Method and device for neurocryo analgesia and anesthesia

• US 20020161360A1
• Filed: 02/05/2002
• Published: 10/31/2002
• Est. Priority Date: 04/26/2001
• Status: Active Grant

• Current Assignee: Access Point Technologies, Inc., Applied Cryoneurologics, LLC
• Original Assignee: Applied Cryoneurologics, LLC
• Inventors: Carroll, Ronald J.
• Granted Patent: US 6,761,715 B2
• Time in Patent Office: Days
• US Class Current: 606/21
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 2017/00039 Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect
• CPC Class Codes: A61B 2017/00084 Temperature
• CPC Class Codes: A61B 2017/22051 with an inflatable part, e.g. balloon, for positioning, blocking, or immobilisation A61B2017/22048, A61B2017/3486 take precedence
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0262 using a circulating cryogenic fluid
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes

Abstract

A catheter system and method for selectively cooling or freezing target neuronal tissue to induce lesions along the neuroaxis and produce cryoanalgesia by impairing nerve conduction of the targeted neuronal tissue. The system includes a catheter that has cryogenic capability for variable cooling or freezing of neuronal tissue. The catheter also includes temperature sensing and electrodiagnostic capabilities. A pressurized fluid source is included for inflating a portion of the catheter body. The system includes electrodiagnostic equipment for stimulating and monitoring sensory evoked potentials in the patient. The method involves placement of the catheter tip in the subarachnoid space of the spinal canal and location of the tip on the neuronal target using imaging and electrodiagnostic techniques.

Claims

1. A catheter for cooling or freezing neuroaxis structure targets, said catheter comprising:

a catheter body having a proximate end and a distal end;

means for holding said distal end of said catheter body in position adjacent to a neuroaxis structure target; and

means for internally delivering a coolant fluid to said distal end of said catheter body.

2. The catheter of claim 1 wherein said catheter body is sized and dimensioned for insertion into the subarachnoid space of a patient.

3. The catheter of claim 1 wherein said catheter body is a tube having first and second chambers formed therein.

4. The catheter of claim 3 wherein said means for holding includes an expandable portion formed in said tube and a pressurized fluid source connected to said first chamber for inflating said expandable portion.

5. The catheter of claim 3 wherein said means for internally delivering a coolant fluid includes a delivery tube disposed in said second chamber and a source of coolant fluid connected to said delivery tube.

6. The catheter of claim 5 wherein said delivery tube has at least one expansion opening located near said distal end of said catheter body.

7. The catheter of claim 1 wherein at least a portion of said catheter is made of a material suitable for radiological imaging.

8. The catheter of claim 1 further comprising a temperature detector disposed on an external surface of said catheter body, at said distal end thereof.

9. The catheter of claim 1 further comprising:

an electrically conductive tip member formed on an external surface of said catheter body, at said distal end thereof; and

means for electrically connecting said electrically conductive tip member to an external device.

10. The catheter of claim 1 further comprising means for changing the angle of a distal tip portion of said catheter body relative to the rest of said catheter body.

11. The catheter of claim 1 further comprising a conduit disposed in said catheter body, said conduit having a needle tip and being movable longitudinally within said catheter body such that said needle tip can be extended out of and retracted into said catheter body.

13. The catheter system of claim 12 wherein said catheter body is a tube having an interior and a septum formed in said tube interior, said septum dividing said tube interior into a first chamber on said dorsal side and a second chamber on said ventral side.

14. The catheter system of claim 13 further comprising a pressurized fluid source connected to said first chamber for inflating said expandable portion.

15. The catheter system of claim 13 wherein said means for cooling includes a delivery tube disposed in said second chamber and a source of coolant fluid connected to said delivery tube, said delivery tube having at least one expansion opening located near said tip member.

16. The catheter system of claim 12 wherein at least a portion of said catheter body is made of a material suitable for radiological imaging.

17. The catheter system of claim 12 further comprising a temperature detector disposed on said tip member.

18. The catheter system of claim 12 wherein said tip member is electrically conductive, said catheter system further comprising:

an external electrode for application to a patient'"'"'s body; and

a device electrically connected to said tip member and to said external electrode, said device being capable of delivering an electrical stimulus to said external electrode and measuring sensory evoked potentials in response to input from said tip member.

19. The catheter system of claim 12 further comprising means for changing the angle of a distal tip portion of said catheter body relative to the rest of said catheter body.

20. The catheter system of claim 12 further comprising a conduit disposed in said catheter body, said conduit having a needle tip and being movable longitudinally within said catheter body such that said needle tip can be extended out of and retracted into said catheter body.

12. A catheter system for cooling or freezing neuroaxis structure targets, said catheter system comprising:

a catheter body having a proximate end and a distal end and a dorsal side and a ventral side, said catheter body being sized and dimensioned for insertion into the subarachnoid space of a patient;

a tip member formed on said ventral side of said catheter body, at said distal end thereof;

an expandable portion formed on said dorsal side of said catheter body; and

means for cooling said tip member.

21. A method of cooling or freezing neuroaxis structure targets with a cryocatheter having a distal end and a proximate end, said method comprising:

inserting said distal end of said cryocatheter into the subarachnoid space of a patient; and

delivering a coolant fluid into said cryocatheter so as to effect cooling or freezing of a neuronal tissue target.

22. The method of claim 21 further comprising positioning said distal end adjacent to said neuronal tissue target and wherein said coolant fluid is delivered to said distal tip such that the temperature of said distal tip is reduced.

23. The method of claim 22 further comprising using imaging guidance when positioning said distal end.

24. The method of claim 22 further comprising inflating at least a portion of said cryocatheter once said distal end is positioned adjacent to said neuronal tissue target.

25. The method of claim 22 further comprising measuring the temperature of said distal tip and controlling delivery of said coolant fluid in response to distal tip temperature.

26. The method of claim 22 further comprising applying an electrical stimulus to a dermatome on said patient that corresponds to said neuronal tissue target and using an electrode disposed on said cryocatheter to measure resultant sensory evoked potentials.

27. The method of claim 26 wherein measurement of sensory evoked potentials is used to verify that said distal end is properly positioned relative to said neuronal tissue target.

28. The method of claim 21 wherein said neuronal tissue target is selected from the group consisting of dorsal root filaments, dorsal root ganglia, dorsal horns, and Lissauer'"'"'s tract.