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 system for neuromodulating an anatomical site in the vicinity of a lumen, comprising:
a subsystem configured to perform a surgical procedure on the anatomical site;
a guidewire configured to monitor electrophysiological activity within the parenchyma of an organ coupled to the lumen and to generate one or more signals therefrom; and
a control unit configured to accept signals from the guidewire, and to at least one of adjust the surgical procedure dependent upon the signals, display the signals, evaluate the surgical procedure dependent upon the signals, plan a surgical path dependent upon the signals, and determine the extent of the procedure dependent upon the signals;
wherein the guidewire comprises an array of two or more fibers packed into a jacket, the jacket enabling (i) longitudinal movement between the two or more fibers in the array and (ii) deployment of the two or more fibers, one or more segments of the two or more fibers in the array being bonded together; and
wherein a given one of the two or more fibers in the array comprises a core, a clad layer covering one or more segments of the core, and an insulating layer covering one or more segments of the clad layer; and
wherein the clad layer comprises at least one of a bioactive material and an enzymatic layer providing an analyte identifier of the given fiber.
2. The system in accordance with claim 1 , wherein the surgical procedure comprises at least one of an ablation, an excision, a cut, a burn, a radio frequency ablation, radiosurgery, an ultrasonic ablation, an abrasion, a biopsy, and delivery of a substance.
3. The system in accordance with claim 1 , further comprising at least one of a stimulation electrode and an ablation electrode configured so as to convey at least one of a pulsatile signal and a radio frequency signal to the anatomical site from the control unit, the guidewire configured to convey one or more feedback signals related to said at least one of the pulsatile signal and the radio frequency signal back to the control unit.
4. The system in accordance with claim 3 , wherein the feedback signals are related to at least one of an electrode impedance, a bioimpedance, a local electrical field, and an electrophysiological response to said at least one of the pulsatile signal and the radio frequency signal.
5. The system in accordance with claim 3 , wherein said at least one of the stimulation electrode and the ablation electrode is comprised within the guidewire.
6. The system in accordance with claim 5 , wherein said at least one of the stimulation electrode and the ablation electrode is comprised within a sensing tip of the guidewire.
7. The system in accordance with claim 1 , wherein the subsystem is situated coaxially with the guidewire in the lumen.
8. The system in accordance with claim 1 , further comprising a sensor configured to measure one or more physiologic signals associated with a body comprising the lumen, and to convey the physiologic signals to the control unit for use in the procedure.
9. The system in accordance with claim 8 , wherein the sensor is configured to measure at least one of water concentration, tone, blood oxygen saturation of local tissues, evoked potential, stimulation of nervous activity, sensing of nervous activity, electromyography, temperature, blood pressure, vasodilation, vessel wall stiffness, muscle sympathetic nerve activity (MSNA), central sympathetic drive, tissue tone, blood flow, a blood flow differential signal, blood perfusion, pupil dilation, electrolyte levels in a biofluid, a blood analyte level, and nerve traffic.
10. The system of claim 1 , wherein the guidewire comprises:
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.
11. The system of claim 1 , wherein the jacket comprises one of a microspring and an insulated microspring.
12. The system of claim 1 , wherein the jacket comprises one of a polymer sheath, an elastomer sheath, a shrink tube and a braided thin walled tube.
13. The system of claim 1 , wherein at least a first one of the two or more fibers in the array is electrically isolated from at least a second one of the two or more fibers in the array.
14. The system of claim 1 , wherein the clad layer is configured to improve a longitudinal conductivity of the core.
15. The system of claim 1 , wherein the insulating layer has a first thickness near to a distal region of the guidewire that increases in thickness in a proximal direction of the guidewire.
16. The system of claim 1 , wherein at least one segment of the two or more fibers in the array are bonded together with a retraining restraining matrix.
17. The system of claim 16 , wherein the restraining matrix comprises at least one of a biodegradable matrix, an electrochemically degradable matrix and a water soluble matrix.
18. The system of claim 16 , wherein the restraining matrix comprises a bolus of a stressing medicament.
19. The system of claim 18 , wherein the control unit is configured to monitor a physiologic response while the bolus of the stressing medicament is delivered to the anatomical site.