Method and system to select an instrument for lead stabilization

• US 9,668,818 B2
• Filed: 10/15/2014
• Issued: 06/06/2017
• Est. Priority Date: 10/15/2014
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Biffi, Mauro, Schilling, Eric A., Justen, Manfred
• Primary Examiner(s): ANSARI, TAHMINA N
• Application Number:
  US14/515,083
• Publication Number:
  US 20160106512A1
• Time in Patent Office: 965 Days
• Field of Search: None
• CPC Class Codes: A61B 2034/105 Modelling of the patient, e.g. for ligaments or bones
• CPC Class Codes: A61B 2576/02 specially adapted for a particular organ or body part
• CPC Class Codes: A61B 34/10 Computer-aided planning, simulation or modelling of surgical operations
• CPC Class Codes: A61N 1/00 Electrotherapy; Circuits therefor A61N2/00 takes precedence; irradiation apparatus A61N5/00
• CPC Class Codes: A61N 1/057 Anchoring means; Means for fixing the head inside the heart
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

Disclosed is a system to assist in selecting and/or suggesting an instrument for a procedure. The suggestion may be based upon or include analysis of image data of a subject. The instrument may be suggested for placement inside a tubular structure.

Claims

1. A method of selecting an instrument for placement within a subject, comprising:

preparing image data of the subject;

analyzing a geometry of a subject structure in the prepared image data;

determining a type of structure within the subject based on the analyzed geometry of the subject structure;

evaluating, by a processor executing instructions, an instrument database including parameters of a plurality of instruments in the instrument database based on the determined type of structure of the subject; and

displaying on a display device viewable by a user at least one suggested instrument based on the evaluation of the instrument database and based on the determined type of structure within the subject.

2. The method of claim 1, wherein preparing the image data of the subject includes creating a model of the subject based on the image data.

3. The method of claim 2, further comprising:

accessing the image data of the subject.

4. The method of claim 3, wherein the image data includes at least one of a venogram of a vasculature, magnetic resonance image data, computed tomography image data, or combinations thereof.

5. The method of claim 2, further comprising:

identifying a coronary sinus in the created model; and

dividing the coronary sinus into three sections.

6. The method of claim 5, further comprising:

inputting a first target location as at least one point in the created model; and

determining a branch vessel from the coronary sinus including the first target location.

7. The method of claim 6, wherein determining the type of structure includes analyzing the determined branch vessel relative at least one section of the three sections.

8. The method of claim 6, wherein determining the type of structure includes determining a take-off angle of the determined branch vessel from the identified coronary sinus.

9. The method of claim 8, wherein evaluating the instrument database includes determining whether an active fixation lead is suggested based on at least one of the analyzed determined branch vessel location relative at least one section of the three sections or the determined take-off angle of the determined branch vessel from the identifying coronary sinus.

10. The method of claim 9, wherein evaluating the instrument database includes evaluating whether a passive fixation lead is suggested prior to determining whether the active fixation lead is suggested.

11. The method of claim 10, further comprising:

selecting a second target location;

inputting the second target location; and

evaluating the created model relative to the second target location.

12. The method of claim 1, wherein evaluating the instrument database includes determining whether an active fixation lead is suggested based on at least one of the analyzed determined branch vessel location relative to at least one section of the three sections or the determined take-off angle of the determined branch vessel from the identifying coronary sinus.

13. A method of selecting an instrument for placement within a subject, comprising:

creating a model of at least a structure in a subject with image data of the subject;

analyzing a geometry of the structure in the created model;

identifying a coronary sinus in the created model and divide the coronary sinus into three sections along a length of the coronary sinus;

inputting a target location to a processor;

determining, by the processor executing instructions, a type of a target vein that includes the target location based on the analyzed geometry of the subject;

evaluating, by a processor executing instructions, an instrument database including parameters of a plurality of lead instruments in the instrument database and based on the determined type of target vein of the subject; and

displaying on a display device at least one suggested lead instrument based on the evaluation of the instrument database and the determined type of the target vein within the subject.

14. The method of claim 13, wherein determining the type of the target vein includes:

determining a take-off location of the target vein from the identified coronary sinus; and

determining a take-off angle of the target vein from the coronary sinus.

15. The method of claim 14, wherein determining the type of the target vein includes determining that the target vein is a type-A vein or a type-B vein if the determined take off location is within a proximal one-third of the coronary sinus or the determined take-off angle is greater than eighty degrees.

16. The method of claim 15, further comprising:

determining if a sidebranch is present on the target vein; and

determining if a second target location in the sidebranch is acceptable for a passive fixation or not acceptable for passive fixation.

17. The method of claim 16, wherein the parameters of a plurality of instruments includes an active fixation parameter and a passive fixation parameter and outputting the at least one suggested lead instrument includes outputting a suggested active fixation lead when the determination is that the target vein is the type-A vein or the type-B vein and a determination of the second target location is not acceptable for passive fixation.

18. The method of claim 13, further comprising:

determining if an occlusion is present in the created model prior to the target location, and if an occlusion is present selecting a new target location different from the first target location.

22. The method of claim 13, wherein determining the type of the target vein includes classifying the vein as a Type-A or a Type-B vein if the vein has a take off in the proximal one-third of the coronary sinus and includes a take-off or bifurcation angle of greater than 80°

,

wherein outputting on a display device at least one suggested lead instrument based on the evaluation of the instrument database and the determined type of the target vein within the subject includes suggesting an active fixation if no sidebranch target vein is available.

19. A system for selecting an instrument for placement within a subject, comprising:

a display device configured to display a created model;

an input to allow for input; and

a processor system configured to execute instructions to;

create a model of at least a structure in a subject with image data of the subject;

analyze a geometry of the structure in the created model;

identify a coronary sinus in the created model and divide the coronary sinus into three sections;

receive an input of a target location in a target vein;

determine a type of the target vein that includes the target location based on the analyzed geometry of the subject;

evaluate parameters of a plurality of instruments in an instrument database based on the determined type of structure of the target vein; and

output at least one suggested lead instrument based on the evaluation of the parameters and the determined type of the target vein within the subject;

wherein the display device is further configured to display the output.

20. The system of claim 19, wherein in executing instructions to determine the type of the target vein that includes the target location based on the analyzed geometry of the subject, an evaluation of a take-off location of the target vein from the identified coronary sinus and an evaluation of a take-off angle of the target vein from the coronary sinus is made;

wherein the target vein is a type-A vein or a type-B vein if the determined take off location is within a proximal one-third of the coronary sinus or the determined take-off angle is greater than eighty degrees.

21. The method of claim 20, wherein outputting the at least one suggested instrument includes outputting a suggested active fixation lead when the determination is that the target vein is the type-A or the type-B and a determination of at least a second target location is not acceptable for passive fixation.