External Autonomic Modulation
In some embodiments, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some embodiments, different types of energy sources are utilized singly or combined with one another. In some embodiments, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents.
1 ) A method to inhibit the function of a renal nerve comprising:
a. Introducing an intravascular catheter into a renal artery;
b. Applying vibrational energy, from the catheter, in an unfocused manner, to at least a portion of the circumference of the artery sufficient to at least inhibit a partial function of a renal nerve.
2 ) A method to at least partially inhibit the function of a renal nerve comprising:
a. Introducing an intravascular catheter into a renal artery;
b. Stabilizing the catheter in the renal artery;
c. Determining the size of the renal artery;
d. Modeling the transfer of vibrational power from the catheter inside the artery to the region outside the artery and determining the appropriate power required to the catheter to reach a level outside the artery to inihibit nerve function;
e. Applying vibrational power from inside the artery to the region outside the artery at the appropriate pre-determined power level.
3 ) The method of claim 2 wherein the vibrational power outside the artery is in the range from 20 mW/cm2 to 500 W/cm2.
4 ) The method of claim 1 further comprising: stabilizing the catheter within the artery and approximating the distance to the renal nerves outside the artery based on one of: angiography, ultrasound, CT scan, MRI.
5 ) The method of claim 1 further comprising introducing a cooling lumen or independent cooling catheter into the artery.
6 ) The method of claim 1 wherein the energy transmitting element does not contact the arterial wall.
7 ) A method to inhibit the function of a renal nerve comprising:
a. Introducing an intravascular catheter into an aorta;
b. Applying energy, from the catheter, in an unfocused manner, to at least a portion of the circumference of the aorta to affect the function of nerves traveling to the kidney.
8 ) The method of claim 7 further comprising cooling the region immediately adjacent the intravascular catheter during inhibition of the renal nerve function.
9 ) The method of claim 7 wherein the intravascular catheter is placed into the ostium of at least one of the renal arteries.
10 ) A method to stimulate or inhibit the function of a nerve traveling to or from the kidney comprising:
a. Identifying an acoustic window at the posterior region of a patient in which the renal arteries can be visualized;
b. transmitting a first energy through the skin of a patient from the posterior region of the patient;
c. imaging an arterial region using the first transmitted energy;
d. applying a second transmitted energy to the arterial adventitia by coupling the imaging and the second transmitted energy.
11 . The method of claim 10 further comprising: tracking the image created by the first transmitted energy.
12 . A method to locate the position of a blood vessel in the body of a patient comprising:
Applying a first wave of ultrasound, from a first direction, to a region of a blood vessel from outside of the patient and detecting its return signal;
Comparing the applied first wave and its return signal;
Simultaneously, or sequentially, applying a second wave of ultrasound from a second direction to the blood vessel and detecting a its return signal;
Integrating the return signals from the first wave and the return signals from the second wave to determine the position, in a three dimensional coordinate reference, of the blood vessel.
13 . The method of claim 12 further comprising the step of instructing a therapeutic ultrasound transducer to apply energy to the position of the blood vessel.