Methods and devices for endovascular ablation of a splanchnic nerve

Abstract

Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

1 - 10 . (canceled) 
     
     
         11 . A method for treating a patient diagnosed with heart failure, comprising:
 advancing a distal section of an elongate shaft of an ablation catheter over a guidewire and into a T9, T10, or T11 intercostal vein, the distal section having a linear configuration when radially unconstrained,
 the ablation catheter further comprising a coiled ablation electrode having an axial length from 5 mm-30 mm, a plurality of irrigation ports between windings of the coiled ablation electrode, wherein the windings are axially spaced apart such that the plurality of irrigation ports are not radially underneath the windings and are visible in a side view of the elongate shaft; 
   activating an energy source disposed external to the patient and in operable communication with the coiled ablation electrode;   delivering ablation energy with the coiled ablation electrode to ablate a greater splanchnic nerve; and   removing the ablation catheter from the patient.   
     
     
         12 . The method of  claim 11 , further comprising delivering a fluid through the ablation catheter and out of the plurality of irrigation ports. 
     
     
         13 . The method of  claim 11 , wherein delivering the ablation energy comprises delivering the ablation energy from the coiled ablation electrode in monopolar mode. 
     
     
         14 . The method of  claim 11 , wherein the coiled ablation electrode is a first coiled ablation electrode, the ablation catheter further comprising a second coiled ablation electrode axially spaced from the first coiled ablation electrode, wherein delivering energy comprises delivering energy in bipolar mode. 
     
     
         15 . The method of  claim 11 , wherein the ablation catheter includes an ultrasound imaging transducer, the method further comprising imaging tissue proximate the T9, T10, or T11 intercostal vein with the ultrasound imaging transducer. 
     
     
         16 . A method for treating a patient diagnosed with heart failure, comprising:
 advancing a guidewire into a T9, T10, or T11 intercostal vein;   advancing a distal section of an elongate shaft of an ablation catheter over the guidewire, the distal section having a linear configuration when radially unconstrained,
 the ablation catheter further comprising a coiled ablation electrode having an axial length from 5 mm-30 mm, a plurality of irrigation ports between windings of the coiled ablation electrode, wherein the windings are axially spaced apart such that the plurality of irrigation ports are not radially underneath the windings and are visible in a side view of the elongate shaft; 
   activating an energy source disposed external to the patient and in operable communication with the coiled ablation electrode;   delivering ablation energy with the coiled ablation electrode to ablate a greater splanchnic nerve; and   removing the ablation catheter from the patient.   
     
     
         17 . The method of  claim 16 , further comprising positioning the coiled ablation element in an azygos vein, and delivering the ablation energy with the coiled ablation electrode while the coiled ablation electrode is in the azygos vein. 
     
     
         18 . The method of  claim 16 , further comprising positioning the coiled ablation element in the intercostal vein, and delivering the ablation energy with the coiled ablation electrode while the coiled ablation electrode is in the intercostal vein. 
     
     
         19 . The method of  claim 16 , further comprising delivering a fluid through the ablation catheter and out of the plurality of irrigation ports. 
     
     
         20 . The method of  claim 16 , wherein delivering the ablation energy comprises delivering the ablation energy from the coiled ablation electrode in monopolar mode. 
     
     
         21 . The method of  claim 16 , wherein the coiled ablation electrode is a first coiled ablation electrode, the ablation catheter further comprising a second coiled ablation electrode axially spaced from the first coiled ablation electrode, wherein delivering energy comprises delivering energy in bipolar mode.