The present invention relates generally to devices for use in vascular treatments. More particularly the present invention relates to devices used in vascular. treatments that incorporate a magnetic resonance visibility enhancing structure, the devices being adapted for use in magnetic resonance imaging.
Vascular stents are known medical devices used in various vascular treatments of patients. Stents commonly include a tubular member that is moveable from a collapsed, low profile, delivery configuration to an expanded, deployed configuration. In the expanded configuration, an outer periphery of the stent frictionally engages an inner periphery of a lumen. The deployed stent then maintains the lumen such that it is substantially unoccluded and flow therethrough is substantially unrestricted. However, various stent designs render the stent substantially invisible during a Magnetic Resonance Imaging procedure.
Magnetic Resonance Imaging, (MRI) is a non-invasive medical procedure that utilizes magnets and radio waves to produce a picture of the inside of a body. An MRI scanner is capable of producing pictures of the inside of a body without exposing the body to ionizing radiation (X-rays). In addition, MRI scans can see through bone and provide detailed pictures of soft body tissues.
A typical MRI scanner includes a magnet that is utilized to create a strong homogeneous magnetic field. A patient is placed into or proximate the magnet. The magnetic field causes a small majority of the atoms with a net magnetic moment, also referred to as spin, to align in the same direction as the magnetic field. When a radiowave is directed at the patient's body, atoms precessing in the magnetic field with a frequency equal to the radiowave are able to adapt the radiowave energy, which causes them to “tumble over” and align in the opposite direction of the magnetic field. The frequency at which atoms with a net spin precess in a magnetic field is also referred to as the Larmor frequency. The opposing alignment is at a higher energy level compared to the original orientation. Therefore, after removing the radiowave, atoms will return to the lower energetic state. As the atoms return to the lower energetic state, a radio signal is sent at the Lamor frequency. These return radio waves create signals (resonance signals) that are detected by the scanner at numerous angles around the patient's body. The signals are sent to a computer that processes the information. and compiles an image or images. Typically, although not necessarily, the images are in the form of 2-dimensional “slice” images.
An ability to effectively view areas proximate a stent during an MRI procedure is desirable. In particular, viewing areas inside and proximate a tubular member of a stent may be desirable both during deployment and after deployment of the stent in a patient. However, various current stent designs prevent adequate imaging of the area surrounding the stent. Instead, the images are distorted and thus cannot be used.
Embodiments of the present invention relate to medical devices that reduce the distortion of medical resonance images taken of the devices. In particular, various structures are utilized to enhance visibility proximate and inside of a tubular member of a stent. In one particular embodiment, the stent does not contain electrically conductive loops. In another embodiment, ring portions in the stent are arranged such that current in one ring portion is opposed by current in another connected ring portion.
RF source 140 radiates pulsed radio frequency energy into subject 100 and stent 150 at predetermined times and with sufficient power at a predetermined frequency to influence nuclear magnetic spins in a fashion known to those skilled in the art. The influence on the atoms causes them to resonate at the Larmor frequency. The Larmor frequency for each spin is directly proportional to the absolute value of the magnetic field experienced by the atom. This field strength is the sum of the static magnetic field generated by magnetic field generator 120 and the local field generated by magnetic field gradient generator 130. In an illustrative embodiment, RF source 140 is a cylindrical external coil that surrounds the region of interest of subject 100. Such an external coil can have a diameter sufficient to encompass, the entire subject 100. Other geometries, such as smaller cylinders specifically designed for imaging the head or an extremity can be used instead. Non-cylindrical external coils such as surface coils may alternatively be used.
External RF receiver 160 illustratively detects RF signals emitted by the subject in response to the radio frequency field created by RF source 140. In an illustrative embodiment, external RF receiver 160 is a cylindrical external coil that surrounds the region of interest of subject 100. Such an external coil can have a diameter sufficient to encompass the entire subject 100. Other geometries, such as smaller cylinders specifically designed for imaging the head or an extremity can be used instead. Non-cylindrical external coils, such as surface coils, may alternatively be used. External RF receiver 160 can share some or all of its structure with RF source 140 or can have a structure entirely independent of RF source 140. The region of sensitivity of RF receiver 160 is larger than that of the stent 150 and can encompass the entire subject 100 or a specific region of subject 100. The RF signals detected by external RF receiver 160 are sent to imaging and tracking controller unit 170 where they are analyzed. Controller 170 displays signals received by RF receiver 160 on visual display 190.
Establishing a homogenous, or uniform, magnetic field with magnetic field generator 120 in addition to switched linear gradient magnetic fields activated in various sequences as well as timely switching the RF radiowave in various sequences, as known in the art, enables the production of internal images of subject 100. It is common that the magnetic field surrounding stent 150 is distorted, which causes distortion of images obtained proximate stent 150. This is because devices that include ferromagnetic materials will generally distort magnetic fields. For example, it is common for the material and structure of stent 150 to affect the magnetic field around stent 150. Such effects reduce the influence that magnetic field generator 120, gradient generator 130 and RF source 140 have on the nuclear magnetic spins in subject 100. In particular, the spins inside a tubular member of a stent are commonly not excited during an MRI and thus no image is detected.
One embodiment of the present invention includes using non-ferromagnetic materials in stent 150 to reduce this distortion. Such materials include, by way of example, platinum, iridium, tantalum, titanium, gold, niobium, hafnium alloys exhibiting non-ferromagnetic properties, and other non-ferromagnetic materials. Combinations of non-ferromagnetic materials can also be utilized without departing from the scope of the present invention. Another effect that commonly distorts the magnetic field around an intravascular device is associated with Faraday's Law. Faraday's Law simply states that any change in a magnetic environment of a coil will cause a voltage (emf) to be “induced” in the coil. Stent 150 can act as a coil when implanted in a subject during an MDRI process. The change in magnetic environment is caused either by stent 150 moving within a magnetic field, or by changes in the magnetic field proximate stent 150. For example, stent 150 may move due to the heart beating or magnetic field changes may be induced by gradient generator 130 or RF Source 140.
According to Faraday's Law, the induced emf in a coil is equal to the negative of the rate of change of magnetic flux through the coil times the number of turns in the coil. When an emf is generated by a change in magnetic flux, the polarity of the induced emf produces a current creating a magnetic field that opposes the change which produces it. Accordingly, the induced magnetic field inside any loop of wire acts to keep the magnetic flux inside the loop constant.
When attempting to produce an image of stent 150 inside subject 100, the stent acts as a coil or, depending on the structure of the stent, as multiple coils. During various phases of an MRI process to influence the nuclear spins, a change in the magnetic field inside the stent is generated. For example, gradient generator 130 may generate a pulse in order to influence spins to be analyzed by controller 170. The gradient generator 130 thus changes the magnetic field and accordingly a change in magnetic field proximate the stent is opposed by Faraday's Law. As a result, spins proximate the stent are not excited and images of the stent show a lack of signal.
In order to reduce the effect of Faraday's Law on spins inside the stent, various stent designs have been made in accordance with embodiments of the present invention. In one embodiment, the creation of electrical loops within a stent structure is avoided. In yet another embodiment, a structure is used wherein current moving in one direction is opposed by a parallel current moving in the opposite direction. Using these designs, the visibility of a stent during an MRI process is enhanced.
Stent 320 is illustrated in
An insulating material has been applied to each of rings 322 prior to assembly of the tubular structure 321. The insulating material could be applied to rings 322 in various ways, such as coating and depositing, for example. Thus, each of the rings 322 is spaced apart from the others by the insulating material. Accordingly, each of the rings 322 is electrically insulated from each other ring in order to prevent electrical loops from forming in tubular structure 321. Various insulating materials may be used including, as examples, polymeric and ceramic materials. As appreciated by those skilled in the art, other stent structures such as mesh or woven structures may also be used.
As illustrated, various rings 322 of tubular structure 321 intersect at an angle to form a braided structure. For example, rings 328 and 330 intersect at an angle.
It will be appreciated that not all of the rings in a stent need to be coated with an insulating material. The insulating material is only needed to prevent any electrically conducting loops. For example, coating may be applied to only one of the rings at an intersection point with another ring. Additionally, intersecting rings may be made of differing materials, such as ring 328 being electrically conductive and ring 330 made of an insulating material.
A pattern in undulating ring 354 is comprised of semi-circular elements that support a greater surface area of a lumen. Other types of patterns may also be used. Ring 354 also includes free ends 360 and 362 that terminate at opposite ends of the stent and prevent the formation of electrical loops within tubular member 351.
Also, ring 354 is wound such that a plurality of rows 366 are formed in tubular member 351. In order to enhance the structural integrity of stent 350, connectors 364 are provided between rows 366 of ring 354. In order to prevent electrical loops from forming in tubular member 351, the connectors 364 are illustratively made of an insulating, material, such as a polymer or a ceramic. Alternatively, connector 364 may be a metal wire coated with an insulating material and connected between rows 366 so as to not make an electrical connection with ring 354.
In some instances, a radiopaque material is used on stents in order to enhance their visibility under x-ray procedures. Typically, a radiopaque metallic layer is applied to stents made of various polymers or ceramics that are non-radiopaque. The radiopaque layer typically distorts magnetic resonance images as discussed earlier. In order to prevent the formation of electrical loops in the radiopaque layer, a stent 370 similar to that shown in
In an alternative embodiment, a design is chosen wherein rings of a stent are twisted in such a way that a current in one direction is counteracted by a current in the opposite direction. This is explained with regard to
Each of the ring portions are connected to each other via connectors 408 and 410. Connector 408 connects end 401 of ring portion 400 to end 405 of ring portion 404. Connector 410 connects end 402 of ring portion 400 to end 406 of ring portion 404. Collectively, ring portions 400 and 404 are connected together to form a ring 411 having a gap 412 along a periphery of the ring 411.
Accordingly, when ring portions 400 and 404 are subject to a changing magnetic field represented as ΔB, current flowing in each of the ring portions 400 and 404 will be opposed, which is represented by arrows 414 and 416. This allows spins, for example spin 418, to be excited by RF source 140 and gradient generator 130. When used in a stent, a plurality of rings similar to ring 411 allows spins inside a tubular member of the stent to be excited.
Other embodiments having electrically opposed rings may be used. For example, a stent as shown in
Insulating materials within the stents in the above examples can be various polymeric or ceramic materials. One such material is ePTFE (expanded polytetrafluoroethylene). Various ePTFE fibers, films and tubes can be purchased from Zeus Industrial Products of Orangeburg, S.C.; International Polymer Engineering of Tempe, Ariz.; and W. L. Gore & Associates, Inc. of Elkton, Md. The ePTFE materials are soft, microporous (herein various pore sizes of 0.2–3 microns), flexible and exhibit dielectric properties, strength and biocompatibility. Flexible films or fibers can be fabricated into connector stent connections and then heated to 372° C. for approximately 10 minutes. Consequently, the ePTFE connections are adhered together to form stent connectors. The heat treatments can be varied and are generally conducted 10° C. below the melting or degrading temperature of PTFE. The treatments increase the tensile strength of the ePTFE films, tubes or fibers. There are various other ways to fabricate ePTFE. For example, stent connectors can be connected by multiple layer tubes, then subjected to heat treatments. The ePTFE film can also be wrapped around stent connectors to make the connections.
Although the present invention has been described with reference to illustrative embodiments, workers skilled in the art will recognize that changes may be made in form and detail without departing from the spirit and scope of the invention.
Number | Name | Date | Kind |
---|---|---|---|
4572198 | Codrington | Feb 1986 | A |
4706670 | Andersen et al. | Nov 1987 | A |
5041126 | Gianturco | Aug 1991 | A |
5160890 | Roschmann | Nov 1992 | A |
5170789 | Narayan et al. | Dec 1992 | A |
5271400 | Dumoulin et al. | Dec 1993 | A |
5307808 | Dumoulin et al. | May 1994 | A |
5445151 | Darrow et al. | Aug 1995 | A |
5447156 | Dumoulin et al. | Sep 1995 | A |
5699801 | Atalar et al. | Dec 1997 | A |
5728079 | Weber et al. | Mar 1998 | A |
5738632 | Karaswa | Apr 1998 | A |
5744958 | Werne | Apr 1998 | A |
5755781 | Jayaraman | May 1998 | A |
5843120 | Israel et al. | Dec 1998 | A |
5916264 | Von Oepen et al. | Jun 1999 | A |
5922020 | Klein et al. | Jul 1999 | A |
5938601 | Young | Aug 1999 | A |
5951494 | Wang et al. | Sep 1999 | A |
5964705 | Truwit et al. | Oct 1999 | A |
6042588 | Munsinger et al. | Mar 2000 | A |
6093157 | Chandrasekaran | Jul 2000 | A |
6168621 | Vrba | Jan 2001 | B1 |
6171240 | Young et al. | Jan 2001 | B1 |
6174329 | Callol et al. | Jan 2001 | B1 |
6231516 | Keilman et al. | May 2001 | B1 |
6241760 | Jang | Jun 2001 | B1 |
6251086 | Cornelius et al. | Jun 2001 | B1 |
6258071 | Brookes | Jul 2001 | B1 |
6263229 | Atalar et al. | Jul 2001 | B1 |
6280385 | Melzer et al. | Aug 2001 | B1 |
6334870 | Her et al. | Jan 2002 | B1 |
6340367 | Stinson et al. | Jan 2002 | B1 |
6409754 | Smith et al. | Jun 2002 | B1 |
6416538 | Ley et al. | Jul 2002 | B1 |
6463317 | Kucharczyk et al. | Oct 2002 | B1 |
6475168 | Pugsley, Jr. et al. | Nov 2002 | B1 |
6487437 | Wiswanathan et al. | Nov 2002 | B1 |
6537310 | Palmaz et al. | Mar 2003 | B1 |
6585755 | Jackson et al. | Jul 2003 | B2 |
6585763 | Keilman et al. | Jul 2003 | B1 |
6767360 | Alt et al. | Jul 2004 | B1 |
20020183829 | Doscher et al. | Dec 2002 | A1 |
20020188345 | Pacetti et al. | Dec 2002 | A1 |
Number | Date | Country |
---|---|---|
0 240 504 | Nov 1990 | EP |
0 824 900 | Feb 1998 | EP |
WO 9313825 | Jul 1993 | WO |
WO 9626689 | Sep 1996 | WO |
WO 0012147 | Mar 2000 | WO |
WO 0108600 | Feb 2001 | WO |
WO 0230331 | Apr 2002 | WO |
WO 02053066 | Nov 2002 | WO |
WO 03075792 | Sep 2003 | WO |
Number | Date | Country | |
---|---|---|---|
20040158310 A1 | Aug 2004 | US |