Bodily sealants and methods and apparatus for image-guided delivery of same

• US 8,150,495 B2
• Filed: 11/07/2008
• Issued: 04/03/2012
• Est. Priority Date: 08/11/2003
• Status: Active Grant

• Current Assignee: Veran Medical Technologies, Inc. (Olympus Corporation)
• Original Assignee: Veran Medical Technologies, Inc. (Olympus Corporation)
• Inventors: Edwards, Jerome R., Lee, Christopher B., Holsing, Troy L., Lyon, Torsten M.
• Primary Examiner(s): Cheng, Jacqueline
• Application Number:
  US12/267,200
• Publication Number:
  US 20090281566A1
• Time in Patent Office: 1,243 Days
• Field of Search: 600/424, 600/414, 600/426
• US Class Current: 600/424
• CPC Class Codes: A61B 17/00491 Surgical glue applicators surgical adhesives A61L24/00; two-component delivery syringes A61M5/19
• CPC Class Codes: A61B 2017/00703 correcting for movement of heart, e.g. ECG-triggered
• 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 2090/3916 Bone tissue
• CPC Class Codes: A61B 2090/3954 magnetic, e.g. NMR or MRI
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/3983 Reference marker arrangements for use with image guided surgery
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• 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 5/062 using magnetic field
• CPC Class Codes: A61B 5/352 Detecting R peaks, e.g. for synchronising diagnostic apparatus; Estimating R-R interval
• CPC Class Codes: A61B 5/7285 for synchronising or triggering a physiological measurement or image acquisition with a physiological event or waveform, e.g. an ECG signal A61B6/5205, A61B6/541, A61B8/5207, A61B8/543 take precedence
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/541 involving acquisition triggered by a physiological signal
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for

Abstract

Generally, systems, methods, and apparatus related to the use of a dynamic imaging modality in an image guided intervention are disclosed herein. More specifically, the use of such modalities in sealing a bodily opening, such as those that may be formed during an invasive medical procedure are disclosed herein. In some embodiments, a method includes viewing a representation of an instrument within a body of a patient, adjusting a position of the instrument based on the viewing such that a portion of the instrument is at a location within the body of the patient, and delivering a sealant via the instrument to the location within the body of the patient. The sealant is configured to seal an opening in the body part.

Claims

1. A method, comprising:

viewing a representation of an instrument within a body of a patient, the representation being superimposed on an image of a plurality of images associated with a cyclical movement of a body part, the image being associated with a match dataset vector (MDV), the MDV being a dataset vector most similar to a current vector that is calculated based on a current position of a first reference marker and a current position of a second reference marker, the second reference marker being depicted in at least one image of the plurality of images;

adjusting a position of the instrument based on the viewing such that a portion of the instrument is at a location within the body of the patient; and

delivering a sealant via the instrument to the location within the body of the patient, the sealant being configured to seal an opening in the body part.

2. The method of claim 1, wherein the viewing includes detecting a representation of a third reference marker, the third reference marker being disposed on the instrument.

3. The method of claim 1, further comprising:

generating the plurality of images using at least one of fluoroscopy, computed tomography, magnetic resonance imaging, positron emission tomography, ultrasound, or optical coherence tomography.

4. The method of claim 1, further comprising:

generating the plurality of images using at least one of a 2-dimensional, 3-dimensional, or 4-dimensional imaging device.

5. The method of claim 1, further comprising:

detecting a first pressure within a portion of the body of the patient proximate to the instrument at a first time; and

detecting a second pressure within a portion of the body of the patient proximate to the instrument at a second time later than the first time, the second pressure being at least a threshold value, the delivering performed when the second pressure is detected.

6. The method of claim 1, wherein the adjusting includes moving the instrument from a first position to a second position different than the first position, further comprising:

detecting a first pressure within a portion of the body of the patient proximate to the instrument at its first position; and

detecting a second pressure within a portion of the body of the patient proximate to the instrument at its second position different than the first position, the second pressure being at least a threshold value, the delivering performed when the second pressure is detected.

7. The method of claim 1, wherein the delivering includes disposing at least a portion of the sealant on an interior surface of the body part.

8. The method of claim 1, wherein the delivering includes:

exposing a coating disposed on an outer surface of a portion of the instrument to a bodily fluid, the coating including the sealant, at least one of the coating or the sealant having a first physical state prior to the exposing and a second physical state different than the first physical state after the exposing; and

placing the coating in contact with the body part having cyclical movement.

9. The method of claim 1, wherein the delivering includes releasing a seal member from the instrument to the body part having cyclical movement, the seal member includes a substrate, the sealant disposed on a portion of the substrate.

10. The method of claim 1, wherein the delivering includes moving a seal member from a first configuration to a second configuration, the seal member being collapsed and at least partially disposed within a portion of the instrument when the seal member is in its first configuration, the seal member being expanded and at least partially disposed outside of the portion of the instrument when the seal member is in its second configuration.

11. The method of claim 1, wherein the delivering includes moving a protrusion of a delivery mechanism of the instrument from a first position to a second position, the protrusion being extended from the delivery mechanism at a first angle when the protrusion is in its first position, the protrusion being extended from the delivery mechanism at a second angle when the protrusion is in its second position, the second angle greater than the first angle.

12. The method of claim 1, wherein the delivering includes moving a first shaft of the instrument with respect to a second shaft of the instrument to place an opening defined by the first shaft in fluid communication with an opening defined by the second shaft.

13. The method of claim 1, wherein the sealant is configured to form a seal between a portion of the instrument and the body part defining the opening.

14. The method of claim 1, wherein the sealant includes at least one of thrombin, fibrinogen, a cyanocrylate, collagen, a cross-linker, an aldehyde, or a hydrogel.