Percutaneous devices and methods to visualize, target and ablate nerves

Abstract

Apparatuses for identifying nerve tissue and methods for making and using the same are disclosed. An example apparatus may include an elongate shaft having a distal region configured to be percutaneously deployed within a patient. An active imaging structure may be disposed on the distal region. The active imaging structure may be configured to remotely image nerve tissue by exciting a signal in nerve tissue from a percutaneous location and receiving the signal from a percutaneous location. The active imaging structure may include one or more probes.

1 .- 20 . (canceled) 
     
     
         21 . A method of imaging and treating targeted nerve tissue, the method comprising:
 deploying an elongate shaft having a distal region to a location within a body lumen of a patient, the shaft comprising an inflatable balloon along the distal region;   expanding the balloon from a collapsed configuration to an expanded configuration;   rotating a module on the elongate shaft within the balloon and about a central axis with respect to the balloon and the elongate shaft, the module comprising one or more light emitters and a phased array of ultrasonic transducers;   remotely imaging the targeted nerve tissue by exciting a signal in the targeted nerve tissue from the location and receiving the signal at the location;
 wherein the one or more light-emitters emit light toward the targeted nerve tissue, 
 wherein the phased array of ultrasonic transducers detect the signal generated by the light in the targeted nerve tissue; and 
   focusing treatment energy onto the targeted nerve tissue at a first focal point, which is a distance from the phased array of ultrasonic transducers, such that the treatment energy passes through an untreated tissue region to treat the targeted nerve tissue.   
     
     
         22 . The method of  claim 21 , wherein the light emitted from the one or more light-emitters is coherent light. 
     
     
         23 . The method of  claim 21 , wherein the one or more light-emitters emit the light towards a second focal point. 
     
     
         24 . The method of  claim 23 , wherein the one or more light-emitters are configured to change the depth of focus of the second focal point. 
     
     
         25 . The method of  claim 23 , wherein the one or more light-emitters comprise a phased array of light emitting elements. 
     
     
         26 . The method of  claim 25 , wherein the phased array of light emitting elements is configured to change the radial, longitudinal and angular location of the second focal point and to change the depth of focus of the second focal point. 
     
     
         27 . The method of  claim 21 , wherein the phased array of ultrasonic transducers is configured to change the radial, longitudinal and angular location of the first focal point and to change the depth of focus of the first focal point. 
     
     
         28 . The method of  claim 26 , wherein the phased array of ultrasonic transducers is configured to change the radial, longitudinal and angular location of the first focal point and to change the depth of focus of the first focal point. 
     
     
         29 . The method of  claim 28 , wherein the phased array of light emitting elements and the phased array of ultrasonic transducers are configured to change the first focal point and the second focal point to the same radial, longitudinal and angular location. 
     
     
         30 . A method of treating a nerve within targeted tissue, the method comprising:
 deploying an elongate shaft having a distal region to a location within a body lumen of a patient, the shaft comprising an expandable member within the distal region;   expanding the member within the body lumen;   rotating a module disposed along the elongate shaft within the member and about a central axis with respect to the member and the elongate shaft, the module comprising a phased array of light emitters and a phased array of ultrasonic transducers;   imaging the targeted tissue by emitting light from the phased array of light emitters toward the targeted tissue to excite a signal in the targeted tissue, and detecting the signal generated by the light in the targeted tissue at the phased array of ultrasonic transducers; and   focusing treatment energy onto the targeted tissue at a first focal point, which is a distance from the phased array of ultrasonic transducers, such that the treatment energy passes through an untreated tissue region to treat the nerve within the targeted tissue.   
     
     
         31 . The method of  claim 30 , wherein the phased array of light-emitters emits light towards a second focal point. 
     
     
         32 . The method of  claim 31 , wherein the phased array of light-emitters is configured to change the depth of focus of the second focal point. 
     
     
         33 . The method of  claim 31 , wherein the phased array of light emitters is configured to change the radial, longitudinal and angular location of the second focal point and to change the depth of focus of the second focal point. 
     
     
         34 . The method of  claim 30 , wherein the phased array of ultrasonic transducers is configured to change the radial, longitudinal and angular location of the first focal point and to change the depth of focus of the first focal point. 
     
     
         35 . The method of  claim 33 , wherein the phased array of ultrasonic transducers is configured to change the radial, longitudinal and angular location of the first focal point and to change the depth of focus of the first focal point. 
     
     
         36 . The method of  claim 35 , wherein the phased array of light emitting elements and the phased array of ultrasonic transducers are configured to change the first focal point and the second focal point to the same radial, longitudinal and angular location. 
     
     
         37 . A method of treating a nerve within targeted tissue, the method comprising:
 deploying an elongate shaft having a distal region to a location within a body lumen of a patient, the shaft comprising an inflatable balloon along the distal region;   inflating the balloon within the body lumen;   rotating one or more light emitters and a phased array of ultrasonic transducers disposed along the elongate shaft within the balloon and about a central axis of the elongate shaft;   emitting light from the one or more light emitters toward the targeted tissue to excite a signal in the targeted tissue, and detecting the signal at the phased array of ultrasonic transducers; and   focusing treatment energy onto the targeted tissue to treat the nerve within the targeted tissue.   
     
     
         38 . The method of  claim 37 , wherein the one or more light emitters comprises a phased array of a plurality of light emitters. 
     
     
         39 . The method of  claim 37 , wherein the focusing step further comprises focusing the treatment energy onto the targeted tissue at a first focal point, which is a distance from the phased array of ultrasonic transducers, such that the treatment energy passes through an untreated tissue region to treat the nerve within the targeted tissue. 
     
     
         40 . The method of  claim 37 , wherein the one or more light-emitters emit pulses of coherent light.