Methods and devices for endovascular ablation of a splanchnic nerve

Abstract

Systems, devices, and methods for transvascular ablation of target tissue are disclosed herein. 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 method of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

What is claimed is: 
     
         1 . A vascular catheter, comprising:
 a catheter shaft comprising an exit port and a needle assembly lumen;   a telescopic needle assembly, the telescopic needle assembly configurable from a first position to a second position, wherein the telescopic needle assembly is within the catheter in the first position and in the second position extends from the exit port, the needle assembly configured to puncture vascular tissue when transitioned to the second position, the needle assembly comprising:
 a first section and a second section, the first section surrounding the second section, and wherein the second section comprises an outer surface with one or more electrodes thereon, 
 wherein in the second position, the first section extends outward from the needle assembly lumen and the second section extends outwards from the first section, and
 wherein the first and second sections exit the exit port in a straight direction when transitioning to the second position; and 
 
   
       a guidewire lumen. 
     
     
         2 . The vascular catheter of  claim 1 , wherein the needle assembly comprises a third section that is a telescoping relationship with the first and second sections. 
     
     
         3 . The vascular catheter of  claim 1 , wherein the needle assembly comprises a third section that is co-axial with the first and second sections. 
     
     
         4 . The vascular catheter of  claim 1 , wherein the one or more electrodes comprise first and second electrodes positioned and adapted to be operated in bipolar mode. 
     
     
         5 . The vascular catheter of  claim 1 , further comprising a marker configured to indicate radial orientation. 
     
     
         6 . The vascular catheter of  claim 1 , further comprising a stimulation electrode for delivering a nerve stimulation signal. 
     
     
         7 . The vascular catheter of  claim 1 , wherein first section has a sharped distal end. 
     
     
         8 . The vascular catheter of  claim 1 , further comprising a base electrode on an outer surface of the catheter. 
     
     
         9 . The vascular catheter of  claim 1 , wherein the one or more electrodes comprises a first and a second electrode, and wherein the vascular catheter is configured to provide a first ablation energy to the first electrode and a second ablation energy to the second electrode, wherein the first ablation energy and the second ablation energy are independent of one another. 
     
     
         10 . The vascular catheter of  claim 1 , further comprising an electrode advancer configured to extend the needle assembly and one or more electrodes through the exit port. 
     
     
         11 . A vascular catheter, comprising:
 a catheter shaft comprising an exit port and a needle assembly lumen;   a telescopic needle assembly configurable from a first position to a second position, wherein the telescopic needle assembly is within the catheter in the first position and in the second portion extends from the exit port, the needle assembly comprising:
 a first section and a second section, the first section surrounding the second section, the second section having a distal end configured to puncture vascular tissue, and one or more electrodes, 
 wherein in the second position,
 the first section extends outwards from the needle assembly lumen, 
 the second section extends outwards from the first section, and 
 the first and second sections have straight configurations; and 
 
   a guidewire lumen.   
     
     
         12 . The vascular catheter of  claim 11 , wherein the needle assembly comprises a third section that is a telescoping relationship with the first and second sections, wherein the second section surrounds the third section and the third section extends outward from the second section. 
     
     
         13 . The vascular catheter of  claim 11 , wherein the needle assembly comprises a third section within the second section that is co-axial with the first and second sections. 
     
     
         14 . The vascular catheter of  claim 11 , wherein the one or more electrodes comprises first and second electrodes positioned and adapted to be operated in bipolar mode. 
     
     
         15 . The vascular catheter of  claim 11 , further comprising a marker configured to indicate radial orientation. 
     
     
         16 . The vascular catheter of  claim 11 , further comprising a stimulation electrode for delivering a nerve stimulation signal. 
     
     
         17 . The vascular catheter of  claim 11 , further comprising a base electrode on an outer surface of the catheter. 
     
     
         18 . The vascular catheter of  claim 11 , wherein the one or more electrodes comprises a first and a second electrode, and wherein the vascular catheter is configured to provide a first ablation energy to the first electrode and a second ablation energy to the second electrode, wherein the first ablation energy and the second ablation energy are independent of one another. 
     
     
         19 . The vascular catheter of  claim 11 , further comprising an electrode advancer configured to extend the needle assembly and the one or more electrodes through the exit port.