Systems, devices, and methods for modulating renal nerve tissue

Abstract

Methods for treating a patient using therapeutic renal neuromodulation and associated devices, system, and methods are disclosed herein. One aspect of the present technology is directed to neuromodulating nerve tissue in selected anatomical regions. In one embodiment, the method can include intravascularly advancing an elongate shaft of a catheter to renal vasculature of a human patient and locating a first neuromodulation element of the catheter within a distalmost portion of a main renal artery. The method includes locating a second neuromodulation element of the catheter within a branch vessel of the renal artery distal to a bifurcation at a distal end of the main renal artery. Neuromodulation of the nerve tissue surrounding the selected anatomical treatment locations can inhibit sympathetic neural activity in nerves proximate a portion of a renal artery and/or a renal branch artery proximate a renal parenchyma.

1 - 26 . (canceled) 
     
     
         27 . A method, comprising:
 intravascularly advancing an elongate shaft of a catheter to renal blood vessel of a human patient;   locating a first neuromodulation element of the catheter within a distalmost portion of a main renal artery directly connected to an aorta of the patient and extending distally toward a kidney of the patient;   locating a second neuromodulation element of the catheter within a branch vessel of the renal artery distal to a bifurcation at a distal end of the main renal artery;   modulating nerve tissue within an anatomical region extending about the distalmost portion of the main renal artery via the first neuromodulation element, wherein modulating nerve tissue via the first neuromodulation element comprises forming a plurality of lesions within the anatomical region extending around the main renal artery, and wherein the distalmost lesion is approximately 1-6 mm proximal of the bifurcation of the main renal artery; and   modulating nerve tissue within an anatomical region extending about the branch vessel via the second neuromodulation element.   
     
     
         28 . The method of  claim 27  wherein intravascularly advancing an elongate shaft of a catheter to renal vasculature comprises delivering the catheter over a guidewire, and wherein the first neuromodulation element assumes a preformed spiral/helical configuration within the distalmost portion of the main renal artery when the guidewire is retracted. 
     
     
         29 . The method of  claim 27  wherein intravascularly advancing an elongate shaft of a catheter to renal vasculature comprises delivering the catheter within a sheath, and wherein the first neuromodulation element assumes a preformed spiral/helical configuration within the distalmost portion of the main renal artery when removed from the sheath. 
     
     
         30 . The method of  claim 27  wherein the second neuromodulation element is operably connected to the shaft. 
     
     
         31 . The method of  claim 27  wherein the second neuromodulation element is operably connected to the first neuromodulation element. 
     
     
         32 . The method of  claim 27  wherein the second neuromodulation element comprises at least one wire electrode, and wherein locating the second neuromodulation element of the catheter within the branch vessel comprises delivering the second neuromodulation element to the branch vessel in a low-profile state and transforming the second neuromodulation element to an unconstrained spiral/helical state within the branch vessel. 
     
     
         33 . The method of  claim 27  wherein the second neuromodulation element comprises multiple wire electrodes, and wherein locating the second neuromodulation element of the catheter within the branch vessel comprises locating a first wire electrode within a first branch vessel and a second wire electrode within a second, different branch vessel. 
     
     
         34 . The method of  claim 27  wherein the first and second neuromodulation elements are a single continuous elongate element, and wherein:
 locating a first neuromodulation element of the catheter within a distalmost portion of a main renal artery comprises locating a proximal portion of the single elongate element within the distalmost portion of the main renal artery; and 
 locating a second neuromodulation element of the catheter within a branch vessel comprises locating a distal portion of the single elongate element within the branch vessel. 
 
     
     
         35 . The method of  claim 27  wherein the first neuromodulation element further comprises a balloon, and wherein locating the first neuromodulation element of the catheter within the distalmost portion of the main renal artery comprises inflating the balloon before modulating nerve tissue via the first neuromodulation element. 
     
     
         36 . The method of  claim 27  wherein the second neuromodulation element further comprises a balloon, and wherein locating the second neuromodulation element of the catheter within the branch vessel comprises inflating the balloon before modulating nerve tissue via the second neuromodulation element. 
     
     
         37 . The method of  claim 27  wherein modulating nerve tissue via the second neuromodulation element comprises forming a plurality of lesions, and wherein the proximalmost lesion is at least about 5 mm distal to the bifurcation of the main renal artery. 
     
     
         38 . The method of  claim 27  wherein modulating nerve tissue via the first neuromodulation element comprises forming a plurality of lesions, and wherein the proximalmost lesion is at least about 2 mm to 6 mm distal to the bifurcation of the main renal artery. 
     
     
         39 . The method of  claim 27  wherein the branch vessel is modulated before the main renal artery is modulated. 
     
     
         40 . The method of  claim 27  wherein the main renal artery is modulated before the branch vessel is modulated. 
     
     
         41 . The method of  claim 27  wherein the main renal artery and the branch vessel are modulated simultaneously. 
     
     
         42 . The method of  claim 27  wherein locating the second neuromodulation element within the branch vessel comprises locating at least one electrode in each branch of the main renal artery, and wherein modulating nerve tissue within an anatomical region extending about the branch vessel comprises modulating each branch of the main renal artery. 
     
     
         43 . The method of  claim 42  wherein each branch of the main renal artery is modulated simultaneously. 
     
     
         44 . The method of  claim 42  wherein each branch of the main renal artery is modulated sequentially. 
     
     
         45 . The method of  claim 27  wherein the branch vessel is a first branch vessel, and wherein the method further comprises:
 retracting the second neuromodulation element from the first branch vessel; 
 locating the second neuromodulation element of the catheter within a second branch vessel of the renal artery distal to the bifurcation at the distal end of the main renal artery; and 
 modulating nerve tissue within an anatomical region extending about the second branch vessel via the second neuromodulation element.