JP7071442B2 - 血管のナビゲーション、評価および/または診断を行うための機器および方法 - Google Patents
血管のナビゲーション、評価および/または診断を行うための機器および方法 Download PDFInfo
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0002—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network
- A61B5/0004—Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network characterised by the type of physiological signal transmitted
- A61B5/0008—Temperature signals
-
- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B5/01—Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0275—Measuring blood flow using tracers, e.g. dye dilution
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/026—Measuring blood flow
- A61B5/0275—Measuring blood flow using tracers, e.g. dye dilution
- A61B5/028—Measuring blood flow using tracers, e.g. dye dilution by thermo-dilution
-
- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- A61B5/06—Devices, other than using radiation, for detecting or locating foreign bodies ; determining position of probes within or on the body of the patient
- A61B5/065—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe
- A61B5/068—Determining position of the probe employing exclusively positioning means located on or in the probe, e.g. using position sensors arranged on the probe using impedance sensors
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/24—Detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof
- A61B5/25—Bioelectric electrodes therefor
- A61B5/279—Bioelectric electrodes therefor specially adapted for particular uses
- A61B5/28—Bioelectric electrodes therefor specially adapted for particular uses for electrocardiography [ECG]
- A61B5/283—Invasive
- A61B5/29—Invasive for permanent or long-term implantation
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0102—Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M31/00—Devices for introducing or retaining media, e.g. remedies, in cavities of the body
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6851—Guide wires
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/72—Signal processing specially adapted for physiological signals or for diagnostic purposes
- A61B5/7235—Details of waveform analysis
- A61B5/7239—Details of waveform analysis using differentiation including higher order derivatives
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B7/00—Instruments for auscultation
- A61B7/02—Stethoscopes
- A61B7/023—Stethoscopes for introduction into the body, e.g. into the oesophagus
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/445—Details of catheter construction
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
- A61M2025/0166—Sensors, electrodes or the like for guiding the catheter to a target zone, e.g. image guided or magnetically guided
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M2025/09175—Guide wires having specific characteristics at the distal tip
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- Health & Medical Sciences (AREA)
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- Engineering & Computer Science (AREA)
- Public Health (AREA)
- General Health & Medical Sciences (AREA)
- Veterinary Medicine (AREA)
- Animal Behavior & Ethology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Biophysics (AREA)
- Medical Informatics (AREA)
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- Anesthesiology (AREA)
- Cardiology (AREA)
- Physiology (AREA)
- Pulmonology (AREA)
- Human Computer Interaction (AREA)
- Computer Networks & Wireless Communication (AREA)
- Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
- Media Introduction/Drainage Providing Device (AREA)
- Infusion, Injection, And Reservoir Apparatuses (AREA)
- Measurement And Recording Of Electrical Phenomena And Electrical Characteristics Of The Living Body (AREA)
- High Energy & Nuclear Physics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Optics & Photonics (AREA)
- Radiology & Medical Imaging (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
Description
1) 流体がカテーテルの輸液ルーメンを通して輸液されると、流体の大部分が流路2518を経由して血管カテーテルから流出するように、導管を通り/それを越える流体の流れを可能にしながら、血管カテーテルの輸液ルーメンの遠位端部を実質的に密閉する。導管は、カテーテルの輸液ルーメンを十分に閉塞せず、流体がそこを通過できるようにし、および場合によっては、その周りにあるチャンネルを通過できるようにすることに留意することが重要である。
コントローラは、媒質の送給、および血流中での媒質パラメータの検出を制御し得る。さらに、コントローラは、1つ以上のセンサーから情報を受信し、かつ情報を解釈して、血管系内の場所、相対的位置、および/または危険区域を評価する。センサー信号は、ワイヤ、光ファイバーケーブル、または他の手段を介して、コントローラに戻るように通信され、そこで、測定されたパラメータ、パラメータプロファイル、2つ以上のセンサーのパラメータ、または経時的なパラメータの変化、および/または距離に基づいて、信号が分析される。例えば、コントローラは、血管カテーテルナビゲーション機器の近くの血流の大きさおよび方向、および/または他のフローパラメータに基づいて、血管カテーテルナビゲーション機器の遠位端部が静脈の代わりに動脈内にあるかどうかを決定し得る。例えば、コントローラが、血管カテーテルナビゲーション機器の遠位端部が静脈の代わりに動脈内にあると決定する場合、可聴、視覚信号などを含む特定の識別信号が合図して、ユーザに、血管カテーテルナビゲーション機器、および任意の他の機器、例えばシース、カテーテルなどを除去し、および血管に圧力を加えるように、指示する。例えば、血管カテーテルナビゲーション機器の前進、後退、向きの変更、停止または除去の指示は、コントローラによって、コントローラのいずれかに接続されたスクリーン上に表示され得る。接続は有線でもまたは無線でもよく、およびスクリーンは、ローカルでもまたはリモートでもよい。コントローラからの信号は、Bluetooth(登録商標)、または他の無線プロトコルで、ラップトップ、タブレット、電話、腕時計、または他の周辺機器などのコンピュータへ伝送され得る。
カテーテルの場所を検出するために使用される輸液の滴下、ボーラス、液滴、ストリームなどは、特定のパラメータを有し得る。輸液は滴下としてもよいし、またはストリームとしてもよい。好ましい間欠的な量のサイズ(滴下、滴、ボーラス、間欠的なストリーム)は約0.5cc~約3ccとし得るが、約0.1cc~約10ccの範囲ともし得る。あるいは、量は約0.5cc~約1ccの範囲ともし得る。あるいは、量は約0.5cc~約2ccの範囲ともし得る。
図52は、本発明の任意の実施形態と一緒に使用され得るデータ処理システムのブロック図である。例えば、システム5200は、コントローラの一部として使用され得る。図52は、コンピュータシステムの様々な構成要素を示すが、構成要素を相互接続するいずれかの特定のアーキテクチャまたは方法を表すものではないことに留意されたい;そのようなものとして、詳細は本発明に直接関係するものではない。ネットワークコンピュータ、ハンドヘルドコンピュータ、モバイル機器、タブレット、セル方式の携帯電話、およびより少数の構成要素またはおそらくはより多数の構成要素を有する他のデータ処理システムも、本発明と一緒に使用され得ることも理解されたい。
Claims (16)
- 場所検出システムであって:
ルーメンのある長尺状本体;
前記長尺状本体の遠位端部にまたはそれに近接して前記長尺状本体に沿って位置決めされた第1のセンサー;
前記第1のセンサーより近位の前記長尺状本体に沿って位置決めされた第2のセンサー;
前記第1および第2のセンサーの間に前記長尺状本体に沿って置かれる1つ以上の開口部であって、前記第1および第2のセンサーは、第1の流体が前記1つ以上の開口部から第2の流体に放出された後で、前記第1および第2の流体の混合物の少なくとも1つのパラメータを測定するように構成されている、開口部;および
前記第1および第2のセンサーと通信するコントローラであって、前記混合物の前記少なくとも1つのパラメータの刺激信号を受信するように構成され、およびさらに、前記信号に基づいて対象者の体内での前記第1および第2のセンサーの位置を獲得するように構成されている、コントローラ
を含む、場所検出システム。 - さらに、前記長尺状本体を規定するカテーテルを含む、請求項1に記載のシステム。
- 前記長尺状本体がスタイレットを含む、請求項1に記載のシステム。
- 前記長尺状本体がガイドワイヤを含む、請求項1に記載のシステム。
- 前記第1のセンサーが、前記長尺状本体の開口部にまたはそれよりも遠位に位置決めされている、請求項1に記載のシステム。
- 前記第1のセンサーが、前記長尺状本体の前記遠位端部に位置決めされている、請求項1に記載のシステム。
- 前記第1および第2のセンサーが導電センサーを含む、請求項1に記載のシステム。
- さらに、少なくとも部分的に前記長尺状本体内に位置決めされる導管を含む、請求項1に記載のシステム。
- 前記第1および第2のセンサーが、前記長尺状本体の長手方向軸に沿って位置決めされている、請求項1に記載のシステム。
- 前記第1および第2のセンサーが、前記1つ以上の開口部の開口部に対して固定距離に位置決めされている、請求項1に記載のシステム。
- さらに、前記長尺状本体に組み込まれたECG電極を含む、請求項1に記載のシステム。
- さらに、前記長尺状本体に組み込まれた圧力センサーを含む、請求項1に記載のシステム。
- さらに、前記ルーメンと連通する液溜め部を含む、請求項1に記載のシステム。
- センサーデータが前記第1および第2のセンサーと前記コントローラとの間で伝送される、請求項1に記載のシステム。
- 前記センサーデータが導電データを含む、請求項14に記載のシステム。
- 前記コントローラが、前記信号に基づいて、前記対象者の前記体の血管系内の前記第1および第2のセンサーの位置を獲得するように構成される、請求項1に記載のシステム。
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JP2022076775A JP7253654B2 (ja) | 2016-06-29 | 2022-05-06 | 血管のナビゲーション、評価および/または診断を行うための機器 |
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US201662356383P | 2016-06-29 | 2016-06-29 | |
US62/356,383 | 2016-06-29 | ||
US201662405879P | 2016-10-08 | 2016-10-08 | |
US62/405,879 | 2016-10-08 | ||
US201762444941P | 2017-01-11 | 2017-01-11 | |
US62/444,941 | 2017-01-11 |
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JP2020104897A Active JP7071442B2 (ja) | 2016-06-29 | 2020-06-17 | 血管のナビゲーション、評価および/または診断を行うための機器および方法 |
JP2022076775A Active JP7253654B2 (ja) | 2016-06-29 | 2022-05-06 | 血管のナビゲーション、評価および/または診断を行うための機器 |
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US (3) | US10092215B2 (ja) |
EP (1) | EP3451908A4 (ja) |
JP (3) | JP6824299B2 (ja) |
CN (1) | CN109310338B (ja) |
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JP6824299B2 (ja) | 2016-06-29 | 2021-02-03 | ピッコロ・メディカル,インコーポレーテッド | 血管のナビゲーション、評価および/または診断を行うための機器および方法 |
EP3593833A1 (en) | 2018-07-13 | 2020-01-15 | Medtronic Inc. | Catheter for increased intrathecal drug dispersion |
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US10092215B2 (en) | 2018-10-09 |
EP3451908A4 (en) | 2019-11-06 |
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WO2018005169A1 (en) | 2018-01-04 |
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US20180344205A1 (en) | 2018-12-06 |
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US11826137B2 (en) | 2023-11-28 |
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