Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen

• US 20070129720A1
• Filed: 11/14/2006
• Published: 06/07/2007
• Est. Priority Date: 04/08/2002
• Status: Active Grant

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Ardian, Inc. (Medtronic Plc)
• Inventors: Demarais, Denise, Zadno, Nicolas, Gifford, Hanson, Wu, Andrew, Michlitsch, Kenneth, Deem, Mark, Clark, Benjamin
• Granted Patent: US 8,347,891 B2
• Time in Patent Office: Days
• US Class Current: 606/41
• CPC Class Codes: A61B 18/1206 Generators therefor
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00077 high, i.e. electrically conducting
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1435 Spiral
• CPC Class Codes: A61B 2018/1465 Deformable electrodes
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/327 for enhancing the absorption properties of tissue, e.g. by electroporation
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.

Claims

1. A method for non-continuous circumferential treatment of a body lumen of a patient, the method comprising:

positioning an energy delivery element at least proximate to a wall of the body lumen;

delivering energy from the energy delivery element to less than a full radial circumference of the body lumen at a first lengthwise position relative to the body lumen to form a first treatment zone; and

delivering energy from the energy delivery element to less than a full radial circumference of the body lumen at a second lengthwise position relative to the body lumen to form at least a second treatment zone, wherein the first lengthwise position and the second lengthwise position are spaced apart from one another along a lengthwise dimension of the lumen.

2. The method of claim 1, wherein delivering energy at the second lengthwise position further comprises re-positioning the energy delivery element relative to the body lumen of the patient.

3. The method of claim 1, wherein positioning the energy delivery element at least proximate to the body lumen of the patient further comprises positioning the energy delivery element at least proximate to a blood vessel of the patient.

4. The method of claim 1, wherein positioning the energy delivery element at least proximate to the body lumen of the patient further comprises positioning the energy delivery element within the body lumen of the patient.

5. The method of claim 3, wherein positioning the energy delivery element at least proximate to the blood vessel of the patient further comprises positioning the energy delivery element within the blood vessel of the patient.

6. The method of claim 3, wherein positioning the energy delivery element at least proximate to the blood vessel of the patient further comprises positioning the energy delivery element external to the blood vessel of the patient.

7. The method of claim 1, wherein delivering energy from the energy delivery element at the first and second lengthwise positions further comprises repositioning the energy delivery element.

8. The method of claim 3 further comprising blocking blood flow within the blood vessel during the energy delivery.

9. The method of claim 4, wherein positioning the energy delivery element within the body lumen of the patient further comprises contacting the wall of the body lumen with the energy delivery element.

10. The method of claim 4, wherein positioning the energy delivery element within the body lumen of the patient further comprises passing the energy delivery element across the wall of the body lumen prior to the energy delivery.

11. The method of claim 1, wherein positioning the energy delivery element in proximity to the body lumen further comprises positioning an energy delivery element comprising energy delivery sub-elements that are spaced lengthwise and angularly relative to one another.

12. The method of claim 11, wherein delivering energy at the first and at least second lengthwise positions further comprises delivering energy with the lengthwise-and angularly-spaced energy delivery sub-elements.

13. The method of claim 12, wherein delivering energy with the energy delivery sub-elements further comprises concurrently delivering energy at the first and the at least second lengthwise positions.

14. The method of claim 12, wherein delivering energy with the energy delivery sub-elements further comprises sequentially delivering energy at the first and the at least second lengthwise positions in any desired order.

15. The method of claim 1, wherein positioning the energy delivery in proximity to the body lumen of the patient further comprises positioning the energy delivery element in proximity to multiple body lumens of the patient.

16. The method of claim 3, wherein positioning the energy delivery element at least proximate the blood vessel of the patient further comprises positioning the energy delivery element at least proximate a renal vasculature of the patient.

17. The method of claim 1, wherein positioning the energy delivery element in proximity to the body lumen further comprises positioning at least one electrode in proximity to the body lumen, and

wherein delivering energy with the energy delivery element further comprises delivering an electric field from the at least one electrode.

18. The method of claim 17 further comprising attaching an external ground to an exterior of the patient,

wherein delivering the electric field further comprises delivering the electric field in a monopolar fashion between the at least one electrode and the external ground.

19. Apparatus for non-continuous circumferential treatment of a body lumen of a patient, the apparatus comprising:

a device configured for positioning in proximity to the body lumen;

a first energy delivery element coupled to the device; and

a second energy delivery element coupled to the device,

wherein the first energy delivery element and the second energy delivery element are spaced apart lengthwise and angularly offset from one another about a length of the device,

wherein each of the first energy delivery element and the second energy delivery element are configured to deliver energy to a less than a full circumference of the body lumen of the patient.

20. The apparatus of claim 19, wherein the device comprises a catheter configured for positioning within the body lumen, and

wherein the first energy delivery element and the second energy delivery element are coupled to an expandable element that is configured to bring the first energy delivery element and the second energy delivery element into contact with a wall of the body lumen.

21. The apparatus of claim 20, wherein the expandable element is configured to block fluid flow within the body lumen during energy delivery.

22. The apparatus of claim 19, wherein the device comprises a catheter configured for positioning within the body lumen, and

wherein the first energy delivery element and the at least second energy delivery element are configured for passage across a wall of the body lumen.

23. The apparatus of claim 19 further comprising at least one sensor configured to monitor a parameter of the apparatus or of tissue within the patient.

24. The apparatus of claim 23 further comprising a feedback control system configured to alter treatment in response to the monitored parameter.

25. A method for treatment, the method comprising:

positioning an energy delivery element at a first lengthwise and angular position relative to a body lumen of a patient;

delivering energy from the energy delivery element to less than a full circumference of the body lumen at the first lengthwise and angular position to form a first treatment zone;

repositioning the energy delivery element to a second lengthwise and angular position relative to the body lumen that is different than the first lengthwise and angular position; and

delivering energy from the energy delivery element to less than a full circumference of the body lumen at the second lengthwise and angular position to form a second treatment zone.

26. The method of claim 25, wherein a composite treatment zone formed via superimposition of the first treatment zone and the second treatment zone comprises a non-continuous, circumferential treatment zone.

27. A method for treating a patient, comprising:

delivering energy to a first treatment zone at an inner wall of a body lumen and to a second treatment zone at the inner wall of the lumen, wherein the first treatment zone has a discrete, non-continuous first lesion at a first radial plane and the second treatment zone has a discrete, non-continuous second lesion at a second radial plane spaced apart from the first radial plane; and

affecting neural tissue outside of the inner wall body lumen.