External autonomic modulation

• US 9,005,143 B2
• Filed: 05/19/2011
• Issued: 04/14/2015
• 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
• Primary Examiner(s): REMALY, MARK DONALD
• Application Number:
  US13/111,837
• Publication Number:
  US 20110257524A1
• Time in Patent Office: 1,426 Days
• Field of Search: 600407-475, 601 2- 4
• US Class Current: 601/2
• 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 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• 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 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: A61B 5/4528 Joints A61B5/4533, A61B5/4538 take precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/489 Blood vessels
• CPC Class Codes: A61B 5/4893 Nerves
• CPC Class Codes: A61B 6/03 Computed tomography [CT] echo-tomography A61B8/14
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/037 Emission tomography
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• CPC Class Codes: A61B 8/00 Diagnosis using ultrasonic, sonic or infrasonic waves imaging of objects using sonar G01S15/00
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• 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 8/0833 : involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 : for locating instruments
• 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 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61N 2005/063 : comprising light transmitting means, e.g. optical fibres
• CPC Class Codes: A61N 2007/0026 : Stimulation of nerve tissue
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0039 : using microbubbles
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 2007/025 : interstitial
• CPC Class Codes: A61N 5/0601 : Apparatus for use inside the body
• CPC Class Codes: A61N 5/062 : Photodynamic therapy, i.e. excitation of an agent
• CPC Class Codes: A61N 5/0622 : Optical stimulation for exciting neural 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
• CPC Class Codes: A61N 7/022 : intracavitary

Abstract

In some embodiments, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some embodiments, different types of energy sources are utilized singly or combined with one another. In some embodiments, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents.

Claims

1. A method to stimulate or to at least partially inhibit a function of a nerve traveling to or from a kidney, comprising:

identifying an acoustic window at a back of a torso of a patient through which an arterial region can be imaged;

transmitting a first energy through a skin of the patient from the back of the torso of the patient;

imaging the arterial region using the transmitted first energy to obtain an image; and

applying a second energy to an arterial adventitia in the arterial region that has been imaged.

2. The method of claim 1, further comprising tracking the arterial region using the image created by the first energy.

3. The method of claim 1, wherein the second energy is applied to stimulate the nerve traveling to or from the kidney.

4. The method of claim 1, wherein the second energy is applied to at least partially inhibit the nerve traveling to or from the kidney.

5. A method to locate a position of a blood vessel in a body of a patient, comprising:

applying a first wave of ultrasound, from a first direction, to a region of an intact blood vessel from outside of the patient;

detecting a first return signal that is that is associated with a reflection of the first wave of ultrasound;

comparing the applied first wave and the first return signal;

simultaneously, or sequentially, applying a second wave of ultrasound from a second direction to the region of the blood vessel, wherein the second direction is different from the first direction;

detecting a second return signal that is associated with a reflection of the second wave of ultrasound;

using the first and second return signals to determine a position, in a three dimensional coordinate reference, of the region of the blood vessel to track the position of the region of the blood vessel.

6. The method of claim 5, further comprising controlling a therapeutic ultrasound transducer to apply energy to the position of the blood vessel.

7. The method of claim 6, wherein the energy is applied to stimulate a nerve outside the blood vessel.

8. The method of claim 6, wherein the energy is applied to at least partially inhibit a function of a nerve outside the blood vessel.

9. A system for stimulating or to at least partially inhibiting a function of a nerve traveling to or from a kidney, comprising:

an energy source configured for transmitting a first energy from a back of a torso of a patient through a skin of the patient; and

an imager configured for imaging an arterial region using the transmitted first energy to obtain an image;

wherein the energy source is also configured for applying a second energy to an arterial adventitia in the arterial region that has been imaged.

10. The system of claim 9, further comprising a processor configured for tracking the arterial region using the image created by the first energy.

11. The system of claim 9, wherein the energy source is configured to apply the second energy at a level sufficient to stimulate the nerve traveling to or from the kidney.

12. The system of claim 9, wherein the energy source is configured to apply the second energy at a level sufficient to at least partially inhibit the nerve traveling to or from the kidney.

13. A system for locating a position of a blood vessel in a body of a patient, comprising:

a first energy source configured for applying a first wave of ultrasound, from a first direction, to a region of an intact blood vessel from outside of the patient;

a first detector configured for detecting a first return signal that is associated with a reflection of the first wave of ultrasound;

a second energy source configured for applying a second wave of ultrasound from a second direction to the region of the blood vessel, wherein the second direction is different from the first direction;

a second detector configured for detecting a second return signal that is associated with a reflection of the second wave of ultrasound; and

a processor configured to use the first and second return signals to determine a position, in a three dimensional coordinate reference, of the region of the blood vessel to track the position of the region of the blood vessel.

14. The system of claim 13, further comprising a therapeutic ultrasound transducer configured to apply energy to the position of the blood vessel.

15. The system of claim 14, wherein the therapeutic ultrasound transducer is configured to apply the energy at a level sufficient to stimulate a nerve outside the blood vessel.

16. The system of claim 14, wherein the therapeutic ultrasound transducer is configured to apply the energy at a level sufficient to at least partially inhibit a function of a nerve outside the blood vessel.