Method and system to inhibit a function of a nerve traveling with an artery

• US 8,295,912 B2
• Filed: 01/11/2010
• Issued: 10/23/2012
• 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
• Primary Examiner(s): Smith, Ruth S
• Application Number:
  US12/685,655
• Publication Number:
  US 20110118598A1
• Time in Patent Office: 1,016 Days
• Field of Search: 601/2, 601/3, 600/424, 600/426, 600/427, 600/437, 600/439, 600/454, 600/455, 345/419
• US Class Current: 600/426
• 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 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 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/2074 Interface software
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3975 active
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• 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 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 : for locating instruments
• CPC Class Codes: A61B 8/0891 : for diagnosis of blood vessels
• CPC Class Codes: A61B 8/483 : involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 8/488 : involving Doppler signals
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• 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 embodiments, sympathetic 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 of inhibiting a function of a a plexus of autonomic nerves traveling with an artery comprising:

providing an external detecting device to detect a location of the artery of a patient, wherein the location of the artery is expressed in a first three dimensional coordinate reference frame;

placing a therapeutic energy source in the first three dimensional coordinate reference frame;

modeling a delivery of energy to regions on at least two sides of the artery where the autonomic nerves travel to determine a power level for the therapeutic energy source, wherein the act of modeling considers heat transfer due to blood flow in the artery; and

delivering therapeutic energy from the therapeutic energy source, through a skin of the patient, to the regions on the at least two sides of the artery, wherein the act of delivering the therapeutic energy is based on a result from the act of modeling;

wherein the delivered therapeutic energy at least partially inhibits the function of the autonomic nerves traveling with the artery.

2. The method of claim 1 wherein the therapeutic energy is ultrasound.

3. The method of claim 1 wherein the artery is a renal artery.

4. The method of claim 1 wherein the artery is located using a doppler ultrasound signal.

5. The method of claim 1, wherein the detecting device is configured to detect the location of the artery by detecting a position of a reference location in the artery using a fiducial, wherein the fiducial is placed internal to the patient, and wherein the act of delivering is performed based on the detected position of the reference location.

6. The method of claim 5 wherein said fiducial is a catheter placed in the artery of the patient.

7. The method of claim 6 wherein said catheter is detectable using a radiofrequency signal.

8. The method of claim 1 wherein the therapeutic energy from the energy source is delivered in a distribution along a length of the artery.

9. The method of claim 1 wherein the therapeutic energy is ionizing radiation.

10. The method of claim 1, wherein the therapeutic energy comprises low intensity ultrasound.

11. The method of claim 1, wherein at least one of the regions comprises an adventitial region of the artery.

12. The method of claim 1, wherein at least one of the regions is adjacent to the artery.

13. The method of claim 1, wherein the therapeutic energy is delivered to a first nerve fiber at a first one of the regions on a first one of the at least two sides of the artery, and to a second nerve fiber at a second one of the regions on a second one of the at least two sides of the artery.

14. A system to inhibit a function of a nerve traveling with a renal artery comprising:

a detector to determine a location of the renal artery from a position external to a patient;

an ultrasound component to deliver therapeutic energy through a skin of the patient from at least two directions to the nerve surrounding the renal artery; and

a modeling algorithm configured to receive the location of the renal artery in a three dimensional coordinate space and a position of the ultrasound component in the three dimensional coordinate space, and determine the directions and energy level of the therapeutic energy using the location of the renal artery and the position of the ultrasound component wherein the modeling algorithm considers heat transfer due to blood flow in the renal artery, and wherein the modeling algorithm is configured to generate an output for operating the ultrasound component to create multiple lesions around the renal artery.

15. The system of claim 14, further comprising a fiducial, locatable by the detector from a position outside the patient, adapted to be temporarily placed in the renal artery of the patient.

16. The system of claim 15, wherein the fiducial is a passive reflector of ultrasound.

17. The system of claim 15, wherein the fiducial generates radiofrequency energy.

18. The system of claim 15, wherein the fiducial is activated to transmit energy based on a signal from an ultrasound or magnetic field generator.

19. The system of claim 14 wherein the modeling algorithm is configured to generate the output for operating the ultrasound component to create the lesions around the artery in which a major axis of at least one of the lesions is longitudinal along a length of the artery.

20. The system of claim 19 wherein the lesions are around the renal artery just proximal to a bifurcation of the renal artery in a hilum of a kidney.

21. The system of claim 14 wherein the modeling algorithm is configured to generate the output for operating the ultrasound component to create a circumferential lesion formed by the multiple lesions around the renal artery.

22. A method of inhibiting nerve function, comprising:

placing a therapeutic energy source in a three dimensional coordinate space that is external to a patient;

delivering first therapeutic energy from the therapeutic energy source, through a skin of the patient, to a first region on a first side of the artery; and

delivering second therapeutic energy from the therapeutic energy source, through the skin of the patient, to a second region on a second side of the artery;

wherein the delivered first therapeutic energy at least partially inhibits a function of a first nerve fiber in the first region;

wherein the delivered second therapeutic energy at least partially inhibits a function of a second nerve fiber in the second region; and

wherein the method further comprises applying a model of tissue heating that accounts for a convective heat transfer to model heat transfer due to blood flow through the artery, and a conductive heat transfer to model heat transfer from the therapeutic energy source through tissue in a region of the artery, to calculate power and phase for the therapeutic energy source to produce a desired degree of heating of the first nerve fiber.

23. The method of claim 22, wherein the therapeutic energy comprises low intensity ultrasound.

24. The method of claim 22, wherein the first region comprises an adventitial region of the artery.

25. The method of claim 22, wherein the first region is adjacent to the artery.

26. The method of claim 22, wherein the therapeutic energy is ultrasound.

27. The method of claim 22, wherein the artery is a renal artery.

28. The method of claim 22, further comprising:

determining a position of a reference location in the artery using a fiducial, wherein the fiducial is placed internal to the patient, and wherein the act of delivering the first therapeutic energy is performed based on the determined position of the reference location.

29. The method of claim 28, wherein the fiducial is at a catheter placed in the artery of the patient.

30. The method of claim 29, wherein the catheter is detectable using a radiofrequency signal.

31. The method of claim 22, wherein the first therapeutic energy from the energy source is delivered in a distribution along a length of the artery.