. The fluid is delivered over a selected amount of time during a treatment portion of a patient treatment or during a patient treatment process. In some configurations, the flow rate is adjusted to a given temperature. The amount of time selected for a particular treatment area to provide the body is a maximum of 120 seconds. In some configurations, the amount of time selected for a particular treatment portion is less than 60 seconds. In some configurations, a temperature sensor is selected for a particular treatment area to provide a fluid having a given temperature. The amount of time that the fluid is provided with a given temperature is between 60 and 120 seconds. The amount of time selected for a particular treatment portion to be administered is at least 120 seconds. While the amount of time selected may vary depending on the system and patient requirements, such values ​​and ranges may vary. In some configurations, the flow rate of the heat exchanger cartridge may vary beyond 100 rpm. The body is allowed to cool to a temperature of at least 20° C. upon exiting the cartridge, and more preferably Preferably, the fluid is cooled to a temperature of 5°C to -5°C upon exiting the cartridge. The temperature of the fluid within the cartridge may vary over such temperatures and ranges.

[0035] In some aspects, a method of treating a patient is provided. The fluid delivery device for delivering fluid to a patient, such as the cooling devices and heat exchanger cartridges discussed herein, The method may include providing a cooling device having a heat exchanger. Positioning the ablation assembly of the delivery device within the canal and The ablation assembly may be adapted to appose the ablation assembly against a wall of the airway. The assembly can include electrodes adapted to deliver energy. coupling the fluid heat exchanger to the ablation assembly in fluid communication with each other; The method may include cooling the fluid in the fluid heat exchanger using a cooling device. and treating tissue by circulating fluid from a fluid heat exchanger through the delivery device. The method can include simultaneously discharging energy from the electrodes of the ablation assembly. The method can include delivering energy to treat tissue adjacent to the patient's airway. Thus, the method damages nerve tissue in nerve trunks adjacent to the airway and a portion of the bronchial tree. The present disclosure may include attenuating neural signals transmitted to the As discussed above, fluid is drawn through the fluid heat exchanger at negative pressure and drawn through the fluid heat exchanger at positive pressure. As discussed further in this disclosure, during treatment, the heat exchanger The fluid in the cooling device is cooled at a given temperature by a cooling device, and the fluid is cooled at a given temperature by a selected is delivered to (or circulated through) the delivery device for a specified amount of time. .

[0036] Those skilled in the art upon review of this disclosure will appreciate that the fluid cooling supply system and heat exchanger cartridge The present methods and systems for treating patients, as discussed further herein, The results of circulating chilled fluid through a treatment device positioned within a patient during It will be appreciated that these can be combined in various ways while still achieving the same result. There will be. [Brief description of the drawings]

[0037] (Short description of some figures of the drawing) [Figure 1] FIG. 1 is a perspective view of a treatment system having a fluid cooling delivery system according to one embodiment. [Diagram 2] FIG. 2 is a partial exploded view of a fluid cooling delivery system according to one embodiment. [Diagram 3] 1 is a schematic diagram of a fluid cooling delivery system coupled to a patient. [Figure 4] 1A is a front view of a fluid cooling delivery system and a schematic diagram of a treatment system during a treatment session, according to one embodiment. [Diagram 5] FIG. 1 is a schematic diagram of a fluid cooling delivery system coupled to an energy delivery device positioned within a patient during a treatment session, according to one embodiment. [Figure 5A] 5A is a cross-sectional view of the supply and return lumens of the treatment device of FIG. 5 taken along line 5A-5A of FIG. 5. [Figure 6A] FIG. 2 illustrates an isometric view of a heat exchanger cartridge, according to one embodiment. [Figure 6B] FIG. 2 is an exploded view of a heat exchanger according to one embodiment. [Figure 6C] FIG. 2 is an exploded view of a heat exchanger according to one embodiment. [Figure 6D] 6D is a cross-sectional side view of the heat exchanger of FIG. 6A taken along line 6D-6D of FIG. 6A. [Figure 6E] FIG. 6E is a cut-out view of a portion of the heat exchanger of FIG. 6D. [Figure 7A] FIG. 2 is a side view of a heat exchanger according to one embodiment, showing the cartridge in a first state detached from the cooling device. [Figure 7B] 7B is a side view of the heat exchanger of FIG. 7A, showing the heat exchanger engaged with a cooling device in a second state. [Figure 8] FIG. 1 is a perspective view of a fluid cooling delivery system during a treatment session, according to one embodiment. [Figure 9] FIG. 2 is a partial exploded view of a fluid cooling delivery system according to one embodiment. [Figure 10] FIG. 1 is a schematic diagram of a fluid cooling delivery system during a treatment session, according to one embodiment. [Figure 11A]FIG. 1 is a rear perspective view of a portion of a fluid cooling delivery system according to one embodiment, showing the cam system decoupled and the heat exchanger removed. [Figure 11B] FIG. 11B is a rear perspective view of FIG. 11A showing the cam system engaged and the heat exchanger installed. [Figure 12A] FIG. 11B is a side view of the front plate of FIG. 11A, according to one embodiment. [Figure 12B] 12B is a side cross-sectional view of a portion of the fluid cooling delivery system of FIG. 11B taken along line 12B-12B of FIG. 11B. [Figure 13A] FIG. 11B is an isometric view of the heat exchanger cartridge of FIG. [Figure 13B] FIG. 11B is an interior perspective view of the heat exchanger of FIG. [Figure 13C] 13C is a cross-sectional view of the heat exchanger of FIG. 13A taken along line 13C-13C of FIG. 13A. [Figure 14] FIG. 1 is a perspective view of a treatment system having a fluid cooling delivery system according to one embodiment. [Figure 15] 1A is a front view of a fluid cooling delivery system and a schematic diagram of a treatment system during a treatment session, according to one embodiment. [Figure 16] FIG. 2 is a partial exploded view of a fluid cooling delivery system according to one embodiment. [Figure 17] FIG. 1 is a rear perspective view of a hinged door assembly according to one embodiment. [Figure 18] FIG. 1 is a schematic diagram of a fluid cooling delivery system coupled to an energy delivery device positioned within a patient during a treatment session, according to one embodiment. [Figure 19A] FIG. 2 illustrates a front perspective view of a heat exchanger cartridge according to one embodiment. [Figure 19B] FIG. 2 is a rear perspective view of a heat exchanger cartridge according to one embodiment. [Figure 20] FIG. 1 illustrates a rear perspective view of a coaxial dual spike assembly according to one embodiment. DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

[0038] (Detailed Description) In accordance with the present disclosure, FIGS. 1-7B show a treatment device having a fluid cooling delivery system for treatment of a patient. 8-13C show a first embodiment of a placement system for a fluid cooling delivery system for treatment of a patient. 14 to 20 show a second embodiment of a treatment system having a fluid cooling system for treatment of a patient. 3 shows a third embodiment of a treatment system having a cooling supply system. It is understood that the various features described herein may be combined into further features and configurations. It will be appreciated that this may be discussed further in this disclosure with respect to specific configurations.

[0039] 1 and 2 illustrate a system including a fluid cooling supply system 12 coupled to a treatment system 17. FIG. 2 illustrates a partial exploded view of certain components of the fluid cooling supply system 12 of FIG. vinegar.

[0040] In the example of FIG. 1, the fluid cooling supply system 12 is coupled to a treatment system 17. The system 17 may be at least partially positionable within the patient (FIG. 4). The cooling system 12 cools the fluid, pumps the fluid, and directs the fluid through the treatment system 17. In a closed loop system, the fluid cooling supply system 12 is configured to supply a fluid A vessel 22, a fluid 24, a cooling system 26, a heat exchanger cartridge 28, a supply line 14 and and a return line 16, which together operate to return cooled fluid during treatment. The supply line 14 originates at a fluid container 22 and is circulated through the treatment system 17. The supply line 14 extends through the ridge 28 and along the pump 30. The supply line 14 is adapted to supply the pump 30 during operation of the pump 30. The line 14 may extend through a pulse damper 37 for damping vibrations in the line 14. Ultimately, the supply line 14 extends into a treatment system 17 that is positionable within the patient. A return line 16 in fluid communication with the inlet 14 originates at the treatment system 17 and recirculates the fluid during treatment. The catheter extends from within the patient back into the container 22 for circulation.

[0041] 2 further illustrates an exploded view of a portion of the cooling system 26. The cooling system 26 is disposed within the housing 3. 2, a cooling device 36, a heat exchanger cartridge 28, a control device 42, and a pump 30. The housing 32 may include a first portion 31, a second portion 33, and a second portion 34 connected to the first portion 31. The first and second parts 31, 33 of the housing 32 are detachable from each other. and configured to structurally support and house the various components of the system. The cooling device 36 is configured as a thermal plate extending at least partially through the front plate 34. The front plate 34 is fixed to the front area of ​​the first portion 31 of the housing 32. The front plate 34 and the housing 32 cooperate to provide structural support for the cooling device 36 and to The front plate 34 positions the thermal plate 38 of the cooling device 36 substantially vertically. and facilitating biasing of the cartridge 28 against the thermal plate 38. The housing 32 includes a cooling device 36 and a cooling device cover 34a for further support of the cooling device 36 (FIG. 7B). The thermal plate 38 is positioned between the thermal switch 36 and the front plate 34 through which the thermal plate 38 exits. The spacer 40 enables the above.

[0042] The cooling device 36 includes, for example, a thermal plate 38, a hot plate 39, and fins 46. The front portion 31 of the housing may be a conventional TEC with a heater, a fan 48, and a A multi-plate 38 is provided with an opening 35 for receiving a cooling device 36 so as to extend outside the housing 32. The support plate 47 of the cooling device 36 is arranged to properly position the cooling device 36. The support plate 47 may be secured to the first portion 31 of the housing 32. It may further be secured to spacer 40 and front plate 34 for support.

[0043] A spacer 40 is coupled between the front plate 34 and the cooling device 36. The spacer 40 is The plate 38 is disposed adjacent the opening 34a in the front panel 34 to allow the plate 38 to exit. The spacer 40 has an opening 40a for positioning the thermal plate 38 and the hot plate 39. 39. Thus, the outer surface 49 of the spacer 40 and the thermal plate 38 The flat surfaces 51 are substantially planar with respect to each other (FIG. 7B), so that the cartridge 28 is The valve plate 38 may be biased against the valve plate 38.

[0044] The heat exchanger cartridge 28 includes a first plate 41 and a second plate 43. A magnet 99 is attached to the second plate 43. The spacer 40 is positioned to engage the magnet 99 of the heat exchanger cartridge 28 (FIG. 6A). The magnets 99 of the second plate 43 are arranged at positions corresponding to the magnets 53. , in a spacer 40 for removably coupling the cartridge 28 to the thermal plate 38. The first plate 41 is magnetically coupled to the magnet 53 of the thermal plate 42 with a given biasing force. 6. The cartridge 28 is then biased against the flat surface 51 of the cartridge 38, causing thermal conduction of the fluid contained therein (see FIG. 6). A-Figures 6C and 7B).

[0045] The control device plate 55 is fixed to the front area of ​​the first portion 31 of the housing 32. The controller plate 55 may include an opening 57 for receiving the pump 30. The pump 30 includes a cover 50 for coupling to the supply line 14 using an available peristaltic pump or the like. and a rotating device 59. The fluid supply tube may be a peristaltic pump having a rotating device 59. The pump is placed in contact with the rotating device. A cam surface on the rotating device controls the fluid supply. A periodic pressurization of the fluid occurs in the supply line. The pump 30 has a plurality of pumps, one upstream and one downstream of the pump 30. The pump has a clamping mechanism on the side to prevent the fluid supply line from being pulled into the rotating device when the pump direction is reversed. In this example, the pump 30 is a cartridge. 28, and during normal operation of the treatment system, the cartridge 28 is provided with a negative fluid pressure 4, causing the treatment system 17 to be subjected to a positive fluid pressure.

[0046] The pulse damper 37 may be removably mounted to the controller plate 55 . The damper 37 may be, for example, a chamber with an inlet and an outlet. The damper accumulates a fluid volume directly downstream of the pump. A signal filtering device in that it smooths out the pressure oscillations generated by the chair. It functions in a similar manner to the capacitor in

[0047] The controller system 60 includes a control device 62 and a controller 64 for controlling the fluid temperature, pressure and velocity. The control device 62 is provided on the control device plate 55, and the control device 42. The practitioner can operate the control device 62 to control the system. A controller 42 is operatively coupled to the pump 30 and controls the speed and direction of the pump 30. Thus, the flow direction and volume of the fluid circulating through the system can be adjusted ( The controller 42 is also operatively coupled to the cooling device 36 to regulate the temperature of the fluid within the cartridge 28. regulating the temperature of the fluid circulating through the treatment system 17; This allows further regulation of the temperature of the treatment device and / or the patient's tissue (FIG. 4). and sensors for detecting tissue temperature, tissue impedance, and fluid delivery to the treatment device. Feedback from sensors (e.g., pressure sensors, temperature sensors, thermocouples, contact sensors, etc.) Performance can be optimized based on the temperature of the patient's tissue. If it becomes hot, a cooling device 36 is used to create deep lesions while protecting the surface tissue. Thus, fluid cooling can be increased and / or electrode current can be reduced. .

[0048] FIG. 3 is a schematic diagram of a treatment system 101 according to one embodiment of the present disclosure. The fluid cooling supply system 12 includes a cooling system 26, a heat exchanger 28, and a fluid container 22. The fluid cooling supply system 12 includes a cooling device 36, a controller 42, and a pump 30. The heat exchanger 28 is coupled to the fluid reservoir 22, the cooling device 36, and the pump 30. A conduit 66 and a return path 68 extend from the fluid cooling supply system 12 and are positioned within the patient 64. The supply path 66 originates in the fluid reservoir 22 and connects to the heat exchanger 28. Extending through the patient 64, then through the pump 30, and then through the patient 64 to the treatment device 20. The return path 68 connects the treatment device 20 to the treatment device 20 for recirculation of fluid through the system 101. 22. Alternatively, the return path 68 may be The waste container 67 can be connected to the waste container 67 via the waste container 67.

[0049] In the example shown, pump 30 draws fluid at negative pressure from fluid reservoir 22 through heat exchanger 28. As the fluid travels through the heat exchanger 28, it is cooled by the cooling device 36. The fluid is then delivered to the treatment device 20 by the pump 30 at positive pressure via the delivery path 66. The fluid is circulated through the treatment device 20 and back from the treatment device 20. In some embodiments, the heat exchanger 28 can include a fluid reservoir 22 within the fluid exchanger 28 (FIG. 6). C).

[0050] In this example, the pump 30 is equipped with a forward gear and a reverse gear, as indicated by the arrow P. The forward gear draws fluid from the fluid reservoir 22 through a heat exchanger 28, which cools the fluid. The reverse gear circulates the fluid through the treatment device 20. Conversely, the reverse gear circulates the fluid through the heat exchanger 28. In some embodiments, the system 101 is pumped in the opposite direction to evacuate any gas that may be present in that portion of the system 101. In this manner, the pump 30 can be configured to vary the pump speed to control the amount of fluid delivered to the treatment device. The device is coupled to a control device for controlling the size and applied pressure of the treatment device. can be controlled by a variable speed controller. Further, the non-contact pressure measurement device The pressure sensor is electrically coupled to the pump and is connected to a pressure sensor, for example, a pressure sensor connected to a non-contact pressure measuring device. to adjust the system pressure, such as by varying the speed of a pump in response. It may be positioned adjacent to the high pressure side of the pathway.

[0051] In some embodiments, the pump 30a is provided downstream of the treatment device 20. Thus, pump 30 and auxiliary pump 30a work together to pump fluid through the system. The pump 30a functions to circulate the chilled fluid through the treatment device 20. A maximum fluid pressure of 14 psi can be drawn. The pressure can be lower, such as about 10 psi to 20 psi, while the pressure upstream of the treatment device 20 The pressure can be higher, such as about 80 psi to 100 psi. Such a configuration provides a pump to improve cooling in the treatment area of ​​the patient. Then, you can use one pump to push fluid out while another pump draws fluid out at the same time. This is because the flow rate through the treatment device is increased by performing the treatment device 20. By drawing fluid from the pump 30a through the pump 30a, no additional pump is required. In some embodiments, the fluid pressure in the treatment device 20 can be lower than in the absence of the treatment device 20. In this example, pump 30a is the only pump or device that circulates fluid through the system. Such a configuration can further reduce fluid pressure downstream of the treatment device.

[0052] FIG. 4 illustrates a treatment system 201 according to one embodiment of the present disclosure. The treatment system 201 includes a fluid cooling system. The system may include a cooling supply system 12 and a pulmonary treatment system 19. 12 can be coupled to a pulmonary treatment system 19 by a supply line 14 and a return line 16. The pulmonary treatment system 19 includes a flexible catheter having a control portion 68, a steering mechanism 70, and a video system 72. The flexible bronchoscope 18 may be provided with a flexible bronchoscope 18 that is controlled externally to the patient's body. From section 76, a treatment device is passed through the trachea 78 to a treatment site within the left main bronchus 80 of the patient's lung 81. The treatment device 20 may include an insertion tube 74 extending into the left main bronchus 80. or in other locations such as in the right main bronchus, lobar bronchi, and intermediate bronchi. The treatment device 20 can be positioned in a location that can guide the treatment device 20 through a tortuous airway, for example, a portion of a lobe, A wide variety of procedures are available, including whole-lobe, multiple-lobe, or unilateral or bilateral denervation of the lungs. In some embodiments, the lobar bronchi can be navigated to perform the procedure. Based on the effectiveness of the treatment, the surgeon may choose to treat additional lobes simultaneously or sequentially. and can be treated.

[0053] The steering mechanism 70 may be coupled to the bronchoscope 18 and may receive the supply line 14 and the return line 16 to guide the trachea. It is possible to allow the line to exit into the scope 18 and ultimately to the treatment device 20. (FIG. 5). The bronchoscope 18 can be coupled to a video system 72, which can As the insertion tube 74 is steered with the aid of the control unit 68, the practitioner passes the patient over on the monitor 82. The video system 72 allows the practitioner to view the movement of the insertion tube 74. The bronchoscope 18 may be able to determine whether or not a catheter is to be delivered to the placement device 20. may be coupled to the controller 68 to control some of the treatments, such as the amount of energy delivered to the treatment device 20. Or all aspects can be controlled.

[0054] The fluid cooling supply system 12 has the same features as those described with reference to FIGS. or similar features. The supply line 14 begins at the vessel 22, passes through the heat exchanger 28 and the pump 30, and passes through a damper 37. , then extends through a steering mechanism 70 for fluid delivery to the treatment device 20. Originates at the treatment device 20 and extends from the steering mechanism 70 back to the fluid container 22. Thus, the pump 30 draws heat from the fluid reservoir 22 while the fluid is being cooled by the cooling device 36. Fluid may be drawn through the heat exchanger 28 (FIG. 3). The fluid may be drawn through the fluid passages 114 of the heat exchanger 28. The fluid is then delivered to the treatment device under positive pressure via supply line 14. The fluid can be circulated through the treatment device 20 to form a closed loop system. The fluid can be returned from the treatment device 20 to the fluid reservoir 22 in the system. can be manually controlled by the controller device 62.

[0055] FIG. 5 illustrates a treatment system 301 according to one embodiment of the present disclosure. The system 301 is positioned within a patient. A device for circulating fluid through the treatment device 20', the device being coupled to the treatment device 20'. For illustrative purposes, the treatment device 20' includes a bronchus 80. 1. As an example, a supply in fluid communication with the treatment device 20′ is shown in side view. A schematic diagram of the fluid cooling supply system 12 of FIG. The cooling supply system 12 may be any of the components described, for example, with reference to FIG. 3 and with reference to FIG. Since it includes some or all of the same features as those described above, it will not be described in detail with reference to FIG. do not have.

[0056] In some embodiments, the treatment device 20' includes an expandable catheter extending from the distal end of the elongate member 91. 5A shows a cross-sectional view of elongate member 91 taken along line 5A-5A. The cooling system may include a supply lumen 93 and a return lumen 95. The supply lumen 93 is The fluid supply lumen 95 is in fluid communication with the return path 68 of the system 12. A passageway 97 is also extendable from the distal end of the elongate member 91 and around a portion of the circumference of the expandable member 82. The proximal end of the fluid supply passage 97 is in fluid communication with the supply lumen 93. The distal end of the fluid supply passage 97 is in fluid communication with the interior of the expandable member 82. is in fluid communication with the interior of expandable member 82 at the proximal end of expandable member 82. The cavity 95 may surround the supply lumen 93 in the elongate member 91. The fluid in the supply lumen 93 may be , is at a higher pressure and a lower temperature than the cooling fluid in the return lumen 95. By locating the delivery lumen 93 within the lumen 95, the delivery size of the treatment device 20' is reduced. This reduces heat loss in the supply lumen 93. The outer surface of the fluid supply passage 97 is Adjacent to 80 is an electrode 90 for creating a lesion 92 .

[0057] The fluid is cooled by the fluid cooling supply system 12 during energy delivery to the electrodes 90. Fluid is circulated through the supply lumen 93 through the fluid supply passage 97. The fluid is continuously circulated to the member 82 and then exits through the return lumen 95. The fluid circulating through the material 82 is contacted with the inner wall of the airway and with the airway walls at radially spaced intervals from the inner wall of the airway. In this example, the treatment device is 20 uses energy to damage a target area. The term "energy" includes, but is not limited to, thermal energy, cryogenic energy (e.g. , cooling energy), electrical energy, acoustic energy (e.g., ultrasonic energy), Linear frequency energy, Pulsed high voltage energy, Mechanical energy, Ionizing radiation, Optical energy (e.g., light energy), microwave and combinations thereof, and tissue The term "energy therapy" is broadly construed to include other types of energy suitable for treating some In one embodiment, the treatment device comprises a combination of energy and one or more substances (e.g., radioactive seeds, radioactive In the examples shown in FIG. 5 and FIG. 5A, the treatment devices each deliver It outputs ultrasonic, microwave, electrical and / or radio frequency (RF) energy. The device may include one or more electrodes 90 operable to

[0058] In some embodiments, the fluid is provided by a fluid cooling supply system 12 directly adjacent to the electrode 90. Therefore, it is advantageous to position the supply and return lumens adjacent to the electrode 90. These can provide a high mass flow rate of chilled fluid across the surface of the electrode 90. can.

[0059] In another example, an energy converter configured to circulate a cooled fluid within the expandable member may be used. For example, an ultrasonic energy delivery device or a microwave antenna is placed on the The nozzle can be placed in an inflatable balloon through which a cooled fluid is circulated. will be done.

[0060] A continuous flow of chilled fluid through the energy delivery device provides energy delivery. The new device creates a much deeper injury while delivering the same amount of energy through the patient's tissue. This allows neural tissue in the target area to be stimulated more effectively and efficiently. As described in this disclosure, the entire treatment device is damaged. The treatment is more rapid and effective in the target area than without providing continuous chilled fluid. It will be more effective.

[0061] As mentioned above, the heat exchangers discussed with reference to Figs. 1 to 5B may be replaced by bags, etc. The bag may be made of an elastic material such as PTFE or PTFE. Removably attached to a cooling device using a given biasing force to induce thermal conduction from the liquid. The bag may have the same or similar features as the cartridge discussed herein. For example, the bag may have a fluid passageway with a serpentine pattern. The bag may have an outlet port in fluid communication with a treatment device positioned within the patient. As further described elsewhere in this disclosure, the patient selected delivery temperature configured to bias the bag with a given force to cool the fluid to at least A biasing mechanism may be coupled to the bag. The at least one biasing mechanism may include a cooling The cooling device may be a plate removably attached to the cooling device, and the bag may be attached to the cooling device. The bag may be positioned between the vice and the plate or may be biased against the object. The cooling device may be attached to the cooling device by other attachment devices such as clamps or other devices that exert a force. The bag is positioned adjacent to the cooling device and is biased 2 mm. The membrane may have a thickness of up to 4 mm, but this thickness may vary depending on the material of the bag. Depending on the material, the thickness may be less than 2 millimeters. Furthermore, the bag may be placed over the cooling device. and a weight, such as a metal plate, can be positioned on top of the bag to A sufficient biasing force can be applied to cool the fluid to the desired fluid temperature. The given biasing force between the cooling device may be 5 to 10 pounds of force, such It may vary beyond the range.

[0062] In other embodiments, a cartridge and a bag may be used together. The cartridge may have a slot for receiving a bag configured to contain a fluid. The bag can be inserted into the slot, and fluid can be inserted into the bag and This allows the bag to expand within the slot. This allows the bag and the cartridge to A given flow rate sufficient to cause thermal conduction of the fluid by the cooling device between the hot surface of the edge and the heat source. The cartridge is positioned adjacent to the cooling device, for example. will be done.

[0063] 6A and 6B show a heat exchanger cartridge 28 according to one embodiment of the present disclosure. The cartridge 28 is shown having a first plate 41 and a second plate 43 fixed to one another. The first plate 41 is preferably made of a heat-conductive material such as copper and is The first plate 41 has a thermally conductive surface 98 for biasing (FIGS. 1 and 2). , for improving heat transfer between the fluid in the heat exchanger cartridge 28 and the cooling device 36; It can contain silver material of 0.5 microns to 1 micron. This allows the fluid to pass through the heat exchanger. It also provides a biocompatible, inert surface for contact in the cartridge 28. The second plate 43 is preferably made of a thermally insulating material such as polymer, ABS, nylon or polycarbonate. The cartridge 28 is constructed of insulating foam or natural cork insulation. The cartridge 28 may be provided with a plurality of nozzles 26. The nozzles 26 may be disposed on the exterior surface of the cartridge 28 to insulate the fluid from the ambient air temperature around the cartridge 28. stomach.

[0064] The cartridge 28 may include at least four magnets 99 secured to the cartridge. Each of the second plates 43 may have one biasing mechanism. The magnet 99 can be secured within the bore 100 using a magnet 99a. A long magnet or multiple magnets are fixed along various parts of the cartridge so that the magnets can be easily inserted. The same biasing force can be achieved for the cooling device. By fixing the magnet 99, the thermally conductive surface 98 of the first plate 41 and the cooling device 36 are aligned. This provides improved face-to-face contact between the magnet and the thermal plate 38 because the magnet When biased against the multiplate 38, the thermally conductive surface 98 is heated along most or all of its surface area. This tends to provide a uniform biasing force, thereby providing consistent and efficient fluid flow during treatment. This is to improve and maintain efficient thermal conduction (Figure 7B).

[0065] The cartridge 28 is inserted into an inlet 104 positioned at the upper end 106 of the second plate 43. The inlet port 102 and the outlet port 110 are located at the lower portion 112 of the second end 112 of the second plate 43. and a port 108. The inlet port 102 may be connectable to a fluid container; The outlet port 108 may be connectable to a treatment device positioned within the patient.

[0066] Continuing with reference to FIG. 6B, the second plate 43 has flow inlet port 102 and outlet port 108. The fluid passage 114 is vertically connected from the upper portion 104 to the lower portion 110. The cartridge is then snaked throughout the entire cartridge, thereby trapping any gas in the system in the fluid passages. The fluid passage 114 may have a tendency to rise toward the upper portion of the fluid passage 114. The flow path is formed to have a substantially flat cross-sectional area across the flow path (FIG. 6D). The body passes next to the first plate 41 in a substantially thin and flat manner, so that according to thermodynamic principles This can maximize heat transfer from the fluid, improving heat transfer from the fluid during treatment. One advantage of this is that the thermally conductive surface 98 of the second plate 43 is 3 is adapted to receive the first plate 41 so as to be substantially flush and flat with the biasing surface 118 of the third plate 41. The outer circumferential recess 116 is formed so that the first plate 41 is supported by the second plate 42. 1. The sealing passage 120 may be provided to receive adhesive for fastening to the port 43 ( 6D and 6E). Thus, the first plate 41 has a plurality of portions extending from the first plate 41 to the various portions of the first plate 41. 43, thereby preventing the suction or other forces from This can prevent or reduce the bulge or distortion of the first plate 41 caused by the heat treatment. Due to the particular configuration of the cartridge, the surface area between the first plate 41 and the thermal plate 38 Since greater contact is maintained, heat transfer is increased.

[0067] FIG. 6C illustrates a heat exchanger cartridge 28' according to one embodiment of the present disclosure. Edge 28' may have the same or similar features as those described with reference to Figures 6A and 6B. The cartridge 28' includes a first plate 41' and a second plate 43'. and four magnets 99 positioned in bores 100 at each corner. Cartridge 28' has many of the same or similar features as those discussed with reference to FIGS. 6A and 6B. The second plate 43' is completely a fluid reservoir 122 housed within a cavity 124 of the cartridge 28', the external fluid reservoir being adapted for fluid cooling; From the fluid container 122, the fluid passage 114' , snakes vertically across the entire cartridge from top to bottom, thereby Any gas within the system will tend to rise toward the upper portion of the fluid passage 114' and then toward the fluid container 122. By providing the fluid container 122 inside the cartridge 28', , various supply tubes and connections that the practitioner must handle, connect and disconnect during the procedure. The advantage is improved sterility since it is no longer necessary to provide an outer container having By providing a fluid reservoir 122 inside the cartridge 28', Rapid installation of cooling devices, sterile use of fluids during treatment, and cartridge storage between treatments Disposable, easily manufactured and supplied to practitioners for easy removal and replacement The advantage of having a cartridge is further provided. In some embodiments, a small battery The gasket can be positioned within cavity 124 and coupled to fluid passageway 114'. As fluid is drawn from the bag, the bag collapses, thereby reducing fluid flow within the fluid passage 114' during operation. The fluid pressure is kept constant.

[0068] In some embodiments, the fluid pathways in each cartridge discussed in this disclosure The corners have a relatively large radius as indicated by the shading of corner 121 in FIG. The corners 121 provide a gradual transition between the horizontal and vertical sidewalls of the fluid passage. This helps overcome the surface tension of air bubbles that may otherwise get stuck in the corners of the fluid passages. This allows the cartridge to be more stable than, for example, if it had tighter radius corners. Fewer air bubbles in the fluid passages results in increased fluid pressure within the cartridge. do.

[0069] FIG. 6D shows a cross-sectional view of the heat exchanger cartridge 28 taken along line 6D-6D of FIG. 6A. 6D and 6E show a portion of FIG. 6D. The features shown in FIG. 6D and 6E are the same or similar features as those shown in FIG. 6C. The cartridge 28 includes a first plate 41 and a second plate 42 fixed to each other. The second plate 43 is a first plate 44 extending across the cartridge 28. The second plate 43 has a fluid passage 114 that meanders next to the first plate 41. The plate 43 is provided with a peripheral recess 116 capable of receiving adhesive and a sealing passage 120. Thus, the first plate 41 is provided with a second plate 43, so that the first It is possible to prevent or reduce distortion of the plate 41. This configuration allows for a relatively thin first plate 41 (discussed further herein). This improves heat transfer from the fluid in the fluid passages 114 which cools the fluid.

[0070] The first plate 41 provides a substantially flat surface between the cartridge 28 and the thermal plate 38. When placed under vacuum, the first plate 41 may have a thickness T to maintain the thickness of the first plate 41. is too thin for a particular metal, the first plate 41 may present a corrugated surface in multiple locations. 10, along which the fluid passage 114 is positioned. Air pockets may be created between the surface 51 of the thermal plate 38 and the surface 51 of the thermal plate 38. This results in poor heat transfer from the fluid. The thickness T of the plate 41 is between 0.005 inches and 0.01 inches, but the thickness T does not include such a range. Preferably, the thickness T is 0.01 inches.

[0071] Additionally, the cross-sectional profile of the fluid passage 114 has a radius as compared to having a right angle profile (FIG. 6D). The corner R is shown at the lower corner of the fluid passage for illustrative purposes (FIG. 6E). However, the angle R is ideally formed in the upper part of the fluid passage, and in particular, when the fluid passage is a single vertical Near the upper corner where the passageway area transitions into the horizontal passageway area (Figure 6C), Rounded corners prevent air bubbles from being trapped in the corners. The cartridge has fewer air bubbles in the fluid passages than if it had sharp corners. The fluid pressure can be increased.

[0072] 7A and 7B show top views of a heat exchanger cartridge 28 according to one embodiment. The cartridge 28 may have the same or similar features as the cartridge shown in FIGS. 1-6E. Thus, the cartridge is made up of a first plate 141 and a second plate 142 fixed to each other. The first plate 141 may include a thermally conductive surface 98. Magnets 99 can be secured to the cartridge 28 at opposing ends of the cartridge 28. Similarly, the cooling device 36 having the thermal plate 38 and the hot plate 39 is also shown in FIG. It may have the same or similar features as those described with reference to FIG. The thermal plate 38 includes a flat surface 51 that presses against the thermally conductive surface 98 of the cartridge 29. Spacers 40 may extend around the periphery of the heater 38 and hot plate 39 (FIG. 2). The spacer 40 includes a magnet 53 that is positioned in a corresponding position relative to the cartridge magnet 99. The spacer 40 has an outer surface 49 that is substantially planar with the planar surface 51 of the thermal plate 38. together providing a coplanar surface area upon which the cartridge 28 is biased. It is possible.

[0073] The cartridge 28 is in a first state A when it is separated from the thermal plate 38. (FIG. 7A) and in a second state B (FIG. 7B) when engaged with the thermal plate 38. Thus, FIG. 7A shows a curved surface in a first state A (prestressed configuration). The cartridge 28 is a cover having a convex shape with respect to the plane 51 of the thermal plate 38. This is accomplished by forming the first plate 141 and the second plate 143 of the cartridge 28. Thus, the first end 106 and the second end 112 of the cartridge 28 are 10. The cartridge 28 may be positioned slightly away from the central area 115, which may be at the end 106 of the cartridge 28. , indicated by distance X shown at 112. As shown in FIG. 7B, the cartridge 28 is a cooling device. When engaged with 36, the cartridge 28 is thermally coupled due to the prestressed shape and magnetic forces. The cartridge 28 is biased flush with the plate 38. Therefore, the cartridge 28 is flattened due to the magnetic force. As such, the thermal plate 38 has a substantially flat profile. The structure and biasing means are arranged such that the thermally conductive surface 98 of the first plate 141 of the cooling device 36 and the thermal plate Improved interfacial contact between the plate 38 and the heat sink 39, thereby reducing and improving heat loss. Improving heat transfer and reducing heat loss is of paramount importance during patient treatment. This is necessary because some treatment systems, such as the pulmonary treatment systems discussed in this disclosure, The system may require a given fluid temperature and a given fluid pressure for a given amount of time during treatment. This is because.

[0074] 8 and 9 show a treatment system 210 according to one embodiment of the present disclosure. 14 and a return line 216. FIG. 9 illustrates a treatment system 210 having a cooling system 217. 1 shows a partial exploded view of some components.

[0075] The treatment system 210 shown in FIGS. 8-13B has the same characteristics as the system described and shown with reference to FIGS. 1-7B. The pulmonary treatment system 217 may have the same or similar characteristics as the treatment A flexible tracheal catheter having a placement device 20, a control unit 68, a steering mechanism 70, and a video system 72. A flexible bronchoscope 18 may be provided with a control section that is external to the patient's body. 76, an insertion tube 74 extends through the trachea 78 to a treatment site within the left main bronchus 80 of the patient's lung 81. The treatment device 20 may be positioned in the left main bronchus 80, or It may be positioned in other locations, such as in the right main bronchus, in the lobar bronchi, and in the intermediate bronchi. The device 20 may be adapted to guide the airway through a tortuous airway, for example to a portion of a lobe, an entire lobe, multiple lobes, or one The device can be navigated to perform a wide variety of procedures, including denervation of one or both lungs. In some embodiments, the lobar bronchus is treated to denervate the lobe. Based on the effectiveness of the procedure, the surgeon may choose to treat additional lobes simultaneously or sequentially.

[0076] The steering mechanism 70 may be coupled to the bronchoscope 18 and may receive a supply line 214 and a return line 216 to guide the bronchoscope 18. The line can be allowed to exit to the bronchoscope 18 and ultimately to the treatment device 20. The bronchoscope 18 can be coupled to a video system 72, which can be used to As the operator navigates the insertion tube 74 through the patient on the monitor 82, the operator can see the insertion tube 74 being steered with the aid of the control unit 68. The video system 72 allows the practitioner to observe the progress of the fluid cooling. It is possible to determine whether the treatment device 20 is being supplied with the signal from the supply system 212. Additionally, the bronchoscope 18 can be coupled to a controller 68 to control the energy delivered to the treatment device 20. Some or all aspects of the treatment, such as the amount of energy, can be controlled. The treatment device 20 of the bronchoscope 18 includes a supply line 214 and a return line 212 of a fluid cooling supply system 212. 216. Thus, the fluid cooling supply system 212 cools the fluid and The treatment device 20 is adapted to pump and circulate the fluid through the treatment device 20.

[0077] Continuing with reference to FIGS. 8 and 9, in some embodiments, the fluid cooling supply system 212 includes: a housing 232 having a front plate 234; and a thermal plate 238 extending through the front plate 234. a cooling device 236; a pump 230 for pumping the fluid; and a cooling A heat exchanger cartridge 228 biased against the device 236; and a cam system 237 coupled to the front plate 234 for biasing the pump 230 against the rate 238; A controller 242 coupled to the cooling device 236 may be included.

[0078] The housing 232 provides structural support and containment for the various components of the system, both together and together. The first portion 231 and the second portion 233 may be fixed to each other. may include an opening 235 for receiving and supporting a front portion of a cooling device 236 . The cooling device 236, like a commonly available TEC, may be a thermal plate 238 and a hot The thermal plate 238 includes a plate 239, fins 246, and a fan 248. The cooling device 236 may include a flat surface 251 for biasing against the edge 228. The support plate 247 may be secured to the first portion 231 of the housing 232. 240 for further support of the cooling device 236 and through the front plate 234 to the thermal plate 2 38 to exit the cooling device 236 and the front plate 234. can be done.

[0079] In some embodiments, the cartridge 228 is slidably coupled to the front plate 234 and includes a cooling device 11A and 11B. As discussed further below, As such, the cartridge 228 can include a fluid reservoir 222 contained within the cartridge 228. Alternatively, the system may include an external device external to the cartridge 228 and in fluid communication with the cartridge 228. In the embodiment shown, the cartridge is coupled to a supply line 214. The supply line 214 extends along a pump 230 and then to the bronchoscope 18. 2 through the supply line 214 and is further coupled to the treatment device 20 within the patient. A return line 216 in fluid communication with the placement device 20 and also in fluid communication with the treatment device 20 is closed. For recirculation of fluid during treatment in a loop system, the cartridge 228 is inserted through the insertion tube 74. Alternatively, the return line 216 may extend back to the waste stream in an open loop system. It may extend to the container 219 .

[0080] Continuing with reference to FIG. 9, a front plate 234 is attached to the front portion 231 of the housing 232. The front plate 234 and the housing 232 cooperate to provide structural support for the cooling device 236 and the pump 230. The front plate 234 receives a thermal plate 238 of the cooling device 236 and supports the cooling device 236. The front plate 234 includes an opening 243 for facilitating biasing of the cartridge 228 against the pump 2. The pump 230 may include an opening 244 for receiving a portion of the supply line 214. A cover 250 and a rotation device 259 for coupling can be provided. The pump 230 is positioned downstream of the cartridge 228 such that the fluid in the cartridge 228 is in a negative flow state. The fluid supplied to the treatment device 20 is subjected to body pressure so that the fluid is maintained constant during normal operation of the treatment system. The front plate 234 is provided with a control to control aspects of the system. The control device 262 may be coupled to the control unit 242. The control unit 242 may include a control device 262 coupled to the control unit 242. 2 to adjust the speed and direction of the pump 230 to thereby circulate the water through the system. The controller 242 controls the cooling device 236 to adjust the flow direction and volume of the fluid. is also coupled to regulate the temperature of the fluid within the cartridge 228, thereby controlling the treatment system 20 The temperature of the fluid circulating through the catheter may be further regulated to thereby regulate the temperature of the patient tissue during treatment. The treatment device 20 discussed with reference to FIGS. 8 and 9 can be seen in FIGS. 1 to 7B, in particular It will be understood that the present invention may include features that are the same as or similar to those discussed with reference to FIG. Let's do it.

[0081] FIG. 10 is an embodiment that may include some or all of the features of FIGS. A schematic diagram of a treatment system 310 is shown. The treatment system 310 is a treatment device positioned within a patient 264. A fluid cooling supply system 212 is coupled to the device 20. The fluid cooling supply system 212 includes , a cooling device 236, a heat exchanger 228, a pump 230, and a control device 242. 242 may be coupled to a cooling device 236 and a pump 230 to regulate temperature and liquid circulation. The heat exchanger 228 may be removably coupled to the cooling device 236. The supply path 266 includes: The supply path 266 begins at the fluid reservoir 222, which is entirely contained within the heat exchanger 228. The treatment device 262 extends through the heat exchanger 228 and the pump 230 to deliver the fluid to the patient 264. The return path 268 originates at the treatment device 20 and continues for recirculation. The fluid can then be returned to the fluid container 222 or returned to the waste container 219. Negative pressure can be drawn from the vessel 222 through the heat exchanger 228 by the pump 230. As the fluid travels through the heat exchanger 228, it is cooled by the cooling device 236. The fluid is then delivered to the treatment device 20 at positive pressure by the pump 230. The blood may be circulated through the treatment device 20 and returned from the treatment device 20 outside the patient 264 .

[0082] A pump 230 draws fluid through the heat exchanger 228 during treatment, as indicated by arrow P. The forward gear can be provided for pushing the vehicle forward and the reverse gear for pushing the vehicle forward. , which draws fluid from the heat exchanger 228 during normal operation of the system 310. Conversely, reverse gear Pushing fluid backwards through the exchanger 228 to evacuate gases that may be present in the system 310 The speed and direction of the pump 230 can be controlled by a controller 242. do.

[0083] In some embodiments, the pump 230 is configured to pump fluid to control the amount of fluid delivered to the treatment device. The pump is coupled to a control device for variably controlling the speed of the pump. The depth and applied pressure can be controlled by a variable speed controller. The measuring device is electrically coupled to the pump and measures, for example, a non-contact pressure measuring device. Regulating system pressure, such as by varying the pump speed in response to the set pressure. The pressure regulator may be positioned adjacent the high pressure side of the fluid path to provide a pressure regulator.

[0084] 11A-13C show the front plate 234, cam system 237 and cartridge 232 of the fluid cooling supply system 212. 11A and 11B show several aspects of the cartridge 228. The front plate can include a cam system 237 that engages the front plate. When actuated between state E and the disconnected state D, allows removal of the cartridge 228 FIG. 12A shows a side view of the front plate 234, and FIG. 12B shows the front plate 234, the cam system 237, and the cartridge. FIG. 13A shows a cross-sectional view of edge 228 and cooling device 236 taken along line 12B-12B of FIG. 13C shows various views of cartridge 228. FIG.

[0085] Continuing with reference to FIGS. 11A and 11B, the cartridge 228 includes a first plate 228 secured together. The first plate 241 is a thermal The front plate 234 includes an opening 298 for biasing the front plate 234 against the heat conductive surface 298 (FIGS. 9 and 12B). 243 and a receiving surface 245. The opening 243 is adapted to receive the cover for the thermal plate of the cooling device 236. The receiving surface 245 may be sized to facilitate biasing of the cartridge 228. A portion of the cooling device 236 is disposed so that the port 238 can extend partially through the opening 243. The front plate 234 is sized to receive the fluid through the cartridge 228. The front plate 234 may also have an opening 244 for receiving a pump for pumping the cartridge 22. A cam system 237 may be housed and supported to bias the cam 8 against the cooling device. In some configurations, the cam system 237 includes a camshaft 340 having four cam lobes 342. The cam lever 338 is attached directly to the camshaft 340. The camshaft 340 may be dynamically coupled to the camshaft 340 in other configurations. Four cam lobes 342 are formed along the length of the cam 40 and are spatially separated from one another. The system 237 may include an actuating member 344 and an actuating device 346. Each actuating device 346 may include an actuating member 344 and an actuating device 346. The piston rods 354 and the springs 35 positioned below each piston rod 354 6. The actuation device 346 may be configured with at least one of the actuation members 344 disposed within each of the bores 348. The piston 354 can be partially positioned such that the rotation of the cam lobe 342 moves the piston 354 downward. 12. The cam lobes 342 may be positioned adjacent to each other so as to actuate the cam lobes 342 in a coordinated manner. B).

[0086] When the cam system 237 is in the disengaged state D, the cam system 237 The cartridge 228 is positioned so as to be slidably received therein. When cartridge 228 is fully engaged within front plate 234, cam system 237 drives cartridge 228 within front plate 234. and urging the cartridge 228 against the thermal plate 38 of the cooling device 236 (FIG. 12B). In order to rotate the cam lever 338 and the camshaft 34 downward in the direction indicated by the arrow C, 0. Thus, the cam lobe 342 is actuated into the engaged state E by rotating the cam lobe 342. When moved to the engaged state E, the actuation devices 346 are simultaneously actuated by the respective piston rods 354. This tends to propel the actuation device 346 downward in the direction indicated by arrow F. 3 which moves actuating member 344 generally in the direction indicated by arrow G relative to cartridge 228. This is discussed further below (FIG. 12B). Conversely, the cam system 237 is moved from the engaged state E to the disengaged state D to remove the cartridge 228. Then, the cam lever 338 is operated in the direction indicated by the arrow B, so that the cam shaft 340 and cam lobe 342 rotates in a similar direction, which removes the force applied to actuation device 346. This is done by actuating member 344 so that cartridge 228 can be removed. As discussed above, the cartridge and cooling device When a sufficient biasing force is applied between the cartridge and the cooling device, the interface between the cartridge and the cooling device is This improves the efficiency of fluid passing through the cartridge for delivery to the patient. This helps in efficient and targeted cooling.

[0087] FIG. 12A shows a left side view of the front plate 234 of FIG. 11A according to one embodiment of the present disclosure. When the system 237 is in the disconnected state D, the cartridge 228 is loosely received in the system 237. The front plate 234 includes a slot 358 sized to closely receive the cartridge 228. The actuator includes an upper biasing surface 360 ​​and a lower biasing surface 362 that are sized to accommodate a thermal The lower end 238 is formed at an angle that is not substantially parallel to the plane 251 of the plate 238 (FIG. 12B). The pressure surface 362 is formed at an angle that is not substantially parallel to the plane 251 of the thermal plate 238. To this end, slot 358 has a trapezoidal cross-sectional profile for receiving cartridge 228. and the cartridge 228 can have a corresponding trapezoidal cross-sectional profile (FIG. 13). C). FIG. 12A shows the cam lever 3 in a disengaged state D to allow the passage of the supply line 214. 38 and recess 364 are further shown (FIGS. 8 and 9).

[0088] FIG. 12B illustrates a front plate 234, a cartridge 228 positioned within the front plate 234, and a cartridge 228. 8 and a cooling device 236 and a thermal plate 238 positioned adjacent to the thermal plate 238 in an engaged state E. 3 shows a cross-sectional view of the cam system 237. With respect to the cam system 237, the actuating member 344 The lower working surface 366 is formed at an angle to the plane 251 of the multi-plate 238. As discussed further above, the cam system 237 is driven via a cam lever 338 and a cam shaft 340. When engaged, the cam lobe 342 propels the actuation device 346 downward, thus The force 346 propels the actuating member 344 downward in the direction indicated by arrow F. As a result, the lower actuating surface 3 66 biases the upper angular surface 368 of the cartridge 228 and simultaneously biases the lower The side biasing surface 362 biases against a lower angle surface 374 of the cartridge 228, which The flow tends to proceed inwardly in the direction indicated by arrow G. As a result of this configuration and operation, 2. Promotes heat transfer from the body and improves surface-to-surface contact between the cartridge 228 and the cooling device 236 A given force biases the cartridge 228 generally laterally against the thermal plate 238 . This is due in part to the trapezoidal geometry of slot 358 and cartridge 228, and due to the This is accomplished due to the angled surfaces of movable member 344, which together form a curve in the direction indicated by arrow G. 20. The cartridge 228 is then caused to "slide" into place along each of the angled surfaces in the direction Therefore, the cam system 237, the front plate 234 and the cartridge 228 are The cartridge 228 is connected to the thermal plate 2 so as to cause thermal conduction from the fluid contained therein. 38. The actuators 34 and 36 are dimensioned to cooperate to bias the actuator 34 against the actuator 38.

[0089] FIG. 13A is a front perspective view of a cartridge 228 according to one embodiment of the present disclosure. 28 allows for easy insertion and removal of cartridge 228 into slot 358 in front plate 234 as discussed above. A handle 370 is located on the left end of the cartridge for easy loading and removal. The cartridges 228 are formed at respective angles to allow insertion of the cartridges 228 into the front plate 234. The cartridge 228 includes a side angle surface 368 and a lower angle surface 374. The cartridge 228 is supported by a plurality of cross members 375. The system further comprises a plurality of cavities 372 defined by a plurality of cartridges 372. The cavities 372 accommodate cartridges 372 during operation of the system. 228 and sized to improve heat transfer from the fluid in the cartridge to the front portion It is formed along.

[0090] FIG. 13B shows a rear perspective view of a cartridge 228 according to one embodiment of the present disclosure. The plate 228 includes a first plate 241 and a second plate 243 attached to each other. The plate 241 is preferably constructed of a copper material and is a thermally conductive surface for powering a cooling device. The first plate 241 communicates with the fluid in the heat exchanger cartridge 228 and the cooling surface 298 (FIG. 12B). To improve thermal conduction between the device 236 and the copper material, a 0.5 micron to 1 micron thick layer is The heat exchanger cartridge 228 may include a silver material, which allows the fluid to The second plate 43 also provides a biocompatible inert surface for contact. Most are constructed of insulating materials such as ABS, nylon or polycarbonate. A natural cork separator may be placed within the cartridge 28 or on the exterior surface of the cartridge 28 to prevent fluid from entering the cartridge. The second plate 243 may provide thermal insulation from the ambient air temperature around the ridge 28. The fluid reservoir 322 is positioned in the upper portion 376 of the second plate 228. The fluid passage 314 is 34 and in fluid communication with a fluid reservoir 322. A fluid passage 314 extends vertically from the top to the bottom. The cartridge is then spun directly across the cartridge, thereby preventing any gas in the system from passing through the cartridge. The fluid may have a tendency to rise into the fluid container 322 toward the upper portion 376 of the channel 314. The second plate 243 may have a recessed sealing surface 240 to receive the first plate 241. The sealing surface 240 may be an adhesive for fastening the first plate 241 to the second plate 243. For this reason, the first plate 241 can receive various portions of the first plate 241. The second plate 243 is fixed to the first plate 241 over the entire length of the first plate 241. Distortion of the copper plate due to attractive or other forces can be prevented.

[0091] The second plate 243 is positioned in the lower portion 378 of the cartridge 228 and includes the fluid passages 314 and and an outlet port 308 in fluid communication with the fluid reservoir 322. The outlet port 308 can include The fluid supply may be coupled to a supply line for supplying fluid to a patient. The cartridge 228 may include an inlet port 302 in fluid communication with a fluid reservoir 322 . The outlet portion 302 may be connectable to a return line for returning fluid from within the patient. In some embodiments, the fluid reservoir 322 is in fluid communication with the fluid passageway 314 and the outlet port 308. A collapsible bag can be accommodated, so that the fluid pressure experienced by the system is In some embodiments, the cartridge 228 is a cartridge The cartridge 228 may not have a fluid reservoir 322 housed within it; The fluid passage may be coupled to the external container.

[0092] FIG. 13C shows a cross-sectional view of cartridge 228 taken along line 13C-13C of FIGS. 13A and 13B. The cartridge 228 includes a first plate 241 and a second plate 243 attached to each other. The first plate 243 is a thermally conductive plate positioned adjacent to the fluid container 322 and the fluid passage 314. The second plate 243 is positioned on the upper portion 376 of the cartridge 228. The cartridge 228 includes a fluid container 322 and a fluid passage 314 in fluid communication with the fluid container 322. The support may include a plurality of cavities 372 defined by a plurality of cross members 375 (FIG. 13A). The cavity 372 is sized to reduce the average thickness of the second plate and the front portion cartridge. As a result, the fluid in the cartridge 228 during operation of the cooling system The cartridge 228 has an upper angle surface 368 and a lower angle surface 374. The cartridge 228 includes a cooling machine 236 for powering the cooling machine 236, as discussed further above. 358 in the front plate 234. The cartridge 228 has a contour that allows for insertion of the cartridge 228 into a slot 358 in the front plate 234 for receiving the cartridge.

[0093] The first plate 241 maintains a flat surface between the cartridge 228 and the thermal plate 238. When placed under vacuum, the first plate 241 can have a thickness T for If the first plate 241 is too thin for a certain metal, it may exhibit a corrugated surface in some places. This allows the thermally conductive surface 251 and the fluid passage 314 to be positioned along this location. Air pockets may form between the flat surface of the thermal plate 238 and the This results in poor heat transfer from the fluid. The thickness T of the plate 241 is between 0.005 inches and 0.01 inches, although the thickness T may vary beyond such range. Preferably, the thickness T is 0.01 inches.

[0094] As discussed above with reference to FIGS. 1-5A, the heat exchanger discussed with reference to FIGS. 8-13C The reservoir cartridge may alternatively be an elastic body such as a bag. A given biasing force is applied to induce thermal conduction from a liquid contained therein or moving therethrough. The bag is removably coupled to the cooling device using a The bag may include the same or similar features as the cartridge. For example, the bag may include a serpentine putter. The bag may include a fluid passage having a fluid passageway. The device may have an outlet port in fluid communication with the chair, as further described elsewhere in this disclosure. The bag is then applied with a given force to cool the fluid to the patient's selected delivery temperature. At least one biasing mechanism configured to bias the cooling device may be coupled to the cooling device. At least one biasing mechanism may be the cam system 237 described above. Thus, the bag having a fluid chamber for holding a fluid may include a slot, and a plate, etc., and a cam system can be used to bias the bag against the and biasing the biasing member to bias the bag against the cooling device with a given biasing force. For this reason, the bag can be operated as described with reference to Figs. 8 to 13C. Similarly, the cam system and biasing plate may be disconnected from the bag to allow the bag to be By making it removable, it can be replaced with another bag.

[0095] 14-20 show a system including a fluid cooling supply system 412 coupled to a treatment system 417. The treatment system 410 shown in FIGS. 14 to 20 includes a treatment system 410 shown in FIGS. 1 to 7B and 8 to 13C. The system may have the same or similar features as those of the system described and shown above.

[0096] In the example of FIG. 14, the fluid cooling supply system 412 is coupled to a treatment system 417. As mentioned above, the treatment system 417 may be at least partially positionable within the patient 464. (FIG. 15). The fluid cooling supply system 412 provides cooling, pumping, and processing of the fluid. The fluid is delivered through the fluid supply system 417. In a closed loop system, the fluid The cooling supply system 412 includes a fluid container 422, a fluid 424, a cooling system 426, and a heat exchanger cartridge. A trough 428, a supply line 414, and a return line 416 may be provided, which may be aligned in a line-to-line fashion. 417. The treatment system 417 includes a cooling unit 418 and a cooling unit 419. The cooling unit 418 and the cooling unit 420 cooperate to circulate a cooled fluid through the treatment system 417 during treatment. The supply line 414 originates at a fluid reservoir 422, passes through a cartridge 428, and continues along to a pump 430. The supply line 414 extends through a gap 416 that is adapted to damp vibrations in the supply line 414 during operation of the pump 430. Finally, the supply line may extend through a pulse damper (not shown) for 414 extends into a treatment system 417 that is positionable within the patient. A return line 416 originates at the treatment system 417 and is used to recirculate the fluid during treatment. In some embodiments, the supply line 414 and The return line 416 is connected to a fluid container 422 by a coaxial double spike 423 (FIGS. 15-16). This is considered in more detail below.

[0097] Referring to FIG. 15, similar to the description of the previous embodiment, in some embodiments, a pulmonary treatment system The system 417 includes a treatment device 420, a control unit 468, a steering mechanism 470, and a video system 472. The flexible bronchoscope 418 may include a flexible bronchoscope for detecting the bronchial From the outer control section 476, through the trachea 478 to the treatment site within the left main bronchus 480 of the patient's lung 481. The treatment device 420 can be positioned within the left main bronchus 480. or in other locations such as in the right main bronchus, lobar bronchus, and intermediate bronchus. The treatment device 420 can be positioned through a tortuous airway, e.g., a portion of a lobe, A wide variety of procedures, including total, multi-lobar, or unilateral or bilateral pulmonary denervation In some embodiments, the lobar bronchus can be navigated to denervate the lobe. Based on the effectiveness of the treatment, the surgeon may choose to treat additional lobes simultaneously or sequentially. This can be treated.

[0098] The steering mechanism 470 may be coupled to the bronchoscope 418 and may receive the supply line 414 and the return line 416. Allowing lines to exit to the bronchoscope 418 and ultimately to the treatment device 420 The bronchoscope 418 can be coupled to a video system 472, The operator can view the patient's condition on a monitor 482 as the insertion tube 474 is steered with the aid of the control unit 468. The video system 472 allows the practitioner to view the movement of the insertion tube 474 through the patient. determining whether fluid is being supplied from the fluid cooling supply system 412 to the treatment device 420; Additionally, the bronchoscope 418 can detect the energy delivered to the treatment device 420. The device may be coupled to a control unit 468 to control some or all aspects of the treatment, such as the amount of energy. Thus, the treatment device 420 of the bronchoscope 418 is connected to the supply line of the fluid cooling supply system 412. The fluid cooling supply system 412 is in fluid communication with the inlet 414 and the return line 416. The fluid is cooled, pumped, and circulated through the treatment device 420. It is adapted to:

[0099] FIG. 16 shows a partial exploded view of some components of the fluid cooling supply system 412 of FIGS. 14-15. Referring to the above, in a similar manner to the embodiment described above, in some aspects, a fluid cooling supply system The system 412 includes: a housing 432 having a front plate 434; and a thermal plate 43 extending through the front plate 434. 8; a pump 430 for pumping a fluid; and a cooling device 436 having a front plate 434 attached thereto. a heat exchanger 436 that is operably coupled to the cooling device 436 and biased against and in contact with the cooling device 436; A fuse for biasing the cartridge 428 against the thermal plate 438. a hinged door 437 connected to the front plate 434 of the housing 423 by a spring; 36. A controller 442 (FIG. 18) coupled to the controller 36.

[0100] The housing 432 is secured together and provides structural support and containment for the various components of the system. The first portion 431 may include a first portion 431 and a second portion 433 for receiving the cooling medium. An opening 435 may be provided for receiving and supporting a front portion of the cooling device 436. The Vise 436, like the commonly available TEC, is equipped with a Thermal Plate 438 and a Hot Plate The thermal plate 438 includes a cartridge 42 and a heat exchanger 439, fins 446, and a fan 448. The cooling device 436 may include a flat surface 451 for biasing against the housing 48. The support plate 447 may be secured to the first portion 431 of the support 32 .

[0101] The front plate 434 may include an opening 444 for receiving a portion of the pump 430. The supply line 414 may include a cover 450 and a rotation device 459 for coupling to the supply line 414. The pump 430 is positioned downstream of the cartridge 428 to pump the fluid within the cartridge 428. The treatment device 420 is subjected to a negative fluid pressure so that the fluid supplied to the treatment device 420 is Provide positive fluid pressure during normal operation.

[0102] Continuing with reference to FIG. 16, a front plate 434 is attached to the front portion 431 of the housing 432. The front plate 434 and the housing 432 cooperate to structurally support the cooling device 436 and the pump 430. The front plate 434 has an opening 443 for receiving a thermal plate 438 of the cooling device 436. In some embodiments, the hinged door 437 can be rotated between an open position and a closed position relative to the front panel 434. In the open position, the cartridge 428 is inserted into or removed from the opening 443. In the closed position, the cartridge 428 is in contact with the thermal plate of the cooling device 436. 438.

[0103] FIG. 17 illustrates a rear perspective view of a hinged door assembly 440 according to one embodiment of the present disclosure. In this embodiment, the hinged door 437 includes a plurality of magnets 453 (FIG. 17) for securing the hinged door 437 in a closed position. ) may include at least one biasing mechanism. The hinged door 437 may be secured within a bore 455 defined within the hinged door 437. Alternatively, one long hinged door 437 may be secured within a bore 455 defined within the hinged door 437. A magnet or magnets may be secured along various portions of the hinged door 437 or front panel 434 to provide a magnet according to the present disclosure. The biasing force can be achieved by the same force as that discussed in the previous section. 4. providing improved surface-to-surface contact between the edge 428 and the thermal plate 438 of the cooling device 436; This improves and maintains consistent and efficient heat transfer from the fluid during the procedure.

[0104] The hinged door assembly 440 couples the hinged door 437 to the front plate 434 or first portion 431 of the housing 432. A plurality of hinges 460 for fastening the hinged door assembly may also be provided. 437 may include two hinges 460, which allow the hinged door 437 to be hinged to the front panel 434 or in the open position. and a housing 432 having a first portion 431 that is rotatably movable relative to the first portion 431 of the housing 432 between the left and right positions. become.

[0105] In one embodiment, the hinged door 437 is adapted to receive and house a portion of the heat exchanger cartridge 428. The recess 462 may be defined by a notch 461 sized to accommodate the recess 462. In one embodiment, The hinged door 437 is sized to receive and accommodate the inlet port 402 and the outlet port 408. and one or more recessed notches 462 and associated bubble removal devices in the heat exchanger cartridge 428. It is possible.

[0106] FIG. 18 is a schematic diagram of a treatment system 310, similar to that of FIG. 5, in accordance with one embodiment of the present invention. A schematic diagram of a treatment system 410 is shown. The treatment system 410 is a treatment device positioned within a patient 464. In one embodiment, a cooling device 420 includes a fluid cooling supply system 412 coupled to the cooling device 420. Similarly, the treatment device 420 may each be configured to deliver ultrasound, microwave, electrical energy, and / or radiofrequency energy. One or more electrodes 90 operable to output radio frequency (RF) energy may be included. do.

[0107] The fluid cooling supply system 412 includes a cooling device 436, a heat exchanger 428, a pump 430, and a control and a control unit 442. The control unit 442 controls the cooling device to regulate the temperature and circulation of the fluid. 436 and pump 430. The heat exchanger 428 can be detachably connected to the cooling device 436. The fluid supply line 414 originates at a fluid reservoir 422. Line 414 continues to a heat exchanger 428 and pumps 428 to provide chilled fluid to a patient 464. The fluid return line 416 passes through the treatment device 420 and terminates at the treatment device 420. 420 and back to the fluid reservoir 422 for recirculation and / or back to the waste reservoir 419. Thus, fluid is pumped from the reservoir 422 to the heat exchanger 420 at negative pressure by the pump 430. 8. As the fluid travels through the heat exchanger 428, it is cooled by the The fluid is supplied to the treatment device 420 at positive pressure by the pump 430. The fluid is then circulated through the treatment device 420 and delivered to the treatment device outside the patient 464. The data may be returned from process 420.

[0108] A control unit 468 (FIG. 15) may be coupled to the controller 442 to control aspects of the system. The control device 442 adjusts the speed and direction of the pump 430, thereby circulating the water through the system. The control device 442 may be coupled to the pump 430 to adjust the flow direction and volume of the fluid passing through the pump 430. It also regulates the temperature of the fluid within the cartridge 428, thereby increasing the temperature of the fluid passing through the treatment device 420. The apparatus further regulates the temperature of the circulating fluid, thereby regulating the temperature of the patient's tissue during treatment. For this purpose, the cooling device 436 may be coupled to the cooling device 436 .

[0109] A pump 430 draws fluid through the heat exchanger 428 during treatment, as indicated by arrow P. The forward gear may be provided for pushing the shaft forward and the reverse gear for pushing the shaft forward. During normal operation of the stem 410, the reverse gear draws fluid from the heat exchanger 428. Fluid can be pushed in the reverse direction through 428 to evacuate any gas that may be present in the system 410. The speed and direction of the pump 430 can be controlled by a controller 442.

[0110] In some embodiments, the pump 430 may be configured to: The pump is coupled to a controller for variably controlling the speed of the pump. The size and applied pressure can be controlled by a variable speed controller. The measurement device is electrically coupled to the pump and is, for example, a non-contact pressure measurement device. Regulating system pressure, such as by varying pump speed in response to the measured pressure The pressure regulator may be positioned adjacent the high pressure side of the fluid path to provide a pressure regulator.

[0111] 19A and 19B each show a thermoformed heat exchanger cartridge 428 according to one embodiment of the present disclosure. The heat exchanger cartridge 428 is mounted on a first plate 441. The plate 441 includes a flexible thermoformed tray 443 bonded or joined to the tray. 443 is connected to the inlet supply line 414a (uncooled fluid) and and outlet supply line 414b (chilled fluid).

[0112] The first plate 441 is preferably made of a copper material and is biased against a flat surface 451 of the cooling device 436 . For example, the first plate 441 may be a heat exchanger. To improve and optimize the heat transfer between the fluid in the cartridge 428 and the cooling device 436, e.g. For example, plating, coating (e.g., conductive ink or coating) and / or lamination (e.g., For example, a conductive material may be deposited on a copper material by The conductive material may include silver, parylene, aluminum, or a combination thereof. The first plate 441 maintains a flat surface between the cartridge 428 and the thermal plate 438. When the pump is reversed, etc., the thickness T can be set to 100 mm. If the first plate 441 is too thin for a particular metal, the first plate 441 may have corrugations in multiple places. The surface may have a contour along which the fluid passages 450 are positioned. Therefore, if an air pocket is generated between the first plate 441 and the thermal plate 438, This can result in poor contact and therefore poor heat transfer from the fluid. Also, the tray recess is completely folded, thereby blocking the fluid passage. In some embodiments, the thickness T of the first plate 441 is between 0.005 inches and 0.01 inches. 5 inches, although the thickness T can vary beyond such range. The thickness T is approximately 0.010 inches (or 10 milliinches).

[0113] In one particular embodiment, the plate 441 is coated with 0.5 microns to 1 micron of silver material. The copper plate is approximately 10 milliinches thick and is coated with a The heat exchange cartridge 428 is provided with a biocompatible, inert surface for contact. Optionally, a parylene coating is provided over at least a portion of the silver material. 443 to provide barrier properties and to help seal or adhere the tray 443 to the plate 441.

[0114] The thermoformed tray 443 is preferably made of polyvinyl chloride (PVC) or polyethylene terephthalate. The tray 443 is made of a transparent or translucent thermoformed material such as polyethylene terephthalate (PET). The tray 443 exhibits sufficient flexibility to remain adhered to the plate 441 under the application of heat. The thickness of the tray 443 is optimized to provide sufficient rigidity so that the vacuum can be When the system is backpressurized as shown, the tray heats up the cartridge 428. It does not deform or corrugate so as not to impair or significantly weaken its exchange properties. Then, insulating foam or natural cork pieces are placed on the inside of the cartridge 428 or on the outside of the cartridge 428. A thermal material (not shown) is provided to insulate the fluid from the ambient air temperature around the cartridge 428. It is possible.

[0115] The tray 443 is spaced inwardly from the outer periphery of the tray 443 by a sealing surface or flange 440. The sealing surface 440 further comprises a lip or recess 452 that is adapted to receive a UV-activated or UV-curable adhesive. Alternatively, an adhesive such as epoxy can be used to secure the plate 441 and the tray 443 together. Any excess adhesive will be collected in recess 452 and will not block fluid passageway 450. Thus, the first plate 441 is supported by the tray 443 over various periphery portions of the first plate 441. and distortion of the copper plate due to suction or other forces acting on the first plate 441. In one embodiment, the first plate 441 and the tray 443 are made of a UV-curable adhesive. The assembly is bonded by exposing it to UV radiation. The transparency of the tray material allows the adhesive This allows for sufficient exposure to UV radiation to properly cure the resin.

[0116] The fluid passage 450 is formed by a recessed area formed in the tray 443 and a space between the first plate 441. The fluid passage 450 is defined as a fluid container 422 that cools the fluid passing through the fluid passage 450. 430 and ultimately the treatment device 420. In one embodiment, the fluid passage 450 is passed through the fluid passage 450 for a desired number of passes, such as seven passes as shown. The number of passes and the depth and width of the passages 450 are varied to accommodate the flow. Based on the desired residence time of the fluid within the cartridge 428 to cool the body to the desired temperature. For example, the fluid container 450 may be configured to accommodate a coolant such as saline at a flow rate of approximately 100 mL / min. , from room temperature (25°C) to about 0.1°C to 10°C, more specifically from about 1°C to 6°C, and even more specifically It is sized to provide adequate residence time for cooling to 3°C to 5°C.

[0117] Referring to FIG. 19A, an inlet port 402 is formed at a second end 450a of the fluid passageway 450. The inlet supply line 414 a is in fluid communication with a fluid reservoir 422 . An outlet port 408 is formed in a second end 450b of the fluid passageway 450 and is in fluid communication with an outlet supply line 414b. This portion of the supply line 414 is in fluid communication with a pump 430 and then through a bronchoscope 418. 402 and connects to a treatment device 420 within the patient. The port 408 starts at a depth greater than the depth of the fluid passage 450 and extends to a depth equal to the depth of the fluid passage. This allows the system to have a sloped profile that slopes downwards. This allows the inlet fluid to pool with a head space to collect air bubbles. In other words, any gas in the system will tend to rise up into the head space at ports 402 and 408. It is in that direction.

[0118] The heat exchanger cartridge 428 is connected to the hinged door 437 and the cooling device 436. The outer shape allows the insertion of the casing 438 into the space between the casing 438 and the multi-plate 438. In use, the cartridge 428 can be inserted into the opening 443 when the hinged door 437 is open. When the hinged door 437 is closed, the cartridge 428 is cooled by the thermal plate 438, thereby connecting the hinged door 437 and the cooling system, as discussed further above. The cartridge 428 is clamped between the thermal plate 438 of the cooling device 436. In an embodiment, an opening 443 is further disposed on the side of the cartridge 428 and defined in the front plate 434. In some embodiments, the heat exchanger cartridge 428 may include a The one or more edges may include one or more notches 479 defined in the one or more edges. To ensure that cartridge 428 is inserted in an orientation that allows normal operation, front plate 434 The cotter pin 481 may be sized to receive the cotter pin 481 .

[0119] Referring now to FIG. 20, a fluid container 422 is coupled to a system 410 according to one embodiment of the present disclosure. 4 shows a perspective view of a coaxial bag spike assembly 423 for attaching a bag to a patient. , the supply line 414 and the return line 416 are connected to a coaxial bag spike assembly 423 (e.g., 15-16) to a fluid reservoir 422 in a single location. In this embodiment, the return line 416 is in fluid communication with the inner passage 425 and the supply line 414 is in fluid communication with the inner passage 425. The side passage 425 is in fluid communication with a coaxial outer passage 427. Both the inner passage 425 and the outer passage 427 are in fluid communication with each other. The body reservoir 422 and the fluid 424 within the fluid reservoir 422 are in fluid communication with each other, but are separate from each other. , the reverse configuration can also be considered.

[0120] In one embodiment, the assembly 423 has an inner diameter 431 that is larger than the inner diameter 431 of the hypotube 429. 502 is inserted through the lumen of the injection molded non-vented spiked female luer 500. A hypotube 429 having a diameter 431 is provided, creating coaxial outer and inner passages 427 and 425. The assembly 423 includes a female connector for fluidly connecting the fluid container 422 with the outer passageway and the inner passageway 425. and an injection molded vented spike cap 504 coupled to the first end of the lure 500. The assembly 423 also couples the inlet supply line 414 to the outer passage 427. a first port 508 for connecting the outlet supply line 316 to the inner passage 425 of the hypotube 429; and a second port 510 for connecting to the bag spike adapter 506. The reverse configuration (i.e., inlet supply line 414 is coupled to the second port 510 and outlet supply line 416 to the first port 508) can also be considered.

[0121] The inner diameter 431 of the hypotube is preferably adapted to control back pressure in the treatment system 417. or sized to effect pressure on the expandable member of the treatment device. Optionally, various clamps (e.g., (not shown) to further regulate the supply and / or return flow of fluid into and out of the vessel 422. Thus, the coaxial double spike 423 allows fluid 424 to enter and exit the fluid container simultaneously. By allowing the two to flow through the same location in the vessel 422, the separate supply springs can be Eliminates the need for lead and return spikes.

[0122] The various embodiments and aspects described above are intended to provide further embodiments and aspects. In light of the above detailed description, these modifications to the embodiments may be Modifications and other changes may be made to the aspects, embodiments, features, and aspects described herein. The systems, devices, materials, methods and techniques, in some embodiments, are No. 8,088,127, filed in 2010, and International Application No. PCT / US2010 / 056424 (International Publication No. PCT / US2011 / No. 12 / 913,702, filed October 27, 2010; U.S. Patent Application No. 12 / 913,702, filed November 11, 2010 No. 12 / 944,666, filed on Apr. 6, 2011; No. 13 / 081,406 and U.S. Provisional Patent Application No. 61 / 543,759. The present invention may be similar to any one or more of the following systems, devices, materials, methods and techniques: Each of these applications is incorporated herein by reference in its entirety. Aspects, embodiments, features, systems, devices, materials, methods and techniques described herein In some embodiments, the present invention relates to the embodiments, features, and / or functions disclosed in the above-referenced applications and patents. Applying or using in conjunction with any one or more of the systems, devices, materials, methods and techniques This may be done.

[0123] Unless the context otherwise requires, throughout the specification and subsequent claims. The words "comprise" and "comprises" and "comprising" The above variations are to be interpreted in an open, inclusive sense, i.e., "including but not limited to." shall be interpreted as follows.

[0124] Generally, in the following claims, the terms used shall be interpreted as though they were interpreted in accordance with the scope of the specification and claims. The claims should be construed to limit the claims to the specific embodiments and aspects disclosed in the following paragraphs. rather, all possible embodiments and aspects to which such claims are entitled are included herein. The claims should therefore be construed to include the full scope of equivalents thereto. It is not limited to that. The present application provides the following invention. (Configuration 1) 1. A system for treating a patient, comprising: A fluid is drawn through a heat exchanger at negative pressure to cool the fluid and then the cooled fluid is pumped to a positive pressure. a fluid cooling supply device configured to deliver to the patient at a pressure of an energy delivery device positioned within the patient, the fluid cooling supply device and wherein the fluid cooling supply device is coupled to the energy delivery device during treatment of the patient. circulating the chilled fluid through a cooling system to cool the energy delivery device. the energy delivery device; The system comprising: (Configuration 2) The fluid cooling supply device is a supply between the heat exchanger and the energy delivery device. a pump positioned in the supply line, the pump directing the fluid through the heat exchanger; and circulating the fluid through the energy delivery device. 2. The system of claim 1, configured to: (Configuration 3) a heat exchanger cartridge coupled to the fluid cooling supply device, A cartridge having a thermally conductive surface and a fluid passageway extending therethrough, At least a portion of the fluid passage is disposed adjacent the thermally conductive surface, the fluid passage extending through the air passage. The system of embodiment 1, in fluid communication with an energy delivery device. (Configuration 4) The temperature of the fluid delivered by the fluid cooling supply device during treatment of the patient is The temperature at the energy delivery device is maintained at or below 20° C. The system described in configuration 1. (Configuration 5) The temperature of the fluid delivered by the fluid cooling supply device during treatment of the patient is The temperature in the energy delivery device is maintained at 20°C to -5°C. The system of configuration 1. (Configuration 6) The temperature of the fluid delivered by the fluid cooling supply device during treatment of the patient is The temperature in the energy delivery device is maintained at 5°C to -2°C. The system of configuration 1. (Configuration 7) The temperature of the fluid delivered by the fluid cooling supply device is The temperature in the device is maintained at 20°C to -5°C, and the energy delivery device The temperature in the device is maintained for a selected amount of time during the treatment portion of the patient's treatment. 2. The system of claim 1, (Configuration 8) 8. The system of claim 7, wherein the selected amount of time for the treatment portion is less than 60 seconds. . (Configuration 9) 8. The system of claim 7, wherein the selected amount of time for the treatment portion is between 60 seconds and 120 seconds. Hmm. (Configuration 10) The energy delivery device is adapted to deliver energy to a target tissue of the patient. and an electrode coupled to said energy delivery device, said fluid being adapted to cool said fluid during treatment. The energy supply device may be adapted to circulate through the energy delivery device to cool the electrode. The system of claim 1, further comprising at least one lumen for (Configuration 11) The energy delivery device includes an electrode coupled to a cooling member, the electrode and the cooling member being A member is disposed adjacent to the airway wall of the patient and controls delivery of energy to the electrode and cooling. The circulation of chilled fluid through the member causes damage to the nerve tissue, thereby causing the patient to The system of embodiment 1, wherein neural signals in a subject are attenuated. (Configuration 12) The energy delivery device delivers the energy at a flow rate of between 70 milliliters and 160 milliliters per minute. 2. The system of claim 1, configured to deliver chilled fluid to the patient. (Configuration 13) The fluid cooling supply device is downstream of the energy delivery device in a return path. a pump positioned to couple the heat exchanger and the energy delivery device to the heat exchanger; 2. The system of claim 1, further configured to draw the fluid through a vice. (Configuration 14) The fluid cooling supply device is a supply between the heat exchanger and the energy delivery device. a pump positioned in the supply line to draw the fluid through the heat exchanger; and configured to circulate the fluid through the energy delivery device. the pump and a pump positioned downstream of the energy delivery device in a return path, and an auxiliary pump configured to cooperate with the pump to circulate the fluid. The system is as follows: (Configuration 15) a fluid cooling supply device, the fluid cooling supply device further comprising an elastic body, the elastic body being configured to pass through the elastic body; a fluid passage extending through the thermally conductive surface, at least a portion of the fluid passage being adjacent to the thermally conductive surface; 2. The system of claim 1, wherein the fluid passage is in fluid communication with the energy delivery device. Stem. (Configuration 16) and a biasing device removably coupled to the elastic body, the biasing device comprising: biasing the elastic body with a given force to cool the fluid to a temperature below a selected temperature; 16. The system of claim 15, (Configuration 17) The elastic bag has a thermally conductive surface, and at least a portion of the fluid passage is disposed on the thermally conductive surface. 16. The system of embodiment 15, wherein the system is disposed adjacent to the (Configuration 18) 1. A method of treating a patient, comprising: Providing a cooling system for chilling and delivering fluid to the patient, the cooling system the stem having a fluid heat exchanger; An ablation assembly of a delivery device is placed in the airway of the patient. positioning the abrasion assembly so that it is apposed against a wall of the airway; the assembly having an electrode; The fluid heat exchanger is coupled to the ablation assembly, and the fluid heat exchanger and the ablation assembly are placing the fusion assemblies in fluid communication with each other; chilling the fluid in the fluid heat exchanger with the cooling device; The fluid is circulated from the fluid heat exchanger through the delivery device while simultaneously delivering energy to the electrodes. and heat treating tissue by delivering ghee to the patient adjacent to the airway. treating the tissue where it is located; and The method comprising: (Configuration 19) Heat treatment of the tissue damages the nerve tissue of the nerve trunk and transmits it to a portion of the bronchial tree. 20. The method of claim 18, further comprising causing the neural signal to be attenuated. (Configuration 20) passing the fluid through the fluid heat exchanger to supply the fluid to the delivery device. 20. The method of embodiment 18, further comprising drawing with negative pressure. (Configuration 21) Treating tissue provides the chilled fluid to the delivery device at positive pressure. 20. The method of claim 18, further comprising: (Configuration 22) Circulating the fluid provides the fluid to the delivery device and treats the patient. and maintaining a temperature in the delivery device at or below 20° C. The method described. (Configuration 23) Circulating the fluid provides the fluid to the delivery device and during treatment of the patient. maintaining the temperature in the delivery device at between 20°C and -5°C. 18. The method described in 18. (Configuration 24) Circulating the fluid provides the fluid to the delivery device and during treatment of the patient. and maintaining the temperature in the delivery device at 5°C to -2°C. 8. The method according to claim 8. (Configuration 25) Cooling the fluid removes heat from the fluid in the heat exchanger during treatment of the patient. 20. The method of claim 18, further comprising conducting the mixture until the temperature reaches or exceeds 100°C. (Configuration 26) Cooling the fluid removes heat from the fluid in the heat exchanger during treatment of the patient. 20. The method of claim 18, further comprising conducting the mixture to a temperature of between 0.5 °C and -2 °C. (Configuration 27) the delivery device for a selected interval between each of a plurality of tissue treatments of the patient. 20. The method of claim 18, further comprising maintaining the selected temperature at . (Configuration 28) 28. The method of claim 27, wherein the selected interval between tissue treatments is less than 60 seconds. (Configuration 29) 28. The method according to claim 27, wherein the selected temperature is 20°C to -5°C. (Configuration 30) Pumping the fluid at a flow rate of between 70 milliliters and 160 milliliters per minute. 19. The method of claim 18. (Configuration 31) 19. The method of claim 18, further comprising delivering the fluid to the patient at a pressure between 25 psi and 150 psi. Law. (Configuration 32) energizing the fluid heat exchanger to a cooling device of the cooling system; The heat exchanger includes an elastomeric body having a fluid passage extending therethrough, the fluid passage being 20. The method of embodiment 18, further comprising fluid communication with the ablation assembly. (Configuration 33) biasing the fluid heat exchanger against a cooling device of the cooling system; A fluid heat exchanger includes a cartridge having a fluid passage extending therethrough. 20. The method of claim 18, wherein the fluid passage is in fluid communication with the ablation assembly. (Configuration 34) 1. A fluid cooling system for thermally treating a fluid for treatment of a patient, comprising: a cooling device comprising a thermal plate; a heat exchanger removably coupled to the cooling device, the heat exchanger comprising a thermally conductive surface and a fluid passage extending through the heat exchanger, at least a portion of the fluid passage being disposed on the heat transfer surface; the heat exchanger disposed adjacent to a surface; at least one heat exchanger arranged to removably couple the heat exchanger to the cooling device; and a biasing mechanism, the thermally conductive surface being biased against the thermal plate of the cooling device. and biasing the at least one biasing member against the fluid to conduct heat from the fluid. Canism and The system comprising: (Configuration 35) The heat exchanger is a disposable heat exchanger cartridge, and the at least one actuation medium The cartridge has two pairs of biasing mechanisms, each pair located at an opposite end of the cartridge. The system of embodiment 34, wherein (Configuration 36) The cartridge is in a first state when disconnected from the cooling device. a cooling device configured to be in a second state when engaged with the cooling device, the first state being The thermally conductive surface of the cartridge has a first contour that is convex with respect to the thermal plate. wherein the second state is such that the thermally conductive surface of the cartridge is in contact with the thermal plate. a second contour having a substantially flat shape relative to the thermally conductive surface of the cartridge and the Thermal plates are substantially biased toward one another to effect heat transfer from the fluid. The system of embodiment 35, further comprising: (Configuration 37) The cooling device, when the cartridge is engaged with the cooling device, At least one corresponding biasing mechanism coupled to the at least one biasing mechanism of the cartridge. 36. The system of claim 35, further comprising a peripheral portion having a biasing mechanism. (Configuration 38) the at least one biasing mechanism and the at least one corresponding biasing mechanism Each of the cartridge and the cooling device is composed of a plurality of magnets that can be attracted to each other. A given biasing force is applied between the seat and the fluid to cause heat conduction from the fluid. The system described in 37. (Configuration 39) The cartridge comprises a first plate and a second plate coupled to each other, a first plate having said thermally conductive surface having a thickness of at least 0.01 inches or less; 36. The system of claim 35. (Configuration 40) 39. The method of claim 38, wherein the second plate comprises a thermal insulator and comprises a groove that defines the fluid passage. The system is as follows: (Configuration 41) The fluid passage has at least one groove proximate a transition between a first sidewall and a second sidewall of the fluid passage. and wherein the at least one corner is adapted to be in contact with the at least one corner during operation of the system. 36. The system of claim 35, wherein the system is configured to prevent air bubbles from being trapped proximate to one of the corners. Hmm. (Configuration 42) The cartridges are in fluid communication with one another and are positioned within the patient. and an input port and an output port in fluid communication with the fluid passage for supplying fluid to the The system of configuration 35, comprising: (Construction 43) The cartridge further comprises a variable volume reservoir contained within the cartridge, the fluid being passed through an outlet of the reservoir. 36. The system of claim 35, wherein the blood is drawn from the blood vessel and delivered to the patient. (Configuration 44) Automatic alignment of the cartridge and its position relative to the cooling device 36. The system of embodiment 35, further comprising a self-aligning means for automatic energization. (Configuration 45) At least one coupled to the cooling device for regulating the amount of heat transfer from the fluid. The system of embodiment 34 further comprises one control device. (Configuration 46) a pump configured to regulate the amount of fluid circulating through the system; the pump is positioned adjacent to the heat exchanger, the heat exchanger comprising a negative fluid pressure; The system described in 34. (Configuration 47) The pump circulates the fluid at a flow rate of between 70 milliliters and 160 milliliters per minute. The method of claim 46, wherein the method is configured as follows: (Configuration 48) The pump is configured to deliver the fluid to the patient at a pressure between 25 psi and 150 psi. 47. The method of claim 46, (Composition 49) A port positioned downstream of the treatment device positioned within the patient in the return path. The treatment device further includes a pump, the pump pulling the fluid from the heat exchanger through the treatment device. 47. The method of claim 46, further comprising: (Configuration 50) In fluid communication with the fluid passage of the heat exchanger and with a treatment device positioned within the patient. 35. The system of embodiment 34, further comprising a supply line. (Composition 51) a supply line in fluid communication with the fluid passage, a treatment device positioned within the patient's bronchus, 35. The system of embodiment 34, in fluid communication with (Configuration 52) and a pulmonary treatment system having a bronchoscope and a treatment device, the treatment device comprising: a heat exchanger positioned adjacent to the patient's lung tissue, the heat exchanger being in fluid communication with the treatment device; 35. The system of claim 34, wherein the system supplies chilled fluid to the patient during treatment. (Composition 53) 35. The system of embodiment 34, wherein the heat exchanger is an elastic material. (Configuration 54) The at least one biasing mechanism includes a plate removably coupled to the elastic body. The plate is a thermal plate, and the elastic body is located between the plate and the thermal plate. 54. The system of embodiment 53, wherein the elastic body is removably coupled to the elastic body as determined. (Configuration 55) The elastic bodies are in fluid communication with each other and with a treatment device positioned within the patient. an input port and an output port in fluid communication with the fluid passage for supplying a fluid to the The system described in 53. (Composition 56) 1. A disposable heat exchanger cartridge for thermally treating a fluid for the treatment of a patient, comprising: a thermally conductive surface and a fluid passageway extending through the cartridge, a thermally conductive surface and a fluid passageway, at least a portion of which is disposed adjacent to the thermally conductive surface; , at least one cartridge arranged to removably couple to a cooling device; a biasing mechanism that causes the thermally conductive surface to conductively cool the fluid; the at least one biasing mechanism; The cartridge comprising: (Configuration 57) The at least one biasing mechanism includes two pairs of magnets, each pair being associated with a pair of magnets on the cartridge. each pair being positioned at an end facing the cartridge and defining an interface between the cartridge and the cooling device; 56. The method of claim 55, wherein the cooling device is adapted to improve contact and increase heat exchange efficiency. Cartridge included. (Composition 58) The cooling device is in a first state when it is disconnected from the cooling device, 57. The cartridge of embodiment 56, configured to be in a second state when mated. (Composition 59) the first condition includes the cartridge having a substantially convex outer shape; 58. The method of claim 57, wherein the second condition includes the cartridge having a substantially rectangular outer shape. Cartridge included. (Configuration 60) The at least one biasing mechanism may include a plurality of magnets that are attractable to the cooling device. a given biasing force is applied to the cartridge to induce heat transfer from the fluid; 57. The cartridge of claim 56, (Composition 61) The device further includes a first plate and a second plate coupled to each other, the first plate being the first plate having a thickness of at least 0.01 inches or less; 57. The cartridge of claim 56. (Configuration 62) 6. The method of claim 5, wherein the second plate is constructed of a thermal insulating material and includes a groove that defines the fluid passage. 1. The cartridge described in 1. (Composition 63) The fluid passage has at least one groove proximate a transition between a first sidewall and a second sidewall of the fluid passage. and wherein the at least one corner is adapted to be in contact with the at least one corner during operation of the system. 57. The cart of claim 56, wherein the cart is configured to prevent air bubbles from being trapped proximate one of the corners. ridge. (Configuration 64) an input port and an output port in fluid communication with each other and with the fluid passage; 57. The cartridge of claim 56. (Composition 65) The cartridge further comprises a variable volume reservoir contained within the cartridge, the fluid being drawn from the reservoir. 57. The cartridge of claim 56, adapted to be dispensed and delivered to the patient. (Configuration 66) automatic alignment of the cartridge when engaged with the cooling device; 57. The cartridge of embodiment 56, further comprising a self-aligning means for automatic energization. (Composition 67) 1. A liquid cooling system for thermally treating a fluid for patient treatment, comprising: a cooling device comprising a thermal plate; a disposable heat exchanger cartridge removably coupled to the cooling device, a thermally conductive surface and a fluid passage extending through the cartridge, at least one of the fluid passages being the disposable heat exchanger cartridge, a portion of which is disposed adjacent to the thermally conductive surface; and, at least one cartridge configured to removably couple to the cooling device; and a biasing mechanism, the thermally conductive surface being biased against the thermal plate of the cooling device. and biasing the at least one biasing member against the fluid to conduct heat from the fluid. Canism and The system comprising: (Composition 68) The at least one biasing mechanism engages the cartridge with the cooling device. a first position for connecting the cartridge to the cooling device and a second position for disconnecting the cartridge from the cooling device. 68. The system of claim 67, further comprising a cam system operable between the device and the (Composition 69) The cam system includes a cam lever and a cam shaft having at least one cam lobe. The system of embodiment 68, comprising: (Configuration 70) The first position of the cam system causes the thermally conductive surface of the cartridge to A locking structure that is biased against the multiplate to cause thermal conduction, An unlocked position allows the cartridge to be removed from the cooling device. 69. The system of claim 68, (Configuration 71) The cooling device further includes a front plate coupled to the cooling device and the cam system, the front plate comprising a sliding 70. The method of claim 67, further comprising: system. (Configuration 72) The front plate includes an upper biasing surface and a lower biasing surface, the upper biasing surface and the lower biasing surface being The cartridge is not parallel to the thermal plate and is aligned at a corresponding upper angle. a corresponding upper angled surface and a corresponding lower angled surface; the corresponding lower angled surfaces are each non-parallel to the thermal plate, are parallel to the upper and lower urging surfaces of the front plate, respectively, and the cartridge 72. The system of aspect 71, wherein the connector is slidably received within the slot. (Composition 73) The at least one biasing mechanism engages the cartridge with the cooling device. a first position for connecting the cartridge to the cooling device and a second position for disconnecting the cartridge from the cooling device. and wherein the first position is such that the cam system is operable between the front a plate having a thermally conductive surface and a thermal plate having a thermally conductive surface and a thermal plate having a thermally conductive surface and a thermal plate having a thermally conductive surface and a thermal plate having a thermally conductive surface and a thermal plate. The system of claim 72, wherein the actuators are biased toward each other with a given force. (Configuration 74) The cartridge comprises a first plate and a second plate coupled to each other, A first plate includes the thermally conductive surface and a second plate includes a thermal insulator and the fluid passage. 68. The system of aspect 67, further comprising a groove defining a (Composition 75) The fluid passage has at least one groove proximate a transition between a first sidewall and a second sidewall of the fluid passage. and wherein the at least one corner is adapted to be in contact with the at least one corner during operation of the system. 68. The system of claim 67, wherein the system is configured to prevent air bubbles from being trapped proximate to one of the corners. Hmm. (Configuration 76) The second plate includes a variable volume reservoir from which the fluid is drawn and into the patient. The system of configuration 74, wherein the information is provided to a user. (Configuration 77) a pump configured to regulate the amount of fluid circulating through the system; The pump is positioned adjacent to the cartridge and the fluid within the cartridge is negatively charged. 68. The system of embodiment 67, wherein the fluid pressure is (Configuration 78) The pump circulates the fluid at a flow rate of between 70 milliliters and 160 milliliters per minute. The system of embodiment 77, configured as follows. (Composition 79) 77. The method of claim 75, wherein the pump is configured to deliver the fluid at a pressure between 25 psi and 150 psi. The system described. (Configuration 80) and a pump positioned downstream of the treatment device positioned within the patient. 68. The method of claim 67, wherein the pump is configured to draw the fluid through the treatment device. The system is as follows: (Configuration 81) The fluid passage of the cartridge and a treatment device positioned within the patient and a fluid 68. The system of embodiment 67, further comprising a supply line in communication. (Configuration 82) a supply line in fluid communication with the fluid passage, at least a portion of the supply line a treatment device positioned within the patient and positioned within the patient's bronchus; 68. The system of embodiment 67, in fluid communication with. (Configuration 83) and a pulmonary treatment system having a bronchoscope and a treatment device, the treatment device comprising: The cartridge is positioned adjacent to the lung tissue of the patient, the cartridge being in fluid communication with the treatment device. 68. The system of claim 67, wherein the system supplies chilled fluid to the patient during treatment. (Configuration 84) 1. A method of cooling a fluid for treatment of a patient, comprising: Biasing the heat exchanger cartridge against a thermal plate of a cooling device. the heat exchanger cartridge has a fluid passageway and connects the heat exchanger cartridge to the cooling device. at least one biasing mechanism for removably attaching; removing the heat exchanger cartridge from the cooling device; biasing an alternative heat exchanger cartridge against the thermal plate of the cooling device; the alternative heat exchanger cartridge having a fluid passage and an alternative heat exchanger At least one biasing member for removably attaching the cartridge to the cooling device. Having a mechanism; The method comprising: (Configuration 85) The act of biasing the cartridge is by utilizing a magnetic force. 85. The method of embodiment 84, comprising applying a given biasing force between the cooling device. (Configuration 86) 86. The method of aspect 85, wherein the given biasing force is at least 10 pounds of force. (Configuration 87) 86. The method of claim 85, wherein the given biasing force is between 10 pounds and 60 pounds of force. (Configuration 88) Biasing the cartridge causes a thermally conductive surface of the cartridge to contact the thermal plate. wherein at least a portion of the thermally conductive surface is biased against a front surface of the cartridge. 85. The method of embodiment 84, adjacent to the fluid passageway. (Composition 89) Pumping the fluid through the heat exchanger cartridge for fluid delivery to the patient. 85. The method of embodiment 84, further comprising: (Configuration 90) During pulmonary treatment, a treatment device positioned adjacent to the patient's lung tissue is 85. The method of embodiment 84, further comprising supplying a fluid. (Configuration 91) Biasing the heat exchanger cartridge actuates a cam system into engagement. 85. The method of claim 84, further comprising biasing the cartridge against the thermal plate. method. (Configuration 92) Removing the heat exchanger cartridge activates the cam system to disengage. and separating the cartridge from the thermal plate. The method described. (Composition 93) Actuating the cam system moves the cam lever and the cam shaft to the engaged state. 91. The method of claim 90, further comprising: moving the cartridge against the thermal plate. Method of posting. (Configuration 94) 1. A liquid cooling system for thermally treating a fluid for patient treatment, comprising: a cooling device comprising a thermal plate; a heat exchanger coupled to the cooling device, the heat exchanger having a thermally conductive surface and a heat transfer element extending through the heat exchanger; and a fluid passageway disposed adjacent the thermally conductive surface, at least a portion of the fluid passageway being disposed adjacent the thermally conductive surface. The heat exchanger is disposed in the a pump positioned downstream of the fluid passage of the heat exchanger for pumping fluid through the fluid passage; The fluid is adapted to be drawn through a passage with negative pressure and provided to a treatment device with positive pressure. The pump, The system comprising: (Composition 95) The pump has a forward gear and a reverse gear, the reverse gear passing the forward flow through the heat exchanger. 95. The method of claim 94, further comprising: system. (Composition 96) 9. The method of claim 8, wherein the pump provides fluid at a flow rate between 70 milliliters and 160 milliliters per minute. 4. The system described in (Composition 97) 94. The pump is configured to deliver the fluid at a pressure between 25 psi and 150 psi. The system described. (Composition 98) the heat exchanger is positioned substantially perpendicular to the heat exchanger plate. 94. The system described in (Composition 99) 95. The system of embodiment 94, wherein the positive pressure is at least 80 psi. (Configuration 100) 95. The system of claim 94, wherein the fluid returned to the heat exchanger is at or below 10 psi. (Configuration 101) and a secondary pump positioned downstream of the treatment device, the pump 95. The method of claim 94, further comprising drawing said fluid from an exchanger through said treatment device. system. (Configuration 102) The heat exchanger includes a cardboard plate having a first plate and a second plate bonded together. a heat transfer surface of said first plate and a heat transfer surface of said second plate, 95. The system of embodiment 94, comprising a groove defining a body passageway. (Configuration 103) The fluid passage has at least one groove proximate a transition between a first sidewall and a second sidewall of the fluid passage. and wherein the at least one corner is adapted to be in contact with the at least one corner during operation of the system. 103. The system of claim 102, wherein the system is configured to prevent air bubbles from being trapped proximate to any one of the corners. Hmm. (Configuration 104) 94. The method of claim 94, wherein the heat exchanger is an elastic body having a membrane, the membrane being the heat transfer surface. system. (Configuration 105) 105. The system of embodiment 104, wherein the elastic body comprises a serpentine groove that defines the fluid passageway. . (Configuration 106) 1. A method of cooling a fluid for treatment of a patient, comprising: drawing a coolant through a heat exchanger at negative pressure to chill the coolant; Delivering the chilled coolant under positive pressure to a treatment device positioned within the patient. And, circulating the coolant through the treatment device; The method comprising: (Configuration 107) The method of aspect 106, wherein the positive pressure is at least 80 psi. (Configuration 108) The method of aspect 106, wherein the return pressure to the heat exchanger is 10 psi or less. (Configuration 109) The method of embodiment 106, further comprising adjusting an amount of heat transfer from the fluid. (Configuration 110) 10. The method of claim 10, further comprising adjusting a volume of the fluid delivered for treatment of the patient. 6. The method according to claim 6. (Configuration 111) The method of embodiment 106, further comprising energizing the heat exchanger against a cooling device. (Configuration 112) The treatment device is adapted to receive the circulated chilled fluid through the patient's bronchus. The method of embodiment 106, further comprising positioning the interior. (Configuration 113) positioning a pump downstream of the heat exchanger; The pump is used to pump the fluid back through the heat exchanger to remove the fluid from the heat exchanger. substantially removing the gas; and The method of embodiment 106, further comprising: (Configuration 114) Providing the chilled coolant to the treatment device includes: circulating the cooled coolant, including pumping the coolant through the pump; The method of embodiment 106, further comprising drawing the fluid from the treatment device using an auxiliary pump. (Configuration 115) The cooled coolant is circulated at a flow rate of 70 to 160 milliliters per minute. The method of claim 106. (Configuration 116) The chilled fluid is supplied to the treatment device at a pressure of between 25 psi and 150 psi. The method described in 06. (Configuration 117) and biasing the heat exchanger against a cooling device, the heat exchanger being adapted to The method of embodiment 106, wherein the cartridge has a fluid passage in communication with the chair. (Configuration 118) and biasing the heat exchanger against a cooling device, the heat exchanger being adapted to The method of aspect 106, wherein the elastic body has a fluid passage in fluid communication with the chair. (Configuration 119) 1. A liquid cooling system for thermally treating a fluid for patient treatment, comprising: a cooling device comprising a thermal plate; an elastomer removably coupled to the cooling device, the elastomer having a thermally conductive surface; and a fluid passage extending through the thermally conductive surface, at least a portion of the fluid passage being disposed on the thermally conductive surface. The elastic body is disposed adjacent to the elastic body. At least one configured to removably couple the elastic body to the cooling device. a biasing mechanism for biasing the thermally conductive surface against the thermal plate of the cooling device; the at least one biasing mechanism being biased by a biasing means for transferring heat from the fluid. And, The system comprising: (Configuration 120) The at least one biasing mechanism engages the elastic body with the cooling device. and a second position for disconnecting the elastomer from the cooling device. The system of aspect 119 includes a cam system that can be operated. (Configuration 121) The cam system includes a cam lever and a cam shaft having at least one cam lobe. The system of embodiment 120, comprising: (Configuration 122) The first position of the cam system causes the thermally conductive surface of the elastic body to contact the thermal plate. a locking configuration that is biased against the plate to cause thermal conduction, said second position being an unlocking configuration that allows the elastic body to be removed from the cooling device; The system of configuration 120. (Configuration 123) The at least one biasing mechanism is adapted to engage the elastic body with the cooling device. and a second position for decoupling the elastomer from the cooling device. a cam system that can be moved relative to the thermal plate, 120. The system of aspect 119, comprising the cam system biased with a given force. (Configuration 124) a pump configured to regulate the amount of fluid circulating through the system; The pump is positioned adjacent to the elastomeric body, and the fluid within the elastomeric body exerts a negative fluid pressure. The system of configuration 119, further comprising: (Configuration 125) The pump circulates the fluid at a flow rate of between 70 milliliters and 160 milliliters per minute. The system of configuration 124, configured as follows. (Configuration 126) The pump is configured to deliver the fluid at a pressure between 25 psi and 150 psi. The system described. (Configuration 127) a fluid passageway in the elastic body and in fluid communication with a treatment device positioned within the patient; The system of embodiment 119, further comprising a supply line. (Configuration 128) a supply line in fluid communication with the fluid passage, a treatment device positioned within the patient's bronchus, 120. The system of claim 119, in fluid communication with (Composition 129) and a pulmonary treatment system having a bronchoscope and a treatment device, the treatment device comprising: The elastic body is positioned adjacent to the lung tissue of the patient, the elastic body being in fluid communication with the treatment device. The system of claim 119, further comprising: a first fluid supply unit for supplying chilled fluid to the patient during treatment. (Configuration 130) 1. A method of cooling a fluid for treatment of a patient, comprising: urging an elastic body against a thermal plate of a cooling device, the elastic body comprising: The elastic body has a fluid passageway, and the elastic body is biased by at least one biasing mechanism to bias the thermal plate. and Removing the elastic body from the cooling device; Using the at least one biasing mechanism against the thermal plate of the cooling device. and biasing a replacement elastic body therein; The method comprising: (Configuration 131) 130. The method of claim 130, wherein biasing the elastic body includes applying a biasing force to the elastic body. The method described. (Configuration 132) 132. The method of aspect 131, wherein the given biasing force is at least 10 pounds of force. (Configuration 133) The method of aspect 131, wherein the given biasing force is between 10 pounds and 60 pounds of force. (Configuration 134) and pumping the fluid through the elastic body for fluid delivery to the patient. The method of embodiment 130, comprising: (Configuration 135) During pulmonary treatment, a treatment device positioned adjacent to the patient's lung tissue is The method of embodiment 130, further comprising supplying a fluid. (Configuration 136) Biasing the resilient body actuates a cam system into engagement, moving the resilient body forward. The method of embodiment 130, further comprising biasing the thermal plate. (Configuration 137) Releasing the resilient body actuates the cam system into a disengaged state; The method of embodiment 130 comprising separating the elastomer from the thermal plate. (Composition 138) Actuating the cam system moves the cam lever and the cam shaft to the engaged state. 138. The method of claim 137, further comprising: moving the elastic body against the thermal plate. method. (Composition 139) 1. A disposable heat exchanger cartridge for thermally treating a fluid for the treatment of a patient, comprising: a plate having a thermally conductive surface; A thermoformed tray having a recess or groove defined therein, the thermoformed tray being disposed on the thermally conductive surface. the thermal expansion module being coupled to the cartridge, thereby defining a fluid passageway extending through the cartridge. A forming tray; the cartridge configured to be removably connectable to a cooling device. , the thermally conductive surface conductively cools the fluid. (Configuration 140) 140. The cartridge of embodiment 139, wherein the plate has a thickness of at least 0.01 inches or less. J. (Configuration 141) 141. The cartridge of embodiment 140, wherein the plate comprises copper and the thermally conductive surface comprises a layer of silver. . (Configuration 142) 142. The cartridge of embodiment 141, wherein the silver layer has a thickness of about 0.5 microns to 1 micron. (Composition 143) a first end of the fluid passage, the first end of the fluid passage being connected to a first end of the fluid passage and a second end of the fluid passage being connected to a second end of the fluid passage and to a second end of the fluid passage; an inlet port in fluid communication with the body container; and a second end of the fluid passage, the second end of the fluid passage being coupled to the fluid passage; and an outlet port in fluid communication with a pumping mechanism external to the cartridge. The cartridge of aspect 139. (Configuration 144) The inlet port and the outlet port each have a tapered or trapezoidal cross-sectional profile. and wherein the at least one port is adapted to trap air bubbles during operation of the system. A cartridge as described in configuration 143. (Composition 145) When at least one edge of the cartridge is engaged with a cooling device, the cartridge 140. The camera of claim 139, further comprising a self-alignment means for automatic alignment of the cartridge. Cartridge. (Configuration 146) The fluid passageway meanders along the length and width of the cartridge, making multiple passes. 139. A cartridge as described in claim 139. (Configuration 147) The tray is made of a thermoformed plastic containing polyvinyl chloride (PVC) or polyethylene terephthalate (PET). 140. The cartridge of aspect 139, formed of a formable material. (Composition 148) 1. A fluid cooling system for thermally treating a fluid for treatment of a patient, comprising: a housing having a hinged door movable between an open position and a closed position; A cooling device mounted at least partially within the housing, the cooling device comprising a thermal plate the cooling device comprising a a disposable heat exchanger cartridge removably coupled to the cooling device, a plate having a thermally conductive surface and a thermoformed tray having a recess or groove defined therein; The thermoformed tray is coupled to the thermally conductive surface thereby extending through the cartridge. the disposable heat exchanger cartridge defining a fluid passage through which the at least one cartridge configured to removably couple to the cooling device; and a biasing mechanism, the thermally conductive surface being biased against the thermal plate of the cooling device. and biasing the at least one biasing member against the fluid to conduct heat from the fluid. Canism and The system comprising: (Composition 149) The at least one biasing mechanism may include one or more magnets that are attractable to the cooling plate. and applying a given biasing force between the cartridge and the cooling device to remove the fluid from the The system of embodiment 148 is configured to cause thermal conduction therebetween. (Configuration 150) a pump configured to regulate the amount of fluid circulating through the system; The pump is positioned adjacent to the cartridge and the fluid within the cartridge is negatively charged. The system of embodiment 148, wherein the fluid pressure is (Configuration 151) The pump circulates the fluid at a flow rate of between 70 milliliters and 160 milliliters per minute. The system of embodiment 148, configured as follows: (Configuration 152) The pump is configured to deliver the fluid at a pressure between 25 psi and 150 psi. The system described. (Composition 153) and a pump positioned downstream of the treatment device positioned within the patient. 148. The method of claim 147, wherein the pump is configured to draw the fluid through the treatment device. The system is as follows: (Configuration 154) The fluid passage of the cartridge and a treatment device positioned within the patient and a fluid 149. The system of embodiment 148, further comprising a supply line in communication. (Configuration 155) a supply line in fluid communication with the fluid passage, at least a portion of the supply line a treatment device positioned within the patient and positioned within a bronchus of the patient; The system of aspect 148, in fluid communication. (Configuration 156) and a pulmonary treatment system having a bronchoscope and a treatment device, the treatment device comprising: The cartridge is positioned adjacent to the lung tissue of the patient, the cartridge being in fluid communication with the treatment device. The system of embodiment 148, wherein the system supplies chilled fluid to the patient during treatment. (Configuration 157) a variable volume fluid reservoir in fluid communication with the fluid passageway via a reservoir supply line; The system of configuration 148. (Composition 158) Fluid is pumped from a fluid container and circulated through a device in a patient, and then returned to the container. The system of embodiment 148, which is a return closed loop system. (Composition 159) The fluid container is connected to a single location on the container via a coaxial bag spike assembly. 19. The system of embodiment 158, wherein the fluid supply line and the fluid return line are in fluid communication with each other. (Configuration 160) The coaxial bag spike assembly includes a first lumen extending therethrough and having a first inner diameter. a second lumen extending therethrough and having a second inner diameter smaller than the first inner diameter; a second tubular member positioned within the first lumen of the first tubular member. the first lumen and the second lumen are coaxial, thereby defining a first passageway and a second passageway. The system of configuration 159 is configured to determine the (Configuration 161) One of the first passageway and the second passageway is in fluid communication with a fluid return line. The coolant is returned to the container through the passage, and the first passage and the second passage the other is in fluid communication with a fluid supply line so that coolant is supplied from the container to the fluid passage. The system of configuration 160. (Configuration 162) Each of the first lumen and the second lumen is connected to a respective supply via a spike adapter. a first end of the first tubular member and a second end of the second tubular member; a tubular member adapted to be mated with the adapter, the adapter connecting the fluid return line to the first passage and the a first passage for coupling to the fluid return line in fluid communication with one of the second passages; a port, the fluid supply line and the other of the first passage and the second passage. and a second port for coupling to the fluid supply line so as to Stem. (Configuration 163) The second tubular member is a hypotube and the first tubular member is a non-vented female luer. The system of configuration 160, (Configuration 164) 1. A coaxial bag spike assembly comprising: A first tubular member having structure defining a first lumen therethrough, the first lumen being a first the first tubular member having an inner diameter of a second tubular member having structure defining a second lumen therethrough, the second lumen being the second tubular member having a second inner diameter smaller than the first inner diameter; Equipped with The second tubular member is positioned within the first lumen of the first tubular member, and the first lumen and and the second lumen are coaxial, thereby defining a first passageway and a second passageway; One of the first passage and the second passage is connected to a fluid return line and a fluid volume of a cooling device. a first passageway and a second passageway in fluid communication with the vessel such that a coolant is returned to the vessel through the lumen; The other of the second passages is in fluid communication with a fluid supply line and a fluid container, and the coolant is passed from the container to the The assembly is adapted to be supplied to the cooling device. (Configuration 165) One of the supply line and the return line is coupled to the first passage, the supply line being a spike adapter for coupling the other of the in and return lines to the second passage. the spike adapter further comprising a tubular portion coupled to the first end of the first tubular member. the adapter connecting the fluid return line to one of the first passageway and the second passageway. a first port for coupling to the fluid return line in fluid communication with the fluid supply; The fluid supply line is connected to the other of the first passage and the second passage so as to be in fluid communication with the line. 165. The assembly of embodiment 164, having a second port for coupling to an in. (Configuration 166) The second tubular member is a hypotube and the first tubular member is a non-vented female luer. The assembly of embodiment 164, (Configuration 167) The assembly of embodiment 164, wherein the first tubular member is injection molded plastic. (Composition 168) The assembly of embodiment 165, wherein the spike adapter is injection molded plastic. (Composition 169) a vented slot for coupling the first tubular member and the second tubular member to the fluid container; The assembly of aspect 164, further comprising a pike cap.

Claims

1. A disposable heat exchanger cartridge for thermally treating a fluid with a cooling device having an outwardly facing thermal plate, comprising: a thermally conductive surface; and a fluid passageway extending through the cartridge, at least a portion of the fluid passageway being disposed adjacent to the thermally conductive surface; an input port and an output port in fluid communication with each other and with the fluid passageway, the input port and the output port being on opposite sides of the cartridge; and at least one biasing mechanism arranged to removably couple the cartridge to the outwardly facing thermal plate of the cooling device, the thermally conductive surface contacting and at least partially covering the outwardly facing thermal plate to conductively cool the fluid and with a side of the cartridge opposite the thermally conductive surface facing outward; The cartridge, wherein the fluid passage is dimensioned to provide a residence time sufficient for the fluid to experience a temperature differential of about 15 to 35° C. through the fluid passage at a flow rate of about 100 mL / min when the thermally conductive surface is biased against the thermal plate.

2. 2. The cartridge of claim 1, wherein the at least one biasing mechanism comprises two pairs of magnets, each pair positioned at opposite ends of the cartridge, each pair capable of being attracted to the cooling device to improve surface-to-surface contact between the cartridge and the cooling device to increase heat exchange efficiency.

3. The cartridge of claim 1 , configured to be in a first state when disconnected from the cooling device and in a second state when engaged with the cooling device.

4. 4. The cartridge of claim 3, wherein the first state includes the cartridge having a substantially convex outer shape, and the second state includes the cartridge having a substantially rectangular outer shape.

5. The cartridge of claim 1 , wherein the at least one biasing mechanism comprises a plurality of magnets that are attractable to the cooling device to exert a biasing force on the cartridge to induce heat transfer from the fluid.

6. 10. The cartridge of claim 1, further comprising a first plate and a second plate bonded together, the first plate comprising the thermally conductive surface, the first plate having a thickness of at least 0.01 inches or less.

7. The cartridge of claim 6 , wherein the second plate is constructed from a thermally insulating material and includes a groove that defines a portion of the fluid passageway.

8. 2. The cartridge of claim 1, wherein the fluid passage comprises at least one corner proximate a transition between a first side wall and a second side wall of the fluid passage, the at least one corner configured to prevent air bubbles from being trapped proximate the at least one corner during operation of the system.

9. The cartridge of claim 1 , further comprising a variable volume reservoir contained within the cartridge, such that the fluid is drawn from the reservoir and delivered to a patient.

10. 10. The cartridge of claim 1, further comprising self-alignment means for automatic alignment and energization of said cartridge when engaged with said cooling device.

11. A cartridge comprising: a plate having said thermally conductive surface; and a thermoformed cover having a recess or groove defined therein, said thermoformed cover being bonded to said thermally conductive surface thereby defining said fluid passageway extending through said cartridge; the cartridge is removably coupleable to the cooling device, the thermally conductive surface being urged against the thermal plate of the cooling device to transfer heat from the fluid; and 2. The cartridge of claim 1, wherein the cartridge comprises a first port positioned adjacent to and in fluid communication with a first end of the fluid passage, the first port configured to be connected to a fluid supply line along an axis parallel to the fluid passage and offset from the fluid passage at the first end.

12. 12. The cartridge of claim 11, further comprising one or more magnets coupled to the plate, the magnets being capable of being attracted to the thermal plate and applying a biasing force between the cartridge and the cooling device to effect heat transfer from the fluid.

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