Percutaneous devices and methods to visualize, target and ablate nerves

• US 9,579,030 B2
• Filed: 07/20/2012
• Issued: 02/28/2017
• Est. Priority Date: 07/20/2011
• Status: Active Grant

• Current Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Original Assignee: Boston Scientific Scimed (Boston Scientific Corporation)
• Inventors: Scheuermann, Torsten, Teo, Tat-Jin, Hastings, Roger N.
• Primary Examiner(s): Le, Long V
• Assistant Examiner(s): Weatherby, Ellsworth
• Application Number:
  US13/554,391
• Publication Number:
  US 20130165764A1
• Time in Patent Office: 1,684 Days
• Field of Search: 600/439, 600/462, 600/466, 606/11
• US Class Current: 1/1
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• 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 18/24 with a catheter A61B18/26, A61B18/28 take precedence
• CPC Class Codes: A61B 18/26 for producing a shock wave, e.g. laser lithotripsy
• CPC Class Codes: A61B 2018/00023 closed, i.e. without wound contact by the fluid
• CPC Class Codes: A61B 2018/00214 Expandable means emitting energy, e.g. by elements carried thereon
• CPC Class Codes: A61B 2018/0022 Balloons
• CPC Class Codes: A61B 2018/00285 Balloons
• CPC Class Codes: A61B 2018/00386 Coronary vessels
• CPC Class Codes: A61B 2018/00404 Blood vessels other than those in or around the heart
• CPC Class Codes: A61B 2018/00494 Stomach, intestines or bowel
• CPC Class Codes: A61B 2018/00511 Kidney
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00791 Temperature
• CPC Class Codes: A61B 2090/3966 Radiopaque markers visible in an X-ray image
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0095 by applying light and detecting acoustic waves, i.e. photoacoustic measurements
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/201 Assessing renal or kidney functions
• CPC Class Codes: A61B 5/24 Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
• CPC Class Codes: A61B 5/4029 : for evaluating the peripheral nervous systems A61B5/24 takes precedence
• CPC Class Codes: A61B 8/4461 : Features of the scanning mechanism, e.g. for moving the transducer within the housing of the probe
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 2007/003 : Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0082 : Scanning transducers
• CPC Class Codes: A61N 2007/0091 : with moving parts, e.g. transducers, lenses, reflectors
• 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

Apparatuses for identifying nerve tissue and methods for making and using the same are disclosed. An example apparatus may include an elongate shaft having a distal region configured to be percutaneously deployed within a patient. An active imaging structure may be disposed on the distal region. The active imaging structure may be configured to remotely image nerve tissue by exciting a signal in nerve tissue from a percutaneous location and receiving the signal from a percutaneous location. The active imaging structure may include one or more probes.

Claims

1. An apparatus for identifying nerve tissue, the apparatus comprising:

an elongate shaft having a distal region configured to be percutaneously deployed within a patient;

wherein the elongate shaft comprises an inflatable balloon in the distal region, the balloon having a collapsed configuration and an expanded configuration;

an active imaging structure disposed on the distal region, the active imaging structure configured to remotely image nerve tissue by exciting a signal in nerve tissue from a percutaneous location and receiving the signal from a percutaneous location;

wherein the active imaging structure includes one or more probes;

wherein the elongate shaft further comprises a module disposed in the distal region, wherein the one or more probes are disposed on said module, wherein said one or more probes include a photo-acoustic sensor comprising a light-emitter that is configured to emit pulses of coherent light towards targeted nerve tissue and a phased array of ultrasonic transducers configured to detect acoustic return signals generated by the pulses of coherent light in the targeted nerve tissue, wherein said phased array is configured to focus ablation energy onto the targeted tissue at a distance from the phased array such that the ablation energy can pass through a first tissue to ablate the targeted nerve tissue, wherein the module is configured to change a first focal point of the ablation energy during use, and wherein the module further comprises an electrical actuation element disposed within the balloon for rotating the module within the balloon and about a central axis with respect to the balloon and with respect to the elongate shaft; and

wherein the module is disposed within a cavity of the balloon and attached to an outer surface of the elongate shaft.

2. The apparatus of claim 1, wherein the light-emitter includes a laser diode.

3. The apparatus of claim 1, wherein the light-emitter is configured to emit coherent light towards a second focal point.

4. The apparatus of claim 3, wherein the light-emitter is configured to change the depth of focus of the second focal point.

5. The apparatus of claim 3, wherein the light-emitter comprises a phased array of light emitting elements.

6. The apparatus of claim 1, further comprising signal processing circuitry configured to use the signal to measure temperature.

7. The apparatus of claim 4, wherein the first focal point of the ablation enemy and the second focal points of the coherent light are the same.

8. The apparatus of claim 5, wherein the phased array of light emitting elements is configured to change the radial, longitudinal and angular location of the second focal point and to change the depth of focus of the second focal point.

9. The apparatus of claim 1, wherein the phased array of ultrasonic transducers is configured to change the radial, longitudinal and angular location of the first focal point and to change the depth of focus of the first focal point.

10. The apparatus of claim 8, wherein the phased array of ultrasonic transducers is configured to change the radial, longitudinal and angular location of the first focal point and to change the depth of focus of the first focal point.

11. The apparatus of claim 10, wherein the phased array of light emitting elements and the phased array of ultrasonic transducers are configured to change the first focal point and the second focal point to the same radial, longitudinal and angular location.