Electrical stimulation of blood vessels

• US 8,862,243 B2
• Filed: 07/25/2006
• Issued: 10/14/2014
• Est. Priority Date: 07/25/2005
• Status: Active Grant

• Current Assignee: Enopace Biomedical Ltd.
• Original Assignee: Rainbow Medical Ltd.
• Inventors: Gross, Yossi
• Primary Examiner(s): Layno, Carl H
• Assistant Examiner(s): Bays, Pamela M
• Application Number:
  US11/995,904
• Publication Number:
  US 20080215117A1
• Time in Patent Office: 3,003 Days
• Field of Search: 607/2, 607/50, 607/115, 607/116, 607/118, 607/119
• US Class Current: 607/116
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61F 2/856 Single tubular stent with a side portal passage
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2230/0008 elliptical or oval
• CPC Class Codes: A61F 2250/0001 Means for transferring electromagnetic energy to implants
• CPC Class Codes: A61F 2250/0004 adjustable
• CPC Class Codes: A61M 29/02 Dilators made of swellable material balloon catheters for angioplasty A61M25/104
• 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 1/056 Transvascular endocardial electrode systems
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36017 with leads or electrodes penetrating the skin
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/37205 Microstimulators, e.g. implantable through a cannula
• CPC Class Codes: A61N 1/375 Constructional arrangements, e.g. casings

Abstract

Apparatus (20) is provided, including a bifurcation stent (50) comprising one or more electrodes (32), the stent (50) configured to be placed in a primary passage (52) and a secondary passage (54) of a blood vessel (30), and a control unit (34), configured to drive the electrodes (32) to apply a signal to a wall (36) of the blood vessel (30), and to configure the signal to increase nitric oxide (NO) secretion by the wall (36). Other embodiments are also described.

Claims

1. Apparatus comprising:

a bifurcation stent comprising one or more electrodes, the stent configured to be placed in a primary passage and a secondary passage of a blood vessel; and

a control unit, configured to drive the electrodes to apply a signal to a wall of the blood vessel, and to configure the signal to increase nitric oxide (NO) secretion by the wall,

wherein the blood vessel includes an artery and wherein the control unit is configured to drive the electrodes to apply counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject,

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating, and

withholding the electrodes from the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

2. Apparatus for applying counterpulsation to an artery of a subject, the apparatus comprising:

one or more electrodes, adapted to be placed in a vicinity of the artery; and

a control unit, configured to apply the counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject,

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating, and

withholding the electrodes from applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

3. The apparatus according to claim 2, comprising a physiological sensor, which is configured to generate a sensor signal, wherein the control unit is configured to set at least one parameter of the systolic signal responsively to the sensor signal.

4. The apparatus according to claim 2, wherein the control unit is configured to drive the electrodes to begin application of the systolic signal slightly prior to a commencement of systole.

5. The apparatus according to claim 2, wherein the control unit is configured to drive the electrodes to begin application of the systolic signal less than 50 ms prior to a commencement of systole.

6. The apparatus according to claim 2, wherein the control unit is adapted to configure the systolic signal to have an amplitude of between 1 and 10 mA.

7. The apparatus according to claim 2, wherein the control unit is adapted to configure the systolic signal to have a frequency of less than 30 Hz.

8. The apparatus according to claim 2, wherein the control unit is adapted to drive the electrodes to apply a diastolic electrical signal to the wall during at least a portion of diastole, and to configure the diastolic signal to enhance constriction of the artery during diastole.

9. The apparatus according to claim 8, wherein the control unit is adapted to configure a diastolic value of a parameter of the diastolic signal to be between 1.5 and 4 times a systolic value of the parameter of the systolic signal, the parameter selected from the group consisting of:

an amplitude, and a frequency.

10. The apparatus according to claim 8, wherein the control unit is adapted to configure the diastolic signal to have an amplitude of between 5 and 20 mA.

11. The apparatus according to claim 8, wherein the control unit is adapted to configure the diastolic signal to have a frequency of between 15 and 100 Hz.

12. The apparatus according to claim 8, wherein the control unit is configured to drive the electrodes to apply the diastolic electrical signal to the wall of the artery by driving the electrodes to apply a biphasic diastolic signal to the wall of the artery.

13. The apparatus according to claim 2, further comprising an element configured to mechanically dilate the artery.

14. The apparatus according to claim 13, wherein the element is configured to mechanically dilate the artery during at least a portion of systole.

15. The apparatus according to claim 14, wherein the element is configured to be placed at least partially in the artery.

16. The apparatus according to claim 14, wherein the element is configured to be placed at least partially outside the artery.

17. The apparatus according to claim 14, wherein the element is configured to serve as at least one of the one or more electrodes.

18. The apparatus according to claim 13, wherein the element is configured to be placed at least partially in the artery.

19. The apparatus according to claim 13, wherein the element is configured to be placed at least partially outside the artery.

20. The apparatus according to claim 13, wherein the element is configured to serve as at least one of the one or more electrodes.

21. The apparatus according to claim 13, wherein the element configured to dilate the artery comprises a magnet.

22. The apparatus according to claim 13, wherein the element configured to dilate the artery comprises a coil.

23. The apparatus according to claim 13, wherein the element configured to dilate the artery comprises a piezoelectric element.

24. The apparatus according to claim 13, wherein the element is configured to dilate the artery using electricity.

25. The apparatus according to claim 13, wherein the element is configured to dilate the artery using hydraulic pressure.

26. The apparatus according to claim 2, wherein the artery includes a coronary artery of the subject and wherein the one or more electrodes are configured to be placed in a vicinity of the coronary artery.

27. The apparatus according to claim 2, wherein the artery includes an aorta of the subject and wherein the one or more electrodes are configured to be placed in a vicinity of the aorta.

28. The apparatus according to claim 27, wherein the aorta includes an ascending aorta of the subject and wherein the one or more electrodes are configured to be placed in a vicinity of the ascending aorta.

29. The apparatus according to claim 27, wherein the aorta includes a descending aorta of the subject and wherein the one or more electrodes are configured to be placed in a vicinity of the descending aorta.

30. The apparatus according to claim 2, wherein, at at least one time, the control unit is configured to drive only a portion of the electrodes.

31. The apparatus according to claim 30, wherein the control unit is configured to activate the electrodes in a sequence by time dividing activation of the electrodes.

32. The apparatus according to claim 2, wherein the control unit is configured drive the electrodes to apply the systolic electrical signal to the wall of the artery by driving the electrodes to apply a biphasic systolic signal to the wall of the artery.

56. The method according to claim 30, wherein the artery includes a coronary artery of the subject and wherein applying the systolic electrical signal to the wall of the artery comprises applying the systolic electrical signal to a wall of the coronary artery.

57. The method according to claim 30, wherein the artery includes an aorta of the subject and wherein applying the systolic electrical signal to the wall of the artery comprises applying the systolic electrical signal to a wall of the aorta.

58. The method according to claim 57, wherein the aorta includes an ascending aorta of the subject, and wherein applying the systolic electrical signal to the wall of the aorta comprises applying the systolic electrical signal to a wall of the ascending aorta.

59. The method according to claim 57, wherein the aorta includes a descending aorta of the subject, and wherein applying the systolic electrical signal to the wall of the aorta comprises applying the systolic electrical signal to a wall of the descending aorta.

60. The method according to claim 30, wherein applying the systolic electrical signal comprises applying the systolic electrical signal through a plurality of electrodes, and, at at least one time, applying the systolic electrical signal via a first portion of the electrodes and not via a second portion of the electrodes.

61. The method according to claim 60, wherein applying the systolic electrical signal comprises activating a set electrodes in a sequence by time dividing activation of the electrodes.

33. A method comprising:

placing a bifurcation stent including one or more electrodes in a primary passage and a secondary passage of a blood vessel;

driving the electrodes to apply a signal to a wall of the blood vessel; and

configuring the signal to increase nitric oxide (NO) secretion by the wall,

wherein the blood vessel includes an artery, the method comprising applying counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject;

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating; and

withholding applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

34. A method for applying counterpulsation to an artery of a subject, the method comprising:

applying a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject;

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating; and

withholding applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

35. The method according to claim 34, wherein applying the systolic signal comprises sensing a physiological parameter of the subject, and setting at least one parameter of the systolic signal responsively to the sensed physiological parameter.

36. The method according to claim 34, wherein applying the systolic signal comprises beginning applying the systolic signal less than 50 ms prior to a commencement of systole.

37. The method according to claim 34, wherein applying the systolic signal comprises configuring the systolic signal to have an amplitude of between 1 and 10 mA.

38. The method according to claim 34, applying the systolic signal comprises configuring the systolic signal to have a frequency of less than 30 Hz.

39. The method according to claim 34, comprising applying a diastolic electrical signal to the wall during at least a portion of diastole, and configuring the diastolic signal to enhance constriction of the artery during diastole.

40. The method according to claim 39, wherein applying the diastolic signal comprises configuring a diastolic value of a parameter of the diastolic signal to be between 1.5 and 4 times a systolic value of the parameter of the systolic signal, the parameter selected from the group consisting of:

an amplitude, and a frequency.

41. The method according to claim 39, wherein applying the diastolic signal comprises configuring the diastolic signal to have an amplitude of between 5 and 20 mA.

42. The method according to claim 39, applying the diastolic signal comprises configuring the diastolic signal to have a frequency of between 15 and 100 Hz.

43. The method according to claim 39, wherein applying the diastolic electrical signal comprises applying a biphasic diastolic signal.

44. The method according to claim 34, further comprising mechanically dilating the artery.

45. The method according to claim 44, wherein mechanically dilating the artery comprises mechanically dilating the artery during at least a portion of systole.

46. The method according to claim 45, wherein mechanically dilating the artery comprises mechanically dilating the artery from within the artery.

47. The method according to claim 45, wherein mechanically dilating the artery comprises mechanically dilating the artery from outside the artery.

48. The method according to claim 44, wherein mechanically dilating the artery comprises mechanically dilating the artery from within the artery.

49. The method according to claim 44, wherein mechanically dilating the artery comprises mechanically dilating the artery from outside the artery.

50. The method according to claim 44, wherein mechanically dilating the artery comprises mechanically dilating the artery using an electrode.

51. The method according to claim 44, wherein dilating the artery comprises dilating the artery with a magnet.

52. The method according to claim 44, wherein dilating the artery comprises dilating the artery with a coil.

53. The method according to claim 44, wherein dilating the artery comprises dilating the artery with a piezoelectric element.

54. The method according to claim 44, wherein dilating the artery comprises dilating the artery using electricity.

55. The method according to claim 44, wherein dilating the artery comprises dilating the artery using hydraulic pressure.

62. The method according to claim 34, wherein applying the systolic electrical signal comprises applying a biphasic systolic signal.

63. Apparatus comprising:

one or more electrodes configured to be placed on a wall of a blood vessel; and

a control unit, configured to reduce platelet aggregation in a vicinity of the blood vessel wall by driving the electrodes to apply a signal to the blood vessel wall and by configuring the signal to increase nitric oxide (NO) secretion by the wall,

wherein the blood vessel includes an artery and wherein the control unit is further configured to apply counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject,

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating, and

withholding the electrodes from applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

64. Apparatus comprising:

one or more electrodes configured to be placed in a vicinity of a blood vessel bifurcation; and

a control unit, configured to drive the electrodes to apply a signal to a wall of the blood vessel in the vicinity, and to configure the signal to increase nitric oxide (NO) secretion by the wall,

wherein the blood vessel includes an artery and wherein the control unit is configured to drive the electrodes to apply counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject,

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating, and

withholding the electrodes from the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

65. The apparatus according to claim 64, wherein the control unit is configured to reduce platelet aggregation in the vicinity of the bifurcation by increasing the NO secretion.

66. A method comprising:

placing one or more electrodes inside a blood vessel;

driving the electrodes to apply a signal to a wall of the blood vessel; and

reducing platelet aggregation inside the blood vessel by configuring the signal to increase nitric oxide (NO) secretion by the wall,

wherein the blood vessel includes an artery, the method further comprising applying counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject;

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating; and

withholding applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

67. A method comprising:

placing one or more electrodes in a primary passage and a secondary passage of a blood vessel;

driving the electrodes to apply a signal to a wall of the blood vessel; and

reducing platelet aggregation inside the blood vessel by configuring the signal to increase nitric oxide (NO) secretion by the wall,

wherein the blood vessel includes an artery, the method further comprising applying counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject;

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating; and

withholding applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

68. Apparatus, comprising:

one or more electrodes, adapted to be placed in a vicinity of a blood vessel; and

a control unit, configured to;

drive the electrodes to apply an electrical signal to a wall of the blood vessel, the electrical signal having an amplitude of 1-10 mA, and

configure the signal to dilate the blood vessel by inducing an increase in nitric oxide secretion by the wall,

wherein the blood vessel includes an artery and wherein the control unit is configured to apply counterpulsation to the artery, by;

driving the electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject,

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating, and

withholding the electrodes from applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.

69. A method, comprising:

applying an electrical signal to a wall of a blood vessel, the signal having an amplitude of 1-10 mA; and

configuring the signal to dilate the blood vessel by inducing an increase in nitric oxide secretion by the wall,

wherein the blood vessel includes an artery, the method comprising applying counterpulsation to the artery, by;

driving electrodes to apply a systolic electrical signal to a wall of the artery during at least a commencement of systole of a cardiac cycle of the subject;

configuring the systolic signal to induce an increase in nitric oxide (NO) secretion by the wall, such that during at least the commencement of systole, the artery stores energy by the wall of the artery dilating; and

withholding applying the systolic signal to the wall during at least a portion of diastole of the subject'"'"'s cardiac cycle, such that during the at least a portion of diastole the wall of the artery releases the stored energy.