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Methods and devices for denervation

a technology of denervation and denervation tube, which is applied in the field of denervation tube methods and devices, can solve the problems of limiting the selection of particular therapeutic agents, difficult to deliver therapeutic agents with sufficient precision to the renal nerve, and toxic to the patient or surrounding tissues

Inactive Publication Date: 2011-07-28
NORTHWIND MEDICAL
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

However, it may be difficult to deliver therapeutic agents with sufficient precision to the renal nerves.
This approach uses more of the agent than is necessary and may be toxic to the patient or surrounding tissues.
Moreover, the toxicity concerns can also significantly limit the selection of particular therapeutic agents to kill nerves and the ability to provide effective treatment.
Radio frequency (RF) ablation of the renal nerves has been practiced and often lacks fine control, and may cause unintended damage to neighboring tissue such as the endothelium lining blood vessels and smooth muscles that constitute blood vessel walls, resulting in vessel injury or occlusion.

Method used

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  • Methods and devices for denervation
  • Methods and devices for denervation
  • Methods and devices for denervation

Examples

Experimental program
Comparison scheme
Effect test

example 1

A vasoconstrictor (antidiuretic hormone (ADH or vasopressin) or tetrahydrozoline) is first administered to vessels surrounding the target site to minimize leakage of the priming or secondary agents.

A priming agent of digoxin at a concentration of 0.0001-10 mM in a volume of 0.05-2 cc is then administered at a nerve proximal site to prime the neurons by inhibiting the transport of potassium and sodium across the nerve cell membrane and subsequently inducing an intracellular calcium flux.

Approximately 0.1-20 minutes later, a secondary agent of glutamate at a concentration of 0.1-700 mM in a volume of 0.05-2 cc is then administered at a nerve proximal site to induce neuronal excitotoxicity.

Vasoconstriction results from the increased concentration of calcium (Ca2+ ions) within vascular smooth muscle cells. However, the specific mechanisms for generating an increased intracellular concentration of calcium depends on the vasoconstrictor. Two common stimuli for eliciting smooth muscle cont...

example 2

A vasoconstrictor (antidiuretic hormone (ADH or vasopressin) or tetrahydrozoline) is first administered to vessels surrounding the target site to minimize leakage of the priming or secondary agents.

A priming agent of proscillaridin at a concentration of 0.0001-10 mM in a volume of 0.05-2 cc is then administered at a nerve proximal site to prime the neurons by inhibiting the transport of potassium and sodium across the nerve cell membrane and subsequently inducing an intracellular calcium flux.

Approximately 0.1-20 minutes later, a secondary agent of domoic acid at a concentration of 0.00005-0.005 mM in a volume of 0.05-2 cc is then administered at a nerve proximal site to induce neuronal excitotoxicity.

Proscillaridin binds to a site on the extracellular aspect of the α-subunit of the Na+ / K+ ATPase pump in the membranes of heart cells (myocytes) and decreases its function. This causes an increase in the level of sodium ions in the myocytes, which leads to a rise in the level of intrac...

example 3

A vasoconstrictor (antidiuretic hormone (ADH or vasopressin) or tetrahydrozoline) is first administered to vessels surrounding the target site to minimize leakage of the priming or secondary agents.

A priming agent of N-Methyl-D-aspartic acid (NMDA) at a concentration of 0.01-300 mM in a volume of 0.05-2 cc is then administered at a nerve proximal site to prime the neurons by inducing excitatory intracellular signaling.

Approximately 0.1-20 minutes later, a secondary agent of digoxin at a concentration of 0.0001-10 mM in a volume of 0.05-2 cc is then administered at a nerve proximal site to inhibit the transport of potassium and sodium across the nerve cell membrane and subsequently induce high levels of intracellular calcium to mediate pro-apoptotic signaling and neuronal toxicity.

N-Methyl-D-aspartic acid (NMDA) is an amino acid derivative, which acts as a specific agonist at the NMDA receptor mimicking the action of glutamate, the neurotransmitter, which normally acts at that recept...

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Abstract

Various delivery devices are described to deliver an agent locally to the renal nerves. The delivery devices are positioned in the renal artery and penetrate into the wall of the renal artery to deliver the agent to the renal nerves. The delivery devices may be used to deliver the agent according to longitudinal position, radial position, and depth of the renal nerves relative to the renal artery. In addition, various methods are described to denervate, modulate, or otherwise affect the renal nerves and other neural tissue. Also, various agents are described to denerve, modulate, or otherwise affect the renal nerves and other neural tissue.

Description

BACKGROUNDA blood vessel or other bodily passage may be used to access parts of the body to deliver an agent to a target site in the wall of the vessels. For example, the renal arteries may be used as access pathways to deliver a therapeutic agent to the renal nerves, which run within the wall of the renal arteries. However, it may be difficult to deliver therapeutic agents with sufficient precision to the renal nerves. One approach is to “flood” the entire region about the circumference of the renal artery using the agent. This approach uses more of the agent than is necessary and may be toxic to the patient or surrounding tissues. Moreover, the toxicity concerns can also significantly limit the selection of particular therapeutic agents to kill nerves and the ability to provide effective treatment.What is needed is a way of locally delivering the amount of an agent needed to effect a desired therapeutic response while reducing injury or harm to surrounding tissue. What is also nee...

Claims

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Application Information

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IPC IPC(8): A61M37/00A61M25/00A61M25/10A61F2/958
CPCA61B5/0215A61B5/4839A61B2017/22054A61B2017/22061A61B2017/22067A61B2019/5276A61K31/7048A61M25/0084A61M25/04A61M2025/0086A61M2025/0087A61M2025/1047A61B2019/528A61B5/4094A61B2090/3784A61B2090/378A61K45/06A61K31/198A61K31/55A61P25/00A61P43/00A61P9/04A61P9/06A61P9/12A61K2300/00
Inventor EVANS, MICHAEL A.VENKATESWARA-RAO, KONDAPAVULUR T.STEIN, EMILY A.
Owner NORTHWIND MEDICAL
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