Methods for renal nerve blocking

• US 9,192,715 B2
• Filed: 03/21/2014
• Issued: 11/24/2015
• Est. Priority Date: 04/08/2002
• Status: Expired due to Fees

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Gelfand, Mark, Levin, Howard R.
• Primary Examiner(s): BOCKELMAN, MARK
• Application Number:
  US14/221,536
• Publication Number:
  US 20140324016A1
• Time in Patent Office: 613 Days
• Field of Search: 604/890.1, 604/891.1, 604/131, 604/151, 604/522, 607/3
• US Class Current: 1/1
• CPC Class Codes: A61K 31/135 having aromatic rings , e.g. ketamine, nortriptyline methadone A61K31/137
• CPC Class Codes: A61K 31/52 Purines, e.g. adenine
• CPC Class Codes: A61K 31/529 forming part of bridged ring systems
• CPC Class Codes: A61K 45/06 Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• CPC Class Codes: A61K 9/0004 Osmotic delivery systems; Sustained release driven by osmosis, thermal energy or gas
• CPC Class Codes: A61K 9/0012 Galenical forms characterised by the site of application
• CPC Class Codes: A61K 9/7007 Drug-containing films, membranes or sheets A61K9/0041, A61K9/0043, A61K9/006, A61K9/0063 take precedence
• CPC Class Codes: A61L 29/146 Porous materials, e.g. foams or sponges
• CPC Class Codes: A61M 2005/14513 with secondary fluid driving or regulating the infusion
• CPC Class Codes: A61M 2205/05 combined with other kinds of therapy
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/145 using pressurised reservoirs, e.g. pressurised by means of pistons
• CPC Class Codes: A61M 5/1723 using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00
• CPC Class Codes: A61N 1/0551 Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 1/326 for promoting growth of cells, e.g. bone cells
• CPC Class Codes: A61N 1/36007 of urogenital or gastrointestinal organs, e.g. for incontinence control
• CPC Class Codes: A61N 1/36114 Cardiac control, e.g. by vagal stimulation stimulating the heart A61N1/362
• CPC Class Codes: A61N 1/36117 for treating hypertension
• CPC Class Codes: A61N 1/3627 : for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

Claims

1. A method for treatment of a human patient diagnosed with hypertension, the method comprising:

positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve of the patient; and

delivering a nerve blocking agent via the catheter to inhibit neural traffic along the renal nerve,

wherein delivering the nerve blocking agent results in a therapeutically beneficial reduction in blood pressure of the patient.

2. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning the catheter near a renal hilum of the patient.

3. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning the catheter within a renal hilum of the patient.

4. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning a distal tip of the catheter within a target site in continuity with a periarterial fat tissue layer surrounding a renal pedicle of the patient.

5. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning a distal tip of the catheter within renal fascia of the patient.

6. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery comprises intravascularly delivering the catheter through an abdominal aorta to the renal artery of the patient.

7. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery comprises extravascularly positioning the catheter within the periarterial space.

8. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve of the patient comprises delivering the catheter over a guidewire.

9. The method of claim 1 wherein the renal nerve innervates a kidney of the patient, and wherein inhibiting neural traffic along the renal nerve comprises denervating the kidney.

10. The method of claim 1 wherein inhibiting neural traffic along the renal nerve comprises ablating the renal nerve.

11. The method of claim 1 wherein delivering a nerve blocking agent via the catheter comprises delivering at least one of an anesthetic, a neurotoxin, an alcohol, and an antidepressant to the renal nerve.

12. The method of claim 1 wherein delivering a nerve blocking agent via the catheter comprises delivering an alcohol to the renal nerve.

13. The method of claim 1 wherein the catheter has a sealed tip and at least one side hole or pore through a sidewall of the catheter, and wherein delivering a nerve blocking agent via the catheter comprises delivering alcohol via the at least one side hole or pore.

14. The method of claim 1, further comprising removing the catheter from the patient after delivering nerve blocking agent to conclude the procedure.

15. The method of claim 1 wherein inhibiting neural traffic along the renal nerve further results in a reduction of systemic sympathetic tone in the patient.

16. A method for catheter-based renal denervation of a hypertensive human patient, the method comprising:

positioning a catheter having a drug delivery element within a renal hilum of the patient and adjacent neural fibers innervating a kidney of the patient; and

at least partially ablating the neural fibers via a nerve blocking agent delivered from the drug delivery element,

wherein at least partially ablating the neural fibers results in a therapeutically beneficial reduction in blood pressure in the patient.

17. The method of claim 16 wherein positioning a catheter having a drug delivery element within a renal hilum of the patient comprises positioning the catheter within a distal portion of the renal vasculature of the patient.

18. The method of claim 16 wherein the nerve blocking agent comprises at least one of an anesthetic, a neurotoxin, an alcohol, and an antidepressant.

19. The method of claim 16 wherein the nerve blocking agent comprises an alcohol.

20. The method of claim 16, further comprising monitoring a parameter of the catheter and/or tissue within the patient before and during delivery of the nerve blocking agent from the drug delivery element.

21. The method of claim 20, further comprising altering delivery of the nerve blocking agent in response to the monitored parameter.

22. The method of claim 16, further comprising removing the catheter from the patient after delivering the nerve blocking agent to conclude the procedure.

23. The method of claim 16 wherein the catheter has a sealed tip and at least one aperture through a sidewall of the catheter, and wherein at least partially ablating the neural fibers via a nerve blocking agent comprises delivering alcohol via the at least one aperture.