Controlled sympathectomy and micro-ablation systems and methods

Patent metadata

Field	Value
Publication number	US-10470684-B2
Application number	US-201314374466-A
Country	US
Kind code	B2
Filing date	Jan 25, 2013
Priority date	Jan 26, 2012
Publication date	Nov 12, 2019
Grant date	Nov 12, 2019

Abstract

A microsurgical tool is configured for monitoring, evaluating, mapping, and/or modulating electrophysiological activity in the vicinity of a lumen within a body. The microsurgical tool may be part of a system used in evaluating the sympathetic tone of a subject and/or neuromodulating an anatomical site in the vicinity of a lumen within a body. Such systems include a catheter system for controlled sympathectomy procedures and/or controlled micro ablation procedures. Such systems may be used in methods for performing a controlled surgical procedure, including performing controlled surgical procedures in a minimally invasive manner.

First claim

What is claimed is:

1. A microsurgical tool for monitoring electrophysiological activity within the vicinity of a lumen, the microsurgical tool comprising:
a microfinger having a substantially elongate structure configured so as to bias a region thereof against a wall of the lumen upon deployment within the lumen;
a plurality of sensing tips electrically and mechanically coupled to the microfinger in the vicinity of the region, configured to interface with the wall of the lumen, a given one of the sensing tips configured:
to measure electrophysiological activity within the vicinity of the lumen; and
to convey, to an extracorporeal system, one or more electrophysiological signals associated with the measured physiological activity within the vicinity of the lumen; and

a microcircuit electrically coupled to the given sensing tip and attached to the microfinger proximate to the given sensing tip such that, upon deployment of the microfinger within the lumen, the microcircuit is positioned in the lumen;
wherein the microcircuit is configured to condition the electrophysiological signals sensed by the given sensing tip within the lumen prior to conveying the electrophysiological signals outside the lumen to the extracorporeal system;
wherein conditioning the electrophysiological signals sensed by the given sensing tip comprises at least one of: converting the electrophysiological signals into digital form; and amplifying the electrophysiological signals;
wherein the given sensing tip comprises a first core flexure and at least a second core flexure;
wherein the first core flexure and the second core flexure each comprise at least one region covered with an insulating layer and at least one exposed region;
wherein the first core flexure comprises a first exposed region providing a first electrode at a tip region of the given sensing tip;
wherein the second core flexure comprises a second exposed region providing at least a second electrode at a shank region of the given sensing tip;
wherein a portion of the insulating layer extends between the first and second exposed regions; and
wherein the microcircuit is configured to utilize electrophysiological signals measured by the first electrode and the second electrode to monitor neural activity differences between the tip region and the shank region of the given sensing tip.

2. The microsurgical tool in accordance with claim 1 , wherein the electrophysiological signals are related to one or more of water concentration, tone, evoked potential, remote stimulation of nervous activity, an electromyographic signal [EMG], a mechanomyographic signal [MMG], a local field potential, an electroacoustic event, vasodilation, vessel wall stiffness, muscle sympathetic nerve activity [MSNA], central sympathetic drive, tissue tone and nerve traffic.

3. The microsurgical tool in accordance with claim 1 , wherein the microfinger is configured so as to substantially maintain contact with the wall of the lumen while it is swept longitudinally down the lumen and/or circumferentially around the lumen.

4. The microsurgical tool in accordance with claim 1 , wherein the microfinger is configured so as to substantially maintain a constant force against the wall of the lumen during relative movement there between.

5. The microsurgical tool in accordance with claim 1 , wherein the microfinger has a characteristic width of less than 150 um, less than 100 um, less than 75 um, less than 50 um, less than 25 um, less than 10 um, or less than Sum.

6. The microsurgical tool in accordance with claim 1 comprising a plurality of microfingers, each microfinger configured so as to substantially independently bias against the wall of the lumen upon deployment.

7. The microsurgical tool in accordance with claim 6 , wherein a plurality of microfingers are configured to form a cage, a mesh, or a stent-like structure.

8. The microsurgical tool in accordance with claim 6 , wherein each microfinger is configured so as to independently maintain contact with the wall during relative movement there between.

9. The microsurgical tool in accordance with claim 8 , wherein one or more of the microfingers are configured to convey signals in the presence of the relative movement.

10. The microsurgical tool in accordance with claim 1 , wherein the given sensing tip comprises a needle electrode, the microfinger configured to plunge the needle electrode into the wall of the lumen upon deployment.

11. The microsurgical tool in accordance with claim 1 , wherein the microfinger comprises an active material element configured to alter a contact force between the given sensing tip and the wall upon receipt of a control signal.

12. The microsurgical tool in accordance with claim 11 , wherein the given sensing tip comprises a force sensor configured to measure a change in the contact force.

13. The microsurgical tool in accordance with claim 12 , wherein the given sensing tip further comprises a strain sensor, and wherein the given sensing tip is configured to combine one or more force sensing signals obtained from the force sensor and one or more strain sensing signals obtained from the strain sensor to generate a mechanomyographic (MMG) signal.

14. The microsurgical tool in accordance with claim 1 , wherein the first exposed region of the first core flexure is configured so as to substantially embed the given sensing tip into the wall of the lumen.

15. The microsurgical tool in accordance with claim 1 , wherein the second exposed region of the second core flexure is oriented to one side of a neutral axis of the second core flexure of the given sensing tip so as to substantially maintain a constant force against the wall of the lumen during relative movement there between.

16. The microsurgical tool in accordance with claim 1 , wherein the microfinger is part of a plurality of microfingers forming a longitudinal wire cage configured to maintain contact with the wall of the lumen without inhibiting flow of fluids through the lumen.

17. The microsurgical tool in accordance with claim 16 , wherein the microsurgical tool further comprises a guidewire configured to assist with guiding the longitudinal wire cage to a target region within the lumen.

18. The microsurgical tool in accordance with claim 17 , wherein the microsurgical tool further comprises a distal ringlet configured to accommodate passage of the guidewire through the longitudinal wire cage.

19. The microsurgical tool in accordance with claim 1 , wherein the microfinger comprises a radially biased flexural spring.

20. The microsurgical tool in accordance with claim 1 , wherein the microfinger is configured so as to be deployed from a delivery catheter and at least a portion of the delivery catheter has a diameter less than 3 mm.

21. The microsurgical tool in accordance with claim 1 , wherein the microcircuit is embedded into the substantially elongate structure of the microfinger.

22. The microsurgical tool in accordance with claim 1 , wherein the sensing tip comprises a compliance sensor configured to generate a tissue tone signal.

23. The microsurgical tool in accordance with claim 1 , wherein the given sensing tip further comprises a flex circuit comprising a plurality interconnects.

24. The microsurgical tool in accordance with claim 1 , wherein the first core flexure and the second core flexure are surrounding by a same insulating layer.

Assignees

• Autonomix Medical Inc

Inventors

• Toth Landy
• Schwartz Robert

Classifications

• A61N1/36114

  Cardiac control, e.g. by vagal stimulation (stimulating the heart A61N1/362) · CPC title

• A61B2018/00654

  with individual control of each of a plurality of energy emitting elements · CPC title

• A61B5/1106

  to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia · CPC title

• A61B2018/1425

  Needle · CPC title

• A61B2018/00505

  Urinary tract · CPC title