In some embodiments, disclosed herein are systems and methods of treating a patient that can include the steps of accessing the sphenopalatine fossa, and cannulating the inferior orbital fissure from the sphenopalatine fossa to access the retro-orbital space. The sphenopalatine fossa can be accessed via various routes, including percutaneously. Accessing the sphenopalatine fossa can include the step of inserting a needle-catheter system into the sphenopalatine fossa. Integrated needle-catheter systems as described herein can also be configured to access the trigeminal ganglion, epidural space, intrathecal space, and other desired anatomical locations.

An apparatus includes a flexible electrically-insulating substrate including an inner surface and an outer surface. The substrate is shaped to define multiple channels passing between the inner surface and the outer surface, at least some of the channels being concave channels. The apparatus further includes an outer layer of an electrically-conducting metal covering at least part of the outer surface, an inner layer of the electrically-conducting metal covering at least part of the inner surface, and respective columns of the electrically-conducting metal that fill the channels such as to connect the outer layer to the inner layer.

Disclosed herein are systems and methods for locating and identifying nerves innervating the wall of arteries such as the renal artery. The present invention identifies areas on vessel walls that are innervated with nerves; provides indication on whether energy is delivered accurately to a targeted nerve; and provides immediate post-procedural assessment of the effect of energy delivered to the nerve. The methods includes evaluating a change in physiological parameters after energy is delivered to an arterial wall; and determining the type of nerve that the energy was directed to (sympathetic or parasympathetic or none) based on the evaluated results. The system includes at least a device for delivering energy to the wall of blood vessel; sensors for detecting physiological signals from a subject; and indicators to display results obtained using said method. Also provided are catheters for performing the mapping and ablating functions.

A device for therapeutic neuromodulation in a nasal region can include, for example, a shaft and a therapeutic element at a distal portion of the shaft. The shaft can locate the distal portion intraluminally at a target site inferior to a patient's sphenopalatine foramen. The therapeutic element can include an energy delivery element configured to therapeutically modulate postganglionic parasympathetic nerves at microforamina of a palatine bone of the human patient for the treatment of rhinitis or other indications. In other embodiments, the therapeutic element can be configured to therapeutically modulate nerves that innervate the frontal, ethmoidal, sphenoidal, and maxillary sinuses for the treatment of chronic sinusitis.

Methods and systems for modulating intraosseous nerves (e.g., nerves within bone) are provided. For example, the methods and systems described herein may be used to modulate (e.g., denervate, ablate) basivertebral nerves within vertebrae. The modulation of the basivertebral nerves may facilitate treatment of chronic back pain. The modulation may be performed by a neuromodulation device (e.g., an energy delivery device).

The present disclosure relates to methods, devices, kits and systems for enhancing the efficacy and longevity of denervation procedures.

An apparatus includes a shaft assembly, first and second electrode assemblies, and a controller. The shaft assembly is configured to fit in a nasal cavity of a patient. The first and second electrode assemblies are at the distal end of the shaft assembly. The second electrode assembly includes a stimulus electrode and a sensing electrode. The stimulus and sensing electrodes are positioned on opposing lateral sides in relation to the longitudinal axis of the shaft assembly. The controller is operable to generate an electrical signal to perform one or both of tissue ablation or denervation of a targeted nerve via the first electrode assembly, generate an electrical stimulus signal to stimulate the targeted nerve via the stimulus electrode of the second electrode assembly, and process a response signal received from the targeted nerve via the sensing electrode of the second electrode assembly.

A method may include positioning a distal portion of a neuromodulation catheter in a first renal vessel of a patient. The distal portion may include a plurality of therapeutic elements arranged around a perimeter of the distal portion. The method also may include imaging the distal portion to visualize positions of the plurality of therapeutic elements; manipulating the distal portion so that at least one therapeutic element is oriented toward a second renal vessel adjacent the first renal vessel; deploying the at least one therapeutic element to extend at least partially through the wall of the first renal vessel such that the at least therapeutic element extends toward the second renal vessel; and delivering a chemical agent through the plurality of therapeutic elements to modulate activity of at least one renal nerve adjacent to the first renal vessel and at least one renal nerve adjacent to the second renal vessel.

Provided are devices and methods for anesthetizing a patient undergoing surgery, and/or pain block procedures. In certain embodiments the disclosure provides a curved cryoneurolysis needle. In some forms, the methods include inserting at least one cryoneurolysis needle into a target region of the patient, and cooling the cryo-needle to inhibit the target intercostal nerve.

Method for ameliorating secondary pulmonary hypertension in a patient including determining a pulmonary vascular resistance (PVR) of the patient suffering from secondary pulmonary hypertension; assessing a change in the PVR in response to a selection treatment; and treating the patient with a pulmonary artery manipulation device to provide pulmonary artery denervation if the patient is determined to suffer from fixed PH, thereby ameliorating the secondary pulmonary hypertension of the patient.