Devices for thermally-induced renal neuromodulation
Methods and system 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. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.
1. A system for renal neuromodulation of a human patient, the system comprising:
a catheter;
at least one neuromodulation element carried by a distal portion of the catheter;
a generator configured to:
generate energy sufficient to ablate renal neural fibers adjacent a renal blood vessel of the patient, and
deliver the energy, via the at least one neuromodulation element, to the neural fibers to reduce sympathetic nerve activity in the neural fibers; and
an expandable positioning element carried by the distal portion of the catheter, wherein the expandable positioning element is configured to receive a cooling fluid configured to remove heat from within the expandable positioning element,
wherein the distal portion of the catheter, the expandable positioning element, and the at least one neuromodulation element are configured to be positioned in the renal blood vessel of the human patient,
wherein the expandable positioning element is transformable from a low profile delivery configuration to an expanded configuration, and
wherein, in the expanded configuration, the at least one neuromodulation element is spaced radially inward from an outer diameter of the expandable positioning element.
2. The system of claim 1 , wherein the expandable positioning element comprises a balloon.
3. The system of claim 1 , wherein the at least one neuromodulation element comprises at least one electrode.
4. The system of claim 1 , wherein the at least one neuromodulation element comprises an ultrasound transducer, and wherein the expandable positioning element is positioned around the ultrasound transducer.
5. The system of claim 1 , wherein the at least one neuromodulation element comprises a microwave transducer.
6. The system of claim 1 , wherein the system is configured to circulate the cooling fluid within the expandable positioning element.
7. The system of claim 1 , wherein the system is configured to exchange the cooling fluid within the expandable positioning element.
8. The system of claim 1 , further comprising a pump configured to pump the cooling fluid to the expandable positioning element.
9. The system of claim 1 , wherein the expandable positioning element is configured to center the at least one neuromodulation element relative to an outer diameter of the expandable positioning element.
10. The system of claim 1 , wherein the expandable positioning element is configured to be expanded in response to the cooling fluid being introduced to an interior of the expandable positioning element.
11. The system of claim 1 , wherein the at least one neuromodulation element is configured to deliver neuromodulation therapy to a renal nerve adjacent to the renal blood vessel of the patient.
12. A method comprising:
positioning a distal portion of a catheter in a renal vessel of a patient, wherein the distal portion of the catheter carries at least one neuromodulation element and an expandable positioning element;
expanding the expandable positioning element from a low profile delivery configuration to an expanded configuration in which the expandable positioning element contacts a wall of the renal vessel, wherein, in the expanded configuration, the at least one neuromodulation element is spaced radially inward from an outer diameter of the expandable positioning element;
introducing a cooling fluid configured to remove heat from the expandable positioning element to an interior of the expandable positioning element; and
causing a generator to generate and deliver, via the at least one neuromodulation element, energy sufficient to ablate renal neural fibers adjacent the renal vessel.
13. The method of claim 12 , wherein the expandable positioning element comprises a balloon, and wherein expanding the expandable positioning element from the low profile delivery configuration to the expanded configuration comprises introducing the cooling fluid configured into the interior of the balloon.
14. The method of claim 13 , wherein the at least one neuromodulation element comprises at least one electrode, and wherein causing the generator to generate and deliver the energy to the neural fibers adjacent the renal vessel via the at least one neuromodulation element comprises causing the generator to generate and deliver the energy to the neural fibers adjacent the renal vessel via the electrode.
15. The method of claim 13 , wherein the at least one neuromodulation element comprises an ultrasound transducer, and wherein causing the generator to generate and deliver the energy to the neural fibers adjacent the renal vessel via the at least one neuromodulation element comprises causing the generator to generate and deliver ultrasonic energy to the neural fibers adjacent the renal vessel via the ultrasound transducer.
16. The method of claim 15 , wherein the expandable positioning element is positioned around the ultrasound transducer.
17. The method of claim 12 , wherein the at least one neuromodulation element comprises a microwave transducer, and wherein causing the generator to generate and deliver the energy to the neural fibers adjacent the renal vessel via the at least one neuromodulation element comprises causing the generator to generate and deliver microwave energy to the neural fibers adjacent the renal vessel via the microwave transducer.
18. The method of claim 12 , wherein introducing the cooling fluid into the interior of the expandable positioning element comprises circulating the cooling fluid within the expandable positioning element.
19. The method of claim 12 , wherein introducing the cooling fluid into the interior of the expandable positioning element comprises pumping, via a pump, the cooling fluid to the expandable positioning element.