Apparatus and method for modulating the baroreflex system

Abstract

An apparatus for insertion into a blood vessel and for modulating the baroreflex system of a mammal includes an expandable support member for engaging a wall of a blood vessel at a desired location where baroreceptors are located, and at least one electrode connected with the expandable support member. The at least one electrode is arranged to selectively deliver electric current to modulate the baroreceptors. The apparatus further includes an insulative material attached to at least a portion of the expandable support member for isolating blood flowing through the vessel from the electric current delivered by the at least one electrode.

1 . An apparatus for insertion into a blood vessel and for modulating the baroreflex system of a mammal, said apparatus comprising: an expandable support member for engaging a wall of a blood vessel at a desired location where baroreceptors are located; at least one electrode connected with said expandable support member and arranged to selectively deliver electric current to modulate the baroreceptors; and an insulative material attached to at least a portion of said expandable support member and for isolating blood flowing through the vessel from the electric current delivered by said at least one electrode. 
   
   
       2 . The apparatus of  claim 1 , wherein said insulative material is disposed radially inward of said electrode. 
   
   
       3 . The apparatus of  claim 2 , wherein said expandable support member is disposed radially inward of said insulative material. 
   
   
       4 . The apparatus of  claim 2 , wherein said insulative material is disposed radially inward of said expandable support member. 
   
   
       5 . The apparatus of  claim 2 , wherein said at least one electrode is disposed radially inward of said expandable support member. 
   
   
       6 . The apparatus of  claim 1 , wherein said expandable support member further comprises a filter sized to allow blood flow through said expandable support member while retaining obstructive material, said filter being integrally formed with said expandable support member. 
   
   
       7 . The apparatus of  claim 1 , wherein at least one magnetic member is securely attached to said expandable support member. 
   
   
       8 . The apparatus of  claim 1 , wherein at least one sensor for measuring at least one metabolic parameter of interest is securely attached to said expandable support member. 
   
   
       9 . The apparatus of  claim 8 , wherein said at least one sensor is positioned in or on a blood vessel. 
   
   
       10 . The apparatus of  claim 8 , wherein said at least one sensor is positioned in or on an organ. 
   
   
       11 . The apparatus of  claim 1 , wherein said expandable support member chemically modulates baroreceptors in the vessel wall. 
   
   
       12 . The apparatus of  claim 1 , wherein said expandable support member biologically modulates baroreceptors in the vessel wall. 
   
   
       13 . The apparatus of  claim 1 , wherein said insulative material extends the entire length of said expandable support member. 
   
   
       14 . A method for modulating the baroreflex system of a mammal, said method comprising the steps of: providing an expandable support for engaging a wall of a blood vessel at a desired location where baroreceptors are located, at least one electrode being connected with the expandable support member and arranged to selectively deliver electric current to modulate the baroreceptors, and an insulative material attached to at least a portion of the expandable support member for isolating blood flowing through the vessel from the electric current delivered by the at least one electrode; implanting the expandable support member intravascularly so that at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in the vessel wall; and delivering electric current to the at least one electrode to induce a baroreceptor signal to effect a change in the baroreflex system. 
   
   
       15 . The method of  claim 14 , wherein the baroreceptor signal is chemically modulated. 
   
   
       16 . The method of  claim 14 , wherein the baroreceptor signal is biologically modulated. 
   
   
       17 . The method of  claim 14 , wherein the change in the baroreflex system includes a change in parasympathetic nervous system activity. 
   
   
       18 . The method of  claim 14 , wherein the change in the baroreflex system includes a change in sympathetic nervous system activity. 
   
   
       19 . The method of  claim 14 , wherein the change in the baroreflex system includes a change in neurohormonal activation. 
   
   
       20 . The method of  claim 14 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in the vessel wall. 
   
   
       21 . The method of  claim 14 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a high pressure baroreceptor in the vessel wall. 
   
   
       22 . The method of  claim 14 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in an arterial wall. 
   
   
       23 . The method of  claim 22 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in an arterial wall selected from the group consisting of a carotid arterial wall, an aortic arterial wall, a subclavian arterial wall, a brachiocephalic arterial wall, a renal arterial wall, a hepatic arterial wall, a splenic arterial wall, a pancreatic arterial wall, a jugular arterial wall, a femoral arterial wall, an iliac arterial wall, a pulmonary arterial wall, a brachial arterial wall, a cardiac arterial wall, a popliteal arterial wall, a tibial arterial wall, a celiac arterial wall, an axillary arterial wall, a radial arterial wall, an ulnar arterial wall, and a mesenteric arterial wall. 
   
   
       24 . The method of  claim 23 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in the common carotid artery. 
   
   
       25 . The method of  claim 23 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in the internal carotid artery. 
   
   
       26 . The method of  claim 23 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in the external carotid artery. 
   
   
       27 . The method of  claim 23 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in the carotid sinus. 
   
   
       28 . The method of  claim 14 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a low pressure baroreceptor in the vessel wall. 
   
   
       29 . The method of  claim 14 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in a venous wall. 
   
   
       30 . The method of  claim 29 , wherein at least a portion of the expandable support member is positioned substantially adjacent to a baroreceptor in a venous wall selected from the group consisting of a hepatic venous wall, an inferior vena cava venous wall, a superior vena cava venous wall, a jugular venous wall, a subclavian venous wall, an iliac venous wall, a femoral venous wall, a pulmonary venous wall, a splenic venous wall, a renal venous wall, a pancreatic venous wall, a cephalic venous wall, a tibial venous wall, an axillary venous wall, a brachial venous wall, a popliteal venous wall, a cardiac venous wall, and a brachiocephalic venous wall. 
   
   
       31 . The method of  claim 14 , wherein at least one sensor for measuring at least one metabolic parameter of interest is securely attached to the expandable support member. 
   
   
       32 . The method of  claim 31 , wherein the at least one sensor is positioned in or on a blood vessel. 
   
   
       33 . The method of  claim 31 , wherein the at least one sensor is positioned in or on an organ. 
   
   
       34 . A method for modulating the baroreflex system of a mammal, said method comprising the steps of: providing first and second expandable support members, each of the first and second expandable support members for engaging a wall of a blood vessel at a desired location where baroreceptors are located, the first and second expandable support members having at least one electrode arranged to selectively deliver electric current to modulate the baroreceptors, the first and second expandable support members having an insulative material attached to at least a portion of the expandable support members for isolating blood flowing through the vessel from the electric current delivered by the at least one electrode, the first and second expandable support members having at least one magnetic member securely attached thereto; implanting the first and second expandable support members at first and second intravascular locations so that the first and second expandable support members are positioned substantially adjacent from one another and so that at least a portion of each of the first and second expandable support members is positioned substantially adjacent to a baroreceptor in the vessel wall at each of the first and second intravascular locations; and generating an electromagnetic current between the first and second expandable support members so that the at least one electrode induces a baroreceptor signal to effect a change in the baroreflex system. 
   
   
       35 . The method of  claim 34 , wherein step of implanting the first and second expandable support members further comprises implanting the first and second expandable support members in an aterial vessel and a venous vessel, respectively. 
   
   
       36 . The method of  claim 35 , wherein step of implanting the first and second expandable support members further comprises implanting the first and second expandable support members in the carotid artery and the jugular vein, respectively. 
   
   
       37 . The method of  claim 34 , wherein step of implanting the first and second expandable support members further comprises implanting the first and second expandable support members in first and second arterial vessels. 
   
   
       38 . The method of  claim 37 , wherein step of implanting the first and second expandable support members further comprises implanting the first and second expandable support members in the aorta and pulmonary artery, respectively. 
   
   
       39 . The method of  claim 37 , wherein step of implanting the first and second expandable support members further comprises implanting the first and second expandable support members in the external carotid artery and the internal carotid artery, respectively. 
   
   
       40 . The method of  claim 34 , wherein step of implanting the first and second expandable support members further comprises implanting the first and second expandable support members in first and second venous vessels. 
   
   
       41 . The method of  claim 34 , wherein at least one sensor for measuring at least one metabolic parameter of interest is securely attached to the expandable support member. 
   
   
       42 . The method of  claim 41 , wherein the at least one sensor is positioned in or on a blood vessel. 
   
   
       43 . The method of  claim 41 , wherein the at least one sensor is positioned in or on an organ.