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Methods and devices for endovascular ablation of a splanchnic nerve

a technology of splanchnic nerve and endovascular ablation, which is applied in the field of methods and devices for endovascular ablation of splanchnic nerve, can solve the problems of increasing the cost of treatment, increasing the risk of complications,

Active Publication Date: 2021-09-30
AXON THERAPIES INC
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

This approach potentially reduces the volume of blood returned to the heart, alleviating heart failure symptoms and decreasing healthcare costs associated with recurrent admissions.

Problems solved by technology

Heart failure is a serious condition and affects millions of patients in the United States and around the world.
While a number of drug therapies successfully target systolic dysfunction and HFrEF, for the large group of patients with diastolic dysfunction and HFpEF no promising therapies have yet been identified.
Recurrent admissions for ADHF utilize a large part of current health care resources and could continue to generate enormous costs.
While the pathophysiology of HF is becoming increasingly better understood, modern medicine has, thus far, failed to develop new therapies for chronic management of HF or recurrent ADHF episodes.

Method used

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  • Methods and devices for endovascular ablation of a splanchnic nerve
  • Methods and devices for endovascular ablation of a splanchnic nerve
  • Methods and devices for endovascular ablation of a splanchnic nerve

Examples

Experimental program
Comparison scheme
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first embodiment

[0190]In a method of ablating a right GSN an ablation catheter having a proximal radiopaque marker 136, a distal radiopaque marker 130, an ablation element 131 or plurality of ablation elements 132, 133, and an optional gap 135 between the ablation element and the distal radiopaque marker is advanced from an azygos vein 50 into an intercostal vein 55 at one of the lower three thoracic levels (e.g., T9, T10, T11). The C-Arm is placed in Anterior-Posterior (AP) orientation. The proximal radiopaque marker 136 is aligned with the midline of the vertebra 69, which is possible if the azygos vein 50 is centered or left-biased. If the azygos vein 50 is left-biased the proximal radiopaque marker will need to be advanced into the intercostal vein to align it with the midline of the vertebra 69. If the azygos vein is right-biased the proximal radiopaque marker 136 will not be able to be placed at the midline of the vertebra 69. In this case the proximal radiopaque marker 136 may be placed at t...

second embodiment

[0191]In a method of ablating a right GSN an ablation catheter having a proximal radiopaque marker 136, a distal radiopaque marker 130, an ablation element 131 or plurality of ablation elements 132, 133, and an optional gap 135 between the ablation element and the distal radiopaque marker is advanced from an azygos vein 50 into an intercostal vein 55 at one of the lower three thoracic levels (e.g., T9, T10, T11). The C-Arm is placed in Anterior-Posterior (AP) orientation. The proximal radiopaque marker 136 is aligned with the intercostal vein ostium 59. The ostium can be found for example by injecting contrast agent and viewing the vasculature on fluoroscopy or if a guidewire was previously positioned in a target intercostal vein a bend in the guidewire or ablation catheter may indicate the location of the ostium. If the azygos vein is left-biased the catheter is advanced distal to the ostium to align the proximal radiopaque marker 136 with the midline of the vertebra 69. In this pl...

third embodiment

[0192]In a method of ablating a right GSN an ablation catheter having a distal radiopaque marker 130, an ablation element 131 or plurality of ablation elements 132, 133, and a gap 135 between the ablation element and the distal radiopaque marker is advanced from an azygos vein 50 into an intercostal vein 55 at one of the lower three thoracic levels (e.g., T9, T10, T11). The C-Arm is obliquely angled to the right to maximize the 2D projection of the section of intercostal vein between the costovertebral joint 61 and anterior midline of the vertebra 69 (FIG. 2). For example, the C-arm may be positioned with a Right Anterior Oblique (RAO) angle in a range of 20° to 70° from AP (e.g., in a range of 30° to 60°, in a range of 35° to 55°, about 30°, at an angle that maximizes projected distance between the proximal and distal RO markers). A fluoroscopy image in an anterior-posterior (AP) view is shown in FIG. 6. In comparison a fluoroscopy image in a RAO 300 is shown in FIG. 7. The cathete...

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Abstract

Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

Description

INCORPORATION BY REFERENCE[0001]This application is a continuation of U.S. application Ser. No. 17 / 152,665 dated Jan. 19, 2021 which claims priority to U.S. Provisional Application No. 62 / 962,627, filed Jan. 17, 2020 and U.S. Provisional Application No. 63 / 086,516, filed Oct. 1, 2020, the disclosures of which are incorporated by reference herein in their entireties for all purposes.[0002]All publications and patent applications mentioned in this specification are herein incorporated by reference to the same extent as if each individual publication or patent application was specifically and individually indicated to be incorporated by reference.[0003]This disclosure is related by subject matter to the disclosure in U.S. Provisional Application 62 / 864,093, filed Jun. 20, 2019, U.S. Provisional Application 62 / 881,251, filed Jul. 31, 2019, U.S. Provisional Application 62 / 962,627 filed Jan. 17, 2020, U.S. Pub. Nos. US2019 / 0175912, US2019 / 0183569, U.S. Pat. Nos. 10,376,308, 10,207,110, Ap...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): A61B18/14
CPCA61B18/1492A61B2018/00642A61B2018/00434A61B2018/1435A61B2018/00029A61B2218/002A61B2018/00791A61B2018/00875A61B2018/00678A61B2018/00702A61B2018/00886A61B2018/1467A61B2018/00214A61B2018/0022A61B2018/00577A61B2018/00672A61B2018/00267A61B2018/00613A61B2018/00994A61B2018/00982A61B2018/1472A61B2018/1253A61B2018/126A61B2018/00726A61B2018/124A61B2018/167A61B2217/007A61B2018/00077A61M25/0052A61B2018/00863A61B2018/00708A61M25/0108A61N7/00A61N2007/003
Inventor IRANITALAB, PAJHANDMILLER, CASEY ANDREWMCGRATH, THOMAS RYANJAVIER, MANUEL ARZADONBAPNA, ANISHAENGELMAN, ZOAR JACOBLEVIN, HOWARDVANDILLEN, NICHOLAS C.AHONEN, ANNE MARIE
Owner AXON THERAPIES INC