Methods and devices to modulate the autonomic nervous system via the carotid body or carotid sinus

Abstract

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

1 . A method of inhibiting the function of a nerve traveling with an artery comprising:
 providing an external imaging modality to determine the location of the artery of a patient;   placing the artery in a first three dimensional coordinate reference based on the imaging;   placing or associating a therapeutic energy generation source in the first three dimensional coordinate reference frame;   modeling the delivery of energy to the adventitial region of the artery or a region adjacent to the artery where a nerve travels;   delivering therapeutic energy from the therapeutic energy source, from at least two different angles, through the skin of a patient, to intersect at the artery or the region adjacent to the artery;   and, at least partially inhibiting the function of the nerve traveling with the artery.   
     
     
         2 . The method of  claim 1  wherein the imaging modality is one of: ultrasound, MRI, and CT. 
     
     
         3 . The method of  claim 1  wherein the therapeutic energy is ultrasound. 
     
     
         4 . The method of  claim 1  wherein the artery is a renal artery. 
     
     
         5 . The method of  claim 1  wherein placing the artery in a three dimensional reference frame comprises locating the artery using a doppler ultrasound signal. 
     
     
         6 . The method of  claim 1  further comprising: utilizing a fiducial wherein the fiducial is placed internal to the patient. 
     
     
         7 . The method of  claim 6  wherein said fiducial is temporarily placed in a position internal to the patient. 
     
     
         8 . The method of  claim 6  wherein said fiducial is a catheter placed in the artery of the patient. 
     
     
         9 . The method of  claim 8  wherein said catheter is detectable using a radiofrequency signal and said imaging modality is ultrasound. 
     
     
         10 . The method of  claim 1  wherein the therapeutic energy from the energy source is delivered in a distribution along the length of the artery. 
     
     
         11 . The method of  claim 1  wherein the therapeutic energy is ionizing radiation. 
     
     
         12 . A system to inhibit the function of a nerve traveling with a renal artery comprising:
 a detector to determine the location of the renal artery and renal nerve from a position external to a patient;   an ultrasound component to deliver therapeutic energy through the skin from at least two directions to the nerve surrounding the renal artery;   a modeling algorithm comprising an input and an output, said input to the modeling algorithm comprising a three dimensional coordinate space containing a therapeutic energy source and the position of the renal artery in the three dimensional coordinate space; and,   said output from the modeling algorithm comprising: the direction and energy level of the ultrasound component;   a fiducial, locatable from a position outside a patient, adapted to be temporarily placed in the artery of the patient and communicate with the detector to determine the location of the renal artery in a three dimensional reference frame, the information regarding the location transmittable as the input to the model.   
     
     
         13 . The system of  claim 12  wherein the fiducial is a passive reflector of ultrasound. 
     
     
         14 . The system of  claim 12  wherein the fiducial generates radiofrequency energy. 
     
     
         15 . The system of  claim 12  wherein the fiducial is activated to transmit energy based on a signal from an ultrasound or magnetic field generator. 
     
     
         16 . The system of  claim 12  wherein the output from the model instructs the ultrasound component to deliver a lesion on the artery in which the major axis of the lesion is longitudinal along the length of the artery. 
     
     
         17 . The system of  claim 16  wherein the output from the model instructs the ultrasound component to deliver multiple lesions around an artery simultaneously. 
     
     
         18 . The system of  claim 12  wherein the output from the model instructs the ultrasound component to deliver a circumferential lesion around the artery. 
     
     
         19 . The system of  claim 16  wherein the lesion is placed around the renal artery just proximal to the bifurcation of the artery in the hilum of the kidney.