METHODS FOR DELIVERING ENERGY TO MODULATE NEURAL STRUCTURES
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.
1 - 148 . (canceled)
149 . A treatment method, comprising:
providing a therapeutic ultrasonic energy source comprising a transducer outside a patient;
using the transducer to apply ultrasonic energy to a nerve region containing a blood vessel based on a treatment plan that considers minimization of energy delivery to a wall of the blood vessel;
wherein the act of using the transducer comprises operating the transducer to treat tissue in the nerve region on at least two sides of the blood vessel so that the tissue on the at least two sides of the blood vessel receives more therapeutic effect than the blood vessel.
150 . The method of claim 149 , further comprising tracking a motion of the blood vessel.
151 . The method of claim 149 , wherein the tissue in the nerve region on the at least two sides of the blood vessel comprise nerves, and wherein the transducer is operated to create a zone of heat surrounding the blood vessel to create an annular region around the blood vessel to substantially inhibit the nerves surrounding the blood vessel.
152 . The method of claim 149 , wherein the transducer applies power to the nerve region, the power having a value that is anywhere from 100 W/cm 2 to 2500 W/cm 2 .
153 . The method of claim 149 , further comprising positioning the transducer relative to the patient so that regions of bone are avoided by the ultrasonic energy from the transducer.
154 . The method of claim 149 , wherein the nerve region is an autonomic nerve region, and the transducer applies the ultrasonic energy at an energy level to create a reduction in a norepinephrine output of the autonomic nerve region.
155 . The method of claim 149 , further comprising tracking speckles at the nerve region.
156 . The method of claim 149 , further comprising determining a three dimensional coordinate of the blood vessel.
157 . The method of claim 149 , further comprising tracking a doppler ultrasound signal from the blood vessel.
158 . The method of claim 149 , wherein the transducer applies the ultrasonic energy simultaneously to the tissue on the at least two sides of the blood vessel.
159 . The method of claim 149 , further comprising visualizing the blood vessel in the nerve region using an imaging device.
160 . A treatment method, comprising:
providing a therapeutic ultrasonic energy source comprising a transducer at a location outside a patient;
determining a model of an ultrasound delivery, wherein the model considers minimization of energy delivery to a wall of a blood vessel, and
controlling the transducer based on the model to apply ultrasonic energy to autonomic nerves leading to or from a kidney;
wherein the act of controlling transducer comprises tracking a position associated with the autonomic nerves to thereby reduce an amount of energy being delivered to the wall of the blood vessel; and
wherein the ultrasonic energy is applied to treat a first one of the autonomic nerves on a first side of a blood vessel, and to treat a second one of the autonomic nerves on a second sided of the blood vessel.
161 . The method of claim 160 , further comprising adjusting an aiming by the transducer.
162 . The method of claim 161 , wherein the aiming by the transducer is adjusted based on a position of a fiducial located inside the blood vessel.
163 . The method of claim 161 , wherein the aiming by the transducer is adjusted automatically.
164 . The method of claim 161 , wherein the aiming by the transducer is adjusted to track the blood vessel.
165 . The method of claim 160 , wherein the transducer is controlled also based on a doppler ultrasound signal received from inside the blood vessel.
166 . The method of claim 160 , wherein the transducer is controlled to create an annular zone of heat that at least partially surrounds a lumen of the blood vessel.
167 . A treatment method, comprising:
providing a therapeutic ultrasonic energy source comprising a transducer at a location outside a patient;
controlling the transducer based on a signal from inside a blood vessel to apply ultrasonic energy to autonomic nerves around a lumen of the blood vessel;
wherein the transducer is controlled to apply the ultrasonic energy to treat a first one of the autonomic nerves on a first side of the blood vessel, and to treat a second one of the autonomic nerves on a second sided of the blood vessel, so that the first one and the second one of the autonomic nerves are heated to a temperature above 60 degrees Celsius.
168 . The method of claim 167 , further comprising adjusting an aiming by the transducer.
169 . The method of claim 168 , wherein the aiming by the transducer is adjusted based on a position of a fiducial located inside the blood vessel.
170 . The method of claim 169 , wherein the fiducial comprises a passive fiducial.
171 . The method of claim 169 , wherein the fiducial comprises an active fiducial.
172 . The method of claim 168 , wherein the aiming by the transducer is adjusted automatically.
173 . The method of claim 168 , wherein the aiming by the transducer is adjusted automatically to track the blood vessel.