FR2970169A1 - Method for determining characteristic of implant implanted in body of patient, involves examining database based on read pattern to obtain characteristic of desired implant from database - Google Patents

Abstract

The method involves providing a plate (70) having a pattern (51) resulting from a label formed on an implant, where the plate having the pattern is set in the skin of a patient using an imaging apparatus after implantation of the implant in patient's body. The pattern on the plate is read by a reading device (65) independent of the imaging apparatus. A database is examined based on the read pattern to obtain characteristic of the desired implant from the database, where the data base associates identification data of the implant. An independent claim is also included for a method for adjusting flow of fluid to be injected into a body of a patient via an implantable chamber.

Description

The present invention relates to a method for determining at least one characteristic of an implant, implanted in a body of a patient, the implant being masked by the skin of the patient.

When an implant is implanted in the body of a patient, it is often masked by the skin and is no longer visible from the outside. However, it is sometimes necessary to know certain characteristics of the implant after implantation. This need arises particularly in the case of implantable chambers. These chambers are used in particular for the injection of fluids into a patient, for example in the field of oncology or in the context of medical imaging, in which case the injected fluid is generally a contrast medium. Indeed, when one wishes to achieve for example a computer tomography angiography (designated by the term "CT" or "Computed Tomography"), it is necessary to inject very rapidly, with a high flow rate, a contrast product. in the vascular system of the patient to obtain a concentration of contrast medium in the patient's vascular system high enough to have sufficient contrast during the entire scan time is of the order of 30 to 45 seconds. In order to facilitate this injection, it is known to use an implantable chamber in order to define an injection point in the patient that is located away from the blood circulation duct into which the product is to be injected. This avoids damaging the blood circulation conduit by repeated taps. However, all implantable chambers do not allow, because of their design, a high-speed injection. In particular, some chambers are not able to withstand the internal pressure that is generated at high injection rate.

It is therefore important for the practitioner to determine, prior to injection of the contrast medium, whether an implantable chamber implanted under the patient's skin is adapted to receive a high-speed liquid injection. US patent application 2009/0227951 discloses an implantable chamber whose septum is provided with a radiopaque pattern that can be radiographically detected through the skin of the patient. This pattern makes it possible to determine whether an implantable chamber implanted under the skin of the patient is designed to withstand injection of a fluid at a high flow rate, and more particularly at a flow rate greater than 1 ml / s. For this purpose, the practitioner takes a radiographic image of the pattern formed on the implantable chamber and determines, by direct reading on the plate, whether the chamber is suitable or not for high-speed injection.

Such a method is not entirely satisfactory. Indeed, the pattern inscribed on the implantable chamber gives the practitioner only very limited information, namely whether the

2 chamber resists or not to a high-speed injection, the high flow being defined as a flow rate greater than a particular value. However, it is possible that, for example because of the evolution of technologies in the field of injection equipment, imaging or the nature of contrast fluids, the practitioner needs additional information, different from the maximum flow rate accepted, to determine whether the implant is able to receive a fluid injection in a safe manner for the patient. In this case, the information on the implant will be insufficient since it will not allow him to determine if the implant is able to receive such an injection. In addition, the information carried on the implant is fixed and can not be changed once the implant is implanted in the patient. However, it may be useful to be able to modify or supplement later information on the properties of the implant. The patent application US 2010/0198057 describes a method for determining an injection characteristic of an implantable chamber, in which: - prior to the injection into the implantable chamber of a contrast liquid necessary for the production of a medical imaging examination using an imaging device, the practitioner takes, with the aid of this imaging device, a snapshot of a label formed on the implantable chamber implanted under the skin of the patient. patient; the software controlling the imaging apparatus then analyzes the geometrical pattern resulting from the label on the digital format plate, compares this pattern with reference patterns recorded in a database, and deduces therefrom the rate for which the chamber is dimensioned and therefore if it is able to receive a high-speed liquid injection; - If so, this software allows the injection of the liquid into the implantable chamber. This process is not entirely satisfactory. Indeed, it requires intervention on existing imaging devices, installed in health centers, to modify the software installed on these devices, or to install new software adapted to implement the described process. However, such an intervention is generally possible only with the authorization of the manufacturer of the imaging apparatus. In addition, such a solution requires providing a computer program adapted to each brand of imaging apparatus. Finally, some devices do not allow the installation of new software or modification of installed software. This process is therefore not very versatile. Another difficulty is that this method requires access to the digital format snapshot, which is not always the case.

An object of the invention is to provide a method which makes it possible to determine a plurality of characteristics of an implant, masked under the skin of a patient, these characteristics being able to be updated, if necessary, after implantation. implant in the patient's body, without the need for surgery. An object of the invention is also to provide a method that is versatile and can be implemented in a simple manner. To this end, the subject of the invention is a method of the aforementioned type, characterized in that it comprises the following steps: - providing a photograph showing a pattern resulting from a label formed on the implant or carried by it , the image having been taken through the patient's skin using an imaging device after implantation of the implant into the patient's body; - read the pattern on the plate by means of a reading device independent of the imaging apparatus; - Query a database based on the pattern read and obtain from the database the characteristic of the desired implant. The method according to the invention may comprise one or more of the following characteristics, taken separately or in any technically possible combination: the database associates an identification data item of the implant with at least the desired characteristic of the implant, the pattern representing the identification data in coded form, and the reading device decoding the pattern read on the plate to deduce the identification data of the implant, the interrogation of the database being done based on the decoded identification data; the method further comprises, prior to implantation of the implant in the body of the patient, a learning step by the code reading apparatus used to code the identification data, this step of constituting, in a memory of the reading apparatus, a second database associating a pattern specific to each identification data so as to constitute the code, the reading apparatus then decoding the pattern read on the plate on the basis of this code; the pattern is unfit to be decoded by simply viewing the pattern on the snapshot and interrogating the database on the basis of this visualization of the pattern; the pattern is a graphic code, in particular a barcode, more particularly a two-dimensional barcode, in particular a DataMatrix code; the database is stored in a memory of the reading apparatus, the reading apparatus interrogating the database on the basis of the pattern read on the plate and deducing the characteristic of the desired implant; the reading apparatus comprises means of remote connection to the database via a network, advantageously via the Internet, and the reading apparatus remotely connects to the database to query the database on the basis of the pattern read on the plate and deduce the characteristic of the desired implant; - The label is a radiopaque marking, visible by X-ray, and the image is a radiograph; the implant is chosen from the group consisting of an implantable chamber, a vascular prosthesis, a tubular stent, in particular a coronary stent or a peripheral stent, an orthopedic prosthesis, a vascular patch, a dental implant, a wall reinforcement, a heart valve, pacemaker, artificial heart, gastric band, cochlear implant, genital implant and neural implant; and the implant is an implantable chamber, and the characteristic to be determined is an injection characteristic of the implantable chamber, chosen from the maximum flow rate that can be injected into the implantable chamber and the maximum pressure supported by the implantable chamber. The invention also relates to a method for controlling the flow rate of a fluid intended to be injected into the body of a patient via an implantable chamber, in particular before it is injected into the patient's body, the method comprising the following successive steps: - determination of an injection characteristic of the implantable chamber by means of the determination method as defined above, and - before injecting fluid into the implantable chamber, adjusting the flow rate a fluid injection apparatus for connection to the implantable chamber, based on the injection characteristic of the implantable chamber determined in the determining step. The subject of the invention is also a method of injecting a liquid, advantageously a non-therapeutic liquid such as a diagnostic product, especially a contrast medium for medical imaging, into a patient, comprising the steps following: - implementation of a flow rate control method of a fluid to be injected into the body of a patient as defined above; - Connecting the injection apparatus to the chamber, including pricking a needle through the patient's skin and through the septum to insert the free end of the needle into the interior volume of the chamber; injecting fluid into the patient's body from the injection apparatus through the chamber with the defined flow rate by implementing the adjustment method. The invention will be better understood on reading the description which follows, given solely by way of example, and with reference to the appended drawings, in which: FIG. 1 is a schematic view of a determination set a feature of an implantable chamber implanted under the skin of a patient; FIG. 2 is a view, taken in section along a median vertical plane, of an injection set in a patient comprising the implantable chamber implanted under the skin of the patient, during the injection of fluid into the patient; Figure 3 is a side perspective view of the implantable chamber of Figure 2; Figure 4 is a schematic representation of an injection method in the implantable chamber of Figure 2; FIG. 5 is a schematic view of a snapshot obtained during the implementation of the injection method of FIG. 4, as well as a part of the determination assembly of FIG. 1; Figure 6 is an enlarged view of a portion of the photograph of Figure 5; - Figure 7 is a view similar to Figure 2 of an injection kit comprising an implantable chamber according to a second embodiment; and - Figure 8 is a top view of an implantable chamber according to a third embodiment. In what follows, the terms "upstream" and "downstream" generally refer to the normal direction of circulation of a fluid.

The invention relates to a method for determining a characteristic of an implant, implanted in the body of a patient, and masked by the skin of the patient in the implanted state. According to a first embodiment, the implant is an implantable chamber 5, and the characteristic of the implant to be determined is an injection characteristic of the implantable chamber 5. This characteristic is in particular the maximum flow rate that can be injected into the implant. implantable chamber 5 or the maximum pressure supported by the implantable chamber 5. Thus, the determination method according to the first embodiment is a method for determining an injection characteristic of the implantable chamber 5.

The determination method according to the first embodiment is implemented in a liquid injection kit 10 in a patient 7 using a set 11 for determining the desired characteristic. Figure 1 shows schematically the set 11 for determining the desired characteristic. The injection kit 10 is intended in particular to inject a liquid at a high flow rate into the vascular system of a patient, for example at a flow rate greater than 1 ml / second, advantageously greater than 5 ml / s. The injected liquid is for example a drug. Alternatively, the liquid is a non-therapeutic liquid, such as a diagnostic product, especially a contrast medium for medical imaging. The contrast medium makes it possible to produce an image of the patient's vascular system, for example by computed tomography ("computed tomography"). The injection kit 10 is shown in more detail in FIG. 2. It comprises, upstream to downstream, an injection apparatus 12 placed outside the body of the patient 7, a needle injection device 14 intended to be inserted through the skin 16 of the patient 7, and the implantable chamber 5.

The chamber 5 is implanted in the body of the patient 7 and is completely masked by the skin 16 of the patient 7. It is connected hydraulically downstream to a blood circulation conduit 20. The injection device 12 is able to distribute a liquid with adjustable volume flow. It is for example of the type comprising a cylinder pump 22 suitable for dispensing the liquid with an adjustable volume flow rate. It advantageously comprises a member 24 for adjusting the volume flow rate of the pump 22, which can be actuated by a user. The injection apparatus 12 is connected to the injection device 14 via an outlet pipe 26.

The needle injection device 14 is for example of the type described in the French applications FR 2 869 806 and FR 2 886 857 of the Applicant. The device 14 comprises an intermediate flexible tubing 28 removably connected to the outlet tubing 26, an injection needle 30 to be stitched into the skin 16 of the patient 7 to enter the chamber 5 and a mechanism 32 for gripping the the needle which will not be described in detail. The needle 30 is advantageously a bent needle called "Huber". It is connected upstream to the intermediate pipe 28. It has downstream a free end 34 beveled to facilitate the introduction of the needle 30 through the skin 16 and into the chamber 5.

As illustrated in FIGS. 2 and 3, the implantable chamber 5 comprises a base body 40 delimiting an internal volume 42 for receiving liquid, a septum 44 closing the internal volume 42 and intended to be stitched by the needle 30, and a conduit 46 for discharging the liquid out of the inner volume 42 to the blood circulation conduit 20. The base body 40 comprises, on the side opposite the septum 44, a bottom 48. It further comprises passage openings 49, which are clean. to allow the passage of sutures during implantation of the implantable chamber 5 in the body of the patient 7. According to the invention, the implantable chamber 5 comprises a label 50 intended to form a pattern 51 on a snapshot of the chamber 5 taken after implantation in the body of the patient 7. Thus, the pattern 51 is the image of the label 50. The tag 50 is formed in the chamber 5 or attached thereto. In the embodiment shown in Figures 1 to 3, the label 50 is carried by the septum 44. The pattern 51 represents an identification data of the implantable chamber 5 implanted in the body of the patient 7. This data of identification is specific to a given implantable chamber 5. The pattern 51 is obtained from the identification data by applying a determined coding algorithm to the identification data item. Thus, the pattern 51 represents the identification data in coded form. As will be seen below, taking a snapshot, including X-ray, and then decoding the pattern 51 visible on the plate 70 using the adapted decoding algorithm provides the identification data. The only visualization of the pattern 51 by a user does not make it possible to obtain the corresponding identification data. Obtaining the corresponding identification data requires the decoding of the pattern 51 by suitable decoding means. The pattern 51 appears on the plate in addition to the image formed by the chamber 5 itself, and in particular with a contrast vis-à-vis the image of the chamber 5. The pattern 51 is independent of the image of the chamber 5 as obtained from its structure.

In the first embodiment, the pattern 51 is a graphic code, such as a one-dimensional barcode or a two-dimensional barcode. In the case where the pattern 51 is a two-dimensional barcode, it is for example a DataMatrix code, obtained from the identification data by applying the DataMatrix code. It is in this case in the form of a matrix consisting of juxtaposed points or squares, the arrangement and the dimensions of these points and / or squares being representative of the identification data. In a variant, the pattern 51 is any other type of graphic code, obtained from the identification data using a determined coding algorithm. Advantageously, the label 50 is a radiopaque marking visible by X-ray radiography through the skin 16 of the patient 7. The pattern 51 is, in this case, the image on a radiographic x-ray 70 of the label 50. The label 50 is formed by any method making it possible to obtain a radiographic contrast different from that of the implantable chamber 5 so as to show on a photograph 70 the pattern 51 with a contrast with respect to the implantable chamber 5. It is for example formed by applying a radiopaque material on the base body 40, in particular on the outer or inner surface of the septum 44, on or under the bottom 48 or in the interior space delimited by the body. In a variant, it is formed by processes resulting in a differentiation of the thicknesses of the materials, for example by etching a metal surface of the chamber 5. The identification data is, in the first embodiment of the invention. sation, a URL ("Uniform resource locator") of an Internet page containing the desired characteristic. The set 11 for determining the desired characteristic shown in FIG. 1 comprises: a medical imaging apparatus 58; a database 60; and - a reading apparatus 65. The medical imaging apparatus 58 is adapted to take, through the skin 16 of the patient 7, a picture 70 of the tag 50 of the implantable chamber 5 even when the skin 16 of the patient 7 completely masks the chamber 5. In the embodiment shown, the medical imaging apparatus 58 is an X-ray apparatus capable of taking a radiographic x-ray 70 of the radiopaque label 50. The database 60 is stored on a remote server 62. It associates at least the characteristic to be determined with the identification data coded in the pattern 51 read on the plate 70 by the reading device 65.

According to a particular embodiment, the database 60 associates, with a given identification data, at least one characteristic and advantageously a list of characteristics of the implant 5, the desired characteristic being included in this list of characteristics. This list of characteristics is chosen in particular from the maximum flow rate that can be injected into the implantable chamber 5 for different viscosities of injected product, the maximum pressure supported by the implantable chamber 5, the materials constituting the chamber 5, the implantation date of the chamber 5, the date of manufacture of the chamber 5, the operating tips of the implantable chamber 5 and / or a traceability data of the implant 5, in particular the batch number and / or the serial number of the implant 5.

The database 60 is in particular informed and updated by the manufacturer of the implant. Alternatively or optionally, the database 60 is informed and updated by the practitioner. The reading apparatus 65 is an apparatus independent of the imaging apparatus 58. In particular, it is a mobile apparatus capable of being moved independently of the imaging apparatus 58. Thus, the apparatus of Reading 65 is for example a portable device, such as a scanner, a digital tablet or a mobile phone, in particular of the pocket terminal type or "smartphone". The reading apparatus 65 is a device separate from the imaging apparatus 58. It is not capable of operating the imaging apparatus 58. In particular, i is not clean as such. to control the taking of a snapshot by the imaging apparatus 58. In addition, it is not connected to the imaging apparatus 58. The reading apparatus 65 is adapted to read the pattern 51 on the For this purpose, it comprises a device 72 for recognizing the pattern 51, for example an image acquisition tool, such as a camera or any other means capable of reading the pattern 51. In addition, it comprises calculation means 74 capable of implementing a decoding algorithm of the pattern 51 read on the plate 70. The calculation means 74 thus decode the pattern 51 read to give the identification data. The decoding algorithm is stored for example in a memory 76 of the reading apparatus 65. The reading apparatus 65 further comprises means 78 for connecting to the remote server 62 via a network, for example via the Internet network. Finally, the reading apparatus 65 comprises means for making the user of the desired characteristic of the imaged implant available to the user. These means include means for displaying the desired characteristic, in particular means for displaying the Internet page corresponding to the URL encoded in the pattern 51.

These display means comprise in particular a display screen 87. The dimensions of the label 50 are chosen so that the pattern 51 has on the plate 70 a contrast sufficient to be readable and analysable by the device of the present invention. Thus, the dimensions of the tag 50 depend in particular on the resolution of the tag 50, as well as the resolution of the reading device 65.

A method of injecting a fluid into the body of a patient via the implantable chamber 5 will now be explained with reference to FIG. 4. Prior to the implementation of this method, the implantable chamber 5 has been surgically implanted in the patient's body 7, that is to say that it has been surgically disposed under the skin 16 of the patient 7.

For this purpose, it is applied against tissue of the patient 7 and is held in position by suturing through the passage openings 49. The septum 44 is then placed facing the skin 16, in the vicinity thereof, for The implantable chamber 5 is then hydraulically connected to the vascular system of the patient, for example to the blood circulation conduit 20. Finally, the skin 16 of the patient is put back into position. place, so that the implantable chamber 5 is masked by the skin 16. When a fluid injection is to be performed via the pre-implanted implantable chamber 5, the practitioner implements the injection method shown in FIG. FIG. 4. This injection method comprises successively: a step 200 of producing a snapshot 70 of at least one zone of the implantable chamber 5 through the skin 16 of the patient 7 by means of the apparatus of FIG. medial imaging The area of the imaged implantable chamber 5 is an area comprising the label 50. In the first embodiment, the label 50 is formed on the septum 44, and the plate 70 is made to include at least the region of the septum 44 comprising the tag 50. In this embodiment, the plate 70 is a radiograph, taken by means of an X-ray machine. The pattern 51, image of the tag 50, is a two-dimensional barcode, in particular a DataMatrix code, representing in coded form the identification data of the implantable chamber 5 implanted in the patient 7. FIG. step 200. FIG. 6 schematically represents a part of the plate 70 having the pattern 51. a step 210 of determining an injection characteristic of the implantable chamber 5, in particular the maximum flow rate authorized by the implantable chamber 5; a step 220 for regulating the flow control member 24 at a flow rate less than or equal to the maximum flow rate authorized by the chamber 5 determined in step 210, this step being implemented before the injection of liquid into the patient 7; a step 230 for forming a continuous fluid path between the injection apparatus and the blood circulation conduit 20, during which the practitioner connects the outlet tubing 26 to the intermediate tubing 28 and plants the needle 30 through the skin 16 of the patient 7 and through the septum 44, grasping the mechanism 32 to bring the free end 34 of the needle 30 into the interior volume 42. A continuous fluid path is then established from the device 12 to the blood circulation conduit 20. A step 240 of injecting liquid into the patient. Step 210 corresponds to the method of determining a characteristic of the implant according to the first embodiment. Thus, the method for determining a characteristic of the implant is implemented after the embodiment of the implant plate 70, implanted in the body of the patient 7 and masked by the skin 16 of the patient 7, and before the injecting the fluid into the body of the patient 7 using the injection device 10. At the beginning of the method for determining the characteristic of the desired implant, that is to say at the beginning of step 210 of the injection method, the practitioner has at his disposal the plate 70 having the pattern 51 taken previously in step 200. The successive substeps of the determination method (step 210 of Figure 4) will now be explained. According to one embodiment, the photograph 70 is provided on a film. Alternatively, it is provided by display on a display screen, for example on a screen of the imaging apparatus 58 or on a computer screen.

In a sub-step 212, the practitioner scans the plate 70 having the pattern 51 by means of the reading device 65. In this step, the practitioner for example scans the snapshot 70 from the film or scans the snapshot 70 displayed on the display screen. In this sub-step 212, the reading device 65 reads the pattern 51 from the plate 70, in particular by means of the camera 72, integrated in the reading apparatus 65.

In a sub-step 214, the reading apparatus 65 queries the database 60 on the basis of the pattern 51 read on the plate 70. For this purpose, the reading device 65 decodes the pattern 51 read on the plate 70 It thus obtains the identification data of the implantable chamber 5 imaged. In this step, the reading device 65 decodes the pattern 51 using the calculation means 74 and the decoding algorithm stored in its memory 76. In the case where the pattern 51 is a barcode, the The coding used is sufficiently complicated for the pattern 51 to be unfit for decoding by simple visualization of the pattern 51 on the plate 70 by the practitioner and interrogation of the database 60 by the practitioner on the basis of the pattern 51 visualized. The reading apparatus 65 then connects, via the connection means 78, to the database 60 stored on the remote server 62 and queries the database 60 on the basis of the identification data item. 5 imaged implant obtained by decoding the pattern 51. The database 60 associating, with each identification data, the desired characteristic, or a list of characteristics, including the desired characteristic, the reading device 65 deduced from its interrogation of the database 60 the characteristic of the desired implant 5. In the first embodiment, the identification data is a URL of an Internet page specific to the imaged implant, including the desired characteristic. In this embodiment, after decoding the concerned URL from the pattern 51, the reading apparatus 65 connects to the target web page via the connection means 78. This target web page is then displayed on the screen 87. The user can then read the characteristic sought on the screen 87.

At the end of step 230 of forming a continuous fluid path between the injection apparatus and the blood circulation conduit 20, the practitioner can, safely, during step 240, start the product injection through the continuous fluid path by the cylinder pump 22 at the rate set with the aid of the member 24.

Thus, the safety of the patient is ensured during the injection, since the practitioner knows, before the start of the injection, the maximum flow that can support the chamber 5 during injection. It is thus possible to use a chamber 5 previously implanted in the patient, in a configuration close to its maximum flow rate, without having to intervene surgically on the patient to determine the characteristics of the chamber 5 or to implant another chamber of known characteristics. . This is more economical and uncomfortable for the patient. According to a second embodiment, shown in FIG. 7, the label 50 is carried by the bottom 48 of the base body 40, and not by the septum 44. The method of determining the characteristic of the implant sought according to the second embodiment differs from the method according to the first embodiment only by the area of the implant imaged in step 200. Indeed, in this embodiment, the practitioner obtains, prior to the implementation of the method determining, and therefore of step 210 of the injection method, a photograph 70 of at least the bottom area 48 of the base body 40 including the label 50. It thus obtains a picture 70 having the pattern 51 image of the tag 50. According to a third embodiment, shown in FIG. 8, the tag 50 is carried by the evacuation duct 46. The method of determining the characteristic of the implant sought according to the third embodiment of FIG. ACHIEVEME n differs from the previously described method only in the area of implant 5 imaged in step 200. Indeed, in this embodiment, the practitioner performs during step 200 a snapshot 70 comprising at least the area of the evacuation duct 46 comprising the label 50. It thus obtains, prior to the implementation of the determination method, and therefore of the step 210 of the injection process, a plate 70 having the image pattern 51 50 label.

According to a first variant of the first, second and third embodiments, the database 60 is stored in the memory 76 of the reading device 65, and not on the remote server 62. As described above, the database 60 associates the identification data, coded in the pattern 51, with at least the characteristic of the desired implant 5 or with a list of characteristics of the implant 5 comprising the desired characteristic. In this variant, the identification data item is in particular a numerical indication, making it possible to identify the implant 5, for example the reference number of the implant 5 or a traceability data item of the implant 5, in particular the number of the implant 5. batch or the serial number of the implant 5. It may also be the maximum flow rate that can be injected into the implantable chamber 5. The method for determining the characteristic of the implant sought according to this variant does not differ from the described method. previously that by the course of the sub-step 214 of step 210. In this variant, when the reading device 65 has decoded the identification data from the pattern 51 read on the plate 70, it directly questions the database 60, stored in its memory 76 on the basis of this identification data and thus obtains the desired characteristic or the list of characteristics, including the desired characteristic, as associated with the identification data of the imaged implant 5. It then displays this characteristic or the list of characteristics on the screen 87. According to a second variant of the first, second and third embodiments, the pattern 51 is not a two-dimensional barcode, but any other type of graphic code , adapted to reliably represent in coded form the identification data. The number, shape and / or combinations of the symbols used in this case to form the pattern 51 depend in particular on the number of identification data to be encoded using these symbols. In addition, these symbols are chosen so that they can be recognized automatically by the recognition device 72 integrated in the reading device 65, for example by a camera or by any other suitable device. In the case where there is an algorithm for decoding this pattern 51, it is stored in the memory 76 of the reading apparatus 65. In a variant, a second database associating with each symbol or combination of symbols used the corresponding identification data is stored in the memory 76 of the reading apparatus 65. In this case, the method for determining the characteristic of the desired implant comprises, prior to implantation of the implant 5 into the body of the patient 7, a learning phase of the coding code of the identification data by the reading device 65. This learning phase consists of constituting this second database and storing it in the memory 76 of the reading apparatus 65.

According to a third variant, the label 50 is ultrasonically visible through the skin of the patient 7. It is for example a relief of particular shape. In this case, the medical imaging apparatus 58 is an ultrasound machine. The pattern 51 is the ultrasound image of the tag 50. This pattern 51 represents in coded form the identification data. The recognition device 72 of the pattern 51 is a device capable of analyzing the image pattern 51 of the relief 50 formed on the implantable chamber 5, to allow its subsequent decoding by the calculating means 74. This decoding is carried out with the aid of FIG. a suitable decoding algorithm stored in the memory 76 of the reading device 65. In this case, in step 200, the practitioner performs an ultrasound of the implantable chamber 5 through the skin 16 of the patient 7, and in particular an ultrasound of the zone of the implantable chamber 5 comprising the label 50. At the substep 212, the practitioner scans the echography 70 of the pattern 51 by means of the reading device 65. According to a fourth variant, at the beginning in step 210, the pattern 70 having the pattern 51 is provided in digital form. It is for example recorded on a computer storage medium, such as a CD or a USB key or stored in a memory of a computer. It can also be transmitted electronically, for example by e-mail. In this case, the reading apparatus 65 is according to an embodiment integrated with a computer, and consists for example of an image processing program. In this case, in the sub-step 212, the practitioner does not scan the snapshot 70, but retrieves the digital file corresponding to the snapshot 70 from the computer storage medium and controls its analysis by the image processing program. The calculating means 74 then decode, in the same manner as in the embodiments and variants described above, the pattern 51 read on the digital plate 70 to derive the identification data.

According to other variants, the implant 5 is not an implantable chamber, but a vascular prosthesis, a tubular stent, in particular a coronary stent or a peripheral stent, an orthopedic prosthesis, a vascular patch, a dental implant, a wall reinforcement, heart valve, pacemaker, artificial heart, gastric band, cochlear implant, genital implant or neural implant.

In this case, the label 50 corresponding to the pattern 51 is formed on an area of the vascular prosthesis, the tubular stent, in particular the coronary stent or the peripheral stent, the orthopedic prosthesis, the vascular patch, the implant dental implant, the heart valve, the heart valve, the pacemaker, the artificial heart, the gastric band, the cochlear implant, the genital implant or the neuronal implant that can be imaged by means of modalities. traditional imaging. The picture 70 is in particular made by radiography. In this case, the label 50 is a radiopaque pattern, formed by any method making it possible to obtain a radiographic contrast different from that of the implant 5 so as to show on a plate 70 the pattern 51 with a contrast with respect to the implant 5. It is formed in particular by applying a radio-opaque material to the area of the implant 5. As a variant, it is formed by processes resulting in a differentiation of the thicknesses of the materials, for example by etching a metal surface of the implant 5. The determination method according to the invention is advantageous because, the image image of the label formed on the implant representing an implant identification data. , and not directly a characteristic of the implant, it is possible to associate not only a specific characteristic, but also a list of characteristics to a given implant, characterized by its identification data. The list of characteristics is not limited by the space available on the implant since, whatever the number of characteristics to be defined, the pattern carried by the implant depends only on the identification data. In addition, the characteristics of the implant being stored in a database outside the patient, it is possible to modify or complete the characteristics associated with an implant characterized by a given identification data, even after its implantation. in the body of the patient, without the need to remove the implant by a surgical operation. Finally, the reading device is a mobile device, it is not linked to a particular imaging device and can be used regardless of the make or model of the imaging device used to make the snapshot . This process is therefore particularly versatile and flexible to use. In addition, there is no need to access software controlling the operation of medical devices. The independence of the reading apparatus from a particular imaging apparatus and the portability of the reading apparatus also makes it possible to analyze pictures provided solely on film or snapshots taken by others. practitioners for example in other services. Indeed, the snapshot analysis does not require access to the imaging device that took the snapshot to be analyzed.

Claims (1)

CLAIMS 1. A method for determining at least one characteristic of an implant (5), implanted in a body of a patient (7), the implant (5) being masked by the skin (16) of the patient (7). ), the method being characterized in that it comprises the following steps: - providing a snapshot (70) having a pattern (51) resulting from a label (50) formed on the implant (5) or carried by it ci, the snapshot (70) having been taken through the skin (16) of the patient (7) with the aid of an imaging apparatus (58) after implantation of the implant (5) into the patient's body (7); - read the pattern (51) on the plate (70) by means of a reading device (65) independent of the imaging apparatus (58); - interrogating a database (60) based on the pattern (51) read and obtain from the database (60) the characteristic of the implant (5) sought. 2. Method according to claim 1, wherein the database (60) associates an identification data of the implant (5) with at least the desired characteristic of the implant (5), the pattern (51). representing the identification data in coded form, and the reading device (65) decoding the pattern (51) read on the plate (70) to deduce therefrom the identification data of the implant (5), the querying the database (60) on the basis of the decoded identification data. 3. A method according to claim 2, further comprising, prior to implantation of the implant (5) in the body of the patient (7), a learning step by the reading device (65) of the code used to encode the identification data, this step of constituting, in a memory (76) of the reading apparatus (65), a second database associating a pattern (51) specific to each identification data of in order to constitute the code, the reading device (65) then decoding the pattern (51) read on the plate (70) on the basis of this code. 4. A method according to claim 2, wherein the pattern (51) is unfit to be decoded by simply viewing the pattern (51) on the snapshot (70) and interrogating the database (60) on the basis of this visualization of the pattern (51). 5. Method according to one of claims 2 to 4, wherein the pattern (51) is a graphic code, in particular a barcode, more particularly a two-dimensional barcode, including a DataMatrix code. The method of any one of claims 1 to 5, wherein the database (60) is stored in a memory (76) of the reading apparatus (65), the reading apparatus (65) querying the database (60) based on the pattern (51) read on the snapshot (70) and deriving the characteristic of the desired implant (5). 7. A method according to any one of claims 1 to 5, wherein the reading apparatus (65) comprises means (78) for remote connection to the database (60) via a network, advantageously via the an Internet network, and wherein the reading apparatus (65) remotely connects to the database (60) for querying the database (60) based on the pattern (51) read on the snapshot (70) and deduce the characteristic of the implant (5) sought. 8. A process according to any one of the preceding claims, wherein the label (50) is a radiopaque marking, visible by X-ray radiography, and the plate (70) is a radiograph. The method of any of the preceding claims, wherein the implant (5) is selected from the group consisting of an implantable chamber, a vascular prosthesis, a tubular stent, including a coronary stent or peripheral stent, a orthopedic prosthesis, vascular patch, dental implant, wall reinforcement, heart valve, pacemaker, artificial heart, gastric band, cochlear implant, genital implant and neural implant. 10. A method according to any one of the preceding claims, wherein the implant is an implantable chamber (5), and the characteristic to be determined is an injection characteristic of the implantable chamber (5), selected from the maximum flow rate. can be injected into the implantable chamber (5) and the maximum pressure supported by the implantable chamber (5). 11.- Method for regulating the flow rate of a fluid intended to be injected into the body of a patient (7) via an implantable chamber (5) before it is injected into the patient's body (7) the method comprising the following successive steps: - determining an injection characteristic of the implantable chamber (5) via the determination method according to any one of the preceding claims, taken in combination with claim 10; before fluid injection into the implantable chamber (5), controlling the flow rate of a fluid injection apparatus (12) for connection to the implantable chamber (5), based on the characteristic of injecting the implantable chamber (5) determined in the determining step.