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US 9,174,065 B2Granted
Energetic modulation of nerves
AssigneeKona Medical, Inc.
InventorMichael Gertner
Life of this patent
Estimating the term…
Abstract
In some examples, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some examples, different types of energy sources are utilized singly or combined with one another. In some examples, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents or the agents are enhanced by the energy sources.
Claims150
A method of treatment, comprising:
- placing an energy source outside a patient;
- imaging a region inside the patient with ultrasound delivered from outside the patient, the region having a blood vessel with nerves around it, the nerves being parts of an autonomic nervous system;
- identifying a tracking target in the region;
- tracking the tracking target in the region;
- obtaining a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an estimated nerve position relative to the tracking target;
- and
- operating the energy source to deliver treatment energy for treating the nerves inside the patient;
- wherein the act of operating the energy source comprises using the energy source to deliver the treatment energy sequentially from outside the patient to multiple treatment areas corresponding with the defined multiple treatment locations in accordance with the tracking target in the region.
5 more elements
A system for treatment, comprising:
- an energy source for placement outside a patient, wherein the energy source is configured to deliver treatment energy for treating nerves that are parts of an autonomic nervous system inside the patient;
- and
- a processor configured to
- identify a tracking target in a region, the region having a blood vessel with the nerves around it,
- track the tracking target in the region, and
- obtain a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an estimated nerve position relative to the tracking target;
- wherein the energy source is configured to deliver the treatment energy from outside the patient to multiple treatment areas sequentially and in accordance with the tracking target being tracked.
4 more elements
A system to deliver energy from a position outside a skin of a patient to treatment areas adjacent a blood vessel in a region inside the patient, comprising:
- a processor configured to receive image signal, and determine a three dimensional coordinate of the region containing the blood vessel using the image signal;
- and
- an energy source configured to deliver energy from the position outside the skin of the patient to multiple treatment areas sequentially, the multiple treatment areas comprising nerves adjacent the blood vessel;
- wherein the processor is also configured to
- track a tracking target in the region, and
- obtain a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an estimated nerve position relative to the tracking target, and
- control the energy source in accordance with the defined pattern and a position of the tracking target.
4 more elements
A system to deliver energy from a position outside a skin of a patient to a plurality of treatment areas next to a blood vessel comprising:
- a fiducial for placement inside the blood vessel;
- a detection device to detect the fiducial inside the blood vessel;
- a processor configured to
- obtain a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to a tracking target that is based on an estimated nerve position relative to the tracking target, the tracking target comprising the fiducial, and
- track the fiducial using an output of the detection device, wherein the processor is configured to track the fiducial by determining a three dimensional coordinate of the detected fiducial;
- and
- an energy source configured to sequentially transmit energy through the skin to multiple treatment areas at the treatment locations, at least one of the treatment areas having a nerve;
- wherein the processor is configured to operate the energy source in accordance with the defined pattern and the tracked fiducial.
5 more elements
A method to treat hypertension in a patient comprising:
- planning a delivery of energy from outside the patient to multiple treatment areas in a region in the patient, wherein the act of planning results in a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to a tracking target that is based on an assumed nerve position relative to the tracking target;
- tracking the tracking target in the region that includes a blood vessel, wherein the act of tracking the tracking target comprises determining a location of the tracking target in the region;
- and
- delivering energy sequentially to the treatment areas corresponding with the treatment locations from outside a skin of the patient in accordance with the planned delivery and the tracked tracking target, wherein at least some of the energy is delivered to an autonomic nerve in the region that contains the blood vessel.
1 more element
A system to modulate an autonomic nerve in a patient utilizing transcutaneous energy delivery, the system comprising:
- a processor comprising:
- an input for receiving information regarding a tracking target in a region that includes a vessel and a nerve;
- and
- an output for outputting a signal;
- wherein the processor is configured for obtaining a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an assumed nerve position;
- and
- wherein the processor is configured to track the tracking target by determining a position of the tracking target based on the received information;
- a therapeutic energy device comprising:
- a transducer for delivering energy from outside the patient;
- a controller to control an aiming of the transducer using at least the signal from the processor;
- and
- an imaging system coupled to the processor or the therapeutic energy device;
- wherein the therapeutic energy device is configured to sequentially deliver the energy to multiple treatment areas corresponding to the respective multiple treatment locations.
10 more elements
A method to deliver energy from a position outside a skin of a patient to multiple treatment areas inside the patient, comprising:
- placing a device inferior to ribs, superior to an iliac crest, and lateral to a spine;
- using the device to maintain an energy delivery system at a desired position relative to the patient so that the energy delivery system can deliver energy through the skin without traversing bone, wherein the device comprises a mechanism for coupling to a patient support;
- and
- tracking a tracking target in a region inside the patient, and
- obtaining a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an assumed nerve position;
- and
- using the energy delivery system to sequentially deliver energy to the multiple treatment areas in accordance with the defined pattern, at least one of the treatment areas having a probability of including a nerve.
4 more elements
A device for use in a system to deliver focused ultrasound energy, comprising:
- a processing unit configured to
- track a tracking target in a region inside a patient, and
- obtain a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an assumed nerve position;
- an energy delivery system configured to deliver ultrasound energy to multiple treatment areas corresponding to the treatment locations in the region inside the patient, at least one of the treatment areas comprising a nerve;
- a positioning device configured to maintain the energy delivery system at a desired position relative to the patient so that the energy delivery system can deliver energy through a skin without traversing bone, wherein the positioning device comprises a mechanism for coupling to a patient support;
- wherein the positioning device is configured to be placed inferior to ribs, superior to an iliac crest, and lateral to a spine.
3 more elements
A system for treatment, comprising:
- a treatment device configured to deliver energy from outside a patient to a nerve inside the patient;
- a catheter configured for placement inside a vessel, the catheter configured to transmit a signal;
- and
- a processor configured to
- obtain a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the tracking target that is based on an estimated nerve position, the tracking target comprising the vessel, and
- track the tracking target by receiving the signal and determining a reference position in the vessel;
- wherein the treatment device is configured to sequentially deliver the energy to treatment areas corresponding with the treatment locations in accordance with the defined pattern and the tracked tracking target, one of the treatment areas having a probability of including the nerve.
4 more elements
A method of inhibiting a function of a nerve traveling with an artery in a patient, the method comprising:
- tracking the artery to account for movement of the artery, wherein the act of tracking the artery comprises using an external imaging modality to determine a location of the artery;
- obtaining a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the artery that is based on an assumed nerve position;
- and
- sequentially delivering therapeutic energy from the therapeutic energy source through a skin of the patient to multiple treatment areas that are around the artery in accordance with the defined pattern and the tracked artery, one of the treatment areas having a probability of including the nerve.
1 more element
A system to inhibit a function of nerves traveling with a renal artery comprising:
- a detector configured to track the renal artery to account for movement of the renal artery, wherein the detector is configured to communicate with a fiducial placed in the renal artery to determine a location of the renal artery;
- a processor configured to obtain a defined pattern that includes multiple treatment locations, at least one of the multiple treatment locations having a spatial relationship with respect to the renal artery that is based on an assumed nerve position relative to the renal artery;
- and
- an ultrasound component to sequentially deliver therapeutic energy through a skin to multiple treatment areas that comprise nerves around the renal artery in accordance with the defined pattern and the tracked renal artery;
- wherein the processor is configured to execute a modeling algorithm that receives a position of the ultrasound component as a first input, and the location of the renal artery as a second input.
2 more elements
A method to stimulate or inhibit the function of a nerve traveling to or from the kidney comprising:
- identifying an acoustic window at a posterior region of a torso of a patient in which the renal arteries can be visualized;
- transmitting a first energy through the skin of a patient from the posterior region of the patient;
- imaging an arterial region using the first transmitted energy;
- applying a second transmitted energy to the arterial adventitia after the act of imaging, wherein the second transmitted energy is applied sequentially to multiple treatment areas, one of the treatment areas having a probability of including the nerve.
1 more element
Dependencies are inferred from the claim text.