Evaluation of implantation site for implantation of implantable medical device

• US 8,280,478 B2
• Filed: 08/10/2009
• Issued: 10/02/2012
• Est. Priority Date: 04/29/2004
• Status: Active Grant

• Current Assignee: Medtronic Incorporated (Medtronic Plc)
• Original Assignee: Medtronic Incorporated (Medtronic Plc)
• Inventors: Singhal, Ruchika, Wahlstrand, Carl D., Skime, Robert M., Urquhart, Steven J.
• Primary Examiner(s): Patel, Niketa
• Assistant Examiner(s): Voorhees, Catherine
• Application Number:
  US12/538,605
• Publication Number:
  US 20090299380A1
• Time in Patent Office: 1,149 Days
• Field of Search: 600/407, 600/411, 600/416, 600/427, 600/311, 600377-378, 600/383
• US Class Current: 600/377
• CPC Class Codes: A61B 5/107 Measuring physical dimensions, e.g. size of the entire body or parts thereof
• CPC Class Codes: A61B 5/686 Permanently implanted devices, e.g. pacemakers, other stimulators, biochips A61B5/6861 takes precedence
• CPC Class Codes: A61B 5/6864 Burr holes
• CPC Class Codes: A61B 5/6868 Brain

Abstract

In general, the invention is directed to strategies pertaining to implantation of an implantable medical device between a scalp and a skull of the patient. The invention pertains to collection of data such as data pertaining to the skull of the patient, the scalp of the patient, the vascular structure or neurological structures in the head of the patient, and the like. The data may be in the form of images, such as images generated by X-ray, magnetic resonance imaging, CT-scan and fluoroscopy. A surgeon can use the collected data to determine, for example, whether the patient is a candidate for a cranial implantation, whether the patient'"'"'s skull and scalp can support the implantation, what configuration of device should be implanted, where the device should be implanted, and how the surgical incisions should be made.

Claims

1. A non-transitory computer-readable medium comprising instructions for causing a programmable processor to:

receive image data representing at least one image of a head of a patient;

evaluate, as a function of the at least one image, whether an implantation site under a scalp of the patient for a housing of an implantable medical device satisfies an implantation criterion, the implantable medical device including;

the housing, control electronics encased within the housing, and a lead coupled to the housing; and

disclose to a user whether the implantation site for the housing satisfies the implantation criterion;

wherein the instructions to evaluate, as a function of the at least one image, whether the implantation site satisfies the implantation criterion include instructions to identify, based on the at least one image, one or more of skull curvature, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp, and evaluate whether the implantation site satisfies the implantation criterion based on the one or more of the skull contour, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp.

2. The medium of claim 1, wherein receiving the at least one image comprises receiving an image generated by at least one of X-ray, magnetic resonance imaging, CT-scan, or fluoroscopy.

3. The medium of claim 1, the instructions further causing the processor to evaluate, as a function of the at least one image, whether the patient is a candidate for implantation of the implantable medical device deployed in a recess created in the skull.

4. The medium of claim 1, the instructions further causing the processor to evaluate, based on the at least one image, whether there are any irregularities in the skull or the scalp of the patient that would impede implantation of the implantable medical device.

5. The medium of claim 1, the instructions further causing the processor to select, from a plurality of configurations of the implantable medical device, one of the configurations of the implantable medical device as a function of the at least one image.

6. The medium of claim 5, wherein the plurality of configurations includes a configuration of at least three modules in a triangular configuration and a configuration of at least two modules in a linear configuration.

7. The medium of claim 5, wherein selecting one of the configurations includes selecting the configuration as a function of one or more of skull contour, skull thickness, scalp thickness, locations of one or more vascular structures, or locations of one or more neurological structures indicated by the at least one image.

8. The medium of claim 1, wherein the at least one image of the head of the patient includes an image of a scalp of the patient.

9. The medium of claim 1, the instructions further causing the processor to:

evaluate skull contour data based on the at least one image of the head;

propose, as a function of the skull contour data, the implantation site for the housing; and

disclose the proposed implantation site to the user.

10. The medium of claim 1, the instructions further causing the processor to:

receive the implantation criterion; and

propose at least the implantation site for the housing based on the implantation criterion and the one or more of the skull contour, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp.

11. The medium of claim 10, the instructions further causing the processor to:

propose a second implantation site for the housing based on the implantation criterion and the one or more of the skull contour, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp.

12. The medium of claim 1, wherein the implantation criterion comprises one or more potential incision locations.

13. The medium of claim 1, the instructions further causing the processor to receive an indication of the implantation site from the user.

14. The medium of claim 1, wherein the at least one image of the head of the patient includes a soft-tissue image and a hard-tissue image of the head of the patient.

15. The medium of claim 1, wherein the instructions to evaluate, as a function of the at least one image, whether the implantation site satisfies the implantation criterion include instructions to identify, based on the at least one image, the skull curvature and evaluate whether the implantation site satisfies the implantation criterion based on the skull curvature.

16. The medium of claim 1, wherein the instructions to evaluate, as a function of the at least one image, whether the implantation site satisfies the implantation criterion include instructions to identify, based on the at least one image, the skull thickness and evaluate whether the implantation site satisfies the implantation criterion based on the skull thickness.

17. The medium of claim 1, wherein the instructions to evaluate, as a function of the at least one image, whether the implantation site satisfies the implantation criterion include instructions to identify, based on the at least one image, the scalp thickness and evaluate whether the implantation site satisfies the implantation criterion based on the scalp thickness.

18. The medium of claim 1, wherein the instructions to evaluate, as a function of the at least one image, whether the implantation site satisfies the implantation criterion include instructions to identify, based on the at least one image, the locations of one or more vascular structures within the scalp and evaluate whether the implantation site satisfies the implantation criterion based on the locations of one or more vascular structures within the scalp.

19. The medium of claim 1, wherein the instructions to evaluate, as a function of the at least one image, whether the implantation site satisfies the implantation criterion include instructions to identify, based on the at least one image, the locations of one or more nerves within the scalp and evaluate whether the implantation site satisfies the implantation criterion based on the locations of one or more nerves within the scalp.

20. A method comprising:

receiving, with a computer system, image data representing at least one image of a head of a patient;

evaluating, with the computer system, as a function of the at least one image, whether an implantation site under a scalp of the patient for a housing of an implantable medical device satisfies an implantation criterion, the implantable medical device including;

the housing, control electronics encased within the housing, and a lead coupled to the housing; and

disclosing to a user, with the computer system, whether the implantation site for the housing satisfies the implantation criterion;

wherein evaluating, as a function of the at least one image, whether the implantation site satisfies the implantation criterion includes identifying, with the computer system, based on the at least one image, one or more of skull curvature, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp, and evaluating, with the computer system, whether the implantation site satisfies the implantation criterion based on the one or more of the skull contour, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp.

21. The method of claim 20, wherein receiving the at least one image comprises receiving an image generated by at least one of X-ray, magnetic resonance imaging, CT-scan, or fluoroscopy.

22. The method of claim 20, further comprising, evaluating, with the computer system, as a function of the at least one image, whether the patient is a candidate for implantation of the implantable medical device deployed in a recess created in the skull.

23. The method of claim 20, further comprising, evaluating, with the computer system, based on the at least one image, whether there are any irregularities in the skull or the scalp of the patient that would impede implantation of the implantable medical device.

24. The method of claim 20, further comprising, selecting, with the computer system, from a plurality of configurations of the implantable medical device, one of the configurations of the implantable medical device as a function of the at least one image.

25. The method of claim 24, wherein the plurality of configurations includes a configuration of at least three modules in a triangular configuration and a configuration of at least two modules in a linear configuration.

26. The method of claim 24, wherein selecting one of the configurations includes selecting the configuration as a function of one or more of skull contour, skull thickness, scalp thickness, locations of one or more vascular structures, or locations of one or more neurological structures indicated by the at least one image.

27. The method of claim 20, wherein the at least one image of the head of the patient includes an image of a scalp of the patient.

28. The method of claim 20, further comprising:

evaluating, with the computer system, skull contour data based on the at least one image of the head;

proposing, with the computer system, as a function of the skull contour data, the implantation site for the housing; and

disclosing, with the computer system, the proposed implantation site to the user.

29. The method of claim 20, further comprising:

receiving, with the computer system, the implantation criterion; and

proposing, with the computer system, at least the implantation site for the housing based on the implantation criterion and the one or more of the skull contour, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp.

30. The method of claim 29, further comprising:

proposing, with the computer system, a second implantation site for the housing based on the implantation criterion and the one or more of the skull contour, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp.

31. The method of claim 20, wherein the implantation criterion comprises one or more potential incision locations.

32. The method of claim 20, further comprising receiving, with the computer system, an indication of the implantation site from the user.

33. The method of claim 20, wherein the at least one image of the head of the patient includes a soft-tissue image and a hard-tissue image of the head of the patient.

34. The method of claim 20, wherein evaluating, as a function of the at least one image, whether the implantation site satisfies the implantation criterion includes identifying, based on the at least one image, the skull curvature and evaluating whether the implantation site satisfies the implantation criterion based on the skull curvature.

35. The method of claim 20, wherein evaluating, as a function of the at least one image, whether the implantation site satisfies the implantation criterion includes identifying, based on the at least one image, the skull thickness and evaluating whether the implantation site satisfies the implantation criterion based on the skull thickness.

36. The method of claim 20, wherein evaluating, as a function of the at least one image, whether the implantation site satisfies the implantation criterion includes identifying, based on the at least one image, the scalp thickness and evaluating whether the implantation site satisfies the implantation criterion based on the scalp thickness.

37. The method of claim 20, wherein evaluating, as a function of the at least one image, whether the implantation site satisfies the implantation criterion includes identifying, based on the at least one image, the locations of one or more vascular structures within the scalp and evaluating whether the implantation site satisfies the implantation criterion based on the locations of one or more vascular structures within the scalp.

38. The method of claim 20, wherein evaluating, as a function of the at least one image, whether the implantation site satisfies the implantation criterion includes identifying, based on the at least one image, the locations of one or more nerves within the scalp and evaluating whether the implantation site satisfies the implantation criterion based on the locations of one or more nerves within the scalp.

39. The method of claim 20, further comprising implanting at least the housing of the medical device at the implantation site.

40. The method of claim 39, wherein the implantable medical device includes an implantable neurostimulator.

41. The method of claim 20, further comprising:

generating a model of the skull of the patient as a function of the at least one image of the head of the patient; and

providing the implantable medical device as a function of the model of the skull.

42. The method of claim 41,

wherein generating the model of the skull comprises generating a physical model of the skull, and

wherein providing the implantable medical device comprises adjusting a standard configuration of the implantable medical device to fit the physical model of the skull.

43. The method of claim 41, wherein generating the model of the skull comprises generating, with the computer system, a virtual model of the skull.

44. The method of claim 20, further comprising:

selecting, with the computer system, an incision site for the implantation site as a function of the evaluation of the one or more of skull curvature, skull thickness, scalp thickness, locations of one or more vascular structures within the scalp, or locations of one or more nerves within the scalp; and

indicating, with the computer system, the incision site to the user.

45. The method of claim 20, wherein the implantable medical device includes an implantable neurostimulator.