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WO2023178123A2 - Techniques de détermination de types de tissu - Google Patents

Techniques de détermination de types de tissu Download PDF

Info

Publication number
WO2023178123A2
WO2023178123A2 PCT/US2023/064362 US2023064362W WO2023178123A2 WO 2023178123 A2 WO2023178123 A2 WO 2023178123A2 US 2023064362 W US2023064362 W US 2023064362W WO 2023178123 A2 WO2023178123 A2 WO 2023178123A2
Authority
WO
WIPO (PCT)
Prior art keywords
electrodes
medical device
instrument head
extension
tissue
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/US2023/064362
Other languages
English (en)
Other versions
WO2023178123A3 (fr
Inventor
Les BOGDANOWICZ
Anthony Appling
Donato M. Ceres
Terry Daglow
Alexander Grycuk
Benjamin Morris
Isaac Raijman
Christen Andrew SPRINGS
Paul Richard Voith
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.)
NovaScan Inc
Original Assignee
NovaScan Inc
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
Priority claimed from US17/695,745 external-priority patent/US20220233089A1/en
Application filed by NovaScan Inc filed Critical NovaScan Inc
Publication of WO2023178123A2 publication Critical patent/WO2023178123A2/fr
Publication of WO2023178123A3 publication Critical patent/WO2023178123A3/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
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6859—Catheters with multiple distal splines
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0536—Impedance imaging, e.g. by tomography
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/05—Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves
    • A61B5/053—Measuring electrical impedance or conductance of a portion of the body
    • A61B5/0538—Measuring electrical impedance or conductance of a portion of the body invasively, e.g. using a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
    • A61B5/316—Modalities, i.e. specific diagnostic methods
    • A61B5/318—Heart-related electrical modalities, e.g. electrocardiography [ECG]
    • A61B5/367—Electrophysiological study [EPS], e.g. electrical activation mapping or electro-anatomical mapping
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6855—Catheters with a distal curved tip
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6856—Catheters with a distal loop
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6858—Catheters with a distal basket, e.g. expandable basket
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/0033—Features or image-related aspects of imaging apparatus, e.g. for MRI, optical tomography or impedance tomography apparatus; Arrangements of imaging apparatus in a room
    • A61B5/004—Features or image-related aspects of imaging apparatus, e.g. for MRI, optical tomography or impedance tomography apparatus; Arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part
    • A61B5/0044—Features or image-related aspects of imaging apparatus, e.g. for MRI, optical tomography or impedance tomography apparatus; Arrangements of imaging apparatus in a room adapted for image acquisition of a particular organ or body part for the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
    • A61B5/7235—Details of waveform analysis
    • A61B5/7264—Classification of physiological signals or data, e.g. using neural networks, statistical classifiers, expert systems or fuzzy systems
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/74—Details of notification to user or communication with user or patient; User input means
    • A61B5/742—Details of notification to user or communication with user or patient; User input means using visual displays

Definitions

  • tissue types can vary in appearance, and different tissue types can have similar appearances.
  • the tissue type on one side of the instrument head such as on a left side of the instrument head, can differ from the tissue type on the other side of the instrument head, such as on a right side of the instrument head.
  • a medical device can be used to extract a tissue sample from a given location, and a healthcare professional can determine how to treat the tissue at the given location by visually inspecting or performing a biopsy on the tissue sample.
  • the instrument head moves between sampling the tissue and treating the tissue, then the healthcare professional could end up treating tissue that is different than the extracted tissue.
  • Figure 14 is a more detailed illustration of the instrument head of Figure 1 , according to other various embodiments;
  • Figures 15A-15B are more detailed illustrations of the instrument head of Figure 1 , according to other various embodiments;
  • FIGs 8A-8B are more detailed illustrations of the instrument head of Figure 1 , according to other various embodiments.
  • the instrument head 108 includes, without limitation, a sheath 204 including an aperture 302, a guidewire 602, and an extension 606 including two or more electrodes 202.
  • the sheath 204 encloses wires that selectively couple the two or more electrodes 202 to external electrical components 106 (not shown).
  • the extension 606 forms a curved shape 804 along a length of the extension 606.
  • the extension 606 includes a shape memory material, such as Nitinol, which causes the extension 606 to form the curved shape 804 when the extension 606 extends from the sheath 204.
  • the extension 606 includes a channel, and wires within the channel attach to one or more locations of an interior surface of the channel. Electrical and/or mechanical actuation of one or more of the wires can cause the extension 606 to form the curved shape 804.
  • the extension 606 selectively forms a circular shape 1002 that encircles a longitudinal axis (e.q., a length axis) of the instrument head.
  • a longitudinal axis e.q., a length axis
  • the extension 606 when retracted into the sheath 204, can form a straight shape.
  • a first portion 1004 of the extension 606 When extended through the aperture 302 of the sheath 204, a first portion 1004 of the extension 606 can extend in a straight or forward direction.
  • Another portion of the extension 606 that is distal to the first portion 1004 can form a circular shape 1002.
  • the extension 606 can include a shape memory material, such as Nitinol, which forms the circular shape 1002 in an unconstrained state.
  • each band 1602 protrudes in different outward direction relative to the longitudinal axis of the wire 1502 than the other bands 1602.
  • the external electrical components 106 can record a second set of impedance measurements of two or more electrodes 202, including selected subsets thereof, to determine impedance measurements of tissue types between various pairs of bands 1602.
  • the external electrical components 106 can record a first subset of impedance measurements between two or more electrodes 202 at a first position along the lengths of the respective bands 1602 and a second subset of impedance measurements between two or more electrodes 202 at a second position along the lengths of the respective bands 1602.
  • Presenting the indication can inform a user of the medical device 100 that the location 102 of the instrument head 108 matches a target location. Further, in various embodiments, the processor 1906 performs the one or more operations 1914 to control a medical device tool based on presenting the tissue type map 1912 and receiving a signal to activate the medical device tool.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Pathology (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Physics & Mathematics (AREA)
  • Biophysics (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Radiology & Medical Imaging (AREA)
  • Physiology (AREA)
  • Cardiology (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)

Abstract

Dans divers modes de réalisation, un dispositif médical comprend une tête d'instrument qui comprend deux électrodes ou plus et un outil de dispositif médical, un pont d'impédance couplé sélectivement aux deux électrodes ou plus, et un processeur couplé au pont d'impédance. Dans divers modes de réalisation, un procédé de commande d'outils de dispositif médical consiste à enregistrer, à une ou plusieurs fréquences, au moins deux mesures d'impédance, chaque mesure d'impédance étant associée à au moins deux électrodes incluses dans une tête d'instrument d'un dispositif médical ; et à déterminer, sur la base des deux mesures d'impédance ou plus, une carte de type de tissu à un emplacement associé à la tête d'instrument.
PCT/US2023/064362 2022-03-15 2023-03-15 Techniques de détermination de types de tissu Ceased WO2023178123A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US17/695,745 US20220233089A1 (en) 2021-01-27 2022-03-15 Techniques for determining tissue types
US17/695,745 2022-03-15

Publications (2)

Publication Number Publication Date
WO2023178123A2 true WO2023178123A2 (fr) 2023-09-21
WO2023178123A3 WO2023178123A3 (fr) 2023-11-02

Family

ID=88024375

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2023/064362 Ceased WO2023178123A2 (fr) 2022-03-15 2023-03-15 Techniques de détermination de types de tissu

Country Status (1)

Country Link
WO (1) WO2023178123A2 (fr)

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5630426A (en) * 1995-03-03 1997-05-20 Neovision Corporation Apparatus and method for characterization and treatment of tumors
US7419487B2 (en) * 2000-07-25 2008-09-02 Angiodynamics, Inc. Apparatus for detecting and treating tumors using localized impedance measurement
US6807444B2 (en) * 2001-11-05 2004-10-19 Hosheng Tu Apparatus and methods for monitoring tissue impedance
US20060135953A1 (en) * 2004-12-22 2006-06-22 Wlodzimierz Kania Tissue ablation system including guidewire with sensing element
AU2007310988B2 (en) * 2006-10-18 2013-08-15 Vessix Vascular, Inc. Tuned RF energy and electrical tissue characterization for selective treatment of target tissues
EP2194895A1 (fr) * 2007-08-08 2010-06-16 Impediguide Ltd. Procédé et dispositif d'identification de tissu
US8221418B2 (en) * 2008-02-07 2012-07-17 Tyco Healthcare Group Lp Endoscopic instrument for tissue identification
CN108472481A (zh) * 2015-10-06 2018-08-31 哈尔西恩医疗有限公司 主动脉肾神经节检测
US10687890B2 (en) * 2015-10-13 2020-06-23 Biosense Webster (Israel) Ltd. Lasso catheter with moveable ablation spine

Also Published As

Publication number Publication date
WO2023178123A3 (fr) 2023-11-02

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