Method, system and devices for transjugular intrahepatic portosystemic shunt (TIPS) procedures
Inventors
Glossop, Neil David • Wood, Bradford Johns • Tang, Thomas S. Y.
Assignees
Philips Electronics Ltd Canada • Koninklijke Philips NV • US Department of Health and Human Services
Publication Number
US-8632468-B2
Publication Date
2014-01-21
Expiration Date
2029-02-25
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Abstract
Systems and methods for assisting/performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures in a portion of an anatomy of a patient include a guide needle portion having a hollow tube with a bend toward its distal tip, and a puncture needle portion that includes at least one position indicating element at its tip. The puncture needle is slidably mounted within the hollow tube of the guide needle such that a distal tip of the puncture needle can be extended from an opening in the distal tip of the guide needle and used to place a shunt between the portal and hepatic veins of a patient. The position indicating element of the puncture needle is used to produce a display of the puncture needle relative to a target vessel, including a projected path of the puncture needle that can be adjusted to accurately locate a shunt.
Core Innovation
The invention provides methods, systems, and devices for assisting or performing image-guided transjugular intrahepatic portosystemic shunt (TIPS) procedures. It focuses on instrumentation and methods for accurately targeting the portal vessel during TIPS procedures using electromagnetic tracking techniques. The invention involves a guide needle portion with a hollow tube bent toward its distal tip, and a puncture needle portion that includes at least one position indicating element at its tip, enabling precise location and trajectory tracking.
Current TIPS procedures involve significant challenges, including blind needle passes to connect the portal and hepatic veins, causing extended procedure times and high doses of fluoroscopy and contrast agents, which may harm patients and physicians. The invention addresses these issues by enabling accurate real-time visualization of needle position relative to target vessels, facilitating informed adjustments during the procedure to improve accuracy and reduce associated risks.
Claims Coverage
The patent claims three independent claims covering methods and systems for assisting image-guided transvascular shunting procedures with inventive features related to needle assemblies, tracking, and display of needle and vessel positions.
Method for assisting image-guided transvascular shunting using needle assembly and tracking
The method includes receiving images of patient anatomy, determining a 3D path of the target vessel, receiving position and orientation data from a tracking device for a puncture needle with position indicating elements, determining the puncture needle's position relative to the target vessel, and displaying the puncture needle position, a projected path if extended beyond the guide needle's distal end, intersection points or closest approach indicators to the target vessel, along with simultaneous numerical values for projected and absolute target distances.
System for performing image-guided transvascular shunting with needle assembly and processing devices
The system comprises a needle assembly including a hollow tube with a bend and a puncture needle slidably mounted within, with position indicating elements at the puncture needle's distal tip extending tangentially from the guide needle. It includes a fluid flow lumen allowing flow between distal tip and external assembly. Processing devices determine the target vessel path in three dimensions from images and produce displays of puncture needle position and projected paths relative to the target vessel, also showing intersection points, closest approaches, and numerical distances concurrently.
System for assisting image-guided transvascular shunting with needle assembly, tracking device, and processing devices
The system includes a needle assembly with a hollow bent tube and a slidably mounted puncture needle having position indicating elements, a tracking device sampling position and orientation of these elements, and processing devices that determine a 3D path of the target vessel, receive positioning data, calculate the puncture needle's location relative to the target vessel, and produce displays showing the puncture needle's position, projected path, intersections, closest approaches, and numerical values for projected and absolute target distances simultaneously.
These inventive features collectively advance TIPS procedures by enabling precise tracking and visualization of the puncture needle relative to the target vessel using integrated imaging, tracking, and computational display technologies, improving procedural accuracy and safety.
Stated Advantages
Improved accuracy in targeting the portal vein during TIPS procedures by providing real-time visualization of needle position and trajectory relative to the target vessel.
Reduced radiation exposure and contrast agent dosage by minimizing blind needle passes and reliance on fluoroscopy.
Shortened procedure times through enhanced guidance and the ability to simulate needle paths before actual puncture.
Increased procedural safety for patients and physicians by decreasing multiple needle pass attempts.
Documented Applications
Performing transjugular intrahepatic portosystemic shunt (TIPS) procedures to create a shunt between the portal vein and hepatic vein in a patient's liver.
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