Methods for renal nerve blocking
A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.
1. A method for treatment of a human patient diagnosed with hypertension, the method comprising:
positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve of the patient; and
delivering a nerve blocking agent via the catheter to inhibit neural traffic along the renal nerve,
wherein delivering the nerve blocking agent results in a therapeutically beneficial reduction in blood pressure of the patient.
2. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning the catheter near a renal hilum of the patient.
3. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning the catheter within a renal hilum of the patient.
4. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning a distal tip of the catheter within a target site in continuity with a periarterial fat tissue layer surrounding a renal pedicle of the patient.
5. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve comprises positioning a distal tip of the catheter within renal fascia of the patient.
6. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery comprises intravascularly delivering the catheter through an abdominal aorta to the renal artery of the patient.
7. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery comprises extravascularly positioning the catheter within the periarterial space.
8. The method of claim 1 wherein positioning a catheter in a periarterial space of a renal artery and proximate a renal nerve of the patient comprises delivering the catheter over a guidewire.
9. The method of claim 1 wherein the renal nerve innervates a kidney of the patient, and wherein inhibiting neural traffic along the renal nerve comprises denervating the kidney.
10. The method of claim 1 wherein inhibiting neural traffic along the renal nerve comprises ablating the renal nerve.
11. The method of claim 1 wherein delivering a nerve blocking agent via the catheter comprises delivering at least one of an anesthetic, a neurotoxin, an alcohol, and an antidepressant to the renal nerve.
12. The method of claim 1 wherein delivering a nerve blocking agent via the catheter comprises delivering an alcohol to the renal nerve.
13. The method of claim 1 wherein the catheter has a sealed tip and at least one side hole or pore through a sidewall of the catheter, and wherein delivering a nerve blocking agent via the catheter comprises delivering alcohol via the at least one side hole or pore.
14. The method of claim 1 , further comprising removing the catheter from the patient after delivering nerve blocking agent to conclude the procedure.
15. The method of claim 1 wherein inhibiting neural traffic along the renal nerve further results in a reduction of systemic sympathetic tone in the patient.
16. A method for catheter-based renal denervation of a hypertensive human patient, the method comprising:
positioning a catheter having a drug delivery element within a renal hilum of the patient and adjacent neural fibers innervating a kidney of the patient; and
at least partially ablating the neural fibers via a nerve blocking agent delivered from the drug delivery element,
wherein at least partially ablating the neural fibers results in a therapeutically beneficial reduction in blood pressure in the patient.
17. The method of claim 16 wherein positioning a catheter having a drug delivery element within a renal hilum of the patient comprises positioning the catheter within a distal portion of the renal vasculature of the patient.
18. The method of claim 16 wherein the nerve blocking agent comprises at least one of an anesthetic, a neurotoxin, an alcohol, and an antidepressant.
19. The method of claim 16 wherein the nerve blocking agent comprises an alcohol.
20. The method of claim 16 , further comprising monitoring a parameter of the catheter and/or tissue within the patient before and during delivery of the nerve blocking agent from the drug delivery element.
21. The method of claim 20 , further comprising altering delivery of the nerve blocking agent in response to the monitored parameter.
22. The method of claim 16 , further comprising removing the catheter from the patient after delivering the nerve blocking agent to conclude the procedure.
23. The method of claim 16 wherein the catheter has a sealed tip and at least one aperture through a sidewall of the catheter, and wherein at least partially ablating the neural fibers via a nerve blocking agent comprises delivering alcohol via the at least one aperture.