Apparatus and methods for treating pulmonary hypertension

• US 9,005,100 B2
• Filed: 12/14/2012
• Issued: 04/14/2015
• Est. Priority Date: 12/15/2011
• Status: Active Grant

• Current Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Original Assignee: Board of Trustees of the Leland Stanford Junior University (Stanford Management Co.)
• Inventors: Gnanashanmugam, Swaminadhan, Coe, Jonathan A., Suh, Insoo, Koehler, Jeremy Christopher
• Primary Examiner(s): Marmor, II, Charles A
• Assistant Examiner(s): Dorna, Carrie R
• Application Number:
  US13/715,944
• Publication Number:
  US 20130204068A1
• Time in Patent Office: 851 Days
• Field of Search: 606 20- 34, 606/45, 606 48- 50, 607/44
• US Class Current: 600/9
• CPC Class Codes: A61B 17/00 Surgical instruments, devices or methods, e.g. tourniquets A61B18/00 takes precedence; contraceptive devices, pessaries, or applicators therefor A61F6/00; eye surgery A61F9/007; ear surgery A61F11/00
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 18/18 by applying electromagnetic radiation, e.g. microwaves radiation therapy A61N5/00
• CPC Class Codes: A61B 18/1815 using microwaves
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00345 Vascular system
• CPC Class Codes: A61B 2018/00357 Endocardium
• CPC Class Codes: A61B 2018/00375 Ostium, e.g. ostium of pulmonary vein or artery
• 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 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00613 Irreversible electroporation reversible electroporation A61N1/327
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/046 in liquid form
• CPC Class Codes: A61B 2018/143 multiple needles
• CPC Class Codes: A61B 2018/1432 curved
• CPC Class Codes: A61M 2025/006 having a special surface topography or special surface properties, e.g. roughened or knurled surface
• CPC Class Codes: A61M 25/00 Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/0043 : characterised by structural features
• CPC Class Codes: A61M 25/10 : Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61M 25/1002 : characterised by balloon shape A61M25/1006, A61M25/1009 take precedence
• CPC Class Codes: A61M 29/00 : Dilators with or without means for introducing media, e.g. remedies instruments for performing visual medical inspections of cavities or tubes of the body A61B1/00
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104
• CPC Class Codes: A61N 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/36117 : for treating hypertension
• CPC Class Codes: A61N 2/02 : using magnetic fields produced by coils, including single turn loops or electromagnets A61N2/12 takes precedence
• CPC Class Codes: A61N 2/06 : using magnetic fields produced by permanent magnets A61N2/12 takes precedence
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 5/1002 : Intraluminal radiation therapy
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

A method is described for decreasing activity of at least one sympathetic nerve, nerve fiber or neuron innervating at least one blood vessel in the pulmonary vasculature of a patient to ameliorate pulmonary hypertension. In one embodiment, the method may involve advancing an intravascular treatment device to a target location in a target blood vessel within the pulmonary vasculature of the patient and using the treatment device to decrease activity of at least one sympathetic nerve, nerve fiber or neuron innervating the target blood vessel at or near the target location to ameliorate pulmonary hypertension.

Claims

1. A method of decreasing sympathetic nerve activity in pulmonary vasculature of a patient to treat pulmonary hypertension, the method comprising:

advancing a denervation catheter to a target location in a pulmonary artery of the patient;

changing a shape of an energy delivery portion of the catheter to circumferentially contact an inner wall of the pulmonary artery with the catheter; and

delivering energy from the energy delivery portion for a defined period of time to at least partially destroy at least one sympathetic nerve innervating the pulmonary artery at or near the target location to treat pulmonary hypertension.

2. A method as in claim 1, wherein delivering energy comprises delivering energy selected from the group consisting of radiofrequency, ultrasound, microwave, light, heat, cold radiation, phototherapy, magnetic, electrical, electromagnetic, cryotherapy, plasma, mechanical, chemical, kinetic, potential, nuclear, elastic and hydrodynamic energy.

3. A method as in claim 1, wherein the denervation catheter comprises a substance delivery catheter, and wherein the method further comprises delivering a substance selected from the group consisting of saline, phenol, ethanol, vincristine, an antineoplastic drug, botulinum toxin, neurotoxins, anesthetic agents, depolarizing agents, non-depolarizing agents, bupivacaine, lidocaine, anesthetic agents, and agents capable of reducing nerve signal transmission.

4. A method as in claim 1, wherein at least partially destroying the nerve comprises altering the nerve by at least one mechanism selected from the group consisting of irreversible electroporation, necrosis, apoptosis, gene expression alteration, cytokine up regulation or downregulation alteration, ablation, electrofusion and combinations thereof.