Systems and methods for neurological traffic and/or receptor functional evaluation and/or modification
Systems and methods for controlled sympathectomy procedures for neuromodulation are disclosed. A system for controlled micro ablation procedures is disclosed. A guidewire including one or more sensors or electrodes for accessing and recording physiologic information from one or more anatomical sites within the parenchyma of an organ as part of a physiologic monitoring session, a diagnostic test, or a neuromodulation procedure is disclosed. A guidewire including one or more sensors and/or a means for energy delivery, for performing a neuromodulation procedure within a small vessel within a body is disclosed.
1. A guidewire, comprising:
an elongate body dimensioned for insertion into a lumen within a body; and
a sensing tip electrically and mechanically coupled to the elongate body, the sensing tip being configured to interface with the wall of the lumen and to convey one or more electrophysiological signals associated with an electrophysiological activity in the vicinity of an anatomical site of interest within the vicinity of the lumen;
wherein the sensing tip comprises:
a flexible substrate comprising a base portion and two or more tines extending from the base portion;
a plurality of electrodes disposed on each of the two or more tines extending from the base portion of the flexible substrate; and
one or more microcircuits disposed on the base portion of the flexible substrate, the one or more microcircuits being coupled to (i) the plurality of electrodes disposed on the two or more tines extending from the base portion of the flexible substrate and (ii) one or more lead wires.
2. The guidewire of claim 1 , wherein at least a subset of the plurality of electrodes are arranged along at least one of the two or more tines with a predetermined spacing.
3. The guidewire of claim 1 , wherein at least one of the two or more tines has a width that is tapered along the length of the at least one tine.
4. The guidewire of claim 1 , wherein the sensing tip further comprises one or more traces disposed on the two or more tines interconnecting the plurality of electrodes with the one or more microcircuits.
5. The guidewire of claim 1 , wherein the flexible substrate comprises a laminate composite structure.
6. The guidewire of claim 5 , wherein the laminate composite structure comprises a base substrate, one or more traces disposed on the base substrate interconnecting the plurality of electrodes with the one or more microcircuits, and one or more overcoats disposed over the one or more traces and the base substrate.
7. The guidewire of claim 1 , wherein at least a subset of the plurality of electrodes are configured to extend above a height of the flexible substrate.
8. The guidewire of claim 7 , wherein the subset of the plurality of electrodes are formed as bumps disposed on a surface of the one or more tines of the flexible substrate.
9. The guidewire of claim 7 , wherein the subset of the plurality of electrodes comprise whisker features that extend above the height of the substrate.
10. The guidewire of claim 7 , wherein the subset of the plurality of electrodes are plated to extend above the height of the substrate.
11. The guidewire of claim 1 , wherein the two or more tines extending from the base portion of the flexible are shaped to form a tine envelope.
12. The guidewire of claim 11 , wherein at least a subset of the plurality of electrodes are disposed on the two or more tines of the tine envelope and the one or more microcircuits are located at a root of the tine envelope.
13. The guidewire of claim 12 , wherein the subset of the plurality of electrodes are positioned on the two or more tines of the tine envelope such that, when the tine envelope is rolled, the subset of the plurality of electrodes interface with different positions of an elongate span of the lumen into which the guidewire is placed.
14. The guidewire of claim 13 , further comprising at least one of a jacket and a coil disposed surrounding at least a portion of the rolled tine envelope.
15. The guidewire of claim 1 , further comprising one or more stabilizing anchors coupled to the elongate body, the one or more stabilizing anchors being configured to deploy from the elongate body and couple to at least a first lumen proximate the anatomical site of interest.
16. The guidewire of claim 15 , wherein the sensing tip is configured to deploy from the elongate body to interface with a wall of a second lumen.
17. The guidewire of claim 16 , wherein the first lumen and the second lumen are the same.
18. The guidewire of claim 16 , wherein the sensing tip comprises an insulating layer configured to isolate one or more portions of the sensing tip from its surroundings.
19. The guidewire of claim 18 , wherein the insulating layer has a varying thickness to form one or more step transitions along a length of the sensing tip, the one or more step transitions limiting a depth of penetration of the sensing tip into the wall of the second lumen.
20. The guidewire of claim 15 , wherein the one or more stabilizing anchors are shaped to bias against a wall of the first lumen on deployment from the elongate body.
21. The guidewire of claim 1 , wherein a given one of the lead wires is coupled with power management hardware configured to provide both power and signal communication on the given lead wire.