Multiple sclerosis therapeutic methods using therapeutic delivery devices and systems

摘要

Methods and devices are disclosed that, in various embodiments and permutations and combinations of inventions, diagnose and treat Multiple Sclerosis or associated symptoms. In one series of embodiments, the invention consists of methods and devices for identifying patients whose Multiple Sclerosis or associated symptoms are caused or exacerbated, at least in part, by blockages of one or more of the patient's internal jugular veins (IJV) or azygous veins (AZV). In some instances, stenoses or other flow limiting structures or lesions in the patient's affected veins are identified. Further, in some instances the nature of such lesions and whether there is a significant disruption of blood pressure, or both, is ascertained. In some embodiments, methods and devices for applying one or more therapies to the blockages in the patient's IJV or AZV veins are provided.

主权项

1. A method of treating multiple sclerosis, comprising:
providing a treatment device comprising a therapy agent delivery catheter capable of applying a therapeutic agent to a lesion of a vein through the therapy agent delivery catheter to dissolve fibrin or thrombus present at or causing the lesion or otherwise treat the lesion, the therapy agent delivery catheter including an intravascular ultrasound (IVUS) component adjacent to a therapeutic delivery component, wherein the IVUS component is configured to image the vein and wherein the therapeutic delivery component is configured to apply the therapeutic agent to the lesion of the vein; identifying at least one venous outflow obstruction site of a patient based on images obtained from the IVUS component of the therapy agent delivery catheter; assessing the at least one venous outflow obstruction site to determine whether the at least one venous outflow obstruction site causes significant narrowing of the vein, wherein venous outflow obstruction sites causing significant narrowing of the vein are identified for treatment with the therapeutic agent via the therapeutic delivery component of the therapy agent delivery catheter; verifying the at least one venous outflow obstruction site by determining a pressure gradient across the at least one venous outflow obstruction site, the pressure gradient being calculated as a ratio of a pressure distal to the at least one venous outflow obstruction site and a pressure in the superior vena cava; and applying the treatment device to an identified venous outflow obstruction site of the vein to treat multiple sclerosis symptoms of the patient, including applying the therapeutic agent to the identified venous outflow obstruction site to increase a cross-sectional area of a lumen of the vein.