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11. 发明申请

WO2007035537A3 METHODS AND APPARATUS FOR INDUCING CONTROLLED RENAL NEUROMODULATION 审中-公开
公开(公告)号：WO2007035537A3
公开(公告)日：2007-03-29
申请号：PCT/US2006/036120
申请日：2006-09-14
申请人： ARDIAN, INC. , DEMARAIS, Denise , ZADNO, Nicolas
发明人： DEMARAIS, Denise , ZADNO, Nicolas
IPC分类号： A61N1/32
摘要： Methods and apparatus are provided for inducing, monitoring and controlling renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. In some embodiments, tissue impedance, conductance or conductivity may be monitored to determine the effects of pulsed electric field therapy, e.g., to determine an extent of electroporation and its degree of irreversibility. Pulsed electric field electroporation of tissue causes a decrease in tissue impedance and an increase in tissue conductivity. If induced electroporation is reversible, upon cessation of the pulsed electric field, tissue impedance and conductivity should approximate baseline levels; however, if electroporation is irreversible, impedance and conductivity changes should persist. Thus, monitoring of impedance or conductivity may be utilized to determine the onset of electroporation and to determine the type or extent of electroporation. Furthermore, monitoring data may be used in one or more manual or automatic feedback loops to control the electroporation.

12. 发明申请

WO2007086965A3 METHODS AND APPARATUS FOR INTRAVASCULARLY-INDUCED NEUROMODULATION 审中-公开
标题翻译：用于血管内诱导神经调节的方法和装置
公开(公告)号：WO2007086965A3
公开(公告)日：2008-12-18
申请号：PCT/US2006041889
申请日：2006-10-26
申请人： ARDIAN INC , DEMARAIS DENISE , ZADNO NICOLAS , CLARK BENJAMIN J , THAI ERIK
发明人： DEMARAIS DENISE , ZADNO NICOLAS , CLARK BENJAMIN J , THAI ERIK
IPC分类号： A61N1/00
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。

13. 发明申请

WO2008061152A3 METHODS AND APPARATUS FOR PERFORMING A NON-CONTINUOUS CIRCUMFERENTIAL TREATMENT TO A BODY LUMEN 审中-公开
公开(公告)号：WO2008061152A3
公开(公告)日：2008-05-22
申请号：PCT/US2007/084708
申请日：2007-11-14
申请人： ARDIAN, INC. , DEMARAIS, Denise , GIFFORD, Hanson , ZADNO, Nicolas , DEEM, Mark , CLARK, Benjamin, J. , WU, Andrew , MICHLITSCH, Kenneth, J.
发明人： DEMARAIS, Denise , GIFFORD, Hanson , ZADNO, Nicolas , DEEM, Mark , CLARK, Benjamin, J. , WU, Andrew , MICHLITSCH, Kenneth, J.
IPC分类号： A61B18/18
摘要： Methods and apparatus are provided for discontinuous 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 discontinuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such discontinuous circumferential treatment are provided.

14. 发明申请

WO2008061152A2 METHODS AND APPARATUS FOR PERFORMING A NON-CONTINUOUS CIRCUMFERENTIAL TREATMENT TO A BODY LUMEN 审中-公开
标题翻译：用于对身体不良液体进行非连续循环治疗的方法和装置
公开(公告)号：WO2008061152A2
公开(公告)日：2008-05-22
申请号：PCT/US2007084708
申请日：2007-11-14
申请人： ARDIAN INC , DEMARAIS DENISE , GIFFORD HANSON , ZADNO NICOLAS , DEEM MARK , CLARK BENJAMIN J , WU ANDREW , MICHLITSCH KENNETH J
发明人： DEMARAIS DENISE , GIFFORD HANSON , ZADNO NICOLAS , DEEM MARK , CLARK BENJAMIN J , WU ANDREW , MICHLITSCH KENNETH J
IPC分类号： A61B18/18
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 discontinuous 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 discontinuous circumferential treatment zone without formation of a continuous circumferential lesion. Various embodiments of methods and apparatus for achieving such discontinuous circumferential treatment are provided.
摘要翻译：提供了用于体腔内不连续周边处理的方法和装置。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了不连续的圆周处理区，而不形成连续的周向损伤。提供了用于实现这种不连续周向处理的方法和装置的各种实施例。

15. 发明申请

WO2008003058A2 METHODS AND SYSTEMS FOR THERMALLY-INDUCED RENAL NEUROMODULATION 审中-公开
标题翻译：用于热诱导的肾脏神经调节的方法和系统
公开(公告)号：WO2008003058A2
公开(公告)日：2008-01-03
申请号：PCT/US2007/072396
申请日：2007-06-28
申请人： ARDIAN, INC. , DEMARAIS, Denise , ZADNO, Nicolas , CLARK, Benjamin, J. , THAI, Erik , LEVIN, Howard, R. , GELFAND, Mark , WU, Andrew , GIFFORD, Hanson , DEEM, Mark
发明人： DEMARAIS, Denise , ZADNO, Nicolas , CLARK, Benjamin, J. , THAI, Erik , LEVIN, Howard, R. , GELFAND, Mark , WU, Andrew , GIFFORD, Hanson , DEEM, Mark
IPC分类号： A61N1/00
CPC分类号： A61B18/1233 , A61B18/12 , A61B18/1206 , A61B18/14 , A61B18/1492 , A61B18/1815 , A61B90/39 , A61B2017/00084 , A61B2017/22054 , A61B2017/22068 , A61B2018/00023 , A61B2018/00214 , A61B2018/0022 , A61B2018/00261 , A61B2018/00279 , A61B2018/00404 , A61B2018/00434 , A61B2018/00505 , A61B2018/00511 , A61B2018/00577 , A61B2018/00636 , A61B2018/00666 , A61B2018/00702 , A61B2018/00714 , A61B2018/00755 , A61B2018/00779 , A61B2018/00791 , A61B2018/00875 , A61B2018/00994 , A61B2018/143 , A61B2018/1432 , A61B2018/144 , A61B2018/1475 , A61F7/007 , A61F7/10 , A61F7/12 , A61F2007/0056 , A61F2007/0075 , A61F2007/126 , A61N1/0558 , A61N1/057 , A61N1/06 , A61N1/36007 , A61N1/36017 , A61N1/403 , A61N5/0601 , A61N5/0622 , A61N7/02 , A61N7/022 , A61N2005/0612 , A61N2007/0026 , A61N2007/003
摘要： 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.
摘要翻译：提供热诱导肾神经调节的方法和系统。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。

16. 发明申请

WO2007121309A3 METHODS AND APPARATUS FOR MONOPOLAR RENAL NEUROMODULATION 审中-公开
公开(公告)号：WO2007121309A3
公开(公告)日：2007-10-25
申请号：PCT/US2007/066539
申请日：2007-04-12
申请人： ARDIAN, INC. , DEMARAIS, Denise , GIFFORD, Hanson , DEEM, Mark , LEVIN, Howard, R. , GELFAND, Mark , ZADNO, Nicolas
发明人： DEMARAIS, Denise , GIFFORD, Hanson , DEEM, Mark , LEVIN, Howard, R. , GELFAND, Mark , ZADNO, Nicolas
IPC分类号： A61N1/08
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.

17. 发明申请

WO2007078997A2 METHODS AND APPARATUS FOR PULSED ELECTRIC FIELD NEUROMODULATION VIA AN INTRA-TO-EXTRAVASCULAR APPROACH 审中-公开
标题翻译：脉冲电场神经网络的方法和装置，通过内向外方法
公开(公告)号：WO2007078997A2
公开(公告)日：2007-07-12
申请号：PCT/US2006/048822
申请日：2006-12-21
申请人： ARDIAN, INC. , DEMARAIS, Denise , CLARK, Benjamin, J. , ZADNO, Nicolas , THAI, Erik , GIFFORD, Hanson, III
发明人： DEMARAIS, Denise , CLARK, Benjamin, J. , ZADNO, Nicolas , THAI, Erik , GIFFORD, Hanson, III
IPC分类号： A61N1/00
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：为脉冲电场神经调制提供了方法和装置。通过血管外途径进行，例如，以实现不可逆的电穿孔或电融合，细胞凋亡的坏死和/或诱导，基因表达的改变，细胞因子上调的变化和靶神经纤维中的其它条件。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以接近目标神经纤维。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传递并且达到所需神经调节所必需的能量的大小系统具有一个或多个位于血管内的电极。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。

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