Pre-deployment positioning of an implantable device within a moving organ

• US 9,308,052 B2
• Filed: 12/30/2009
• Issued: 04/12/2016
• Est. Priority Date: 03/08/2007
• Status: Active Grant

• Current Assignee: Sync-Rx, Ltd. (Koninklijke Philips N.V.)
• Original Assignee: Sync-Rx, Ltd. (Koninklijke Philips N.V.)
• Inventors: Tolkowsky, David
• Primary Examiner(s): Brutus, Joel F
• Application Number:
  US12/650,121
• Publication Number:
  US 20100161022A1
• Time in Patent Office: 2,295 Days
• Field of Search: 600/427, 600/407, 623 111- 113
• US Class Current: 1/1
• CPC Class Codes: A61B 17/12036 partial occlusion
• CPC Class Codes: A61B 17/1204 temporary occlusion
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• 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 18/24 with a catheter A61B18/26, A61B18/28 take 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 2017/1205 Introduction devices
• 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 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2034/254 being adapted depending on the stage of the surgical procedure
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• 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 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/0044 for the heart
• 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 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 6/469 : for selecting a region of interest [ROI]
• CPC Class Codes: A61B 6/481 : involving the use of contrast agents
• CPC Class Codes: A61B 6/501 : for diagnosis of the head, e.g. neuroimaging or craniography
• 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 6/5247 : combining images from an ionising-radiation diagnostic technique and a non-ionising radiation diagnostic technique, e.g. X-ray and ultrasound
• 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: A61F 2/958 : Inflatable balloons for placing stents or stent-grafts
• CPC Class Codes: G06T 11/60 : Editing figures and text; Combining figures or text
• CPC Class Codes: G06T 2207/10121 : Fluoroscopy
• CPC Class Codes: G06T 2207/30048 : Heart; Cardiac
• CPC Class Codes: G06T 2207/30101 : Blood vessel; Artery; Vein; Vascular
• CPC Class Codes: G06T 5/00 : Image enhancement or restoration
• CPC Class Codes: G06T 7/0012 : Biomedical image inspection
• CPC Class Codes: G06T 7/0014 : using an image reference approach
• CPC Class Codes: G06T 7/13 : Edge detection
• CPC Class Codes: G06T 7/246 : using feature-based methods, e.g. the tracking of corners or segments
• CPC Class Codes: G06T 7/62 : of area, perimeter, diameter or volume
• CPC Class Codes: G06V 2201/034 : of medical instruments
• CPC Class Codes: G06V 40/103 : Static body considered as a whole, e.g. static pedestrian or occupant recognition
• CPC Class Codes: G16H 50/30 : for calculating health indices; for individual health risk assessment

Abstract

Apparatus and methods are described for deploying an implantable tool at an implantation location of a blood vessel. The tool is placed at the implantation location in a non-deployed configuration. A plurality of image frames are acquired of the non-deployed tool at the implantation location, during respective phases of the vessel'"'"'s motion cycle. A stabilized image stream is generated of the non-deployed tool at the implantation location. It is determined based upon the stabilized image stream of the non-deployed tool that, during the vessel'"'"'s motion cycle, the tool moves from the implantation location by a given distance in a first direction. Movement of the tool by the given distance is accounted for, by deploying the tool at a deployment location that is distant from the implantation location in the opposite direction to the first direction. Other embodiments are also described.

Claims

1. A method for deploying an implantable tool at a pre-designated implantation location within a blood vessel of a subject, comprising:

advancing the implantable tool to the pre-designated implantation location;

while the implantable tool, in a non-deployed configuration, is disposed at the pre-designated implantation location, acquiring a plurality of image frames of the implantable tool, during respective phases of a cardiac cycle of the subject;

using at least one computer processor, by analyzing at least some of the image frames, automatically determining that, due to variations in blood flow within the blood vessel at the respective phases of the subject'"'"'s cardiac cycle, the implantable tool shifts with respect to the blood vessel, moving from the pre-designated implantation location by a given distance in a first direction;

using the at least one computer processor, in order to account for movement of the implantable tool by the given distance, determining a deployment location, at which to deploy the implantable tool, the deployment location being distant from the pre-designated implantation location in a second direction, the second direction being an opposite direction to the first direction; and

using the at least one computer processor, automatically generating an output indicating the determined deployment location.

2. The method according to claim 1, wherein determining the deployment location comprises determining a deployment location that is at the given distance from the implantation location in the second direction.

3. The method according to claim 1, wherein determining the deployment location comprises determining a deployment location that is at a distance from the implantation location in the second direction that is greater than the given distance.

4. The method according to claim 1, wherein determining the deployment location comprises determining a deployment location that is at a distance from the implantation location in the second direction that is less than the given distance.

5. The method according to claim 1, wherein the implantable tool includes a stent, and wherein determining the deployment location of the implantable tool comprises determining the deployment location of the stent.

6. The method according to claim 1, wherein the implantable tool includes a replacement valve, and wherein determining the deployment location of the implantable tool comprises determining the deployment location of the replacement valve.

7. The method according to claim 1, wherein the implantable tool includes a graft, and wherein determining the deployment location of the implantable tool comprises determining the deployment location of the graft.

8. The method according to claim 1, wherein automatically determining that, due to variations in blood flow within the blood vessel at the respective phases of the subject'"'"'s cardiac cycle, the implantable tool shifts with respect to the blood vessel, comprises determining that the implantable tool is at different positions with respect to the blood vessel at different phases in the subject'"'"'s cardiac cycle, by analyzing at least some of the image frames that were acquired at the respective phases of the subject'"'"'s cardiac cycle.

9. Apparatus comprising:

an implantable tool configured to be advanced to a pre-designated implantation location of a blood vessel of a subject, while the implantable tool is in a non-deployed configuration;

an image acquisition device configured, while the implantable tool is disposed at the pre-designated implantation location in a non-deployed configuration, to acquire a plurality of image frames of the implantable tool, during respective phases of a cardiac cycle of the subject;

a display; and

at least one computer processor configured to;

determine, by analyzing at least some of the image frames, that, due to variations in blood flow within the blood vessel at the respective phases of the subject'"'"'s cardiac cycle, the implantable tool shifts with respect to the blood vessel, moving from the pre-designated implantation location by a given distance in a first direction,

account for movement of the implantable tool by the given distance, by determining a deployment location, at which to deploy the implantable tool, the deployment location being distant from the pre-designated implantation location in a second direction that is an opposite direction to the first direction, and

drive the display to display an output indicating the determined deployment location.

10. The apparatus according to claim 9, wherein the at least one computer processor is configured to account for movement of the implantable tool by the given distance by determining a deployment location for the implantable tool that is at the given distance from the implantation location in the second direction.

11. The apparatus according to claim 9, wherein the at least one computer processor is configured to account for movement of the implantable tool by the given distance by determining a deployment location for the implantable tool that is greater than the given distance.

12. The apparatus according to claim 9, wherein the at least one computer processor is configured to account for movement of the implantable tool by the given distance by determining a deployment location for the implantable tool that is less than the given distance.

13. The apparatus according to claim 9, wherein the implantable tool comprises a stent.

14. The apparatus according to claim 9, wherein the implantable tool comprises a replacement valve.

15. The apparatus according to claim 9, wherein the implantable tool comprises a graft.

16. The apparatus according to claim 9, wherein the at least one computer processor is configured to determine that, due to variations in blood flow within the blood vessel at the respective phases of the subject'"'"'s cardiac cycle, the implantable tool is at different positions with respect to the blood vessel at different phases in the subject'"'"'s cardiac cycle, by analyzing at least some of the image frames that were acquired at the respective phases of the subject'"'"'s cardiac cycle.