The subject disclosure relates to a system for illustrating a device, and particularly for illustrating a device relative to a diameter of a vessel.
This section provides background information related to the present disclosure which is not necessarily prior art.
During various procedures, an instrument can be positioned within a volume of a vessel. The vessel can include a vasculature, such as a vein, of a patient. The vessel of the patient may include a diameter along its length. The instrument positioned within the vessel may include a lead, such as a stimulation or cardiac rhythm lead. The lead may generally be held within the vessel based upon an interference fit of the lead within the vessel.
Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure.
In a selected procedure, an instrument can be positioned within a structure. The structure may be any appropriate structure into which an instrument may be placed. For example, the structure may include a vasculature of a patient, tubing of a system, or pipes of a sewer system. The instrument may be any appropriate instrument as well. For example, the instrument may include an optic camera, such as one to view an interior of a water passage system, oil passage system, or other exemplary system. For example, a user may select to investigate an integrity of a pipe system that may be included in an architectural structure, a cooling system (e.g. heat exchanger) for a vehicle or engine, or an oil transport line. The investigative device can include a geometry, such as a diameter. The geometry of the instrument may be determined to fit within interior wall surfaces of the pipe or passage system. Accordingly, a selection system and/or method can be used to ensure or select an appropriate size of the investigative instrument.
According to various embodiments, the instrument may include a lead. The lead can include a lead for a cardiac resynchronization system. The lead may also include a lead for a stimulation system, such as a nervous stimulation system. In addition, the instrument can include a pulmonary instrument that may include sensors such as pressure sensors and/or position sensors.
A selection or suggestion system can include information that is analyzed to determine a geometry of a structure, such as a tubing or pipe system, although the structure may include a vasculature of a subject. The analysis can be performed on a model that is generated or based upon image data acquired of the subject. The model can be a selected model, such as a two-dimensional (2D) model and/or a three-dimensional (3D) model. The analysis of the geometry of the passage system, such as a vasculature, can be used to identify a diameter at various arc-like segments over a selected length of the vasculature.
The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure.
Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings.
Example embodiments will now be described more fully with reference to the accompanying drawings.
In a physical structure, a passage may be bounded by a surface formed by a wall. The surface formed by a wall can include a pipe structure, such as in tubes of a heat exchanger, pipe passages in a building structure, or a vasculature of a patient. In a selected physical structure it may be selected to position an instrument for various procedures. The procedure may include moving a viewing instrument, such as a fiber optic camera, to inspect a pipeline in a building structure or heat exchanger for issues, such as leaks or cracks. Also, a procedure may include positioning of a lead for implantation within a subject. The lead can include a cardiac rhythm lead, pressure sensing lead, or other implantable instrument. Nevertheless, according to various embodiments, including those discussed herein, it may be selected to identify the geometry, including at least an internal diameter, of a passage for determining an appropriate size, path, and other features of positioning an instrument. It may be selected, for example, to obtain analysis such as image analysis of a structure to determine the geometry of the passages.
It is understood that the following disclosure may relate to positioning an instrument within a subject, such as a human subject, however, an instrument can be positioned within any appropriate system, such as tubes in a heat exchanger, water pipes in a structure, or other appropriate system. Further, although the following example may relate to positioning a cardiac lead within the vasculature of a patient, such as a cardiac resynchronization lead, other appropriate instruments may be used. For example, a pressure sensor, an ablation instrument, or the like may be incorporated into an instrument. It is understood that the system discussed herein may relate to such instruments.
In one example, a lead can include any appropriate lead that can be delivered to a patient. For example, the cardiac resynchronization therapy (CRT) leads can include the Attain Ability® leads and the Attain STARFIX® leads that can be interconnected with a selected resynchronization implant (generally referred to as an implanted medical device (IMD)). IMDs can include the VIVA XT® IMD or the Protecta® XT CRT-D IMD sold by Medtronic, Inc. The Attain® leads can be a part of the Attain® CRT implant system sold by Medtronic, Inc., having a place of business in Minnesota, U.S.A. Further, additional portions could be used to assist in positioning the leads such as an Attain Command® catheter or catheters and one or more Attain Select® II sub-selection catheters. All of these systems can be passed through vasculature of the patient prior to implanting the lead within the patient. Further, the lead may be held within the patient at a selected location that is based upon an interaction of the lead with the anatomy of the patient, such as a wall of the vasculature.
For example, as illustrated in
Various systems can be used to determine or analyze the anatomy or geometry of a vessel or passage system. For example, the CardioGuide® System sold by Medtronic, Inc. can obtain image data or analyze image data of a patient. The image data can be used to generate a 2D or 3D model of the geometry of a vessel over a length can be analyzed and/or determined. In addition thereto, or alternatively thereto, other systems can be used to analyze the geometry of vessels of a subject or other appropriate system. For example, magnetic resonance image data (MRI data) could be used to determine the geometry of a portion of a subject. Further, any appropriate venogram image data system can be used to generate image data that can be analyzed in an appropriate manner. Further, certain systems, such as those disclosed in U.S. patent application Ser. No. ______ (Attorney Docket No. 5074D-000086-US) entitled, “A METHOD AND SYSTEM FOR RANKING INSTRUMENTS” describes a system that can be used to analyze image data, incorporated herein by reference.
With reference to
As exemplarily illustrated in
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With reference to
With continuing reference to
As discussed above, the device 110 can be handheld, such as being portable or handheld by a user such that a hand 120 of a user can carry and operate the device 110. Various inputs, such as a touchscreen and/or access buttons 122 can also be used to access various portions of the device 110. For example, touching on the display 112 can identify the target location 30. It is understood that the access or inputs can also be used to change or augment the target, or other appropriate portion. Nevertheless, the display 112 can display image data and/or a model generated from image data and/or other information 130. The image data and/or model 130 can be used by a user to identify the target 30, select a lead for display, select a portion of the vasculature 40 to plot, and to display the plots as illustrated in
With continuing reference to
With continuing reference to
The flowchart 200 can begin with start block 202. Initially, accessing subject data can occur in block 204. Subject data can include appropriate data, such as image data, drafting data, and other appropriate data. For example, subject data can include measurements or engineering drawing data for various structures, such as tubing. Further, subject data can include image data, such as venographic data, MRI data, or other appropriate image data of a subject. For example, and according to various embodiments including those discussed exemplarily herein in detail, the image data can include venographic image data. Venographic image data can include image data similar to that disclosed in U.S. patent application Ser. No. ______ (Attorney Docket No. 5074D-000086-US). Additionally, the venographic image data can include image data that is analyzed and used with the Cardio Guide® System, as noted above. Nevertheless, the image data can be acquired according to generally known techniques and/or any appropriate techniques to obtain image data of a subject.
After the image data is accessed, such as directly from an imaging system or stored in the memory 116, the subject data can be prepared in block 210. Preparing the subject data in block 210 can be any appropriate preparation. For example, a 2D model and/or a 3D model can be generated with the subject data. As discussed above, engineering drawings can also be used to generate a drawing model of a physical structure. Further, the subject data that may include image data can be analyzed to generate a 2D or 3D model of the imaged portion. According to various embodiments, the image data can be a venogram of a subject, such as a human patient, and including vasculature around and near the heart.
The image data of the subject can be analyzed and used to generate a 3D model of the vasculature of the subject. The 3D model can then be further analyzed to determine various geometric configurations, sizes, and the like of the imaged portion. For example, as is generally understood in the art, the venographic image data can be used to identify a diameter of a vessel at its centerline along its length. The diameter may be segmented along selected arc length portions of the vessel, and in appropriate increment, as discussed above. For example, an arc length may include about 0.1 millimeters (mm) to about 2 mm, further including about 0.5 mm to about 1 mm, and further including about 1 mm. The arc length can be used to identify or define a segment or portion of the vasculature to allow for a determination of the diameter at the arc length portion.
Accordingly, the preparation of the subject image data can be used to generate the 3D model, identify the selected arc length segments, and measuring or determining a diameter at each arc length. An input can then be received to input a target structure in block 214. The input can be a direct input, such as by a user using the input button 122 and/or touching the screen 112 of the device 110. For example, the image 130 can be an exemplary model generated with the image data, then the user can use a digit of the hand to identify a target structure. A target structure can include a length or section of the vessel 40 to be analyzed further. The target structure need not be a specific location within the structure, but can identify a whole structure, such as a branch from the coronary sinus or other appropriate structural portion.
After a target structure is input from block 214, an analysis of the prepared data of the target structure can be performed in block 220. The analysis of the prepared data in block 220 can include a determination of a diameter at various arc lengths of the structure. The diameter vs. the arc length can be determined for the entire length of the input structure or a selected portion of the input structure as selected by a user. The diameter can be determined based upon analysis of the image data, such as determining a pixel width of the structure in the image and correlating the number of pixels to a physical dimension, such as in millimeters, centimeters, or the like.
Further, the analysis of the prepared image data in block 220 can be compared to an envelope diameter at each arc length. As discussed above, and illustrated in
The analyzed prepared target data can then be displayed on the display device 112 in block 224. The display of the analyzed prepared data can be based upon or include an input target location from block 226. The input target location can include a direct input or recalled input of the target. Again, for example, the user can touch a portion of the display 112 to identify a specific target location, such as the target 30. The display plot of the analyzed data in block 224 can then be displayed on the display device 112, as illustrated in
Also, as noted above, the envelope size relative to the diameter of the vessel can also be determined and illustrated, as exemplary illustrated in
Relative to the displayed diameter vs. arc length plots are displayed the instrument lines 90-94 or any selected number of instruments can be made. Accordingly, input to the system can include input of selected instruments in block 240. Again, it is understood that the input of selected instruments in block 240 can be input by a user directly or in real time, such as with the device 110, or substantially automatically. In various embodiments, the processor 114 in executing the instructions can recall selected or preferred or possible instruments for display relative to the plot. Additionally, a user may specifically select one or more instruments for displaying on the plots in the input block 240. Thus, display of the selected instruments relative to the displayed envelopes can be performed in block 242 on the display 112.
Again, as illustrated in
Once the instruments have been selected and/or displayed in blocks 240 and 242, a determination of a deviation of the instrument diameter vs. the structure diameter over the arc lengths can be determined in block 250. The determination of the deviation can include a least squares of the difference of the instrument diameter relative to the arc length segment illustrated by the vessel line 40a and/or 40b. For example, with reference to
With continued reference to
If the determination that a displayed instrument is appropriate or acceptable, a YES path 272 can be followed to end the procedure or the analysis in block 274. It is understood that once an acceptable instrument is determined by following the YES path 272 that a procedure may be performed in block 280. The procedure performed may be separate from or following a determination of an appropriate instrument, but can include implantation of a cardiac lead, placement of a pulmonary lead, positioning of a scope within a tubing of a structure (e.g., a compressor or heat exchanger), or other appropriate procedure.
If the decision block 270 follows a NO path 290 that none of the displayed leads are acceptable, a second decision block 292 can be used to determine whether all possible target structures and target locations and instruments have been displayed. If it is determined that all target structures, all target locations, and that all possible instruments have been displayed, then a YES path 294 may be followed to the end block 274. In this instance, however, performing a procedure 280 may not occur as no target structure, target location, or possible instrument has been determined to be appropriate. It is understood, however, that further image data may be acquired, a larger library of possible instruments, or other analysis may occur to perform a procedure, as selected.
Nevertheless, if it is determined that all target structures, all target locations, or all possible instruments have not been displayed, a NO path 300 can be followed to a request for input of a new target structure and/or a new target location in block 310. It is understood that the input of a new target structure or a new target location can be made by a user, such as a surgeon, inputting instruction into the system 110 or an automatic selection of a new target location or a new target structure. For example, a user or system can identify a new branch vessel to select for analysis by the procedure 200 for possible placement of an instrument. Further, the system or user can select a new location, such as a more distal location, for implantation of a lead. Accordingly, a request for input can lead to an alternative of input target structure in block 214 or input target location in block 226 by following input path 314 and/or 316, respectively. It is understood that the flowchart 200 can be executed in such a manner until stopped by the system, stopped by the user, or stopped by the algorithm based upon having determined that all possible structures, target locations, and instruments have been displayed or analyzed and all have been determined to be not acceptable.
Accordingly, as discussed above, a user can use the method 200, such as executed by the processor 114, to assist in illustrating and/or suggesting possible or acceptable lead instruments for selected target structures and/or selected target locations as input in blocks 214 and/or 226, respectively. The results can be displayed on plots, as exemplary illustrated in
The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure.
Example embodiments are provided so that this disclosure will be thorough, and will fully convey the scope to those who are skilled in the art. Numerous specific details are set forth such as examples of specific components, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to those skilled in the art that specific details need not be employed, that example embodiments may be embodied in many different forms and that neither should be construed to limit the scope of the disclosure. In some example embodiments, well-known processes, well-known device structures, and well-known technologies are not described in detail.