Methods and Devices for Renal Nerve Blocking

• US 20180303839A1
• Filed: 04/24/2018
• Published: 10/25/2018
• Est. Priority Date: 04/08/2002
• Status: Active Grant

• Current Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Original Assignee: Medtronic Ardian Luxembourg SARL (Medtronic Plc)
• Inventors: Gelfand, Mark, Levin, Howard R.
• Granted Patent: US 10,376,516 B2
• Time in Patent Office: Days
• CPC Class Codes: A61K 31/135 having aromatic rings , e.g. ketamine, nortriptyline methadone A61K31/137
• CPC Class Codes: A61K 31/52 Purines, e.g. adenine
• CPC Class Codes: A61K 31/529 forming part of bridged ring systems
• CPC Class Codes: A61K 45/06 Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• CPC Class Codes: A61K 9/0004 Osmotic delivery systems; Sustained release driven by osmosis, thermal energy or gas
• CPC Class Codes: A61K 9/0012 Galenical forms characterised by the site of application
• CPC Class Codes: A61K 9/7007 Drug-containing films, membranes or sheets A61K9/0041, A61K9/0043, A61K9/006, A61K9/0063 take precedence
• CPC Class Codes: A61L 29/146 Porous materials, e.g. foams or sponges
• CPC Class Codes: A61M 2005/14513 with secondary fluid driving or regulating the infusion
• CPC Class Codes: A61M 2205/05 combined with other kinds of therapy
• CPC Class Codes: A61M 2205/50 with microprocessors or computers
• CPC Class Codes: A61M 2210/1082 Kidney
• CPC Class Codes: A61M 5/14276 specially adapted for implantation
• CPC Class Codes: A61M 5/145 using pressurised reservoirs, e.g. pressurised by means of pistons
• 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 1/0551 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 1/3627 : for treating a mechanical deficiency of the heart, e.g. congestive heart failure or cardiomyopathy

Abstract

Methods for treating a hypertensive human patient are disclosed herein. A method in accordance with one embodiment comprises delivering a neuromodulatory agent to a renal nerve of the patient via an intravascularly positioned drug delivery catheter. The method includes at least partially blocking neural activity along the renal nerve with the neuromodulatory agent, which results in a therapeutically beneficial reduction in blood pressure of the patient.

Claims

1-23. -23. (canceled)

24. A method, comprising:

delivering a neuromodulatory agent to a renal nerve of a hypertensive human patient via an intravascularly positioned drug delivery catheter,

wherein delivering a neuromodulatory agent to the renal nerve comprises delivering the neuromodulatory agent via an intravascular to extravascular approach; and

at least partially blocking neural activity along the renal nerve with the neuromodulatory agent,

wherein at least partially blocking neural activity along the renal nerve results in a therapeutically beneficial reduction in blood pressure of the patient.

25. The method of claim 24 wherein delivering a neuromodulatory agent to a renal nerve of a hypertensive human patient comprises positioning a needle within a periarterial space of the patient and injecting the neuromodulatory agent via the needle into the periarterial space of the patient.

26. The method of claim 25 wherein positioning a needle within a periarterial space of the patient comprises positioning the needle under CT guidance.

27. The method of claim 25 wherein positioning a needle within a periarterial space of the patient comprises positioning a distal tip of the drug delivery catheter within a target site in continuity with a periarterial fat tissue layer surrounding a renal pedicle of the patient.

28. The method of claim 25 wherein positioning a needle within a periarterial space of the patient comprises positioning a distal tip of the drug delivery catheter within renal fascia of the patient.

29. The method of claim 24, further comprising intravascularly delivering the drug delivery catheter through an abdominal aorta to the renal artery of the patient before delivering the neuromodulatory agent.

30. The method of claim 29 wherein intravascularly delivering the drug delivery catheter through an abdominal aorta to the renal artery comprises intravascularly delivering the drug delivery catheter over a guidewire.

31. The method of claim 24, further comprising removing the drug delivery catheter from the patient after delivering the neuromodulatory agent to conclude the procedure.

32. The method of claim 24 wherein delivering a neuromodulatory agent via an intravascularly positioned drug delivery catheter comprises intravascularly positioning the drug delivery catheter within the renal artery under guidance imaging.

33. The method of claim 25 wherein intravascularly positioning the drug delivery catheter within the renal artery under guidance imaging comprises intravascularly positioning the drug delivery catheter within the renal artery under fluoroscopic guidance.

34. The method of claim 24, further comprising determining whether neural activity along the renal nerve has been substantially blocked.

35. The method of claim 34 wherein determining whether neural activity has been substantially blocked comprises electrically stimulating the renal nerve and detecting a response in the patient.

36. The method of claim 24, further comprising monitoring a parameter of the drug delivery catheter and/or tissue within the patient before and during delivery of the neuromodulatory agent.

37. The method of claim 36, further comprising altering delivery of the neuromodulatory agent in response to the monitored parameter.

38. The method of claim 24 wherein at least partially blocking neural activity along the renal nerve comprises at least substantially blocking sympathetic neural activity along the renal nerve of the patient.

39. The method of claim 24 wherein delivering a neuromodulatory agent to a renal nerve of a hypertensive human patient comprises delivering a neurotoxin to the renal nerve of the patient.

40. The method of claim 24 wherein delivering a neuromodulatory agent to a renal nerve of a hypertensive human patient comprises delivering alcohol to the renal nerve of the patient.

41. The method of claim 24 wherein delivering a neuromodulatory agent to a renal nerve of a hypertensive human patient comprises delivering phenol, ketamine, and/or an antidepressant to the renal nerve of the patient.

42. The method of claim 24 wherein at least partially blocking neural activity along the renal nerve with the neuromodulatory agent comprises denervating a kidney of the patient.

43. The method of claim 24 wherein at least partially blocking neural activity along the renal nerve with the neuromodulatory agent comprises ablating the renal nerve via the neuromodulatory agent.

44. The method of claim 24 wherein at least partially blocking neural activity along the renal nerve with the neuromodulatory agent further results in a reduction of systemic sympathetic tone in the patient.