External Autonomic Modulation

• US 20110118600A1
• Filed: 03/16/2010
• Published: 05/19/2011
• Est. Priority Date: 11/16/2009
• Status: Abandoned Application

• Current Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Original Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Inventors: Gertner, Michael
• Application Number:
  US12/725,450
• Publication Number:
  US 20110118600A1
• Time in Patent Office: Days
• US Class Current: 600/439
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/0225 the pressure being controlled by electric signals, e.g. derived from Korotkoff sounds
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/489 Blood vessels
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 6/03 Computed tomography [CT] echo-tomography A61B8/14
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 8/00 Diagnosis using ultrasonic, sonic or infrasonic waves imaging of objects using sonar G01S15/00
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/08 : Detecting organic movements or changes, e.g. tumours, cysts, swellings A61B8/02 - A61B8/06 take precedence
• CPC Class Codes: A61B 8/0833 : involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 : for locating instruments
• CPC Class Codes: A61B 8/4245 : involving determining the position of the probe, e.g. with respect to an external reference frame or to the patient
• CPC Class Codes: A61B 8/485 : involving measuring strain or elastic properties
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61N 2005/063 : comprising light transmitting means, e.g. optical fibres
• CPC Class Codes: A61N 2007/0026 : Stimulation of nerve tissue
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0039 : using microbubbles
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 2007/025 : interstitial
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent
• CPC Class Codes: A61N 5/0622 : Optical stimulation for exciting neural tissue
• 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 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

In some embodiments, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some embodiments, different types of energy sources are utilized singly or combined with one another. In some embodiments, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents.

Claims

1. ) A method to inhibit the function of a renal nerve comprising:

a. Introducing an intravascular catheter into a renal artery;

b. Applying vibrational energy, from the catheter, in an unfocused manner, to at least a portion of the circumference of the artery sufficient to at least inhibit a partial function of a renal nerve.

4. ) The method of claim 1 further comprising:

stabilizing the catheter within the artery and approximating the distance to the renal nerves outside the artery based on one of;

angiography, ultrasound, CT scan, MRI.

5. ) The method of claim 1 further comprising introducing a cooling lumen or independent cooling catheter into the artery.

6. ) The method of claim 1 wherein the energy transmitting element does not contact the arterial wall.

2. ) A method to at least partially inhibit the function of a renal nerve comprising:

a. Introducing an intravascular catheter into a renal artery;

b. Stabilizing the catheter in the renal artery;

c. Determining the size of the renal artery;

d. Modeling the transfer of vibrational power from the catheter inside the artery to the region outside the artery and determining the appropriate power required to the catheter to reach a level outside the artery to inihibit nerve function;

e. Applying vibrational power from inside the artery to the region outside the artery at the appropriate pre-determined power level.

3. ) The method of claim 2 wherein the vibrational power outside the artery is in the range from 20 mW/cm2 to 500 W/cm2.

7. ) A method to inhibit the function of a renal nerve comprising:

a. Introducing an intravascular catheter into an aorta;

b. Applying energy, from the catheter, in an unfocused manner, to at least a portion of the circumference of the aorta to affect the function of nerves traveling to the kidney.

8. ) The method of claim 7 further comprising cooling the region immediately adjacent the intravascular catheter during inhibition of the renal nerve function.

9. ) The method of claim 7 wherein the intravascular catheter is placed into the ostium of at least one of the renal arteries.

10. ) A method to stimulate or inhibit the function of a nerve traveling to or from the kidney comprising:

a. Identifying an acoustic window at the posterior region of a patient in which the renal arteries can be visualized;

b. transmitting a first energy through the skin of a patient from the posterior region of the patient;

c. imaging an arterial region using the first transmitted energy;

d. applying a second transmitted energy to the arterial adventitia by coupling the imaging and the second transmitted energy.

11. The method of claim 10 further comprising:

tracking the image created by the first transmitted energy.

12. A method to locate the position of a blood vessel in the body of a patient comprising:

Applying a first wave of ultrasound, from a first direction, to a region of a blood vessel from outside of the patient and detecting its return signal;

Comparing the applied first wave and its return signal;

Simultaneously, or sequentially, applying a second wave of ultrasound from a second direction to the blood vessel and detecting a its return signal;

Integrating the return signals from the first wave and the return signals from the second wave to determine the position, in a three dimensional coordinate reference, of the blood vessel.

13. The method of claim 12 further comprising the step of instructing a therapeutic ultrasound transducer to apply energy to the position of the blood vessel.