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Methods of Placement of Neurostimulation Lead, Infusion Catheter, and/or Sensor via the Vasculature to the Brain

IP.com Disclosure Number: IPCOM000012135D
Publication Date: 2003-Apr-10

Publishing Venue

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Abstract

The present invention provides a method for delivery of medical devices such as leads, catheters, and/or sensors via the vasculature to the brain. The methods of the present invention provide less invasive and less cumbersome procedures for patients and physicians than traditional stereotactic procedures. More specifically, the present invention provides methods for placing a lead(s) for neurostimulation, specifically deep brain stimulation, via the vasculature. The present invention also provides methods for placing an infusion catheter(s) via the vasculature to facilitate targeted application of drugs to neural tissue. The present invention also provides methods for placing a sensor(s) via the vasculature near neural tissue for detection of electrical, chemical, or other activity.

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Methods of Placement of Neurostimulation Lead, Infusion Catheter, and/or Sensor via the Vasculature to the Brain

Background and Summary

        � � � � � � � � � � � Millions of individuals suffer from the painful physical and emotional effects of epilepsy, chronic pain syndromes, spasticity, mood disorders, anxiety disorders, and certain types of dementia.� Medical practitioners can effectively treat these maladies and lessen their harmful effects through various procedures.� Deep brain stimulation and drug delivery to areas within the brain using neurostimulation leads and catheters are two treatments that may help patients with these maladies.� Unfortunately, implementation of these treatments requires invasive stereotactic procedures that are often cumbersome, painful, and detrimental to patients.

        � � � � � � � � � � � Current implantable neurostimulation devices (e.g., spinal cord stimulators, deep brain stimulators) typically use leads to deliver an electrical stimulus from an implantable pulse generator (IPG) at the proximal end of a lead to an electrode(s) at the distal end of the lead.� In spinal cord stimulation (SCS), the lead typically contains an electrode array.

        � � � � � � � � � � � SCS electrode arrays are typically positioned by insertion of the lead between vertebral bodies into the spinal column.� SCS electrode arrays are usually positioned in an extradural location, although in the past, some researchers have placed them inside the dura through a small incision.� Similarly, in motor cortex and cerebellar stimulation, the lead is placed through a small opening in the skull, and the electrode or electrode array may rest in an extradural location or may be positioned beneath the dura via a small incision.

        � � � � � � � � � � � Deep brain stimulation electrodes are conventionally placed inside the skull with the aid of a stereotactic frame.� A stereotactic placement procedure requires that the physician cut through the skin, skull, dura mater, and brain parenchyma to ultimately reach a desired target.� The target site is located through reference to pre-surgical diagnostic images and via intraoperative microelectrode electrical stimulation and recording.� Conventional stereotactic frames are large, external metal frames that mount directly on a patient’s skull with sharp, pointed metal contacts that penetrate the skin.� Stereotactic frames are used, among other purposes, to guide and steady instruments during a procedure.� Unfortunately, stereotactic procedures may require several hours, can cause permanent damage, and are typically very uncomfortable for the patient.

        � � � � � � � � � � � Pacemaker and implantable cardiac defibrillator leads are usually placed through a vascular approach to the cardiac tissue, rather than a direct approach that penetrates through the bone and tissue of the thoracic cavity.� This vascular approach, in contrast to the stereotactic procedure, requires significantly less time and is typically more comf...