Methods and apparatus for thermally-induced renal neuromodulation
Methods and apparatus are provided for thermally-induced renal neuromodulation. 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. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.
1. A method for thermally-induced renal neuromodulation of a human patient, the method comprising:
intravascularly positioning a thermal apparatus at least proximate to a neural fiber that contributes to renal function;
delivering pulsed energy via the thermal apparatus to modulate a function of the neural fiber via thermal effects; and
intravascularly removing the thermal apparatus from the patient after renal neuromodulation.
2. The method of claim 1 , wherein positioning the thermal apparatus further comprises delivering the thermal apparatus at least proximate to the neural fiber via an intra-to-extravascular approach.
3. The method of claim 1 , wherein delivering the pulsed energy further comprises directly applying pulsed thermal energy to the neural fiber.
4. The method of claim 1 , wherein delivering the pulsed energy further comprises indirectly applying pulsed thermal energy to the neural fiber.
5. The method of claim 1 , wherein delivering the pulsed energy further comprises delivering a pulsed thermal electric field to the neural fiber via at least one electrode.
6. The method of claim 5 , wherein delivering a pulsed thermal electric field to the neural fiber via at least one electrode further comprises delivering the pulsed thermal electric field via at least one wall-contact electrode.
7. The method of claim 1 further comprising monitoring a parameter of at least one of the neural fiber, a non-target tissue or the apparatus during thermally-induced modulation of the function of the neural fiber.
8. The method of claim 7 further comprising controlling the delivery of the pulsed energy in response to the monitored parameter.
9. The method of claim 1 further comprising actively protecting non-target tissue during thermal modulation of the neural fiber.
10. The method of claim 9 , wherein actively protecting the non-target tissue further comprises reducing a degree of thermal damage induced in the non-target tissue.
11. The method of claim 9 , wherein actively protecting the non-target tissue further comprises delivering a thermal fluid to a vicinity of the non-target tissue.
12. The method of claim 9 , wherein actively protecting the non-target tissue further comprises establishing a heat transfer rate discrepancy between the non-target tissue and the neural fiber.
13. The method of claim 1 , wherein delivering the pulsed energy further comprises delivering pulsed high intensity focused ultrasound to the neural fiber.
14. The method of claim 1 , wherein delivering the pulsed energy further comprises heating the neural fiber via the pulsed thermal energy.
15. The method of claim 1 , wherein delivering the pulsed energy further comprises cooling the neural fiber via the pulsed thermal energy.
16. The method of claim 1 , wherein intravascularly positioning a thermal apparatus comprises intravascularly positioning the thermal apparatus within a renal artery proximate to the neural fiber.
17. A method for catheter-based renal denervation, the method comprising:
positioning a catheter having an energy delivery element within a renal artery of a human patient;
delivering pulsed energy via the energy delivery element to reduce renal sympathetic nerve activity; and
removing the catheter from the patient after treatment.