Systems and methods for sympathetic cardiopulmonary neuromodulation

Inventors

Bright, Corinne

Abstract

Methods, devices and systems are described for decreasing the activity of the sympathetic nervous innervation to and from the lungs and the vessels supplying the lungs to treat pulmonary medical conditions such as asthma. In one embodiment, the method may involve advancing an intravascular instrument to a target location in a blood vessel within the intercostal vasculature to ablate either or both the sympathetic afferent and efferent nerves lying within the paravertebral gutter including the visceral fibers that travel to the cardiothoracic cavity and abdominopelvic viscera and the T1 to T4/5 sympathetic chain. In another embodiment, an intravascular instrument may be advanced to the bronchial vessels to ablate either or both the sympathetic afferent and efferent nerves in and around the posterior pulmonary plexus. In one embodiment the ablative agent is a neurolytic agent delivered in a gel. This approach may be utilized to treat other cardiac and pulmonary diseases.

Core Innovation

The invention provides a method of modulating nerves of a patient by accessing the paravertebral gutter using a percutaneous intravascular approach. A catheter is inserted into a first blood vessel, advanced into a second blood vessel, and a portion of the catheter penetrates a wall of the second blood vessel to access the paravertebral gutter. Nerves within the paravertebral gutter are modulated by delivering a gel comprising a therapeutic agent into the paravertebral gutter.

The disclosed approach includes delivering a gel formulation into the paravertebral gutter, where the therapeutic agent can be a neurolytic. In related refinements, the neurolytic is asserted to reduce norepinephrine release. The nerves involved can include sympathetic visceral efferent, sympathetic peripheral efferent, visceral afferent, somatic afferent, and somatic efferent.

A further selective modulation method is described by protecting a first group of nerves or neurons within the paravertebral gutter from neurolysis while neuromodulating a first group of nerves or neurons. Protecting comprises delivering a first hydrogel into the paravertebral gutter in a first direction, and neuromodulating comprises delivering a second hydrogel into the paravertebral gutter. The first hydrogel is used for neuroprotection, while the second hydrogel includes a neurolytic agent.

Claims Coverage

The independent claims cover three inventive features centered on percutaneous intravascular catheter access to the paravertebral gutter and gel-based nerve modulation, including a selective neuroprotection-versus-neurolysis arrangement using first and second hydrogels.

The claim coverage supports an intravascular percutaneous catheter approach for accessing the paravertebral gutter and delivering gels for nerve modulation, with one independent claim covering direct gel-mediated modulation using a therapeutic agent and another independent claim covering selective modulation using first hydrogel neuroprotection and second hydrogel neurolysis.

Stated Advantages

Documented Applications