Methods for bilateral renal neuromodulation via catheter apparatuses having expandable baskets

摘要

Methods and apparatus are provided for bilateral renal neuromodulation, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

主权项

1. A method for catheter-based renal neuromodulation of a human patient with a diagnosed condition comprising at least one of heart failure, hypertension, acute myocardial infarction, impaired renal function or chronic renal failure, the method comprising:
positioning a first catheter having a first therapeutic element in a low profile delivery configuration within a first renal blood vessel of the patient and proximate to neural fibers innervating a first kidney of the patient,
wherein the first therapeutic element comprises a first expandable basket sized and shaped for the first renal blood vessel, and wherein the first expandable basket comprises a plurality of first electrodes arranged thereon, transforming the first therapeutic element from the delivery configuration to a treatment configuration such that the first electrodes on the first expandable basket are in contact with an inner wall of the first renal blood vessel; inhibiting neural communication along the neural fibers innervating the first kidney via radio frequency (RF) energy from the first electrodes; positioning a second catheter having a second therapeutic element in a low profile delivery configuration within a second renal blood vessel of the patient and proximate to neural fibers innervating a second kidney of the patient,
wherein the second therapeutic element comprises a second expandable basket sized and shaped for the second renal blood vessel, and wherein the second basket comprises a plurality of second electrodes arranged thereon; transforming the second therapeutic element from the delivery configuration to a treatment configuration such that the plurality of second electrodes on the second expandable basket are in contact with an inner wall of the second renal blood vessel; and inhibiting neural communication along the neural fibers innervating the second kidney via RF energy from the second electrodes wherein inhibiting neural communication along the neural fibers innervating the first and second kidney significantly improves a measureable physiological parameter corresponding to the diagnosed condition of the patient.