Methods and devices to modulate the autonomic nervous system via the carotid body or carotid sinus

• US 9,119,952 B2
• Filed: 10/29/2012
• Issued: 09/01/2015
• 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:
  US13/663,447
• Publication Number:
  US 20130138095A1
• Time in Patent Office: 1,037 Days
• US Class Current: 1/1
• 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 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 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2034/2074 Interface software
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 2090/378 using ultrasound
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3975 active
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 6/506 for diagnosis of nerves
• 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 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 : for locating instruments
• CPC Class Codes: A61B 8/0891 : for diagnosis of blood vessels
• CPC Class Codes: A61B 8/483 : involving the acquisition of a 3D volume of data
• CPC Class Codes: A61B 8/488 : involving Doppler signals
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0078 : with multiple treatment transducers
• 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

In some embodiments, sympathetic 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 modulate an autonomic nerve in a patient comprising:

positioning an energy delivery device at a position for delivery of energy to a carotid body or carotid sinus;

determining a position of the carotid body or the carotid sinus relative to the position of the energy delivery device;

determining a dose and a direction for the energy using the determined position of the carotid body or the carotid sinus relative to the position of the energy delivery device; and

delivering the energy from the energy delivery device to the carotid body or the carotid sinus.

2. The method of claim 1, wherein the act of positioning the energy delivery is performed via percutaneous access.

3. The method of claim 1, wherein the act of positioning the energy delivery device comprises placing the energy delivery device in a jugular vein.

4. The method of claim 1, wherein the act of positioning the energy deliver device comprises placing the energy delivery device in a carotid artery.

5. The method of claim 1, wherein the energy delivery device is configured to deliver radiofrequency energy, and the act of delivering the energy comprises delivering the radiofrequency energy.

6. The method of claim 1, wherein the energy is delivered from outside a skin of the patient to the carotid body or the carotid sinus.

7. The method of claim 1, wherein the energy is delivered to the carotid body, not the carotid sinus.

8. The method of claim 1, further comprising determining a functioning of an autonomic nervous system, wherein the functioning is determined before, during, or after the act of delivering the energy.

9. The method of claim 1, wherein the energy delivery device comprises an ultrasound device, and the act of delivering the energy comprises delivering ultrasonic energy.

10. The method of claim 1, wherein the energy delivery device comprises an ultrasound device at the tip of an intravascular catheter.

11. The method of claim 1, wherein the energy delivery device comprises a transcutaneous access needle.

12. The method of claim 11, wherein the energy is delivered from a tip of the needle.

13. The method of claim 1, wherein the act of determining the position of the carotid body or the carotid sinus is at least partially performed using an imaging modality.

14. The method of claim 1, wherein the act of determining the position of the carotid body or the carotid sinus is at least partially performed using ultrasound imaging.

15. The method of claim 1, further comprising verifying the position of the carotid body or the carotid sinus relative to the energy delivery device by performing a stimulatory test of an autonomic nervous system of the patient.

16. The method of claim 1, wherein the energy delivery device is positioned at a distance away from the carotid body or the carotid sinus.

17. The method of claim 1, wherein the energy is delivered to the carotid body or the carotid sinus from a distance away from the carotid body or the carotid sinus.