Catheter Apparatuses, Systems, and Methods for Renal Neuromodulation

Abstract

Catheter apparatuses, systems, and methods for achieving renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a catheter treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver an energy delivery element to a renal artery via an intravascular path. Thermal or electrical renal neuromodulation may be achieved via direct and/or via indirect application of thermal and/or electrical energy to heat or cool, or otherwise electrically modulate, neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

1 - 44 . (canceled) 
     
     
         45 . A method, comprising:
 introducing a neuromodulation assembly at a distal portion of a treatment device proximate to neural fibers innervating penile tissue of a human patient diagnosed with erectile dysfunction or premature ejaculation;   at least partially disrupting function of the neural fibers innervating the penile tissue by applying thermal energy to the neural fibers via the neuromodulation assembly; and   removing the neuromodulation assembly from the patient after treatment,   wherein at least partial disruption of the function of the neural fibers innervating the penile tissue therapeutically treats the diagnosed erectile dysfunction or premature ejaculation.   
     
     
         46 . The method of  claim 45  wherein the neuromodulation assembly is introduced percutaneously. 
     
     
         47 . The method of  claim 45  wherein the patient is diagnosed with premature ejaculation, and wherein at least partial disruption of the function of the neural fibers decreases a frequency of premature ejaculation in the patient. 
     
     
         48 . The method of  claim 45  wherein the patient is diagnosed with erectile dysfunction, and wherein at least partial disruption of the function of the neural fibers increases a frequency of penile erections in the patient. 
     
     
         49 . A method for treating erectile dysfunction in a human patient, the method comprising:
 transluminally positioning an energy delivery element of a catheter within a target blood vessel of the patient and adjacent to neural fibers that innervate a kidney or penile tissue of the patient; and   at least partially ablating the neural fibers innervating the kidney or penile tissue of the patient via the energy delivery element,   wherein at least partially ablating the neural fibers results in a therapeutically beneficial reduction in one or more physiological conditions associated with erectile dysfunction of the patient.   
     
     
         50 . The method of  claim 49  wherein the reduction in one or more physiological conditions associated with erectile dysfunction includes a reduction in the number of instances of impotence in the patient. 
     
     
         51 . A method of treating a human patient diagnosed with erectile dysfunction, the method comprising:
 intravascularly positioning a neuromodulation assembly within a target blood vessel of the patient and adjacent to a target sympathetic nerve of the patient;   reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve via the neuromodulation assembly; and   removing the neuromodulation assembly from the patient after treatment,   wherein reducing sympathetic neural activity therapeutically treats the diagnosed erectile dysfunction.   
     
     
         52 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient increases a frequency of penile erections in the patient. 
     
     
         53 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient reduces whole body norepinephrine spillover in the patient. 
     
     
         54 . The method of  claim 51  wherein the patient is further diagnosed with hypertension, and wherein reducing sympathetic neural activity in the patient further results in a therapeutically beneficial reduction in blood pressure of the patient. 
     
     
         55 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises at least partially inhibiting efferent neural activity. 
     
     
         56 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises selectively neuromodulating efferent penile nerves in the patient compared to afferent penile nerves in the patient. 
     
     
         57 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises at least partially inhibiting afferent neural activity. 
     
     
         58 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises thermally modulating the target sympathetic nerve of the patient via an intravascularly positioned catheter carrying the neuromodulation assembly. 
     
     
         59 . The method of  claim 58  wherein thermally modulating the target sympathetic nerve comprises at least partially ablating the target sympathetic nerve via the neuromodulation assembly. 
     
     
         60 . The method of  claim 58  wherein thermally modulating the target sympathetic nerve comprises cryotherapeutically cooling the target sympathetic nerve. 
     
     
         61 . The method of  claim 58  wherein thermally modulating the target sympathetic nerve comprises heating the target sympathetic nerve. 
     
     
         62 . The method of  claim 51  wherein intravascularly positioning a neuromodulation assembly within a target blood vessel of the patient comprises positioning the neuromodulation assembly within a renal artery. 
     
     
         63 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises reducing sympathetic neural activity in one or more sympathetic nerves innervating penile tissue of the patient. 
     
     
         64 . The method of  claim 51  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises reducing sympathetic neural activity in one or more sympathetic nerves innervating a kidney of the patient.