Measurement confirmation devices and methods for fluoroscopically directed surgery

• US 6,097,978 A
• Filed: 07/03/1997
• Issued: 08/01/2000
• Est. Priority Date: 07/03/1997
• Status: Expired due to Fees

• Current Assignee: Medtronic Ave Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Demarais, Denise M., Davis, Glen R., Zarins, Sascha K., Evans, Michael A., Will, Allan R.
• Primary Examiner(s): Casler, Brian L.
• Application Number:
  US08/887,550
• Time in Patent Office: 1,125 Days
• Field of Search: 600/407, 600/429, 600/414, 600/417, 600/426, 378/204, 378/205, 378/163
• US Class Current: 600/429
• CPC Class Codes: A61B 2017/00924 for ultrasonic waves
• CPC Class Codes: A61B 2090/061 for measuring dimensions, e.g. length
• CPC Class Codes: A61B 2090/3925 ultrasonic
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2220/0041 using additional screws, bolts, dowels or rivets, e.g. connecting screws
• CPC Class Codes: A61F 2220/0091 connected by a hinged linkage mechanism, e.g. of the single-bar or multi-bar linkage type
• CPC Class Codes: A61F 2250/0097 Visible markings, e.g. indicia

Abstract

The present invention provides methods and apparatus for measuring and/or marking the internal features of a patient body when those features are viewed under fluoroscopy or another medical imaging modality. Although suitable for the physiological measurement of many body lumens, including the intestines, the urethra, and the like, the present invention will find its most immediate use in the measurement of vascular lesions, particularly vascular aneurysms adjacent the aortoiliac junction and other bifurcations. The positions and bend angles of such branching body lumens can be accurately mapped on a panel which remains outside the patient body. By imaging the patient through the panel, and by providing markings on the panel which give a bright contrast when imaged, the panel provides a guide that highlights the length, position, and geometry of the luminal lesion. The guide may be tailored for the specific bifurcated prosthesis to be deployed, and can also graphically illustrate the safe and effective range of target positions in which to deploy the prosthesis.

Claims

1. A position guide for reference to internal anatomical features of a patient body, the guide comprising:

a panel which defines a reference plane, the panel comprising a radiotranslucent material for imaging of the patient body therethrough;

a first gauge portion supported by the panel, the first gauge portion having radiopaque markings; and

a second gauge portion extending from the first gauge portion, the second gauge portion having radiopaque markings and being movable relative to the first gauge portion along the reference plane;

wherein the markings of the first gauge portion define an axis, and wherein the second gauge portion is laterally deflectable relative to the gauge axis so that the markings of the first and second gauge portions are alignable along axially curving anatomical features; and

wherein said guide further comprises a third gauge portion extending from the first gauge portion, the third gauge portion laterally deflectable relative to the first gauge portion axis independently of the second gauge portion so that the markings of the second gauge portion so that the markings of the second and third gauge portions are alignable along branching anatomical features.

2. A position guide for reference to internal anatomical features of a patient body, the guide comprising:

a panel which defines a reference plane, the panel comprising a radiotranslucent material for imaging of the patient body therethrough;

a first gauge portion supported by the panel, the first gauge portion having radiopaque markings; and

a second gauge portion extending from the first gauge portion, the second gauge portion having radiopaque markings and being movable relative to the first gauge portion along the reference plane;

wherein the markings of the first gauge portion define an axis, and wherein the second gauge portion is laterally deflectable relative to the gauge axis so that the markings of the first and second gauge portions are alignable along axially curving anatomical features; and

wherein the second gauge portion rotatably engages the first gauge portion.

3. A position guide for reference to internal anatomical features of a patient body, the guide comprising:

a panel which defines a reference plane, the panel comprising a radiotranslucent material for imaging of the patient body therethrough;

a first gauge portion supported by the panel, the first gauge portion having radiopaque markings; and

a second gauge portion extending from the first gauge portion, the second gauge portion having radiopaque markings and being movable relative to the first gauge portion along the reference plane;

wherein the first gauge portion is slidable relative to the panel along the reference plane.

4. A position guide for reference to internal anatomical features of a patient body, the guide comprising:

a panel which defines a reference plane, the panel comprising a radiotranslucent material for imaging of the patient body therethrough;

a first gauge portion supported by the panel, the first gauge portion having radiopaque markings; and

a second gauge portion extending from the first gauge portion, the second gauge portion having radiopaque markings and being movable relative to the first gauge portion along the reference plane;

wherein the panel has a major surface which is substantially aligned with the reference plane and disposable adjacent the patient body and said positionguide further comprising a mechanism for moving the second gauge portion relative to the first gauge portion from a minor surface of the panel adjacent the major surface.

5. A fluoroscopic guide for a curving body lumen, the guide comprising:

a panel having a major surface defining a reference plane and an edge adjacent the major surface, the panel comprising a radiotranslucent material;

a first gauge portion supported by the panel, the first gauge portion having radiopaque markings which define an axis;

a second gauge portion extending from the first gauge portion, the second gauge portion having radiopaque markings and being laterally deflectable along the reference plane relative to the axis of the first gauge portion; and

a deflecting mechanism extending from the second gauge portion to the edge of the panel for aligning the markings of the first and second gauge portions along the curving body lumen while the body lumen is imaged through the panel.

6. A curving lumen guide as claimed in claim 5, wherein the first gauge portion is axially slidable relative to the panel.

7. A curving lumen guide as claimed in claim 6, further comprising a third gauge portion extending from the first gauge portion, the third gauge portion having radiopaque markings and being laterally deflectable along the reference plane relative to the axis of the first gauge portion independently of the second gauge portion.

8. A curving lumen guide as claimed in claim 7, wherein the deflecting mechanism comprises a first mechanical linkage extending between second gauge portion and the edge, a second mechanical linkage for axially sliding the first gauge portion and a third mechanical linkage for axial aligning the markings of the third gauge portions along the curving body lumen.

9. A curving lumen guide as claimed in claim 7, wherein the markings of the gauge portions comprise acceptable position ranges for positioning ends of a bifurcated endoluminal prosthesis.

10. A method comprising:

imaging a vascular system of a patient body through a panel disposed adjacent the patient body;

aligning markings of a first gauge portion on the panel with a first target site of the vascular system;

aligning markings of a second gauge portion on the panel with a second target site of the vascular system, wherein a vascular axis at the first target site is disposed at an angle relative to a vascular axis at the second target site, and wherein the markings of the first and second gauge portions substantially indicate an axial length along the vascular system between the first and second target sites.

11. A method as claimed in claim 10, further comprising aligning markings of a third gauge portion on the panel with a third target site of the vascular system which is disposed at an angle relative to the first target site so that the markings of the first and third gauge portions indicate an axial length along the vascular system between the first and third target sites.

12. A method as claimed in claim 11, further comprising deploying a branching endoluminal prosthesis between the first, second, and third sites while imaging the vascular system through the panel, the first site being disposed along a trunk vessel and the second and third sites being disposed along branch vessels off the trunk vessel.

13. A position guide for reference to internal anatomical features of a patient body, the guide comprising:

a panel which defines a reference plane, the panel comprising a radiotranslucent material for imaging of the patient body therethrough;

a first gauge portion supported by the panel, the first gauge portion having radiopaque markings;

a second gauge portion extending from the first gauge portion, the second gauge portion having radiopaque markings and being movable relative to the first gauge portion along the reference plane; and

a parallax indicator having a first radiopaque marker at a first distance from the reference plane and a second radiopaque marker at a second distance from the reference plane.