Techniques for placing medical leads for electrical stimulation of nerve tissue

Abstract

This disclosure is directed to extra, intra, and transvascular medical lead placement techniques for arranging medical leads and electrical stimulation and/or sensing electrodes proximate nerve tissue within a patient.

1 . An implantable medical lead system configured to deliver electrical stimulation from within a lumen of a blood vessel within a patient to nerve tissue located adjacent to and outside of the blood vessel, the system comprising:
 a medical lead arranged within a lumen of the blood vessel;   an electrode connected toward a distal end of the lead adjacent the nerve tissue; and   an active fixation member connected toward a distal end of the lead adjacent the nerve tissue and configured to anchor the lead to a wall of the blood vessel lumen.   
     
     
         2 . The system of  claim 1 , wherein the active fixation member comprises a helical wire configured to be screwed into tissue of the blood vessel wall. 
     
     
         3 . The system of  claim 2 , wherein the helical fixation member has a length in the range from and including approximately 0.5 millimeters to and including approximately 2.5 millimeters. 
     
     
         4 . The system of  claim 3 , wherein the length of the helical fixation member is in the range from and including approximately 1 millimeters to and including approximately 2 millimeters. 
     
     
         5 . The system of  claim 2 , wherein a pitch of the helical fixation member is in the range from and including approximately 0.5842 millimeters to and including approximately 1.016 millimeters. 
     
     
         6 . The system of  claim 1 , further comprising a catheter configured to be arranged within a lumen of the blood vessel adjacent the nerve tissue, wherein the medical lead is advanceable from catheter to the wall of the blood vessel lumen. 
     
     
         7 . The system of  claim 6 , wherein a distal end of the catheter is configured to direct the medical lead transversely toward the wall of the blood vessel lumen when the medical lead is advanced from the distal end of the catheter. 
     
     
         8 . The system of  claim 6 , further comprising a deployment member extendable and retractable from the catheter to arrange the lead, electrode and active fixation member proximate the blood vessel wall adjacent the nerve tissue. 
     
     
         9 . The system of  claim 8 , wherein the deployment member comprises at least one of a guide member or a tubular member within and through a lumen of which the medical lead is received and advanceable. 
     
     
         10 . The system of  claim 9 , wherein the guide member comprises one of a guidewire or a stylus. 
     
     
         11 . The system of  claim 8 , further comprising an electrode connected to at least one of the catheter or the deployment member. 
     
     
         12 . The system of  claim 1 , wherein the nerve tissue comprises one of a vagus nerve, a hypoglossal nerve, a nerve plexus, nerve ganglia, or a vascular baroreceptor. 
     
     
         13 . The system of  claim 1  wherein the active fixation member comprises one or more of a plurality of barbs or hooks configured to engage tissue of the blood vessel wall. 
     
     
         14 . The system of  claim 1 , wherein the active fixation member comprises the electrode. 
     
     
         15 . The system of  claim 1 , wherein the active fixation member comprises an additional electrode. 
     
     
         16 . A method comprising:
 deploying a lead through a lumen of a blood vessel to a target nerve tissue site;   arranging an electrode connected to the lead within the blood vessel lumen adjacent the nerve tissue; and   actively fixing the lead to a wall of the blood vessel lumen.   
     
     
         17 . The method of  claim 16  further comprising energizing the electrode to deliver electrical stimulation from within the blood vessel lumen to the nerve tissue. 
     
     
         18 . The method of  claim 17  further comprising determining an efficacy of the nerve tissue stimulation. 
     
     
         19 . The method of  claim 18  further comprising:
 comparing the efficacy of the nerve tissue stimulation to a threshold efficacy; and 
 repositioning the delivery catheter and the electrode within the blood vessel lumen if the efficacy of the nerve tissue stimulation does not meet or exceed the threshold efficacy. 
 
     
     
         20 . The method of  claim 16 , wherein actively fixing the lead to the blood vessel wall comprises screwing a helical wire into tissue of the wall. 
     
     
         21 . The method of  claim 16 , wherein the nerve tissue comprises one of a vagus nerve, a hypoglossal nerve, a nerve plexus, nerve ganglia, or a vascular baroreceptors.