In Vivo Localization and Tracking of Tissue Penetrating Catheters Using Magnetic Resonance Imaging

• US 20060184011A1
• Filed: 04/14/2006
• Published: 08/17/2006
• Est. Priority Date: 02/06/2001
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Macaulay, Patrick, Nayak, Asha
• Granted Patent: US 8,214,015 B2
• Time in Patent Office: Days
• US Class Current: 600/423
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/374 NMR or MRI
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/064 using markers A61B5/062 takes precedence
• CPC Class Codes: A61B 5/416 the spleen
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/6852 Catheters
• CPC Class Codes: A61M 2025/0037 characterized by lumina being arranged side-by-side
• CPC Class Codes: A61M 2025/0096 being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 25/0029 characterized by features relating to least one lumen located at the middle part of the catheter, e.g. slots, flaps, valves, cuffs, apertures, notches, grooves or rapid exchange ports catheter shaft surface irregularities A61M2025/006
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/0127 Magnetic means; Magnetic markers
• CPC Class Codes: G01R 33/287 involving active visualization of interventional instruments, e.g. using active tracking RF coils or coils for intentionally creating magnetic field inhomogeneities

Abstract

Magnetic resonance image (MRI) guided tissue penetrating catheters and their methods of use. One or more MRI apparatus (e.g., one or more coils) are positioned on or in a catheter device that includes a tissue penetrator that may be used to form a penetration tract from a body lumen in which the catheter is positioned to a target location outside of that body lumen. The MRI apparatus (e.g., coil(s)) is/are used in conjunction with an MRI imaging system to indicate the position and/or rotational orientation of the penetrating catheter within the subject'"'"'s body.

Claims

1. A tissue penetrating catheter device useable with a magnetic resonance imaging system, said device comprising:

a catheter body having a distal end;

a tissue penetrator that is advanceable from the catheter body; and

at least one magnetic resonance apparatus that sends signals to a magnetic resonance imaging system adapted to use said signals to provide an indication of the position of said at least one magnetic resonance apparatus.

2. A device according to claim 1 wherein said at least one magnetic resonance apparatus comprises at least one coil.

3. A device according to claim 1 wherein said at least one magnetic resonance apparatus comprises at least one magnetic resonance receiver.

4. A device according to claim 1 wherein said at least one magnetic resonance apparatus comprises at least one antenna.

5. A device according to claim 4 wherein said at least one magnetic resonance apparatus comprises at least one loopless antenna.

6. A device according to claim 1 wherein a magnetic resonance apparatus is located on or in the catheter body.

7. A device according to claim 1 wherein a magnetic resonance apparatus is located on or in the penetrator.

8. A device according to claim 1 wherein a first magnetic resonance apparatus is located on or in the catheter body and a second magnetic resonance apparatus is located on or in the penetrator.

9. A device according to claim 1 wherein a first magnetic resonance apparatus is located at a first location situated on or in the catheter body, a second magnetic resonance apparatus is located at a second location situated on or in the penetrator and a third magnetic resonance apparatus is located at a third location situated on or in the catheter body.

10. A device according to claim 9 wherein the first magnetic resonance apparatus is located at or near the distal end of the catheter body and the third magnetic resonance apparatus is located at or near a location where the tissue penetrator advances out of the catheter body.

11. A device according to claim 1 wherein the tissue penetrator comprises an elongate penetration member and wherein the device further comprises a penetrator housing within which at least a portion of the elongate penetration member resides when in its retracted position.

12. A device according to claim 11 wherein a magnetic resonance apparatus is located on, in or adjacent to the penetrator housing.

13. A device according to claim 12 wherein the penetrator housing comprises a tubular penetrator housing and wherein a magnetic resonance apparatus comprises a coil that substantially surrounds the tubular penetrator housing.

14. A device according to either of claims 11 or 12 wherein the penetrator exits from a side opening in the catheter body and the penetrator housing is curved in the direction of sad side opening.

15. A device according to claim 14 wherein a magnetic resonance apparatus is positioned on, in or adjacent to the curved penetrator housing such that it provides an image of the curvature of the penetrator housing.

16. A device according to claim 15 wherein the image provided of curvature of the penetrator housing generally indicates the trajectory on which the penetrator will advance from the catheter body.

17. A device according to claim 11 wherein a first magnetic resonance apparatus is located at or near the distal end of the catheter body, a second magnetic resonance apparatus is located on or in the penetrator member and a third magnetic resonance apparatus is located on, in or adjacent to the penetrator housing.

18. A device according to claim 1 wherein the tissue penetrator comprises an elongate member having a lumen.

19. A device according to claim 1 wherein the tissue penetrator comprises a needle.

20. A device according to claim 1 wherein the tissue penetrator has a lumen through which a substance, article or device may be delivered.

21. A system comprising a device according to claim 20 in combination with substance delivery apparatus useable to deliver a substance through the lumen of the tissue penetrator.

22. A system comprising a device according to claim 20 in combination with a catheter that is advanceable through the lumen of the tissue penetrator.

23. A system according to claim 22 wherein the catheter that is advanceable through the lumen of the tissue penetrator comprises a microcatheter.

24. A system comprising a device according to claim 20 in combination with a device that is advanceable through the lumen of the tissue penetrator.

25. A system according to claim 24 wherein the device that is advanceable through the lumen of the tissue penetrator comprises a guidewire.

26. A system according to claim 1 in combination with a magnetic resonance system that is programmed to receive signals from the at least one magnetic resonance apparatus and to display the location of the at least one magnetic resonance apparatus in response to said signals.

27. A system according to claim 26 wherein the magnetic resonance system displays the location of the at least one magnetic resonance apparatus in relation to images of anatomical structures located near the current position of the at least one magnetic resonance apparatus.

28. A system according to claim 27 wherein the location of the at least one magnetic resonance apparatus is superimposed on an anatomical image.

29. A system according to claim 26 wherein the tissue penetrating catheter device includes a plurality of magnetic resonance apparatus and wherein the magnetic resonance system displays a different indicator for the position of each magnetic resonance apparatus.

30. A system according to claim 29 wherein the magnetic resonance system displays a different colored indicator for the location of each magnetic resonance apparatus.

31. A system according to claim 26 wherein the magnetic resonance system receives signals from the at least one magnetic resonance apparatus defining the rotational orientation of the tissue penetrating catheter device and in response to said signals displays an indication of the rotational orientation of the tissue penetrating catheter device.

32. A method for penetrating from a location within a natural or man-made body lumen within the body of a human or animal subject to a target location outside of that body lumen, said method comprising the steps of:

(A) providing a tissue penetrating catheter device that comprises i) a catheter body having a distal end, ii) a tissue penetrator that is advanceable from the catheter body and iii) at least one magnetic resonance apparatus that sends signals to a magnetic resonance imaging system adapted to use said signals to provide an indication of the current position of said at least one magnetic resonance apparatus;

(B) inserting the tissue penetrating catheter into the subject'"'"'s body;

(C) causing a magnetic resonance imaging system to receive signals from said at least one magnetic resonance apparatus and to provide, in response to the received signals, an indication of the current position of the at least one magnetic resonance apparatus within the subject'"'"'s body;

(D) using the indication of the current position of the at least one magnetic resonance apparatus within the subject'"'"'s body to guide the tissue penetrating catheter to a position within said body lumen near the target location, and

(E) advancing the tissue penetrator from the tissue penetrating catheter to the target location.

33. A method according to claim 32 wherein, in Step D, the tissue penetrating catheter is advanced to a location in a body lumen that is surrounded by a vessel wall.

34. A method according to claim 33 wherein the target location is within the vessel wall.

35. A method according to claim 34 wherein the vessel wall is a blood vessel wall that comprises an intima, a media and an adventitia, wherein the target location is outside of the intima.

36. A method according to claim 35 wherein the target location is within the media.

37. A method according to claim 35 wherein the target location is within the adventitia.

38. A method according to claim 33 wherein the target location is outside of the vessel wall.

39. A method according to claim 38 wherein the target location is within a mass of anatomic or pathologic tissue.

40. A method according to claim 39 wherein the target location is within the myocardium.

41. A method according to claim 39 wherein the target location is within an organ.

42. A method according to claim 39 wherein the target location is within a pathological lesion.

43. A method according to claim 42 wherein the pathological lesion comprises a tumor.

50. A method according to claim 32 wherein the tissue penetrator comprises a penetration member having a lumen through which a substance, article or device may be delivered and wherein the method further comprises the step of:

(F) delivering a substance, article or device through the lumen of the penetration member.

44. A method according to claim wherein the target location is within another body lumen.

45. A method according to claim 44 wherein the tissue penetrating catheter is positioned in the lumen of a first blood vessel and the penetrator is advanced to a target location within the lumen of a second blood vessel.

46. A method according to claim 44 wherein the tissue penetrating catheter is positioned at a first location within the lumen of a blood vessel and the penetrator is advanced to a target location elsewhere within the lumen of that same blood vessel.

47. A method according to claim 44 wherein the tissue penetrating catheter is positioned in the lumen of a blood vessel and the penetrator is advanced to a target location within a chamber of the heart.

48. A method according to claim 47 wherein the penetrating catheter is positioned in the lumen of a coronary vein and the penetrator is advanced to a location within a ventricle of the heart.

49. A method according to claim 47 wherein the penetrating catheter is positioned in the lumen of a coronary artery and the penetrator is advanced to a location within a ventricle of the heart.