Energetic modulation of nerves

• US 8,517,962 B2
• Filed: 03/15/2011
• Issued: 08/27/2013
• 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, Perozek, David, Sabet, Arash, Zhang, Jimin
• Primary Examiner(s): Chen, Tse
• Assistant Examiner(s): REMALY, MARK DONALD
• Application Number:
  US13/048,830
• Publication Number:
  US 20120065492A1
• Time in Patent Office: 896 Days
• Field of Search: 600407-475, 601 2- 4
• US Class Current: 601/2
• 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 5/0263 using NMR
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/061 Determining position of a probe within the body employing means separate from the probe, e.g. sensing internal probe position employing impedance electrodes on the surface of the body A61B1/00158 takes precedence
• CPC Class Codes: A61B 5/201 Assessing renal or kidney functions
• 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 6/487 involving fluoroscopy
• CPC Class Codes: A61B 6/504 : for diagnosis of blood vessels, e.g. by angiography
• 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 8/0841 : for locating instruments
• CPC Class Codes: A61B 8/0891 : for diagnosis of blood vessels
• CPC Class Codes: A61B 8/14 : Echo-tomography
• 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 8/488 : involving Doppler signals
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• 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 2007/0052 : using the same transducer for therapy and imaging
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• 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

A system for treatment includes a focused ultrasound energy source for placement outside a patient, wherein the focused ultrasound energy source is configured to deliver ultrasound energy towards a blood vessel with a surrounding nerve that is a part of an autonomic nervous system inside the patient, and wherein the focused ultrasound energy source is configured to deliver the ultrasound energy from outside the patient to the nerve located inside the patient to treat the nerve.

Claims

1. A system for treatment, comprising:

a focused ultrasound energy source for placement outside a patient;

wherein the focused ultrasound energy source is configured to deliver ultrasound energy from outside the patient towards a region inside the patient containing one or more nerves that are parts of an autonomic nervous system inside the patient, the one or more nerves surrounding a blood vessel;

wherein the focused ultrasound energy source is configured to deliver the ultrasound energy to a plurality of locations sequentially around a reference location;

wherein the system further comprises a processor configured to (1) determine a coordinate of the reference location, (2) use the coordinate of the reference location to compute a first coordinate for one of the plurality of locations that has a probability of including the one or more nerves, and (3) compute a second coordinate for another one of the plurality of locations that has a probability of including the one or more nerves; and

wherein the focused ultrasound energy source is configured to deliver the ultrasound energy to the plurality of locations sequentially around the reference location by delivering the ultrasound energy to the one of the plurality of locations, and delivering the ultrasound energy to the other one of the plurality of locations.

2. The system of claim 1, wherein the focused ultrasound energy source comprises a transducer, and an angle of the focused ultrasound source is anywhere between 30 degrees to 80 degrees with respect to a line traveling down a center of the transducer relative to a line connecting the transducer to the blood vessel.

3. The system of claim 1, wherein the focused ultrasound energy source is configured to provide the ultrasound energy to achieve partial ablation of the one or more nerves.

4. The system of claim 1, wherein the focused ultrasound energy source is configured to deliver the ultrasound energy to the one or more nerves from multiple directions outside the patient while the focused ultrasound energy source is stationary relative to the patient.

5. The system of claim 1, wherein the processor is configured for determining a position of the blood vessel as the coordinate of the reference location.

6. The system of claim 5, wherein the processor is configured to receive information from a CT device, a MRI device, a thermography device, an infrared imaging device, an optical coherence tomography device, a photoacoustic imaging device, a PET imaging device, a SPECT imaging device, or an ultrasound device.

7. The system of claim 1, wherein the processor is configured to determine the coordinate of the reference location using a Doppler triangulation technique.

8. The system of claim 1, wherein the focused ultrasound energy source is configured to deliver the ultrasound energy to decrease a sympathetic stimulus to the kidney, decrease an afferent signal from the kidney to an autonomic nervous system, or both.

9. The system of claim 1, wherein the focused ultrasound energy source has an orientation so that the focused ultrasound energy source aims at a direction that aligns with the blood vessel.

10. The system of claim 1, wherein the focused ultrasound energy source is configured to track a movement of the one or more nerves.

11. The system of claim 10, wherein the focused ultrasound energy source is configured to track the movement of the one or more nerves by tracking a movement of the blood vessel.

12. The system of claim 1, further comprising:

a device for placement inside the patient;

wherein the processor is configured for determining the coordinate of the reference location using the device.

13. The system of claim 12, wherein the device is for insertion into the blood vessel.

14. The system of claim 1, wherein the focused ultrasound energy source is oriented to deliver the ultrasound energy towards the blood vessel at an angle anywhere between −

10 degrees and −

48 degrees relative to a horizontal line connecting transverse processes of a spinal column, the angle directed from a lower torso to an upper torso of the patient.

15. A system for treatment of one or more nerves next to a blood vessel comprising:

an ultrasound energy source for placement outside a patient;

wherein the ultrasound energy source is configured to deliver ultrasound energy from outside the patient to a plurality of locations inside the patient;

wherein the system further comprises a processor configured to (1) determine a coordinate of a reference location, (2) use the coordinate of the reference location to compute a first coordinate for one of the plurality of locations that has a probability of including the one or more nerves, and (3) compute a second coordinate for another one of the plurality of locations that has a probability of including the one or more nerves; and

wherein the ultrasound energy source is configured to deliver the ultrasound energy to the plurality of locations sequentially by delivering the ultrasound energy to the one of the plurality of locations, and delivering the ultrasound energy to the other one of the plurality of locations.

16. The system of claim 15, wherein the ultrasound energy source is configured to provide the ultrasound energy to achieve partial ablation of the one or more nerves.

17. The system of claim 15, wherein the ultrasound energy source is configured to deliver the ultrasound energy to the one or more nerves from multiple directions outside the patient while the ultrasound energy source is stationary relative to the patient.

18. The system of claim 15, wherein the processor is configured for determining a position of the blood vessel as the reference location.

19. The system of claim 18, wherein the processor is configured to receive information from a CT device, a MRI device, a thermography device, an infrared imaging device, an optical coherence tomography device, a photoacoustic imaging device, a PET imaging device, a SPECT imaging device, or an ultrasound device.

20. The system of claim 18, wherein the processor is configured to determine the coordinate of the reference location using a Doppler triangulation technique.

21. The system of claim 15, wherein the ultrasound energy source is configured to deliver the ultrasound energy to decrease a sympathetic stimulus to the kidney, decrease an afferent signal from the kidney to an autonomic nervous system, or both.

22. The system of claim 15, wherein the ultrasound energy source has an orientation so that the ultrasound energy source aims at a direction that aligns with the blood vessel.

23. The system of claim 15, wherein the ultrasound energy source is configured to track a movement of the one or more nerves.

24. The system of claim 23, wherein the ultrasound energy source is configured to track the movement of the one or more nerves by tracking a position of the blood vessel.

25. The system of claim 15, further comprising:

a device for placement inside the patient;

wherein the processor is configured for determining the coordinate of the reference location using the device.

26. The system of claim 25, wherein the device is for insertion into the blood vessel.

27. The system of claim 15, wherein the ultrasound energy source is oriented to deliver the ultrasound energy towards the blood vessel at an angle anywhere between −

10 degrees and −

48 degrees relative to a horizontal line connecting transverse processes of a spinal column, the angle directed from a lower torso to an upper torso of the patient.

28. The system of claim 15, wherein the ultrasound energy source comprises a transducer, and an angle of the ultrasound energy source is anywhere between 30 degrees to 80 degrees with respect to a line traveling down a center of the transducer relative to a line connecting from the transducer to the blood vessel.