Nerve treatment system

• US 9,579,518 B2
• Filed: 06/01/2012
• Issued: 02/28/2017
• 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:
  US13/487,135
• Publication Number:
  US 20120238919A1
• Time in Patent Office: 1,733 Days
• Field of Search: 600407-475, 601 2- 4
• US Class Current: 1/1
• CPC Class Codes: A61B 17/320068 using mechanical vibrations, e.g. ultrasonic A61B17/22012 takes precedence; dental tooth drilling devices operated by vibration A61C3/03; removing intra-ocular material using mechanical vibrations A61F9/00745
• CPC Class Codes: A61B 18/14 Probes or electrodes therefor
• 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 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 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 5/4035 Evaluating the autonomic nervous system
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/4047 afferent nerves, i.e. nerves that relay impulses to the central nervous system
• CPC Class Codes: A61B 5/4052 efferent nerves, i.e. nerves that relay impulses from the central nervous system
• 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 8/4245 : 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 1/0551 : Spinal or peripheral nerve electrodes
• CPC Class Codes: A61N 2/006 : for magnetic stimulation of nerve tissue
• 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 2007/0078 : with multiple treatment transducers
• CPC Class Codes: A61N 2007/025 : interstitial
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00
• 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

Abstract

In some examples, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some examples, different types of energy sources are utilized singly or combined with one another. In some examples, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents or the agents are enhanced by the energy sources.

Claims

1. A treatment system, comprising:

a therapeutic ultrasonic energy source comprising a transducer; and

a processor coupled to the transducer, wherein the processor is configured to control the transducer to deliver ultrasonic energy to multiple target regions in a torso, one or more of the target regions containing a nerve;

wherein the processor is configured to control the transducer to deliver the ultrasonic energy to a plurality of locations that are offset from an axis of a blood vessel based on a tracking of the blood vessel.

2. The system of claim 1, wherein the processor is configured to operate the transducer to create a heat zone having an annular configuration.

3. The system of claim 1, wherein the processor is configured to operate the transducer to create a heat zone having a spiral configuration.

4. The system of claim 1, wherein the processor is configured to operate the transducer to heat tissue that is at least ten millimeters away from the blood vessel.

5. The system of claim 1, wherein the processor is configured to operate the transducer to heat tissue that comprises an adventitia surrounding the blood vessel.

6. The system of claim 1, wherein the processor is further configured to obtain anatomy information, and execute a treatment plan using the anatomy information to deliver the ultrasonic energy through a path from an external position posterior to a patient, the path being prescribed by the treatment plan and intersecting a kidney while avoiding bone and bowel tissue.

7. The system of claim 1, wherein the multiple target regions form an arrangement that resembles a spherical configuration or ellipsoidal configuration.

8. The system of claim 1, wherein the multiple target regions lie in at least two intersecting imaginary planes and also on a surface of a sphere or an ellipsoid.

9. A treatment system, comprising:

a transducer for placement at a location external to a patient; and

a processor configured for;

obtaining a first signal associated with a first position of a blood vessel;

controlling the transducer using the first signal to deliver ultrasonic energy;

obtaining a second signal associated with a second position of the blood vessel;

adjusting the delivery of the ultrasonic energy using the second signal;

wherein the first and second positions are positions of a reference location inside a lumen of the blood vessel, and the processor is configured to control the transducer to deliver the ultrasonic energy to a nerve region; and

wherein the processor is configured to control the transducer to deliver the ultrasonic energy to a plurality of locations that are offset from an axis of the blood vessel.

10. The system of claim 9, wherein the processor is configured to obtain the first signal from a fiducial located inside the blood vessel.

11. The system of claim 9, wherein the processor is configured to adjust the delivery of the ultrasonic energy by changing a position of a focal point of the ultrasonic energy.

12. The system of claim 9, wherein the processor is configured to control the transducer to deliver the ultrasonic energy to a first nerve that is at a first side of the blood vessel, and the processor is configured to control the transducer to deliver another ultrasonic energy to a second nerve at a second side of the blood vessel.

13. The system of claim 9, wherein the processor is configured to control the transducer to create a heat zone having an annular configuration.

14. The system of claim 9, wherein the transducer is configured to deliver the ultrasonic energy to a first nerve in the nerve region by aiming a focal point of the ultrasonic energy away from the reference location in the blood vessel.

15. The system of claim 9, wherein the first signal comprises a Doppler flow signal.

16. The system of claim 9, wherein the processor is configured to execute a treatment plan to control the transducer to deliver the ultrasonic energy through a path from an external position posterior to the patient, the path being prescribed by the treatment plan and intersecting a kidney to which the blood vessel leads while avoiding bone and bowel tissue.

17. The system of claim 9, wherein the plurality of locations are at multiple target regions forming an arrangement that resembles a spherical configuration or ellipsoidal configuration.

18. The system of claim 9, wherein the plurality of locations are at multiple target regions that lie in at least two intersecting imaginary planes and also on a surface of a sphere or an ellipsoid.

19. A treatment system, comprising:

a detector for detecting a doppler flow signal from a blood vessel;

a transducer configured for applying ultrasonic energy from outside a patient'"'"'s body to multiple target regions, one or more of the multiple target regions comprising a nerve region in a torso; and

a processor configured for determining an effect of the ultrasonic energy being applied;

wherein the transducer is configured to apply the ultrasonic energy to a plurality of locations that are offset from an axis of the blood vessel based on the detected doppler flow signal from the blood vessel.

20. The system of claim 19, wherein the processor is configured to execute a treatment plan to control the transducer to apply the ultrasonic energy to tissue on at least two sides of the blood vessel.

21. The system of claim 19, wherein the transducer is configured to apply the ultrasonic energy to create a zone of heat surrounding a lumen of the blood vessel to create an annular region around the lumen of the blood vessel to inhibit nerves surrounding the lumen of the blood vessel.

22. The system of claim 19, wherein the processor is also configured to create a map that represents the effect of the ultrasonic energy.

23. The system of claim 19, wherein the processor is also configured to control the transducer to modify the application of ultrasonic energy using the determined effect of the ultrasonic energy.

24. The system of claim 19, wherein the processor is configured for determining the effect by determining a change in tissue elasticity.

25. The system of claim 19, wherein the effect comprises an increase of temperature, and the processor is configured to determine the effect by determining the increased temperature.

26. The system of claim 19, wherein the processor is also configured for altering an amount of the ultrasonic energy being applied in dependence on the determined effect.

27. The system of claim 19, wherein the multiple target regions form an arrangement that resembles a spherical configuration or ellipsoidal configuration.

28. The system of claim 19, wherein the multiple target regions lie in at least two intersecting imaginary planes and also on a surface of a sphere or an ellipsoid.