METHOD AND APPARATUS FOR REDUCING RENAL BLOOD PRESSURE

• US 20100125288A1
• Filed: 11/17/2009
• Published: 05/20/2010
• Est. Priority Date: 11/17/2008
• Status: Abandoned Application

• Current Assignee: G & L Consulting LLC.
• Original Assignee: G & L Consulting LLC.
• Inventors: Gelfand, Mark, Levin, Howard
• Application Number:
  US12/620,258
• Publication Number:
  US 20100125288A1
• Time in Patent Office: Days
• US Class Current: 606/158
• CPC Class Codes: A61B 17/12 for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord specially adapted for vas deferens or fallopian tubes A61F6/20; materials for ligaturing blood vessels A61L17/00
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 2017/00221 with wireless transmission of data, e.g. by infrared radiation or radiowaves
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02241 of small dimensions, e.g. adapted to fingers
• CPC Class Codes: A61B 5/201 Assessing renal or kidney functions
• CPC Class Codes: A61B 5/6846 specially adapted to be brought in contact with an internal body part, i.e. invasive
• CPC Class Codes: A61B 5/6876 Blood vessel
• CPC Class Codes: A61B 5/6884 Clamps or clips

Abstract

A method and apparatus for treatment of chronic renal failure by reducing renal perfusion pressure. Treatment is performed by partial occlusion of renal artery. A device to constrict the renal artery may be implanted in the body of a patient and include a renal pressure sensor and a mechanical control applied the renal artery to adjustably constrict a cross sectional area of the artery.

Claims

1. A method for treating renal dysfunction in a patient with abnormally high blood pressure by controllably reducing renal perfusion pressure in the patient, the method comprising:

implanting a device in the patient to partially and controllably constrict a renal artery;

adjusting, externally of the body, a degree of constriction applied by the device to the renal artery, and

controlling the degree of construction by the device to maintain the degree within a predetermined physiological range.

2. The method of claim 1 wherein the control of the degree is performed to prevent a clinically significant increase in hormone secretion due to renal ischemia while limiting barotrauma to the glomeruli as indexed by a clinically significant reduction in the filtration of normally unfiltered substances

3. The method of claim 1 wherein implanting the device further comprises implanting the device via an approach chosen from a group consisting of at least one of intravascularly, extravascularly and intra-to-extravascularly.

4. The method of claim 1 further comprising adjusting the degree of constriction to maintain a renal perfusion pressure within a predetermined autoregulatory range

5. The method of claim 1 further comprising adjusting the degree of constriction to maintain a mean renal arterial pressure in a range of 60 mmHg and 100 mmHg.

6. The method of claim 1 further comprising monitoring a parameter of at least one of a renal function and a non-target tissue, and applying the monitored parameter as part of the control of the device.

7. The method of claim 1 further comprising measuring hormones as an index of renal ischemia including at least one of renin, norepinephrine, aldosterone, angiotension I and angiotensin II.

8. The method of claim 1 further comprising sensing renal ischemia by monitoring a parameter of sympathetic nervous system activity

9. The method of claim 1 further comprising sensing excessive renal perfusion pressure by measuring a level of protein in the urine.

12. The method of claim 1 further comprising monitoring for excessive or inadequate renal perfusion pressure by measuring a level of substances in the urine or blood released due to renal damage.

13. The method of claim 12 wherein the substances includes at least one of KIM-1 and NGAL.

10. The method of claim 10 wherein the protein includes at least one of albumin and other proteins not normally filtered into the urine by the kidney