Lead Tracking and Positioning System and Method

• US 20110160568A1
• Filed: 12/30/2009
• Published: 06/30/2011
• Est. Priority Date: 12/30/2009
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Hegland, Michael, Falkner, Phillip, Seeley, Dale F.
• Granted Patent: US 9,320,571 B2
• Time in Patent Office: Days
• US Class Current: 600/424
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2034/2072 Reference field transducer attached to an instrument or patient
• CPC Class Codes: A61B 2090/0811 for the position of a particular part of an instrument with respect to the rest of the instrument, e.g. position of the anvil of a stapling instrument
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis

Abstract

Image data can be obtained with an imaging device. A location of the imaging device relative to a subject can be determined. A location of an instrument can be tracked relative to the subject using a tracking system. Also, the tracked location of the instrument can be illustrated relative to the image data.

Claims

1. A lead placement system for placing a lead in a subject, comprising:

a stylet including a stylet tube formed by a stylet wall encompassing a stylet internal volume, the stylet tube having a stylet body extending along a first axis between a stylet proximal end and a curved portion, the stylet tube further having an angled portion extending along a second axis from the curved portion to a stylet distal end;

a first tracking device positioned within the angled portion of the stylet internal volume of the stylet tube; and

a second tracking device positioned proximal to the curved portion within the stylet internal volume of the stylet tube;

wherein the stylet is operable to be positioned within a lead internal volume of the lead to move the lead into the subject.

2. The lead placement system of claim 1, further comprising:

a third tracking device positioned within the stylet internal volume and proximal to the second tracking device.

3. The lead placement system of claim 2, further comprising:

the lead, where the lead includes a lead wall extending along a longitudinal lead axis and defining the internal lead volume that is open;

a lead electrode;

wherein the stylet is positioned within the internal lead volume and the third tracking device is positioned at the lead electrode when the stylet is within the lead.

4. The lead placement system of claim 3, further comprising:

a tracking system associated with a processor system;

wherein the tracking system is operable to track all of the first tracking device, the second tracking device, and the third tracking device;

wherein the processor system associated with the tracking system is operable to determine a direction of the angled portion of the stylet relative to the stylet body.

5. The lead placement system of claim 4, further comprising:

a display device operable to display an icon representing at least one of the first tracking device, the second tracking device, the third tracking device, the lead, and an icon representing the orientation of the angled portion of the stylet relative to the stylet body.

6. The lead placement system of claim 2, wherein all of the first tracking device, the second tracking device, and the third tracking device are fixed within the stylet tube at selected positions.

7. The lead placement system of claim 6, wherein the first tracking device, the second tracking device, or the third tracking device are adhered within the stylet tube with an adhesive.

8. A lead placement system for placing a lead in a subject, comprising:

a trackable stylet including a stylet tube formed by a stylet wall encompassing a stylet internal volume, the stylet tube having a stylet body extending along a first axis between a stylet proximal end and a curved portion, the stylet tube further having an angled portion extending along a second axis from the curved portion to a stylet distal end;

a tracking system including;

a first tracking device positioned within the stylet internal volume in the angled portion;

a second tracking device positioned within the stylet internal volume proximal the curved portion of the stylet tube; and

a third tracking device positioned within the stylet internal volume and proximal to the second tracking device in the stylet body;

wherein a position of all of the first tracking device, the second tracking device, and the third tracking device is operable to be determined;

a lead that includes a lead wall extending along a longitudinal lead axis and defining an lead internal volume, wherein the trackable stylet is positioned within the lead internal volume and the third tracking device is positioned equivalent with an end of the lead; and

a display device operable to display an image and an icon representing a location of at least a portion of the trackable stylet, the lead, or combinations thereof;

wherein the trackable stylet is operable to be positioned within the lead internal volume of the lead to move the lead into the subject.

9. The lead placement system of claim 8, wherein the trackable stylet includes a first outer diameter defined by an external surface of the stylet wall and the lead has an inner diameter defined by an internal surface of the lead wall;

wherein a clearance between the outer diameter of the stylet wall and the inner diameter of the lead wall is about 0.01 mm to about 0.02 mm.

10. The lead placement system of claim 8, wherein the first axis is angled about 25 degrees to about 35 degrees relative to the second axis.

11. The lead placement system of claim 8, wherein the tracking system is an electromagnetic tracking system and includes:

an electromagnetic field generating localizer;

wherein each of the first tracking device, the second tracking device, and the third tracking device include a coil operable to sense the electromagnetic field generated by the electromagnetic localizer.

12. The lead placement system of claim 11, wherein each of the first tracking device, the second tracking device and the third tracking device includes a plurality of coils positioned at an angle relative to one another.

13. The lead placement system of claim 11, wherein each of the first tracking device, the second tracking device, and the third tracking device includes a conductive wire coil formed around an elongated magnetic permeable core.

14. The lead placement system of claim 8, further comprising:

a navigation system processor;

wherein the navigation system processor is operable to receive tracking information from the tracking system and determine the appropriate location of the icon relative to the image on the display device.

15. A method of placing a lead in a subject, comprising:

positioning a trackable stylet including a stylet tube formed by a stylet wall encompassing an stylet internal volume, the stylet tube having a stylet body extending along a first axis between a stylet proximal end and a curved portion, the stylet tube further having an angled portion extending along a second axis from the curved portion to a stylet distal end;

tracking a first tracking device positioned within the stylet internal volume at an angled portion of the trackable stylet that is distal to the curved portion of the trackable stylet;

tracking a second tracking device positioned within the stylet internal volume positioned in a stylet body proximal to the curved portion of the trackable stylet;

moving the lead within a subject; and

displaying an icon representing a position of at least one of the trackable stylet and the lead.

16. The method of claim 15, further comprising:

displaying a location of a proximal lead electrode.

17. The method of claim 16, further comprising:

tracking a third tracking device positioned within the internal stylet volume and proximal to the second tracking device;

wherein the third tracking device is substantially equivalent with the proximal electrode to determine a location of the proximal electrode.

18. The method of claim 15, further comprising:

pushing the stylet to move the lead within the subject;

wherein the stylet is formed of a material with a selected rigidity to allow a force to be transferred to the stylet then to the lead to move the lead within the subject.

19. The method of claim 18, wherein pushing the stylet includes moving the stylet along a path that is defined by the angled portion of the trackable stylet relative to the stylet body;

wherein the angled portion of the stylet is at a distal end of the stylet and the angled portion of the stylet interacts with the subject to direct movement of the lead and stylet within the subject.

20. The method of claim 15, further comprising:

adhering the first tracking device and the second tracking device within the stylet internal volume by adhering each of the first tracking device and the second tracking device to an internal stylet wall surface of the stylet wall.

21. The method of claim 15, wherein tracking a first tracking device and tracking a second tracking device includes generating an electromagnetic field within a subject and sensing the electromagnetic field with the first tracking device and the second tracking device;

and

determining a position of the first tracking device and the second tracking device within the electromagnetic field.