ENERGETIC MODULATION OF NERVES

• US 20110319765A1
• Filed: 09/08/2011
• Published: 12/29/2011
• Est. Priority Date: 10/12/2009
• Status: Abandoned Application

• Current Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Original Assignee: Kona Medical, Inc.
• Inventors: Gertner, Michael, Perozek, David, Zhang, Jimin, Sabet, Arash
• Application Number:
  US13/228,366
• Publication Number:
  US 20110319765A1
• Time in Patent Office: Days
• US Class Current: 600/453
• CPC Class Codes: A61B 2017/00106 ultrasonic
• 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 6/506 for diagnosis of nerves
• 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 8/44 Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
• 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 2007/003 Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 2007/0095 by modifying an excitation signal
• 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

A system for applying focused ultrasound energy to a nerve surrounding an artery of a patient includes a piezoelectric array comprising a plurality of piezoelectric elements, a controller configured to control at least a subset of the piezoelectric elements so that at least one of the piezoelectric elements in the subset is in a signal transmitting mode, in a signal sensing mode, or both, a first platform on which the piezoelectric elements are coupled and a second platform, wherein the second platform is configured to support at least a part of the patient, a programmable generator configured to generate output power for one or more of the piezoelectric elements, and a programmable processor configured to process a signal sensed by at least one of the piezoelectric elements.

Claims

1. A system for applying focused ultrasound energy to a nerve surrounding an artery of a patient comprising:

a piezoelectric array comprising a plurality of piezoelectric elements;

a controller configured to control at least a subset of the piezoelectric elements so that at least one of the piezoelectric elements in the subset is in a signal transmitting mode, in a signal sensing mode, or both;

a first platform on which the piezoelectric elements are coupled and a second platform, wherein the second platform is configured to support at least a part of the patient;

a programmable generator configured to generate output power for one or more of the piezoelectric elements; and

a programmable processor configured to process a signal sensed by at least one of the piezoelectric elements.

2. The system of claim 1, wherein a first one of the piezoelectric elements is configured to generate the signal, and a second one of the piezoelectric elements is configured to sense the signal after it has been reflected from tissue in the patient.

3. The system of claim 1, wherein one of the piezoelectric elements is configured to both generate the signal, and to sense the signal after it has been reflected from the tissue.

4. The system of claim 1, wherein the platform is compatible in a magnetic field.

5. The system of claim 4, wherein the magnetic field is a permanent magnetic field with a field strength less than 1.0 Tesla.

6. The system of claim 1, wherein at least one of the piezoelectric elements is optimized to receive signals from a depth of greater than 8 cm and less than 14 cm from a skin of the patient.

7. The system of claim 1, wherein the controller is configured to control a phasing of at least some of the piezoelectric elements based at least in part on the signal;

and

wherein the generator is configured to generate the output power which drives the one or more of the piezoelectric elements at a power sufficient for high intensity focused ultrasound.

8. The system of claim 1, wherein the piezoelectric elements are controlled by the controller to focus therapeutic ultrasound energy at a target in the patient greater than 7 cm from a skin of the patient, and wherein the signal comprises a flow signal from a renal artery.

9. The system of claim 1, wherein the processor is coupled to the piezoelectric array, and the processor is configured to determine a speed of blood, a direction of blood flow, or both.

10. The system of claim 1, further comprising a mechanical motion actuator coupled to the first platform, the mechanical motion actuator configured to mechanically move the piezoelectric array to follow a movement of the artery within the patient.

11. The system of claim 1, wherein the first platform is coupled to a ball and socket mechanism.

12. The system of claim 11, wherein the ball and socket mechanism comprises a locking mechanism.

13. The system of claim 1, wherein at least one of the piezoelectric elements is configured to receive an ultrasound signal from an intravascular piezoelectric transmitter.

14. The system of claim 13, wherein the processor is configured to determine an acoustic parameter based at least in part on the signal.

15. The system of claim 1 wherein the first platform is in a position underneath the patient.

16. The system of claim 1 wherein the first platform is automatically moveable to track a motion of the artery based on the signal after the signal is processed by the processor.

17. The system of claim 1 wherein at least one of the piezoelectric elements is configured to both transmit and receive an ultrasonic wave.

18. The system of claim 1 wherein the programmable generator is configured to transmit a phased output power sufficient to cause the piezoelectric elements to transmit a focused ultrasound output to the nerve to inhibit a function of the nerve.

19. The system of claim 1, wherein the programmable processor is configured to process the signal to determine a temperature.

20. The system of claim 1 wherein the programmable processor is configured to process the signal to determine an elastography parameter.

21. The system of claim 1 wherein the signal comprises a Doppler flow signal.

22. The system of claim 21, wherein the programmable processor is configured to determine a position at which energy from the piezoelectric array is focused based on the Doppler flow signal.

23. The system of claim 22, wherein the position is inside the vessel.

24. The system of claim 1 wherein the signal comprises a Doppler flow signal, and the first platform is configured to move to track the Doppler flow signal.

25. The system of claim 1 wherein the signal comprises a Doppler flow signal, and the controller is configured to control the piezoelectric elements based on a phasing pattern so that energies from the piezoelectric elements are focused in different positions to at least partially surround the artery.

26. A system for delivering energy to nerves surrounding a blood vessel in a patient comprising:

a first ultrasound transducer configured to apply therapeutic energy across the blood vessel to heat nerves on both sides of the blood vessel;

a receiver configured to receive reflected energy resulting from an ultrasound pulse; and

a processor configured to

receive first data from the receiver at a first time point,

receive second data from the receiver at a second time point,

compare the first data with the second data, and

provide an output signal to a mover to control a position of the first ultrasound transducer.

27. The system of claim 26, further comprising a mover, wherein the mover is inside of a table, and the table is configured to support a patient while allowing the first ultrasound transducer to couple to the patient.

28. The system of claim 26, further comprising a mover, wherein the mover comprises a ball and socket mechanism.

29. The system of claim 28, wherein the ball and socket mechanism is lockable.

30. The system of claim 29, wherein the ball and socket mechanism comprises a vacuum lock mechanism.

31. The system of claim 28, wherein the entire ball and socket assembly is moveable along a plane substantially parallel to the patient.

32. The system of claim 31, wherein the ball and socket mechanism is lockable along the plane with a vacuum mechanism.

33. A system for applying focused ultrasound energy to a patient comprising:

a piezoelectric array comprising a plurality of piezoelectric elements;

a controller configured to control at least a subset of the piezoelectric elements so that at least one of the piezoelectric elements in the subset is in a signal transmitting mode, in a signal sensing mode, or both;

a first platform on which the piezoelectric elements are coupled, and a second platform, wherein the second platform is configured to support at least a part of the patient;

a programmable generator configured to generate output power for one or more of the piezoelectric elements;

a programmable processor configured to process a signal sensed by the at least one of the piezoelectric elements; and

a medium storing a treatment plan, wherein the treatment plan is configured to be processed by the programmable processor to cause the piezoelectric array to deliver ultrasound energy through a skin of the patient about a circumference of a blood vessel in the patient, to thereby affect a function of one or more nerves surrounding the blood vessel.

34. The system of claim 33, wherein the blood vessel leads to a kidney.

35. The system of claim 33, wherein the signal comprises a Doppler flow signal.

36. The system of claim 33, wherein the at least one of the piezoelectric elements is configured to sense the signal from an indwelling catheter.

37. The system of claim 33, wherein the treatment plan is configured to be processed by the programmable processor to cause the piezoelectric array to deliver the ultrasound energy to the blood vessel at a depth from about 7 cm to about 14 cm by utilizing varying outputs from the generator to the piezoelectric array.

38. The system of claim 33, wherein the treatment plan is configured to be processed by the programmable processor to cause the piezoelectric array to deliver the ultrasound energy to the circumference of the blood vessel over a blood vessel length of about 1-2 cm.

39. The system of claim 33, wherein the at least one of the piezoelectric elements is configured to emit an ultrasound pulse, and receive the ultrasound pulse as the signal after the ultrasound pulse is reflected from a region of the blood vessel.

40. The system of claim 33, wherein the second platform has a shape configured for allowing delivery of focused ultrasound by the piezoelectric array through a back of the patient to the blood vessel that leads to a kidney.

41. The system of claim 33, further comprising a first mover, the first mover configured to move the first platform to track a movement of the blood vessel to maintain ultrasound foci about the blood vessel.

42. The system of claim 41, further comprising a second mover, the second mover configured to move the first platform in at least one direction that is substantially parallel to the patient.

43. The system of claim 33, wherein a first group of the piezoelectric elements is configured to provide a pulse of focused ultrasound, and a second group of the piezoelectric elements is configured to receive reflections from the pulse of focused ultrasound.

44. The system of claim 33, wherein the first platform is underneath the patient when the second platform supports the patient, the second platform allowing for a fluoroscopy machine to be placed around the patient.