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 an ovary of a human patient diagnosed with polycystic ovary syndrome or infertility; and   at least partially disrupting function of the neural fibers innervating the ovary by applying thermal energy to the neural fibers via the neuromodulation assembly,   wherein at least partial disruption of the function of the neural fibers innervating the ovary therapeutically treats the diagnosed polycystic ovary syndrome or infertility.   
     
     
         46 . The method of  claim 45  wherein the patient is diagnosed with polycystic ovary syndrome, and wherein therapeutically treating the diagnosed polycystic ovary syndrome comprises reducing at least one of insulin resistance and blood pressure in the patient. 
     
     
         47 . The method of  claim 45  wherein the patient is diagnosed with infertility, and wherein at least partial disruption of the function of the neural fibers innervating the ovary reverses infertility in the patient. 
     
     
         48 . The method of  claim 45  wherein at least partially disrupting function of the neural fibers innervating the ovary by applying thermal energy to the neural fibers comprises ablating the neural fibers. 
     
     
         49 . The method of  claim 45  wherein at least partially disrupting function of the neural fibers innervating the ovary by applying thermal energy to the neural fibers comprises partially ablating the neural fibers. 
     
     
         50 . The method of  claim 45  wherein at least partially disrupting function of the neural fibers innervating the ovary by applying thermal energy to the neural fibers comprises blocking or inhibiting communication along the neural fibers. 
     
     
         51 . The method of  claim 45 , further comprising removing the neuromodulation assembly from the patient after treatment. 
     
     
         52 . A method of treating a human patient diagnosed with polycystic ovary syndrome, the method comprising:
 intravascularly positioning a neuromodulation assembly within a blood vessel of the patient and adjacent to sympathetic nerves innervating an ovary of the patient; and   reducing sympathetic neural activity in the patient by delivering energy to the sympathetic nerves via the neuromodulation assembly,   wherein reducing sympathetic neural activity treats the patient diagnosed with polycystic ovary syndrome.   
     
     
         53 . The method of  claim 52  wherein reducing sympathetic neural activity in the patient reduces whole body norepinephrine spillover in the patient. 
     
     
         54 . The method of  claim 52  wherein reducing sympathetic neural activity in the patient reduces ovarian norepinephrine spillover to plasma in the patient. 
     
     
         55 . The method of  claim 52  wherein reducing sympathetic neural activity in the patient by delivering energy to the sympathetic nerves comprises at least partially inhibiting afferent neural activity. 
     
     
         56 . The method of  claim 52  wherein reducing sympathetic neural activity in the patient by delivering energy to the sympathetic nerves comprises at least partially inhibiting efferent neural activity. 
     
     
         57 . The method of  claim 52  wherein reducing sympathetic neural activity in the patient by delivering energy to the sympathetic nerves comprises modulating an ovarian nerve of the patient via thermal energy from an intravascularly positioned catheter carrying a thermal energy delivery element positioned at least proximate to the ovarian nerve. 
     
     
         58 . The method of  claim 52  wherein intravascularly positioning a neuromodulation assembly within a blood vessel of the patient comprises positioning the neuromodulation assembly within the inferior mesenteric artery or a branch thereof. 
     
     
         59 . The method of  claim 52  wherein reducing sympathetic neural activity in the patient by delivering energy to the sympathetic nerves comprises thermally modulating the sympathetic nerves. 
     
     
         60 . The method of  claim 59  wherein thermally modulating the sympathetic nerves comprises delivering electrical energy to the sympathetic nerves. 
     
     
         61 . The method of  claim 59  wherein thermally modulating the sympathetic nerves comprises delivering radiofrequency (RF) energy to the sympathetic nerves. 
     
     
         62 . A method for treating polycystic ovary syndrome in a human patient, the method comprising:
 positioning an energy delivery element of a denervation catheter within a blood vessel of the patient and adjacent to nerves that innervate an ovary of the patient; and   at least partially ablating the nerves innervating the ovary of the patient via energy delivered by the energy delivery element,   wherein at least partially ablating the nerves innervating the ovary results in a therapeutically beneficial improvement in one or more physiological conditions associated with polycystic ovary syndrome of the patient.   
     
     
         63 . The method of  claim 62 , further comprising administering one or more pharmaceutical drugs to the patient, wherein the pharmaceutical drugs are selected from the group consisting of antihypertensive drugs and anti-diabetic drugs. 
     
     
         64 . The method of  claim 62  wherein the therapeutically beneficial improvement in one or more physiological conditions associated with polycystic ovary syndrome comprises a reduction in insulin resistance in the patient, a reduction in blood pressure, and/or an improvement in a hormonal response in the patient.