Methods 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.
1. A method for thermally-induced neuromodulation of a human patient, the method comprising:
intravascularly delivering a device to a vicinity of a neural fiber that contributes to renal function of the patient; and
thermally inducing modulation of a function of the neural fiber with the device.
2. The method of claim 1 wherein intravascularly delivering a device to a vicinity of a neural fiber that contributes to renal function comprises intravascularly delivering the device via a renal blood vessel to a position proximate the neural fiber.
3. The method of claim 1 wherein intravascularly delivering a device to a vicinity of a neural fiber that contributes to renal function comprises:
intravascularly delivering the device in a low profile delivery configuration to a position within a renal blood vessel of the patient and proximate the neural fiber; and
transforming the device from the delivery configuration to a deployed configuration within the renal blood vessel before thermally inducing modulation.
4. The method of claim 3 , further comprising:
transforming the device from the deployed configuration to the low profile configuration after thermally inducing modulation of a function of the neural fiber; and
removing the device from the patient.
5. The method of claim 3 wherein the device comprises an expandable wire basket carrying multiple electrodes, and wherein transforming the device from the delivery configuration to a deployed configuration comprises positioning the electrodes in contact with a wall of the renal blood vessel proximate to the neural fiber.
6. The method of claim 1 wherein intravascularly delivering a device to a vicinity of a neural fiber that contributes to renal function comprises delivering the device to renal vasculature of the patient via a guidewire.
7. The method of claim 1 wherein thermally inducing modulation of a function of the neural fiber comprises ablating the neural fiber.
8. The method of claim 1 wherein thermally inducing modulation of a function of the neural fiber comprises at least partially denervating a kidney of the patient.
9. The method of claim 1 wherein thermally inducing modulation of a function of the neural fiber comprises thermally modulating afferent and efferent renal nerves via the device.
10. The method of claim 1 wherein:
intravascularly delivering a device to a vicinity of a neural fiber of the patient comprises intravascularly delivering the device in a patient diagnosed with chronic heart failure, hypertension, chronic renal failure, end-stage renal disease, myocardial infarction, and/or atrial fibrillation; and
thermally inducing modulation of a function of the neural fiber with the device alleviates clinical symptoms of the diagnosed disease of the patient.
11. The method of claim 1 wherein thermally inducing modulation of a function of the neural fiber further comprises delivering a thermal electric field to the neural fiber via at least one electrode.
12. The method of claim 11 wherein delivering a thermal electric field to the neural fiber via at least one electrode further comprises delivering the thermal electric field via at least one wall-contacting electrode.
13. The method of claim 1 wherein thermally inducing modulation of the function of the neural fiber further comprises heating the neural fiber.
14. The method of claim 1 wherein thermally inducing modulation of the function of the neural fiber further comprises cooling the neural fiber.
15. The method of claim 1 wherein thermally inducing modulation of a function of the neural fiber further comprises delivering ultrasound energy to the neural fiber.
16. The method of claim 1 wherein thermally inducing modulation of a function of the neural fiber further comprises delivering high intensity focused ultrasound energy to the neural fiber.
17. A method, comprising:
intravascularly delivering a renal denervation catheter in a reduced profile delivery configuration to a vicinity of a neural pathway that contributes to renal function of a human patient, wherein the renal denervation catheter comprises a basket having a plurality of electrodes arranged thereabout;
transforming the renal denervation catheter from the reduced profile delivery configuration to a deployed configuration with the electrodes in contact with an inner wall of a renal blood vessel of the patient, and wherein, in the deployed configuration, the basket is configured to allow blood to flow therethrough; and
thermally altering the neural pathway via energy from the electrodes such that neural communication along the neural pathway is inhibited.
18. The method of claim 17 wherein intravascularly delivering a renal denervation catheter comprises delivering the catheter over a guidewire.
19. The method of claim 17 wherein thermally altering the neural pathway via energy from the electrodes comprises delivering radiofrequency energy via the electrodes.
20. The method of claim 17 , further comprising removing the device from the patient after thermally altering the neural pathway.
21. The method of claim 17 wherein thermally altering the neural pathway via energy from the electrodes results in a therapeutically beneficial reduction in blood pressure of the patient.
22. The method of claim 17 wherein thermally altering the neural pathway via energy from the electrodes such that neural communication along the neural pathway is inhibited comprises blocking neural traffic to and/or from a kidney of the patient.
23. The method of claim 17 wherein thermally altering the neural pathway via energy from the electrodes comprises ablating target neural fibers of the neural pathway.
24. The method of claim 17 wherein thermally altering the neural pathway via energy from the electrodes comprises at least partially denervating a kidney of the patient.