Energy delivery to intraparenchymal regions of the kidney to treat hypertension

Abstract

A method to apply a nerve inhibiting cloud surrounding a blood vessel includes creating a treatment plan, wherein the treatment plan prescribes application of the nerve inhibiting cloud towards at least a majority portion of a circumference of a blood vessel wall, and applying the nerve inhibiting cloud towards the majority portion of the circumference of the blood vessel wall for a time sufficient to inhibit a function of a nerve that surrounds the blood vessel wall.

1 - 19 . (canceled) 
     
     
         20 . A method to apply energy to an intraparenchymal region of a kidney in a patient to ablate nerves inside the kidney, the method comprising:
 obtaining an image using an imager, the image having an image of a blood vessel;   verifying that the blood vessel travels to a kidney by identifying the kidney in the image that has the image of the blood vessel;   determining a target region which includes nerves around the blood vessel; and   applying pulses of energy to the target region;   wherein a feature in the image is used as a fiducial during the application of the pulses of the energy to ensure that the pulses of energy are applied to the target region.   
     
     
         21 . The method of  claim 20 , wherein the pulses of energy are delivered using a micro catheter placed inside an artery inside the kidney. 
     
     
         22 . The method of  claim 21 , wherein the micro catheter is configured to apply radio frequency energy to the intraparenchymal region of the kidney. 
     
     
         23 . The method of  claim 20 , wherein the pulses of energy are delivered from outside the patient using an ultrasound transducer. 
     
     
         24 . The method of  claim 20 , wherein the pulses of energy are delivered using an intravascular catheter, which is configured to apply ultrasound to the intraparenchymal region inside the kidney. 
     
     
         25 . The method of  claim 20 , wherein the target region comprises a plurality of sub-target regions. 
     
     
         26 . The method of  claim 20 , wherein the target region is at the cortex of the kidney 
     
     
         27 . The method of  claim 20 , wherein the target region is at the medulla of the kidney. 
     
     
         28 . The method of  claim 20 , wherein the target region comprises calyces of the kidney. 
     
     
         29 . The method of  claim 20 , wherein the imager comprises a fluoroscopic imager. 
     
     
         30 . A method to apply energy to an intraparenchymal region of a kidney to treat hypertension comprising:
 obtaining an image using an imager, the image having an image of a blood vessel;   verifying that the blood vessel travels to a kidney by identifying a kidney in the image that has the image of the blood vessel;   placing a part of the micro catheter into an intraparenchymal region of the kidney via the blood vessel;   determining a target region which includes kidney parenchyma;   applying energy to the target region to ablate the kidney parenchyma to treat hypertension in a patient.   
     
     
         31 . The method of  claim 30 , wherein the intraparenchymal region secretes hormones. 
     
     
         32 . The method of  claim 30 , wherein the intraparenchymal region comprises nerves. 
     
     
         33 . The method of  claim 30 , wherein the energy is radio frequency energy. 
     
     
         34 . The method of  claim 30 , the energy is microwave energy. 
     
     
         35 . The method of  claim 30 , wherein the energy is in a form of heated water vapor. 
     
     
         36 . The method of  claim 30 , wherein the energy is ultrasound energy. 
     
     
         37 . The method of  claim 30 , wherein the intraparenchymal region surrounds a calyx in the kidney. 
     
     
         38 . The method of  claim 30 , wherein the intraparenchymal region comprises mechanoreceptors or chemoreceptors.