Renal neuromodulation for treatment of patients

• US 9,743,983 B2
• Filed: 03/14/2016
• Issued: 08/29/2017
• Est. Priority Date: 04/08/2002
• Status: Expired due to Term

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Levin, Howard R., Gelfand, Mark
• Primary Examiner(s): MAHMOOD, NADIA AHMAD
• Application Number:
  US15/069,636
• Publication Number:
  US 20170007319A1
• Time in Patent Office: 533 Days
• Field of Search: 607 2, 607 17, 607101, 607116, 607118
• 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 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• 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 2018/00577 Ablation
• CPC Class Codes: A61M 1/3627 Degassing devices; Buffer reservoirs; Drip chambers; Blood filters
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/142 Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• 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 1/05 for implantation or insertion into the body, e.g. heart electrode A61N1/06 takes precedence
• 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 1/36125 Details of circuitry or electric components
• CPC Class Codes: A61N 1/36135 using physiological parameters
• CPC Class Codes: A61N 1/3627 for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy
• CPC Class Codes: A61N 1/40 : Applying electric fields by inductive or capacitive coupling microwave apparatus A61N5/00; Applying radio-frequency signals
• CPC Class Codes: A61N 1/403 : for thermotherapy, e.g. hyperthermia
• CPC Class Codes: A61N 5/00 : Radiation therapy ultrasound therapy A61N7/00; devices or apparatus applicable to both therapy and diagnosis A61B6/00

Abstract

A method and apparatus for treatment of heart failure, hypertension and renal failure by stimulating the renal nerve. The goal of therapy is to reduce sympathetic activity of the renal nerve. Therapy is accomplished by at least partially blocking the nerve with drug infusion or electrostimulation. Apparatus can be permanently implanted or catheter based.

Claims

1. A method of treating a disease of a human patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, impaired renal function, or chronic renal failure, the method comprising:

positioning an energy transfer device within a renal blood vessel and in a vicinity of post-ganglionic neural fibers that innervate a kidney of the patient; and

thermally modulating the neural fibers with the device,

wherein thermally modulating the neural fibers results in a therapeutically beneficial reduction in blood pressure of the patient.

2. The method of claim 1 wherein thermally modulating the neural fibers with the device comprises thermally modulating one or more afferent neural fibers.

3. The method of claim 1 wherein thermally modulating the neural fibers with the device comprises thermally modulating one or more efferent neural fibers.

4. The method of claim 1 wherein thermally modulating the neural fibers with the device comprises at least partially ablating at least one of an efferent neural fiber and an afferent neural fiber with the device.

5. The method of claim 1 wherein thermally modulating the neural fibers comprises reducing neural activity along the neural fibers with the device within the renal blood vessel.

6. The method of claim 5 wherein reducing neural activity along the neural fibers with the device from within the renal blood vessel comprises reducing afferent neural activity along the neural fibers.

7. The method of claim 5 wherein reducing neural activity across the neural fibers with the device from within the renal blood vessel comprises reducing efferent neural activity across the neural fibers.

8. A method of treating a disease of a human patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, impaired renal function, or chronic renal failure, the method comprising:

intravascularly delivering a device within a renal blood vessel and in a vicinity of a post-ganglionic neural fiber that innervates a kidney of the patient; and

thermally inducing modulation of the neural fiber with the device,

wherein thermally inducing modulation results in a therapeutically beneficial reduction in blood pressure of the patient.

9. A method of treating a disease of a human patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, impaired renal function, or chronic renal failure, the method comprising:

intravascularly delivering a device within a renal blood vessel and adjacent to efferent and afferent neural fibers transmitting signals to and from a kidney of the patient; and

thermally affecting the neural fibers via the device to reduce neural communication along the neural fibers,

wherein reducing neural communication along the neural fibers results in a therapeutically beneficial reduction in central sympathetic nervous system overactivity in the patient.

10. A method for treatment of a human patient via renal denervation, the method comprising:

introducing a renal denervation catheter into a renal artery and proximate to a renal nerve of the patient, wherein the renal denervation catheter is intravascularly introduced into the renal artery via a femoral artery and aorta of the patient; and

at least partially ablating the renal nerve of the patient via an energy delivery element carried by the renal denervation catheter,

wherein at least partially ablating the renal nerve results in a therapeutically beneficial reduction in central sympathetic nervous system overactivity of the patient.

11. The method of claim 10 wherein at least partially ablating the renal nerve comprises reducing afferent neural signals along the renal nerve.

12. The method of claim 10 wherein at least partially ablating the renal nerve comprises reducing efferent neural signals along the renal nerve.

13. The method of claim 10 wherein the therapeutically beneficial reduction in central sympathetic nervous system overactivity comprises a reduction in clinical symptoms of hypertension in the patient.

14. The method of claim 10 wherein the therapeutically beneficial reduction in central sympathetic nervous system overactivity comprises a reduction in clinical symptoms of heart failure in the patient.

15. A method of treating a disease of a human patient diagnosed with at least one of heart failure, hypertension, acute myocardial infarction, impaired renal function, or chronic renal failure, the method comprising:

intravascularly positioning an energy transfer device within a renal artery and in a vicinity of post-ganglionic neural fibers adjacent the renal artery that innervate a kidney of the patient; and

thermally modulating the neural fibers with the energy transfer device,

wherein thermally modulating the neural fibers results in a therapeutically beneficial reduction in blood pressure of the patient.

16. The method of claim 15 wherein thermally modulating the neural fibers with the energy transfer device comprises thermally modulating one or more afferent neural fibers.

17. The method of claim 15 wherein thermally modulating the neural fibers with the energy transfer device comprises thermally modulating one or more efferent neural fibers.

18. The method of claim 15 wherein thermally modulating the neural fibers with the energy transfer device comprises ablating at least one of an efferent neural fiber and an afferent neural fiber with the device.

19. The method of claim 15 wherein thermally modulating the neural fibers with the energy transfer device comprises reducing afferent neural activity along the neural fibers.

20. The method of claim 15 wherein thermally modulating the neural fibers with the energy transfer device comprises reducing efferent neural activity along the neural fibers.

21. The method of claim 15 wherein the energy transfer device comprises a plurality of electrodes, and wherein thermally modulating the neural fibers with the energy transfer device comprises delivering radio frequency (RF) energy to the neural fibers via one or more electrodes.