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WO2018170448A1 - Fenêtres soniques implantables pour imager la cavité thoracique - Google Patents

Fenêtres soniques implantables pour imager la cavité thoracique Download PDF

Info

Publication number
WO2018170448A1
WO2018170448A1 PCT/US2018/022962 US2018022962W WO2018170448A1 WO 2018170448 A1 WO2018170448 A1 WO 2018170448A1 US 2018022962 W US2018022962 W US 2018022962W WO 2018170448 A1 WO2018170448 A1 WO 2018170448A1
Authority
WO
WIPO (PCT)
Prior art keywords
sonic window
implantable
rib cage
window
imaging
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2018/022962
Other languages
English (en)
Inventor
Jotham Charles Manwaring
Kim Manwaring
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of South Florida
University of South Florida St Petersburg
Original Assignee
University of South Florida
University of South Florida St Petersburg
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by University of South Florida, University of South Florida St Petersburg filed Critical University of South Florida
Publication of WO2018170448A1 publication Critical patent/WO2018170448A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A61B17/8076—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for the ribs or the sternum
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00831—Material properties
    • A61B2017/00902—Material properties transparent or translucent
    • A61B2017/00924—Material properties transparent or translucent for ultrasonic waves

Definitions

  • CT computed tomography
  • MRI magnetic resonance imaging
  • CT computed tomography
  • ultrasound imaging can be performed using much simpler equipment. For example, ultrasound imaging can be performed in an office setting using a handheld probe connected to a small ultrasound machine.
  • ultrasound imaging is advantageous for these reasons, it can be difficult to image the heart and its blood vessels using ultrasound imaging due to the presence of the thoracic cage, or rib cage, which comprises the sternum and the ribs. Specifically, these bones can block the ultrasonic waves that are emitted by the ultrasound probe to prevent full imaging of the heart and its vessels. It can, therefore, be appreciated that it would be desirable to have a way in which ultrasound cardiac imaging can be performed without interference from the rib cage.
  • Fig. 1 A is a front view of a first embodiment of an implantable sonic window.
  • Fig. 1 B is a side view of the implantable sonic window of Fig. 1 A.
  • Fig. 2 is an anterior view of the rib cage with the implantable sonic window of Fig. 1 shown attached to the rib cage using wires.
  • Fig. 3 is an anterior view of the rib cage with the implantable sonic window of Fig. 1 shown attached to the rib cage using fasteners.
  • Fig. 4 is an anterior view of the rib cage with the implantable sonic window of Fig. 1 shown attached to the rib cage using clamps.
  • Fig. 5 is an anterior view of the rib cage with a second embodiment of an implantable sonic window shown attached to the rib cage using fasteners.
  • Fig. 6 is a lateral view of the rib cage illustrating ultrasound imaging of the thoracic cavity through an implantable sonic window that has been attached to the rib cage.
  • implantable ultrasonic windows that can be affixed to the rib cage over an opening formed in the rib cage that protects the organs within the thoracic cavity while still enabling ultrasound imaging of the heart and its vessels, as well as any other organs within the cavity.
  • the opening can be an opening in the sternum that is formed during a cardiac surgical procedure, such as a coronary bypass.
  • the sonic window is made of a strong but sonically translucent polymeric material.
  • Figs. 1 A and 1 B illustrate a first embodiment of a sonic window 10 that can be used to overlie an opening formed in the rib cage, such as through the sternum, for purposes of ultrasound imaging of organs in the thoracic cavity, including the heart and its vessels.
  • the window 10 comprises a generally planar body 12 that is unitarily formed from a single piece of material.
  • the material is strong but sonically translucent such that ultrasonic waves can easily pass through it for purposes of imaging the organs.
  • the material is a polymeric material, such as polyether ether ketone (PEEK), high molecular weight polyethylene, polyoxymethylene (POM), or polypropylene.
  • the body 12 has been described as being "planar,” it is noted that, in at least some embodiments, the body can be deformed to match the contours of the rib cage to which it is to be applied. Such deformation can be achieved by the user (e.g., surgeon) prior to implantation of the sonic window 10, for example, by first heating it to a temperature at which its material is malleable.
  • the body 12 is generally rectangular such that it includes four corners and four outer edges 14.
  • the body 12 can have length and width dimensions in the range of approximately 2 to 12 inches. Other dimensions are possible, however, and, in general, the dimensions will correspond to the size of the opening that has been formed through the rib cage.
  • the body 12 is shown as being rectangular in Figs. 1 A and 1 B, it is noted that the body can have substantially any shape.
  • Fig. 5 illustrates a non-rectilinear configuration for an implantable sonic window.
  • the body 12 has a thickness that is much smaller than its length and width. In some embodiments, the body can be approximately 1 to 6 millimeters (mm) (e.g., 3 mm) thick.
  • mounting holes 14 can be formed through the body 12 to facilitate attachment of the implantable sonic window 10 to the rib cage.
  • six holes 14 are formed along the periphery of the body 12, although a greater or smaller number of holes (including none) can be used.
  • the holes 18 are adapted to receive fastening elements that can pass through the body 12 and either around the ribs or into the bone of the sternum or ribs.
  • the fastening elements can comprise wires, screws, bone anchors, or clamps.
  • the holes are approximately 1 mm in diameter.
  • Fig. 2 illustrates an example application of an implantable sonic window 20 similar to that shown in Fig. 1 . More particularly, Fig. 2 illustrates the sonic window 20 secured to a rib cage 22 over an opening 24 formed in the sternum 26.
  • the opening 24 can have been formed during a sternoplasty procedure as part of a cardiac surgical procedure.
  • the sonic window 20 has been secured with wires 28, such as stainless steel wires, that have been wrapped around individual ribs adjacent the sternum 24.
  • Fig. 3 illustrates a further application of an implantable sonic window 30.
  • the sonic window 30 is secured to the rib cage 22 with fasteners 32, such as screws, bolts, or anchors.
  • Fig. 4 illustrates yet another application of an implantable sonic window 40.
  • the sonic window 40 is secured to the rib cage 22 with adjustable clamps 42 that clamp onto the sternum 26.
  • Fig. 5 illustrates another embodiment of an implantable sonic window 50.
  • the sonic window 50 includes a lateral extension 52 that extends over the left paramedian rib area to enable full visualization of the left cardiac ventricle.
  • fasteners 54 are used to secure the sonic window 50 to the rib cage 22.
  • the sonic windows can have substantially any size and shape that would facilitate ultrasound imaging.
  • the implantable sonic windows can be used in a diagnostic manner to image the organs of the thoracic cavity.
  • Fig. 6 illustrates an example of this.
  • an implantable sonic window 60 has been affixed to the rib cage 22 and an ultrasound probe 62 can be used to transmit ultrasonic radiation through the skin (not shown) and the window, and into the thoracic cavity.
  • Dopper ultrasound can be performed to observe blood flow through the heart and its blood vessels.
  • images obtained from the ultrasound imaging may provide enough information on their own, it is noted that other imaging modalities can be used to supplement that information.
  • CT scanning and/or MRI imaging can be used in conjunction with the ultrasound imaging to obtain a more complete picture of what is happening within the patient's thoracic cavity

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)

Abstract

L'invention concerne une fenêtre sonique implantable qui comprend un corps qui est dimensionné et configuré pour recouvrir une ouverture formée à travers la cage thoracique, le corps étant constitué d'un matériau acoustiquement transparent à travers lequel des ondes ultrasonores peuvent passer. Dans certains modes de réalisation, le matériau polymère est le polyétheréthercétone (PEEK), le polyéthylène de masse moléculaire élevée, le polyoxyméthylène (POM) ou le polypropylène.
PCT/US2018/022962 2017-03-16 2018-03-16 Fenêtres soniques implantables pour imager la cavité thoracique Ceased WO2018170448A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US201762472095P 2017-03-16 2017-03-16
US62/472,095 2017-03-16

Publications (1)

Publication Number Publication Date
WO2018170448A1 true WO2018170448A1 (fr) 2018-09-20

Family

ID=63523318

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2018/022962 Ceased WO2018170448A1 (fr) 2017-03-16 2018-03-16 Fenêtres soniques implantables pour imager la cavité thoracique

Country Status (1)

Country Link
WO (1) WO2018170448A1 (fr)

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090234357A1 (en) * 2006-09-22 2009-09-17 Aesculap Ag Sternum closure device
US20140330123A1 (en) * 2013-05-02 2014-11-06 University Of South Florida (A Florida Non-Profit Corporation) Implantable sonic windows
US20150230237A1 (en) * 2014-02-11 2015-08-13 Intel IP Corporation Communication terminal and a method for reporting a channel quality

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20090234357A1 (en) * 2006-09-22 2009-09-17 Aesculap Ag Sternum closure device
US20140330123A1 (en) * 2013-05-02 2014-11-06 University Of South Florida (A Florida Non-Profit Corporation) Implantable sonic windows
US20150230237A1 (en) * 2014-02-11 2015-08-13 Intel IP Corporation Communication terminal and a method for reporting a channel quality

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
DOSEMECI ET AL.: "Utility of Transcranial Doppler Ultrasonography for Confirmatory Diagnosis of Brain Death: Two Sides of the Coin", TRANSPLANTATION, vol. 77, no. 1, 15 January 2004 (2004-01-15), pages 71 - 75, XP055542605 *

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