Image-Guided Navigation for Catheter-Based Interventions

• US 20070276216A1
• Filed: 08/16/2005
• Published: 11/29/2007
• Est. Priority Date: 08/16/2004
• Status: Active Grant

• Current Assignee: Corindus, Inc. (Siemens AG)
• Original Assignee: Corindus, Inc. (Siemens AG)
• Inventors: Wenderow, Tal, Beyar, Refael
• Granted Patent: US 8,600,477 B2
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/463 characterised by displaying multiple images or images and diagnostic data on one display
• CPC Class Codes: A61B 6/481 involving the use of contrast agents
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal

Abstract

A navigation system for catheter-based interventions, the system comprising a processing device; an angiogram x-ray system connected by data transfer connection to the processing device and capable of capturing angiographic images of a patient; an electrocardiogram monitoring device that is also connected by data transfer connection to the processing device and to the x-ray system; a medical instrument to be inserted into the area of the patient captured by the angiographic image; a position capture module for getting position information about the position of the medical instrument, the unit connected by data transfer connection to the processing device, wherein the processing device is capable of triggering the capturing of the angiographic images as a roadmap and superimposing on the roadmap the position information about the medical instrument.

Claims

1. A navigation system for catheter-based interventions, the system comprising:

a processing device;

an angiogram x-ray system connected by data transfer connection to the processing device and capable of capturing angiographic images of a patient;

an electrocardiogram monitoring device that is also connected by data transfer connection to the processing device and to the x-ray system;

a medical instrument to be inserted into the area of the patient captured by the angiographic image;

a position capture module for getting position information about the position of the medical instrument, the unit connected by data transfer connection to the processing device,

wherein the processing device is capable of triggering the capturing of the angiographic images as a roadmap and superimposing on the roadmap the position information about the medical instrument.

2. The system of claim 1 wherein the medical instrument is selected from a group comprising:

guidewire, balloon, stent and catheter.

3. The system of claim 1 wherein the position capture module is incorporated with the angiogram x-ray system adapted to be triggered periodically by the electrocardiogram monitoring device.

4. The system of claim 1 wherein the position capture module comprises a sensor integrated into the medical instrument and a detector for reading the sensor position.

5. The system of claim 1 wherein the position capture module comprises at least one magnet integrated into the medical instrument and a detector for detecting magnetic field of said at least one magnet.

6. The system of claim 1 further comprising a remote manipulation system for performing insertion of the medical instrument, the remote manipulation system comprising:

an attachment unit for attachment to the medical instrument, and

a manipulating unit for manipulating the medical instrument.

7. The system of claim 6 wherein the remote manipulation system operates in a closed loop, the remote manipulation system further comprising:

a desired position module for receiving a path to a desired target position from a user,

a comparator module that compares the actual position of the medical instrument with the desired path position, and

a correction module for correcting the medical instrument position.

8. A navigation method for catheter-based interventions, the method comprising:

selecting an angiographic x-ray image, wherein a lesion is most apparent, to serve as a roadmap image,

inserting a medical instrument into an artery leading to the lesion,

capturing progress of the medical instrument by retrieving angiographic x-ray images,

displaying the captured progress of the medical instrument superimposed on the roadmap image, and

manipulating the instrument according to the captured progress to reach the target lesion.

9. The method of claim 8 wherein capturing progress of the medical instrument by retrieving angiographic x-ray images is done occasionally.

10. The method of claim 8 wherein capturing progress of the medical instrument by retrieving angiographic x-ray images is done periodically.

11. The method of claim 10, wherein the period is chosen to be the diastole.

12. The method of claim 8 wherein the inserting of the instrument is done using a remote manipulation system.

13. The method of claim 8, wherein the road map is updated occasionally.

14. An automated navigation method for catheter-based interventions, the method comprising:

selecting an angiographic x-ray image, wherein a lesion is most apparent, to serve as a roadmap image,

tracing a desired path to the lesion,

inserting a medical instrument into an artery leading to the lesion,

capturing progress of the medical instrument by retrieving angiographic x-ray images

comparing the captured position of the instrument with a desired position along the desired path and determining an error if it exists;

if the error is greater than a predefined threshold, correcting the instrument position;

continuing with comparing and correcting until the instrument reaches a desired position.

15. The method of claim 14 further comprising manipulating the instrument to overcome an obstacle further by:

detecting the direction of the instrument,

determining an optimal degree of rotation for the instrument to overcome the obstacle, and

rotating the instrument at the determined optimal degree of rotation.