303 results about "Renal artery" patented technology

A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump eluting implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

An ablation catheter comprises a catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis; and an ablation element assembly comprising ablation elements connected to the catheter body, each ablation element to be energized to produce an ablation zone. The ablation elements are distributed in a staggered configuration such that the ablation zones of the ablation elements span one or more open arc segments around the longitudinal axis, but the ablation zones of all ablation elements projected longitudinally onto any lateral plane which is perpendicular to the longitudinal axis span a substantially closed loop around the longitudinal axis. Since the ablation zones do not form a closed loop, the risk of renal artery / vein stenosis is reduced or eliminated. Since the ablation zones of all ablation elements projected longitudinally onto any lateral plane span a substantially closed loop, substantially complete renal denervation is achieved.

Methods and apparatus are provided for treating congestive heart by actively or passively enhancing perfusion to the renal arteries. A first embodiment comprises a specially configured balloon catheter and extracorporeal pump, wherein the pump operates in a “once-through” fashion or alternating volume displacement mode. In another embodiment the catheter includes a pair of balloons to isolate a region of the aorta, and a third balloon that directs flow into the renal arteries. In still further embodiments, a stent or cuff having a constricted region is deployed in or around the aorta, respectively, to create a backpressure upstream of the stent or cuff. Methods of enhancing renal perfusion also are provided.

An introducer system delivers therapy locally to a renal system in a patient. A proximal coupler assembly is coupled to an introducer sheath that delivers multiple devices simultaneously into a location within an abdominal aorta associated with first and second renal artery ostia. The coupler assembly has a network of branch lumens arranged to allow for smooth slideable engagement of multiple coupled devices without substantial interference therebetween. A first branch lumen typically introduces a percutaneous translumenal interventional device such as an angiography or guiding catheter into the introducer sheath and is substantially aligned with a longitudinal axis of the sheath. One or more other branch lumen are off-axis from the longitudinal axis by about 30 degrees or less and introduce components of a bilateral renal delivery assembly into the introducer sheath in conjunction with the other device. Novel insertion devices are provided to coordinate the coupling of the multiple devices.

Stimulation energy is delivered to one or more renal artery sites in accordance with a predetermined energy delivery protocol. The stimulation energy is sufficient to elicit a physiologic response from the patient but insufficient to ablate renal nerves. Target renal artery sites that elicit a physiologic response are identified, and renal nerve tissue at or proximate the target sites is ablated.

One or more markers or sensors are positioned in the vasculature of a patient to facilitate determining the location, configuration, and / or orientation of a vessel or certain aspects thereof (e.g., a branch vessel), determining the location, configuration and / or orientation of a endovascular devices prior to and during prosthesis deployment as well as the relative position of portions of the vasculature and devices, generating an image of a virtual model of a portion of one or more vessels (e.g., branch vessels) or devices, and / or formation of one or more openings in a tubular prosthesis in situ to allow branch vessel perfusion when the prosthesis is placed over one or more branch vessels in a patient (e.g., when an aortic abdominal artery stent-graft is fixed to the aorta superior to the renal artery ostia).

Two renal delivery members have two distal ports that are adapted to be positioned within two renal arteries via their corresponding renal ostia at unique locations along an abdominal aortic wall. A proximal coupler assembly is outside the body and is coupled to deliver material to the two distal ports for bi-lateral renal therapy. One or both of the delivery members may be self-cannulating into the corresponding renal ostium, or may be controllably steered into the respective ostium. Non-occlusive anchors may be coupled with one or both of the delivery members at anchoring positions in the renal artery or abdominal aorta to secure the renal delivery member within the renal artery. Renal-active fluid agents are coupled to the bi-lateral delivery system. Another renal therapy system cannulates a renal vein from the vena cava and controls a retrograde delivery of agents to the respective kidney.

A local renal delivery system includes a flow isolation assembly and a local injection assembly. The flow isolation assembly in one mode is adapted to isolate only a partial flow region along the outer circumference along the aorta wall such that fluids inject there are maintained to flow substantially into the renal arteries. Various types of flow isolation assemblies and local injection assemblies are described.

Methods and apparatus are provided for treating congestive heart by actively or passively enhancing perfusion to the renal arteries. A first embodiment comprises a specially configured balloon catheter and extracorporeal pump, wherein the pump operates in a “once-through” fashion or alternating volume displacement mode. In another embodiment the catheter includes a pair of balloons to isolate a region of the aorta, and a third balloon that directs flow into the renal arteries. In still further embodiments, a stent or cuff having a constricted region is deployed in or around the aorta, respectively, to create a backpressure upstream of the stent or cuff. Methods of enhancing renal perfusion also are provided.

Sympathetic nerves run through the adventitia surrounding renal arteries and are critical in the modulation of systemic hypertension. Hyperactivity of these nerves can cause renal hypertension, a disease prevalent in 30-40% of the adult population. Hypertension can be treated with neuromodulating agents (such as angiotensin converting enzyme inhibitors, angiotensin II inhibitors, or aldosterone receptor blockers), but requires adherence to strict medication regimens and often does not reach target blood pressure threshold to reduce risk of major cardiovascular events. A minimally invasive solution is presented here to reduce the activity of the sympathetic nerves surrounding the renal artery by locally delivering neurotoxic or nerve-blocking agents into the adventitia. Extended elution of these agents may also be accomplished in order to tailor the therapy to the patient.

An introducer system delivers therapy locally to a renal system in a patient. A proximal coupler assembly is coupled to an introducer sheath that delivers multiple devices simultaneously into a location within an abdominal aorta associated with first and second renal artery ostia. The coupler assembly has a network of branch lumens arranged to allow for smooth slideable engagement of multiple coupled devices without substantial interference therebetween. A first branch lumen typically introduces a percutaneous translumenal interventional device such as an angiography or guiding catheter into the introducer sheath and is substantially aligned with a longitudinal axis of the sheath. One or more other branch lumen are off-axis from the longitudinal axis by about 30 degrees or less and introduce components of a bilateral renal delivery assembly into the introducer sheath in conjunction with the other device. Novel insertion devices are provided to coordinate the coupling of the multiple devices.

A renal flow system injects a volume of fluid agent into a location within an abdominal aorta in a manner that flows bilaterally into each of two renal arteries via their respectively spaced ostia along the abdominal aorta wall. A local injection assembly (100) includes two injection members (104, 106), each having an injection port (112) that couples to a source of fluid agent externally of the patient. The injection ports may be positioned within an outer region of blood flow along the abdominal aorta wall perfusing the two renal arteries.

Methods and apparatus are provided for treating congestive heart by actively or passively enhancing perfusion to the renal arteries. A first embodiment comprises a specially configured balloon catheter and extracorporeal pump, wherein the pump operates in a “once-through” fashion or alternating volume displacement mode. In another embodiment the catheter includes a pair of balloons to isolate a region of the aorta, and a third balloon that directs flow into the renal arteries. In still further embodiments, a stent or cuff having a constricted region is deployed in or around the aorta, respectively, to create a backpressure upstream of the stent or cuff. Methods of enhancing renal perfusion also are provided.

A system and method is provided that is adapted to allow for rapid cannulation of a guidewire into a branch lumen extending from a main lumen in a body of a patient, and in particular into two renal arteries extending from an abdominal aorta wall. A dual lumen catheter shaft delivers first and second pre-shaped guidewires to the location of the renal arteries in the aorta, such that the first and second pre-shaped guidewires self-cannulate within the renal arteries. Additional guidewires and / or interventional devices may be incorporated into the system and method for use with the catheter shaft, or over the two pre-shaped guidewires, to meet a particular need for a particular patient or intended procedure.

A method for the treatment of a patient for the purpose of lowering blood pressure and / or treating cardiac arrhythmias, particularly atrial fibrillation includes the insertion of an ablation catheter into the lumen of a renal artery. The ablation catheter is equipped with an electrode that can stimulate the wall tissue in the renal artery to help identify the location of a renal nerve. High-frequency stimulation of the renal nerve causes a decrease in the blood pressure of the patient thereby indicating that a renal nerve is nearby. The ablation catheter is used to ablate the renal nerve using radiofrequency, ultrasound, microwave energy or cryogenic cooling. An irrigated ablation catheter may be used to decrease damage to cells in the wall of the lumen of the renal artery other than the renal nerve, such as the endothelial cells.

A dual lumen introducer sheath provides access to at least one renal artery and at least one peripheral blood vessel of a patient. The introducer sheath includes a proximal hub comprising first and second ports, a first lumen, and a second lumen. The first lumen extends from the first port to a first distal aperture and has sufficient length such that when the first port is positioned outside the patient the first distal aperture is positionable in the abdominal aorta at or near origins of the patient's renal arteries. The second lumen extends from the second port to a second distal aperture, has a shorter length than the length of the first lumen, and is configured to allow passage of a catheter device through the second lumen and into or through an iliac artery contralateral to an insertion point of the introducer sheath into the patient.

Systems, devices, and methods for delivering treatment to the renal arteries are provided. Exemplary systems include a delivery catheter having a distal bifurcation, an introducer assembly comprising an introducer sheath in operative association with a Y-hub, wherein Y-hub includes a first port for receiving the delivery catheter and a second port for receiving a second catheter, and a constraint assembly for holding the distal bifurcation of the delivery catheter in a low-profile configuration when it is advanced distally beyond the introducer sheath.

A renal flow system injects a volume of fluid agent into a location within an abdominal aorta in a manner that flows bi-laterally into each of two renal arteries via their respectively spaced ostia along the abdominal aorta wall. A local injection assembly includes two injection members, each having an injection port that couples to a source of fluid agent externally of the patient. The injection ports may be positioned with an outer region of blood flow along the abdominal aorta wall perfusing the two renal arteries. A flow isolation assembly may isolate flow of the injected agent within the outer region and into the renals. The injection members are delivered to the location in a first radially collapsed condition, and bifurcate across the aorta to inject into the spaced renal ostia. A delivery catheter for upstream interventions is used as a chassis to deliver a bilateral local renal injection assembly to the location within the abdominal aorta.

A stent / graft especially designed to be used in a minimally invasive surgical procedure for treating an abdominal aortic aneurysm (AAA) comprises an innermost tubular structure of a length (L1) formed by braiding a relatively few strands of shape memory alloy wire. The pick and pitch of the braid are such as to provide relative large fenestrations in the tubular wall. A portion of the innermost tubular structure of a length L2<L1 is surrounded by a further braided tubular structure having relatively many strands that occlude the fenestrations of the innermost tubular structure. The composite structure can be stretched to reduce the outer diameter of the stent / graft, allowing it to be drawn into a lumen of a delivery catheter. The catheter can then be advanced through the vascular system to the site of the AAA and then ejected, allowing it to self-expand with the portion L2 bridging the aneurysm. The portion L1>L2 does not block blood flow to the renal arteries while the portion L2 prevents the aneurysm to grown and burst.

An endograft for a vessel having a vascular branch extending from the vessel is provided. The endograft includes a main body having a wall separating interior and exterior surfaces and adapted to be inserted within the vessel. The main body is characterized by a single proximal opening and a single terminal opening and at least one aperture extending through the wall. At least one stent is secured to the main body that upon expansion pressure fits the main body into the vessel. An open tunnel is secured to the interior surface of the main body around the main body aperture and secured somewhere along the tunnel length to provide fluid communication between the interior and exterior surfaces of the main body through the aperture and with the vascular branch in proximity to the main body aperture. The tunnel is readily formed independent of an expandable stent. Through the addition of further apertures and tunnels, an endograft is well suited for revascularizing the superior mesenteric artery and renal arteries for the treatment of a suprarenal aortic aneurysm. The insertion of a sleeve positioned partly within the tunnel and extending beyond the exterior surface of the main body into the vascular branch assures continued fluid flow to the vascular branch.

At the present time, physicians often treat patients with atrial fibrillation (AF) using radiofrequency (RF) catheter systems to ablate conducting tissue in the wall of the Left Atrium of the heart around the ostium of the pulmonary veins. These systems are expensive and take time consuming to use. The present invention circular ablation system CAS includes a multiplicity of expandable needles that can be expanded around a central axis and positioned to inject a fluid like ethanol to ablate conductive tissue in a ring around the ostium of a pulmonary vein quickly and without the need for expensive capital equipment. The expansion of the needles is accomplished by self-expanding or balloon expandable structures. The invention includes centering means so that the needles will be situated in a pattern surrounding the outside of the ostium of a vein. Also included are members that limit the distance of penetration of the needles into the wall of the left atrium, or the aortic wall. The present invention also has an important application to ablate tissue around the ostium of one or both renal arteries, for the ablation of the sympathetic nerve fibers and / or other afferent or efferent nerves going to or from each kidney in order to treat hypertension.

A medicament injection kit, for use in occluding a renal artery and a renal vein in a kidney and injecting a therapeutic medicament into the kidney so as to pressurize the kidney, includes: an artery catheter which includes a first balloon capable of occluding the renal artery; a vein catheter which includes a second balloon capable of occluding the renal vein; a syringe for injecting the therapeutic medicament, the syringe being capable of being connected to at least one of the artery catheter and the vein catheter; and a syringe for pressurizing the inside of the kidney by injecting a liquid, the syringe being capable of being connected to at least one of the artery catheter and the vein catheter.

A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

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.

A stent graft extends in a flow lumen to span a defective portion of the flow lumen and seal the defective portion from further blood contact. The stent graft includes a pair of apertures, from which extensions project into the renal arteries to seal the passage of blood into the renal arteries from the abnormality. The apertures are larger than the opening of the renal arteries, such that the apertures need not be centered with the renal arteries to enable placement of the extensions. The aperture opening and side branch extensions contain hook and loop structures to provide a variably positionable seal of the aperture opening.

A branch vessel in a human patient is located or mapped using in vivo tracked field sensors where in one variation the sensor positions can be located by determining the positions of the sensors relative to a plurality of magnetic field sources of known location. This approach is used, for example, in locating the opening in a renal artery and positioning the proximal end of the AAA stent-graft adjacent to the opening. In another example, the sensors are tracked along the inner wall of an aneurysm and the acquired sensor location data processed to map the contour of the aneurysm to size a prostheses for spanning the aneurysm. The portions of the vessel adjacent the aneurysm also can be mapped. In a further embodiment, an in vivo sensor is positioned in a deployed prosthesis to create a reference for a prosthetic member having a sensor to track to during cannulation of the deployed prosthesis with the prosthetic member.

An intravascular catheter for peri-vascular and / or peri-urethral tissue ablation includes multiple needles advanced through supported guide tubes which expand with open ends around a central axis to engage the interior surface of the wall of the renal artery or other vessel of a human body allowing the injection an ablative fluid for ablating tissue, and / or nerve fibers in the outer layer or deep to the outer layer of the vessel, or in prostatic tissue. The system also includes means to limit and / or adjust the depth of penetration of the ablative fluid into and beyond the tissue of the vessel wall. The preferred embodiment of the catheter includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened injection needles are advanced to penetrate into the vessel wall.

Sympathetic nerves run through the adventitia surrounding renal arteries and are critical in the modulation of systemic hypertension. Hyperactivity of these nerves can cause renal hypertension, a disease prevalent in 30-40% of the adult population. Hypertension can be treated with neuromodulating agents (such as angiotensin converting enzyme inhibitors, angiotensin II inhibitors, or aldosterone receptor blockers), but requires adherence to strict regimens and often does not reach target blood pressure threshold to reduce risk of major cardiovascular events. A minimally invasive solution is presented here to reduce the activity of the sympathetic nerves surrounding the renal artery by locally delivering neurotoxic or sympathetic nerve-blocking agents into the adventitia. Extended elution of these agents may also be accomplished in order to tailor the therapy to the patient.