Apparatus, systems, and methods for achieving intravascular, thermally-induced renal neuromodulation related application
Apparatus, systems, and methods for achieving thermally-induced renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a thermal element to a renal artery via an intravascular path. 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.
1. A neuromodulation treatment device, comprising:
an elongated shaft having a proximal end region and a distal end region, the distal end region including a first flexure zone, a portion of the first flexure zone being configured to rest in an aorta of a patient and a remaining portion configured to rest in a renal artery of the patient, and a second flexure zone that is distal to the first flexure zone, the first flexure zone and the second flexure zone being configured to flex about an axis of the elongated shaft; and
a neuromodulation element carried by the second flexure zone and configured to apply treatment to a tissue region,
wherein the second flexure zone is an unrestrained flexure zone configured to passively flex in any plane about the axis in response to an applied force from the neuromodulation element contacting a tissue surface.
2. The neuromodulation treatment device of claim 1 , wherein the portion of the first flexure zone is configured to rest and be supported by a wall of the aorta, wherein the remaining portion of the first flexure zone is configured to rest and be supported by a wall of the renal artery.
3. The neuromodulation treatment device of claim 1 , wherein the first flexure zone defines a transitional bend that is configured to be supported and stable within vasculature of the patient.
4. The neuromodulation treatment device of claim 1 further comprising:
a flexure control element coupled to the first flexure zone and configured to apply a force to the first flexure zone to move the first flexure zone away from the axis.
5. The neuromodulation treatment device of claim 4 , further comprising:
a flexure controller coupled to the flexure control element and configured to cause the flexure control element to apply the force to the first flexure zone.
6. The neuromodulation treatment device of claim 1 , further comprising:
a handle coupled to the proximal end region of the elongated shaft; and
a rotating fitting coupled to the handle and configured to rotate the elongated shaft.
7. The neuromodulation treatment device of claim 6 , wherein the rotating fitting is mounted on a tab that is carried in a circumferential channel on a distal end of the handle.
8. The neuromodulation treatment device of claim 6 , wherein the rotating fitting is configured to rotate independently of the handle and rotate the elongated shaft without rotating the handle.
9. The neuromodulation treatment device of claim 1 , wherein the second flexure zone has a flexible structure that is coupled to the neuromodulation element and that allows the second flexure zone to flex in any plane about the axis.
10. The neuromodulation treatment device of claim 1 , further comprising a flexure controller at a proximal portion of the neuromodulation treatment device, wherein the flexure controller is configured to cause movement of the first flexure zone away from the axis, and wherein the flexure controller is not coupled to the second flexure zone.
11. A neuromodulation treatment device, comprising:
an elongated shaft having a proximal end region and a distal end region, the distal end region including a controlled flexure zone, a portion of the controlled flexure zone being configured to be within an aorta of a patient and a remaining portion configured to be within a renal artery of the patient, and an unrestrained flexure zone that is distal to the controlled flexure zone, the controlled flexure zone and the unrestrained flexure zone being configured to move about an axis in response to an applied force;
a handle coupled to the proximal end region of the elongated shaft;
a rotating fitting coupled to the handle and configured to rotate the elongated shaft; and
a neuromodulation element carried by the unrestrained flexure zone and configured to apply treatment to a tissue region,
wherein the unrestrained flexure zone is configured to passively flex in any plane about the axis in response to an applied force from the neuromodulation element contacting a tissue surface.
12. The neuromodulation treatment device of claim 11 , further comprising:
a flexure control element coupled to the controlled flexure zone and configured to apply a force to the first controlled flexure zone to move the controlled flexure zone away from the axis.
13. The neuromodulation treatment device of claim 12 , further comprising:
a flexure controller coupled to the flexure control element and configured to cause the flexure control element to apply the first force to the controlled flexure zone.
14. The neuromodulation treatment device of claim 11 , wherein the portion of the controlled flexure zone is configured to rest and be supported by a wall of the aorta, wherein the remaining portion of the controlled flexure zone is configured to rest and be supported by a wall of the renal artery, wherein the controlled flexure zone defines a transitional bend that is configured to be supported and stable within vasculature of the patient.
15. The neuromodulation treatment device of claim 11 , wherein the rotating fitting is configured to rotate independently of the handle and rotate the elongated shaft without rotating the handle.
16. The neuromodulation treatment device of claim 11 , wherein the unrestrained flexure zone has a flexible structure that is coupled to the neuromodulation element and that allows the unrestrained flexure zone to flex in any plane about the axis.
17. The neuromodulation treatment device of claim 11 , further comprising a flexure controller at a proximal portion of the neuromodulation treatment device, wherein the flexure controller is configured to cause movement of the controlled flexure zone away from the axis, and wherein the flexure controller is not coupled to the unrestrained flexure zone.
18. A treatment device, comprising:
an elongated shaft having a proximal end region and a distal end region, the distal end region including a first flexure zone, a portion of the first flexure zone being configured to rest in an aorta of a patient and a remaining portion configured to rest in a renal artery of the patient, and a second flexure zone that is distal to the first flexure zone, the first flexure zone defining a transitional bend that is configured to be supported and stable within vasculature of the patient;
an electrode carried by the second flexure zone configured to apply treatment to a tissue region; and
a flexure control element coupled to the first flexure zone and configured to apply a first force to the first flexure zone to move the first flexure zone away from an axis,
wherein the second flexure zone is an unrestrained flexure zone configured to passively flex in any plane about the axis in response to an applied force from the neuromodulation element contacting a tissue surface, wherein flexing of the second flexure zone is not directly controlled by the flexure control element.
19. The treatment device of claim 18 , further comprising:
a handle coupled to the proximal end region of the elongated shaft; and
a rotating fitting coupled to the handle and configured to rotate the elongated shaft.
20. The treatment device of claim 18 , wherein the rotating fitting is mounted on a tab that is carried in a circumferential channel on the distal end of the handle.