System for image-guided endovascular prosthesis and method for using same
Inventors
Glossop, Neil David • Wood, Bradford Johns
Assignees
Philips Electronics Ltd Canada • Koninklijke Philips NV • US Department of Health and Human Services
Publication Number
US-8041412-B2
Publication Date
2011-10-18
Expiration Date
2027-06-11
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Abstract
Systems and methods for obtaining position sensor space data regarding an endovascular prosthesis within an anatomical region of a patient include at least one position indicating element which is movable within an endovascular prosthesis is tracked by a tracking system. A guidance portion of the endovascular prosthesis constrains movement of position indicating elements within the endovascular prosthesis.
Core Innovation
The invention relates to a system for image-guided placement and deployment of an endovascular prosthesis equipped with position indicating elements movable within the prosthesis, tracked by a tracking system. The system enables obtaining position sensor space data regarding locations within or around the endovascular prosthesis by constraining the movement of position indicating elements via a guidance portion, thereby facilitating enhanced placement, deployment, modification, and tracking of the prosthesis within a patient's anatomy.
The problem being solved is the difficulty and inaccuracy in placing endovascular devices such as stents or grafts precisely within anatomical regions using traditional imaging and navigation methods like fluoroscopy and angiography. Positioning errors as small as one millimeter can cause serious complications. Additionally, current techniques do not adequately compensate for patient motion such as breathing or cardiac effects, nor provide precise dynamic referencing with respect to anatomy or internal structures. These limitations affect the success of minimally invasive treatments for conditions like vascular aneurysms and atherosclerotic plaques.
The invention addresses these challenges by integrating position sensing elements that can move within or along an endovascular prosthesis under control of motive portions and constrained by guidance portions such as rails or lumens. Electromagnetic tracking systems obtain detailed spatial information about the prosthesis and its deformation. This data supports real-time dynamic referencing, planning, registration, and modification of the prosthesis, including selective application or removal of coatings and activation of agents. The system may also involve image guidance integration for precise navigation and positioning in the patient.
Claims Coverage
The patent contains multiple independent claims that define inventive systems and methods for obtaining position data of endovascular prostheses within a patient's anatomy. The main inventive features relate to movable position indicating elements constrained by guidance portions, tracking mechanisms, and modification capabilities.
System for tracking movable position indicating elements within an endovascular prosthesis
A system comprising a tracking system including a coordinate system, at least one position indicating element tracked by the system, an endovascular prosthesis with an expandable body portion, a guidance portion constraining movement of the position indicating element within the prosthesis, and a motive portion that moves the position indicating element while the system tracks it to produce position data at at least two points within the prosthesis. The tracking system is electromagnetic, the position indicating element is an electromagnetic sensor coil with a hollow interior, mounted on a rail through the coil, enabling sliding movement along the rail.
Guidance portion design for mapping and deformation tracking
A guidance portion that includes either a straight line portion traversing the prosthesis lengthwise and deforming with the prosthesis or a spiral portion that tortuously traverses height-wise, width-wise, and lengthwise to form a path mapping the three dimensional shape of the expandable body portion. Both designs enable the position indicating element to reflect prosthesis deformations during movement.
Movement control via control wire attached to position indicating element
A motive portion comprising a control wire with ends attached to the position indicating element and accessible outside the delivery instrument, where movement of the wire translates into movement of the position indicating element constrained by the guidance portion within the prosthesis.
Use of position data for modification of prosthesis material
Utilizing position data from at least two points within the prosthesis to define regions where material is added to or removed from the expandable body portion. Additionally, a modification device tracked by the system can be positioned at these regions to implement precise modifications.
Endovascular prosthesis integrated with coil windings as position indicating elements
An endovascular prosthesis having an expandable body with structural support members integrated with coil windings that serve as position indicating elements. These coil windings expand with the structural support members and are mounted on a rail through a hollow interior portion, allowing movement and tracking of the prosthesis within the anatomical region.
Method for obtaining position data using tracking and constrained movement
A method involving positioning a prosthesis equipped with at least one position indicating element within an anatomical region; tracking the element with an electromagnetic system; moving the element within the prosthesis constrained by a guidance portion; sampling position data at at least two points where movement is constrained by the guidance portion; the element is an electromagnetic sensor coil sliding along a rail, enabling detailed spatial data acquisition of the prosthesis.
The independent claims collectively cover systems and methods involving electromagnetic tracking of movable position indicating elements constrained within and movable along guidance portions of expandable endovascular prostheses, enabling detailed spatial data acquisition for placement, deformation mapping, and selective modification of prostheses within a patient's anatomical region.
Stated Advantages
Enables enhanced and accurate placement, deployment, and modification of endovascular prostheses.
Provides dynamic referencing that can correct for breathing, cardiac, and other patient motion during placement and deployment.
Allows for detailed spatial mapping of endovascular prostheses including deformations inside the anatomy.
Permits selective application or removal of coatings and activation of agents on the prosthesis with precise spatial control.
Facilitates real-time visualization of prosthesis location and orientation in combination with preoperative or intraoperative imaging.
May reduce delivery system dimensions by enabling in-situ fabrication of endovascular prostheses.
Documented Applications
Minimally invasive treatment of vascular conditions such as aneurysms, atherosclerotic plaque, vascular occlusion, and stenosis using stents, grafts, or endovascular prostheses.
Image-guided navigation and placement of endovascular prostheses within patient vasculature, including navigation along branch vessels like carotid, renal, and celiac arteries.
Selective coating of endovascular prostheses to render regions impermeable or leave others permeable to preserve branch vessel patency.
Selective removal or modification of pre-applied coatings on endovascular prostheses using tracked modification elements.
Dynamic referencing and registration of endovascular prostheses relative to patient anatomy during implantation.
Use of endovascular prostheses as scaffolds for agents that can be selectively activated at precise anatomical locations.
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