Vessel position and configuration imaging apparatus and methods

• US 8,473,030 B2
• Filed: 01/12/2007
• Issued: 06/25/2013
• Est. Priority Date: 01/12/2007
• Status: Active Grant

• Current Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Original Assignee: Medtronic Vascular, Inc. (Medtronic Plc)
• Inventors: Greenan, Trevor, Yamasaki, Dwayne, Bruszewski, Walter, Gardeski, Ken, Simon, David
• Primary Examiner(s): Chen, Tse
• Assistant Examiner(s): REARDON, ROCHELLE D
• Application Number:
  US11/622,935
• Publication Number:
  US 20080171934A1
• Time in Patent Office: 2,356 Days
• Field of Search: 600/407, 600/410, 600/414, 600/415, 600/423, 600/424, 600/426, 600/433, 600/437, 600/462, 600/464, 600/466, 600/467, 623/1.11, 623/1.13, 623/1.15, 623/1.23, 623/1.34
• US Class Current: 600/423
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00867 shape memory effect for prostheses A61F2210/0014
• 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 2034/2051 Electromagnetic tracking systems
• CPC Class Codes: A61B 2562/043 in a linear array
• 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 5/06 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 5/6857 with a distal pigtail shape
• CPC Class Codes: A61B 90/36 Image-producing devices or illumination devices not otherwise provided for
• CPC Class Codes: A61F 2/07 Stent-grafts
• CPC Class Codes: A61F 2/954 for placing stents or stent-grafts in a bifurcation
• CPC Class Codes: A61F 2002/061 provided with means for allowing access to secondary lumens
• CPC Class Codes: A61F 2002/065 Y-shaped blood vessels
• CPC Class Codes: A61F 2250/0002 for data transfer
• CPC Class Codes: A61F 2250/0096 Markers and sensors for detecting a position or changes of a position of an implant, e.g. RF sensors, ultrasound 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 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
• CPC Class Codes: A61M 25/0108 using radio-opaque or ultrasound markers

Abstract

One or more markers or sensors are positioned in the vasculature of a patient to facilitate determining the location, configuration, and/or orientation of a vessel or certain aspects thereof (e.g., a branch vessel), determining the location, configuration and/or orientation of a endovascular devices prior to and during prosthesis deployment as well as the relative position of portions of the vasculature and devices, generating an image of a virtual model of a portion of one or more vessels (e.g., branch vessels) or devices, and/or formation of one or more openings in a tubular prosthesis in situ to allow branch vessel perfusion when the prosthesis is placed over one or more branch vessels in a patient (e.g., when an aortic abdominal artery stent-graft is fixed to the aorta superior to the renal artery ostia).

Claims

1. A method of real time monitoring the position of a portion of a second vessel, which branches from a first vessel in a human patient comprising:

acquiring a multi-dimensional data set of a portion of first and second vessels where the second vessel branches from the first vessel;

delivering at least one marker attached to a catheter in vivo to one of the first and second vessels at a juncture where the second vessel branches from the first vessel;

securing the marker to one of the first and second vessels at the juncture where the second vessel branches from the first vessel by expanding a stent-graft to pin at least the catheter to which the at least one marker is attached against a wall of the first vessel;

determining the position of the marker in real time; and

updating the position of a portion of the multi-dimensional data set relative to the juncture between the first and second vessels in real time based on change in position of the marker caused by motion of the anatomy of the human patient.

2. The method of claim 1 wherein acquiring the multi-dimensional data set comprises acquiring a three-dimensional data set.

3. The method of claim 2 including displaying the updated position of a portion of the three-dimensional data set in real time.

4. The method of claim 3 wherein displaying the updated position of a portion of the three-dimensional data set comprises displaying an image of the second vessel ostium in real time.

11. The method of claim 1 further comprising the steps of:

acquiring a three-dimensional data set of the portion of the first and second vessels prior to acquisition of the multi-dimensional data set;

registering the data sets; and

associating the marker position with one of the data sets.

12. The method of claim 11 wherein acquiring the multi-dimensional data set comprises acquiring a two-dimensional data set.

13. The method of claim 11 wherein acquiring the multi-dimensional data set comprises acquiring a three-dimensional data set.

5. A method of forming an opening in a prosthesis, having a tubular wall, in vivo, comprising the steps of:

positioning a plurality of electromagnetic coils in a second vessel that branches from a first vessel in a human patient in a configuration that has an axis that extends generally along the central axis of a portion of the second vessel;

endovascularly positioning a tubular prosthesis in the first vessel such that it overlaps an ostium of the second vessel that opens to the first vessel

introducing a puncture device having a distal end portion having a second axis and a proximal end portion in the prosthesis, wherein the distal end portion of the puncture device includes electromagnetic coils attached thereto that are spaced along the second axis thereof;

generating electromagnetic fields about the plurality of coils in the second vessel and the coils attached to the puncture device distal end portion;

processing signals from the plurality of coils in the second vessel to create a three-dimensional model of the axis of the configuration of coils and processing signals from the coils of the puncture device distal end portion to create a three-dimensional model of the second axis;

aligning the axis of the configuration of coils that extends generally along the central axis of the portion of the second vessel and the second axis of the puncture device distal end portion such that they are substantially coaxial;

advancing the distal end portion of the puncture device through a portion of the tubular wall of the prosthesis while maintaining the axes substantially coaxial; and

forming an opening in the tubular prosthesis adjacent to the second vessel ostium.

6. The method of claim 5 wherein the plurality of coils are arranged in a helical array.

7. The method of claim 5 wherein the plurality of coils are oriented in a generally circular array.

8. A method of forming an opening in a prosthesis, having a tubular wall, in vivo, comprising the steps of:

positioning a plurality of electromagnetic coils in a second vessel that branches from a first vessel in a human patient in a configuration that has a first axis that extends generally along the central axis of a portion of the second vessel;

endovascularly positioning a tubular prosthesis in the first vessel such that it overlaps an ostium of the second vessel that opens to the first vessel;

introducing a puncture device in the first vessel where the puncture device has a distal end portion and a proximal end portion and the distal end portion has a pair of antenna coils aligned with a longitudinal axis of the distal end portion;

generating electromagnetic fields about the coils in the second vessel and the puncture device antenna coils;

processing signals from the puncture device antenna coils and second vessel coils and generating a three-dimensional model of the longitudinal axis of the distal end portion of the puncture device and the first axis of the configuration of coils;

aligning the puncture device distal end portion longitudinal axis with the first axis;

advancing the distal end portion of the puncture device through a portion of the tubular wall of the prosthesis while maintaining the axes substantially aligned; and

forming an opening in the tubular prosthesis adjacent to the second vessel ostium.

9. The method of claim 8 wherein the plurality of coils are arranged in a helical array.

10. The method of claim 8 wherein the plurality of coils are oriented in a generally circular array.