Systems, methods, and devices for monitoring and treatment of tissues within and/or through a lumen well

Patent metadata

Field	Value
Publication number	US-9956034-B2
Application number	US-201314439989-A
Country	US
Kind code	B2
Filing date	Oct 31, 2013
Priority date	Nov 5, 2012
Publication date	May 1, 2018
Grant date	May 1, 2018

Abstract

A system for controlled sympathectomy procedures is disclosed. A system for controlled micro ablation procedures is disclosed. Methods for performing a controlled surgical procedure are disclosed. A system for performing controlled surgical procedures in a minimally invasive manner is disclosed. Systems and methods for accessing target tissues as part of a neuromodulation procedure from within a lumen are disclosed.

First claim

What is claimed is:

1. A tool, comprising:
an elongate member with a distal tip and a control end, the distal tip thereof shaped and dimensioned so as to fit within a lumen, the elongate member shaped and dimensioned so as to extend from an entry site on a body into the lumen; and
one or more probes each configured with a probe tip, the probes deploy-ably coupled with the distal tip of the elongate member and at least one of electrically, mechanically, and fluidly coupled to the control end of the elongate member, the probe tips shaped so as to at least one of penetrate into and penetrate through a wall of the lumen upon deployment from the elongate member, one or more of the probes comprising one or more electrodes electrically coupled to the probes, one or more of the electrodes configured to at least one of convey a signal associated with an electrophysiological activity and to alter the electrophysiological activity upon deployment;
wherein the tool is configured for at least one of monitoring and altering electrophysiological activity within the vicinity of the lumen within the body; and
a controller configured:
to record one or more electrophysiological signals from monitored electrophysiological activity within the vicinity of one or more of the electrodes coupled to the probes;
to cancel one or more movement artifacts from the recorded electrophysiological signals utilizing a corrective signal, the corrective signal being generated from monitoring one or more physiological parameters of the subject at a location remote from the vicinity of the one or more electrodes coupled to the probes.

2. The tool of claim 1 , wherein the signal is an electrophysiological signal related to a water concentration, a tissue tone, an evoked potential, a remotely stimulated nervous activity, a sympathetic nervous activity, an electromyographic signal [EMG], a mechanomyographic signal [MMG], a local field potential, an electroacoustic event, a vasodilation, a vessel wall stiffness, a muscle sympathetic nerve activity, a central sympathetic drive, a nerve traffic, or combinations thereof.

3. The tool of claim 1 further comprises a microcircuit, wherein the one or more electrodes coupled to the probes are electrically coupled with the microcircuit, the microcircuit configured to condition the conveyed signal, and wherein the microcircuit is embedded into the tool and at least a portion of the electrical coupling is provided via the elongate member.

4. The tool of claim 1 , wherein one or more of the probes comprises a microelectrode configured to interface with an adjacent tissue volume within or beyond the wall of the lumen, the microelectrode having an area of less than 5000 μm 2 , less than 1000 μm 2 , less than 250 μm 2 , or less than 100 μm 2 .

5. The tool of claim 1 , further comprising one or more stimulating electrodes electrically and mechanically coupled to at least one or more of the probes and the elongate member, the stimulating electrodes configured to provide at least one of a stimulating current and an ablating current to a tissue site in the vicinity of the wall of the lumen.

6. The tool of claim 5 , further comprising a plurality of stimulating electrodes, the tool configured to coordinate at least one of stimulating currents and ablating currents between two or more of the stimulating electrodes, the currents passing through the tissue site.

7. The tool of claim 5 , wherein one or more of the probes comprises a channel, fluidly coupled with the control end of the elongate member, for delivering at least one of a diagnostic substance and a therapeutic substance to a tissue site in the vicinity of the wall of the lumen.

8. The tool of claim 7 , wherein the one or more stimulating electrodes are configured and positioned so as to monitor at least one of: (i) the effect of at least one of the stimulating current and ablating current; and (ii) the effect of the substance, delivered to the tissue site in the vicinity of the wall via the channel, on at least one of the tissue site and tissues related thereto.

9. The tool of claim 5 , wherein each of the one or more stimulating electrodes comprise an area of greater than 0.1 mm 2 , 0.5 mm 2 , 1 mm 2 , 2 mm 2 , or 10 mm 2 .

10. The tool of claim 7 , further comprising the at least one of the diagnostic substance and the therapeutic substance, wherein the at least one of the diagnostic substance and the therapeutic substance is selected from a chemical, a drug substance, a neuromodulating substance, a neuroblocking substance, an acid, a base, a denervating agent, or a combination thereof.

11. The tool of claim 7 , further comprises a therapeutic substance, wherein the therapeutic substance is a selected from a neurotoxin, a botulinum toxin, a tetrodotoxin, a tetraethylammonium, a chlorotoxin, a curare, a conotoxin, a bungarotoxin, arsenic, ammonia, ethanol, hexane, nitric oxide, glutamate, resiniferatoxin, alcohol, phenol, capsaicin, an anesthetic, lidocaine, tetanus toxin, quaternary ammonium salts, a pachycurare, a leptocurare, acetylcholine, aminosteroids, or a combination thereof.

12. The tool of claim 7 further comprises a therapeutic substance, wherein the therapeutic substance is adapted to be comprised within a restraining matrix.

13. The tool of claim 1 , wherein one or more of the probes is slidingly coupled to the elongate member, sliding of the probe along the length of the elongate member providing the deployment thereof.

14. The tool of claim 1 , further comprising:
a stabilizing member coupled to the elongate member, the stabilizing member configured to retain the position of the distal tip of the elongate member within the lumen upon deployment;
wherein the stabilizing member is selected from a balloon, a basket, a plurality of flexible members, a wire cage, an embolic filter, or a combination thereof; and
wherein the stabilizing member comprises one or more electrodes, configured to provide at least one of a stimulating current and an ablating current to the wall of the lumen.

15. The tool of claim 1 , wherein one or more of the probe tips is shaped with a curved probe tip, and is slidingly and rotate-ably coupled with the control end of the elongate member, so as to be steerably advanced through the wall of the lumen upon deployment.

16. The tool of claim 1 , wherein one or more of the probes comprises a stabilizing element positioned at a predetermined distance from the probe tip thereof, the stabilizing element configured so as to limit the depth which the probe can penetrate into the wall of the lumen upon deployment.

17. The tool of claim 1 , wherein one or more of the probes comprises a plurality of electrodes, arranged along a length thereof in relation to the probe tips thereof, the electrodes configured to convey precise signals pertaining to at least one of an electrophysiological activity of an adjacent tissue site in the vicinity thereof and an impedance between the electrodes during deployment.

18. The tool of claim 17 , wherein the conveyed signals relate to the proximity of electrophysiologically active tissues in the vicinity of the wall of the lumen in relation to the probe.

19. The tool of claim 1 , wherein one or more of the probes is sized and dimensioned so as to fit within a precapillary arteriole positioned within the wall of the lumen.

20. The tool of claim 1 , further comprising one or more additional electrodes disposed on the elongate member, and wherein the controller is configured to generate the corrective signal by monitoring th

Assignees

• Autonomix Medical Inc

Inventors

• Toth Landy
• Martin Roy

Classifications

• A61B2018/00839

  Bioelectrical parameters, e.g. ECG, EEG · CPC title

• A61B18/1492 Primary

  having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence) · CPC title

• A61B2018/00511

  Kidney · CPC title

• A61B2017/00053

  Mapping · CPC title

• A61B2018/143

  multiple needles · CPC title