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:
 percutaneously introducing a neuromodulation assembly at a distal portion of a treatment device proximate to neural fibers innervating a gastrointestinal organ of a human subject diagnosed with a gastrointestinal condition;   at least partially disrupting function of the neural fibers via the neuromodulation assembly; and   removing the neuromodulation assembly from the subject after treatment,   wherein at least partial disruption of the function of the neural fibers therapeutically treats the diagnosed gastrointestinal condition.   
     
     
         46 . The method of  claim 45  wherein the gastrointestinal condition is an autoimmune disorder or a gastric motility disorder. 
     
     
         47 . The method of  claim 46  wherein the gastrointestinal condition is an autoimmune disorder, and wherein at least partial disruption of the function of the neural fibers therapeutically reduces inflammation in the gastrointestinal organ of the subject. 
     
     
         48 . The method of  claim 46  wherein the gastrointestinal condition is a gastric motility disorder, and wherein at least partial disruption of the function of the neural fibers therapeutically increases gastric motility. 
     
     
         49 . The method of  claim 46  wherein the gastrointestinal condition is a gastric motility disorder, and wherein at least partial disruption of the function of the neural fibers therapeutically slows gastric motility. 
     
     
         50 . The method of  claim 45  wherein the gastrointestinal organ includes at least one of the stomach, the small intestine, the colon, and the rectum of the subject. 
     
     
         51 . The method of  claim 45  wherein the gastrointestinal condition is at least one of gastric ulcers, gastric motility disorders, irritable bowel syndrome, Crohn's disease, and colitis. 
     
     
         52 . The method of  claim 45  wherein at least partially disrupting function of the neural fibers via the neuromodulation assembly comprises thermally modulating the neural fibers via at least one electrode in contact with a vessel wall. 
     
     
         53 . The method of  claim 45  wherein at least partially disrupting function of the neural fibers via the neuromodulation assembly comprises thermally modulating the neural fibers via one or more electrodes positioned within a gastrointestinal blood vessel of the subject. 
     
     
         54 . A method of treating a human patient diagnosed with a digestive system condition, 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; and   reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve via the neuromodulation assembly,   wherein reducing sympathetic neural activity therapeutically treats the patient diagnosed with the digestive system condition.   
     
     
         55 . The method of  claim 54  wherein the digestive system condition is selected from a group consisting of Crohn's disease, colitis, pancreatitis, obesity, hepatitis, hepatorenal syndrome, gastric ulcer, gastric motility disorders, irritable bowel syndrome, and autoimmune disorders. 
     
     
         56 . The method of  claim 54  wherein intravascularly positioning a neuromodulation assembly within a target blood vessel and adjacent to a target sympathetic nerve comprises positioning the neuromodulation assembly adjacent the target sympathetic nerve innervating an internal structure of the patient selected from a group consisting of a stomach, a small intestine, a colon, a rectum, a liver, a gall bladder, a pancreas, a bile duct, an adrenal gland, and a kidney. 
     
     
         57 . The method of  claim 54  wherein reducing sympathetic neural activity in the patient reduces whole body norepinephrine spillover in the patient. 
     
     
         58 . The method of  claim 54  wherein intravascularly positioning a neuromodulation assembly within a target blood vessel comprises positioning the neuromodulation assembly in at least one of the celiac trunk, the superior mesenteric artery, the inferior mesenteric artery and an abdominal blood vessel. 
     
     
         59 . The method of  claim 54  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises at least partially inhibiting afferent neural activity. 
     
     
         60 . The method of  claim 54  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises at least partially inhibiting efferent neural activity. 
     
     
         61 . The method of  claim 54  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve comprises partially ablating the target sympathetic nerve. 
     
     
         62 . The method of  claim 54  wherein reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve via the neuromodulation assembly comprises delivering an energy field to the target sympathetic nerve via the neuromodulation assembly. 
     
     
         63 . The method of  claim 62  wherein delivering an energy field to the target sympathetic nerve comprises delivering at least one of radio frequency energy, ultrasound energy, high intensity ultrasound energy, laser energy, and microwave energy via the neuromodulation assembly. 
     
     
         64 . The method of  claim 54 , further comprising removing the neuromodulation assembly from the patient after delivering energy to the target sympathetic nerve via the neuromodulation assembly. 
     
     
         65 . A method of treating a human patient diagnosed with obesity, 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; and   reducing sympathetic neural activity in the patient by delivering energy to the target sympathetic nerve via the neuromodulation assembly to modulate the target sympathetic nerve,   wherein modulating the target sympathetic nerve therapeutically treats the patient diagnosed with obesity.   
     
     
         66 . The method of  claim 65  wherein the target sympathetic nerve comprises a sympathetic nerve innervating a stomach of the patient. 
     
     
         67 . The method of  claim 65  wherein intravascularly positioning a neuromodulation assembly within a target blood vessel comprises positioning the neuromodulation assembly in the celiac trunk or a branch thereof. 
     
     
         68 . The method of  claim 65  wherein intravascularly positioning a neuromodulation assembly within a target blood vessel comprises positioning the neuromodulation assembly in at least one of the superior mesenteric artery, the inferior mesenteric artery, or a branch thereof. 
     
     
         69 . The method of  claim 65  wherein the patient is further diagnosed with obesity-related hypertension, and wherein reducing sympathetic neural activity in the patient further results in a therapeutically beneficial reduction in blood pressure of the patient. 
     
     
         70 . The method of  claim 65  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 one or more electrodes. 
     
     
         71 . The method of  claim 65  wherein modulating the target sympathetic nerve therapeutically causes a reduction in body weight of the patient diagnosed with obesity.