Methods and apparatus for intracranial ultrasound delivery

• US 20070016041A1
• Filed: 08/15/2005
• Published: 01/18/2007
• Est. Priority Date: 06/24/2005
• Status: Active Grant

• Current Assignee: Penumbra, Inc.
• Original Assignee: Henry Nita
• Inventors: Nita, Henry
• Granted Patent: US 7,717,853 B2
• Time in Patent Office: Days
• US Class Current: 600/439
• CPC Class Codes: A61B 2017/22008 used or promoted
• CPC Class Codes: A61B 8/0808 for diagnosis of the brain
• CPC Class Codes: A61B 90/11 with guides for needles or instruments, e.g. arcuate slides or ball joints
• CPC Class Codes: A61N 2007/0047 interstitial
• CPC Class Codes: A61N 7/00 Ultrasound therapy lithotripsy A61B17/22, A61B17/225; massage using supersonic vibration A61H23/00 ; using ultrasound for introducing media into the body A61M37/0092
• CPC Class Codes: A61N 7/022 intracavitary

Abstract

A method for delivering ultrasound energy to a patient'"'"'s intracranial space involves forming at least one hole in the patient'"'"'s skull, advancing at least one ultrasound delivery device at least partway through the hole(s), and transmitting ultrasound energy from the ultrasound delivery device(s). According to various embodiments, ultrasound delivery devices may be advanced into the epidural space, one or both ventricles and/or an intracerebral space of the patient'"'"'s brain. In alternative embodiments, one or multiple holes may be formed in the skull, and any number of ultrasound delivery devices may be used. Intracranial ultrasound delivery may be used in diagnostic or therapeutic treatment of ischemic stroke, head trauma, atherosclerosis, perfusion disorders and other acute or chronic neurological conditions.

Claims

1. A method for delivering ultrasound energy to a patient'"'"'s intracranial space, the method comprising:

forming at least one hole in the patient'"'"'s skull;

advancing at least one ultrasound device at least partway through the hole; and

transmitting ultrasound energy from the ultrasound device for cerebrovascular diagnostics.

2. The method of claim 1, wherein the at least one hole is formed using a drill or burr device.

3. The method of claim 1, wherein advancing the at least one ultrasound device comprises advancing the device into the patient'"'"'s epidural space.

4. The method of claim 1, wherein advancing the at least one ultrasound device comprises advancing the device into at least one ventricle of the patient'"'"'s brain.

5. The method of claim 1, wherein advancing the at least one ultrasound device comprises advancing the device into an intracerebral space of the patient'"'"'s brain.

6. The method of claim 1, wherein advancing the ultrasound device comprises advancing a device selected from the group consisting of an ultrasound transducer and a transducer-tipped ultrasound catheter.

38. The method of claim 1, further providing a conductive medium which interfaces between the ultrasound transducer and the patient.

39. The method of claim 1, further comprising placing an introducer device at least partway into the at least one hole, with the at least one ultrasound delivery device advanced through the introducer device.

40. The method of claim 39, further providing a conductive medium which interfaces between the ultrasound transducer and the patient.

7. A method for delivering ultrasound energy to a patient'"'"'s intracranial space, the method comprising:

forming at least one hole in the patient'"'"'s skull;

advancing at least one ultrasound device at least partway through the hole; and

transmitting ultrasound energy from the ultrasound delivery device for cerebrovascular diagnostics and therapeutic treatment.

8. The method of claim 7, wherein one of the at least one ultrasound device performs diagnostic and therapeutic functions.

9. The method of claim 7, wherein one of the at least one ultrasound device performs diagnostic functions and another of the at least one ultrasound device performs therapeutic functions.

10. The method of claim 7, wherein one or more holes are formed using a drill or burr device.

11. The method of claim 7, wherein advancing the at least one ultrasound device comprises advancing the device into the patient'"'"'s epidural space.

12. The method of claim 7, wherein advancing the at least one ultrasound device comprises advancing the device into at least one ventricle of the patient'"'"'s brain.

13. The method of claim 7, wherein advancing the at least one ultrasound device comprises advancing the device into an intracerebral space of the patient'"'"'s brain.

14. The method of claim 7, wherein advancing the ultrasound device comprises advancing a device selected from the group consisting of an ultrasound transducer and a transducer-tipped ultrasound catheter.

15. The method of claim 7, wherein the ultrasound energy is transmitted acutely.

16. The method of claim 7, wherein the ultrasound energy is transmitted chronically.

17. The method of claim 7, further comprising delivering at least one pharmacologic agent to the patient.

18. The method of claim 17, wherein the agent is selected from a group consisting of blood clot reducing agents such as tissue plasminogen activator, rTPA, Urokinease, Streptokinase, Alteplase and Desmoteplase, antiplatelet agents such as aspirin, Clopidorgel and Ticclopidine, and GIIb/IIIa inhibitors, such as Abciximab, Tirofiban and Eptifibatide.

19. The method of claim 17, wherein delivering the agent comprises using a method selected from the group consisting of intravenous, arterial and oral delivery.

20. The method of claim 7, further comprising delivering microbubbles or nanobubbles into the patient'"'"'s bloodstream.

21. The method of claim 20, wherein the microbubbles or nanobubbles are delivered intravenously or arterially.

22. The method of claim 20, further comprising providing at least one pharmacologic agent to the patient.

23. The method of claim 22, wherein the microbubbles or nanobubbles and pharmacological agent are delivered in combination or sequentially.

24. The method of claim 7, wherein the ultrasound energy is transmitted to a blood clot in the patient'"'"'s brain to help disrupt the blood clot.

25. The method of claim 24, wherein the clot resides in a blood vessel.

26. The method of claim 24, wherein the clot resides in an intracerebral space of the patient'"'"'s brain, outside of blood vessels.

27. The method of claim 7, wherein the ultrasound energy is transmitted to a blood vessel in the patient'"'"'s brain to help treat atherosclerosis of the blood vessel.

28. The method of claim 7, wherein the ultrasound energy is transmitted to one or more blood vessels in the brain to help treat a blood perfusion abnormality in the patient'"'"'s brain.

29. The method of claim 7, wherein transmitting ultrasound energy comprises simultaneously transmitting energy from multiple ultrasound devices.

30. The method of claim 7, wherein transmitting ultrasound energy comprises sequentially transmitting energy from multiple ultrasound devices.

31. The method of claim 7, wherein the ultrasound energy is transmitted from multiple devices with the same frequency and intensity.

32. The method of claim 7, wherein the ultrasound energy is transmitted from multiple devices with at least one of different frequencies, different intensities and different modes.

33. The method of claim 7, wherein transmitting ultrasound energy comprises transmitting energy having a frequency between about 20 KHz and 10 MHz.

34. The method of claim 7, wherein the ultrasound energy is transmitted in continuous mode.

35. The method of claim 7, wherein the ultrasound energy is transmitted in pulse mode.

36. The method of claim 7, wherein the ultrasound energy is modulated.

37. The method of claim 7, further comprising monitoring treatment progress using one or more visualization or sensing devices.

41. The method of claim 7, further providing a conductive medium which interfaces between the ultrasound transducer and the patient.

42. The method of claim 41, wherein the conductive medium comprises a compliant pack.

43. The method of claim 42, further providing a gel or oil inside the pack.

44. The method of claim 7, further comprising placing an introducer device at least partway into the at least one hole, with the at least one ultrasound delivery device advanced through the introducer device.

45. The method of claim 44, further providing a conductive medium which interfaces between the ultrasound transducer and the patient.