Intravascular Tissue Disruption

Abstract

Disrupting tissue and devices and systems for disrupting tissue. The disclosure describes ways to deliver moieties to a target tissue, where the target tissue in general is not at the point of introduction, in such a way that minimal damage is produced in the tissue at the point of introduction. In some embodiments this is accomplished by jetting fluid at high velocity into the target tissue. The disclosure further describes novel agents deliverable in such systems for use in remodeling tissues. Some of these agents comprise a liquid while others do not. Additionally, although not specifically described in detail much of the disclosure may additionally be used in the delivery of therapeutic drugs.

1 . A method of treating hypertension, comprising:
 positioning a medical device within a renal artery adjacent to the renal artery lumen; and   delivering a fluid at a high velocity from the medical device to a renal nerve through the lumen wall to modulate neural transmission along the renal nerve without piercing the renal artery lumen with the medical device.   
     
     
         2 . The method of  claim 1  wherein positioning the medical device comprises positioning a portion of the medical device to be in contact with the renal artery lumen. 
     
     
         3 . The method of  claim 1  wherein delivering a fluid at a high velocity comprises delivering a fluid at least about 75 msec. 
     
     
         4 . The method of  claim 1  further comprising maintaining a substantially constant pressure at a fluid source in communication with the medical device. 
     
     
         5 . The method of  claim 1  further comprising disrupting renal nerve tissue in a substantially spiral pattern relative to the renal artery. 
     
     
         6 . The method of  claim 5  wherein the medical device comprises a plurality of fluid controls, and wherein delivering the fluid comprises selectively regulating the flow of the fluid out of the plurality of fluid controls to disrupt renal nerve tissue in a substantially spiral pattern relative to the renal artery. 
     
     
         7 . The method of  claim 1  wherein the medical device comprises at least one fluid control, and the delivering step comprises delivering the fluid from a first of the at least one fluid control, the method further comprising selectively regulating the flow of the fluid from the first fluid control. 
     
     
         8 . The method of  claim 7  further comprising minimizing the fluid that is delivered from a second of the at least one fluid controls. 
     
     
         9 . The method of  claim 7  further comprising moving a first fluid control from a closed configuration to an open configuration to deliver the fluid at the high velocity. 
     
     
         10 . The method of  claim 1  further comprising damaging nerve cells peripheral to an intimal layer of the renal artery. 
     
     
         11 . The method of  claim 10  wherein damaging comprises damaging nerves cells while minimally damaging tissue in the intimal and medial layers of the renal artery. 
     
     
         12 . The method of  claim 1  wherein a chemical interaction with the fluid causes the neural transmission modulation. 
     
     
         13 . The method of  claim 1  wherein modulating neural transmission along the renal nerve treats hypertension.