Balloon catheter apparatuses for renal denervation
Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.
1. An apparatus for renal denervation of a human patient, the apparatus comprising:
a catheter configured for intravascular placement within a renal artery of the patient;
a balloon at a distal portion of the catheter, wherein the balloon is configured to vary between a low-profile delivery configuration and an expanded configuration sized and shaped to fit within the renal artery;
a first electrode having a first pair of bipolar contacts carried by the balloon; and
a second electrode having a second pair of bipolar contacts carried by the balloon,
wherein—
the first electrode and the second electrode are spaced apart lengthwise and angularly offset from one another about the balloon to define, at least in part, a spiral pattern about the balloon when the balloon is in the expanded configuration,
the first electrode and the second electrode are each configured to deliver thermal radio frequency (RF) energy to less than a full circumference of the renal artery of the patient.
2. The apparatus of claim 1 wherein:
the first electrode is configured to deliver thermal RF energy to create a first non-continuous, circumferential treatment zone along a lengthwise segment of the renal artery; and
the second electrode is configured to deliver thermal RF energy to create a second non-continuous, circumferential treatment zone along the lengthwise segment of the renal artery,
wherein the first circumferential treatment zone and the second circumferential treatment zone are formed in separate normal radial planes and are not continuous completely around the circumference of the renal artery.
3. The apparatus of claim 2 wherein the first electrode and the second electrode are configured to respectively create the first circumferential treatment zone and second circumferential treatment zone in sequence.
4. The apparatus of claim 2 wherein the first electrode and the second electrode are configured to respectively create the first circumferential treatment zone and second circumferential treatment zone concurrently.
5. The apparatus of claim 1 wherein the first electrode and the second electrode are configured to create respective first and second non-overlapping treatment zones.
6. The apparatus of claim 1 wherein the first electrode and the second electrode are dynamically assignable.
7. The apparatus of claim 1 wherein the first electrode and the second electrode are parts of a flex circuit on a surface of the balloon.
8. The apparatus of claim 7 wherein the flex circuit terminates proximally to a distal end portion of the balloon.
9. The apparatus of claim 1 wherein the balloon is sized and shaped to bring the first electrode and the second electrode into apposition with an inner wall of the renal artery when the balloon is in the expanded configuration.
10. The apparatus of claim 1 wherein the balloon is configured to block fluid flow within the renal artery during delivery of the thermal RF energy.
11. The apparatus of claim 1 wherein the balloon is sized and shaped not to block fluid flow within the renal artery during delivery of the thermal RF energy.
12. The apparatus of claim 1 , further comprising:
a third electrode having a third pair of bipolar contacts carried by the expandable balloon; and
a fourth electrode having a fourth pair of bipolar contacts carried by the expandable balloon,
wherein the third and fourth electrodes are spaced apart lengthwise and angularly offset from each other and from the first and second electrodes and further define, at least in part, the spiral pattern about the balloon when the balloon is in the expanded configuration.
13. The apparatus of claim 1 wherein the first electrode and the second electrode each occupy a distinct longitudinal position and a distinct radial position with respect to a longitudinal axis of the balloon.
14. The apparatus of claim 1 wherein the first electrode further comprises at least one sensor configured to monitor a parameter of the apparatus or of tissue within the patient.
15. The apparatus of claim 14 , further comprising a feedback control system configured to alter treatment in response to the monitored parameter.
16. The apparatus of claim 14 wherein at least one of the sensors comprises a temperature sensor.
17. The apparatus of claim 16 wherein the temperature sensor is configured to monitor temperature of the balloon, electrodes, and/or non-targeted tissue.
18. The apparatus of claim 1 wherein the first and second electrodes are configured to deliver thermal RF energy sufficient to modulate neural activity in target renal nerves within a wall of, or in proximity to, the renal artery.
19. The apparatus of claim 1 wherein the first and second electrodes are configured to deliver thermal RF energy sufficient to ablate target renal nerves within a wall of, or in proximity to, the renal artery.
20. The apparatus of claim 1 wherein the thermal RF energy from the first and second electrodes is sufficient to modulate renal nerves along the renal artery and at least partially block neural traffic to and/or from a kidney of the patient.
21. The apparatus of claim 1 wherein the catheter and balloon are configured for intravascular placement within the renal artery over a guidewire.
22. The apparatus of claim 1 wherein the catheter is configured for infusion of one or more agents into the renal artery before, during, or after thermal RF energy delivery.
23. The apparatus of claim 1 , further comprising an electric field generator external to the patient, wherein the electric field generator is configured to be electrically coupled to the first and second electrodes and independently control each electrode.