Patent Application
20210236017
The invention relates to the field of devices, in particular guidewires and catheters, needed for minimally invasive interventions.
Minimally invasive interventions in the human body require guidewires and catheters. These are available in a multitude of forms, sizes, configurations and mechanical characteristics for procedures guided by X-ray imaging.
These catheters and guidewires are not applicable to magnetic resonance tomography (MRT)-guided procedures as they usually contain metals. This leads to artifacts which makes evaluation of the images difficult or even impossible. Furthermore, this conceals the risk of inductive heating in the magnetic field leading to a potential risk to the patient.
Three essential requirements have to be fulfilled by devices to make them suitable for use in MRT:
Such effects on the one hand should be strong enough to render the device well visible in the MRT image but on the other hand weak enough not to make important structures in the vicinity unidentifiable.
The strong magnetic field of a magnetic resonance tomography makes the absence of any ferromagnetism a precondition for the use of devices within this equipment. This excludes e.g. many standard catheters which can be attracted and misguided by the strong magnetic field. Materials solely composed of polymers fulfill the prerequisite of absence of ferromagnetism.
The minimal size of devices used for intervention such as guidewires or catheters causes a special problem for application in magnetic resonance tomography and especially for rapid imaging. The faster imaging is done in MRT the lower is the local resolution. In order to make visible such a small item as a catheter which shows up as a dark object due to the relative lack of hydrogen protons, appropriate high-resolution and thus slow imaging is necessary. Furthermore, it is very difficult to make visible such a small item in the usually prepared layer thickness of around 10 mm so that on the one hand it is positioned within the recorded layer and on the other hand it does not become invisible due to partial volume effects.
A solution to this problem resides in markers which lead to a local extinction of the signals in the MRT image and therefore allow easier identification and visualization of the device. For this purpose generally materials which possess a susceptibility (magnetizability) different from water are suitable. The markers have to be applied locally in order to avoid dependence of the marker on the orientation of a device in the main magnetic field. Rare earths which are used as MRT contrast agents have been used for this purpose in higher concentrations. They have been applied or introduced, both locally as markers as well as for catheter fillings to obtain better visibility of devices in the MRT.
A major disadvantage of these substances used so far as local markers resides in their rather high mass required to achieve a sufficient marking effect in the MRT. This is reflected e.g. in the fact that much more complicated techniques for conducting current along a wire within the device, or which mount micro-inductors on the catheter, have been developed although resultant safety issues such as heating from the radio frequency field have not yet been resolved at all. These heating effects occur when electric conductors such as metals are exposed to the radio frequency field over a longer distance in the MR tomograph. If resonance occurs, a summation of the irradiated radio energy over a standing wave results, with the possible consequence of a substantial heating of the conductor.
Known single-stranded homogenous non-metal materials exhibit major disadvantages of their material characteristics in comparison to common metal cores regarding stability, flexibility and elasticity, e.g., materials with high stability mostly possess low flexibility and/or elasticity. Consequently it has not been possible to date to replace the common metal core by an MRT compatible and visible material.
It is an object of the present invention to provide MRT-compatible devices, especially a catheter and a guidewire, which do not contain longer coherent metallic parts and thus do not suffer from the risk of inductive heating. On the other hand the device shall be visible in appropriate MRT sequences over its complete length along and across the main magnetization without having body structures in the vicinity of the device made unrecognizable as a result of artefacts. A further object of this invention is that of providing MRT-compatible devices which do not suffer from any limitations in material characteristics and handling properties as compared to currently known devices.
As a solution to this problem a rod-shaped body (“rod”) is suggested which is composed of one or more non-metallic filaments and a non-ferromagnetic matrix material wherein the matrix material encloses and/or agglutinates the filament(s), and wherein a doping by particles producing artefacts in magnetic resonance tomography is included into the matrix material. The combination of the matrix material with the non-metallic filament(s) results in an unexpectedly simple manner in metal-like stiffness, flexibility and elasticity characteristics.
The filaments forming the rod-shaped body can be produced easily and cost-efficiently, with adequate stability and the ability to transmit compressive and tensile force and torques. By doping of the matrix material which is either necessary for enclosure of a single filament or agglutination of several filaments, a simple and efficient method has been developed to visualize the rod-shaped body in the MRT and at the same time to allow handling according to current standards.
The actual devices such as catheters, guidewires, etc. are constructed from these basic elements as described below. Advantageous developments of the invention are the subject of the dependent claims.
It is especially advantageous if the filaments are made of plastic and/or glass fibre. Such filaments can be easily and cost-efficiently produced with great length and a wide variety of cross-sections and diameters. Especially glass fibre has minimal elongation, making possible very direct transmission of force and momentum.
The matrix material may advantageously be made of epoxy resin. Epoxy resins are available with a wide range of properties and machines for their processing are well-developed.
The rods can be continuously doped along their longitudinal axis with particles generating artefacts in magnetic resonance tomography. This makes the rod well visible in the MRT over its entire length.
For some applications, however, it may be preferred to dope the rod in a discontinuous manner, particularly in sections along its longitudinal axis, with particles generating artefacts in magnetic resonance tomography. This especially applies to the tips of the rods which need to be exceptionally visible in some cases.
Within the rods the filaments can be arranged in parallel. This supports especially simple processing.
The filaments also can be arranged braided with each other, woven, cross-linked, twisted or coiled in especially preferred embodiments in order to realize certain favoured characteristics, especially mechanical properties.
It is advantageous if the mass of a single particle is in the range of micrograms to nanograms and, due to the minimal amount in relation to the matrix material, does not substantially influence the outer shape, stability and the torquing characteristics of the rod.
Typically preferred sizes of the rods are in the diameter range of between 0.005 and 5 mm, preferably between 0.1 and 1 mm.
A cylindrical composite body (“cylinder”), particularly a guidewire, is constructed from the described rods in such a manner that at least one rod is enclosed by a non-ferromagnetic matrix material or several rods are enclosed and/or agglutinated by a non-ferromagnetic matrix material.
In this way cylinders of widely varying geometries and mechanical as well as MRTrelated characteristics can be easily and cost-efficiently constructed with one and the same element (the rod) and the matrix material.
The cylinder may e.g. most simply be built from rods of the same diameter or—in another embodiment—from rods of different diameters. The latter embodiment in particular may have two rods of smaller diameter arranged around a first rod. The individual rods can—similar to the filaments as before—be arranged braided with each other, woven, cross-linked, twisted or coiled.
In a particularly preferred embodiment the cylinders contain rods with different magnetic resonance tomographic properties. For instance the same cylinder (e.g. as a guidewire) can be visualized equally well in different MRT sequences (e.g. for
specific visualization of fatty tissue, muscle tissue, etc.).
It is advantageous to cover the outer surface of the cylinder with a hydrophilic coating thus making it biocompatible.
It is however also possible to construct other devices from the described rods, particularly a tube-shaped composite body (“catheter”). This is composed of at least one rod which is enclosed by a non-ferromagnetic matrix material and/or several rods bonded together and/or enclosed.
In an embodiment of the catheter this is comprised of several rods which are embedded in a radial distribution in the periphery of its wall. Especially for achieving symmetrical properties these can be embedded in a regular radial distribution.
For the same reason the rods forming the catheter can possess the same diameter. In special cases however rods of different diameter can also be used.
Similarly to the cylinders and guidewires, in the case of the catheter rods can be arranged braided with each other, woven, cross-linked, twisted or coiled in the catheter and can possess different magnetic resonance tomographic properties. The outer surface of the catheter can be hydrophilically coated.
Besides the above described devices other devices can be constructed from rod-shaped bodies and the matrix material in similar manner, e.g. Dormia baskets.
Preferred embodiments of the invention are described below with the aid of the enclosed schematic drawings.
The rod 1 and section of a rod respectively shown in
Particles producing magnetic resonance tomographic artefacts, e.g. nanoparticles, —not shown—are included in the epoxy resin. These are homogenously distributed in the matrix material so that a rod 1 homogenously doped along its longitudinal axis results.
As shown in
In
The cylindrical composite body 6 is constructed from several rods 1 which are agglutinated and enclosed by a matrix material 7, e.g. an epoxy resin. This matrix material 7 is, in contrast to the matrix material 4, not doped with particles producing magnetic resonance tomographic artefacts. The visibility of the cylindrical composite body 6 in the MRT relies solely on the visibility of the embedded rods 1. In the depicted embodiment, rods 1, 8, 9 with different dopings are included so that, depending on the sequence, different rods 1, 8, 9 become visible in the MRT.
In the same way, as shown in
The tube-shaped composite body 10 is similarly constructed from a shell material 15 and several rods 1, 8, 9 with different doping. All rods are evenly distributed around 10 the periphery of the tube-shaped composite body 10.
The cylindrical composite body 6 as well as the tube-shaped composite body 10 can be covered with a hydrophilic coating, which is not shown.
The ends of the cylindrical and tube-shaped composite bodies 6, 10 can be treated in an appropriate manner, e.g. rounded, polished or capped. As shown in
| Number | Date | Country | Kind |
|---|---|---|---|
| 102005030472.9 | Jun 2005 | DE | national |
The present application is a Divisional of co-pending U.S. patent application Ser. No. 16/225,637, filed on Dec. 19, 2018, now U.S. Pat. No. ______, which is a divisional application of U.S. patent application Ser. No. 14/710,734, filed on May 13, 2015, now U.S. Pat. No. 10,172,537, which is a Continuation-in-Part application of U.S. patent application Ser. No. 11/993,658, filed on Nov. 23, 2009, now U.S. Pat. No. 9,038,639, which in turn claims priority to PCT Application No. PCT/DE2006/001094 filed on Jun. 26, 2006, which in turn claims priority to German Patent Application No. DE 10 2005 030 472.9 filed on Jun. 28, 2005, the contents of all applications are hereby incorporated by reference herein.
| Number | Date | Country | |
|---|---|---|---|
| Parent | 16225637 | Dec 2018 | US |
| Child | 17235328 | US | |
| Parent | 14710734 | May 2015 | US |
| Child | 16225637 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 11993658 | Nov 2009 | US |
| Child | 14710734 | US |
