a. Field of the Invention
The present disclosure relates to a electromagnetic positioning sensor for a medical device and a method for mounting an electromagnetic positioning sensor on a medical device.
b. Background Art
Medical devices such as guidewires, catheters, introducers and the like with electromagnetic coil position sensors for device navigation are used in various medical procedures in the body. Assembling electromagnetic coil sensors within the space constraints of a medical device without sacrificing sensitivity presents various design and manufacturing challenges. One such challenge is including a sensor in a device manufacturing process that can survive a high temperature fusion step, for example as is conventional for reflow of an outer polymer (e.g., PEBAX) jacket. It is thus essential that the design of the sensor account for the mechanical forces, material state transitions, and dimensional changes that may occur during high-temperature fusion.
There are additional design considerations, beyond manufacturability, when incorporating position sensors into medical device designs, for example, dimensional considerations. For example, it is known to provide a so-called “over-the-wire” type of medical catheter where the catheter includes an inner, longitudinally-extending central lumen for a guidewire, as seen by reference to U.S. Patent Publication 2004/0097804 to Sobe entitled “METHOD AND SYSTEM FOR MOUNTING AN MPS SENSOR ON A CATHETER,” owned by the common assignee of the present invention and hereby incorporated by reference in its entirety. Such a medical catheter may be further configured to be contained within a sheath or introducer. The resulting configuration presents further challenges when incorporating one or more coil position sensors into its design. First, incorporation of one or more position sensors must not enlarge the outside diameter (O.D.) of the device (i.e., its radial size) since the device must still be able to fit within the large central lumen of the above-mentioned outer sheath or introducer. Second, incorporation of one or more position sensors must not block or otherwise impair the central lumen, which must be keep open and otherwise unrestricted for the guidewire.
There is therefore a need for a medical device that incorporates coil position sensors that minimizes or eliminates one or more of the problems set forth above.
A positioning sensor for use in a medical device wherein the device has a heat-fused layer comprising a first material having a first melting temperature associated therewith, comprises: a tubular core comprising a second material having a second melting temperature associated therewith that is higher than said first temperature; said core having a central through-bore extending along an axis between opposing axial ends of said core, said core further having a radially-outermost winding surface; and an electrically conductive coil wound on said winding surface.
A medical device configured for use with a medical positioning system (MPS) comprises: an elongate body having an axis and an outer surface, said outer surface including a plurality of axially spaced circumferentially-extending grooves, each of the grooves configured to receive a respective positioning sensor, the body having an outside diameter taken with respect to the outer surface; and a plurality of sensors respectively disposed in a corresponding one of the grooves, the sensors each comprising a respective coil, each one of the sensors being configured relative to a corresponding one of the grooves so as to remain within an envelope defined by the outside diameter.
Referring now to the drawings wherein like reference numerals are used to identify identical components in the various views,
Before proceeding to a detailed description of the several medical device embodiments of the present invention, a description of an exemplary environment in which such medical device embodiments may be used will be first set forth. With continued reference to
Input/output mechanisms 14 may comprise conventional apparatus for interfacing with a computer-based control unit, for example, a keyboard, a mouse, a tablet, a foot pedal, a switch or the like. Display 16 may also comprise conventional apparatus.
Embodiments consistent with the invention may find use in navigation applications that use imaging of a region of interest. Therefore system 10 may optionally include image database 18. Image database 18 may be configured to store image information relating to the patient's body, for example a region of interest surrounding a destination site for medical device 26 and/or multiple regions of interest along a navigation path contemplated to be traversed by device 26 to reach the destination site. The image data in database 18 may comprise known image types including (1) one or more two-dimensional still images acquired at respective, individual times in the past; (2) a plurality of related two-dimensional images obtained in real-time from an image acquisition device (e.g., fluoroscopic images from an x-ray imaging apparatus, such as that shown in exemplary fashion in
MPS 20 is configured to serve as the localization system and therefore to determine positioning (localization) data with respect to one or more of MPS location sensors 24i (where i=1 to n) and output a respective location reading. The location readings may each include at least one or both of a position and an orientation (P&O) relative to a reference coordinate system, which may be the coordinate system of MPS 20. For example, the P&O may be expressed as a position (i.e., a coordinate in three axes X, Y and Z) and orientation (i.e., an azimuth and elevation) of a magnetic field sensor in a magnetic field relative to a magnetic field generator(s) or transmitter(s).
MPS 20 determines respective locations (i.e., P&O) in the reference coordinate system based on capturing and processing signals received from the magnetic field sensors 24i while such sensors are disposed in a controlled low-strength AC magnetic field (see
At least one of MPS sensors 241 and 242, both in one embodiment, and optionally additional MPS sensors in further embodiments, may be associated with MPS-enabled medical device 26. Another MPS sensor, namely, patient reference sensor (PRS) 243 (if provided in system 10) is configured to provide a positional reference of the patient's body so as to allow motion compensation for gross patient body movements and/or respiration-induced movements. PRS 243 may be attached to the patient's manubrium sternum, a stable place on the chest, or other location that is relatively positionally stable. Like MPS location sensors 241 and 242, PRS 243 is configured to detect one or more characteristics of the magnetic field in which it is disposed wherein MPS 20 provides a location reading (e.g., a P&O reading) indicative of the PRS's position and orientation in the reference coordinate system.
The electro-cardiogram (ECG) monitor 22 is configured to continuously detect an electrical timing signal of the heart organ through the use of a plurality of ECG electrodes (not shown), which may be externally-affixed to the outside of a patient's body. The timing signal generally corresponds to the particular phase of the cardiac cycle, among other things. Generally, the ECG signal(s) may be used by the control unit 12 for ECG synchronized play-back of a previously captured sequence of images (cine loop) stored in database 18. ECG monitor 22 and ECG-electrodes may both comprise conventional components.
The positional relationship between the image coordinate system and the MPS reference coordinate system may be calculated based on a known optical-magnetic calibration of the system (e.g., established during setup), since the positioning system and imaging system may be considered fixed relative to each other in such an embodiment. However, for other embodiments using other imaging modalities, including embodiments where the image data is acquired at an earlier time and then imported from an external source (e.g., imaging data stored in database 18), a registration step registering the MPS coordinate system and the image coordinate system may need to be performed so that MPS location readings can be properly coordinated with any particular image being used. One exemplary embodiment of an MPS 20 will be described in greater detail below in connection with
In sum, medical devices incorporating electromagnetic field coil position sensors provide enhanced capabilities when used in connection with a compatible localization system, such as MPS 20. For example, the P&O information from MPS 20 allows a representation of the MPS-equipped medical device (e.g., at least the distal tip portion) to be superimposed on images of the region of interest, thereby reducing the use of fluoroscopy (including patient exposure to X-rays) as well as reducing or eliminating the use of dyes to enhance visibility in fluoroscopic images.
The sensor 24a may be incorporated in an assembly for making a medical device in an intermediate stage of manufacture, which assembly may thereafter be finished with an outer layer (i.e., radially-outwardly from core 36 and coil 38) that may be heat-fused, e.g., in a reflow lamination process. For example, such a heat-fused outer layer may comprise an elastomer commercially available under the trade designation PEBAX® from Arkema, Inc, with a melting temperature of about 130-175° C. The outer layer may be the radially-outermost layer of the finished device, or it may be an intermediate layer, but still radially-outwardly of the sensor 24a. Reflow may be conducted at a temperature of about 450° F. Core 36 may comprise a material such as, for example only, a polymer, such as polyimide, or metal, which material may withstand typical heat-fusing temperatures—i.e., the material may be associated with a high melting point—so that core 36 does not deform or disintegrate during reflow. For example, core 36 may comprise a polymer material, such as polyimide, that maintains its structural integrity for temperatures exceeding 450° F. (i.e., has a melting temperature higher than 450° F.). Materials for core 36 may also be selected for, among other things, their magnetic permeability to enhance the position sensor sensitivity, or for the similarity of their mechanical properties to the desired mechanical properties of the final medical device. For example, a metal core may be more desirable to increase sensitivity in a smaller-diameter sensor (e.g., for use in a guidewire application). Because the respective melting temperatures associated with the one or more materials included in core 36 may be relatively higher as compared to the melting temperature of the above-mentioned device outer layer, core 36 is capable of maintaining structural integrity despite the exposure to heat attendant the reflow lamination process.
In one embodiment, sensor 24a is manufactured separately and apart from the manufacture of the medical device in which sensor 24a will be ultimately incorporated. In this embodiment, coil 38 may be temporarily (or permanently) fixed both to itself and to core 36, using conventional approaches for example. At least one electrical wire 70 (best shown in
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The assembly thus formed—core 36, coil 38, wiring 70, and outer layer 46—is then subjected to a reflow lamination process, which involves heating the assembly (e.g., in an oven designed for such processes) until the outer layer material flows and redistributes around the circumference, covering and enveloping coil 38, the exposed (not covered by coil 38) outer surface of core 36, and wiring 70. In one embodiment, the reflow process includes heating the device to about 450° F., though the reflow temperature may vary for other embodiments of the method. Core 36 preferably has a melting point higher than the reflow heating temperature, so it remains solid throughout the reflow step. The assembly is then cooled. After cooling, outer layer 46 may be a unitary jacket 46.
Medical device 48 may include an elongate body portion 50 with a proximal end portion 66, a distal end portion 68, an extreme distal end 52, and an outer surface 54. Elongate body portion 50 is configured to include a central lumen 56 extending from proximal end 66 to distal end 68. Lumen 56 is configured in size and shape to accommodate a guidewire, for example. Device 48 also includes a first electromagnetic field coil positioning sensor 58 and a second electromagnetic field coil positioning sensor 60. Coils 58 and 60 may be configured in design and function the same as sensors 241 and 242 or sensor 24a described above. Although second sensor 60 is shown at extreme distal end 52, the number and location of sensors on device 48 may vary according to device needs. In an alternate embodiment, body portion 50 may be solid, rather than hollow, and therefore may lack a central lumen.
The third embodiment advantageously may incorporate multiple sensors 58, 60 without increasing the outer diameter of the device, resulting in a substantially smooth outer surface with no increase in outer diameter. If such smoothness is desired, groove height h defines the desired thickness of a sensor in that groove, so that the outer diameter of device 48 is not increased by the sensor. In other words, where outer diameter d1 defines an envelope radially-outwardly of a groove, the sensor disposed in that groove may remain within the envelope. In an exemplary embodiment, body portion 50 and sensors 58, 60 form a catheter. Because sensors 58, 60 may maintain the outer diameter of the catheter, device 48 advantageously may have a relatively smooth outer surface so that an outer sheath (not shown) or other medical device may be passed radially-outwardly of device 48. The sheath may have its own main lumen and inside diameter selected relative to the outside diameter of the catheter, allowing the catheter to pass through the sheath main lumen. Additionally, lumen 56 may retain its original dimension and shape, allowing continued co-functionality with a guidewire (not shown).
MPS system 110 includes a location and orientation processor 150, a transmitter interface 152, a plurality of look-up table units 1541, 1542 and 1543, a plurality of digital to analog converters (DAC) 1561, 1562 and 1563, an amplifier 158, a transmitter 160, a plurality of MPS sensors 1621, 1622, 1623 and 162N, a plurality of analog to digital converters (ADC) 1641, 1642, 1643 and 164N and a sensor interface 166.
Transmitter interface 152 is connected to location and orientation processor 150 and to look-up table units 1541, 1542 and 1543. DAC units 1561, 1562 and 1563 are connected to a respective one of look-up table units 1541, 1542 and 1543 and to amplifier 158. Amplifier 158 is further connected to transmitter 160. Transmitter 160 is also marked TX. MPS sensors 1621, 1622, 1623 and 162N are further marked RX1, RX2, RX3 and RXN, respectively. Analog to digital converters (ADC) 1641, 1642, 1643 and 164N are respectively connected to sensors 1621, 1622, 1623 and 162N and to sensor interface 166. Sensor interface 166 is further connected to location and orientation processor 150.
Each of look-up table units 1541, 1542 and 1543 produces a cyclic sequence of numbers and provides it to the respective DAC unit 1561, 1562 and 1563, which in turn translates it to a respective analog signal. Each of the analog signals is respective of a different spatial axis. In the present example, look-up table 1541 and DAC unit 1561 produce a signal for the X axis, look-up table 1542 and DAC unit 1562 produce a signal for the Y axis and look-up table 1543 and DAC unit 1563 produce a signal for the Z axis.
DAC units 1561, 1562 and 1563 provide their respective analog signals to amplifier 158, which amplifies and provides the amplified signals to transmitter 160. Transmitter 160 provides a multiple axis electromagnetic field, which can be detected by MPS sensors 1621, 1622, 1623 and 162N. Each of MPS sensors 1621, 1622, 1623 and 162N detects an electromagnetic field, produces a respective electrical analog signal and provides it to the respective ADC unit 1641, 1642, 1643 and 164N connected thereto. Each of the ADC units 1641, 1642, 1643 and 164N digitizes the analog signal fed thereto, converts it to a sequence of numbers and provides it to sensor interface 166, which in turn provides it to location and orientation processor 150. Location and orientation processor 150 analyzes the received sequences of numbers, thereby determining the location and orientation of each of the MPS sensors 1621, 1622, 1623 and 162N. Location and orientation processor 150 further determines distortion events and updates look-up tables 1541, 1542 and 1543, accordingly.
It should be understood that system 10, particularly the main electronic control unit 12, as described above may include conventional processing apparatus known in the art, capable of executing pre-programmed instructions stored in an associated memory, all performing in accordance with the functionality described herein. Such an electronic control unit may further be of the type having both ROM, RAM, a combination of non-volatile and volatile (modifiable) memory so that any software may be stored and yet allow storage and processing of dynamically produced data and/or signals.
Although numerous embodiments of this invention have been described above with a certain degree of particularity, those skilled in the art could make numerous alterations to the disclosed embodiments without departing from the spirit or scope of this invention. All directional references (e.g., plus, minus, upper, lower, upward, downward, left, right, leftward, rightward, top, bottom, above, below, vertical, horizontal, clockwise, and counterclockwise) are only used for identification purposes to aid the reader's understanding of the present invention, and do not create limitations, particularly as to the position, orientation, or use of the invention. Joinder references (e.g., attached, coupled, connected, and the like) are to be construed broadly and may include intermediate members between a connection of elements and relative movement between elements. As such, joinder references do not necessarily infer that two elements are directly connected and in fixed relation to each other. It is intended that all matter contained in the above description or shown in the accompanying drawings shall be interpreted as illustrative only and not limiting. Changes in detail or structure may be made without departing from the spirit of the invention as defined in the appended claims.