Devices and methods for pulmonary hypertension treatment
The present invention in some embodiments thereof relates to a method for selectively modifying nerve activity without causing substantial damage to non-targeted tissue, comprising introducing a catheter device comprising one or more ultrasonic transceivers to the pulmonary artery lumen, receiving, using the one or more ultrasonic transceivers, echo signals reflected from the non-targeted tissue following emission of ultrasound energy by the one or more transceivers, analyzing the received echo signals to identify at least one of a type and location of the non-targeted tissue relative to the one or more transceivers, and emitting ultrasound energy from the one or more ultrasonic transceivers in accordance with the analysis, to modify nerve activity without substantially damaging the identified non-targeted tissue.
1 . A method for selectively targeting nerve tissue, comprising:
introducing a catheter comprising one or more ultrasonic transceivers to a pulmonary artery lumen;
configuring an operating console of said catheter to activate said catheter to selectively damage nerves that are not coated by myelin, by emitting a field of unfocused ultrasound energy, wherein said emitted field of unfocused ultrasound energy is effective to selectively damage said nerves not coated by myelin at a distance larger than 12 mm from a wall of said pulmonary artery;
producing a temperature profile ranging between 47-57 degrees C. in said nerves by said catheter by emitting said field of unfocused ultrasound energy at frequency, intensity and duration selected to thermally damage said nerves not coated by myelin by said emitted field of unfocused ultrasound energy without causing bronchus constriction;
measuring a body lumen diameter while emitting the field of unfocused ultrasound energy, and
modifying at least one of said frequency, intensity and duration of said ultrasound energy in accordance with the body lumen diameter.
2 . The method according to claim 1 , wherein myelin coated nerves remain substantially undamaged.
3 . The method according to claim 1 , wherein said frequency is between 8-13 MHz, and said intensity is between 35-65 W/cm{circumflex over ( )}2.
4 . The method according to claim 1 , comprising, prior to said introducing, diagnosing a patient with at least one of: pulmonary hypertension, asthma and COPD.
5 . The method according to claim 1 , wherein the body lumen diameter is a bronchus diameter.
6 . The method according to claim 1 , comprising positioning said one or more ultrasonic transceivers away from a wall of said pulmonary artery lumen to allow blood to flow between said transceivers and said wall.
7 . The method according to claim 1 , comprising stabilizing said catheter at a treatment location within said pulmonary artery lumen by anchoring said catheter.
8 . The method according to claim 1 , comprising positioning said catheter within the main pulmonary artery, right pulmonary artery or left pulmonary artery at the vicinity of a bifurcation.
9 . The method according to claim 8 , wherein said positioning is at a location that is least subjected to movement due to heart pulsation.
10 . The method according to claim 8 , comprising anchoring said catheter to a tissue or organ which moves in a synchronized manner to the targeted nerve tissue.
11 . The method according to claim 1 , wherein said emitting comprises targeting sympathetic nerves, nerve segments and/or nerve plexuses which innervate the pulmonary vasculature.
12 . The method according to claim 11 , wherein said nerve plexuses are selected from the group of: a left coronary plexus, a right coronary plexus, a right atrial plexus, a left atrial plexus, a right pulmonary plexus, and a left pulmonary plexus.
13 . The method according to claim 1 , wherein said introducing comprises percutaneously introducing said catheter over a guide wire into the right atrium, via the right ventricle and into the main pulmonary artery.
14 . The method according to claim 1 , wherein said catheter comprises a 4F-11F diameter.
15 . The method according to claim 1 , comprising rotating said catheter axially within said pulmonary artery lumen to treat different circumferential segments of the artery wall.
16 . The method according to claim 1 , wherein said emitting is by 3-6 transceivers, each transceiver facing a different direction, each transceiver comprising a flat emitting surface.
17 . The method according to claim 1 , comprising, prior to said emitting, identifying specific nerves according to their innervating function, and targeting said nerves.
18 . The method according to claim 1 , wherein said method is a method for selectively targeting nerve tissue innervating lung vasculature, and wherein said selected frequency, intensity and duration of said emitted field of unfocused ultrasound energy are selected not to damage myelinated nerves, and without causing damage to tissue of said pulmonary artery wall.
19 . The method of claim 18 , wherein said selectively damage of said nerves not coated by said myelin results with bronchodilation.
20 . The method according to claim 18 , wherein said selected frequency, intensity and duration of said emitted field of unfocused ultrasound energy are selected not to damage a lung, a trachea and/or bronchi.
21 . The method of claim 1 , wherein said emitting comprises emitting said field of unfocused ultrasound energy to cover a sector of a cross section of the pulmonary artery having a central angle between 20 degrees and 180 degrees.
22 . A method for selectively targeting nerve tissue, comprising:
introducing a catheter comprising one or more ultrasonic transceivers to a pulmonary artery lumen;
configuring an operating console of said catheter to activate said catheter to selectively damage nerves that are not coated by myelin, by emitting a field of unfocused ultrasound energy;
producing a temperature profile ranging between 47-57 degrees C. in said nerves by said catheter by emitting said field of unfocused ultrasound energy at frequency, intensity and duration selected to selectively thermally damage nerves not coated by myelin, and not to substantially damage nerves coated by myelin, and without causing bronchus constriction;
measuring a body lumen diameter while emitting the field of unfocused ultrasound energy; and
modifying at least one of said frequency, intensity and duration of said ultrasound energy, in accordance with the body lumen diameter, to thermally damage the nerves not coated by myelin while not damaging the non-targeted tissue.