Guidewires for performing image guided procedures

• US 10,631,756 B2
• Filed: 01/27/2017
• Issued: 04/28/2020
• Est. Priority Date: 04/21/2004
• Status: Active Grant

• Current Assignee: Acclarent Incorporated (Johnson & Johnson)
• Original Assignee: Acclarent Incorporated (Johnson & Johnson)
• Inventors: Kim, Isaac J., Goldfarb, Eric, Vo, Tom T., Deckman, Robert K.
• Primary Examiner(s): Henson, Devin B
• Application Number:
  US15/417,655
• Publication Number:
  US 20170202480A1
• Time in Patent Office: 1,187 Days
• CPC Class Codes: A61B 17/24 for use in the oral cavity, larynx, bronchial passages or nose for medical inspection of cavities or tubes in the body A61B1/00; Tongue scrapers
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 17/3478 Endoscopic needles, e.g. for infusion biopsy needles A61B10/0233; catheters with injection needles A61M25/0067
• CPC Class Codes: A61B 2017/22042 Details of the tip of the guide wire
• CPC Class Codes: A61B 2017/22061 for spreading elements apart
• CPC Class Codes: A61B 2034/2048 using an accelerometer or inertia sensor
• CPC Class Codes: A61B 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2090/363 Use of fiducial points
• CPC Class Codes: A61B 2090/365 augmented reality, i.e. correlating a live optical image with another image
• 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 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/055 involving electronic [EMR] or nuclear [NMR] magnetic resonance, e.g. magnetic resonance imaging
• CPC Class Codes: A61B 5/06 Devices, other than using radiation, for detecting or locating foreign bodies for removing same A61B17/50 ; determining position of probes within or on the body of the patient
• CPC Class Codes: A61B 5/062 using magnetic field
• CPC Class Codes: A61B 5/6851 Guide wires
• CPC Class Codes: A61B 6/032 Transmission computed tomography [CT]
• CPC Class Codes: A61B 90/16 Bite blocks
• CPC Class Codes: A61B 90/361 : Image-producing devices, e.g. surgical cameras
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers
• CPC Class Codes: A61M 2025/0166 : Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
• CPC Class Codes: A61M 2025/09083 : having a coil around a core
• CPC Class Codes: A61M 2025/09175 : having specific characteristics at the distal tip
• CPC Class Codes: A61M 2029/025 : characterised by the guiding element
• CPC Class Codes: A61M 25/09 : Guide wires
• CPC Class Codes: A61M 25/09041 : Mechanisms for insertion of guide wires
• CPC Class Codes: A61M 29/02 : Dilators made of swellable material balloon catheters for angioplasty A61M25/104

Abstract

Guidewires and methods useable in conjunction with image guidance systems to facilitate performance of diagnostic or therapeutic tasks at locations within the bodies of human or animal subjects.

Claims

1. A method of navigating a guidewire within a head of a patient, the method comprising:

(a) inserting a distal end of a guidewire through a nose of a head of a patient to thereby position the distal end within the nasal cavity of the patient, wherein the distal end includes a sensor,

(b) generating an electromagnetic field, wherein the head of the patient is positioned within the electromagnetic field;

(c) tracking the position of the distal end of the guidewire within the nasal cavity of the patient, in the electromagnetic field, via the sensor in real time; and

(d) advancing an instrument along the guidewire to perform an operation within the nasal cavity of the patient, based on the tracked position of the distal end of the guidewire within the nasal cavity of the patient.

2. The method of claim 1, wherein the act of tracking the position of the distal end of the guidewire within the nasal cavity of the patient comprises using an image-guided surgery system, wherein the sensor is in communication with the image-guided surgery system.

3. The method of claim 2, wherein the act of tracking the position of the distal end of the guidewire within the nasal cavity of the patient further comprises correlating location data associated with the distal end of the guidewire with at least one preoperatively obtained image.

4. The method of claim 3, wherein the at least one preoperatively obtained image comprises a digital tomographic scan.

5. The method of claim 3, wherein the at least one preoperatively obtained image comprises a CT scan.

6. The method of claim 3, wherein the at least one preoperatively obtained image comprises an MRI scan.

7. The method of claim 3, wherein the act of tracking the position of the distal end of the guidewire within the nasal cavity of the patient further comprises superimposing a location of the distal end of the guidewire on at least one preoperatively obtained image.

8. The method of claim 7, wherein the act of superimposing a location of the distal end of the guidewire on at least one preoperatively obtained image comprises displaying at least one preoperatively obtained image of at least a portion of the patient'"'"'s head with a superimposed indicator showing the real time position of the distal end of the guidewire within the patient'"'"'s head.

9. The method of claim 2, further comprising coupling a proximal end of the guidewire with the image-guided surgery system to thereby provide a pathway for communication between the sensor and the image-guided surgery system.

10. The method of claim 9, further comprising decoupling the proximal end of the guidewire from the image-guided surgery system, wherein the act of advancing the instrument along the guidewire is performed after the act of decoupling the proximal end of the guidewire from the image-guided surgery system.

11. The method of claim 1, wherein the instrument comprises a dilation catheter, wherein the act of advancing the instrument along the guidewire comprises advancing the dilation catheter to position a dilator of the dilation catheter into a drainage passageway associated with a paranasal sinus.

12. The method of claim 11, further comprising dilating the advanced dilator to dilate the drainage passageway associated with the paranasal sinus.

13. The method of claim 12, wherein the dilator comprises a balloon, wherein the act of dilating the advanced dilator comprises inflating the balloon.

14. The method of claim 12, wherein the drainage passageway comprises a paranasal sinus ostium.

15. The method of claim 1, wherein the sensor comprises a coil.

16. The method of claim 15, wherein the act of generating the electromagnetic field is performed via the coil.

17. The method of claim 1, further comprising inserting a guide into the nasal cavity of the patient, wherein the act of inserting the distal end of the guidewire through the nose of the head of the patient is performed via the guide.

18. The method of claim 17, wherein the guide comprises a tube, wherein the guidewire is slidably disposed within the tube.

19. A method of navigating a guidewire within a head of a patient, the method comprising:

(a) inserting a distal end of a guidewire through a nose of a head of a patient to thereby position the distal end within the nasal cavity of the patient, wherein the distal end includes a sensor,

(b) activating an image guidance system, wherein the sensor is in communication with the image guidance system;

(c) tracking the position of the distal end of the guidewire within the nasal cavity of the patient via the sensor and the image guidance system in real time;

(d) passing the distal end of the guidewire into a drainage passageway associated with a paranasal sinus in the head of the patient based on the real time tracking via the sensor and the image guidance system;

(e) advancing a dilation instrument along the guidewire to position a dilator of the dilation instrument in the drainage passageway; and

(f) expanding the dilator to thereby dilate the drainage passageway.

20. A method of navigating a guidewire within a head of a patient, the method comprising:

(a) inserting a guide member through a nose of a head of a patient to thereby position a distal end of the guide member within the nasal cavity of the patient;

(b) advancing a guidewire along the guide member to thereby position a distal end of the guidewire within the nasal cavity of the patient, wherein the distal end includes a sensor;

(c) activating an image guidance system, wherein the sensor is in communication with the image guidance system;

(d) tracking the position of the distal end of the guidewire within the nasal cavity of the patient via the sensor and the image guidance system in real time;

(e) passing the distal end of the guidewire into a drainage passageway associated with a paranasal sinus in the head of the patient based on the real time tracking via the sensor and the image guidance system;

(f) advancing a dilation instrument along the guidewire to position a dilator of the dilation instrument in the drainage passageway; and

(g) expanding the dilator to thereby dilate the drainage passageway.