Energetic modulation of nerves

Abstract

In some examples, nerves surrounding arteries or leading to organs are targeted with energy sources to correct or modulate physiologic processes. In some examples, different types of energy sources are utilized singly or combined with one another. In some examples, bioactive agents or devices activated by the energy sources are delivered to the region of interest and the energy is enhanced by such agents or the agents are enhanced by the energy sources.

1 - 148 . (canceled) 
     
     
         149 . A method to treat one or more nerves, wherein the method is performed by a component of a medical apparatus, the medical apparatus including an energy delivery device configured for placement at an operative position relative to a target site inside a patient that includes one or more nerves, the method comprising:
 determining a coordinate of a reference location associated with a blood vessel;   using the coordinate of the reference location to determine a first coordinate for one of a plurality of locations in the target site that has a probability of including the one or more nerves; and   controlling the energy delivery device to apply energy from outside the patient towards the first coordinate for the one of the plurality of locations;   
     
     
         150 . The method of  claim 149 , further comprising:
 determining a second coordinate for another one of the plurality of locations that has a probability of including the one or more nerves; and   controlling the energy delivery device to apply energy towards the second coordinate for the other one of the plurality of locations.   
     
     
         151 . The method of  claim 149 , wherein the one or more nerves comprise one or more nerves leading to or from a carotid body or a carotid sinus. 
     
     
         152 . The method of  claim 149 , wherein the energy applied towards the first coordinate comprises ablative energy. 
     
     
         153 . The method of  claim 149 , wherein the energy applied towards the first coordinate comprises non-ablative energy. 
     
     
         154 . The method of  claim 149 , wherein the energy applied towards the first coordinate comprises ultrasound energy. 
     
     
         155 . The method of  claim 149 , wherein the energy applied towards the first coordinate is derived from a magnetic field. 
     
     
         156 . The method of  claim 149 , wherein the one or more nerves are located in a hilum, a parenchyma, or a medulla of a kidney. 
     
     
         157 . The method of  claim 149 , further comprising performing a test to determine a potential physiologic effect associated with a delivery of energy at the target site. 
     
     
         158 . The method of  claim 157 , further comprising ablating the one or more nerves if a result of the test confirms an intended effect. 
     
     
         159 . The method of  claim 149 , wherein the energy is applied to the first coordinate to perform tissue ablation at the first coordinate, and wherein the method further comprises obtaining a response from the patient to determine if a correct target site was ablated. 
     
     
         160 . The method of  claim 159 , wherein the response is obtained by obtaining a blood pressure value. 
     
     
         161 . The method of  claim 159 , wherein the response is obtained by obtaining a norepinephrine level. 
     
     
         162 . The method of  claim 159 , wherein the response is obtained by obtaining a temperature. 
     
     
         163 . The method of  claim 159 , wherein the response is obtained by receiving an image that indicates an appearance of an ablated zone. 
     
     
         164 . The method of  claim 163 , wherein the image comprises an ultrasound image. 
     
     
         165 . The method of  claim 163 , wherein the image comprises an MRI image. 
     
     
         166 . The method of  claim 149 , wherein the coordinate of the reference location is determined using an MRI machine. 
     
     
         167 . The method of  claim 149 , wherein the coordinate of the reference location is determined using an ultrasound imaging device. 
     
     
         168 . The method of  claim 149 , wherein the coordinate of the reference location is determined using an intravascular catheter. 
     
     
         169 . The method of  claim 149 , wherein the energy delivery device comprises an ultrasound device. 
     
     
         170 . The method of  claim 149 , wherein the energy delivery device is configured to generate the energy for application towards the first coordinate using an alternating magnetic field. 
     
     
         171 . The method of  claim 149 , wherein the target site comprises a renal nerve region. 
     
     
         172 . The method of  claim 149 , wherein the target site comprises a carotid body or a carotid sinus region. 
     
     
         173 . The method of  claim 149 , wherein the energy is applied to the first coordinate to temporarily turn off only a part of a nerve. 
     
     
         174 . The method of  claim 149 , wherein the energy is applied towards the first coordinate using temperature control to turn off some nerves and not others. 
     
     
         175 . The method of  claim 149 , further comprising determining an effect of nerve inhibition resulted from the delivery of energy towards the first coordinate. 
     
     
         176 . The method of  claim 149 , wherein the target site comprises a renal nerve, and the method further comprises detecting an effect of a stimulation of the renal nerve. 
     
     
         177 . The method of  claim 149 , wherein the target site comprises a carotid body or a carotid sinus, and the method further comprises detecting an effect of a stimulation of the one or more nerves. 
     
     
         178 . The method of  claim 149 , wherein the target site comprises a carotid body or a carotid sinus, and the method further comprises detecting a physiological activity resulted from a temporary inhibition of an activity of the one or more nerves. 
     
     
         179 . The method of  claim 178 , wherein the physiological activity comprises a skin reactivity, a blood pressure lability, a cardiac activity, a pulmonary activity, or a respiratory activity.