FLOW DIRECTED HEATING OF NERVOUS STRUCTURES

• US 20110172529A1
• Filed: 12/13/2010
• Published: 07/14/2011
• Est. Priority Date: 10/12/2009
• Status: Active Grant

• Current Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Original Assignee: Kona Medical, Inc.
• Inventors: GERTNER, Michael
• Granted Patent: US 8,556,834 B2
• Time in Patent Office: Days
• US Class Current: 600/439
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• 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 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 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 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/4052 efferent nerves, i.e. nerves that relay impulses from the central nervous system
• 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 8/4245 : 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 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 2/006 : for magnetic stimulation of nerve tissue
• 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 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 2007/025 : interstitial
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00
• 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

Abstract

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

Claims

1-148. -148. (canceled)

149. A treatment system, comprising:

a therapeutic ultrasonic energy source comprising a transducer; and

a processor coupled to the transducer, wherein the processor is configured to control the transducer based on information from an imaging device to deliver ultrasonic energy to a target region containing a blood vessel and a nerve, wherein the processor is configured to operate the transducer to treat tissue in the target region on at least two sides of the blood vessel; and

a motion tracking system configured to track the blood vessel and update a position of the nerve;

wherein the processor is further configured to adjust the delivery of the ultrasonic energy to the target region based on the updated position of the nerve.

150. The system of claim 149, wherein the processor is configured to operate the transducer to create a heat zone having an annular configuration.

151. The system of claim 149, wherein the processor is configured to operate the transducer to create a heat zone having a spiral configuration.

152. The system of claim 149, wherein the tissue is at least ten millimeters away from the blood vessel.

153. The system of claim 149, wherein the tissue comprises an adventitia surrounding the blood vessel.

154. The system of claim 149, wherein the target region is an autonomic nerve region, and the blood vessel leads to a kidney;

and

wherein the processor is further configured to deliver the ultrasonic energy through a path from an external position posterior to a patient, the path intersecting the kidney while avoiding bone and bowel tissue.

155. A treatment method, comprising:

placing a therapeutic ultrasonic energy source comprising a transducer external to a patient;

controlling the transducer based on information from an imaging device to deliver ultrasonic energy to a target region containing a blood vessel and a nerve, wherein the transducer is controlled to treat tissue in the target region on at least two sides of the blood vessel;

tracking the blood vessel to update a position of the nerve; and

adjusting the delivery of the ultrasonic energy to the target region based on the updated position of the nerve.

156. The method of claim 155, wherein the transducer is controlled to create a heat zone having an annular configuration.

157. The method of claim 155, wherein the transducer is controlled to create a heat zone having a spiral configuration.

158. The method of claim 155, wherein the tissue is at least ten millimeters away from the blood vessel.

159. The method of claim 155, wherein the tissue comprises an adventitia surrounding the blood vessel.

160. The method of claim 155, wherein the target region is an autonomic nerve region, and the blood vessel leads to a kidney;

and

wherein the ultrasonic energy is delivered through a path from an external position posterior to the patient, the path intersecting the kidney while avoiding bone and bowel tissue.

161. A medical method, comprising:

detecting a blood vessel using a doppler flow signal;

applying heat from outside a patient'"'"'s body to a nerve region outside the blood vessel;

determining an effect of the heat being applied to the nerve region using an ultrasound signal, wherein the act of determining the effect is performed based on a change in a tissue property at the nerve region outside the blood vessel.

162. The method of claim 161, wherein the heat is applied to tissue in the nerve region on at least two sides of the blood vessel.

163. The method of claim 161, wherein the act of applying heat comprises creating a zone of heat surrounding the blood vessel to create an annular region around the blood vessel to inhibit nerves surrounding the blood vessel.

164. The method of claim 161, further comprising creating a map that represents the effect of the heat.

165. The method of claim 161, further comprising modifying the application of heat based on the determined effect of the heat.

166. The method of claim 161, wherein the effect comprises tissue elasticity.

167. The method of claim 161, wherein the effect comprises temperature.

168. The method of claim 161, further comprising altering an amount of the heat being applied based on the tissue property.