ENERGETIC MODULATION OF NERVES

• US 20120109018A1
• Filed: 04/20/2011
• Published: 05/03/2012
• 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, Perozek, David, Zhang, Jimin, Sabet, Arash
• Granted Patent: US 9,119,951 B2
• Time in Patent Office: Days
• US Class Current: 601/2
• CPC Class Codes: A61B 2017/00106 ultrasonic
• 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 6/506 for diagnosis of nerves
• 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 8/44 Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
• 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 2007/003 Destruction of nerve tissue
• CPC Class Codes: A61N 2007/0078 with multiple treatment transducers
• CPC Class Codes: A61N 2007/0095 by modifying an excitation signal
• 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

A system for applying high intensity ultrasound energy to a nerve surrounding an artery of a patient includes a piezoelectric array comprising a plurality of ultrasound elements, a controller configured to individually control a phasing of each of the ultrasound elements, a platform on which the ultrasound elements are coupled, wherein the platform is configured to support at least a part of the patient, a programmable generator configured to generate an output power for at least one of the ultrasound elements, and a programmable processor configured to process a signal transmitted from one of the ultrasound elements and reflected back from tissue, and determine a tissue characteristic based on the reflected signal.

Claims

1. A system for applying high intensity ultrasound energy to a nerve surrounding an artery of a patient comprising:

a piezoelectric array comprising a plurality of ultrasound elements;

a controller configured to individually control a phasing of each of the ultrasound elements;

a platform on which the ultrasound elements are coupled, wherein the platform is configured to support at least a part of the patient;

a programmable generator configured to generate an output power for at least one of the ultrasound elements; and

a programmable processor configured to process a signal transmitted from one of the ultrasound elements and reflected back from tissue, and determine a tissue characteristic based on the reflected signal.

2. The system of claim 1, wherein a first one of the ultrasound elements is configured to generate the signal, and a second one of the ultrasound elements is configured to sense the signal after it has been reflected from the tissue.

3. The system of claim 1, wherein one of the ultrasound elements is configured to generate the signal, and to sense the signal after it has been reflected from the tissue.

4. The system of claim 1, wherein the platform is compatible in a magnetic field.

5. The system of claim 4, wherein the magnetic field is a permanent magnetic field with a field strength less than 1.0 Tesla.

6. The system of claim 1, wherein one of the ultrasound elements is optimized to receive signals from a depth of greater than 8 cm.

7. The system of claim 1, wherein the controller is configured to control a phasing of each of the ultrasound elements based at least in part on the determined tissue characteristic.

8. The system of claim 1, wherein the ultrasound generating elements are programmable to focus therapeutic ultrasound energy at a target in the patient greater than 7 cm from a skin of the patient.

9. The system of claim 1, further comprising a processor coupled to the piezoelectric array, wherein the processor is configured to determine a speed of blood, a direction of blood flow, or both.

10. The system of claim 1, further comprising a mechanical motion actuator configured to mechanically move the piezoelectric array relative to a target within the patient.

11. The system of claim 10, wherein the mechanical motion actuator comprises a ball in socket mechanism.

12. The system of claim 11, wherein the mechanical motion actuator further comprises a locking mechanism.

13. The system of claim 1, wherein at least one of the ultrasound elements is configured to receive an ultrasound signal from an intravascular piezoelectric element.

14. The system of claim 13, further comprising a processor configured to determine an acoustic parameter based at least in part on the ultrasound signal.

15. A system for ablating nerves surrounding a blood vessel comprising:

a first ultrasound transducer configured to apply therapeutic energy across a blood vessel to heat nerves on both sides of the blood vessel;

a second ultrasound transducer configured to receive reflected energy resulted an energy pulse from the first ultrasound transducer; and

a processor configured to

receive first reflected energy data from the second ultrasound transducer at a first time point,

receive second reflected energy data from the second ultrasound transducer at a second time point,

compare the first reflected energy data with the second reflected energy data, and

provide an output signal to a mover to control a position of the first ultrasound transducer.

16. The system of claim 15, further comprising the mover, wherein the mover is inside of a table, and the table is configured to support a patient while allowing the first ultrasound transducer to couple to the patient.

17. The system of claim 15, further comprising the mover, wherein the mover comprises a ball and socket mechanism.

18. The system of claim 17, wherein the ball and socket mechanism is lockable.

19. The system of claim 17, wherein the ball and socket mechanism comprises a vacuum lock mechanism.

20. The system of claim 17, wherein the ball and socket mechanism is moveable along a plane.

21. The system of claim 20, wherein the ball and socket mechanism is lockable along the plane with a vacuum mechanism.

22. A method to treat a blood vessel and surrounding nerve comprising:

identifying a region around the blood vessel to define a target zone;

aiming a focal point of a focused ultrasound system towards the target zone, wherein the aiming is performed with respect to a three dimensional coordinate frame;

detecting movement of the target zone relative to the focused ultrasound system; and

determining a quality factor related to a relative degree of movement of the target zone relative to the focal point of the focused ultrasound system.

23. The method of claim 22, wherein the quality factor is determined by a percentage of time the focal point is within the target zone.

24. The method of claim 22, further comprising determining a dosing plan for the focused ultrasound system.

25. The method of claim 24, further comprising modifying the dosing plan based at least in part on the quality factor.

26. The method of claim 24, wherein the dosing plan defines a treatment cloud around the blood vessel.

27. The method of claim 26, wherein the treatment cloud is substantially uniform with respect to the vessel.

28. The method of claim 22, wherein the target zone movement is detected by detecting a Doppler flow signal.

29. The method of claim 22, wherein the quality factor is about 90%.

30. The method of claim 22, wherein the quality factor is about 50%.

31. The method of claim 22, wherein the quality factor is anywhere from 50% to 90%.