JPWO2020121053A5 - - Google Patents
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- JPWO2020121053A5 JPWO2020121053A5 JP2021533359A JP2021533359A JPWO2020121053A5 JP WO2020121053 A5 JPWO2020121053 A5 JP WO2020121053A5 JP 2021533359 A JP2021533359 A JP 2021533359A JP 2021533359 A JP2021533359 A JP 2021533359A JP WO2020121053 A5 JPWO2020121053 A5 JP WO2020121053A5
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- 206010039083 rhinitis Diseases 0.000 claims description 9
- 210000001519 tissue Anatomy 0.000 claims description 9
- 210000003928 nasal cavity Anatomy 0.000 claims description 8
- 239000012636 effector Substances 0.000 claims description 7
- 206010001076 Acute sinusitis Diseases 0.000 claims description 6
- 208000027157 chronic rhinosinusitis Diseases 0.000 claims description 6
- 239000002131 composite material Substances 0.000 claims description 6
- 206010009137 Chronic sinusitis Diseases 0.000 claims description 3
- 206010039085 Rhinitis allergic Diseases 0.000 claims description 3
- 201000010105 allergic rhinitis Diseases 0.000 claims description 3
- 201000009151 chronic rhinitis Diseases 0.000 claims description 3
- 239000003814 drug Substances 0.000 claims description 3
- 229940079593 drug Drugs 0.000 claims description 3
- 230000030214 innervation Effects 0.000 claims description 3
- 210000002850 nasal mucosa Anatomy 0.000 claims description 3
- 201000009240 nasopharyngitis Diseases 0.000 claims description 3
- 208000037916 non-allergic rhinitis Diseases 0.000 claims description 3
- 210000005037 parasympathetic nerve Anatomy 0.000 claims description 3
- 230000037361 pathway Effects 0.000 claims description 3
- 239000012781 shape memory material Substances 0.000 claims description 3
- 230000001734 parasympathetic effect Effects 0.000 claims description 2
- 230000007704 transition Effects 0.000 description 2
- 230000003213 activating effect Effects 0.000 description 1
Description
他の実施形態では、ユーザ動作型コントローラは、ラックアンドピニオンレールアセンブリと動作可能に関連付けられる、スクロールホイール機構を含み、第１の方向へのホイールの回転は、拡張構成への近位および遠位セグメントのうちの少なくとも１つの遷移をもたらし、第２の反対方向へのホイールの回転は、後退構成への近位および遠位セグメントのうちの少なくとも１つの遷移をもたらす。
本発明は、例えば、以下を提供する。
（項目１）
患者の鼻腔内の状態を治療するためのデバイスであって、前記デバイスは、
エネルギーを前記患者の鼻腔内の１つ以上の標的部位に送達するためのマルチセグメントエンドエフェクタ
を備え、
前記マルチセグメントエンドエフェクタは、遠位セグメントから離間される近位セグメントを備える、デバイス。
（項目２）
前記近位セグメントは、第１の構成に配列される可撓性支持要素の第１のセットと、前記支持要素の第１のセットによって提供され、エネルギーを第１の標的部位における組織に送達するように構成される電極の第１のセットとを備え、
前記遠位セグメントは、第２の構成に配列される可撓性支持要素の第２のセットと、前記支持要素の第２のセットによって提供され、エネルギーを第２の標的部位における組織に送達するように構成される電極の第２のセットとを備える、
項目１に記載のデバイス。
（項目３）
前記近位セグメントおよび遠位セグメントはそれぞれ、前記可撓性支持要素の第１および第２のセットが、展開構成であるときに、前記電極の個別の第１および第２のセットのうちの１つ以上のものを前記第１および第２の標的部位に位置付けるように構成されるように、後退構成と拡張された展開構成との間で変換可能である、項目２に記載のデバイス。
（項目４）
前記拡張された展開構成であるとき、前記支持要素の第１のセットは、
第１の対の支柱であって、それぞれが、ループ形状を備え、上向きに延在する、第１の対の支柱と、
第２の対の支柱であって、それぞれが、ループ形状を備え、下向きに延在する、第２の対の支柱と
を備える、項目３に記載のデバイス。
（項目５）
前記拡張された展開構成であるとき、前記支持要素の第２のセットは、支柱の第２のセットを備え、前記支柱の第２のセットは、それぞれが、外向きに延在し、開放端円周形状を形成する、ループ形状を備える、項目３に記載のデバイス。
（項目６）
前記支持要素の第１および第２のセットは、変形可能な複合ワイヤを備える、項目３に記載のデバイス。
（項目７）
前記複合ワイヤは、形状記憶材料を含む、項目６に記載のデバイス。
（項目８）
前記電極の第１および第２のセットは、無線周波数（ＲＦ）エネルギーを前記鼻腔内の個別の標的部位における組織に送達するように構成され、前記個別の標的部位は、副交感神経供給と関連付けられる、項目１に記載のデバイス。
（項目９）
前記電極の第１および第２のセットは、前記患者の鼻腔内の神経支配経路における鼻粘膜に神経を分布させる節後副交感神経を療法的に変調させるために十分なレベルにおいて、ＲＦエネルギーを送達するように構成される、項目８に記載のデバイス。
（項目１０）
前記状態は、アレルギー性鼻炎、非アレルギー性鼻炎、慢性鼻炎、急性鼻炎、慢性副鼻腔炎、急性副鼻腔炎、慢性鼻副鼻腔炎、急性鼻副鼻腔炎、および薬剤耐性鼻炎から成る群から選択される、項目９に記載のデバイス。
（項目１１）
患者の鼻腔内の状態を治療するための方法であって、前記方法は、
エネルギーを前記患者の鼻腔内の１つ以上の標的部位に送達するためのマルチセグメントエンドエフェクタを備えるデバイスを前進させることであって、前記マルチセグメントエンドエフェクタは、遠位セグメントから離間される近位セグメントを備える、ことと、
前記近位セグメントおよび遠位セグメントを介して、エネルギーを前記１つ以上の標的部位における組織に送達することと
を含む、方法。
（項目１２）
前記近位セグメントは、第１の構成に配列される可撓性支持要素の第１のセットと、前記支持要素の第１のセットによって提供され、エネルギーを第１の標的部位における組織に送達するように構成される電極の第１のセットとを備え、
前記遠位セグメントは、第２の構成に配列される可撓性支持要素の第２のセットと、前記支持要素の第２のセットによって提供され、エネルギーを第２の標的部位における組織に送達するように構成される電極の第２のセットとを備える、
項目１１に記載の方法。
（項目１３）
前記近位セグメントおよび遠位セグメントはそれぞれ、前記可撓性支持要素の第１および第２のセットが、展開構成であるときに、前記電極の個別の第１および第２のセットのうちの１つ以上のものを前記第１および第２の標的部位に位置付けるように構成されるように、後退構成と拡張された展開構成との間で変換可能である、項目１２に記載の方法。
（項目１４）
前記拡張された展開構成であるとき、前記支持要素の第１のセットは、
第１の対の支柱であって、それぞれが、ループ形状を備え、上向きに延在する、第１の対の支柱と、
第２の対の支柱であって、それぞれが、ループ形状を備え、下向きに延在する、第２の対の支柱と
を備える、項目１３に記載の方法。
（項目１５）
前記拡張された展開構成であるとき、前記支持要素の第２のセットは、支柱の第２のセットを備え、前記支柱の第２のセットは、それぞれが、外向きに延在し、開放端円周形状を形成する、ループ形状を備える、項目１３に記載の方法。
（項目１６）
前記支持要素の第１および第２のセットは、変形可能な複合ワイヤを備える、項目１３に記載の方法。
（項目１７）
前記複合ワイヤは、形状記憶材料を含む、項目１６に記載の方法。
（項目１８）
前記マルチセグメントエンドエフェクタの近位セグメントおよび遠位セグメントを個別の第１および第２の標的部位において展開し、それによって、前記電極の個別の第１および第２のセットのうちの１つ以上のものを前記第１および第２の標的部位に位置付けることをさらに含む、項目１３に記載の方法。
（項目１９）
前記近位セグメントおよび遠位セグメントを介してエネルギーを送達することは、前記患者の鼻腔内の神経支配経路における鼻粘膜に神経を分布させる節後副交感神経を療法的に変調させるために十分なレベルにおいて、前記電極の個別の第１および第２のセットのうちの１つ以上のものを介して、無線周波数（ＲＦ）エネルギーを送達することを含む、項目１８に記載の方法。
（項目２０）
前記状態は、アレルギー性鼻炎、非アレルギー性鼻炎、慢性鼻炎、急性鼻炎、慢性副鼻腔炎、急性副鼻腔炎、慢性鼻副鼻腔炎、急性鼻副鼻腔炎、および薬剤耐性鼻炎から成る群から選択される、項目１９に記載の方法。
In other embodiments, the user-operated controller includes a scroll wheel mechanism operably associated with the rack and pinion rail assembly, wherein rotation of the wheel in the first direction moves proximally and distally to the expanded configuration. effecting transition of at least one of the segments, and rotation of the wheel in a second opposite direction effecting transition of at least one of the proximal and distal segments to the retracted configuration.
The present invention provides, for example, the following.
(Item 1)
A device for treating an intranasal condition in a patient, said device comprising:
A multi-segment end effector for delivering energy to one or more target sites within the patient's nasal cavity.
with
The device, wherein the multi-segment end effector comprises a proximal segment spaced apart from a distal segment.
(Item 2)
The proximal segment is provided by a first set of flexible support elements arranged in a first configuration and the first set of support elements to deliver energy to tissue at a first target site. a first set of electrodes configured to:
The distal segment is provided by a second set of flexible support elements arranged in a second configuration and the second set of support elements to deliver energy to tissue at a second target site. a second set of electrodes configured to
The device of item 1.
(Item 3)
The proximal segment and the distal segment are respectively one of the respective first and second sets of electrodes when the first and second sets of flexible support elements are in the deployed configuration. 3. The device of item 2, wherein the device is convertible between a retracted configuration and an extended deployed configuration and configured to position more than one at said first and second target sites.
(Item 4)
When in the expanded deployed configuration, the first set of support elements comprises:
a first pair of struts each having a loop shape and extending upward;
a second pair of struts each having a loop shape and extending downward; and
4. The device of item 3, comprising:
(Item 5)
When in the expanded, deployed configuration, the second set of support elements comprises a second set of struts, each of the second set of struts extending outwardly and having an open end. 4. The device of item 3, comprising a loop shape forming a circular shape.
(Item 6)
4. The device of item 3, wherein the first and second sets of support elements comprise deformable composite wires.
(Item 7)
7. The device of item 6, wherein the composite wire comprises a shape memory material.
(Item 8)
The first and second sets of electrodes are configured to deliver radio frequency (RF) energy to tissue at discrete target sites within the nasal cavity, the discrete target sites associated with a parasympathetic supply. , item 1.
(Item 9)
The first and second sets of electrodes deliver RF energy at a level sufficient to therapeutically modulate postganglionic parasympathetic nerves innervating the nasal mucosa in innervation pathways within the patient's nasal cavity. 9. The device of item 8, configured to.
(Item 10)
The condition is selected from the group consisting of allergic rhinitis, non-allergic rhinitis, chronic rhinitis, acute rhinitis, chronic sinusitis, acute sinusitis, chronic rhinosinusitis, acute rhinosinusitis, and drug-resistant rhinitis. 10. The device of item 9, wherein
(Item 11)
A method for treating an intranasal condition in a patient, said method comprising:
advancing a device comprising a multi-segment end effector for delivering energy to one or more target sites within the patient's nasal cavity, the multi-segment end effector being proximally spaced apart from a distal segment; comprising a segment;
delivering energy to tissue at the one or more target sites via the proximal and distal segments;
A method, including
(Item 12)
The proximal segment is provided by a first set of flexible support elements arranged in a first configuration and the first set of support elements to deliver energy to tissue at a first target site. a first set of electrodes configured to:
The distal segment is provided by a second set of flexible support elements arranged in a second configuration and the second set of support elements to deliver energy to tissue at a second target site. a second set of electrodes configured to
12. The method of item 11.
(Item 13)
The proximal segment and the distal segment are respectively one of the respective first and second sets of electrodes when the first and second sets of flexible support elements are in the deployed configuration. 13. The method of item 12, wherein the method is convertible between a retracted configuration and an extended deployed configuration and configured to position more than one at the first and second target sites.
(Item 14)
When in the expanded deployed configuration, the first set of support elements comprises:
a first pair of struts each having a loop shape and extending upward;
a second pair of struts each having a loop shape and extending downward; and
14. The method of item 13, comprising:
(Item 15)
When in the expanded, deployed configuration, the second set of support elements comprises a second set of struts, each of the second set of struts extending outwardly and having an open end. 14. Method according to item 13, comprising a loop shape forming a circumferential shape.
(Item 16)
14. The method of item 13, wherein the first and second sets of support elements comprise deformable composite wires.
(Item 17)
17. The method of item 16, wherein the composite wire comprises a shape memory material.
(Item 18)
Proximal and distal segments of the multi-segment end effector are deployed at respective first and second target sites, thereby activating one or more of the respective first and second sets of electrodes. 14. The method of item 13, further comprising positioning an object at said first and second target sites.
(Item 19)
delivering energy through said proximal and distal segments at a level sufficient to therapeutically modulate postganglionic parasympathetic nerves innervating the nasal mucosa in innervation pathways within said patient's nasal cavity; 19. The method of item 18, comprising delivering radio frequency (RF) energy via one or more of the respective first and second sets of electrodes.
(Item 20)
The condition is selected from the group consisting of allergic rhinitis, non-allergic rhinitis, chronic rhinitis, acute rhinitis, chronic sinusitis, acute sinusitis, chronic rhinosinusitis, acute rhinosinusitis, and drug-resistant rhinitis. 20. The method of item 19, wherein
Claims (10)
エネルギーを前記患者の鼻腔内の１つ以上の標的部位に送達するためのマルチセグメントエンドエフェクタ
を備え、
前記マルチセグメントエンドエフェクタは、遠位セグメントから離間される近位セグメントを備える、デバイス。 A device for treating an intranasal condition in a patient, said device comprising:
a multi-segment end effector for delivering energy to one or more target sites within the patient's nasal cavity;
The device, wherein the multi-segment end effector comprises a proximal segment spaced apart from a distal segment.
前記遠位セグメントは、第２の構成に配列される可撓性支持要素の第２のセットと、前記支持要素の第２のセットによって提供され、エネルギーを第２の標的部位における組織に送達するように構成される電極の第２のセットとを備える、請求項１に記載のデバイス。 The proximal segment is provided by a first set of flexible support elements arranged in a first configuration and the first set of support elements to deliver energy to tissue at a first target site. a first set of electrodes configured to:
The distal segment is provided by a second set of flexible support elements arranged in a second configuration and the second set of support elements to deliver energy to tissue at a second target site. 2. The device of claim 1, comprising a second set of electrodes configured to:
第１の対の支柱であって、それぞれが、ループ形状を備え、上向きに延在する、第１の対の支柱と、
第２の対の支柱であって、それぞれが、ループ形状を備え、下向きに延在する、第２の対の支柱と
を備える、請求項３に記載のデバイス。 When in the expanded deployed configuration, the first set of support elements comprises:
a first pair of struts each having a loop shape and extending upward;
4. The device of claim 3, comprising: a second pair of struts, each comprising a loop shape and extending downwardly.
The condition is selected from the group consisting of allergic rhinitis, non-allergic rhinitis, chronic rhinitis, acute rhinitis, chronic sinusitis, acute sinusitis, chronic rhinosinusitis, acute rhinosinusitis, and drug-resistant rhinitis. 10. The device of claim 9, wherein:
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| JP2024015569A JP2024038520A (en) | 2018-12-11 | 2024-02-05 | Systems and methods for therapeutic nasal nerve modulation |
Applications Claiming Priority (21)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201862778233P | 2018-12-11 | 2018-12-11 | |
| US62/778,233 | 2018-12-11 | ||
| US201962832914P | 2019-04-12 | 2019-04-12 | |
| US201962832925P | 2019-04-12 | 2019-04-12 | |
| US201962832927P | 2019-04-12 | 2019-04-12 | |
| US201962832923P | 2019-04-12 | 2019-04-12 | |
| US201962832928P | 2019-04-12 | 2019-04-12 | |
| US201962832918P | 2019-04-12 | 2019-04-12 | |
| US201962832917P | 2019-04-12 | 2019-04-12 | |
| US201962832920P | 2019-04-12 | 2019-04-12 | |
| US62/832,927 | 2019-04-12 | ||
| US62/832,928 | 2019-04-12 | ||
| US62/832,920 | 2019-04-12 | ||
| US62/832,917 | 2019-04-12 | ||
| US62/832,914 | 2019-04-12 | ||
| US62/832,923 | 2019-04-12 | ||
| US62/832,918 | 2019-04-12 | ||
| US62/832,925 | 2019-04-12 | ||
| US201962896845P | 2019-09-06 | 2019-09-06 | |
| US62/896,845 | 2019-09-06 | ||
| PCT/IB2019/001298 WO2020121053A1 (en) | 2018-12-11 | 2019-12-06 | Systems and methods for therapeutic nasal neuromodulation |
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| JP2024015569A Division JP2024038520A (en) | 2018-12-11 | 2024-02-05 | Systems and methods for therapeutic nasal nerve modulation |
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| JP2022512378A JP2022512378A (en) | 2022-02-03 |
| JPWO2020121053A5 true JPWO2020121053A5 (en) | 2022-12-13 |
| JP7432604B2 JP7432604B2 (en) | 2024-02-16 |
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| JP2024015569A Pending JP2024038520A (en) | 2018-12-11 | 2024-02-05 | Systems and methods for therapeutic nasal nerve modulation |
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| EP (1) | EP4017390A1 (en) |
| JP (2) | JP7432604B2 (en) |
| CN (1) | CN113710181A (en) |
| AU (1) | AU2019398735A1 (en) |
| CA (1) | CA3123178A1 (en) |
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| AU2016262085B2 (en) | 2015-05-12 | 2020-10-22 | National University Of Ireland Galway | Devices for therapeutic nasal neuromodulation and associated methods and systems |
| JP2020089723A (en) * | 2018-12-07 | 2020-06-11 | アヴェント インコーポレイテッド | Device and method for selectively and reversibly modulating nervous system structure to inhibit perception of pain |
| US11419671B2 (en) * | 2018-12-11 | 2022-08-23 | Neurent Medical Limited | Systems and methods for therapeutic nasal neuromodulation |
| WO2021146729A1 (en) * | 2020-01-17 | 2021-07-22 | Prolung, Inc. dba IONIQ Sciences | Noninvasive medical diagnostics using electrical impedance metrics and clinical predictors |
| WO2021205229A1 (en) * | 2020-04-09 | 2021-10-14 | Neurent Medical Limited | Systems and methods for improving sleep with therapeutic nasal treatment |
| WO2021205230A1 (en) | 2020-04-09 | 2021-10-14 | Neurent Medical Limited | Systems and methods for therapeutic nasal treatment |
| US20220061922A1 (en) * | 2020-08-25 | 2022-03-03 | Acclarent, Inc. | Apparatus and method for posterior nasal nerve ablation |
| US20230133359A1 (en) | 2021-11-04 | 2023-05-04 | Neurent Medical Limited | Systems and methods for treating chronic sinusitis |
| CN116269737A (en) * | 2023-05-10 | 2023-06-23 | 杭州祺晟医疗器械有限公司 | Rhinitis treatment electrode assembly and rhinitis treatment device based on temperature control radio frequency ablation |
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