Treatment of renal hypertension or carotid sinus syndrome with heated fluid sympathetic denervation or neuromodulation
Sympathetic nerves run through the adventitia surrounding renal arteries and are critical in the modulation of systemic hypertension. Hyperactivity of these nerves can cause renal hypertension, a disease prevalent in 30-40% of the adult population. Hypertension can be treated with neuromodulating agents (such as angiotensin converting enzyme inhibitors, angiotensin II inhibitors, or aldosterone receptor blockers), but requires adherence to strict medication regimens and often does not reach target blood pressure threshold to reduce risk of major cardiovascular events. A minimally invasive solution is presented here to reduce the activity of the sympathetic nerves surrounding the renal artery by locally delivering neurotoxic or nerve-blocking agents into the adventitia. Extended elution of these agents may also be accomplished in order to tailor the therapy to the patient.
1. A method for treating hypertension, said method comprising the delivery of a therapeutically effective amount of heated fluid into the perivascular tissue surrounding the renal artery, wherein the amount is effective to lower systemic blood pressure by a therapeutically beneficial amount, wherein delivery comprises injecting said heated fluid into tissue bound on the inside by the external elastic lamina of said renal artery and bound on the outside by the outer extent of the adventitial and perivascular connective tissues that surround the renal artery.
2. The method of claim 1 , wherein delivery includes a step of positioning a needle through the wall of the renal artery so that an aperture of the needle is positioned beyond an external elastic lamina (EEL) of the wall.
3. The method of claim 1 , wherein delivery further includes a step of confirming that said heated fluid is penetrating said tissue by imaging either the heated fluid mixed with a diagnostic agent or by the delivery of a diagnostic agent prior to the delivery of the heated fluid.
4. The method of claim 1 , wherein the heated fluid is effective in heating a nerve of the tissue from 42 C to 50 C.
5. A method for treating hypertension, said method comprising the delivery of a therapeutically effective amount of heated fluid into the perivascular tissue surrounding a blood vessel, wherein the amount is effective to lower systemic blood pressure by a therapeutically beneficial amount, wherein delivery comprises injecting said heated fluid into tissue bound on the inside by the external elastic lamina of said blood vessel and bound on the outside by the outer extent of the adventitial and perivascular connective tissues that surround the blood vessel.
6. The method of claim 5 , wherein delivery includes a step of positioning a needle through the wall of the blood vessel so that an aperture of the needle is positioned beyond an external elastic lamina (EEL) of the wall.
7. The method of claim 5 , wherein delivery further includes a step of confirming that said heated fluid is penetrating said tissue by imaging either the heated fluid mixed with a diagnostic agent or by the delivery of a diagnostic agent prior to the delivery of the heated fluid.
8. The method of claim 5 , wherein the heated fluid is effective in heating nerves of the tissue from 42 C to 50 C.
9. The method of claim 5 , wherein the blood vessel is a vein or an artery.
10. The method of claim 5 , wherein the blood vessel is a renal vein.