NON-INVASIVE AND MINIMALLY INVASIVE DENERVATION METHODS AND SYSTEMS FOR PERFORMING THE SAME

• US 20110118725A1
• Filed: 11/11/2010
• Published: 05/19/2011
• Est. Priority Date: 11/11/2009
• Status: Active Grant

• Current Assignee: Nuvaira, Inc.
• Original Assignee: Holaira, Inc. (Nuvaira, Inc.)
• Inventors: Mayse, Martin L., Dimmer, Steven C.
• Granted Patent: US 8,911,439 B2
• Time in Patent Office: Days
• US Class Current: 606/33
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• 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 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/082 Probes or electrodes therefor
• CPC Class Codes: A61B 18/1477 Needle-like probes
• 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 18/1815 using microwaves
• CPC Class Codes: A61B 2017/00323 Cables or rods
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00541 Lung or bronchi
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00642 with feedback, i.e. closed loop control
• 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 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1861 with an instrument inserted into a body lumen or cavity, e.g. a catheter
• CPC Class Codes: A61N 2005/0604 : Lungs and/or airways
• CPC Class Codes: A61N 2005/0651 : Diodes
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• 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 5/1077 : Beam delivery systems
• 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 system and method can be used to denervate at least a portion of a bronchial tree. An energy emitter of an instrument is percutaneously delivered to a treatment site and outputs energy to damage nerve tissue of the bronchial tree. The denervation procedure can be performed without damaging non-targeted tissue. Minimally invasive methods can be used to open airways to improve lung function in subjects with COPD, asthma, or the like. Different sections of the bronchial tree can be denervated while leaving airways intact to reduce recovery times.

Claims

1. A method for denervating a bronchial tree of a subject, comprising:

moving an energy emitter of an instrument through the subject'"'"'s skin;

damaging nerve tissue of the bronchial tree using energy from the energy emitter while the energy emitter is positioned outside of the airway; and

removing the instrument from the subject without severing the entire airway.

2. The method of claim 1, further comprising leaving the airway intact throughout the denervation process.

3. The method of claim 1, wherein damaging the nerve tissue comprises ablating a section of a nerve trunk to impede transmission of nervous system signals traveling along the airway.

4. The method of claim 1, further comprising delivering at least one of radiofrequency energy, microwave energy, radiation energy, high intensity focused ultrasound energy, and thermal energy to damage the nerve tissue.

5. The method of claim 1, further comprising:

percutaneously delivering the energy emitter proximate to the nerve tissue prior to damaging the nerve tissue.

6. The method of claim 1, further comprising:

moving an intraluminal instrument through the subject'"'"'s trachea and the airway; and

delivering energy between the energy emitter of the instrument outside the airway and the intraluminal instrument positioned within the airway to ablate the nerve tissue.

7. The method of claim 1, wherein damaging the nerve tissue comprises irreversibly damaging nerve tissue between the subject'"'"'s trachea and the subject'"'"'s lung to at least partially block a transmission of nervous system signals and to cause a permanent decrease in smooth muscle tone of the portion of a bronchial tree.

8. The method of claim 1, wherein damaging the nerve tissue comprises ablating the nerve tissue without passing the instrument through a wall of the airway.

9. The method of claim 1, wherein damaging the nerve tissue comprises destroying the nerve tissue without damaging to any significant extent blood vessels of the airway.

10. The method of claim 1, wherein the nerve tissue is positioned along a main bronchus of the bronchial tree.

11. The method of claim 1, further comprising wrapping a distal section around the airway to position the energy emitter with respect to the nerve tissue.

12. The method of claim 1, further comprising visualizing the outside of the airway while positioning the energy emitter using a visualization device selected from a group consisting of a thoracoscope, an ultrasonic device, and a fluoroscopy system.

13. The method of claim 1 further comprising moving the energy emitter through a port, a cannula, or a sleeve extending through the skin.

14. A method for treating a subject, comprising:

emitting energy from an external energy source positioned outside of the subject'"'"'s body through the subject'"'"'s skin towards targeted nerve tissue of a bronchial tree; and

damaging the nerve tissue using the energy while the external energy source is outside the subject'"'"'s body.

15. The method of claim 14, wherein the energy is high intensity focused ultrasound.

16. The method of claim 14, wherein delivering the energy further comprises delivering beam radiation towards the nerve tissue.

17. The method of claim 14, further comprising damaging the nerve tissue without destroying the airway.

18. A method comprising:

percutaneously delivering a distal section of an instrument through a subject'"'"'s skin such that the distal section is positioned to damage nerve tissue of a bronchial tree; and

denervating at least a portion of a bronchial tree in a subject'"'"'s lung using the instrument to substantially prevent nervous system signals from traveling to a portion of the bronchial tree.

19. The method of claim 18, further comprising damaging a nerve trunk positioned along a main bronchus.

20. The method of claim 18, wherein denervating comprises damaging nerve tissue positioned between the subject'"'"'s trachea and lung.

21. The method of claim 18, wherein denervating the portion of the bronchial tree comprises ablating a sufficient amount of nerve tissue to prevent nervous system signals from traveling to substantially all bronchial branches of the bronchial tree.

22. The method of claim 18, further comprising denervating the portion of the bronchial tree and removing the instrument without destroying the denervated airways.

23. The method of claim 18, wherein the distal section of the instrument is positioned through a port, a cannula, or a sleeve extending through the subject'"'"'s skin.

24. The method of claim 18, further comprising visualizing the outside of the airway while delivering the distal section using a visualization device selected from a group consisting of a thoracoscope, an ultrasonic device, and a fluoroscopy system.

25. A method of treating a subject, comprising:

endovascularly positioning a catheter in a blood vessel to position a distal portion of the catheter proximate to an airway nerve; and

delivering energy from the catheter to damage the airway nerve such that nerve signals through the airway nerve are attenuated.

26. The method of claim 25, wherein the blood vessel comprises a bronchial artery.

27. The method of claim 25, wherein the airway nerve comprises a nerve trunk extending along the airway wall.

28. The method of claim 25, wherein delivering energy comprises delivering radiofrequency energy from an electrode on the distal portion of the catheter.

29. The method of claim 25, wherein the nerve signals are attenuated so as to reduce constriction of the airway.

30. The method of claim 25, wherein the nerve signals are attenuated so as to inhibit constriction of smooth muscle in the airway.