Energetic modulation of nerves

• US 8,986,231 B2
• Filed: 03/15/2011
• Issued: 03/24/2015
• 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): REMALY, MARK DONALD
• Application Number:
  US13/048,837
• Publication Number:
  US 20110257561A1
• Time in Patent Office: 1,470 Days
• Field of Search: 600/407, 600437-475, 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 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• 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 5/4052 efferent nerves, i.e. nerves that relay impulses from the central nervous system
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 5/489 Blood vessels
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• 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 8/0891 for diagnosis of blood vessels
• 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 2007/0026 : Stimulation of nerve tissue
• CPC Class Codes: A61N 2007/003 : Destruction of nerve 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 of an autonomic nervous system of a patient includes a focused ultrasound energy source for placement outside the 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 the autonomic nervous system inside the patient, and wherein the focused ultrasound energy source is configured to deliver the ultrasound energy based on a position of an indwelling vascular catheter.

Claims

1. A system for treatment of an autonomic nervous system of a patient, comprising:

a focused ultrasound energy source for placement outside the patient;

wherein the focused ultrasound energy source is configured to deliver ultrasound energy in accordance with a treatment plan that prescribes the ultrasound energy be delivered towards a blood vessel with a surrounding nerve that is a part of the autonomic nervous system inside the patient;

wherein the focused ultrasound energy source is configured to deliver the ultrasound energy using a position of an indwelling vascular catheter as guidance for aiming the ultrasound energy; and

wherein the treatment plan includes a parameter for modeling heat transfer due to blood flow so that when the focused ultrasound energy source is configured to deliver the ultrasound energy in accordance with the treatment plan, the ultrasound energy has an energy level sufficient to treat the nerve while blood flow in the blood vessel provides a cooling effect due to heat transfer as modeled by the parameter.

2. The system of claim 1, wherein the focused ultrasound energy source comprises a transducer, and the focused ultrasound source is aimed at a direction that forms an angle anywhere between 30 degrees to 80 degrees with respect to a longitudinal axis of 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 nerve.

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

5. The system of claim 1, further comprising an imaging processor for determining a position of the blood vessel.

6. The system of claim 5, wherein the imaging processor comprises 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 5, wherein the processor is configured to operate the focused ultrasound energy source to target the nerve that surrounds the blood vessel during the ultrasound energy delivery by using the determined position.

8. The system of claim 5, wherein the processor is configured to determine the position using a Doppler triangulation technique.

9. The system of claim 1, wherein the focused ultrasound energy source is configured to deliver the ultrasound energy having an energy level sufficient to decrease a sympathetic stimulus in the patient, decrease an afferent signal within an autonomic nervous system of the patient, or both.

10. The system of claim 1, wherein the focused ultrasound energy source is oriented so that the focused ultrasound energy source aims at a direction that aligns with the vessel that is next to the nerve.

11. The system of claim 1, wherein the focused ultrasound energy source is configured to track a movement of the nerve.

12. The system of claim 11, wherein the focused ultrasound energy source is configured to track the movement of the nerve by tracking a movement of the blood vessel next to the nerve.

13. The system of claim 1, wherein the focused ultrasound energy source is configured to aim towards the nerve by aiming towards the blood vessel that is surrounded by the nerve.

14. The system of claim 1, wherein the focused ultrasound energy source is configured 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, comprising:

a focused ultrasound energy source for placement outside a patient;

wherein the focused ultrasound energy source is configured to deliver ultrasound energy in accordance with a treatment plan that prescribes the ultrasound energy be delivered towards a blood vessel with a surrounding nerve that is a part of an autonomic nervous system inside the patient; and

wherein the treatment plan includes a parameter for modeling heat transfer due to blood flow so that when the focused ultrasound energy source is configured to deliver the ultrasound energy in accordance with the treatment plan, the ultrasound energy has an energy level that is sufficient to treat the nerve while blood flow in the blood vessel provides a cooling effect due to heat transfer as modeled by the parameter.

16. The system of claim 15, wherein the focused ultrasound energy source comprises a transducer, and the focused ultrasound source is aimed at a direction that forms an angle anywhere between 30 degrees to 80 degrees with respect to a longitudinal axis of the blood vessel.

17. The system of claim 15, wherein the focused ultrasound energy source is configured to provide the ultrasound energy to achieve partial ablation of the nerve.

18. The system of claim 15, wherein the focused ultrasound energy source is configured to deliver the ultrasound energy to the nerve from multiple directions outside the patient while the focused ultrasound energy source is stationary relative to the patient.

19. The system of claim 15, further comprising an imaging processor for determining a position of the blood vessel.

20. The system of claim 19, wherein the imaging processor comprises 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.

21. The system of claim 19, wherein the processor is configured to operate the focused ultrasound energy source to target the nerve that surrounds the blood vessel during the ultrasound energy delivery by using the determined position.

22. The system of claim 19, wherein the processor is configured to determine the position using a Doppler triangulation technique.

23. The system of claim 15, wherein the focused ultrasound energy source is configured to deliver the ultrasound energy having an energy level sufficient to decrease a sympathetic stimulus in the patient, decrease an afferent signal within an autonomic nervous system of the patient, or both.

24. The system of claim 15, wherein the focused ultrasound energy source is oriented so that the focused ultrasound energy source aims at a direction that aligns with the vessel that is next to the nerve.

25. The system of claim 15, wherein the focused ultrasound energy source is configured to track a movement of the nerve.

26. The system of claim 25, wherein the focused ultrasound energy source is configured to track the movement of the nerve by tracking a movement of the blood vessel next to the nerve.

27. The system of claim 15, wherein the focused ultrasound energy source is configured to aim towards the nerve by aiming towards the blood vessel that is surrounded by the nerve.

28. The system of claim 15, further comprising:

a device for placement inside the patient; and

a processor for determining a position using the device;

wherein the focused ultrasound energy source is configured to deliver the ultrasound energy using the determined position as a guidance for aiming the ultrasound energy.

29. The system of claim 28, wherein the device is configured for insertion into the blood vessel that is surrounded by the nerve.

30. The system of claim 28, wherein the focused ultrasound energy source is configured to deliver the ultrasound energy to target areas having respective focal zones that are offset from the determined position.