Endovascular catheters and methods for carotid body ablation

• US 9,393,070 B2
• Filed: 04/24/2013
• Issued: 07/19/2016
• Est. Priority Date: 04/24/2012
• Status: Expired due to Fees

• Current Assignee: Cibiem, Inc.
• Original Assignee: Cibiem, Inc.
• Inventors: Grasse, Martin M., Schleicher, Brett, Gelfand, Mark, Levin, Howard, Lennox, Charles, Fudim, Marat, Engelman, Zoar Jacob
• Primary Examiner(s): Peffley, Michael
• Assistant Examiner(s): Giuliani, Thomas
• Application Number:
  US13/869,765
• Publication Number:
  US 20130310823A1
• Time in Patent Office: 1,182 Days
• Field of Search: 606/41, 606/33, 606/52
• US Class Current: 1/1
• CPC Class Codes: A61B 18/0218 with open-end cryogenic probe, e.g. for spraying fluid directly on tissue or via a tissue-contacting porous tip
• 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 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00267 having a basket shaped structure
• CPC Class Codes: A61B 2018/00279 deployable
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00291 using suction
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00589 Coagulation
• CPC Class Codes: A61B 2018/00714 Temperature
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2018/0212 using an instrument inserted into a body lumen, e.g. catheter
• CPC Class Codes: A61B 2018/0225 using an instrument for clamping tissue, e.g. forceps
• CPC Class Codes: A61B 2018/0293 using an instrument interstitially inserted into the body, e.g. needle
• CPC Class Codes: A61B 2018/1407 Loop
• CPC Class Codes: A61B 2018/1425 Needle
• CPC Class Codes: A61B 2018/1475 Electrodes retractable in or deployable from a housing
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• CPC Class Codes: A61M 25/0082 : Catheter tip comprising a tool

Abstract

Systems, devices, and methods for treating a patient having a sympathetically mediated disease associated at least in part with augmented peripheral chemoreflex or heightened sympathetic activation. The treatments include ablating one or more peripheral chemoreceptors or associated afferent nerves to reduce or remove afferent neural signals from the peripheral chemoreceptor.

Claims

1. An ablation method for ablating target tissue within a carotid septum of a patient, the method comprising:

endovascularly advancing an ablation device into an artery of the patient, the ablation device comprising first and second arms, the first arm including a first ablation element and the second arm including a second ablation element;

contacting the first ablation element with an external carotid artery at a wall location that delimits the carotid septum;

contacting the second ablation element with an internal carotid artery at a wall location that delimits the carotid septum; and

ablating target tissue within the carotid septum using the first and second ablation elements while the first and second ablation elements are simultaneously contacting the respective carotid arterial walls delimiting the carotid septum.

2. The method of claim 1 wherein contacting the first ablation element with an external carotid artery at a wall location that delimits vessel the carotid septum comprises contacting the first ablation element with the external carotid artery at a wall location no more than 15 mm superior to a carotid bifurcation saddle.

3. The method of claim 1 wherein the first and second arms support the respective ablation elements in contact with the respective vessel walls.

4. The method of claim 1 further comprising grasping the carotid septum with the first and second arms.

5. The method of claim 1 further comprising compressing the carotid septum with the first and second arms.

6. The method of claim 5 wherein the ablating step is performed during the compressing step.

7. The method of claim 1 further comprising moving the first and second arms away from each other.

8. The method of claim 7 wherein the advancing step comprises advancing the ablation device with the first and second arms in an undeployed configuration, the moving step comprising moving the first and second arms away from each other from the undeployed configuration to a deployed configuration.

9. The method of claim 8 wherein the advancing step comprises advancing the first and second arms within a sheath.

10. The method of claim 7 wherein the moving step comprises permitting the first and second arms to return toward a preset position.

11. The method of claim 1 further comprising moving the first and second arms toward each other.

12. The method of claim 11 wherein the moving step comprises operating an arm actuator.

13. The method of claim 1, wherein the ablation elements comprise, respectively, first and second electrodes, the ablating step comprising using the first and second electrodes to ablate the target tissue with RF energy.

14. The method of claim 13 wherein the first and second electrodes are connected to the same pole of an RF generator.

15. The method of claim 13 wherein the first and second electrodes are connected to opposite poles of an RF generator.

16. The method of claim 1 wherein the ablation elements comprise a pair of bipolar electrodes.

17. The method of claim 1 wherein the ablating step comprises heating the target tissue to a temperature above 37°

C.

18. The method of claim 17 wherein the ablating step comprises heating the target tissue to a temperature above 45°

C.

19. The method of claim 18 wherein the ablating step comprises delivering ablation energy to the target tissue for 30-120 seconds.

20. The method of claim 1 wherein the first ablation element is engaging a wall of the external carotid artery that delimits the carotid septum no more than 15 mm superior to a carotid bifurcation while the second ablation element is engaging a wall of the internal carotid artery that delimits the carotid septum no more than 15 mm superior to the carotid bifurcation.

21. The method of claim 1 wherein ablating the target tissue comprises targeting tissue within the carotid septum while substantially sparing the carotid sinus.