Renal Pelvic Denervation via Urinary Tract Access
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Solution Overview
Problem
Existing renal denervation therapies for hypertension and chronic kidney disease involve intravascular approaches that pose risks to the renal artery and suffer from disadvantages associated with intravascular access, while achieving limited therapeutic benefits.
Innovation Solution
Renal pelvic denervation is performed via a minimally invasive or laparoscopic approach, using an effector introduced through the urinary tract or abdomen to deliver energy or active agents to the renal pelvis, modulating renal nerves to reduce blood pressure and improve kidney function.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If intravascular approach is used for renal denervation, then renal nerves can be disrupted to reduce blood pressure, but the renal artery is at risk of injury and intravascular access has disadvantages
Solution Approach 1:
The patent uses the renal pelvis as an intermediary structure to access and treat renal nerves. Instead of directly accessing the renal artery through the intravascular approach, the procedure introduces an effector through the urinary tract (ureter) to the renal pelvis, where energy is delivered to disrupt renal nerves in the renal pelvic wall and surrounding tissue. This intermediary approach avoids direct intravascular manipulation while achieving similar therapeutic goals.
Solution Approach 2:
The patent replaces the mechanical intravascular catheter approach with a minimally invasive percutaneous or laparoscopic approach. The effector is introduced through the urinary tract or abdominal wall rather than through the renal artery, substituting the mechanical intravascular system with a less invasive external access method that delivers energy to renal nerves through the renal pelvis wall.
2Reliability
If intravascular catheter is advanced to main renal artery, then renal nerves can be targeted, but the procedure complexity and access difficulty increase
Solution Approach 1:
The renal pelvis serves as a natural intermediary pathway that simplifies access to renal nerves. By introducing the effector through the urinary tract to the renal pelvis, the procedure avoids the complex intravascular navigation required to reach the main renal artery, reducing procedural complexity while maintaining accurate targeting of renal nerves in the renal pelvic wall.
Solution Approach 2:
The patent extracts the treatment approach from the intravascular space and relocates it to the extravascular renal pelvic space. This extraction eliminates the need for complex catheter advancement through the arterial system, simplifying the procedure while maintaining effective renal nerve disruption through energy delivery at the renal pelvis.
3Reliability
If existing renal denervation therapies are used, then blood pressure can be reduced, but therapeutic benefits are limited and kidney function does not improve
Solution Approach 1:
The patent applies local quality by selectively disrupting renal nerves in the renal pelvic wall and surrounding tissue while preserving other renal structures and function. The effector delivers energy locally at the renal pelvis to target sympathetic nerves responsible for hypertension, rather than using non-specific intravascular approaches that may damage renal parenchyma. This localized approach maintains kidney function while achieving blood pressure reduction.
Solution Approach 2:
The patent performs preliminary assessment and selection of patients based on their renal function status before treatment. By identifying suitable candidates with preserved kidney function and targeting them for renal pelvic denervation, the procedure optimizes the balance between blood pressure reduction and kidney function preservation, avoiding treatment of patients who would not benefit or could suffer functional deterioration.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
This method significantly reduces blood pressure and increases estimated glomerular filtration rate (eGFR), decreasing the risk of kidney disease and associated morbidities, with sustained 24-hour blood pressure-lowering effects and improved hormone function.
Implementation Method 1
the catheter is used to deliver radiofrequency energy, heat, drugs, or the like to disrupt the function of the renal nerves
Implementation Method 2
an effector is introduced into an interior of the patient's renal pelvis... The effector is used to deliver energy to an interior wall of the renal pelvis, producing an increase in the patient's eGFR
Data Source
AI summary
In an illustrative embodiment, systems and methods for treating kidney disease in a human patient are disclosed. A method includes advancing a collapsible array of RF electrodes through a urinary tract of the patient in collapsed form and into a position in or near a renal pelvis. The effector is deployed to an expanded form to engage at least a portion of an interior wall of the renal pelvis. RF energy delivered through the array of electrodes target afferent nerves proximate the interior wall of the renal pelvis to inhibit or destroy their function. eGFR of the patient can be raised after treatment according to the method.