Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen
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. A method, comprising:
intravascularly positioning a catheter in a low-profile delivery configuration within a renal artery of a hypertensive human patient and proximate to renal nerves innervating a kidney of the patient;
transforming an expandable electrode at a distal region of the catheter between the low-profile delivery configuration and an expanded treatment configuration,
wherein the expandable electrode comprises a double helix arrangement, and wherein, in the treatment configuration, the expandable electrode is sized and shaped such that the expandable electrode contacts an inner wall of the renal artery of the patient; and
delivering electrical energy via the expandable electrode to create a treatment zone along a lengthwise segment of the renal artery,
wherein delivering the electrical energy thermally inhibits neural communication along the renal nerves innervating the kidney of the patient, thereby resulting in a therapeutically beneficial reduction in blood pressure of the patient.
2. The method of claim 1 wherein delivering electrical energy via the expandable electrode comprises delivering radio frequency (RF) energy via the expandable electrode to create the treatment zone.
3. The method of claim 1 wherein delivering electrical energy via the expandable electrode comprises delivering pulsed electrical energy via the expandable electrode to create the treatment zone.
4. The method of claim 1 wherein the expandable electrode in the double helix configuration comprises a plurality of discrete energy delivery contacts, and wherein:
delivering electrical energy via the expandable electrode comprises delivering electrical energy via the individual energy delivery contacts to create multiple, non-continuous treatment zones along the lengthwise segment of the renal artery.
5. The method of claim 4 wherein the multiple treatment zones along the lengthwise segment of the renal artery are formed in separate normal radial planes of the renal artery and are not continuous completely around the circumference of the renal artery.
6. The method of claim 1 wherein delivering electrical energy via the expandable electrode comprises delivering electrical energy in a monopolar fashion between the expandable electrode and a ground pad attached to an exterior of the patient.
7. The method of claim 1 wherein intravascularly positioning a catheter in a low-profile delivery configuration within a renal artery comprises delivering the catheter within a sheath, and wherein the expandable electrode transforms between the low-profile delivery configuration and the expanded treatment configuration when removed from the sheath.
8. The method of claim 1 wherein intravascularly positioning a catheter in a low-profile delivery configuration within a renal artery comprises delivering the catheter over a guidewire.
9. The method of claim 1 wherein the expandable electrode comprises a pair of continuous elongate elements that, when in the treatment configuration, assume the double helix arrangement.
10. The method of claim 1 , further comprising monitoring a parameter of the catheter or of tissue within the patient via at least one sensor at the distal region of the catheter.
11. The method of claim 10 , further comprising altering treatment in response to the monitored parameter.
12. The method of claim 10 wherein at least one of the sensors comprises a temperature sensor, and wherein the method comprises monitoring temperature of the expandable electrode and/or non-targeted tissue during treatment.
13. The method of claim 1 wherein thermally inhibiting neural communication along the renal nerves comprises blocking neural traffic to and/or from the kidney of the patient.
14. The method of claim 1 wherein thermally inhibiting neural communication along the renal nerves comprises ablating the renal nerves.
15. The method of claim 1 wherein thermally inhibiting neural communication along the renal nerves comprises partially ablating the renal nerves.
16. The method of claim 1 , further comprising transforming the expandable electrode from the expanded configuration back to the low-profile configuration and removing the catheter from the patient after delivering the electrical energy to conclude the procedure.