公开(公告)号：US08934978B2

公开(公告)日：2015-01-13

申请号：US14258802

申请日：2014-04-22

申请人： Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

发明人： Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

IPC分类号： A61B18/12 ,  A61B18/14 ,  A61M5/14 ,  A61N1/04 ,  A61N1/05 ,  A61N1/32 ,  A61N1/36 ,  A61B18/18 ,  A61N5/00 ,  A61B18/00 ,  A61N7/00

CPC分类号： A61N1/36007 ,  A61B8/0891 ,  A61B8/12 ,  A61B18/1206 ,  A61B18/1233 ,  A61B18/1492 ,  A61B18/18 ,  A61B2018/00071 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00904 ,  A61B2018/126 ,  A61B2018/1467 ,  A61M5/14 ,  A61M25/0023 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/18 ,  A61N1/205 ,  A61N1/326 ,  A61N1/327 ,  A61N1/36017 ,  A61N1/36057 ,  A61N1/3606 ,  A61N1/36103 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36139 ,  A61N5/00 ,  A61N7/00 ,  A61N2007/0021 ,  A61N2007/003

摘要： Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

公开(公告)号：US08774922B2

公开(公告)日：2014-07-08

申请号：US13898830

申请日：2013-05-21

申请人： Denise Zarins ,  Hanson Gifford, III ,  Mark Deem ,  Douglas Sutton ,  Howard R. Levin ,  Mark Gelfand

发明人： Denise Zarins ,  Hanson Gifford, III ,  Mark Deem ,  Douglas Sutton ,  Howard R. Levin ,  Mark Gelfand

IPC分类号： A61N1/00

CPC分类号： A61B18/12 ,  A61B18/04 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00648 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61N1/0551 ,  A61N1/36117 ,  A61N7/00 ,  A61N2007/003

摘要： Methods and apparatus are provided for treating contrast nephropathy, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation 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, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

摘要翻译： 提供了方法和装置，例如通过脉冲电场，经由刺激电场，经由局部药物递送，经由高频超声波，通过热技术等来治疗对比肾病。这种神经调节可以实现不可逆的电穿孔或电融合，坏死 和/或诱导细胞凋亡，改变基因表达，动作电位减弱或阻断，细胞因子上调和靶神经纤维中的其他条件的变化。 在一些实施方案中，神经调节被应用于有助于肾功能的神经纤维。 在一些实施方案中，这种神经调节以双向方式进行。 与单侧执行的肾神经调节相比，双侧肾神经调节可以在一些患者中提供增强的治疗效果，即与在支配单个肾脏的神经组织上进行的肾神经调节相比。

公开(公告)号：US20120116382A1

公开(公告)日：2012-05-10

申请号：US13281360

申请日：2011-10-25

申请人： Vincent Ku ,  Robert Beetel ,  Andrew Wu ,  Denise Zarins ,  Maria G. Aboytes

发明人： Vincent Ku ,  Robert Beetel ,  Andrew Wu ,  Denise Zarins ,  Maria G. Aboytes

IPC分类号： A61B18/18

CPC分类号： A61B18/1492 ,  A61B2018/00023 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/1435 ,  A61B2018/1467 ,  A61M25/0041 ,  A61M25/0074 ,  A61M25/0133 ,  A61M25/0138 ,  A61M25/0147

摘要： Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present technology, for example, is directed to a treatment device having a multi-electrode array configured to be delivered to a renal blood vessel. The array is selectively transformable between a delivery or low-profile state (e.g., a generally straight shape) and a deployed state (e.g., a radially expanded, generally helical shape). The multi-electrode array is sized and shaped so that the electrodes or energy delivery elements contact an interior wall of the renal blood vessel when the array is in the deployed (e.g., helical) state. The electrodes or energy delivery elements are configured for direct and/or indirect application of thermal and/or electrical energy to heat or otherwise electrically modulate neural fibers that contribute to renal function or of vascular structures that feed or perfuse the neural fibers.

公开(公告)号：US20140107539A1

公开(公告)日：2014-04-17

申请号：US14081634

申请日：2013-11-15

申请人： Denise Zarins ,  Hanson Gifford, III

发明人： Denise Zarins ,  Hanson Gifford, III

IPC分类号： A61B18/14 ,  A61N7/02 ,  A61F7/00 ,  A61M5/00 ,  A61N1/05

CPC分类号： A61M25/0084 ,  A61B17/3478 ,  A61B18/04 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61K38/4893 ,  A61M5/00 ,  A61M2025/0085 ,  A61M2202/0007 ,  A61M2210/1082 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/32 ,  A61N1/36017 ,  A61N1/36114 ,  A61N7/02 ,  C12Y304/24069

摘要： Methods and apparatus are provided for treatment of heart arrhythmia via renal neuromodulation. Such neuromodulation may effectuate irreversible electroporation or electrofusion, ablation, 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, such neuromodulation is achieved through application of an electric field. In some embodiments, such neuromodulation is achieved through application of neuromodulatory agents, of thermal energy and/or of high intensity focused ultrasound. In some embodiments, such neuromodulation is performed in a bilateral fashion.

摘要翻译： 提供了通过肾脏神经调节治疗心律失常的方法和装置。 这种神经调节可以实现不可逆的电穿孔或电融合，消融，坏死和/或诱导凋亡，基因表达的改变，动作电位衰减或阻断，细胞因子上调和靶神经纤维中的其他条件的变化。 在一些实施例中，通过施加电场来实现这种神经调节。 在一些实施方案中，通过应用神经调节剂，热能和/或高强度聚焦超声来实现这种神经调节。 在一些实施方案中，这种神经调节以双向方式进行。

公开(公告)号：US20120143293A1

公开(公告)日：2012-06-07

申请号：US13281395

申请日：2011-10-25

申请人： Kevin Mauch ,  Mario Alvarado ,  Robert Beetel ,  William Chang ,  Justin Goshgarian ,  Leonila Rivera ,  Sukyoung Shin ,  Michele Silver ,  Sina Som ,  Andrew Wu ,  Denise Zarins ,  Juanita Sanchez-Cole ,  Maria G. Aboytes

发明人： Kevin Mauch ,  Mario Alvarado ,  Robert Beetel ,  William Chang ,  Justin Goshgarian ,  Leonila Rivera ,  Sukyoung Shin ,  Michele Silver ,  Sina Som ,  Andrew Wu ,  Denise Zarins ,  Juanita Sanchez-Cole ,  Maria G. Aboytes

IPC分类号： A61N1/18 ,  A61F7/12

CPC分类号： A61B18/1492 ,  A61B2018/00023 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/1435 ,  A61B2018/1467 ,  A61M25/0041 ,  A61M25/0074 ,  A61M25/0133 ,  A61M25/0138 ,  A61M25/0147

摘要： Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present technology, for example, is directed to a treatment device having a multi-electrode array configured to be delivered to a renal blood vessel. The array is selectively transformable between a delivery or low-profile state (e.g., a generally straight shape) and a deployed state (e.g., a radially expanded, generally helical shape). The multi-electrode array is sized and shaped so that the electrodes or energy delivery elements contact an interior wall of the renal blood vessel when the array is in the deployed (e.g., helical) state. The electrodes or energy delivery elements are configured for direct and/or indirect application of thermal and/or electrical energy to heat or otherwise electrically modulate neural fibers that contribute to renal function or of vascular structures that feed or perfuse the neural fibers.

公开(公告)号：US09326817B2

公开(公告)日：2016-05-03

申请号：US14556766

申请日：2014-12-01

申请人： Denise Zarins ,  Hanson Gifford, III

发明人： Denise Zarins ,  Hanson Gifford, III

IPC分类号： A61B18/14 ,  A61N1/05 ,  A61N1/32 ,  A61N1/36 ,  A61F7/00 ,  A61M5/00 ,  A61N7/02 ,  A61B18/04 ,  A61B18/00

CPC分类号： A61M25/0084 ,  A61B17/3478 ,  A61B18/04 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61K38/4893 ,  A61M5/00 ,  A61M2025/0085 ,  A61M2202/0007 ,  A61M2210/1082 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/32 ,  A61N1/36017 ,  A61N1/36114 ,  A61N7/02 ,  C12Y304/24069

摘要： Methods and apparatus are provided for treatment of heart arrhythmia via renal neuromodulation. Such neuromodulation may effectuate irreversible electroporation or electrofusion, ablation, 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, such neuromodulation is achieved through application of an electric field. In some embodiments, such neuromodulation is achieved through application of neuromodulatory agents, of thermal energy and/or of high intensity focused ultrasound. In some embodiments, such neuromodulation is performed in a bilateral fashion.

公开(公告)号：US20120101413A1

公开(公告)日：2012-04-26

申请号：US13278081

申请日：2011-10-20

申请人： Robert J. Beetel ,  Erik Griswold ,  Denise Zarins ,  Maria G. Aboytes

发明人： Robert J. Beetel ,  Erik Griswold ,  Denise Zarins ,  Maria G. Aboytes

IPC分类号： A61B18/04 ,  A61B18/08 ,  A61B18/14 ,  A61N7/02 ,  A61B18/18 ,  B23P17/04 ,  A61B18/20

CPC分类号： A61B18/1492 ,  A61B18/082 ,  A61B18/24 ,  A61B2018/00029 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00642 ,  A61B2018/00678 ,  A61B2018/00702 ,  A61B2018/00708 ,  A61B2018/00779 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61B2018/00886 ,  A61B2018/1861 ,  A61B2218/002 ,  A61N7/022 ,  A61N2007/003 ,  Y10T29/49826

摘要： Catheter apparatuses having expandable mesh structures and associated systems and methods for intravascular renal neuromodulation are disclosed herein. A catheter treatment device includes an expandable mesh structure configured to position an energy delivery element in contact with a renal artery via an intravascular path. The mesh structure can assume an expanded configuration for direct and/or indirect application of thermal and/or electrical energy to heat or otherwise electrically modulate neural fibers that contribute to renal function. A collapsed configuration may facilitate insertion and/or removal of the catheter or repositioning of the energy delivery element within the renal artery.

摘要翻译： 本文公开了具有可扩张网状结构的导管装置和用于血管内肾神经调节的相关系统和方法。 导管治疗装置包括可扩张网状结构，其构造成通过血管内路径将能量递送元件定位成与肾动脉接触。 网状结构可以采取扩展配置，用于直接和/或间接施加热和/或电能以加热或以其他方式电调节有助于肾功能的神经纤维。 折叠构型可以促进导管的插入和/或移除或能量递送元件在肾动脉内的重新定位。

公开(公告)号：US20110060324A1

公开(公告)日：2011-03-10

申请号：US12910631

申请日：2010-10-22

申请人： Andrew Wu ,  Bejamin J. Clark ,  Denise Zarins ,  Erik Thai

发明人： Andrew Wu ,  Bejamin J. Clark ,  Denise Zarins ,  Erik Thai

IPC分类号： A61B18/04

CPC分类号： A61B18/1492 ,  A61B18/02 ,  A61B18/1206 ,  A61B18/18 ,  A61B18/24 ,  A61B90/39 ,  A61B2017/003 ,  A61B2018/00172 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00648 ,  A61B2018/00791 ,  A61B2018/00875 ,  A61M25/0141 ,  A61N2007/003

摘要： Apparatus, systems, and methods for achieving thermally-induced renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a thermal element to a renal artery via an intravascular path. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

摘要翻译： 本文公开了通过血管内通路实现热诱导的肾神经调节的装置，系统和方法。 本申请的一个方面，例如，涉及包含细长轴的治疗装置的装置，系统和方法。 细长轴的尺寸和构造适于通过血管内路径将热元件输送到肾动脉。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。

公开(公告)号：US20150065945A1

公开(公告)日：2015-03-05

申请号：US14379841

申请日：2013-03-07

申请人： Denise ZARINS ,  MEDTRONIC ARDIAN LUXEMBOURG SARL

发明人： Denise Zarins ,  Sean Ward

IPC分类号： A61B18/14 ,  A61B18/18 ,  A61N7/00 ,  A61K31/475 ,  A61M5/14 ,  A61K31/395 ,  A61K31/045 ,  A61K31/05 ,  A61B18/04 ,  A61B18/02

CPC分类号： A61B18/14 ,  A61B18/02 ,  A61B18/04 ,  A61B18/1492 ,  A61B18/18 ,  A61B18/1815 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/0044 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61B2018/0212 ,  A61B2018/1861 ,  A61K31/045 ,  A61K31/05 ,  A61K31/395 ,  A61K31/475 ,  A61M5/14 ,  A61N7/00 ,  A61N2007/003

摘要： Methods for treating a patient using therapeutic spinal neuromodulation and associated devices, systems, and methods are disclosed herein. One aspect of the present technology is directed to methods including modulating nerves of one or more targeted organs proximate one or more dorsal root ganglia, stellate ganglia, vertebral ganglia, or cervical ganglia of the nerves using an intravascularly-positioned therapeutic element. One or more measurable physiological parameters corresponding to at least one condition associated with sympathetic activity in the targeted organs and/or central sympathetic activity in the patient can thereby be reduced.

摘要翻译： 本文公开了使用治疗性脊髓神经调节和相关装置，系统和方法治疗患者的方法。 本技术的一个方面涉及包括使用血管内定位的治疗元件来调节靠近一个或多个背根神经节，星状神经节，脊髓神经节或神经的子宫颈神经节的一个或多个目标器官的神经的方法。 因此可以减少对应于与目标器官中的交感活性和/或患者的中枢交感活性相关联的至少一种病症的一个或多个可测量的生理参数。

公开(公告)号：US08956352B2

公开(公告)日：2015-02-17

申请号：US13281395

申请日：2011-10-25

申请人： Kevin Mauch ,  Mario Alvarado ,  Robert Beetel ,  William Chang ,  Justin Goshgarian ,  Leonila Rivera ,  Sukyoung Shin ,  Michele Silver ,  Sina Som ,  Andrew Wu ,  Denise Zarins ,  Juanita Sanchez-Cole ,  Maria G. Aboytes

发明人： Kevin Mauch ,  Mario Alvarado ,  Robert Beetel ,  William Chang ,  Justin Goshgarian ,  Leonila Rivera ,  Sukyoung Shin ,  Michele Silver ,  Sina Som ,  Andrew Wu ,  Denise Zarins ,  Juanita Sanchez-Cole ,  Maria G. Aboytes

IPC分类号： A61B18/14 ,  A61B18/04 ,  A61B18/18 ,  A61B18/00 ,  A61M25/00 ,  A61M25/01

CPC分类号： A61B18/1492 ,  A61B2018/00023 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/1435 ,  A61B2018/1467 ,  A61M25/0041 ,  A61M25/0074 ,  A61M25/0133 ,  A61M25/0138 ,  A61M25/0147

摘要： Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present technology, for example, is directed to a treatment device having a multi-electrode array configured to be delivered to a renal blood vessel. The array is selectively transformable between a delivery or low-profile state (e.g., a generally straight shape) and a deployed state (e.g., a radially expanded, generally helical shape). The multi-electrode array is sized and shaped so that the electrodes or energy delivery elements contact an interior wall of the renal blood vessel when the array is in the deployed (e.g., helical) state. The electrodes or energy delivery elements are configured for direct and/or indirect application of thermal and/or electrical energy to heat or otherwise electrically modulate neural fibers that contribute to renal function or of vascular structures that feed or perfuse the neural fibers.

摘要翻译： 本文公开了通过血管内通路实现肾脏神经调节的导管装置，系统和方法。 例如，本技术的一个方面涉及具有被配置为输送到肾血管的多电极阵列的治疗装置。 阵列可以在传送或低轮廓状态（例如，大致直线形状）和展开状态（例如，径向膨胀，大致螺旋形状）之间选择性地变换。 多电极阵列的尺寸和形状使得当阵列处于部署（例如螺旋状态）时，电极或能量递送元件接触肾血管的内壁。 电极或能量输送元件构造成用于直接和/或间接施加热和/或电能以加热或以其他方式电调节有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构。