System and method for treating a therapeutic site

Abstract

A targeting catheter is used to locate an arteriotomy, such as is formed during a femoral artery catheterization procedure. The targeting catheter includes one or more targeting aids, such as an inflatable balloon or sensor (e.g., Doppler or temperature sensor), to locate the arteriotomy. The targeting aid may be positioned at the arteriotomy. An ultrasonic beacon on the catheter may then be located relative to a therapeutic ultrasonic applicator (e.g., by using acoustic time-of-flight) so that the focus of ultrasonic energy from the applicator can be aligned with the arteriotomy.

1 . A method of treating a therapeutic site adjacent a blood vessel within a patient, comprising:
 inserting a targeting catheter into a patient;   emitting at least one signal from the targeting catheter from within the patient;   determining a location of a portion of the targeting catheter relative to a therapeutic ultrasound applicator based at least in part on the at least one signal; and   adjusting a focus of the therapeutic ultrasound applicator based on the determined location of the portion of the targeting catheter.   
     
     
         2 . The method of  claim 1 , further comprising emitting a dose of high intensity focused ultrasound from the therapeutic applicator to the determined location. 
     
     
         3 . The method of  claim 1 , further comprising identifying a location of the therapeutic site using the targeting catheter. 
     
     
         4 . The method of  claim 3 , further comprising positioning the targeting catheter proximate to the therapeutic site adjacent the blood vessel. 
     
     
         5 . The method of  claim 1 , wherein determining the location of the portion of the targeting catheter relative to the therapeutic applicator comprises using triangulation of the at least one signal emitted from the targeting catheter. 
     
     
         6 . The method of  claim 5 , wherein the triangulation is based on magnetic fields. 
     
     
         7 . The method of  claim 5 , wherein the triangulation is based on acoustic signals. 
     
     
         8 . The method of  claim 5 , wherein the triangulation is based on an acoustic time-of-flight determination. 
     
     
         9 . The method of  claim 1 , wherein determining the location of the portion of the targeting catheter relative to the therapeutic applicator comprises determining an acoustic time-of-flight from the targeting catheter to the therapeutic applicator. 
     
     
         10 . The method of  claim 9 , wherein the at least one signal is emitted from a beacon disposed on the targeting catheter. 
     
     
         11 . The method of  claim 10 , wherein the at least one signal comprises a tone burst of sound. 
     
     
         12 . The method of  claim 11 , wherein the therapeutic applicator comprises a plurality of receivers disposed about one or more therapeutic ultrasonic transducers and further comprising receiving the at least one signal by the plurality of receivers. 
     
     
         13 . The method of  claim 1 , wherein the at least one signal is an ultrasound signal. 
     
     
         14 . The method of  claim 1 , further comprising providing a user interface to assist a user in adjusting the focus of the therapeutic applicator. 
     
     
         15 . The method of  claim 14 , further comprising displaying graphical elements on the user interface. 
     
     
         16 . A method of treating a therapeutic site within a patient, comprising:
 inserting a targeting catheter into a patient, the targeting catheter comprising a receiver;   emitting at least one signal from a therapeutic ultrasound applicator that is disposed external to the patient;   receiving the at least one signal with the receiver;   determining a location of a portion of the targeting catheter relative to a therapeutic applicator based at least in part on the at least one signal; and   adjusting a focus of the therapeutic ultrasound applicator based on the determined location of the portion of the targeting catheter.   
     
     
         17 . The method of  claim 16 , further comprising emitting a dose of high intensity focused ultrasound from the therapeutic applicator to the determined location. 
     
     
         18 . The method of  claim 16 , further comprising identifying a location of the therapeutic site using the targeting catheter. 
     
     
         19 . The method of  claim 18 , further comprising positioning the targeting catheter proximate to the therapeutic site. 
     
     
         20 . A system for treating a therapeutic site within a patient, the system comprising:
 a targeting catheter configured to be positioned within the patient and comprising a beacon configured to emit at least one signal from within the patient; and   a therapeutic applicator comprising one or more therapeutic ultrasound transducers and a plurality of receivers disposed about the therapeutic ultrasound transducers, wherein the receivers are configured to receive the at least one signal, and wherein the therapeutic ultrasound transducers are configured to determine a location of the portion of the targeting catheter relative to the therapeutic applicator based at least in part on the received signals.   
     
     
         21 . The system of  claim 20 , wherein the therapeutic applicator comprises at least three receivers. 
     
     
         22 . The system of  claim 20 , wherein the beacon is configured to emit a tone burst of sound.