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71. 发明申请

US20130253471A1 Methods and Apparatus for Treating Contrast Nephropathy 有权
标题翻译：治疗对比肾病的方法与装置
公开(公告)号：US20130253471A1
公开(公告)日：2013-09-26
申请号：US13898830
申请日：2013-05-21
申请人： Denise Demarais , Hanson Gifford, III , Mark Deem , Douglas Sutton , Howard R. Levin , Mark Gelfand
发明人： Denise Demarais , Hanson Gifford, III , Mark Deem , Douglas Sutton , Howard R. Levin , Mark Gelfand
IPC分类号： A61N1/05
CPC分类号： A61B18/12 , A61B18/04 , A61B18/1492 , A61B2018/0022 , A61B2018/00267 , A61B2018/00404 , A61B2018/00434 , A61B2018/00511 , A61B2018/00577 , A61B2018/00613 , A61B2018/00642 , A61B2018/00648 , A61B2018/00791 , A61B2018/00875 , A61N1/0551 , A61N1/36117 , A61N7/00 , A61N2007/003
摘要： Methods and apparatus are provided for treating contrast nephropathy, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation of electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.
摘要翻译：提供了用于通过脉冲电场，经由刺激电场，经由局部药物递送，经由高频超声波，经由热技术等来治疗对比肾病的方法和装置。这种神经调节可以实现电融合的坏死性电穿孔，坏死和/或诱导细胞凋亡，改变基因表达，动作电位减弱或阻断，细胞因子上调和靶神经纤维中的其他条件的变化。在一些实施方案中，神经调节被应用于有助于肾功能的神经纤维。在一些实施方案中，这种神经调节以双向方式进行。与单侧执行的肾神经调节相比，双侧肾神经调节可以在一些患者中提供增强的治疗效果，即与在支配单个肾脏的神经组织上进行的肾神经调节相比。

72. 发明授权

US08454594B2 Apparatus for performing a non-continuous circumferential treatment of a body lumen 有权
标题翻译：用于对身体腔进行非连续周边处理的装置
公开(公告)号：US08454594B2
公开(公告)日：2013-06-04
申请号：US12539390
申请日：2009-08-11
申请人： Denise Demarais , Hanson Gifford, III , Mark Deem , Nicolas Zadno , Benjamin J. Clark , Andrew Wu , Kenneth J. Michlitsch
发明人： Denise Demarais , Hanson Gifford, III , Mark Deem , Nicolas Zadno , Benjamin J. Clark , Andrew Wu , Kenneth J. Michlitsch
IPC分类号： A61B18/12
CPC分类号： A61B18/1492 , A61B18/1206 , A61B18/18 , A61B2018/00023 , A61B2018/00077 , A61B2018/0016 , A61B2018/0022 , A61B2018/00267 , A61B2018/00404 , A61B2018/00434 , A61B2018/00511 , A61B2018/00648 , A61B2018/00791 , A61B2018/00875 , A61B2018/124 , A61B2018/1435 , A61B2018/1465 , A61N1/0551 , A61N1/32 , A61N1/327 , A61N1/36007 , A61N7/022
摘要： Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.
摘要翻译：提供了用于不间断地周围处理体腔的方法和装置。装置可以定位在患者的体腔内，并且可以在第一纵向和角位置处递送能量，以在第一位置处产生小于整个圆周的处理区域。该装置还可以在体腔内的一个或多个附加的纵向和角度位置处递送能量，以在一个或多个附加位置处创建小于整个圆周处理区域，该一个或多个附加位置从第一处理区域纵向和角度偏移。第一处理区和一个或多个另外的处理区的叠置限定非连续的圆周处理区而不形成连续的周向损伤。提供了用于实现这种非连续圆周处理的方法和装置的各种实施例。

73. 发明授权

US08444640B2 Methods and apparatus for performing a non-continuous circumferential treatment of a body lumen 有权
公开(公告)号：US08444640B2
公开(公告)日：2013-05-21
申请号：US13620173
申请日：2012-09-14
申请人： Denise Demarais , Hanson Gifford, III , Mark Deem , Nicolas Zadno , Benjamin J. Clark , Andrew Wu , Kenneth J. Michlitsch
发明人： Denise Demarais , Hanson Gifford, III , Mark Deem , Nicolas Zadno , Benjamin J. Clark , Andrew Wu , Kenneth J. Michlitsch
IPC分类号： A61B18/12
CPC分类号： A61B18/1492 , A61B18/1206 , A61B18/18 , A61B2018/00023 , A61B2018/00077 , A61B2018/0016 , A61B2018/0022 , A61B2018/00267 , A61B2018/00404 , A61B2018/00434 , A61B2018/00511 , A61B2018/00648 , A61B2018/00791 , A61B2018/00875 , A61B2018/124 , A61B2018/1435 , A61B2018/1465 , A61N1/0551 , A61N1/32 , A61N1/327 , A61N1/36007 , A61N7/022
摘要： Methods and apparatus are provided for non-continuous circumferential treatment of a body lumen. Apparatus may be positioned within a body lumen of a patient and may deliver energy at a first lengthwise and angular position to create a less-than-full circumferential treatment zone at the first position. The apparatus also may deliver energy at one or more additional lengthwise and angular positions within the body lumen to create less-than-full circumferential treatment zone(s) at the one or more additional positions that are offset lengthwise and angularly from the first treatment zone. Superimposition of the first treatment zone and the one or more additional treatment zones defines a non-continuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such non-continuous circumferential treatment are provided.

74. 发明申请

US20120143181A1 APPARATUSES FOR MONOPOLAR RENAL NEUROMODULATION 审中-公开
标题翻译：单眼神经元神经修复的装置
公开(公告)号：US20120143181A1
公开(公告)日：2012-06-07
申请号：US13371285
申请日：2012-02-10
申请人： Denise Demarais , Hanson Gifford, III , Mark Deem , Howard R. Levin , Mark Gelfand , Nicolas Zadno
发明人： Denise Demarais , Hanson Gifford, III , Mark Deem , Howard R. Levin , Mark Gelfand , Nicolas Zadno
IPC分类号： A61B18/00 , A61N1/36
CPC分类号： A61N1/36007 , A61N1/0551 , A61N1/32 , A61N1/327
摘要： Methods and apparatus are provided for monopolar neuromodulation, e.g., via a pulsed electric field. Such monopolar neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, monopolar neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such monopolar neuromodulation is performed bilaterally.
摘要翻译：提供了用于单极神经调节的方法和装置，例如通过脉冲电场。这种单极神经调节可能会导致不可逆的电穿孔或电融合，坏死和/或诱导凋亡，基因表达的改变，动作电位减弱或阻断，细胞因子上调的变化和靶神经纤维中的其他条件。在一些实施方案中，单极神经调节被应用于有助于肾功能的神经纤维。在一些实施方案中，这种单极神经调节是双侧进行的。

75. 发明授权

US08150520B2 Methods for catheter-based renal denervation 有权
标题翻译：基于导管的肾去神经支配方法
公开(公告)号：US08150520B2
公开(公告)日：2012-04-03
申请号：US11368949
申请日：2006-03-06
申请人： Denise Demarais , Hanson Gifford, III , Mark Deem , Douglas Sutton , Howard R. Levin , Mark Gelfand
发明人： Denise Demarais , Hanson Gifford, III , Mark Deem , Douglas Sutton , Howard R. Levin , Mark Gelfand
IPC分类号： A61N1/00 , A61K9/22
CPC分类号： A61N1/05 , A61N1/0551 , A61N1/327 , A61N1/40
摘要： Methods and apparatus are provided for treating end-stage renal disease, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.
摘要翻译：提供了用于通过脉冲电场经由刺激电场，经由局部药物递送，经由高频超声波，经由热技术等来治疗终末期肾脏疾病的方法和装置。这种神经调节可以实现不可逆的电穿孔或电融合，坏死和/或诱导凋亡，基因表达改变，动作电位衰减或阻断，细胞因子上调和靶神经纤维中的其他条件的变化。在一些实施方案中，神经调节被应用于有助于肾功能的神经纤维。在一些实施方案中，这种神经调节以双向方式进行。与单侧执行的肾神经调节相比，双侧肾神经调节可以在一些患者中提供增强的治疗效果，即与在支配单个肾脏的神经组织上进行的肾神经调节相比。

76. 发明申请

US20110208096A1 METHODS AND APPARATUS FOR THERMALLY-INDUCED RENAL NEUROMODULATION 有权
标题翻译：用于热诱导的肾脏神经调节的方法和装置
公开(公告)号：US20110208096A1
公开(公告)日：2011-08-25
申请号：US13046595
申请日：2011-03-11
申请人： Denise Demarais , Andrew Wu , Hanson Gifford, III , Mark Deem , Mark Gelfand , Howard R. Levin
发明人： Denise Demarais , Andrew Wu , Hanson Gifford, III , Mark Deem , Mark Gelfand , Howard R. Levin
IPC分类号： A61B18/04 , A61N7/02
CPC分类号： A61B18/1492 , A61B2018/00404 , A61B2018/00434 , A61B2018/00505 , A61B2018/00511 , A61B2018/00577 , A61B2018/00642 , A61F7/123 , A61F2007/126 , A61M5/14276 , A61M5/1723 , A61M2210/1082 , A61N1/28 , A61N1/32 , A61N1/326 , A61N1/36007 , A61N1/36017 , A61N1/36114 , A61N1/36117 , A61N1/3627 , A61N1/403 , A61N5/045 , A61N7/02 , A61N2007/003
摘要： Methods and apparatus 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.
摘要翻译：提供了用于热诱导的肾神经调节的方法和装置。热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。在一些实施方案中，热诱导的肾神经调节通过脉冲热疗法的递送来实现。

77. 发明授权

US07873417B2 Methods and apparatus for pulsed electric field neuromodulation via an intra-to-extravascular approach 有权
标题翻译：通过血管内血管内途径进行脉冲电场神经调节的方法和装置
公开(公告)号：US07873417B2
公开(公告)日：2011-01-18
申请号：US12616708
申请日：2009-11-11
申请人： Denise Demarais , Benjamin J. Clark , Nicolas Zadno , Erik Thai , Hanson Gifford, III
发明人： Denise Demarais , Benjamin J. Clark , Nicolas Zadno , Erik Thai , Hanson Gifford, III
IPC分类号： A61N1/05
CPC分类号： A61B18/1477 , A61B18/1206 , A61B2018/0022 , A61B2018/00267 , A61B2018/00404 , A61B2018/00434 , A61B2018/00505 , A61B2018/00613 , A61B2018/126 , A61M5/14 , A61M37/00 , A61N1/05 , A61N1/0514 , A61N1/0551 , A61N1/321 , A61N1/327 , A61N1/36007
摘要： Methods and apparatus are provided for pulsed electric field neuromodulation via an intra-to-extravascular approach, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation and other conditions in target neural fibers. In some embodiments, the ITEV PEF system comprises an intravascular catheter having one or more electrodes configured for intra-to-extravascular placement across a wall of patient's vessel into proximity with target neural fibers. With the electrode(s) passing from an intravascular position to an extravascular position prior to delivery of the PEF, a magnitude of applied voltage or energy delivered via the electrode(s) and necessary to achieve desired neuromodulation may be reduced relative to an intravascular PEF system having one or more electrodes positioned solely intravascularly. The methods and apparatus of the present invention may, for example, be used to modulate one or more target neural fibers that contribute to renal function.
摘要翻译：提供了通过血管外途径进行脉冲电场神经调节的方法和装置，例如，以实现不可逆的电穿孔或电融合，坏死和/或诱导细胞凋亡，基因表达的改变，细胞因子上调的变化以及目标中的其他条件神经纤维。在一些实施方案中，ITEV PEF系统包括具有一个或多个电极的血管内导管，其配置用于穿过患者血管的壁进行血管外放置，使其与目标神经纤维接近。随着电极在PEF递送之前从血管内位置传递到血管外位置，可以相对于血管内PEF减少施加的电压或通过电极递送并且达到所需神经调节所必需的能量的大小系统具有仅位于血管内的一个或多个电极。本发明的方法和装置可以例如用于调节一种或多种有助于肾功能的靶神经纤维。

78. 发明申请

US20100268307A1 METHODS FOR INTRAVASCULARLY-INDUCED NEUROMODULATION 审中-公开
标题翻译：静脉诱导神经修复的方法
公开(公告)号：US20100268307A1
公开(公告)日：2010-10-21
申请号：US12827700
申请日：2010-06-30
申请人： Denise Demarais , Nicolas Zadno , Benjamin J. Clark , Erik Thai
发明人： Denise Demarais , Nicolas Zadno , Benjamin J. Clark , Erik Thai
IPC分类号： A61N1/02
CPC分类号： A61B18/1492 , A61B17/12136 , A61B2018/00083 , A61B2018/00285 , A61B2018/00434 , A61B2018/00613 , A61M25/0108 , A61M25/10 , A61N1/327 , A61N1/36007 , A61N1/36121 , A61N1/36182 , A61N1/37205 , A61N1/40
摘要： Methods and apparatus are provided for intravascularly-induced neuromodulation using a pulsed electric field, e.g., to effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, changes in cytokine upregulation, etc., in target neural fibers. In some embodiments, the intravascular PEF system comprises a catheter having a pair of bipolar electrodes for delivering the PEF, with a first electrode positioned on a first side of an impedance-altering element and a second electrode positioned on an opposing side of the impedance-altering element. A length of the electrodes, as well as a separation distance between the first and second electrodes, may be specified such that, with the impedance-altering element deployed in a manner that locally increases impedance within a patient's vessel, e.g., with the impedance-altering element deployed into contact with the vessel wall at a treatment site within the patient's vasculature, a magnitude of applied voltage delivered across the bipolar electrodes necessary to achieve desired neuromodulation is reduced relative to an intravascular PEF system having similarly spaced electrodes but no (or an undeployed) impedance-altering element. In a preferred embodiment, the impedance-altering element comprises an inflatable balloon configured to locally increase impedance within a patient's vasculature. The methods and apparatus of the present invention may be used to modulate a neural fiber that contributes to renal function.
摘要翻译：提供了使用脉冲电场进行血管内诱导的神经调节的方法和装置，例如，在靶神经纤维中实现不可逆的电穿孔或电融合，坏死和/或诱导细胞凋亡，基因表达的改变，细胞因子上调的变化等。在一些实施例中，血管内PEF系统包括导管，其具有用于传送PEF的一对双极电极，第一电极位于阻抗改变元件的第一侧上，第二电极位于阻抗变换元件的相对侧上，改变元素可以规定电极的长度以及第一和第二电极之间的间隔距离，使得以阻抗变化元件部署的方式，其局部地增加患者血管内的阻抗，例如阻抗 - 改变元件被部署成与病人血管系统中的治疗部位处的血管壁接触，相对于具有类似间隔开的电极而没有（或一个或多个）的血管内PEF系统，减少了实现所需神经调节所需双极电极的施加电压的大小未部署）阻抗变化元件。在优选实施例中，阻抗改变元件包括构造成在患者的脉管系统内局部增加阻抗的可充气球囊。本发明的方法和装置可用于调节有助于肾功能的神经纤维。

79. 发明申请

US20100222851A1 METHODS FOR MONITORING RENAL NEUROMODULATION 有权
标题翻译：监测肾脏神经修复的方法
公开(公告)号：US20100222851A1
公开(公告)日：2010-09-02
申请号：US12777892
申请日：2010-05-11
申请人： Mark Deem , Hanson Gifford, III , Denise Demarais , Douglas Sutton , Erik Thai , Mark Gelfand , Howard R. Levin
发明人： Mark Deem , Hanson Gifford, III , Denise Demarais , Douglas Sutton , Erik Thai , Mark Gelfand , Howard R. Levin
IPC分类号： A61N1/05 , A61B8/06
CPC分类号： A61N1/36007 , A61B8/0891 , A61B8/12 , A61B18/1206 , A61B18/1233 , A61B18/1492 , A61B18/18 , A61B2018/00071 , A61B2018/00214 , A61B2018/0022 , A61B2018/00267 , A61B2018/00404 , A61B2018/00434 , A61B2018/00505 , A61B2018/00511 , A61B2018/00577 , A61B2018/00613 , A61B2018/00642 , A61B2018/00904 , A61B2018/126 , A61B2018/1467 , A61M5/14 , A61M25/0023 , A61N1/0412 , A61N1/05 , A61N1/0551 , A61N1/18 , A61N1/205 , A61N1/326 , A61N1/327 , A61N1/36017 , A61N1/36057 , A61N1/3606 , A61N1/36103 , A61N1/36114 , A61N1/36117 , A61N1/36139 , A61N5/00 , A61N7/00 , A61N2007/0021 , A61N2007/003
摘要： Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.
摘要翻译：提供使用脉冲电场进行肾神经调节以实现电穿孔或电融合的方法和装置。预期肾脏神经调节（例如去神经支配）可以减少急性心肌梗塞的扩张，减少或预防与充血性心力衰竭有关的形态学变化的发生，和/或有效治疗晚期肾脏疾病。本发明的实施例被配置用于经皮血管内递送脉冲电场以实现这种神经调节。

80. 发明申请

US20100137952A1 APPARATUSES FOR THERMALLY-INDUCED RENAL NEUROMODULATION 有权
标题翻译：用于热诱导的肾脏神经调节的装置
公开(公告)号：US20100137952A1
公开(公告)日：2010-06-03
申请号：US12700524
申请日：2010-02-04
申请人： Denise Demarais , Nicolas Zadno , Benjamin J. Clark , Erik Thai , Howard R. Levin , Mark Gelfand
发明人： Denise Demarais , Nicolas Zadno , Benjamin J. Clark , Erik Thai , Howard R. Levin , Mark Gelfand
IPC分类号： A61F7/12
CPC分类号： A61N7/022 , A61B18/02 , A61B18/04 , A61B18/12 , A61B18/1492 , A61B2018/0022 , A61B2018/00434 , A61B2018/00511 , A61B2018/00577 , A61F7/007 , A61F7/12 , A61F7/123 , A61F2007/126 , A61M5/44 , A61M2210/1082 , A61N1/28 , A61N1/36007 , A61N1/403 , A61N5/00 , A61N5/025 , A61N5/045 , A61N5/0603 , A61N7/00 , A61N7/02 , A61N2007/003 , A61N2007/0078
摘要： Methods and apparatus 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.
摘要翻译：提供了用于热诱导的肾神经调节的方法和装置。热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。

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