Nerve treatment system

• US 8,374,674 B2
• Filed: 02/01/2011
• Issued: 02/12/2013
• 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): Chen, Tse
• Assistant Examiner(s): REMALY, MARK DONALD
• Application Number:
  US13/019,273
• Publication Number:
  US 20110137149A1
• Time in Patent Office: 742 Days
• Field of Search: 600407-475, 601 2- 4
• US Class Current: 600/411
• 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 2090/378 using ultrasound
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• 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 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• 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 8/4245 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: A61N 2005/0612 using probes penetrating tissue; interstitial probes
• CPC Class Codes: A61N 2005/0659 infrared
• CPC Class Codes: A61N 2007/0026 Stimulation of nerve tissue
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0039 : using microbubbles
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 2007/025 : interstitial
• 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
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

A method of treatment includes delivering an agent into a patient, and providing energy inside the patient so that the energy can interact with the agent to treat a nerve. A system for treatment includes a source of agent for delivery into a patient, and an energy source for providing energy inside the patient so that the energy can interact with the agent to treat a nerve.

Claims

1. 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 using information regarding a blood vessel from an imaging device to apply ultrasonic energy to a nerve region next to the blood vessel;

wherein the processor is configured to operate the transducer to apply the ultrasonic energy to treatment areas that are arranged approximately in a spherical or ellipsoidal configuration around a reference position associated with the blood vessel, to thereby treat nerve tissue in the nerve region on at least two sides of the blood vessel so that the nerve tissue on the at least two sides of the blood vessel receives more therapeutic effect than the blood vessel.

2. The system of claim 1, further comprising a module to track motion of the blood vessel.

3. The system of claim 1, wherein the nerve tissue extends around the blood vessel, and wherein the processor is configured to cause the transducer to create a zone of heat surrounding the blood vessel to create an annular region around the blood vessel to modulate the nerve tissue surrounding the blood vessel.

4. The system of claim 1, wherein the transducer is configured to apply power to the nerve region, the power having a value that is anywhere from 100 W/cm² to 2500 W/cm².

5. The system of claim 1, further comprising a patient interface configured to position the therapeutic ultrasonic energy source so that regions of bone are avoided by the ultrasonic energy from the transducer.

6. The system of claim 1, wherein the nerve region is an autonomic nerve region, and the transducer is configured to apply the ultrasonic energy at an energy level to create a reduction in a norepinephrine output of the autonomic nerve region.

7. The system of claim 1, further comprising a motion tracking module to track a movement of the blood vessel.

8. The system of claim 7, wherein the motion tracking module is configured to track speckles.

9. The system of claim 7, wherein the motion tracking module is configured to determine a three dimensional coordinate of the blood vessel.

10. The system of claim 7, wherein the motion tracking module is configured to track a doppler ultrasound signal from the blood vessel.

11. The system of claim 1, wherein the processor is configured to operate the transducer so that the transducer applies the ultrasonic energy simultaneously to the nerve tissue on the at least two sides of the blood vessel.

12. The system of claim 1, further comprising the imaging device, wherein the imaging device is configured to visualize the blood vessel in the nerve region with ultrasound.

13. The system of claim 1, further comprising the imaging device, wherein the imaging device is configured to detect a presence of the blood vessel by a Doppler signal.

14. The system of claim 1, further comprising the imaging device, wherein the imaging device comprises an MRI machine.

15. The system of claim 1, further comprising the imaging device, wherein the imaging device is configured to detect a catheter.

16. The system of claim 15, wherein the imaging device is configured to detect the catheter when the catheter is in a renal artery, a renal vein, or a vena cava.

17. The system of claim 15, wherein the imaging device is placed outside a patient and is configured to receive ultrasound pulses emitted from inside the patient to determine a three dimensional coordinate of the catheter.

18. A treatment system, comprising:

a therapeutic ultrasonic energy source comprising a transducer for placement on a patient'"'"'s skin, and for delivery of focused ultrasound energy through the skin of the patient;

a diagnostic imaging device configured to detect flow in a blood vessel; and

a processor coupled to the transducer, wherein the processor is configured to control the transducer using information regarding the blood vessel from the diagnostic imaging device to deliver the focused ultrasound energy to treatment areas that are arranged approximately in a spherical or ellipsoidal configuration, to heat a nerve region that is next to the blood vessel.

19. The system of claim 18, wherein the processor is configured to operate the transducer to heat tissue in the nerve region on at least two sides of the blood vessel by applying the focused ultrasound energy through the blood vessel from the transducer.

20. The system of claim 18, wherein the diagnostic imaging device comprises an ultrasound device.

21. The system of claim 18, wherein the diagnostic imaging device comprises a MRI device.

22. The system of claim 18, wherein the diagnostic imaging device is configured to detect a fiducial inside the patient.

23. The system of claim 22, wherein the fiducial comprises a catheter.

24. The system of claim 18, wherein the processor is configured to operate the transducer to create a heat zone having an annular configuration.

25. The system of claim 18, wherein the processor is configured to determine a position of the blood vessel, and to control the transducer to deliver the focused ultrasound energy to one of the treatment areas that is about ten millimeters away from the position of the blood vessel.

26. The system of claim 18, wherein the processor is configured to control the transducer to deliver the focused ultrasound energy to the treatment areas surrounding a lumen of the blood vessel.

27. The system of claim 18, wherein the processor is configured to execute a treatment plan to control the transducer to deliver the ultrasound energy through a path from an external position posterior to the patient, the path being prescribed by the treatment plan to intersect a kidney while avoiding bone and bowel tissue.

28. The system of claim 18, further comprising a sensor for detecting temperature of the nerve region during the heating of the tissue.

29. The system of claim 18, wherein the processor is configured to control the transducer by targeting the blood vessel.

30. 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 using information from an imaging device, and wherein the processor is configured to operate the transducer to deliver the ultrasonic energy to treatment areas that are arranged approximately in a spherical or ellipsoidal configuration around a reference position associated with a blood vessel to thereby treat a nerve adjacent the blood vessel; and

a motion tracking system configured to track the blood vessel;

wherein the processor is further configured to adjust the delivery of the ultrasonic energy to the nerve using the tracked blood vessel.

31. The system of claim 30, wherein the processor is configured to operate the transducer to create a heat zone having an annular configuration.

32. The system of claim 30, wherein the processor is configured to determine a position of the blood vessel, and to control the transducer to deliver the ultrasonic energy to one of the treatment areas that is about ten millimeters away from the position of the blood vessel.

33. The system of claim 30, wherein the processor is further configured to execute a treatment plan to control the transducer to deliver the ultrasonic energy through a path from an external position posterior to a patient, the path being prescribed by the treatment plan to intersect a kidney while avoiding bone and bowel tissue.

34. The system of claim 30, wherein the motion tracking system is configured to detect a position of an indwelling vascular catheter.

35. The system of claim 30, further comprising the imaging device, wherein the imaging device is configured to detect an indwelling catheter.