Imaging and tools for use with moving organs

• US 20080221440A1
• Filed: 03/10/2008
• Published: 09/11/2008
• Est. Priority Date: 03/08/2007
• Status: Abandoned Application

• Current Assignee: Sync-Rx, Ltd. (Koninklijke Philips N.V.)
• Original Assignee: Sync-Rx, Ltd. (Koninklijke Philips N.V.)
• Inventors: Iddan, Gavriel, Tolkowsky, David
• Application Number:
  US12/075,252
• Publication Number:
  US 20080221440A1
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/00252 for by-pass connections, i.e. connections from heart chamber to blood vessel or from blood vessel to blood vessel
• CPC Class Codes: A61B 2017/00694 with means correcting for movement of or for synchronisation with the body
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• CPC Class Codes: A61B 2017/22044 with a pointed tip
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2090/3735 Optical coherence tomography [OCT]
• CPC Class Codes: A61B 2090/3762 using computed tomography systems [CT]
• CPC Class Codes: A61B 2090/3782 transmitter or receiver in catheter or minimal invasive instrument
• CPC Class Codes: A61B 2576/02 specially adapted for a particular organ or body part
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/7289 Retrospective gating, i.e. associating measured signals or images with a physiological event after the actual measurement or image acquisition, e.g. by simultaneously recording an additional physiological signal during the measurement or image acquisition
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/503 for diagnosis of the heart
• CPC Class Codes: A61B 6/504 for diagnosis of blood vessels, e.g. by angiography
• CPC Class Codes: A61B 6/5217 extracting a diagnostic or physiological parameter from medical diagnostic data
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/0883 : for diagnosis of the heart
• CPC Class Codes: A61B 8/0891 : for diagnosis of blood vessels
• CPC Class Codes: A61B 8/543 : involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: A61M 2210/12 : Blood circulatory system
• CPC Class Codes: A61M 5/007 : for contrast media
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

Apparatus is described for use with a portion of a subject'"'"'s body that moves as a result of cyclic activity of a body system. An imaging device acquires a plurality of image frames of the portion. A sensor senses a phase of the cyclic activity. A medical tool performs a function with respect to the portion. A control unit generates a stabilized set of image frames of the medical tool disposed within the portion, actuates the tool to perform the function or move, in response to the sensor sensing that the cyclic activity is at a given phase thereof, and inhibits the tool from performing the action or moving in response to the sensor sensing that the cyclic activity is not at the given phase. A display facilitates use of the tool by displaying the stabilized set of image frames. Other embodiments are also described.

Claims

1. Apparatus for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the apparatus comprising:

an imaging device for acquiring a plurality of image frames of the portion of the subject'"'"'s body;

a sensor for sensing a phase of the cyclic activity;

a medical tool configured to perform a function with respect to the portion of the subject'"'"'s body;

a control unit configured to;

generate a stabilized set of image frames of the medical tool disposed within the portion of the subject'"'"'s body,

actuate the tool to execute an action selected from the group consisting of performing the function and moving, in response to the sensor sensing that the cyclic activity is at a given phase thereof, and

inhibit the tool from executing the action in response to the sensor sensing that the cyclic activity is not at the given phase; and

a display configured to facilitate use of the tool by displaying the stabilized set of image frames of the medical tool disposed within the portion of the subject'"'"'s body.

2. The apparatus according to claim 1, further comprising a user interface, wherein the control unit is configured to receive an input from a user, via the user interface, and to designate the given phase in response to the input.

3. The apparatus according to claim 1, wherein the tool comprises a valve configured to be implanted within the portion of the subject'"'"'s body by being expanded within the portion, and wherein the control unit is configured to actuate the valve by expanding the valve.

4. The apparatus according to claim 1, wherein the tool comprises a septal-closure device configured to be implanted within the portion of the subject'"'"'s body by being expanded within the portion, and wherein the control unit is configured to actuate the septal-closure device by expanding the septal closure device.

5. The apparatus according to claim 1, wherein the tool comprises a balloon configured to perform the function by being inflated inside a lumen of the portion of the subject'"'"'s body.

6. The apparatus according to claim 1, wherein the tool comprises a tubular structure configured to bypass an occlusion of a blood vessel within the portion of the subject'"'"'s body.

7. The apparatus according to claim 1, wherein the tool comprises a myocardial revascularization tool configured to sequentially apply a revascularization treatment to respective treatment sites within the portion of the subject'"'"'s body, wherein the control unit is configured to:

actuate the tool to perform the function by actuating the tool to apply a revascularization treatment to a treatment site, and

move the tool by moving at least a portion of the revascularization tool toward successive treatment sites.

8. The apparatus according to claim 1, wherein the tool comprises an ablation tool configured to sequentially ablate respective ablation sites within the portion of the subject'"'"'s body, wherein the control unit is configured to:

actuate the tool to perform the function by actuating the tool to ablate an ablation site, and

move the tool by moving at least a portion of the ablation tool toward successive ablation sites.

9. The apparatus according to claim 1, wherein the tool comprises an injection tool configured to inject a substance within the portion of the subject'"'"'s body and wherein the control unit is configured to:

actuate the tool to perform the function by actuating the tool to inject the substance, and

move the tool by moving at least a portion of the tool toward an injection site.

10. The apparatus according to claim 1, wherein the tool comprises a needle configured to suture tissue within the portion of the subject'"'"'s body, and wherein the control unit is configured to:

actuate the tool to perform the function by actuating the tool to suture the tissue, and

move the tool by moving the needle toward successive suturing sites.

11. The apparatus according to claim 1, wherein the tool comprises a needle configured to aspirate tissue from an aspiration site within the portion of the subject'"'"'s body, and wherein the control unit is configured to:

actuate the needle to perform the function by actuating the needle to aspirate the tissue, and

move the needle by moving the needle toward the aspiration site.

12. The apparatus according to claim 1, wherein the tool comprises an occlusion-opening tool configured to perform the function by performing an occlusion-opening action on an at least partial occlusion of a lumen of the portion of the subject'"'"'s body.

13. The apparatus according to claim 12, wherein the tool is configured to perform the occlusion-opening action by moving toward the occlusion, and wherein after actuating the tool at the given phase of a first cycle and before the actuation of the tool at the given phase of a subsequent cycle, the control unit is configured to retract the tool from the occlusion.

14. The apparatus according to claim 1, wherein the control unit is configured to generate the stabilized set of image frames by image tracking at least some of the plurality of image frames to reduce imaged motion of the portion of the subject'"'"'s body associated with the cyclic activity.

15. The apparatus according to claim 14, wherein the control unit is configured to generate the stabilized set of image frames by generating a set of tracked image frames corresponding to image frames of the portion acquired during the given phase.

16. The apparatus according to claim 1, wherein the control unit is configured to generate the stabilized set of image frames by generating a set of the image frames corresponding to image frames of the portion acquired during the given phase.

17. The apparatus according to claim 16, wherein the control unit is configured to reduce imaged motion of the portion of the subject'"'"'s body associated with motion of the portion of the subject'"'"'s body by image tracking the set of image frames.

18. The apparatus according to claim 16, wherein the control unit is configured to generate the set of image frames corresponding to image frames of the portion acquired during the given phase, by actuating the imaging device to acquire the plurality of image frames only when the cyclic activity is at the given phase.

19. The apparatus according to claim 16, wherein the imaging device is configured to acquire the plurality of image frames throughout the cyclic activity, and wherein the control unit is configured to generate the set of image frames corresponding to image frames of the portion acquired during the given phase by selecting image frames corresponding to image frames of the portion acquired during the given phase from the plurality of image frames.

20. The apparatus according to claim 16, wherein the control unit is configured to generate an additional stabilized set of image frames of the portion of the subject'"'"'s body, by identifying a further given phase of the cyclic activity of the body system, and generating a set of the image frames corresponding to image frames of the portion acquired during the further given phase.

21. The apparatus according to claim 1, wherein the cyclic activity includes a cardiac cycle of the subject, and wherein the sensor comprises a sensor for sensing a phase of the subject'"'"'s cardiac cycle.

22. The apparatus according to claim 21, wherein the given phase includes an end-diastolic phase of the subject'"'"'s cardiac cycle, and wherein the control unit is configured to generate a stabilized set of the image frames corresponding to image frames of the portion acquired during the end-diastolic phase of the subject'"'"'s cardiac cycle.

23. The apparatus according to claim 21, wherein the sensor comprises an image processor configured to sense movement of the portion of the subject'"'"'s body by comparing image frames of the plurality of image frames to at least one of the plurality of image frames.

24. The apparatus according to claim 1, wherein the cyclic activity includes a respiratory cycle of the subject, and wherein the sensor comprises a sensor for sensing a phase of the subject'"'"'s respiratory cycle.

25. The apparatus according to claim 24, wherein the sensor comprises an image processor configured to sense movement of the portion of the subject'"'"'s body by comparing image frames of the plurality of image frames to at least one of the plurality of image frames.

26. The apparatus according to claim 1, further comprising an instrument configured to be operated by a user, wherein the control unit is configured to actuate the tool to perform the function, (a) in response to the sensor sensing that the cyclic activity is at the given phase thereof, and (b) in response to the instrument being operated by the user.

27. The apparatus according to claim 26, wherein the instrument is configured to provide force feedback to the user that is independent of the cyclic activity.

28. The apparatus according to claim 26, wherein the instrument is configured to provide force feedback to the user that is smoothened with respect to the cyclic activity.

29. A method for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the method comprising:

inserting a medical tool into the portion of the subject'"'"'s body, the tool being configured to perform a function;

acquiring a plurality of image frames of the tool disposed within the portion of the subject'"'"'s body;

sensing a phase of the cyclic activity;

displaying a stabilized set of image frames of the tool disposed within the portion of the subject'"'"'s body;

facilitated by the displaying of the stabilized set of image frames, actuating the tool to execute an action selected from the group consisting of;

performing the function and moving, in response to sensing that the cyclic activity is at a given phase thereof, and

inhibiting the tool from executing the action in response to sensing that the cyclic activity is not at the given phase thereof.

30. The method according to claim 29, wherein the tool includes a valve configured to be implanted within the portion of the subject'"'"'s body by being expanded within the portion, and wherein actuating the tool to perform the function comprises expanding the valve.

31. The method according to claim 29, wherein the tool includes a septal-closure device configured to be implanted within the portion of the subject'"'"'s body by being expanded within the portion, and wherein actuating the tool to perform the function comprises expanding the septal-closure device.

32. The method according to claim 29, wherein actuating the tool to perform the function comprises actuating a balloon to be inflated inside a lumen of the portion of the subject'"'"'s body.

33. The method according to claim 29, wherein moving the tool comprises moving a tubular structure configured to bypass an occlusion of a blood vessel within the portion of the subject'"'"'s body.

34. The method according to claim 29,

wherein the tool includes a myocardial revascularization tool configured to sequentially apply a revascularization treatment to respective treatment sites within the portion of the subject'"'"'s body,

wherein actuating the tool to perform the function comprises actuating the tool to apply a revascularization treatment to a treatment site, and

wherein moving the tool comprises moving at least a portion of the revascularization tool toward successive treatment sites.

35. The method according to claim 29,

wherein the tool includes an ablation tool configured to sequentially ablate respective ablation sites within the portion of the subject'"'"'s body,

wherein actuating the tool to perform the function comprises actuating the tool to ablate an ablation site, and

wherein moving the tool comprises moving at least a portion of the ablation tool toward successive ablation sites.

36. The method according to claim 29,

wherein the tool includes an injection tool configured to inject a substance within the portion of the subject'"'"'s body,

wherein actuating the tool to perform the function comprises actuating the tool to inject the substance, and

wherein moving the tool comprises moving at least a portion of the tool toward an injection site.

37. The method according to claim 29,

wherein the tool includes a needle configured to suture tissue within the portion of the subject'"'"'s body,

wherein actuating the tool to perform the function comprises actuating the tool to suture the tissue, and

wherein moving the tool comprises moving the needle toward successive suturing sites.

38. The method according to claim 29,

wherein the tool includes a needle configured to aspirate tissue from an aspiration site within the portion of the subject'"'"'s body,

wherein actuating the tool to perform the function comprises actuating the needle to aspirate the tissue, and

wherein moving the tool comprises moving the needle toward the aspiration site.

39. The method according to claim 29, wherein actuating the tool to perform the function comprises actuating an occlusion-opening tool to perform an occlusion-opening action on an at least partial occlusion of a lumen of the portion of the subject'"'"'s body.

40. The method according to claim 39, wherein actuating the tool to perform the occlusion-opening action comprises moving the tool toward the occlusion, and wherein the method further comprises retracting the tool from the occlusion after actuating the tool at the given phase of a first cycle and before the actuation of the tool at the given phase of a subsequent cycle.

41. The method according to claim 29, wherein displaying the stabilized set of image frames comprises image tracking at least some of the plurality of image frames to reduce imaged motion of the portion of the subject'"'"'s body associated with the cyclic activity.

42. The method according to claim 41, wherein displaying the stabilized set of image frames further comprises generating a set of tracked image frames corresponding to image frames of the portion acquired during the given phase.

43. The method according to claim 29, wherein displaying the stabilized set of image frames comprises displaying a set of the image frames corresponding to image frames of the portion acquired during the given phase.

44. The method according to claim 43, wherein displaying the stabilized set of image frames further comprises image tracking the set of image frames to reduce imaged motion of the portion of the subject'"'"'s body associated with motion of the portion of the subject'"'"'s body.

45. The method according to claim 43, wherein acquiring the plurality of image frames comprises acquiring the plurality of image frames only when the cyclic activity is at the given phase, and wherein displaying the set of image frames comprises displaying the plurality of acquired image frames.

46. The method according to claim 43, wherein acquiring the plurality of image frames comprises acquiring the plurality of image frames throughout the cyclic activity, and wherein displaying the set of image frames comprises selecting image frames corresponding to image frames of the portion acquired during the given phase from the plurality of image frames.

47. The method according to claim 43, further comprising displaying an additional set of stabilized images by sensing a further given phase of the cyclic activity of the body system, and displaying a set of the image frames corresponding to image frames of the portion acquired during the further given phase.

48. The method according to claim 29, wherein the cyclic activity includes a cardiac cycle of the subject, and wherein sensing the phase comprises sensing a phase of the subject'"'"'s cardiac cycle.

49. The method according to claim 48, wherein the given phase includes an end-diastolic phase of the subject'"'"'s cardiac cycle, and wherein sensing the phase comprises sensing the end-diastolic phase of the subject'"'"'s cardiac cycle.

50. The method according to claim 48, wherein sensing the given phase comprises comparing image frames of the plurality of image frames to at least one of the plurality of image frames.

51. The method according to claim 29, wherein the cyclic activity includes a respiratory cycle of the subject, and wherein sensing the phase comprises sensing a phase of the subject'"'"'s respiratory cycle.

52. The method according to claim 51, wherein sensing the given phase comprises comparing image frames of the plurality of image frames to at least one of the plurality of image frames.

53. The method according to claim 29, wherein actuating the tool to execute the action comprises actuating the tool to execute the action (a) in response to sensing that the cyclic activity is at the given phase thereof, and (b) in response to an instrument being operated by a user.

54. The method according to claim 53, further comprising providing force feedback to the user that is independent of the cyclic activity.

55. The method according to claim 53, further comprising providing force feedback to the user that is smoothened with respect to the cyclic activity.

56. Apparatus for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, and for use with an imaging device for acquiring a plurality of image frames of the portion of the subject'"'"'s body, a sensor for sensing a phase of the cyclic activity, a medical tool configured to perform a function with respect to the portion of the subject'"'"'s body, and a display configured to facilitate use of the tool by displaying image frames of the portion of the subject'"'"'s body, the apparatus comprising:

a control unit configured to;

generate a stabilized set of image frames of the portion of the subject'"'"'s body,

output the stabilized set of image frames to the display,

actuate the tool to perform the function in response to the sensor sensing that the cyclic activity is at a given phase of the cyclic activity, and

inhibit the tool from performing the function in response to the sensor sensing that the cyclic activity is not at the given phase.

57. Apparatus for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the apparatus comprising:

an imaging device for acquiring a plurality of image frames of the portion of the subject'"'"'s body;

a sensor for sensing a phase of the cyclic activity;

a medical tool configured to mechanically perform an action during a single cycle of the cyclic activity with respect to the portion of the subject'"'"'s body; and

a control unit configured to;

generate a stabilized set of image frames of the portion of the subject'"'"'s body, and

actuate the tool to mechanically perform the action in response to the sensor sensing that the cyclic activity is at a given phase thereof.

58. The apparatus according to claim 57, wherein the control unit is configured to generate the stabilized set of image frames by generating a set of image frames that are stabilized with respect to the given phase of the cyclic activity.

59. The apparatus according to claim 57, wherein the tool comprises a balloon configured to apposition itself to a lumen of the portion of the subject'"'"'s body during a single cycle by being inflated, in response to the sensor sensing that the cyclic activity is at the given phase thereof.

60. The apparatus according to claim 57, wherein the tool comprises a stent configured to be implanted by being expanded inside a lumen of the portion of the subject'"'"'s body during a single cycle of the cyclic activity, in response to the sensor sensing that the cyclic activity is at the given phase thereof.

61. The apparatus according to claim 57, wherein the tool comprises a valve configured to be implanted within the portion of the subject'"'"'s body by mechanically expanding within the portion during a single cycle of the cyclic activity, in response to the sensor sensing that the cyclic activity is at the given phase thereof.

62. The apparatus according to claim 57, wherein the tool comprises a septal-closure device configured to be implanted within a heart of the subject by mechanically expanding within the heart during a single cycle of cardiac cyclic activity of the subject, in response to the sensor sensing that the cyclic activity is at the given phase thereof.

63. A method for use with a portion of a body of a subject that moves as a result of cyclic activity of a body system of the subject, the method comprising:

acquiring a plurality of image frames of the portion of the subject'"'"'s body;

sensing a phase of the cyclic activity;

generating a stabilized set of image frames of the portion of the subject'"'"'s body; and

actuating a tool to mechanically perform an action during a single cycle of the cyclic activity, in response to sensing that the cyclic activity is at a given phase thereof.

64. The method according to claim 63, wherein generating the stabilized set of image frames comprises generating a set of image frames that are stabilized with respect to the given phase of the cyclic activity.

65. The method according to claim 63, wherein the tool includes a balloon, and wherein actuating the balloon comprises actuating the balloon to apposition itself to a lumen of the portion of the subject'"'"'s body during a single cycle by being inflated in response to sensing that the cyclic activity is at the given phase thereof.

66. The method according to claim 63, wherein the tool includes a stent, and wherein actuating the stent comprises implanting the stent by expanding the stent inside a lumen of the portion of the subject'"'"'s body during a single cycle of the cyclic activity, in response to sensing that the cyclic activity is at the given phase thereof.

67. The method according to claim 63, wherein the tool includes a valve, and wherein actuating the valve comprises implanting the valve by expanding the valve inside a lumen of the portion of the subject'"'"'s body during a single cycle of the cyclic activity, in response to sensing that the cyclic activity is at the given phase thereof.

68. The method according to claim 63, wherein the tool includes a septal-closure device, and wherein actuating the septal-closure device comprises implanting the septal-closure device within a heart of the subject by expanding the septal-closure device inside the subject'"'"'s heart during a single cycle of the cyclic activity, in response to sensing that the cyclic activity is at the given phase thereof.