Endobronchial stem cell seeding catheter

Abstract

The present disclosure is a telescopic endobronchial stem cell cultivation catheter that comprises a segment catheter (1), a terminal catheter (2), and a respiratory catheter (3) ensuring that ensures the prevention of the progression of COPD and provides early treatment before it progresses to advanced stages, allows the increase of the number of reduced lung parenchyma by means of its inoculation feature in advanced COPD stages, provides the removal of metaplastic cells in the bronchial walls in the application area with the rhythmic inflation-deflation movement by means of the balloons (1.2, 2.2, 3.2) and reduces the risk of future cancer formation, and increases respiratory ventilation by expanding narrowed terminal bronchioles (11) and increasing air flow to the respiratory bronchioles (12).

Description

[0001] ENDOBRONCHIAL STEM CELL SEEDING CATHETER

[0002] Technical Field

[0003] The present disclosure relates to a catheter that allows stem cells and PRP fluid to reach the farthest airway, the farthest point, the alveoli, and provides repair of respiratory and terminal bronchioles and alveoli by inoculating stem cells, increasing the formation of RASC cells that prevent emphysema, and providing treatment by opening respiratory bronchioles and terminal bronchioles in particular.

[0004] State of the Art

[0005] Chronic obstructive pulmonary disease (COPD) is the most common lung disease in the world and is one of the four most important diseases that cause death. In COPD patients, the air taken into the lungs cannot be easily exhaled, over time the lungs begin to deteriorate and shortness of breath occurs. COPD is known in two groups. The first of these is the condition called emphysema. In the case of emphysema, the airways and air sacs called alveoli break down and expand. Therefore, gas exchange is impaired and shortness of breath occurs. In the second condition, chronic bronchitis, the airways called bronchi leading to the alveoli are frequently inflamed and narrowed due to reasons such as cigarette smoke irritation and infection. As a result, breathing problems occur. In addition to drug therapy, operational treatments are also preferred in advanced COPD patients. The most commonly applied of these treatments is balloon therapy. Balloon therapy in COPD is an accepted and increasingly used supportive treatment method. In chronic bronchitis patients, irritation, narrowing of the airways due to recurrent infections and thickening due to an increase in airway epithelial cells occur. In balloon treatment, the airways in both lungs are reached with the help of a special bronchoscope and the thickened airway tissue is scraped off using a frequency balloon. In this way, the airway thickness returns to its previous state relatively and the airways are mechanically cleaned. Bronchial balloon catheters are used in the widening of narrownesses in the airways caused by infection, tumour, iatrogenic or traumatic causes, and in the treatment of COPD. It is a flexible tube-shaped catheter with an inlet and an inflatable balloon at its distal end for insertion into the bronchus. The balloon will not be able to reach the small airways at the end of the trachea that is most affected in COPD. However, the trachea that it can reach can be temporarily widened and the accumulated phlegm can be cleared. However, the stem cell inoculation (vaccination) into the subsegments and air sacs at the ends of the lungs will not be able to achieve the desired result in the treatment. It is asserted that the bronchial cleaning is done with the resector balloon method and that patients breathe more easily after this procedure, but this is not a definitive treatment method and should be repeated if necessary. In the applied treatment, a catheter with a balloon at its tip is advanced to the trachea that is 3 mm in diameter with the endoscopic method. The balloon is inflated to widen the trachea and the secretions are tried to be reduced by scraping. The trachea that the balloon can reach can be temporarily widened and the accumulated phlegm can be cleared. This does not provide treatment, but only temporary relief. A catheter structure that can reach the farthest subsegments and air sacs is not used in the state of the art.

[0006] Document numbered CN214970647U in the state of the art describes a tracheal catheter for anaesthesia of tracheal tumour surgery. It describes a tracheal catheter that comprises a catheter main body for anaesthesia of tracheal tumour surgery, the catheter main body of which is specially constructed, the catheter main body of which comprises a tracheal catheter and two bronchial catheters, and each bronchial catheter is equipped with a first groove. The outer side of each first groove is covered with a bronchial cuff, and each bronchial cuff is connected with a bronchial cuff inflation tube. The bronchial cuff is a balloon-like structure that inflates. The inflation tube of this cuff is arranged in the catheter body, and a second groove is created at the intersection of the tracheal catheter and two bronchial catheters. A tracheal cuff matching the second groove is arranged on the outside of the second groove, and the tracheal cuff is connected to the tracheal cuff inflation tube in a similar manner. The bronchial cuff inflation tube and the tracheal cuff inflation tube are connected with balloons, respectively. The balloon is connected to a deflation tube, the tracheal catheter is connected to an oxygen interface, and there is a Murphy hole in the tail of the bronchial catheter. The problem of intubation not being suitable for passing through the oral cavity or nasal cavity in tracheal tumour surgery is solved. A telescopic catheter structure with at least 3 bodies and different types of balloons reaching the air sacs is not mentioned.

[0007] A COPD valve with a mesh-covered balloon is explained in the document numbered TR2017 / 12877 in the state of the art. It relates to the structures that allow the air in the ballooned lung to be evacuated in COPD patients in emphysema. It is characterized by comprising the valve that allows the air in the ballooned lung to be evacuated in emphysema and prevents air from entering the ballooned emphysematous parts of the lungs, providing a one-way air exit from the upper part, a balloon-positioned catheter that provides attachment to the bronchial channel in the middle part, and a mesh balloon COPD valve that can be inflated with liquid or air with a valve cannula at the bottom.

[0008] In the document numbered TR2018 / 08066 in the state of the art, the COPD peeling balloon catheter system and application method are described. It is characterised as relating to the COPD peeling balloon catheter system and application method that are developed to ensure the removal of unwanted biological materials and / or lesions, secretions, body fluids and / or biological formations such as endoluminal and / or endobronchial benign, premalignant and / or malignant tissue and / or hypertrophic cellular growths and / or hyperplastic cellular formations and / or solidified lung fluids seen in hollow tubular organs such as tracheobronchial, vascular, oesophageal, urethral, vaginal, gastrointestinal from the mucosal surfaces by peeling and / or scraping without damaging the mucosa using bronchoscopes or endoscopes and / or working channels of rigid and / or flexible endoscopes.

[0009] In the documents numbered TR2006 / 05770, TR2009 / 07264 and TR2015 / 02485 in the state of the art, flexible and rigid catheter resector balloons, multi-lumen resector balloons comprising one or more balloons coated with metal-coated elastic thread or drug, and catheter resector balloons with multiple inlets or multiple outlets are described. The documents relate to a resector (scraper) tumour balloon that is used in the treatment of endoluminal / endobronchial tumoural lesions and endovascular obstructions seen in hollow tubular organs and vessels such as the trachea, trachea, oesophagus, urinary tract, bile ducts, and is inflated to a degree that will provide dilatation within the tubular organs for use in their treatment or provides resection of abnormal tissues such as tumours, clots or plaques by inflating and deflating the balloon with different diameters and frequencies between 1 -20 per second using a resector balloon pump or syringe after being passed behind the stenosis. In addition, the catheter resector balloon describes the catheter-equipped resector balloon as comprising at least two catheter feeding tubes, each with a catheter feeding tip, to ensure that tissue adhesives that assist in the occlusion process of said catheter, different drugs that provide clotting and fluids are delivered to the resector balloon, resection tips as many as the number of catheter feeding tubes and exit holes formed at the end of said mesh sheath as many as the number of resection tips.

[0010] The document numbered CN1 14159664A in the prior art describes the double lumen bronchial catheter with temperature measurement function and usage method. The double lumen bronchial catheter consists of a main tube, a main tracheal balloon, a bronchial balloon, a temperature probe interface and a spring. Its usage comprises some method steps. These are; step 1 , removing the catheter; step 2, removing the compression plates; step 3, connecting an interface; step 4, inserting an air tube; step 5, inflating the air bag; step 6, real-time monitoring; compared with the existing double lumen bronchial catheter, the temperature probe body is additionally arranged in the main tracheal balloon, enabling real-time monitoring of a patient's temperature index. According to the designed drug balloon, drug can be delivered provided that one tube is not pulled out, two groups of different drugs can be delivered, or it solves the technical problem of ensuring that the remaining drug affects the drug effect before mixing the new drug.

[0011] Document numbered US2022323653A1 in the prior art describes drug-coated balloon catheters for body lumens. Various embodiments described relate to drug-coated balloon catheters for treating stenoses in body lumens and methods of using them. A drug-coated balloon catheter for delivering a therapeutic agent to a target area of body lumen stenoses comprises a long balloon having a main diameter. The balloon catheter comprises a coating layer extending on an outer surface of the balloon. The coating layer comprises one or more water-soluble additives and an initial drug load of a therapeutic agent.

[0012] Document numbered CN204543184U in the prior art describes a dual-chamber endotracheal tube. The connection to the main part of the ventilation pipe is made by the user, the main part is ventilated by overlapping the pipe, the bag inflation valve and the bronchial valve main parts are placed on the ventilation pipe, and the user responsible for the valve and the bag inflation valve provide the inflation of the bag. The valve main part is placed on the ventilation pipe together with the bronchial valve bag. The aim of the invention is to provide a double lumen bronchial catheter to reduce the rate of misalignment of the bronchial opening of the right upper lobe by the catheter, increase ventilation efficiency, increase usage safety and facilitate usage. It solves the technical problem of preventing the repeated adjustment and positioning of the tracheal mucosa caused by the patient.

[0013] The existing catheters used in the existing COPD balloon treatments seen in the documents in the prior art cannot descend to the most distal bronchi and provide temporary relief to the patient. The lack of a catheter structure that reaches the terminal airways, allows stem cells to be inoculated into the terminal airways with the same catheter, and thus increases the RASC cells that repair the alveoli in the respiratory terminal bronchioles and prevent emphysema, has necessitated an R&D study in this field.

[0014] The Aim of the Invention

[0015] The aim of the invention is to open obstructed bronchi and bronchioles in chronic obstructive pulmonary disease (COPD), especially by opening respiratory bronchioles and terminal bronchioles and performing stem cell inoculation, to increase the number of air sacs and RASC cells, to relieve breathing and to eliminate respiratory distress.

[0016] The aim of the invention is to provide a catheter structure that can reach the respiratory bronchi starting from segmental 1 and reaching segmental 6 even segmental 10 and 17 by thinnest of the catheter, reaching the stem cell fluid that mixed with PRP (- Platelet Rich Plasma- platelet-rich plasma prepared from the person's own blood) to reach the target cells and not to come back by reaching to the air sacs and respiratory bronchiole groups

[0017] The aim of the invention is to prevent the progression of COPD and to ensure early treatment before it reaches advanced stages.

[0018] The aim of the invention is to increase the number of lung parenchyma that has decreased in the advanced stages of COPD. The aim of the invention is to ensure that the risk of cancer is reduced by ensuring that metaplasia cells are cleaned by means of the specially designed balloons at the end of the catheter.

[0019] The aim of the invention is to widen the narrowed terminal bronchioles, to increase the airflow to the respiratory bronchioles and to provide relief of respiratory ventilation.

[0020] The aim of the invention is to obtain a telescopic catheter with a first catheter starting from the trachea and reaching the segmental bronchi branching after the main bronchus, a second catheter extending from the segmental bronchi to the bronchioles and terminal bronchi, and finally a third catheter reaching the respiratory bronchioles.

[0021] The aim of the invention is to ensure that the spiral balloon at the end of the third catheter reaching the respiratory bronchiole and the alveoli, which are the air sacs, cleans and opens even the farthest parts, thus facilitating breathing.

[0022] The aim of the invention is to provide the stem cell solution prepared with PRP to the respiratory bronchiole and alveoli by means of the inoculation holes located at the end of the third catheter that reaches the respiratory bronchiole and the alveoli, which are the air sacs, and to ensure the renewal of tissue damage there and the increase in the development of RASC cells.

[0023] The aim of the invention is to provide a telescopic catheter that, unlike the catheters used in the state of the art, allows it to reach the respiratory bronchi, which is the furthest point of the bronchi in the lung, and allows both the clearing of obstructions caused by COPD and the reduction of damage caused by the disease.

[0024] The aim of the invention is to ensure the opening of the bronchi and bronchioles by inflating and deflating them starting from the main bronchus and up to the respiratory bronchi by means of the balloons of different diameters and numbers located at the ends of the three catheters.

[0025] The aim of the invention is to ensure that the balloon in each catheter deflates and inflates in turn (1stinflates, 2ndis deflated; 2ndinflates, 1stand 3rdare deflated; 3rdinflates 1stand 2ndare deflated; again, 1stinflates ...) and thus the mucosal structure in the bronchi and bronchioles is cleaned like a massage system. The aim of the invention is to prevent tissue damage or bleeding by preventing the bronchus from being directly inflated by the balloons in the catheter deflating and inflating in turn.

[0026] The aim of the invention is to prevent tissue damage in the event of a possible overinflation by automatically controlling the inflation rates of all balloons by means of the pressure sensors on the spiral balloon in the thinnest catheter.

[0027] The aim of the invention is to inflate and control the balloons in the catheters in turn by using an air device similar to a lithotripsy extracorporeal, pneumatic stone breaking device.

[0028] The aim of the invention is to provide a catheter that acquires telescopic properties by passing through each other and thus can reach the respiratory bronchioles.

[0029] The aim of the invention is to comprise balloons that enable the cleaning of the mucosal structure in the segmental bronchi, terminal bronchioles and respiratory bronchioles.

[0030] The endobronchial stem cell cultivation apparatus that is the subject of the invention comprises segment catheter passing through the trachea and main bronchus and reaching to the lobe and segment bronchi, terminal catheter passing through the working area of the segment catheter and extending from the segment bronchi to the subsegments and terminal bronchiole, respiratory catheter passing through the working area of the segment and terminal catheter and reaching to the respiratory bronchioles, segmental balloon, which provides cleaning of the mucosal structure in the segmental bronchi, terminal balloon, which reaches the terminal bronchioles and provides cleaning of the mucosal tissue there, spiral balloon, which provides cleaning of the mucosal structure in the respiratory bronchioles, the seeding channel that allows the PRP mixed stem cell fluid to be transmitted through the working area of the respiratory catheter, the inoculation tip with holes on it that is located at the tip of the respiratory catheter and allows the stem cell fluid to reach the respiratory bronchioles and alveoli, the indicator balloon that allows the balloons of the catheters to be inflated sequentially by air, the air channel that allows air to be sent to the indicator balloon at a certain frequency, and the air compressor frequency unit that allows the amount and frequency of air going to the air channel to be adjusted. Description of Drawings

[0031] Figure - 1 Segment Catheter Tip Balloon View

[0032] Figure - 2 Segment Catheter Tip Front Body View

[0033] Figure - 3 Segment Catheter Deflation Balloon Body View

[0034] Figure - 4 Segment Catheter Inflated Balloon General Body View

[0035] Figure - 5 Catheter Balloon Air Channel Body Sectional View

[0036] Figure - 6 Terminal Catheter General View

[0037] Figure - 7 Terminal Catheter Inflated Balloon Body View

[0038] Figure - 8 Respiratory Catheter Inoculation Tip Deflated Balloon View

[0039] Figure - 9 Respiratory Catheter Inoculation Tip and Holes View

[0040] Figure - 10 Respiratory Catheter Inoculation Tip Inflated Balloon Body View

[0041] Figure - 11 Respiratory Catheter General View

[0042] Figure - 12 Telescopic Catheter Monolithic View

[0043] Figure - 13 Lung Trachea and Main Bronchus Partial View

[0044] Reference Numbers

[0045] 1. Segment Catheter

[0046] 1.1. Working Channel

[0047] 1.2. Segmental Balloon

[0048] 1.3. Body

[0049] 2. Terminal Catheter

[0050] 2.1. Working Channel

[0051] 2.2. Terminal Balloon

[0052] 2.3. Body

[0053] 3. Respiratory Catheter

[0054] 3.1. Inoculation Tip

[0055] 3.2. Spiral Balloon

[0056] 3.3. Body

[0057] 3.4. Hole 3.5. Seeding Channel

[0058] 3.6. Working Channel

[0059] 4. Indicator Balloon

[0060] 5. Air Channel

[0061] 6. Balloon Air Channel

[0062] 7. Trachea

[0063] 8. Main Bronchus

[0064] 9. Segmental Bronchus

[0065] 10. Bronchiole

[0066] 11. Terminal Bronchiole

[0067] 12. Respiratory Bronchiole

[0068] 13.Alveoli

[0069] Detailed Description of the Invention

[0070] The invention has a structure that can reach the farthest bronchi (subsegmental 1 / 2 / 3 / 4 / 5 / 6) with the endobronchial telescopic catheter, reach the alveoli (13) (air sacs) and respiratory bronchiole (12) groups, and allows the stem cell-comprising liquid formed with PRP (platelet rich plasma) to reach the target cells by means of the inoculation tip (3.1 ) and inoculation holes (3.4) of the respiratory catheter (3) seen in Figure - 8. It provides both the repair of COPD-related tissue damage in the alveoli (13) and the development of RASC cells (respiratory airway secretory cells). Thus, an effective operation is provided in COPD patients and the aim is to eliminate respiratory distress. In addition to their secretory functions, RASC cells serve as precursors for AT2 cells and keep the alveoli (13) healthy by renewing them to protect the AT2 population.

[0071] Catheters (1 ,2,3) are connected to the air compressor frequency unit with three separate connections. (Figure - 12) The balloons (1.2, 2.2, 3.2) at the ends of the catheters (1 ,2,3) inflate and deflate sequentially. The sequential inflation of the balloons (1.2, 2.2, 3.2), which are important for the cleaning of the mucosal structure for the cleaning of the bronchus, prevented possible tissue damage. The balloon movement that descends and inflates in sequence, for each catheter (1 ,2,3) balloon (1.2, 2.2, 3.2) separately, the first inflates the second is deflated, the second inflates and the first is deflated, and the third inflates and meanwhile the first and second are deflated. (For the terminal balloon (2.2), after the fourth inflates and deflates, the first inflates, while the fourth inflates, the first, second and third are deflated.) In this way, a massage system is created and the mucosal structure is cleaned. Thus, the bronchi (8,9) and bronchioles (1 1 ,12) are not inflated directly. The inflation device is a unit similar to a lithotripsy extracorporeal, pneumatic stone crushing device. The air compressor frequency unit allows the inflation of the balloons (1.2, 2.2, 3.2) and the adjustment of the frequency. The endobronchial catheter consists of three parts.

[0072] The first part of the endobronchial catheter is the segment catheter (1 ). The segment catheter (1 ) consists of a hollow body (1 .3) comprising a working area (1 .1 ), a balloon inflation air channel (6) within the working area (1.1 ) and preferably 3 segmental balloons (1.2) at the end of the body (1.3). The segment catheter (1 ) is connected to the air compressor frequency unit by an air channel (5) and an indicator balloon (4). The segment catheter (1 ) passes through the trachea (7) and the main bronchus (8) and reaches the segmental bronchi (9). The segment balloons (1 .2) at the end of the catheter (1 ) that is delivered to the segmental bronchi (9) inflate and deflate in turn by the transmission of air from the air channel (5) and the indicator balloon (4) through the balloon air channel (6). This movement, which progresses like a massage movement, ensures the cleaning of the mucosal structure in the bronchi (9). (Figure - 1 and Figure - 2)

[0073] The segment catheter (1 ) preferably has a body diameter of 1 .7 mm to 1 .8 mm and a length of 150 cm to 200 cm. The given values do not affect the comprehensiveness of the invention. Catheters (1 ) can be created with different diameters or lengths as appropriate. The segmental balloons (1 .2) at the tip of the catheter (1 ) are inflated with the air coming from the air channel (5) through a balloon air channel (6) via the indicator balloon (4). By controlling the segmental balloons (1.2) with the indicator balloon (4), the balloons (1.2) can be inflated in accordance with the bronchus diameter with the pressure coming from the unit and adjustable from the unit. In addition, by means of the unit, a rhythmic balloon movement is provided in the form of inflation and deflation with a certain frequency. The segment catheter (1 ) is the first part used for lobe and lobe segment beginnings. It will reach the beginning of the trachea (7), main bronchus (8), lobar bronchi and segmental bronchi (9). Segmental balloon (1.2) diameters are preferably between 10 mm and 13 mm. (Figure - 4) The terminal catheter (2) is the second part of the endobronchial catheter. It is passed through the working channel (1.1 ) inside the body (1 .3) of the segment catheter (1 ) in a controlled manner and is conveyed further than the part that the segment catheter (1 ) can reach. The terminal catheter (2) advances from the segment bronchus (9), through the bronchiole (10) to the terminal bronchiole (1 1 ). The terminal catheter (2) is connected to the air compressor frequency unit with an air-transmitting air channel (5) and an indicator balloon (4). There are preferably 4 terminal balloons (2.2) at the end of the body (2.3) of the terminal catheter (2). The balloon inflates and deflates rhythmically in turn by transmitting the air coming from the air channel (5) and the indicator balloon (4) through the balloon air channel (6). This movement, which progresses like a massage movement, ensures the cleaning of the mucosal structure between the segmental bronchi (9) and terminal bronchioles (1 1 ). (Figure - 6)

[0074] The terminal catheter (2) body (2.3) diameter is preferably between 1.2 mm and 1.4 mm. This diameter can be changed according to the preferred embodiments of the invention. The terminal catheter (2) is passed through the working channel (1 .1 ) of the segment catheter (1 ) and exits the end of the segment catheter (1 ) body (1.1 ) and is advanced distally in a controlled manner. The catheter (2) reaching from the segment bronchi (9) to the terminal bronchioles (1 1 ) provides mucosal cleaning by fully inflating the balloons (2.2) at its end (inflated air diameter approximately 5 mm). There is a balloon air channel (6) extending to the balloons (2.2) in the inner working channel (2.1 ) of the body (2.3) of the catheter (2). Thus, by giving 6 to 10 cc of air from the unit, the inflation of the balloons and the frequency of the rhythmic movement are adjusted. This balloon air channel (6) reaches from the indicator balloon (4) to the terminal balloons (2.2). The balloon air channel (6) is connected to the unit and opens the small diameter bronchi by allowing the balloons (2.2) to inflate and deflate with 2 cc to 3 cc of air. The end of the segmental bronchi (9) reaches the terminal bronchioles (1 1 ). The balloons (2.2) are thinner. The terminal catheter (2) is preferably at least 30 cm longer than the segmental catheter (1 ). The segmental bronchi (9) and the branching subsegment bronchi reach the subsegment 1 and subsegment 2 parts with the catheter (2). (Figure - 7) The respiratory catheter (3) is the third part of the endobronchial catheter. It is passed through the working channel (1.1 ) inside the body (1 .3) of the segment catheter (1 ) in a controlled manner and is conveyed further than the part that the distal end of the terminal catheter (2) can reach, along the working channel (2.1 ) of the body (2.3) of the terminal catheter (2). The respiratory catheter (3) will advance from the segmental bronchus (9) and subsegment 3, subsegment 4 and subsegment 5 to the respiratory bronchioles (12) until it reaches the 10thand 17thdivisions. The respiratory catheter (3) is connected to the air compressor frequency unit by an air-conducting air channel (5) and an indicator balloon (4). The respiratory catheter (3) has a thin spiral balloon (3.2) at the tip of the body (3.3), preferably in a spiral shape. The balloon inflates and deflates rhythmically by transmitting the air coming from the air channel (5) and the indicator balloon (4) through balloon the air channel (6), and provides the subsegment to swell. The distal end of the respiratory catheter (3) is an inoculation tip (3.1 ) and has a syringe-like structure. In addition, there are inoculation holes (3.4) in the area between the inoculation tip (3.1 ) and the spiral balloon (3.2). The respiratory catheter (3) is connected to a stem cell seeding channel (3.5) at the head of the body (3.3). From the stem cell seeding channel (3.5), a PRP stem cell fluid is injected that will reach the respiratory bronchioles (12), subsegment 3, subsegment 4 and subsegment 5 and further to the alveoli (13). The stem cell seeding channel (3.5) allows the PRP stem cell fluid, which is slowly administered with a syringe-like structure, to pass through the working channel (3.6) of the respiratory catheter (3) and reach the inoculation holes (3.4) and the tip (3.1 ). Thus, by means of the respiratory catheter (3), the number of stem cells reaching the target tissue during stem cell administration in COPD treatment will be greatly increased compared to the state of the art, and thus, the formation of RASC cells, which are important in the treatment of patients, will be induced while simultaneously renewing the damaged alveolar (13) tissue. The respiratory catheter (3) is a catheter as thin as a strand of hair and forms the distal end of the endobronchial catheter structure. (Figure - 9 and Figure - 10)

[0075] The respiratory catheter (3) can pass through the working channels (1.1 , 2.1 ) of the first catheter (1 ) and the second catheter (2) and can extend to the respiratory bronchioles (12) distally. The length of the respiratory catheter (3) is preferably 200 cm. However, these dimensions may vary depending on the use in different preferred embodiments of the invention. At the proximal part of the respiratory catheter (3) (where the air channel (5) and the indicator balloon (4) are connected), there is the beginning of the stem cell seeding channel (3.5) for stem cell injection. The catheter (3) comprising the spiral balloon (3.2) technically moves rhythmically by adjusting the inflation frequency coming from a single air channel (5) unit. The liquid material comprising stem cells and PRP is given to the catheter (3) channel (3.6) with the injector through the preferably horizontal ellipse holes located between the inoculation tip (3.1 ) and the spiral balloon (3.2). The spiral balloon (3.2) is inflated and the stem cell liquid is sent through the working channel (3.6). PRP increases the durability of the stem cell. The catheter (3) that enters subsegment 4-5 allows the stem cells to reach the alveoli (13) by means of its distal tip. The spiral balloon (3.2) reaches subsegment 3, the balloon (3.2) is inflated and an expansion is provided in the tissue, and the balloon (3.2) allows the liquid to reach the alveoli (13) by means of the stem cell injection that takes place while the balloon (3.2) is inflated. The spiral balloon (3.2) preferably serves as an expansion here. (Figure - 1 1 )

[0076] The endobronchial telescopic catheter that enables opening of obstructed bronchi and bronchioles in chronic obstructive pulmonary disease and application of PRP and stem cell fluid comprises segment catheter (1 ) extending from the trachea (7) and main bronchus (8) to the beginning of the segmental bronchus (9), segmental balloon (1 .2) located at the distal end of the body (1 .3) of the segment catheter (1 ), terminal catheter (2) extending from the beginning of the segmental bronchus (9) to the beginning of subsegment 1 , subsegment 2 and terminal bronchiole (1 1 ), terminal balloon (2.2) located at the distal end of the body (2.3) of the terminal catheter (2), respiratory catheter (3) extending from the beginning of the terminal bronchioles (1 1 ) to the beginning of the respiratory bronchioles (12), and spiral balloon (3.2) located at the distal end of the body (3.3) of the respiratory catheter (3). It comprises a terminal catheter (2) that is passed through the working channel (1.1 ) of the segment catheter (1 ) and extends to the beginning of the terminal bronchiole (1 1 ). It comprises a respiratory catheter (3) which is passed through the working channel (1.1 ) of the segment catheter (1 ) and the working channel (2.1 ) of the terminal catheter (2) and extends to the beginning of the respiratory bronchioles (12). It comprises an air compressor frequency unit that provides rhythmic balloon movement by adjusting the amount of air required for the inflation of the segmental balloon (1.2) and terminal balloon (2.2) and the inflation-deflation rhythmic inflation frequency, and allows the inflation of the spiral balloon (3.2). It comprises a segmental balloon (1.2) that is inflated sequentially with a rhythmic inflation-deflation movement in accordance with the bronchus diameter after the segment catheter (1 ) is extended to the beginning of the segmental bronchus (9) and provides cleaning of the mucosal structure in the bronchi. After the terminal catheter (2) is extended to the beginning of the terminal bronchiole (1 1 ), it becomes the terminal balloon (2.2) that allows the opening of small-diameter blocked bronchi by inflating it sequentially with a rhythmic inflation-deflation movement in accordance with the subsegment and bronchiole diameters. After the respiratory catheter (3) is extended to the beginning of the respiratory bronchioles (12), it becomes the spiral balloon (3.2) that provides expansion in accordance with the diameter of the bronchioles. For stem cell injection, it becomes the stem cell seeding channel (3.5) that allows the stem cell liquid comprising PRP to be sent from the proximal to the distal of the catheter (3). There are the inoculation tip (3.1 ) and inoculation holes (3.4) that are located at the distal end of the respiratory catheter (3) and allow the stem cell liquid sent from the seeding channel (3.5) to reach the respiratory bronchioles (12) and alveoli (13). It is the spiral balloon

[0077] (3.2) that provides expansion appropriate to the diameter of the bronchioles when inflated, thus allowing the stem cell fluid comprising PRP sent from the stem cell seeding channel (3.5) to reach the tissues at the distal end. (Figure - 13) The body

[0078] (1 .3) is a segment catheter (1 .2) that has a working channel (1.1 ) inside it. The body

[0079] (1.3) is a segment catheter (1 ) that has a balloon air channel (6) inside it. It has a balloon air channel (6) that allows the air coming from the air channel (5) and the indicator balloon (4) to be transmitted to the segmental balloon (1.2). It has a balloon air channel (6) that allows the air coming from the air channel (5) and the indicator balloon (4) to be transmitted to the terminal balloon (2.2). It has a balloon air channel (6) that allows the air coming from the air channel (5) and the indicator balloon (4) to be transmitted to the spiral balloon (3.2). The invention comprises said segment catheter (1 ) which has a working channel (1.1 ) and a balloon air channel (6) in the body

[0080] (1.3), an air channel (5) and a balloon indicator (4) at the proximal end of the body

[0081] (1 .3), and a segmental balloon (1 .2) at the distal end of the body (1 .3). The invention comprises a terminal catheter (2) which has a working channel (2.1 ) and a balloon air channel (6) in the body (2.3), an air channel (5) and a balloon indicator (4) at the proximal end of the body (2.3), and a terminal balloon (2.2) at the distal end of the body (2.3). The invention comprises the respiratory catheter (3) having a working channel (3.6) and a balloon air channel (6) in the body (3.3), an air channel (5) and a balloon indicator (4) at the proximal end of the body (3.3), and a spiral balloon (3.2) at the distal end of the body (3.3). It comprises segment catheter (1 ), terminal catheter (2), and respiratory catheter (3) which prevent the progression of COPD and treats it at an early stage before it progresses to advanced stages, and increases the number of lung parenchyma that has decreased in advanced COPD stages by means of its inoculation feature. It comprises said catheters (1 , 2, 3) which provide the cleaning of metaplastic cells in the bronchial walls in the application area with the rhythmic inflation-deflation movement by means of the balloons (1 .2, 2.2, 3.2) and reduce the risk of cancer in the future. It comprises said catheters (1 , 2, 3) which widen the narrowed terminal bronchioles (11 ) and increase the air flow to the respiratory bronchioles (12) and thus increase the respiratory ventilation. It comprises a spiral balloon (3.2) with pressure sensors at the top. These are the pressure sensors that control the inflation setting of the balloons (1.2, 2.2, 3.2) which may inflate and damage the tissue in case of a possible excess pressure. There are pressure sensors that automatically control the pressure by connecting to the air compressor frequency unit with a thin wire passing through the air channel (5) in the working channels (1 .1 , 2.1 , 3.6). (Figure - 5)

[0082] Mentioned endobronchial catheter is telescopic and preferably consists of at least 3 catheters (1 , 2, 3). While the balloons (1.2, 2.2) at the distal end of the segment catheter (1 ) and terminal catheter (2) ensure the cleaning of the mucosal structure and the opening of small-diameter bronchi, the balloon (3.2) at the distal end of the respiratory catheter (3) provides expansion by inflating in the region where it is located, thus supporting the stem cell and PRP fluid to reach the section from the respiratory bronchioles (12) to the alveoli (13).

[0083] By means of said endobronchial catheter, the progression of COPD is prevented and it is treated at an early stage before it progresses to advanced stages. In advanced COPD stages, the number of decreased lung parenchyma is increased by means of the inoculation feature. Specially designed balloons (1.2, 2.2, 3.2) at the end of the catheters (1 , 2, 3) clean metaplastic cells in the bronchial wall and reduce the risk of cancer in the future. Expanding the narrowed terminal bronchioles (11 ) increases the airflow to the respiratory bronchioles (12) and provides relief for respiratory ventilation. After the segmental bronchi (9), the spiral balloon (3.2) respiratory catheter (3) can descend to the 10thand 17thdivisions in the subsegmental bronchi. There are pressure sensors at the top of the spiral balloon (3.2). The pressure sensors pass through the air channel (5) in the working channels (1.1 , 2.1 , 3.6) and in this way, the connection with the pressure measuring device is provided. By means of the pressure sensor, the inflation setting of the balloons (1.2, 2.2, 3.2), which may inflate excessively and damage the tissue in case of a possible excess pressure, is provided by automatic control on the unit.

Claims

CLAIMS1. An endobronchial telescopic catheter that enables opening of obstructed bronchi and bronchioles and application of stem cell fluid by PRP (Platelet Rich Plasma- platelet-rich plasma prepared from the person's own blood) for the chronic obstructive pulmonary disease characterized by comprising;- a segment catheter (1 ) extending through the trachea (7) and main bronchus(8) to the beginning of the segmental bronchus (9),- a segmental balloon (1.2) located at the distal end of the body (1.3) of mentioned segments catheter (1 ),- a terminal catheter (2) extending from beginning of the segmental bronchus(9) to the beginning of subsegment 1 , subsegment 2 and terminal bronchiole (1 1 ),- a terminal balloon (2.2) located at the distal end of the body (2.3) of mentioned terminal catheter (2),- a respiratory catheter (3) extending from the beginning of the terminal bronchioles (1 1 ) to the beginning of the respiratory bronchioles (12) and,- a spiral balloon (3.2) located at the distal end of the body (3.3) of mentioned respiratory catheter (3).

2. The endobronchial telescopic catheter according to claim 1 characterized by comprising; the terminal catheter (2) extending through the working channel (1.1 ) of mentioned segment catheter (1 ) to the beginning of the terminal bronchiole (1 1 ).

3. The endobronchial telescopic catheter according to claim 1 characterized by comprising; the respiratory catheter (3) which is passed through the working channel (1.1 ) of mentioned segment catheter (1 ) and the working channel (2.1 ) of mentioned terminal catheter (2) and extends to the beginning of the respiratory bronchioles (12).

4. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; an air compressor frequency unit that provides rhythmic balloon inflation-deflation movement by adjusting the amount of air required for the inflation for mentioned segment balloon (1 .2) and terminal balloon (2.2) and the rhythmic inflation frequency.

5. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the air compressor frequency unit which enables the inflation of mentioned spiral balloon (3.2).

6. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the segmental balloons (1.2) that are inflated sequentially with a rhythmic inflation-deflation movement in accordance with the bronchus diameter after extending mentioned segment catheter (1 ) to the beginning of the segmental bronchus (9), thus ensures the cleaning of the mucosal structure in the bronchi.

7. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the terminal balloons (2.2) that are inflated sequentially with a rhythmic inflation-deflation movement in accordance with the subsegment and bronchiole diameters, which enable the opening of small-diameter occluded bronchi, after extending the terminal catheter (2) to the beginning of the terminal bronchiole (1 1 ).

8. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the spiral balloon (3.2), which is extended to the beginning of the respiratory catheter (3) and then inflated to provide an expansion appropriate to the diameter of the bronchioles.

9. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; a stem cell seeding channel (3.5) which allows the stem cell fluid containing PRP to be sent from the proximal to the distal of a working chanel (3.6) of mentioned catheter (3) for stem cell injection.10.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; an inoculation tip (3.1 ) and inoculation holes (3.4) that are located at the distal end of mentioned respiratory catheter (3) and allow the stem cell liquid sent from mentioned seeding channel (3.5) to reach the respiratory bronchioles (12) and alveoli (13).

11. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the spiral balloon (3.2) that provides expansion appropriate to the diameter of the bronchioles when inflated, thus allowing the stem cell fluid comprising PRP sent from mentioned stem cell seeding channel (3.5) to reach the tissues at the distal end.12.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the segment catheter (1 ) having a working channel (1.1 ) inside mentioned body (1 .3).13.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising the segment catheter (1 ) having a balloon air channel (6) inside mentioned body (1.3).14.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the balloon air channel (6) which allows the air coming from an air channel (5) and an indicator balloon (4) to be transmitted to the segmental balloon (1.2).15.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the balloon air channel (6) which allows the air coming from the air channel (5) and the indicator balloon (4) to be transmitted to the terminal balloon (2.2).16.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the balloon air channel (6) which allows the air coming from the air channel (5) and the indicator balloon (4) to be transmitted to the spiral balloon (3.2).17.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the segment catheter (1 ) which has the working channel (1.1 ) and the balloon air channel (6) in mentioned body (1.3), the air channel (5) and the balloon indicator (4) at the proximal end of mentioned body(1 .3), and the segmental balloon (1 .2) at the distal end of mentioned body (1 .3).18.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the terminal catheter (2) which has the working channel (2.1 ) and the balloon air channel (6) in mentioned body (2.3), the air channel (5) and the balloon indicator (4) at the proximal end of mentioned body(2.3), and a terminal balloon (2.2) at the distal end of mentioned body (2.3).19.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the respiratory catheter (3) having the working channel (3.6) and the balloon air channel (6) in mentioned body (3.3), the air channel (5) and the balloon indicator (4) at the proximal end of mentioned body(3.3), and a spiral balloon (3.2) at the distal end of mentioned body (3.3).20.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the segment catheter (1 ), the terminal catheter (2), and the respiratory catheter (3) which prevent the progression of COPD and treats it at an early stage before it progresses to advanced stages, and increases the number of lung parenchyma that has decreased in advanced COPD stages by means of inoculation stem sell seeding.

21. The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; the catheters (1 , 2, 3) which provide the cleaning of metaplastic cells in the bronchial walls in the application area with the rhythmic inflation-deflation movement by means of mentioned balloons (1.2, 2.2, 3.2) and reduce the risk of cancer in the future.22.The endobronchial telescopic catheter according to any of the previous claims, characterized by comprising; the catheters (1 , 2, 3) which widen the narrowed terminal bronchioles (1 1 ) and increase the air flow to the respiratory bronchioles (12) and thus increase the respiratory ventilation.23.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; spiral balloon (3.2) with pressure sensors at the top.24.The endobronchial telescopic catheter according to any of the previous claims, characterized by comprising; pressure sensors that control the inflation setting of the balloons (1 .2, 2.2, 3.2) which may inflate and damage the tissue in case of a possible excess pressure.25.The endobronchial telescopic catheter according to any of the previous claims characterized by comprising; pressure sensors that automatically control the pressure by connecting to the air compressor frequency unit with a thin wire passing through the air channels (5) in mentioned working channels (1 .1 , 2.1 , 3.6).

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