Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen

• US 8,347,891 B2
• Filed: 11/14/2006
• Issued: 01/08/2013
• Est. Priority Date: 04/08/2002
• Status: Active Grant

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Demarais, Denise, Gifford, Hanson III, Deem, Mark, Zadno, Nicolas, Clark, Benjamin J., Wu, Andrew, Michlitsch, Kenneth J.
• Primary Examiner(s): ROANE, AARON F
• Application Number:
  US11/599,890
• Publication Number:
  US 20070129720A1
• Time in Patent Office: 2,247 Days
• Field of Search: 606 41- 50, 128/898
• US Class Current: 128/898
• CPC Class Codes: A61B 18/1206 Generators therefor
• 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 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00077 high, i.e. electrically conducting
• CPC Class Codes: A61B 2018/0016 Energy applicators arranged in a two- or three dimensional array
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• 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 2018/00648 using more than one sensed parameter
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/00875 Resistance or impedance
• CPC Class Codes: A61B 2018/124 switching the output to different electrodes, e.g. sequentially
• CPC Class Codes: A61B 2018/1435 Spiral
• CPC Class Codes: A61B 2018/1465 Deformable electrodes
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/32 alternating or intermittent currents applying electric fields by inductive or capacitive coupling A61N1/40; microwave apparatus A61N5/02
• CPC Class Codes: A61N 1/327 for enhancing the absorption properties of tissue, e.g. by electroporation
• CPC Class Codes: A61N 1/36007 : of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.

Claims

1. A method for non-continuous circumferential treatment of a renal blood vessel of a patient, the method comprising:

positioning an energy delivery element at least proximate to a wall of the renal blood vessel;

delivering energy from the energy delivery element to less than a full radial circumference of the renal blood vessel at a first lengthwise position relative to the renal blood vessel to form a first treatment zone, wherein the first treatment zone includes a first lesion; and

delivering energy from the energy delivery element to less than a full radial circumference of the renal blood vessel at a second lengthwise position relative to the renal blood vessel to form at least a second treatment zone, wherein the second treatment zone includes a second lesion, and wherein the first lengthwise position and the second lengthwise position are spaced apart from one another along a lengthwise dimension of the renal blood vessel, and further wherein the first and second lesions do not overlap.

2. The method of claim 1, wherein delivering energy at the second lengthwise position further comprises re-positioning the energy delivery element relative to the renal blood vessel of the patient.

3. The method of claim 1, wherein positioning the energy delivery element at least proximate to the renal blood vessel of the patient further comprises positioning the energy delivery element at least proximate to a blood vessel of the patient.

4. The method of claim 3, wherein positioning the energy delivery element at least proximate to the blood vessel of the patient further comprises positioning the energy delivery element within a blood vessel of the patient.

5. The method of claim 3, wherein positioning the energy delivery element at least proximate to the blood vessel of the patient further comprises positioning the energy delivery element external to the blood vessel of the patient.

6. The method of claim 3 further comprising blocking blood flow within the blood vessel during the energy delivery.

7. The method of claim 3, wherein positioning the energy delivery element at least proximate the blood vessel of the patient further comprises positioning the energy delivery element at least proximate a renal vasculature of the patient.

8. The method of claim 1, wherein positioning the energy delivery element at least proximate to the renal blood vessel of the patient further comprises positioning the energy delivery element within the renal blood vessel of the patient.

9. The method of claim 8, wherein positioning the energy delivery element within the renal blood vessel of the patient further comprises contacting the wall of the renal blood vessel with the energy delivery element.

10. The method of claim 8, wherein positioning the energy delivery element within the renal blood vessel of the patient further comprises passing the energy delivery element across the wall of the renal blood vessel prior to the energy delivery.

11. The method of claim 1, wherein delivering energy from the energy delivery element at the first and second lengthwise positions further comprises repositioning the energy delivery element.

12. The method of claim 1, wherein positioning the energy delivery element in proximity to the renal blood vessel further comprises positioning an energy delivery element comprising energy delivery sub-elements that are spaced lengthwise and angularly relative to one another.

13. The method of claim 12, wherein delivering energy at the first and at least second lengthwise positions further comprises delivering energy with the lengthwise- and angularly-spaced energy delivery sub-elements.

14. The method of claim 13, wherein delivering energy with the energy delivery sub-elements further comprises concurrently delivering energy at the first and the at least second lengthwise positions.

15. The method of claim 13, wherein delivering energy with the energy delivery sub-elements further comprises sequentially delivering energy at the first and the at least second lengthwise positions in any desired order.

16. The method of claim 1, wherein positioning the energy delivery in proximity to the renal blood vessel of the patient further comprises positioning the energy delivery element in proximity to multiple renal blood vessels of the patient.

17. The method of claim 1, wherein positioning the energy delivery element in proximity to the renal blood vessel further comprises positioning at least one electrode in proximity to the renal blood vessel, and

wherein delivering energy with the energy delivery element further comprises delivering an electric field from the at least one electrode.

18. The method of claim 17 further comprising attaching an external ground to an exterior of the patient,

wherein delivering the electric field further comprises delivering the electric field in a monopolar fashion between the at least one electrode and the external ground.

19. A method for treatment, the method comprising:

positioning an energy delivery element at a first lengthwise and angular position relative to a renal blood vessel of a patient;

delivering energy from the energy delivery element to less than a full circumference of the renal blood vessel at the first lengthwise and angular position to form a first treatment zone, wherein the first treatment zone includes a first lesion;

repositioning the energy delivery element to a second lengthwise and angular position relative to the renal blood vessel that is different than the first lengthwise and angular position; and

delivering energy from the energy delivery element to less than a full circumference of the renal blood vessel at the second lengthwise and angular position to form a second treatment zone, wherein the second treatment zone includes a second lesion spaced apart from and out of contact with the first lesion.

20. The method of claim 19, wherein a composite treatment zone formed via superimposition of the first treatment zone and the second treatment zone comprises a non-continuous, circumferential treatment zone.

21. A method for treating a patient, the method comprising:

delivering energy to a first treatment zone at an inner wall of a renal blood vessel and to a second treatment zone at the wall of the renal blood vessel, wherein the first treatment zone has a discrete, non-continuous first lesion at a first radial plane and the second treatment zone has a discrete, non-continuous second lesion at a second radial plane spaced apart from the first radial plane, and wherein the first lesion does not come into contact with the second lesion; and

affecting neural tissue outside of the inner wall of the renal blood vessel.

22. The method of claim 21 wherein affecting neural tissue outside of the inner wall comprises blocking neural activity across the neural tissue.