External autonomic modulation

• US 9,125,642 B2
• Filed: 12/06/2013
• Issued: 09/08/2015
• 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:
  US14/099,834
• Publication Number:
  US 20140236048A1
• Time in Patent Office: 641 Days
• Field of Search: 601 2- 4
• US Class Current: 1/1
• 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 inhibit a function of a nerve traveling to or from a kidney, comprising:

identifying an acoustic window at a back of a body of a patient through which a hilum of the kidney can be imaged;

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

imaging the hilum of the kidney using the transmitted first energy to obtain an image; and

applying a second energy to the hilum of the kidney that has been imaged.

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

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

4. The method of claim 1, wherein the first energy comprises ultrasound energy.

5. The method of claim 1, wherein the second energy comprises ultrasound energy.

6. A system to at least partially inhibit a function of a nerve traveling to or from a kidney, comprising:

a first energy source configured for transmitting a first ultrasound energy from a back of a body of a patient through a skin of the patient;

an imager configured for imaging a blood vessel using a transmitted first ultrasound energy to obtain an image; and

a second energy source configured to apply a second ultrasound energy to an adventitial region of the blood vessel region that has been imaged using the first ultrasound energy, the second ultrasound energy being focused ultrasound energy.

7. The system of claim 6, further comprising a processing unit configured for tracking the blood vessel using the image created by the first ultrasound energy.

8. The system of claim 6, further comprising a processing unit executing a modeling algorithm with an input and an output, the input comprising a three dimensional coordinate space and a representation of the second energy source.

9. The system of claim 8, wherein the output of the modeling algorithm comprises an energy level.

10. The system of claim 9, wherein the output of the modeling algorithm further comprises a direction of the second ultrasound energy.

11. The system of claim 6, wherein the imager is configured to image an intravascular catheter.

12. The system of claim 6, further comprising a processing unit configured to determine phase and power output for the second energy source in dependence on an image provided by the imager.

13. The system of claim 6, further comprising a processing unit configured to receive an input regarding error in position of the focused ultrasound energy.

14. The system of claim 6, further comprising a processing unit coupled to the second energy source, wherein the processing unit is configured to receive input regarding lesion size in an ablation zone.

15. The system of claim 6, further comprising a processing unit configured to:

obtain an error variable;

use the error variable to create a representation of temperature and position, and their associated errors, and

use the representation to create a map.

16. The system of claim 6, further comprising a processing unit configured to determine a baseline position for the energy source, and one or more positions of the blood vessel with respect to the baseline.

17. The system of claim 16, wherein the processing unit is configured to update a target of the energy source in dependence on a difference between the one or more positions and the baseline position.

18. The system of claim 17, wherein a frequency of the updates is greater than 50 Hertz.

19. The system of claim 16, wherein the one or more positions of the blood vessel are determined using an intravascular targeting catheter.

20. The system of claim 6, further comprising a processing unit executing a targeting algorithm for tracking the adventitial region of the blood vessel.