Methods for inhibiting renal nerve activity

• US 8,684,998 B2
• Filed: 03/09/2012
• Issued: 04/01/2014
• Est. Priority Date: 04/08/2002
• Status: Expired due to Term

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Demarais, Denise, Zadno, Nicolas, Clark, Benjamin J., Thai, Erik, Levin, Howard R., Gelfand, Mark
• Primary Examiner(s): SCHMIDT, EMILY LOUISE
• Application Number:
  US13/417,044
• Publication Number:
  US 20120172837A1
• Time in Patent Office: 753 Days
• Field of Search: 604507-509, 606/33, 606/41, 607/3
• US Class Current: 604/508
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 18/04 by heating by applying electromagnetic radiation A61B18/18; hyperthermia using electric or magnetic fields, radiation or ultrasound A61N
• CPC Class Codes: A61B 18/12 by passing a current through the tissue to be heated, e.g. high-frequency current
• 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 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00434 Neural system
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61F 2007/126 for invasive application, e.g. for introducing into blood vessels
• CPC Class Codes: A61F 7/007 characterised by electric heating
• CPC Class Codes: A61F 7/12 Devices for heating or cooling internal body cavities
• CPC Class Codes: A61F 7/123 using a flexible balloon containing the thermal element
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/44 having means for cooling or heating the devices or media
• CPC Class Codes: A61N 1/28 Apparatus for applying thermoelectric currents
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/403 for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 2007/003 Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 5/00 Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00
• CPC Class Codes: A61N 5/025 : Warming the body, e.g. hyperthermia treatment
• CPC Class Codes: A61N 5/045 : specially adapted for treatment inside the body
• CPC Class Codes: A61N 5/0603 : for treatment of body cavities
• 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

Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

Claims

1. A method for performing a renal denervation procedure, the method comprising:

percutaneously delivering an intravascular catheter through an abdominal aorta of a human patient to a renal blood vessel of the patient and proximate to renal nerves;

delivering a neuromodulatory agent via the catheter to at least partially inhibit neural signaling along the renal nerves; and

removing the catheter from the patient after delivering the neuromodulatory agent to conclude the procedure.

2. The method of claim 1 wherein delivering a neuromodulatory agent to the renal nerves comprises delivering phenol.

3. The method of claim 1 wherein delivering a neuromodulatory agent to the renal nerves comprises delivering a neurotoxin.

4. The method of claim 1 wherein delivering a neuromodulatory agent to the renal nerves comprises delivering botulinum toxin.

5. The method of claim 1 wherein delivering a neuromodulatory agent via the catheter comprises delivering fluid to block neural signaling along the renal nerves.

6. The method of claim 1 wherein delivering a neuromodulatory agent via the catheter comprises delivering an agent to necrose the renal nerves.

7. The method of claim 1 wherein percutaneously delivering an intravascular catheter through an abdominal aorta of a human patient to a renal blood vessel comprises delivering the catheter to the renal blood vessel via a guidewire.

8. The method of claim 1 wherein delivering a neuromodulatory agent via the catheter comprises delivering fluid to only partially block neural signaling along the renal nerves.

9. The method of claim 1 wherein delivering the neuromodulatory agent to at least partially inhibit neural signaling along the renal nerves alters at least one of urine production, fluid retention, renin secretion, waste excretion, sodium retention, systemic vasoconstriction, renal function, heart function and blood pressure in the patient.

10. The method of claim 9 wherein altering urine production comprises increasing urine output.

11. The method of claim 9 wherein altering renin secretion comprises decreasing renin secretion.

12. The method of claim 9 wherein altering sodium retention comprises increasing sodium excretion.

13. The method of claim 1 wherein delivering the neuromodulatory agent to at least partially inhibit neural signaling along the renal nerves comprises systemically reducing sympathetic tone in the patient.

14. The method of claim 1 wherein delivering the neuromodulatory agent to at least partially inhibit neural signaling along the renal nerves results in a therapeutically beneficial reduction in blood pressure in the patient.

15. The method of claim 1 wherein percutaneously delivering an intravascular catheter through an abdominal aorta of a human patient to a renal blood vessel comprises positioning the catheter within a renal artery of the patient.

16. The method of claim 1 wherein percutaneously delivering an intravascular catheter through an abdominal aorta of a human patient to a renal blood vessel comprises positioning the catheter within a renal vein of the patient.

17. The method of claim 1 wherein delivering the neuromodulatory agent to at least partially inhibit neural signaling comprises reducing afferent and/or efferent renal neural activity.