System and method for mapping functional nerves innervating wall of arteries, 3-d mapping and catheters for same

A catheter and renal artery technology, applied in the field of catheter system for renal nerve mapping and ablation, can solve the problems of lack of immediate postoperative assessment methods, failure of energy transfer, insufficient dose, etc.

Active Publication Date: 2018-09-28
SYMAP MEDICAL (SUZHOU) LIMITED
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0061] Failure of current treatments is attributed to regeneration of nerves after ablation (Esler et al., 2010), and also likely to inability to deliver required doses of energy to target nerves and insufficient dosing of delivered energy for effective ablation
Currently, the success of denervation can only be assessed by measuring secondary episodes of norepinephrine spillover at least several days after the interventional procedure (Krum et al., 2009), and methods for immediate postoperative assessment are lacking

Method used

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  • System and method for mapping functional nerves innervating wall of arteries, 3-d mapping and catheters for same
  • System and method for mapping functional nerves innervating wall of arteries, 3-d mapping and catheters for same
  • System and method for mapping functional nerves innervating wall of arteries, 3-d mapping and catheters for same

Examples

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example 1

[0228] Locate the nerves that innervate the arterial wall

[0229] In acute pig experiments, a method for locating nerves innervating the arterial wall by examining changes in physiological parameters following the delivery of an appropriate dose of energy was designed and performed. The goals of this experiment are:

[0230] 1. For the purpose of renal nerve mapping and ablation, test a currently existing cardiac ablation catheter (7F, Type B, 2-5-2mm spacing, RMT diagnostic / ablation steerable catheter, Biosense Webster, Diamond Bar, CA 91765, USA) and radio frequency generator (STOCKERT 70RF generator, Model Stockert GmbH EP-SHUTTLE ST-3205, STOCKERT GmbH, Freiburg, Germany).

[0231] 2. Test renal nerve mapping by delivering electrical stimulation at different sites within the lumen of the left and right renal arteries to examine changes in blood pressure and heart rate.

[0232] 3. Determine the safe range of high radio frequency energy to be launched into the renal a...

example 2

[0238] Relationship between physiological parameters and nerves innervating arterial walls

[0239] To demonstrate that energy delivered to different locations on the arterial wall can lead to different effects on physiological parameters such as blood pressure and heart rate, and that such features can be used to identify the type of nerves innervating the arterial wall, the electrical energy is delivered to the arterial wall according to several strategies. Innervation area on the wall of the renal artery in experimental pigs. Detailed parameters regarding the electrical energy delivered to pigs 1, 2, 3, 4, 5, 6 and 7 are shown in Tables 1 to 7, respectively. For pigs 4 to 7, the equipment used was SyMapCath S07A600 and SYMPIONEER S1 v01 / 01.

[0240] In pig 1, four separate stimulations were performed in the left renal artery and two separate stimulations were performed in the right renal artery. As a preliminary test, on the ventral side of the left renal artery, two se...

example 3

[0301] Ensure energy can be delivered to the target nerve during ablation

[0302]Following the study of locating and identifying nerves in the arterial wall, energy suitable for ablation doses was again delivered to the innervation points in the renal artery wall of the same porcine model. The four ablations were delivered to the left renal artery and the right renal artery, respectively, starting from the renal side, moving to the abdominal aorta side in the order of movement from the anterior wall to the posterior wall, to the superior wall, and then to the inferior wall; each ablation The location of the previous ablation was ≤5 mm, and the electrode tip (catheter tip) of the ablation catheter was rotated 90 degrees after each ablation. According to literature (Krum 2009, 2010), low levels of energy (5-8 watts) can be applied for renal ablation, therefore, 5 and 8 watts of energy would be used for renal ablation. For left renal artery ablation, the applied energy level ...

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Abstract

Disclosed herein are a system and method for locating and identifying nerves innervating the wall of arteries such as the renal artery. The system identifies an area on a vessel wall innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The method includes evaluating a change in physiological parameters after energy is delivered to arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic ornone) based on the evaluated results. The system includes at least a device (101) for delivering energy to the wall of a blood vessel; a sensor (103) for detecting physiological signals from a subject; and an indicator (105) to display results obtained using said method. Also provided are catheters (2510, 2520) for performing the mapping and ablating functions.

Description

[0001] In this application, various publications are cited. This application combines the published documents published in the related field to more fully express the advanced level of the present invention in the related field. technical field [0002] The present invention relates to systems and methods for accurately and precisely locating and identifying areas innervated by sympathetic and parasympathetic related nerves during and after energy transfer procedures on the arterial wall. The present invention also relates to catheter systems specific for renal nerve mapping and ablation. Background technique [0003] Congestive heart failure, hypertension, diabetes mellitus, and chronic renal failure have many different initial etiologies; however, these diseases all follow a common course in their progression to end-stage disease. This common process is renal sympathetic hyperexcitation. The renal sympathetic nerve acts as a signal input pathway, transmitting the afferen...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): A61B18/14A61N1/00
CPCA61B18/1492A61N1/056A61N1/36117A61B5/0215A61B17/22004A61B18/20A61B2018/00434A61B2018/00511A61B2018/00577A61B2018/0212A61B2018/00839A61B5/6852A61B5/6876A61B5/4893A61B5/24A61N1/36128A61B2018/1407
Inventor 王捷
Owner SYMAP MEDICAL (SUZHOU) LIMITED
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