Thermally-induced renal neuromodulation and associated systems and methods
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 renal neuromodulation, the method comprising:
intravascularly delivering a catheter to a treatment site within a renal blood vessel of a human patient and adjacent to target renal nerves of the patient;
delivering a chilled thermal fluid to the treatment site via the catheter;
thermally modulating a function of the target renal nerves via the chilled thermal fluid; and
removing the catheter from the patient after delivering the thermal fluid to conclude the therapy.
2. The method of claim 1 wherein thermally modulating the function of the target renal nerves via the chilled thermal fluid comprises delivering the chilled thermal fluid to induce non-freezing thermal slowing of nerve conduction along the target renal nerves.
3. The method of claim 1 wherein thermally modulating the function of the target renal nerves via the chilled thermal fluid comprises delivering a non-freezing thermal fluid that reduces neural signalling along the target renal nerves without causing direct neural injury to the target renal nerves.
4. The method of claim 1 wherein thermally modulating the function of the target renal nerves via the chilled thermal fluid comprises delivering a non-freezing thermal fluid that causes direct neural injury to the target renal nerves.
5. The method of claim 1 wherein delivering the chilled thermal fluid to the renal nerves comprises delivering non-freezing chilled fluid to cool the target renal nerves to a temperature between 37° C. and 0° C.
6. The method of claim 1 wherein delivering the chilled thermal fluid to the renal nerves comprises delivering non-freezing chilled fluid to cool the target renal nerves to a temperature between 20° C. and 0° C.
7. The method of claim 1 wherein delivering the chilled thermal fluid to the treatment site via the catheter comprises delivering the chilled thermal fluid continuously during therapy to thermally modulate a function of the target renal nerves.
8. The method of claim 1 wherein delivering the chilled thermal fluid to the treatment site via the catheter comprises delivering the chilled thermal fluid intermittently during therapy to thermally modulate a function of the target renal nerves.
9. The method of claim 1 wherein intravascularly delivering the catheter to a treatment site within a renal blood vessel comprises intravascularly delivering the catheter to a renal artery of the patient over a guidewire.
10. The method of claim 1 wherein thermally modulating the function of the target renal nerves via the chilled thermal fluid results in a therapeutically beneficial reduction in blood pressure of the patient.
11. The method of claim 1 wherein thermally modulating the function of the target renal nerves via the chilled thermal fluid at least partially denervates a kidney of the patient.
12. The method of claim 1 , further comprising monitoring a temperature of the target renal nerves and/or non-target tissue proximate the target renal nerves during therapy.
13. The method of claim 12 , further comprising altering delivery of the chilled thermal fluid in response to the monitored parameter.
14. A method for treating a hypertensive human patient, the method comprising:
transluminally positioning a catheter within a renal artery of the hypertensive patient and proximate to target neural fibers innervating a kidney of the patient;
delivering a non-freezing chilled fluid via the catheter to a treatment site adjacent the target neural fibers,
wherein the delivered non-freezing chilled fluid reduces transmission of neural signals along the neural fibers; and
removing the catheter from the patient after delivering the non-freezing chilled fluid to conclude treatment.
15. The method of claim 14 wherein delivering the non-freezing chilled fluid via the catheter and reducing transmission of neural signals along the neural fibers results in a therapeutically beneficial reduction in blood pressure of the patient.
16. The method of claim 14 wherein delivering the non-freezing chilled fluid via the catheter and reducing transmission of neural signals along the neural fibers comprises blocking neural signaling along the neural fibers.
17. The method of claim 14 wherein delivering the non-freezing chilled fluid via the catheter comprises delivering the non-freezing chilled fluid to cool the target neural fibers to a temperature between 20° C. and 0° C.