Methods and apparatus for multi-vessel renal neuromodulation

• US 8,805,545 B2
• Filed: 04/16/2013
• Issued: 08/12/2014
• Est. Priority Date: 10/05/2004
• Status: Expired due to Fees

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Zarins, Denise
• Primary Examiner(s): Holmes, Rex R
• Application Number:
  US13/864,217
• Publication Number:
  US 20130245726A1
• Time in Patent Office: 483 Days
• Field of Search: 607 2- 3, 607/44, 607/62, 607117-118, 604/891.1
• US Class Current: 607/118
• 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 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00613 Irreversible electroporation
• CPC Class Codes: A61F 2007/126 for invasive application, e.g. for introducing into blood vessels
• CPC Class Codes: A61F 7/10 Cooling bags, e.g. ice-bags
• CPC Class Codes: A61N 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• CPC Class Codes: A61N 1/0507 Electrodes for the digestive system
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/0558 Anchoring or fixation means therefor
• CPC Class Codes: A61N 1/205 for promoting a biological process
• CPC Class Codes: A61N 1/323 Interference currents, i.e. treatment by several currents summed in the body
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• 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 1/3605 : Implantable neurostimulators for stimulating central or peripheral nerve system
• CPC Class Codes: A61N 1/36114 : Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36117 : for treating hypertension

Abstract

Methods and apparatus are provided for multi-vessel neuromodulation, e.g., via a pulsed electric field. Such multi-vessel neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, the multi-vessel neuromodulation is applied to neural fibers that contribute to renal function. Such multi-vessel neuromodulation optionally may be performed bilaterally.

Claims

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

positioning a catheter within a renal artery of a human patient and proximate to renal nerves of the patient;

intravascularly positioning a first electrode carried by the catheter within a first vessel branching from the renal artery;

intravascularly positioning a second electrode carried by the catheter within a second vessel branching from the renal artery, wherein the second vessel is different than the first vessel; and

thermally modulating a function of the renal nerves via radio frequency (RF) energy from the first and second electrodes.

2. The method of claim 1 wherein intravascularly positioning the first electrode within the first vessel occurs before intravascularly positioning the second electrode within the second vessel.

3. The method of claim 1 wherein intravascularly positioning the first electrode within the first vessel and intravascularly positioning the second electrode within the second vessel occur simultaneously or approximately simultaneously.

4. The method of claim 1, further comprising monitoring a parameter of the catheter, the first and second electrodes, and/or tissue proximate the renal nerves during therapy.

5. The method of claim 4, further comprising adjusting therapy in response to the monitored parameter.

6. The method of claim 4, further comprising altering delivery of the RF energy from the first electrode and/or the second electrode in response to the monitored parameter.

7. The method of claim 1 wherein thermally modulating a function of the renal nerves comprises modulating at least one of afferent and efferent signals along the renal nerves.

8. The method of claim 1 wherein thermally modulating a function of the renal nerves results in a therapeutically beneficial reduction in blood pressure in the patient.