CA2655099A1 - Methods and apparatus for multi-vessel renal neuromodulation - Google Patents
Methods and apparatus for multi-vessel renal neuromodulation Download PDFInfo
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- CA2655099A1 CA2655099A1 CA002655099A CA2655099A CA2655099A1 CA 2655099 A1 CA2655099 A1 CA 2655099A1 CA 002655099 A CA002655099 A CA 002655099A CA 2655099 A CA2655099 A CA 2655099A CA 2655099 A1 CA2655099 A1 CA 2655099A1
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Abstract
Methods and apparatus are provided for multi-vessel neurornodulation, e.g., via a pulsed electric field. Such multi-vessel neurornodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up- regulation and other conditions in target neural fibers. In some embodiments, the multi-vessel neuromodulation is applied to neural fibers that contribute to renal function. Such multi-vessel neuromodulation optionally may be performed bilaterally.
Claims (33)
1. A method for multi-vessel renal neuromodulation of a patient, the method comprising:
placing a first electrode in a first vessel of a patient in proximity to a neural fiber that contributes to a function of a kidney of the patient;
placing a second electrode in a second vessel of the patient, wherein the second vessel is a different vessel than the first vessel; and passing electrical current through the first electrode and the second electrode to modulate the function of the neural fiber.
placing a first electrode in a first vessel of a patient in proximity to a neural fiber that contributes to a function of a kidney of the patient;
placing a second electrode in a second vessel of the patient, wherein the second vessel is a different vessel than the first vessel; and passing electrical current through the first electrode and the second electrode to modulate the function of the neural fiber.
2. The method of claim 1 wherein passing electrical current through the first and second electrodes comprises creating an electric field between the first and second electrodes.
3. The method of claim 1 wherein passing electrical current through the first and second electrodes comprises creating a first electric field between the first electrode and a remote electrode and a second electric field between the second electrode and the remote electrode.
4. The method of claim 3 wherein the first and second electric fields are created simultaneously.
5. The method of claim 3 wherein the first and second electric field are created sequentially.
6. The method of claim 1 wherein passing electrical current through the first and second electrodes comprises creating a first electric field between the first electrode and a first remote electrode in the first vessel and a second electric field between the second electrode and a second remote electrode in the second vessel.
7. The method of claim 6 wherein the first and second electric fields are created simultaneously.
8. The method of claim 6 wherein the first and second electric fields are created sequentially.
9. The method of claim 1, wherein passing electrical currentfurther comprises passing pulsed electrical current.
10. The method of claim 1, wherein modulating the function of the neural fiber further comprises at least partially denervating the kidney.
11. The method of claim 1, wherein modulating the function of the neural fiber further comprises inducing an effect in the neural fiber chosen from the group consisting of irreversible electroporation, electrofusion, necrosis, apoptosis, gene expression alteration, cytokine up-regulation alteration, and combinations thereof.
12. The method of claim 1, wherein modulating the function of the neural fiber further comprises thermally modulating the function of the neural fiber.
13. The method of claim 1, wherein modulating the function of the neural fiber further comprises, on average during passage of the electrical current, modulating the function of the neural fiber substantially athermally.
14. The method of claim 1, wherein modulating the function of the neural fiber further comprises treating a medical condition afflicting the patient.
15. The method of claim 14, wherein treating the medical condition afflicting the patient further comprises treating a medical condition chosen from the group consisting of heart failure, hypertension, myocardial infarction, renal disease, contrast nephropathy and combinations thereof.
16. The method of claim 1, wherein placing the first electrode in the first vessel further comprises placing the first electrode in a first vessel of a renal vasculature of the patient.
17. The method of claim 16, wherein placing the second electrode in the second vessel further comprises placing the second electrode in a second vessel of the renal vasculature of the patient, the second vessel being a different vessel of the renal vasculature than the first vessel.
18. The method of claim 17, wherein placing the second electrode in the second vessel of the renal vasculature of the patient further comprises placing the second electrode in a second vessel branching of the renal vasculature.
19. The method of claim 1, wherein placing the first electrode in the first vessel and the second electrode in the second vessel further comprises placing the first electrode and the second electrode in different vessels of the patient chosen from the group consisting of a renal artery, renal artery branchings, a renal vein, renal vein branchings, an inferior vena cava, an abdominal aorta, renal vasculature, venous vasculature, arterial vasculature, and combinations thereof.
20. The method of claim 1 further comprising altering impedance in the first vessel or the second vessel before passage of the electrical current.
21. The method of claim 20, wherein altering impedance further comprises temporarily altering blood flow within the first vessel or the second vessel.
22. The method of claim 1, wherein passing the electrical current further comprises preferentially aligning the electrical current with a longitudinal dimension of the neural fiber.
23. The method of claim 22, wherein aligning the electrical currentfurther comprises placing the first electrode and placing the second electrode such that the first electrode and the second electrode are spaced apart from one another about a lengthwise dimension of the neural fiber.
24. The method of claim 1 further comprising monitoring a change in a renal catecholamine spillover in response to the passage of the electrical current.
25. A method for a renal neuromodulation of a patient, the method comprising:
placing a first electrode within a first vessel of a patient at least substantially proximate to a neural fiber that contributes to a function of a kidney of the patient;
placing a second electrode within a second vessel of the patient, wherein the second vessel is a different vessel than the first vessel; and delivering an electric field between the first electrode and the second electrode such that the resulting electric field is generally aligned with a longitudinal axis of a renal artery associated with the kidney, thereby modulating the function of the neural fiber.
placing a first electrode within a first vessel of a patient at least substantially proximate to a neural fiber that contributes to a function of a kidney of the patient;
placing a second electrode within a second vessel of the patient, wherein the second vessel is a different vessel than the first vessel; and delivering an electric field between the first electrode and the second electrode such that the resulting electric field is generally aligned with a longitudinal axis of a renal artery associated with the kidney, thereby modulating the function of the neural fiber.
26. The method of claim 25, wherein placing the first electrode within the first vessel and the second electrode within the second vessel further comprises placing the first electrode and the second electrode in different vessels of the patient chosen from the group consisting of the renal artery, renal artery branchings, a renal vein, renal vein branchings, an inferior vena cava, an abdominal aorta, renal vasculature, venous vasculature, arterial vasculature, and combinations thereof.
27. The method of claim 25 further comprising monitoring a change in a renal catecholamine spillover in response to the delivery of the electric field.
28. Apparatus for performing renal neuromodulation of a patient, the apparatus comprising:
an electric field generator;
a first element configured for placement within a first vessel of the patient, the first element comprising a first electrode electrically coupled to the electric field generator; and a second element configured for placement within a second vessel of the patient that is different than the first vessel, the second element comprising a second electrode electrically coupled to the electric field generator, wherein the apparatus is configured for delivery of an electric field between the first electrode and the second electrode to modulate a neural fiber that contributes to renal function while the first device is located within the first vessel and the second device is located within the second vessel.
an electric field generator;
a first element configured for placement within a first vessel of the patient, the first element comprising a first electrode electrically coupled to the electric field generator; and a second element configured for placement within a second vessel of the patient that is different than the first vessel, the second element comprising a second electrode electrically coupled to the electric field generator, wherein the apparatus is configured for delivery of an electric field between the first electrode and the second electrode to modulate a neural fiber that contributes to renal function while the first device is located within the first vessel and the second device is located within the second vessel.
29. The apparatus of claim 28, wherein the first element or the second element comprises a positioning element.
30. The apparatus of claim 29, wherein the positioning element is configured to alter impedance within a vessel of the patient.
31. The apparatus of claim 28, wherein the apparatus is configured for monopolar delivery of the electric field between the first electrode or the second electrode and a ground pad positioned external to the patient.
32. The apparatus of claim 28 further comprising an element for monitoring alteration of a renal catecholamine spillover in response to delivery of the electric field.
33. The apparatus of claim 28 wherein the electric field is a pulsed electric field.
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US11/451,728 | 2006-06-12 | ||
US11/451,728 US7853333B2 (en) | 2002-04-08 | 2006-06-12 | Methods and apparatus for multi-vessel renal neuromodulation |
PCT/US2007/070799 WO2007146834A2 (en) | 2006-06-12 | 2007-06-08 | Methods and apparatus for multi-vessel renal neuromodulation |
Publications (1)
Publication Number | Publication Date |
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CA2655099A1 true CA2655099A1 (en) | 2007-12-21 |
Family
ID=38832729
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002655099A Abandoned CA2655099A1 (en) | 2006-06-12 | 2007-06-08 | Methods and apparatus for multi-vessel renal neuromodulation |
Country Status (7)
Country | Link |
---|---|
US (8) | US7853333B2 (en) |
EP (2) | EP3205305B1 (en) |
JP (1) | JP5437063B2 (en) |
CN (2) | CN105079962A (en) |
CA (1) | CA2655099A1 (en) |
ES (1) | ES2751912T3 (en) |
WO (1) | WO2007146834A2 (en) |
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EP3205305A1 (en) | 2017-08-16 |
CN101489624A (en) | 2009-07-22 |
EP2029223B1 (en) | 2019-07-31 |
US7853333B2 (en) | 2010-12-14 |
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CN105079962A (en) | 2015-11-25 |
US20150025603A1 (en) | 2015-01-22 |
WO2007146834A2 (en) | 2007-12-21 |
EP3205305B1 (en) | 2021-11-17 |
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