Intravascular catheter with peri-vascular nerve activity sensors
An intravascular catheter for peri-vascular nerve activity sensing or measurement includes multiple needles advanced through supported guide tubes (needle guiding elements) which expand with open ends around a central axis to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the perivascular space. The system also may include means to limit and/or adjust the depth of penetration of the needles. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. The addition of an injection lumen at the proximal end of the catheter and openings in the needles adds the functionality of ablative fluid injection into the perivascular space for an integrated nerve sending and ablation capability.
1. A catheter for placement into a vessel of a human body comprising:
a catheter body having a central axis extending in a longitudinal direction and also having a central lumen;
at least two needle guiding elements comprising a pre-formed curved shape adapted to advance outwardly from the catheter body toward the interior wall of the target vessel;
at least two needles, at least two electrodes with each of the at least two needles having an electrode, the at least two needles adapted to advance outwardly, guided by the at least two needle guiding elements to penetrate the interior wall of the target vessel, each of the at least two needles comprising a fixed insulation layer, wherein the at least two needle guiding elements are configured to maintain their position against the interior wall of the target vessel as the at least two needles penetrate the interior wall of the target vessel to a target tissue; and
at least two wires, the at least two wires connecting the at least two electrodes to external equipment outside of the catheter.
2. The catheter of claim 1 , where each of the at least two needle guiding elements is a guide tube having a lumen.
3. The catheter of claim 2 , where each of the at least two needles is adapted to advance outwardly coaxially through the lumen of the guide tube.
4. The catheter of claim 1 , wherein the at least two needle guiding elements comprises at least three needle guiding elements and the at least two needles comprises three needles and the at least two wires comprises three wires.
5. The catheter of claim 1 , further including a radiopaque marker attached to or within a portion of a structure selected from the group consisting of: a) a needle of the at least two needles, b) a needle guiding element of the at least two needle guiding elements, and c) the catheter body.
6. A catheter for placement into a target vessel of a human body comprising:
a catheter body having a lumen;
at least two needle guiding elements comprising a curved shape adapted to advance outwardly from the catheter body toward the interior wall of the target vessel;
at least two needles, each of the at least two needles having an electrode, the at least two needles adapted to advance outwardly, guided by the at least two needle guiding elements to penetrate the interior wall of the target vessel, wherein the at least two needle guiding elements are configured to maintain their position against the interior wall of the target vessel as the at least two needles penetrate the interior wall of the target vessel; and
at least two wires adapted for connecting the at least two electrodes to external equipment outside of the catheter.
7. The catheter of claim 6 , where each of the at least two needles guiding element is a guide tube having a lumen.
8. The catheter of claim 7 , where each of the at least two needles is adapted to advance outwardly coaxially through the lumen of the guide tube.
9. The catheter of claim 6 , wherein the catheter includes the at least two needle guiding elements comprises at least three needle guiding elements and the at least two needles comprises three needles and the at least two wires comprises three wires.
10. The catheter of claim 6 , further including a fixed distal guide wire.
11. The catheter of claim 6 , further including a radiopaque marker attached to or within a portion of a structure selected from the group consisting of: a) a needle of the at least two needles, b) a needle guiding element of the at least two needle guiding elements, and c) the catheter body.
12. The catheter of claim 6 , further including a fluid injection port located near a proximal end of the catheter and at least one opening in a distal portion of at least one needle of the at least two needles, the fluid injection port being in fluid communication with the at least one opening in the at least one needle.
13. The catheter of claim 6 , further including a mechanical support structure adapted to support each needle guiding element in a direction selected from the group consisting of: a) radial, in which the mechanical support structure supports the at least two needle guiding elements in a radial direction, and b) lateral, in which the mechanical support structure supports the at least two needle guiding elements in a lateral direction.
14. The catheter of claim 6 , where the at least two wires are insulated.
15. A method, comprising:
providing a catheter having a catheter body with a proximal end, a distal end, and a first electrode and a second electrode, the first electrode and the second electrode movable between a retracted position within the catheter body and an extended position for piercing a vessel wall;
providing a first guiding element and a second guiding element, the first electrode coaxial with the first guiding element and the second electrode coaxial with the second guiding element;
positioning the distal end of the catheter at an intravascular site within a patient; advancing the first guiding element and the second guiding element outwardly from the catheter body toward the vessel wall;
advancing the first electrode through the first guiding element and into the vessel wall and advancing the second electrode through the second guiding element and into the vessel wall, wherein the first guiding element and the second guiding element are configured to maintain their position against the vessel wall as the first electrode and the second electrode are advanced into the vessel wall.
16. The method as in claim 15 , further including placing the first electrode and the second electrode into electrical communication with an instrument electrically coupled to the proximal end of the catheter.
17. The method as in claim 15 , wherein an additional electrode is carried by the catheter.
18. The method as in claim 15 , wherein an additional electrode is in contact with the patient's skin.