Abstract:
In accordance with the present invention, there is provided a system for treating a patient with local hypertension, comprising a hypertension treatment device adapted to have at least one surface of the device attached to the blood flow passageway, wherein said surface comprising a cooling surface able to cool said passageway to restrict said passageway thereby reducing the blood pressure distal to said restriction. In accordance with a another aspect of the present invention, there is provided a system for treating a patient with aneurysm, comprising a aneurysm treatment device adapted to have at least one surface of the device attached to the blood flow passageway, wherein said surface comprising a cooling surface able to cool said passageway to restrict said passageway thereby treating said aneurysm. In accordance with a second aspect of the present invention, there is provided a system for treating a patient with hypotension, comprising a hypotension treatment device adapted to have at least one surface of the device attached to the blood flow passageway, wherein said surface comprising a heating surface able to heat said passageway to dilate said passageway thereby increasing the blood pressure distal to said restriction.

Description:
FIELD OF THE INVENTION 
       [0001]    The present invention relates generally to medical devices and treatment and, more particularly, to a system and a method for treatment of hypertension or hypotension in a local part of the vascular system of a patient. 
       BACKGROUND OF THE INVENTION 
       [0002]    Hypertension, commonly referred to as “high blood pressure” or HTN, is a medical condition in which the blood pressure is chronically elevated. Hypertension may occur when the body&#39;s smaller blood vessels (arterioles) constrict, causing an increase in blood pressure. Because the blood vessels constrict, the heart must work harder to maintain blood flow at the higher pressures. Although the body may tolerate short periods of increased blood pressure, sustained hypertension may eventually result in damage to multiple body organs, including the kidneys, brain, eyes and other tissues, causing a variety of maladies associated therewith. The elevated blood pressure may also damage the lining of the blood vessels, accelerating the process of atherosclerosis and increasing the likelihood that a blood clot may develop. This could lead to a heart attack and/or stroke. Sustained high blood pressure may eventually result in an enlarged and damaged heart (hypertrophy), which may lead to heart failure. 
         [0003]    Hypotension, on the other hand, refers to an abnormally low blood pressure. This is best understood as a physiologic state, rather than a disease. It is often associated with shock, though not necessarily indicative of it. 
         [0004]    Hypertension or hypotension is not something that only affects the whole vascular system, sometimes it is a local part of the vascular system that is affected. By locally dilate or constrict the blood vessel creating the local problem of hypo- or hypertension this problem could be treated. To avoid any kind of damage to the blood vessel a system using heat or cold could be used to regulate the constriction or dilatation of the blood vessel. 
         [0005]    Hypertension may occur in the pulmonary system with too high blood pressure in the pulmonary artery. This could be caused by defective heart valves but often the cause is unknown. 
         [0006]    Hypotension may occur in the renal artery only causing general hypertension because regulation factors are produced in the kidney, which wrongly detects that hypotension is on hand. 
       BRIEF SUMMARY OF THE INVENTION 
       [0007]    An object of the present invention is to provide a system and a method for treatment of hypertension or hypotension in a local part of the vascular system of a patient. 
         [0008]    A constriction device placed on the pulmonary artery of a patient with high blood pressure, either one device before or two devices after the bifurcation, may treat the hypertension locally in the vascular pulmonary system. To avoid damaging the blood vessel the system is adapted to use a cooling surface to achieve the constriction. 
         [0009]    Another important example is hypotension in the renal artery only causing general hypertension because regulation factors are produced in the kidney, which feels that hypotension is on hand. Locally treating the hypotension could be achieved by heating the renal artery causing dilatation thereof. 
         [0010]    Another way of causing contraction may be to combine the cooling system with a stimulation device to stimulate the blood vessel with electrical pulses. Electric stimulation has been proposed to treat aneurysm to strengthen the wall of the blood vessel by increasing the tonus therein. However, we believe electric stimulation in combination with thermal stimulation may also be used also to treat local hypertension as well as aneurysm. 
         [0011]    In accordance with a first aspect of the present invention, there is provided a system for treating a patient with hypertension, comprising a hypertension treatment device adapted to have at least one surface of the device attached to the blood flow passageway, wherein said surface comprising a cooling surface able to cool said passageway to restrict said passageway thereby reducing the blood pressure distal to said restriction. 
         [0012]    In a preferred embodiment, the system comprises a control device for controlling the temperature of the cooling surface. A sensor preferably senses a physical parameter of the patient, preferably the blood pressure, or a functional parameter of the device, wherein the internal control unit controls said cooling surface in response to said sensor. 
         [0013]    In a preferred embodiment, the system comprises a mechanical or hydraulic constriction device for co-operating with said cooling surface to cause said restriction. 
         [0014]    In a preferred embodiment, the system comprises an internal control unit, wherein the temperature of the cooling surface is controlled by the internal control unit. 
         [0015]    In one embodiment the hypertension treatment device is adapted to be placed on the pulmonary artery to reduce high blood pressure in the pulmonary region. In a preferred embodiment, the system comprises a power supply, preferably a rechargeable power supply, and an electronic circuitry adapted to power the cooling surface. 
         [0016]    In a preferred embodiment, the cooling surface comprising an electronic element, preferably a peltier element, further creating heat on a second surface. A cooling system easiest using water may be adapted to transport away heat from the second surface. 
         [0017]    In accordance with a second aspect of the present invention, there is provided a system for treating a patient with hypotension, comprising a hypotension treatment device adapted to have at least one surface of the device attached to the blood flow passageway, wherein said surface comprising a heating surface able to heat said passageway to dilate said passageway thereby increasing the blood pressure distal to said restriction. 
         [0018]    In a preferred embodiment, the system comprises a control device for controlling the temperature of the heating surface. A sensor preferably senses a physical parameter of the patient, preferably the blood pressure, or a functional parameter of the device, wherein the internal control unit controls said heating surface in response to said sensor. 
         [0019]    In a preferred embodiment, the system comprises a mechanical or hydraulic constriction device for co-operating with said heating surface to cause said restriction. 
         [0020]    In a preferred embodiment, the system comprises an internal control unit, wherein the temperature of the heating surface is controlled by the internal control unit. 
         [0021]    In a preferred embodiment, the hypotension treatment device is adapted to be placed on the renal artery to increase the blood pressure in the renal region. 
         [0022]    In a preferred embodiment, the system comprises a power supply, preferably a rechargeable power supply, and an electronic circuitry adapted to power the heating surface. 
         [0023]    In a preferred embodiment, the heating surface comprising an electronic element, preferably a peltier element, further creating cold on a second surface. A heating system easiest using water may be adapted to transport away cold from the second surface. 
         [0024]    In accordance with a third aspect of the present invention, there is provided a system for treating a patient with aneurysm, comprising a aneurysm treatment device adapted to have at least one surface of the device attached to an aneurysm in the blood flow passageway, wherein said surface comprising a cooling surface able to cool said passageway to a) reduce the dilatation of said dilated aneurysmatic passageway or b) increase the tonus of said dilated aneurysmatic passageway thereby reducing the risk of further dilatation of said aneurysm. 
         [0025]    In a preferred embodiment, the aneurysm treatment device, comprising a control device for controlling the temperature of said cooling surface. 
         [0026]    In a preferred embodiment, the aneurysm treatment device, comprising a mechanical or hydraulic constriction device for co-operating with said cooling surface to cause said restriction. 
         [0027]    In a preferred embodiment, the aneurysm treatment device, comprising an internal control unit, wherein the temperature of said cooling surface is controlled by the internal control unit. 
         [0028]    In a preferred embodiment, the aneurysm treatment device, comprising a sensor sensing a physical parameter of the patient or a functional parameter of the device, wherein the internal control unit controls said cooling surface in response to said sensor. 
         [0029]    In a preferred embodiment, said sensor is sensing the blood pressure. 
         [0030]    In a preferred embodiment, said aneurysm treatment device is adapted to be placed attached to an artery of one of the following regions, the abdomen or thorax or arm or legs to treat an aneurysm in respectively region. 
         [0031]    In a preferred embodiment, the aneurysm treatment device, comprising a power supply and an electronic circuitry adapted to power the cooling surface. 
         [0032]    In a preferred embodiment, said power supply is a rechargeable power supply. 
         [0033]    In a preferred embodiment, the cooling surface comprising an electronic element further creating heat on a second surface. 
         [0034]    In a preferred embodiment, the electronic element is a peltier element. 
         [0035]    In a preferred embodiment, the aneurysm treatment device, comprising a water cooling system adapted to transport away heat from the second surface. 
         [0036]    In a preferred embodiment, the aneurysm treatment device, comprising a wireless energy transmitter for wireless charging of the power supply from outside the patients body. 
         [0037]    In accordance with a fourth aspect of the present invention, there is provided a method for controlling hypertension in a human or mammal vascular system, the method comprising the steps of: inserting a needle like tube into the abdomen of the patients body, using the tube like needle like to fill the abdomen with gas thereby expanding the abdominal cavity, placing at least two laparoscopic trocars in the patient&#39;s body, inserting a camera through one of the trocars into the abdomen, inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of a blood vessel of the patient, placing a hypertension treatment device comprising a cooling surface, attached in relation to the blood vessel, and cooling a wall portion of the blood vessel to cause contraction of the wall portion to create a constriction of the blood vessel, to further influence a blood pressure difference before and after the constriction of the blood vessel. The blood vessel is preferably a arterial blood vessel leading from the abdominal aorta to an organ of the patient, wherein the hypertension treatment device is treating a high blood pressure in this vascular system. 
         [0038]    In accordance with a fifth aspect of the present invention, there is provided a method for controlling hypertension locally in a human or mammal patients vascular system, the method comprising the steps of: inserting a needle like a tube into the thorax of the patients body, using the tube like needle to fill the thorax with gas thereby expanding the thoracal cavity, placing at least two laparoscopic trocars in the patient&#39;s body, inserting a camera through one of the trocars into the thorax, inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of a blood vessel, placing a hypertension treatment device comprising a cooling surface attached in relation to the blood vessel and cooling a wall portion of the blood vessel to cause contraction of the wall portion to create a constriction of the blood vessel, to further influence a blood pressure difference before and after the constriction of the blood vessel. 
         [0039]    In accordance with a sixth aspect of the present invention, there is provided a method for controlling hypertension locally in a human or mammal patients vascular system, the method comprising the steps of: cutting the patients skin, dissecting the area of a blood vessel, placing a hypertension treatment device comprising a cooling surface attached in relation to the blood vessel and cooling a wall portion of the blood vessel to cause contraction of the wall portion to create a constriction of the blood vessel, to create a blood pressure difference before and after the constriction of the blood vessel. 
         [0040]    In accordance with a seventh aspect of the present invention, there is provided a method for controlling hypotension locally in a human or mammal patients vascular system, the method comprising the steps of: 
         [0041]    inserting a needle like a tube into the abdomen of the patients body, 
         [0042]    using the tube like needle to fill the abdomen with gas thereby expanding the thoracal cavity, 
         [0043]    placing at least two laparoscopic trocars in the patient&#39;s body, 
         [0044]    inserting a camera through one of the trocars into the abdomen, 
         [0045]    inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of a blood vessel, 
         [0046]    placing a hypotension treatment device comprising a heating surface attached in relation to the blood vessel and 
         [0047]    heating a wall portion of the blood vessel to cause dilatation of the wall portion to create a dilatation of the blood vessel, to further influence a blood pressure difference before and after the dilatation of the blood vessel. 
         [0048]    In accordance with a eight aspect of the present invention, there is provided a method for controlling hypotension locally in a human or mammal patients vascular system, the method comprising the steps of: inserting a needle like a tube into the thorax of the patients body, using the tube like needle to fill the thorax with gas thereby expanding the thoracal cavity, placing at least two laparoscopic trocars in the patient&#39;s body, inserting a camera through one of the trocars into the thorax, inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of a blood vessel, placing a hypotension treatment device comprising a heating surface attached in relation to the blood vessel and heating a wall portion of the blood vessel to cause dilatation of the wall portion to create a dilatation of the blood vessel, to further influence a blood pressure difference before and after the dilatation of the blood vessel. The blood vessel is preferably a arterial blood vessel leading from the abdominal aorta to the kidney of the patient, wherein the hypotension treatment device is treating a low blood pressure in this renal vascular system. 
         [0049]    In accordance with a ninth aspect of the present invention, there is provided a method for controlling hypotension locally in a human or mammal patients vascular system, the method comprising the steps of: cutting the patients skin, dissecting the area of a blood vessel, placing a hypotension treatment device comprising a heating surface attached in relation to the blood vessel and heating a wall portion of the blood vessel to cause dilatation of the wall portion to create a dilatation of the blood vessel, to create a blood pressure difference before and after the dilatation of the blood vessel. In accordance with a tenth aspect of the present invention, there is provided a method for controlling an aneurysm locally in a human or mammal patients vascular system, the method comprising the steps of: 
         [0050]    inserting a needle like tube into the abdomen of the patients body, 
         [0051]    using the tube like needle like to fill the abdomen with gas thereby expanding the abdominal cavity, 
         [0052]    placing at least two laparoscopic trocars in the patient&#39;s body, 
         [0053]    inserting a camera through one of the trocars into the abdomen, 
         [0054]    inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of an aneurysmatic blood vessel of the patient, 
         [0055]    placing a aneurysm treatment device comprising a cooling surface, attached in relation to the aneurysm, and 
         [0056]    cooling a wall portion of the blood vessel to cause contraction of the wall portion to create a constriction of the blood vessel, to treat the aneurysm by the constriction of the blood vessel. 
         [0057]    In accordance with a eleventh aspect of the present invention, there is provided a method for controlling an aneurysm locally in a human or mammal patients vascular system, the method comprising the steps of: 
         [0058]    inserting a needle like tube into the thorax of the patients body, 
         [0059]    using the tube like needle like to fill the thorax with gas thereby expanding the thoraxinal cavity, 
         [0060]    placing at least two laparoscopic trocars in the patient&#39;s body, 
         [0061]    inserting a camera through one of the trocars into the thorax, 
         [0062]    inserting a dissecting tool through any of the trocar and dissecting an area of at least one portion of an aneurysmatic blood vessel of the patient, 
         [0063]    placing a aneurysm treatment device comprising a cooling surface, attached in relation to the aneurysm, and 
         [0064]    cooling a wall portion of the blood vessel to cause contraction of the wall portion to create a constriction of the blood vessel, to treat the aneurysm by the constriction of the blood vessel. 
         [0065]    In accordance with a twelfth aspect of the present invention, there is provided a method for controlling an aneurysm locally in a human or mammal patients vascular system, the method comprising the steps of: 
         [0066]    cutting the patients skin, 
         [0067]    dissecting the area of a blood vessel, 
         [0068]    placing a aneurysm treatment device comprising a cooling surface attached in relation to the blood vessel and 
         [0069]    cooling a wall portion of the blood vessel to cause contraction of the wall portion to create a constriction of the blood vessel, to treat the aneurysm by the contraction of the blood vessel. 
       Thermal Stimulation 
       [0070]    According to the invention, the treatment device thermally stimulates the wall portion of the organ. Thus, the control device may control the treatment device to cool the wall portion, to cause contraction of the wall portion. Alternatively, the control device may control the stimulation device to heat the wall portion to cause expansion of the wall portion. Where the wall portion includes a blood vessel, the control device may control the stimulation device to cool the blood vessel to cause contraction thereof, or heat the blood vessel to cause expansion thereof. Where applicable, thermal stimulation may be practiced in any of the embodiments of the present invention, and the thermal stimulation may be controlled in response to various sensors, for example strain, motion or pressure sensors. 
         [0071]    In one embodiment, the treatment device is used in combination with a constriction device, such as a mechanical or hydraulic device, for thermally stimulating the wall portion of the blood vessel. Thus, the control device may control the stimulation device to cool the wall portion, when the wall portion is constricted, to cause contraction of the wall portion. For example, the constriction device may constrict the wall portion to at least restrict the flow in the lumen, and the control device may control the stimulation device to cool the constricted wall portion to cause contraction thereof, such that the flow in the lumen is at least further restricted, or further restricted but not stopped, or stopped. Alternatively, the control device may control the stimulation device to heat the wall portion, when the wall portion is constricted and contracted, to cause expansion of the wall portion. Where the wall portion includes a blood vessel, the control device may control the stimulation device to cool the blood vessel to cause contraction thereof, or heat the blood vessel to cause expansion thereof. Where applicable, thermal stimulation may be practiced in any of the embodiments of the present invention, and the thermal stimulation may be controlled in response to various sensors, for example strain, motion or pressure sensors. 
         [0072]    The thermal stimulation may be used in combination with electrical stimulation of the wall portion of a blood vessel. 
       Sensor Controlled Treatment Device 
       [0073]    As mentioned above, the system may comprise at least one implantable sensor, wherein the control device controls the treatment device and potentially a constriction device in response to signals from the sensor. Generally, the sensor directly or indirectly senses at least one physical parameter of the patient, or at least one functional parameter of the system. 
         [0074]    Many different kinds of sensor for sensing physical parameters may be used. For example motion sensors for sensing organ motion, i.e. natural contractions, such as stomach or intestinal contractions, pressure sensors for sensing pressure in the organ, strain sensors for sensing strain of the organ, flow sensors for sensing fluid flow in the lumen of the organ, spectro-photometrical sensors, Ph-sensors for sensing acidity or alkalinity of the fluid in the lumen of the organ, oxygen-sensors sensors for sensing the oxygen content of the fluid in the lumen of the organ, or sensors for sensing the distribution of the stimulation on the stimulated organ. Any conceivable sensors for sensing any other kind of useful physical parameter may be used. 
         [0075]    Many different kinds of sensors that sense functional parameters of the apparatus may also be used for the control of the constriction device and/or the thermal stimulation device. For example sensors for sensing electric parameters of implanted electric components of the apparatus, or sensors for sensing the performance of implanted motors of the apparatus. 
         [0076]    The sensor may comprise a pressure sensor for sensing as the physical parameter a pressure in the patient&#39;s body that relates to the pressure in the lumen of the patient&#39;s bodily organ, wherein the control device controls the constriction device and/or stimulation device to change the constriction of the patient&#39;s blood vessel wall portion in response to the pressure sensor sensing a predetermined value of measured pressure. 
         [0077]    Alternatively, or in combination with the pressure sensor, a position sensor may be provided for sensing as the physical parameter the orientation of the patient with respect to the horizontal. The position sensor may be a biocompatible version of what is shown in U.S. Pat. Nos. 4,942,668 and 5,900,909. For example, the control device may control the constriction device and/or stimulation device to change the constriction of the patient&#39;s wall portion in response to the position sensor sensing that the patient has assumed a substantially horizontal orientation, i.e. that the patient is lying down. 
         [0078]    The above described sensors may be used in any of the embodiments of the invention, where applicable. 
         [0079]    The control device may control the constriction device and/or stimulation device to change the constriction of the patient&#39;s wall portion in response to the time of day. For that purpose the control device may include a clock mechanism for controlling the constriction device and/or stimulation device to change the constriction of the patient&#39;s wall portion to increase or decrease the influence on the flow in the lumen during different time periods of the day. In case a sensor of any of the above-described types for sensing a physical or functional parameter is provided, either the clock mechanism is used for controlling the constriction device and/or stimulation device provided that the parameter sensed by the sensor does not override the clock mechanism, or the sensor is used for controlling the constriction device and/or stimulation device provided that the clock mechanism does not override the sensor. Suitably, the control device produces an indication, such as a sound signal or displayed information, in response to signals from the sensor. 
         [0080]    The control device may comprise an implantable internal control unit that directly controls the constriction device and/or thermal stimulation device in response to signals from the sensor. The control device may further comprise a wireless remote control adapted to set control parameters of the internal control unit from outside the patient without mechanically penetrating the patient. At least one of the control parameters, which is sellable by the wireless remote control, is the physical or functional parameter. Suitably, the internal control unit includes the above mentioned clock mechanism, wherein the wireless remote control also is adapted to set the clock mechanism. 
         [0081]    Alternatively, the control device may comprise an external control unit outside the patient&#39;s body for controlling the constriction device and/or stimulation device in response to signals from the sensor. 
       Mechanical Operation 
       [0082]    Where the system comprises a constriction device, an operation device may mechanically operate the constriction device, which may be non-inflatable. Furthermore, the operation device may comprise a servo system, which may include a gearbox. The term “servo system” encompasses the normal definition of a servo mechanism, i.e., an automatic device that controls large amounts of power by means of very small amounts of power, but may alternatively or additionally encompass the definition of a mechanism that transfers a weak force acting on a moving element having a long stroke into a strong force acting on another moving element having a short stroke. Preferably, the operation device operates the constriction device in a non-magnetic and/or non-manual manner. A motor may be operatively connected to the operation device. The operation device may be operable to perform at least one reversible function and the motor may be capable of reversing the function. 
       Hydraulic Operation 
       [0083]    Where the system comprises a constriction device, an operation device may hydraulically operate the constriction device In an embodiment of the invention, the hydraulic means comprises a reservoir and an expandable/contractible cavity in the constriction device, wherein the operation device distributes hydraulic fluid from the reservoir to expand the cavity, and distributes hydraulic fluid from the cavity to the reservoir to contract the cavity. The cavity may be defined by a balloon of the constriction device that abuts the tissue wall portion of the patient&#39;s organ, so that the patient&#39;s wall portion is constricted upon expansion of the cavity and released upon contraction of the cavity. 
         [0084]    Alternatively, the cavity may be defined by a bellows that displaces a relatively large contraction element of the constriction device, for example a large balloon that abuts the wall portion, so that the patient&#39;s wall portion is constricted upon contraction of the bellows and released upon expansion of the bellows. Thus, a relatively small addition of hydraulic fluid to the bellows causes a relatively large increase in the constriction of the wall portion. Such a bellows may also be replaced by a suitably designed piston/cylinder mechanism. 
       Design of Control Device 
       [0085]    The control device suitably controls the treatment device from outside the patient&#39;s body. Preferably, the control device is operable by the patient. For example, the control device may comprise a manually operable switch for switching on and off the treatment device, wherein the switch is adapted for subcutaneous implantation in the patient to be manually or magnetically operated from outside the patient&#39;s body. Alternatively, the control device may comprise a hand-held wireless remote control, which is conveniently operable by the patient to switch on and off the treatment device. The wireless remote control may also be designed for application on the patient&#39;s body like a wristwatch. Such a wristwatch type of remote control may emit a control signal that follows the patient&#39;s body to implanted signal responsive means of the apparatus. 
         [0086]    Where the control device wirelessly controls the treatment device from outside the patient&#39;s body, the wireless control function is preferably performed in a non-magnetic manner, i.e., the control device controls the constriction device of the treatment device in a non-magnetic manner. The patient may use the remote control to control the treatment device to adjust the stimulation intensity and/or adjust the constriction of the wall portion. The wireless remote control may comprise at least one external signal transmitter or transceiver and at least one internal signal receiver or transceiver implantable in the patient. 
         [0087]    The wireless remote control preferably transmits at least one wireless control signal for controlling the treatment device. The control signal may comprise a frequency, amplitude, phase modulated signal or a combination thereof, and may be an analogue or a digital signal, or a combination of an analogue and digital signal. The remote control may transmit an electromagnetic carrier wave signal for carrying the digital or analogue control signal. Also the carrier signal may comprise digital, analogue or a combination of digital and analogue signals. 
         [0088]    Any of the above control signals may comprise wave signals, for example a sound wave signal, an ultrasound wave signal, an electromagnetic wave signal, an infrared light signal, a visible light signal, an ultra violet light signal, a laser light signal, a microwave signal, a radio wave signal, an x-ray radiation signal or a gamma radiation signal. Alternatively, the control signal may comprise an electric or magnetic field, or a combined electric and magnetic field. 
         [0089]    As mentioned above, the control signal may follow the patient&#39;s body to implanted signal responsive means of the apparatus. 
         [0090]    The control device may include a programmable internal control unit, such as a microprocessor, implantable in the patient for controlling the treatment device. The control device may further include an external control unit intended to be outside the patient&#39;s body, wherein the internal control unit is programmable by the external control unit. For example, the internal control unit may be programmable for controlling the treatment device over time, suitably in accordance with an activity schedule program. The apparatus of the invention may comprise an external data communicator and an implantable internal data communicator communicating with the external data communicator, wherein the internal communicator feeds data related to the treatment device back to the external data communicator or the external data communicator feeds data to the internal data communicator. 
       Source of Energy 
       [0091]    The present invention also presents a solution for supplying energy for use in connection with the operation of the treatment device. Thus, in a broad sense, the present invention provides an apparatus for controlling a flow of blood in a blood vessel a patient&#39;s organ, wherein the system may comprise an implantable constriction device for gently constricting a portion of the tissue wall to influence the flow in the blood vessela source of energy, and a control device operable from outside the patient&#39;s body to control the source of energy to release energy for use in connection with the operation of the system. In a simple form of the invention, the source of energy, such as a battery or accumulator, is implantable in the patient&#39;s body. 
       Transmission of Wireless Enemy 
       [0092]    In a more sophisticated form of the invention, which is preferable, the source of energy is external to the patient&#39;s body and the control device controls the external source of energy to release wireless energy. In this sophisticated form of the invention, the apparatus comprises an energy-transmission device that transmits the released wireless energy from outside the patient&#39;s body to inside the patient&#39;s body. Among many things the wireless energy may comprise electromagnetic energy, an electric field, an electromagnetic field or a magnetic field, or a combination thereof, or electromagnetic waves. The energy-transmission device may transmit wireless energy for direct use in connection with the operation of the treatment device, as the wireless energy is being transmitted. For example, where an electric motor or pump operates the constriction device, wireless energy in the form of a magnetic or an electromagnetic field may be used for direct power of the motor or pump. 
         [0093]    Thus, the motor or pump is running directly during transmission of the wireless energy. This may be achieved in two different ways: a) using a transforming device implanted in the patient to transform the wireless energy into energy of a different form, preferably electric energy, and powering the motor or pump with the transformed energy, or b) using the wirelessly transmitted energy to directly power the motor or pump. Preferably wireless energy in the form of an electromagnetic or magnetic field is used to directly influence specific components of the motor or pump to create kinetic energy for driving the motor or pump. Such components may include coils integrated in the motor or pump, or materials influenced by magnetic fields, or permanent magnets, wherein the magnetic or electromagnetic field influences the coils to generate a current for driving the motor or pump, or influences the material or permanent magnets to create kinetic energy for driving the motor or pump. 
         [0094]    Preferably, the energy-transmission device transmits energy by at least one wireless signal, suitably a wave signal. The wave signal may comprise an electromagnetic wave signal including one of an infrared light signal, a visible light signal, an ultra violet light signal, a laser signal, a microwave signal, a radio wave signal, an x-ray radiation signal, and a gamma radiation signal. Alternatively, the wave signal may comprise a sound or ultrasound wave signal. The wireless signal may be a digital or analogue signal, or a combination of a digital and analogue signal. 
       Transforming Wireless Energy 
       [0095]    In accordance with a particular embodiment of the invention, an implantable energy-transforming device is provided for transforming wireless energy of a first form transmitted by the energy-transmission device into energy of a second form, which typically is different from the energy of the first form. The treatment device is operable in response to the energy of the second form. For example, the wireless energy of the first form may comprise sound waves, whereas the energy of the second form may comprise electric energy. In this case, the energy-transforming device may include a piezo-electric element for transforming the sound waves into electric energy. Optionally, one of the energy of the first form and the energy of the second form may comprise magnetic energy, kinetic energy, sound energy, chemical energy, radiant energy, electromagnetic energy, photo energy, nuclear energy or thermal energy. Preferably, one of the energy of the first form and the energy of the second form is non-magnetic, non-kinetic, non-chemical, non-sonic, non-nuclear or non-thermal. 
         [0096]    The energy-transforming device may function differently from or similar to the energy-transmission device. In a special embodiment, the energy-transforming device comprises at least one element, such as at least one semiconductor, having a positive region and a negative region, when exposed to the energy of the first form transmitted by the energy-transmission device, wherein the element is capable of creating an energy field between the positive and negative regions, and the energy field produces the energy of the second form. More specifically, the element may comprise an electrical junction element, which is capable of inducing an electric field between the positive and negative regions when exposed to the energy of the first form transmitted by the energy-transmission device, whereby the energy of the second form comprises electric energy. 
         [0097]    The energy-transforming device may transform the energy of the first form directly or indirectly into the energy of the second form. An implantable motor or pump for operating the constriction device of the treatment device may be provided, wherein the motor or pump is powered by the energy of the second form. The constriction device may be operable to perform at least one reversible function and the motor may be capable of reversing the function. For example, the control device may shift polarity of the energy of the second form to reverse the motor. 
         [0098]    The energy-transforming device may directly power the motor or pump with the transformed energy, as the energy of the second form is being transformed from the energy of the first form. Preferably, the energy-transforming device directly operates the treatment device with the energy of the second form in a non-magnetic, non-thermal or non-mechanical manner. 
         [0099]    Normally, the treatment device comprises electric components that are energized with electrical energy. Other implantable electric components of the apparatus may be at least one voltage level guard or at least one constant current guard. Therefore, the energy-transforming device may transform the energy of the first form into a direct current or pulsating direct current, or a combination of a direct current and pulsating direct current. Alternatively, the energy-transforming device may transform the energy of the first form into an alternating current or a combination of a direct and alternating current. 
         [0100]    The apparatus of the invention may comprise an internal source of energy implantable in the patient for supplying energy for the operation of the treatment device. The apparatus may further comprise an implantable switch operable to switch from an “off” mode, in which the internal source of energy is not in use, to an “on” mode, in which the internal source of energy supplies energy for the operation of the treatment device, and/or for energizing implanted electronic components of the apparatus. The switch may be operable by the energy of the first form transmitted by the energy-transmission device or by the energy of the second form supplied by the energy-transforming device. The described switch arrangement reduces power consumption of the apparatus between operations. 
         [0101]    The internal source of energy may store the energy of the second form supplied by the energy-transforming device. In this case, the internal source of energy suitably comprises an accumulator, such as at least one capacitor or at least one rechargeable battery, or a combination of at least one capacitor and at least one rechargeable battery. Where the internal source of energy is a rechargeable battery it may be charged only at times convenient for the patient, for example when the patient is sleeping. Alternatively, the internal source of energy may supply energy for the operation of the treatment device but not be used for storing the energy of the second form. In this alternative, the internal source of energy may be a battery and the switch described above may or may not be provided. 
         [0102]    Suitably, the system of the invention comprises an implantable stabilizer for stabilizing the energy of the second form. Where the energy of the second form is electric energy the stabilizer suitably comprises at least one capacitor. 
         [0103]    The energy-transforming device may be designed for implantation subcutaneously in the abdomen, thorax or cephalic region of the patient. Alternatively, it may be designed for implantation in an orifice of the patient&#39;s body and under the mucosa or intramuscularly outside the mucosa of the orifice. 
         [0104]    Although the treatment device in the embodiments described above is designed as a single piece, which is most practical for implantation, it should be noted that as an alternative the constriction device and stimulation device could be designed as separate pieces. Any one of the constriction and stimulation units described above may alternatively be replaced by two or more separate constriction/stimulation elements, which are controlled independently of one another. 
         [0105]    The present invention also provides a method for using a system as described above to control the blood flow in the blood vessel of a patient&#39;s organ. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0106]      FIG. 1A  schematically shows a first embodiment of a system according to the invention in a non-operative mode. 
           [0107]      FIG. 1B  show the embodiment of  FIG. 1A  in an operative mode. 
           [0108]      FIG. 2A  schematically shows a second embodiment of a system according to the invention in a non-operative mode. 
           [0109]      FIG. 2B  show the embodiment of  FIG. 2A  in an operative mode. 
           [0110]      FIG. 3A  schematically shows a third embodiment of a system according to the invention in a non-operative mode. 
           [0111]      FIG. 3B  show the embodiment of  FIG. 3A  in an operative mode. 
           [0112]      FIG. 4A  is a detailed view of a treatment device of a system according to the invention in a non-operative mode. 
           [0113]      FIG. 4B  is a view similar to that of  FIG. 4A  but with the treatment device in an operative mode. 
           [0114]      FIG. 5A  is a detailed view of an alternative treatment device of a system according to the invention in a non-operative mode. 
           [0115]      FIG. 5B  is a view similar to that of  FIG. 5A  but with the alternative treatment device in an operative mode. 
           [0116]      FIG. 6A  is a schematic view of hydraulic operation means suited for operating the treatment device of the embodiments of  FIGS. 4A ,  4 B,  5 A, and  5 B. 
           [0117]      FIG. 6B  shows the embodiment of  FIG. 6A  with the treatment device constricting a blood vessel of a patient. 
           [0118]      FIG. 7A  is a schematic view of mechanical operation means suited for operating the treatment device of the embodiments of  FIGS. 4A ,  4 B,  5 A, and  5 B. 
           [0119]      FIG. 7B  shows the embodiment of  FIG. 7A  with the constriction device constricting a blood vessel of a patient. 
           [0120]      FIG. 7C  shows a modification of the embodiment of  FIG. 7B . 
           [0121]      FIGS. 8A and 8B  show an embodiment of the treatment device that aneurysm in a blood vessel, such as for example the aorta. 
       
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       [0122]    Referring to the drawing figures, like reference numerals designate identical or corresponding elements throughout the several figures. 
         [0123]      FIG. 1  illustrates an embodiment of a system according to the invention, generally designated  1 . The system comprises thermal elements  2   a ,  2   b  of a hypotension treatment device  2  are provided so as to thermally heat an arterial blood vessel  10 , i.e., a renal artery leading from the abdominal aorta  11  to the kidney  12  of a patient, wherein the hypotension treatment device is treating a low blood pressure in this renal vascular system. A control device  3  is connected to the hypotension treatment device  2  such as to control the operation thereof, i.e., the temperature of the thermal elements  2   a ,  2   b.    
         [0124]    In the figure, a constriction  10   a  of the renal artery  10  is shown. This constriction creates a lower blood pressure downstream of the constriction than upstream thereof, as indicated by the arrow. This means in turn that the kidney  12  will perceive a low blood pressure, affecting the operation thereof negatively. 
         [0125]    In order to remedy this situation, the hypotension treatment device  2  is operated by the control device  3  so that the thermal elements  2   a ,  2   b  are heated, in turn heating the renal artery  10  locally at the constriction  10   a  thereof. This operational mode is shown in  FIG. 1B , where it can be seen that a dilatation of the blood vessel  10  is achieved at the point of the constriction  10   a , allowing the blood to flow freely within the renal artery and thereby increasing the blood pressure in the kidney  12 . 
         [0126]    An alternative embodiment of a system according to the invention will now be described with reference to  FIGS. 2A and 2B . In many aspects this embodiment is identical to the one described above with reference to  FIGS. 1A and 1B . However, in this second embodiment, the control device includes an external control unit in the form of a hand-held wireless remote control  32 , and an implanted internal control unit  33 , which may include a microprocessor, for controlling the constriction and stimulation devices. The remote control  32  is operable by the patient to control the internal control unit  33  to switch on and off the treatment device. Alternatively, however, the remote control  32  may be replaced by a subcutaneously implanted push button that is manually switched by the patient between “on” and “off”. Such a manually operable push button may also be provided in combination with the remote control  32  as an emergency button to allow the patient to stop the operation of the apparatus in case of emergency or malfunction. 
         [0127]    The internal control unit  33  controls an implanted operation device  34  to operate the treatment device  2 . An implanted source of energy  35 , such as a rechargeable battery, powers the operation device  34 . The internal control unit  33 , which may be implanted subcutaneously or in the abdomen, may also work as an energy receiver, i.e., for transforming wireless energy into electric energy and charging the implanted source of energy  35  (rechargeable battery) with the electric energy. Alternatively, a separate external charging unit  36  is provided to wirelessly charge the source of energy  35 . 
         [0128]    An implanted sensor  37  senses the blood pressure of the patient downstream of the constriction  10   a  and the internal control unit  33  controls the treatment device  2  in response to signals from the sensor  37 . In this embodiment the sensor  37  is a pressure sensor 
         [0129]    The remote control  32  may be equipped with means for producing an indication, such as a sound signal or displayed information, in response to signals from the sensor  37 . When the patient&#39;s attention is taken by such an indication indicating an increased pressure exceeding a threshold value, he or she may use the remote control to control the constriction device and stimulation device to pump intestinal contents through the patient&#39;s stoma. 
         [0130]    The embodiment shown in  FIGS. 3A and 3B  is a system for treating high blood pressure. Turning first to  FIG. 3A , a human heart of a patient is shown and the operation of the right heart pump will now be described, the left heart pump being outlined with dashed lines. The right heart pump consists of the right atrium (RA), tricuspid valve (TV), right ventricle (RV), pulmonic valve (PV), and pulmonary artery (PA). Poorly oxygenated blood returning to the heart from the body&#39;s organs enters the right atrium, and is stored there until the right atrium contracts. When the right atrium contracts, the tricuspid valve opens, allowing the blood to enter the right ventricle. Then, when the right ventricle contracts, the pulmonic valve opens, and the blood is propelled into the pulmonary artery. The pulmonary artery carries the blood to the lungs, where it picks up oxygen. 
         [0131]    When a treatment device of a system according to the invention is applied to a blood vessel leading from the right heart chamber to the lung of the patient, i.e., the pulmonary artery, the treatment device functions as a hypertension treatment device for treating a high blood pressure in this pulmonary vascular system. The system, generally designated  100 , then comprises a treatment device  102  comprising thermal elements  102   a ,  102   b  operating under control of a control device  103 . 
         [0132]    Turning now to  FIG. 3B , in order to lower the pressure of the blood leaving the pulmonary artery, the thermal elements  102   a ,  102   b , are cooled, thereby cooling the walls of the pulmonary artery. This in turn result in a constriction of the pulmonary artery locally at the treatment device, which lower the pressure of the blood downstream of the treatment device. 
         [0133]    Alternative positions of the treatment device after the bifurcation of the pulmonary artery are shown with dashed lines in the  FIGS. 3A and 3B . 
         [0134]    It will be realized that the application described above with reference to  FIGS. 3A and 3B  can also be implemented with the devices described above with reference to  FIGS. 2A and 2B . 
         [0135]      FIGS. 4A and 4B  show an embodiment of the treatment device that controls blood flow in a blood vessel, such as the pulmonary artery PA. The treatment device comprises a stimulation device in the form of two thermal stimulation elements  102   a  and  102   b . A control device  3  for controlling the thermal stimulation elements  102   a ,  102   b  is also shown in the figures. to constrict and releaser, respectively, the blood vessel. The thermal stimulation elements  102   a  and  102   b , which may include Peltier elements, are positioned so that the thermal element  102   a  is facing the thermal element  102   b .  FIG. 4A  shows the treatment device in a non-operating state, wherein the blood flow is unaffected.  FIG. 4B  shows how the control device  3  controls the thermal stimulation elements  102   a ,  102   b  to cool the wall of the blood vessel PA, so that the wall contracts and partly closes the blood vessel PA. To release the blood vessel PA, the control device  3  controls the thermal stimulation elements  102   a ,  102   b  to heat the wall of the blood vessel PA, so that the wall expands. 
         [0136]    The treatment device shown in  FIGS. 4A and 4B  lends itself also for treatment of aneurysm, i.e., a localized, blood-filled dilation (bulge) of a blood vessel caused by disease or weakening of the vessel wall. 
         [0137]      FIGS. 5A and 5B  show another embodiment of the treatment device that controls blood flow in a blood vessel, such as the pulmonary artery PA. The treatment device comprises a constriction device with two clamping elements  102   c  and  102   d , a stimulation device in the form of two thermal stimulation elements  102   a  and  102   b . A control device  3  for controlling the thermal stimulation elements  102   a ,  102   b  and the clamping elements  102   c ,  102   d  is also shown in the figures. The clamping elements  102   c  and  102   d  are movable towards and away from each other to constrict and release, respectively, the blood vessel. The thermal stimulation elements  102   a  and  102   b , which may include Peltier elements, are positioned so that the thermal element  102   a  is facing the thermal element  102   b .  FIG. 4A  shows how the clamping elements  102   c ,  102   d  constrict the blood vessel PA, so that the blood flow is restricted.  FIG. 5B  shows how the control device  103  controls the thermal stimulation elements  102   a ,  102   b  to cool the wall of the blood vessel PA, so that the wall contracts and further closes the blood vessel PA. To release the blood vessel PA, the control device  103  controls the thermal stimulation elements  102   a ,  102   b  to heat the wall of the blood vessel PA, so that the wall expands and the clamping elements may be moved from each other. 
         [0138]      FIGS. 6A and 6B  show hydraulic operation means suited for operating the constriction device of the embodiments described above. Specifically, FIGS.  6 A and  6 B show the apparatus of  FIGS. 5A ,  5 B provided with such means for hydraulic operation of the constriction device in the form of clamping elements  102   c ,  102   d . Thus, the housing  300  forms two hydraulic chambers  302   a  and  302   b , in which the two clamping elements  102   c ,  102   d  are slidable back and forth relative to the tubular wall portion  8  of a patient&#39;s blood vessel. The hydraulic operation means include an expandable reservoir  303 , such as an elastic balloon, containing hydraulic fluid, and conduits  304   a  and  304   b  between the reservoir  303  and the hydraulic chambers  302   a ,  302   b  By pressing the reservoir  303 , the tubular wall portion PA is constricted, see  FIG. 6B , and to pump hydraulic fluid from the chambers  302   a ,  302   b  to the reservoir  303  to move the clamping elements away from the wall portion, whereby the blood vessel is released, see  FIG. 6A . 
         [0139]      FIGS. 7A and 7B  schematically show a mechanically operable embodiment of the invention, comprising an open ended tubular housing  400  applied on the tubular tissue wall portion of a patient&#39;s blood vessel, a constriction device  402  arranged in the housing  400  and a control device  403  for controlling the constriction device  402 . A thermal stimulation device (not shown) as described above is also provided in the housing  400 . The constriction device  402  includes a clamping element  402   a , which is radially movable in the tubular housing  400  towards and away from the tubular wall portion PA between a retracted position, see  FIG. 7A , and a clamping position, see  FIG. 7B , in which the clamping element  402   a  gently constricts the tubular wall portion PA. Mechanical operation means for mechanically operating the clamping element  402   a  includes an electric motor  404  attached to the housing  400  and a telescopic device  405 , which is driven by the motor  404  and operatively connected to the clamping element  402   a . The control device  403  controls the electric motor  404  to expand the telescopic device  405  to move the clamping element  402   a  against the wall portion PA, whereby the tubular wall portion is constricted, see  FIG. 7B , and controls the motor  404  to retract the telescopic device  405  to move the clamping element  402   a  away from the wall portion, whereby the wall portion is released, see  FIG. 7A . 
         [0140]    Alternatively, the motor may be omitted and the telescopic device  405  be modified for manual operation, as shown in  FIG. 7C . Thus, a spring  407   a  may be provided acting to keep the telescopic device  405  expanded to force the clamping element  402   a  against the wall portion PA. The mechanical operation means may include a subcutaneously implanted lever mechanism  408   a  that is operatively connected to the telescopic device  405 . The patient may push the lever mechanism  408   a  through the patient&#39;s skin  408   b  to pull the telescopic device  405  against the action of the spring  407   a  to the retracted position of the telescopic device  405 , as indicated in phantom lines. When the patient releases the lever mechanism  408   a , the spring  407   a  expands the telescopic device  405 , whereby clamping element  402  is forced against the wall portion PA. 
         [0141]      FIGS. 8A and 8B  show an embodiment of the treatment device that aneurysm in a blood vessel, such as the aorta. The treatment device comprises a stimulation device in the form of two thermal stimulation elements  102   a  and  102   b . A control device  103  for controlling the thermal stimulation elements  102   a ,  102   b  is also shown in the figures. to constrict and releaser, respectively, the blood vessel. The thermal stimulation elements  102   a  and  102   b , which may include Peltier elements, are positioned so that the thermal element  102   a  is facing the thermal element  102   b . FIGURE (A shows the treatment device in a non-operating state, wherein the blood flow is unaffected. FIGURE (B shows how the control device  103  controls the thermal stimulation elements  102   a ,  102   b  to cool the wall of the blood vessel aneurysm AN, so that the wall contracts and partly reduces the dilatation of the aneurysmatic blood vessel. In reality it may be enough that the tonus of the aneurysmatic wall increases to minimize the risk of such aneurysm to expand. The drawing may therefore be seen as very exaggerated to understand the principle. To release the blood vessel, the control device  103  controls the thermal stimulation elements  102   a ,  102   b  to stop cooling the wall of the blood vessel, so that the wall expands. 
         [0142]    While the invention has been described in connection with what is presently considered to be the most practical and preferred embodiment, it is to be understood that the invention is not to be limited to the disclosed embodiment, but on the contrary, is intended to cover various modifications and equivalent arrangements included within the spirit and scope of the appended claims.