公开(公告)号：US20190000545A1

公开(公告)日：2019-01-03

申请号：US16019380

申请日：2018-06-26

Applicant: Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

Inventor： Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

IPC: A61B18/14 ,  A61N7/02 ,  A61F7/12 ,  A61M5/142 ,  A61M5/172 ,  A61N1/28 ,  A61N1/32 ,  A61N1/36 ,  A61N1/40 ,  A61N5/04 ,  A61B18/00 ,  A61N7/00 ,  A61N1/362

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

公开(公告)号：US20150282877A1

公开(公告)日：2015-10-08

申请号：US14737254

申请日：2015-06-11

Applicant: Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

Inventor： Denise Zarins ,  Andrew Wu ,  Hanson Gifford, III ,  Mark Deem ,  Mark Gelfand ,  Howard R. Levin

IPC: A61B18/14 ,  A61N7/02 ,  A61N1/28

CPC classification number: A61B18/1492 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00642 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/14276 ,  A61M5/1723 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/32 ,  A61N1/326 ,  A61N1/36007 ,  A61N1/36017 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627 ,  A61N1/403 ,  A61N5/045 ,  A61N7/02 ,  A61N2007/003

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

Abstract translation: 提供了用于热诱导的肾神经调节的方法和装置。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。 在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。 在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。 在一些实施方案中，热诱导的肾神经调节通过脉冲热疗法的递送来实现。

公开(公告)号：US20140324016A1

公开(公告)日：2014-10-30

申请号：US14221536

申请日：2014-03-21

Applicant: Mark Gelfand ,  Howard R. Levin

Inventor： Mark Gelfand ,  Howard R. Levin

IPC: A61M5/145 ,  A61K9/70 ,  A61K9/00 ,  A61L29/14

CPC classification number: A61K31/529 ,  A61K9/0004 ,  A61K9/0012 ,  A61K9/7007 ,  A61K31/135 ,  A61K31/52 ,  A61K45/06 ,  A61L29/146 ,  A61M5/14276 ,  A61M5/145 ,  A61M5/1723 ,  A61M2005/14513 ,  A61M2205/05 ,  A61M2205/50 ,  A61M2210/1082 ,  A61N1/0551 ,  A61N1/326 ,  A61N1/36007 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/3627

Abstract: A method and apparatus for treatment of cardiac and renal diseases associated with the elevated sympathetic renal nerve activity by implanting a device to block the renal nerve signals to and from the kidney. The device can be a drug pump or a drug eluding implant for targeted delivery of a nerve-blocking agent to the periarterial space of the renal artery.

Abstract translation: 一种用于通过植入用于阻断肾脏和/或从肾脏的肾神经信号的装置来治疗与交感神经肾神经活动升高相关的心脏和肾脏疾病的方法和装置。 该装置可以是药物泵或药物迂回植入物，用于将神经阻断剂靶向递送至肾动脉的动脉周围空间。

公开(公告)号：US20140228739A1

公开(公告)日：2014-08-14

申请号：US14258802

申请日：2014-04-22

Applicant: Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

Inventor： Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

IPC: A61B18/12 ,  A61B18/14 ,  A61M5/14

CPC classification number: A61N1/36007 ,  A61B8/0891 ,  A61B8/12 ,  A61B18/1206 ,  A61B18/1233 ,  A61B18/1492 ,  A61B18/18 ,  A61B2018/00071 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00904 ,  A61B2018/126 ,  A61B2018/1467 ,  A61M5/14 ,  A61M25/0023 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/18 ,  A61N1/205 ,  A61N1/326 ,  A61N1/327 ,  A61N1/36017 ,  A61N1/36057 ,  A61N1/3606 ,  A61N1/36103 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36139 ,  A61N5/00 ,  A61N7/00 ,  A61N2007/0021 ,  A61N2007/003

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract translation: 提供使用脉冲电场进行肾神经调节以实现电穿孔或电融合的方法和装置。 预期肾脏神经调节（例如去神经支配）可以减少急性心肌梗塞的扩张，减少或预防与充血性心力衰竭有关的形态学变化的发生，和/或有效治疗 晚期肾脏疾病。 本发明的实施例被配置用于经皮血管内递送脉冲电场以实现这种神经调节。

公开(公告)号：US20140081259A1

公开(公告)日：2014-03-20

申请号：US14056888

申请日：2013-10-17

Applicant: Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

Inventor： Mark E. Deem ,  Hanson Gifford, III ,  Denise Zarins ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

IPC: A61B18/18

CPC classification number: A61N1/36007 ,  A61B8/0891 ,  A61B8/12 ,  A61B18/1206 ,  A61B18/1233 ,  A61B18/1492 ,  A61B18/18 ,  A61B2018/00071 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00904 ,  A61B2018/126 ,  A61B2018/1467 ,  A61M5/14 ,  A61M25/0023 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/18 ,  A61N1/205 ,  A61N1/326 ,  A61N1/327 ,  A61N1/36017 ,  A61N1/36057 ,  A61N1/3606 ,  A61N1/36103 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36139 ,  A61N5/00 ,  A61N7/00 ,  A61N2007/0021 ,  A61N2007/003

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

公开(公告)号：US08603021B2

公开(公告)日：2013-12-10

申请号：US13098853

申请日：2011-05-02

Applicant: Howard R. Levin ,  Mark Gelfand ,  John O'Mahony ,  Hans-Dietrich Polaschegg

Inventor： Howard R. Levin ,  Mark Gelfand ,  John O'Mahony ,  Hans-Dietrich Polaschegg

IPC: A61M37/00 ,  C02F1/44

CPC classification number: A61M1/341 ,  A61M1/1692 ,  A61M1/34 ,  A61M1/361 ,  A61M1/3612 ,  A61M2205/3393 ,  A61M2205/50 ,  A61M2205/7563

Abstract: An ultrafiltration filter for an extracorporeal blood circuit having an input for blood withdrawn from a human patient and a blood output for filtered blood to be infused into the patient including: a filter body having a length of at least 20 centimeters (cm) and an interior diameter of no greater than 1.5 cm; an input at a first end of the body to receive the withdrawn blood; an output at a second end of the body to discharge the filtered blood; a filter membrane in the body defining a blood passage through the body, wherein the membrane has an active filter membrane surface area of no greater than 0.2 meters squared (m2) and the filter membrane blocks passage of blood molecules having a molecular weight cut of greater than 60,000 Daltons and a volume of the blood passage in the filter being less than two percent of a cardiac output of the patient, and an ultrafiltrate output to the body and open to a side of the filter surface area opposite to the blood passage.

Abstract translation: 一种用于体外血液回路的超滤过滤器，其具有从人类患者抽出的血液的输入和用于输入到患者中的过滤血液的血液输出，包括：具有至少20厘米（cm）的长度和内部 直径不大于1.5厘米; 在身体的第一端的输入以接收所抽取的血液; 在身体的第二端处输出以排出经过滤的血液; 身体中的过滤膜限定穿过身体的血液通道，其中膜具有不大于0.2平方米（m2）的活性过滤膜表面积，并且过滤膜阻止具有更大分子量切割的血液分子的通过 超过60,000道尔顿，并且过滤器中的血液通道的体积小于患者的心输出量的2％，并且超滤液输出到身体并且向与血液通道相对的过滤器表面区域的一侧开口。

公开(公告)号：US08548600B2

公开(公告)日：2013-10-01

申请号：US13619851

申请日：2012-09-14

Applicant: Mark Deem ,  Hanson Gifford, III ,  Denise Demarais ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

Inventor： Mark Deem ,  Hanson Gifford, III ,  Denise Demarais ,  Douglas Sutton ,  Erik Thai ,  Mark Gelfand ,  Howard R. Levin

IPC: A61F2/00 ,  A61N1/00 ,  A61N1/30 ,  A61M31/00 ,  A61B18/18

CPC classification number: A61N1/36007 ,  A61B8/0891 ,  A61B8/12 ,  A61B18/1206 ,  A61B18/1233 ,  A61B18/1492 ,  A61B18/18 ,  A61B2018/00071 ,  A61B2018/00214 ,  A61B2018/0022 ,  A61B2018/00267 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00505 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61B2018/00642 ,  A61B2018/00904 ,  A61B2018/126 ,  A61B2018/1467 ,  A61M5/14 ,  A61M25/0023 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/0551 ,  A61N1/18 ,  A61N1/205 ,  A61N1/326 ,  A61N1/327 ,  A61N1/36017 ,  A61N1/36057 ,  A61N1/3606 ,  A61N1/36103 ,  A61N1/36114 ,  A61N1/36117 ,  A61N1/36139 ,  A61N5/00 ,  A61N7/00 ,  A61N2007/0021 ,  A61N2007/003

Abstract: Methods and apparatus are provided for renal neuromodulation using a pulsed electric field to effectuate electroporation or electrofusion. It is expected that renal neuromodulation (e.g., denervation) may, among other things, reduce expansion of an acute myocardial infarction, reduce or prevent the onset of morphological changes that are affiliated with congestive heart failure, and/or be efficacious in the treatment of end stage renal disease. Embodiments of the present invention are configured for percutaneous intravascular delivery of pulsed electric fields to achieve such neuromodulation.

Abstract translation: 提供使用脉冲电场进行肾神经调节以实现电穿孔或电融合的方法和装置。 预期肾脏神经调节（例如去神经支配）可以减少急性心肌梗塞的扩张，减少或预防与充血性心力衰竭有关的形态学变化的发生，和/或有效治疗 晚期肾脏疾病。 本发明的实施例被配置用于经皮血管内递送脉冲电场以实现这种神经调节。

公开(公告)号：US20130012844A1

公开(公告)日：2013-01-10

申请号：US13620043

申请日：2012-09-14

Applicant: Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

Inventor： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

IPC: A61N7/02

CPC classification number: A61N7/022 ,  A61B18/02 ,  A61B18/04 ,  A61B18/12 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61F7/12 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/44 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/36007 ,  A61N1/403 ,  A61N5/00 ,  A61N5/025 ,  A61N5/045 ,  A61N5/0603 ,  A61N7/00 ,  A61N7/02 ,  A61N2007/003 ,  A61N2007/0078

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

Abstract translation: 提供了用于热诱导的肾神经调节的方法和装置。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。 在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。 在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。

公开(公告)号：US20120197198A1

公开(公告)日：2012-08-02

申请号：US13361685

申请日：2012-01-30

Applicant: Denise Demarais ,  Hanson Gifford, III ,  Mark Deem ,  Douglas Sutton ,  Howard R. Levin ,  Mark Gelfand

Inventor： Denise Demarais ,  Hanson Gifford, III ,  Mark Deem ,  Douglas Sutton ,  Howard R. Levin ,  Mark Gelfand

IPC: A61M5/142 ,  A61N1/05

CPC classification number: A61N1/0551 ,  A61B18/12 ,  A61B18/14 ,  A61B18/1492 ,  A61B2018/00267 ,  A61B2018/00351 ,  A61B2018/00404 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61B2018/00613 ,  A61M5/1408 ,  A61M5/14276 ,  A61M2210/1082 ,  A61N1/0412 ,  A61N1/05 ,  A61N1/327 ,  A61N1/36007 ,  A61N1/36017 ,  A61N7/00

Abstract: Methods and apparatus are provided for bilateral renal neuromodulation, e.g., via a pulsed electric field, via a stimulation electric field, via localized drug delivery, via high frequency ultrasound, via thermal techniques, etc. Such neuromodulation may effectuate irreversible electroporation or electrofusion, necrosis and/or inducement of apoptosis, alteration of gene expression, action potential attenuation or blockade, changes in cytokine up-regulation and other conditions in target neural fibers. In some embodiments, neuromodulation is applied to neural fibers that contribute to renal function. In some embodiments, such neuromodulation is performed in a bilateral fashion. Bilateral renal neuromodulation may provide enhanced therapeutic effect in some patients as compared to renal neuromodulation performed unilaterally, i.e., as compared to renal neuromodulation performed on neural tissue innervating a single kidney.

Abstract translation: 提供了双侧肾神经调节的方法和装置，例如通过脉冲电场，通过刺激电场，经由局部药物递送，经由高频超声波，通过热技术等。这种神经调节可以实现不可逆的电穿孔或电融合，坏死 和/或诱导细胞凋亡，改变基因表达，动作电位减弱或阻断，细胞因子上调和靶神经纤维中的其他条件的变化。 在一些实施方案中，神经调节被应用于有助于肾功能的神经纤维。 在一些实施方案中，这种神经调节以双向方式进行。 与单侧执行的肾神经调节相比，双侧肾神经调节可以在一些患者中提供增强的治疗效果，即与在支配单个肾脏的神经组织上进行的肾神经调节相比。

公开(公告)号：US20120172837A1

公开(公告)日：2012-07-05

申请号：US13417044

申请日：2012-03-09

Applicant: Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

Inventor： Denise Demarais ,  Nicolas Zadno ,  Benjamin J. Clark ,  Erik Thai ,  Howard R. Levin ,  Mark Gelfand

IPC: A61M5/158 ,  A61F7/12

CPC classification number: A61N7/022 ,  A61B18/02 ,  A61B18/04 ,  A61B18/12 ,  A61B18/1492 ,  A61B2018/0022 ,  A61B2018/00434 ,  A61B2018/00511 ,  A61B2018/00577 ,  A61F7/007 ,  A61F7/12 ,  A61F7/123 ,  A61F2007/126 ,  A61M5/44 ,  A61M2210/1082 ,  A61N1/28 ,  A61N1/36007 ,  A61N1/403 ,  A61N5/00 ,  A61N5/025 ,  A61N5/045 ,  A61N5/0603 ,  A61N7/00 ,  A61N7/02 ,  A61N2007/003 ,  A61N2007/0078

Abstract: Methods and apparatus are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues.

Abstract translation: 提供了用于热诱导的肾神经调节的方法和装置。 热诱导的肾神经调节可以通过直接和/或通过间接施加热能来加热或冷却有助于肾功能的神经纤维或者供给或灌注神经纤维的血管结构来实现。 在一些实施例中，神经纤维，非目标组织或热能递送元件的参数可以经由一个或多个传感器来监测，以控制热诱导的神经调节。 在一些实施方案中，可以提供保护元件以减少在非靶组织中诱导的热损伤程度。