DE102008049469B3 - Method for monitoring disintegration process of intracorporeal bioresorbable stent utilized for insertion into e.g. esophagus of patient, involves determining information about stent state such that stent disintegration process is monitored - Google Patents
Method for monitoring disintegration process of intracorporeal bioresorbable stent utilized for insertion into e.g. esophagus of patient, involves determining information about stent state such that stent disintegration process is monitored Download PDFInfo
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- DE102008049469B3 DE102008049469B3 DE102008049469A DE102008049469A DE102008049469B3 DE 102008049469 B3 DE102008049469 B3 DE 102008049469B3 DE 102008049469 A DE102008049469 A DE 102008049469A DE 102008049469 A DE102008049469 A DE 102008049469A DE 102008049469 B3 DE102008049469 B3 DE 102008049469B3
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- Prior art keywords
- stent
- intracorporeal
- disintegration process
- image
- fluorophore
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- 238000000034 method Methods 0.000 title claims abstract description 28
- 238000012544 monitoring process Methods 0.000 title claims description 5
- 210000003238 esophagus Anatomy 0.000 title description 3
- 238000003780 insertion Methods 0.000 title 1
- 230000037431 insertion Effects 0.000 title 1
- 238000003325 tomography Methods 0.000 claims abstract description 7
- 239000000463 material Substances 0.000 claims description 14
- 238000003384 imaging method Methods 0.000 claims description 2
- 230000035515 penetration Effects 0.000 description 4
- 210000000056 organ Anatomy 0.000 description 3
- 239000008280 blood Substances 0.000 description 2
- 210000004369 blood Anatomy 0.000 description 2
- 238000000354 decomposition reaction Methods 0.000 description 2
- 238000002513 implantation Methods 0.000 description 2
- 238000005259 measurement Methods 0.000 description 2
- 238000011002 quantification Methods 0.000 description 2
- 206010028980 Neoplasm Diseases 0.000 description 1
- 208000031481 Pathologic Constriction Diseases 0.000 description 1
- 108091005804 Peptidases Proteins 0.000 description 1
- 239000004365 Protease Substances 0.000 description 1
- 102100037486 Reverse transcriptase/ribonuclease H Human genes 0.000 description 1
- 210000004351 coronary vessel Anatomy 0.000 description 1
- 238000001514 detection method Methods 0.000 description 1
- 230000000694 effects Effects 0.000 description 1
- 238000002073 fluorescence micrograph Methods 0.000 description 1
- 239000007943 implant Substances 0.000 description 1
- 238000010348 incorporation Methods 0.000 description 1
- 230000003993 interaction Effects 0.000 description 1
- 238000012634 optical imaging Methods 0.000 description 1
- 230000000630 rising effect Effects 0.000 description 1
- 230000002123 temporal effect Effects 0.000 description 1
- 210000003437 trachea Anatomy 0.000 description 1
- 230000002792 vascular Effects 0.000 description 1
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
- A61B5/0086—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters using infrared radiation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0071—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence by measuring fluorescence emission
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/42—Detecting, measuring or recording for evaluating the gastrointestinal, the endocrine or the exocrine systems
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2210/00—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
- A61F2210/0004—Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Surgery (AREA)
- Physics & Mathematics (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Pathology (AREA)
- Biophysics (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Investigating, Analyzing Materials By Fluorescence Or Luminescence (AREA)
Abstract
Description
Die Erfindung betrifft ein Verfahren zur Überwachung des Zerfallsprozesses eines intrakorporalen, bioresorbierbaren Stents.The The invention relates to a method for monitoring the decomposition process an intracorporeal bioresorbable stent.
Stents sind wohlbekannte medizinische Implantate, die in Hohlorganen das sie umgebende Gewebe abstützen, um die Öffnung des Hohlorgans an der betreffenden Stelle zu sichern. Dementsprechend werden Stents beispielweise bei Gefäßstenosen oder auch in der Luftröhre eingesetzt. Da allerdings auch die Stents selbst zu einem Wiederverschluss des Gefäßes, in das sie eingesetzt wurden, führen können, wurden bioresorbierbare Stents entwickelt. Diese Stents sollen das Gefäß nur für einen bestimmten Zeitraum abstützen, um sich dann aufzulösen und vom Patienten ausgeschieden zu werden.stents are well known medical implants used in hollow organs supporting surrounding tissues, around the opening of the hollow organ at the relevant point. Accordingly Stents are for example in vascular stenoses or in the windpipe used. However, because the stents themselves to a reclosure of the vessel, in that they were used lead can, bioresorbable stents were developed. These stents are supposed to do that Vessel only for a given Support period, to dissolve then and to be excreted by the patient.
Der Erfindung liegt damit die Aufgabe zugrunde, ein Verfahren anzugeben, mit dem sich der Zerfallsprozess eines intrakorporalen, bioresorbierbaren Stents überwachen und quantifizieren lässt.Of the Invention is therefore based on the object of specifying a method with which the decomposition process of an intracorporeal, bioresorbable Monitor stents and quantified.
Zur Lösung der Aufgabe ist bei einem Verfahren der eingangs genannten Art erfindungsgemäß vorgesehen, dass anhand wenigstens einer Bildinformation eines mittels Infrarot-Tomographie gewonnenen Bildes Informationen über den Zustand des fluoreszenzfähigen Stents ermittelt werden.to solution the object is provided according to the invention in a method of the type mentioned, that on the basis of at least one image information of one by means of infrared tomography Image obtained information about the state of the fluorescent Stents are determined.
Bei der Infrarot-Tomographie wird das in das Untersuchungsobjekt eintretende Licht von einem Fluorophor absorbiert und danach wieder abgegeben, siehe beispielsweise U. Mahmood et al., Near-Infrared Optical Imaging of Protease Activity for Tumor Detection, Radiology, Vol. 213, Seiten 866 bis 870, 1999. Ist der in den Patienten eingebrachte Stent fluoreszenzfähig, kann er dementsprechend bildgebend dargestellt werden. Die Infrarot-Tomographie erlaubt dabei eine Überwa chung über lange Zeiträume, bei der der Einsatz von Röntgenstrahlung vermieden werden kann, was aus Patientensicht heraus wünschenswert ist.at Infrared tomography becomes the object entering the examination subject Light absorbed by a fluorophore and then released again, See, for example, U. Mahmood et al., Near-Infrared Optical Imaging of Protease Activity for Tumor Detection, Radiology, Vol. 213, p 866-870, 1999. Is the introduced into the patient stent fluorescent, can he will be represented accordingly imaging. The infrared tomography allows monitoring over long periods of time which avoids the use of X-rays which is desirable from the patient's point of view.
Zur Quantifizierung kann als Bildinformation die Signalintensität zumindest eines Teils der Bildelemente des Bildes verwendet werden. Alternativ oder zusätzlich kann als gegebenenfalls weitere Bildinformation wenigstens ein Gradient der Signalintensität zweier Bildelemente des Bildes verwendet werden.to Quantification can be used as image information, the signal intensity at least a part of the picture elements of the picture. alternative or additionally may be at least one gradient as optionally further image information the signal intensity of two Picture elements of the picture are used.
Die hierzu notwendige Proportionalität zwischen dem Zerfallsprozess und der Signalintensität des Fluorophors kann dadurch hergestellt werden, dass der Fluorophor im Wesentlichen homogen im Stentmaterial verteilt ist. Da die Signalintensität der Bildelemente dann im Wesentlichen von der Konzentration des Fluorophors bzw. dessen Quantität abhängt, ist die Signalintensität gleichzeitig proportional zum Vorhandensein bzw. der Menge des Stentmaterials. Das Vorhandensein oder Nichtvorhandensein von Stentmaterial ist aber gleichzusetzen mit dem Zerfallsprozess, weshalb sich dieser im Rahmen der erreichten Auflösung und der Messfehler gut quantifizieren lässt. In diesem Fall bestehen hinsichtlich der Proportionalität keinerlei Probleme.The For this necessary proportionality between the decay process and the signal intensity of the fluorophore can be prepared by essentially containing the fluorophore is homogeneously distributed in the stent material. As the signal intensity of the picture elements then essentially by the concentration of the fluorophore or its quantity depends is the signal intensity simultaneously proportional to the presence or amount of the stent material. The presence or absence of stent material is but equate with the decay process, which is why this one within the achieved resolution and the measurement error can be quantified well. In this case exist in terms of proportionality no problems.
Alternativ kann auch ein Stent verwendet werden, bei dem der Fluorophor auf wenigstens einem Teil der Oberfläche verteilt ist. Dann können nämlich handelsübliche Stents verwendet werden, die lediglich noch geeignet zu beschichten sind. In diesem Fall muss allerdings Sorge dafür getragen werden, dass der Fluorophor nicht wesentlich schneller als der eigentliche Stent abgebaut wird. Andernfalls ist keine wirkliche Quantifizierung des Zerfallsprozesses des Stents möglich, da der Zerfallsprozess des Fluorophors und des Stents unkorreliert sind. Vorzugsweise kann daher ein Stent verwendet werden, bei dem der Fluorophor auf wenigstens einem Teil der Außenseite verteilt ist. Befindet sich der Stent in einem Gefäß, so wird der Fluorophor zwischen der Gefäßwand und dem Stentmaterial umschlossen. Der Fluorophor kommt mit dem Blut also erst in längerfristigen Kontakt, wenn das Stentmaterial weitgehend oder ganz abgebaut wurde. Auch so kann dann eine Proportionalität zwischen der Signalintensität des Infrarot-Tomographiebildes und dem Zerfallsprozess des Stents hergestellt werden.alternative It is also possible to use a stent in which the fluorophore is present at least part of the surface is distributed. Then, in fact, commercial stents can be used, which are only suitable to coat. In this case, however, care must be taken to ensure that the Fluorophore is not significantly faster than the actual stent is reduced. Otherwise, there is no real quantification of the Decay process of the stent possible because the decay process of the fluorophore and the stent are uncorrelated. Preferably, therefore, a stent may be used in which the Fluorophore is distributed on at least part of the outside. is the stent is in a vessel, so will the fluorophore between the vessel wall and enclosed the stent material. The fluorophore comes with the blood so only in the longer term Contact if the stent material has been largely or completely degraded. Even so, then a proportionality between the signal intensity of the infrared tomographic image and the disintegration process of the stent.
Für das Verfahren wird ein bioresorbierbarer, fluoreszenzfähiger Stent verwendet, bei dem der Fluorophor im Wesentlichen homogen im Stentmaterial verteilt ist, oder bei dem der Fluorophor den Stent auf der Oberfläche wenigstens teilweise bedeckt. Bei diesem kann, wie oben bereits erwähnt, der Fluorophor den Stent auf der Außenseite wenigstens teilweise bedecken.For the procedure a bioresorbable, fluorescent stent is used in the fluorophore is distributed substantially homogeneously in the stent material or where the fluorophore has the stent on the surface at least partially covered. In this, as mentioned above, the Fluorophore the stent on the outside at least partially cover.
Das Verfahren ist auf die Eindringtiefe des verwendeten Lichts beschränkt. Die größte Eindringtiefe in biologischem Gewebe liegt bei 600–800 nm vor, weshalb auch der Fluorophor in diesem Wellenlängenbereich resorbieren und emittieren muss. Problemlos lässt sich das Verfahren beispielsweise bei Stents in den Carotiden einsetzen, wobei dann einfache, handgehaltene Messvorrichtungen zum Einsatz kommen könnten. Bei anderen, weiter im Körperinneren befindlichen Stents ist aber auch der Einsatz eines transösophagealen Detektors denkbar, womit sich beispielsweise auch Stents im Bereich des Herzens überwachen ließen.The Method is limited to the penetration depth of the light used. The largest penetration depth in biological tissue is at 600-800 nm, which is why the Fluorophore in this wavelength range absorb and emit. For example, the process is easy use stents in the carotids, then simple, hand-held Measuring devices could be used. For others, continue inside the body Stents is also the use of a transesophageal Detector conceivable, which, for example, stents in the field of the heart left.
Weitere Vorteile, Merkmale und Einzelheiten der Erfindung ergeben sich aus den im Folgenden beschriebenen Ausführungsbeispielen sowie anhand der Zeichnungen. Dabei zeigen:Further Advantages, features and details of the invention will become apparent the embodiments described below and with reference to the Drawings. Showing:
Stents
sind in vielerlei Ausführungsformen bekannt,
eine weitere zeigt
Zur
Untersuchung des intrakorporalen Stents
In
Claims (6)
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
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DE102008049469A DE102008049469B3 (en) | 2008-09-29 | 2008-09-29 | Method for monitoring disintegration process of intracorporeal bioresorbable stent utilized for insertion into e.g. esophagus of patient, involves determining information about stent state such that stent disintegration process is monitored |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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DE102008049469A DE102008049469B3 (en) | 2008-09-29 | 2008-09-29 | Method for monitoring disintegration process of intracorporeal bioresorbable stent utilized for insertion into e.g. esophagus of patient, involves determining information about stent state such that stent disintegration process is monitored |
Publications (1)
Publication Number | Publication Date |
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DE102008049469B3 true DE102008049469B3 (en) | 2010-05-12 |
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DE102008049469A Expired - Fee Related DE102008049469B3 (en) | 2008-09-29 | 2008-09-29 | Method for monitoring disintegration process of intracorporeal bioresorbable stent utilized for insertion into e.g. esophagus of patient, involves determining information about stent state such that stent disintegration process is monitored |
Country Status (1)
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DE (1) | DE102008049469B3 (en) |
Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005089829A2 (en) * | 2004-03-10 | 2005-09-29 | Scil Technology Gmbh | Coated implants, their manufacturing and use thereof |
DE102007008479A1 (en) * | 2007-02-21 | 2008-09-04 | Orlowski, Michael, Dr. | Coated Expandable System |
-
2008
- 2008-09-29 DE DE102008049469A patent/DE102008049469B3/en not_active Expired - Fee Related
Patent Citations (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
WO2005089829A2 (en) * | 2004-03-10 | 2005-09-29 | Scil Technology Gmbh | Coated implants, their manufacturing and use thereof |
DE102007008479A1 (en) * | 2007-02-21 | 2008-09-04 | Orlowski, Michael, Dr. | Coated Expandable System |
Non-Patent Citations (1)
Title |
---|
U. Mahmood et al.: "Near-Infrared Optical Imaging of Protease Activity for TumorDetection" Radiology, Vol. 213, 1999, S. 866-870 * |
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R081 | Change of applicant/patentee |
Owner name: SIEMENS HEALTHCARE GMBH, DE Free format text: FORMER OWNER: SIEMENS AKTIENGESELLSCHAFT, 80333 MUENCHEN, DE |
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R119 | Application deemed withdrawn, or ip right lapsed, due to non-payment of renewal fee |