US20230000587A1 - Non-migrating biopsy site identifiers - Google Patents

Non-migrating biopsy site identifiers Download PDF

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Publication number
US20230000587A1
US20230000587A1 US17/943,363 US202217943363A US2023000587A1 US 20230000587 A1 US20230000587 A1 US 20230000587A1 US 202217943363 A US202217943363 A US 202217943363A US 2023000587 A1 US2023000587 A1 US 2023000587A1
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Prior art keywords
marker
biopsy site
marker element
examples
tissue
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US17/943,363
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English (en)
Inventor
Emily NICHOLAS
Dave SANDER
Emmanuel V. Tanghal
Brian R. KELLER
Sean Callahan
Jeffrey McClure
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Devicor Medical Products Inc
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Devicor Medical Products Inc
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Priority to US17/943,363 priority Critical patent/US20230000587A1/en
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B10/00—Other methods or instruments for diagnosis, e.g. instruments for taking a cell sample, for biopsy, for vaccination diagnosis; Sex determination; Ovulation-period determination; Throat striking implements
    • A61B10/02—Instruments for taking cell samples or for biopsy
    • A61B10/0233—Pointed or sharp biopsy instruments
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00004—(bio)absorbable, (bio)resorbable or resorptive
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00867—Material properties shape memory effect
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00831—Material properties
    • A61B2017/00898—Material properties expandable upon contact with fluid
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
    • A61B2090/3908—Soft tissue, e.g. breast tissue
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3904—Markers, e.g. radio-opaque or breast lesions markers specially adapted for marking specified tissue
    • A61B2090/3912—Body cavities
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3925—Markers, e.g. radio-opaque or breast lesions markers ultrasonic
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3966—Radiopaque markers visible in an X-ray image
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3983—Reference marker arrangements for use with image guided surgery
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3987—Applicators for implanting markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A61B2090/3991—Markers, e.g. radio-opaque or breast lesions markers having specific anchoring means to fixate the marker to the tissue, e.g. hooks

Definitions

  • Biopsies can include surgical excisional biopsies and stereotactic and ultrasound guided needle breast biopsies.
  • image directed biopsy the radiologist or other physician may take a small sample of the irregular tissue for laboratory analysis. If the biopsy proves to be malignant, additional surgery (e.g., a lumpectomy or a mastectomy) may be required.
  • needle biopsies the patient may return to the radiologist a day or more later, and the biopsy site (the site of the lesion) may need to be relocated in preparation for the surgery.
  • An imaging system such as ultrasound, magnetic resonance imaging (MM) or x-ray may be used to locate the biopsy site.
  • a marker may be placed at the time of the biopsy.
  • a placed marker may not completely correspond to the biopsy site when the marker is relocated.
  • the marker may migrate to another nearby location during the intervening time between the biopsy procedure and subsequent follow up procedures. Migration of the biopsy site marker can cause difficulties when identifying the biopsy site during subsequent follow-up procedures. Accordingly, it may be desirable to incorporate features into a marker to maintain the marker in a fixed position over time.
  • FIGS. 1 A, 1 B, and 1 C show exemplary aspects of placement of a biopsy site marker, in accordance with aspects of the present disclosure
  • FIG. 2 depicts a perspective view of an exemplary marker delivery device
  • FIG. 3 depicts a side cross-sectional view of the marker delivery device of FIG. 2 ;
  • FIG. 4 depicts a cross-sectional view of a marker being deployed from the distal portion of the marker delivery device of FIG. 1 and through a lateral aperture in a biopsy needle to mark a biopsy site;
  • FIG. 5 A depicts a perspective view of another exemplary biopsy site marker
  • FIG. 5 B depicts a front cross-sectional view of the marker of FIG. 5 A inside of a marker delivery device
  • FIG. 5 C depicts a cross-sectional view of the marker of FIG. 5 A deployed inside of a cavity
  • FIG. 6 A depicts a side elevational view of yet another exemplary biopsy marker, with the marker in an initially expanded state
  • FIG. 6 B depicts a cross-sectional view of the marker of FIG. 6 A , with the marker in a retracted state;
  • FIG. 7 A depicts a perspective view of still another exemplary biopsy marker
  • FIG. 7 B depicts a side elevational view of a tab of the marker of FIG. 7 A ;
  • FIG. 7 C depicts a side elevational view of still another exemplary biopsy marker
  • FIG. 8 A depicts a perspective view of still another exemplary biopsy marker
  • FIG. 8 B depicts a cross-sectional view of the marker of FIG. 8 A , with the marker having a substantial triangular cross-section;
  • FIG. 8 C depicts a cross-sectional view of still another exemplary biopsy marker having an alternative configuration of the marker of FIG. 8 A ;
  • FIG. 9 depicts a perspective view of still another exemplary biopsy marker
  • FIG. 10 A depicts a side elevational view of still another exemplary biopsy marker
  • FIG. 10 B depicts a side elevational view of the marker of FIG. 10 A , with an alternative profile
  • FIG. 11 A depicts a side elevational view of still another exemplary biopsy marker, with the marker in a pre-deployment state
  • FIG. 11 B depicts a side elevational view of the marker of FIG. 11 A , with the marker in a deployed state;
  • FIG. 12 A depicts a side elevational view of still another exemplary biopsy marker, with the marker in a closed state
  • FIG. 12 B depicts a side elevational view of the marker of FIG. 12 A , with the marker in an open state;
  • FIG. 13 depicts a side elevational view of still another exemplary biopsy marker
  • FIG. 14 A depicts a perspective view of still another exemplary biopsy marker, with the marker in an unrolled state
  • FIG. 14 B depicts a side elevational view of the marker of FIG. 14 A , with the marker in a rolled state.
  • the marker may be desirable for the marker to remain visible under ultrasound. It may also be desirable to make the marker readily identifiable relative to other structural features of a patient. For instance, it may be desirable for the marker to be distinguishable under ultrasound visualization from microcalcifications to avoid inadvertently characterizing the marker as a microcalcification during subsequent ultrasonic examinations. Generally, microcalcifications are used in the field to identify suspicious lesions or masses. Thus, it is generally desirable for the ultrasound view to be distinguishable as a marker and not inadvertently identified as a new mass.
  • a marker ( 100 ) may be initially placed in the biopsy cavity ( 10 ) to facilitate relocation of the biopsy site.
  • Marker ( 100 ) may comprise a carrier ( 120 ) and a marker element ( 12 ).
  • Carrier ( 120 ) generally includes a bioabsorbable marker material ( 122 ).
  • carrier ( 120 ) is generally configured for absorption into a patient after placement of marker ( 100 ) within the biopsy cavity ( 10 ).
  • carrier ( 120 ) can include a plurality of microbubbles to enhance visualization of carrier ( 120 ) under ultrasound.
  • marker material ( 122 ) is generally bioabsorbable such that marker material ( 122 ) may be generally absorbed into the patient's tissue over time.
  • marker material ( 122 ) comprises a hydrogel that is initially in a dehydrated state. Although a hydrogel is used in the present example, it should be understood that in other examples marker material ( 122 ) may comprise other known bioabsorbable materials
  • marker ( 100 ) further includes a marker element ( 12 ) that is generally not bioabsorbable.
  • Marker element ( 12 ) may comprise a radiopaque or echogenic marker embedded within the bioabsorbable marker material ( 122 ) of carrier ( 120 ).
  • marker element ( 12 ) may comprise metal, hard plastic, or other radiopaque or hyperechoic materials known to those of ordinary skill in the art in view of the teachings herein.
  • marker ( 100 ) may be formed without a marker element ( 12 ).
  • marker ( 100 ) may be formed with only marker element ( 12 ) such that carrier ( 120 ) is omitted and marker element ( 12 ) is in a “bare” form. In other words, in some examples marker ( 100 ) is formed of only carrier ( 120 ) as a bare clip.
  • Marker material ( 122 ) is generally expandable once disposed within a patient at a biopsy site. As shown in FIGS. 1 B and 1 C , the initially dehydrated marker material ( 122 ) may absorb fluid from the surrounding tissue ( 30 ) into which it is inserted. In response to this absorption of fluid, maker material ( 122 ) may swell, thereby permitting carrier ( 120 ) to fill a cavity formed at a biopsy site by removal of tissue samples during a biopsy procedure.
  • Biodegradable materials may be particularly suitable in applications where it is desired that natural tissue growth be permitted to completely or partially replace the implanted material over time. Accordingly, biocompatibility is ensured and the natural mechanical parameters of the tissue are substantially restored to those of the pre-damaged condition.
  • Marker ( 100 ) may be inserted into the body either surgically via an opening in the body cavity ( 30 ), or through a minimally invasive procedure using such devices as a catheter, introducer or similar type insertion device. Marker ( 100 ) may be delivered immediately after removal of the tissue specimen using the same device used to remove the tissue specimen itself.
  • Follow-up noninvasive detection techniques such as x-ray mammography or ultrasound may then be used by the physician to identify, locate, and monitor the biopsy cavity site over a period of time via marker ( 100 ).
  • Marker ( 100 ) of the present example is large enough to be readily visible to a clinician under x-ray or ultrasonic viewing, for example; yet small enough to be able to be percutaneously deployed into the biopsy cavity and to not cause any difficulties with the patient.
  • aspects presented herein may be used for markers in any internal, tissue, e.g., in breast tissue, lung tissue, prostate tissue, lymph gland tissue, etc.
  • the hydration of the marker material ( 122 ) of carrier ( 120 ) by the natural moisture of the tissue surrounding it causes expansion of the polymer and thus minimizes the risk of migration.
  • the growing hydrogel-based marker material ( 122 ) centers marker ( 100 ) in the biopsy cavity as it grows. As the hydrogel expands, naturally present moisture from the surrounding tissue, the hydration enables increasing sound through transmission, appears more and more hypoechoic and is easy to visualize on follow up ultrasound studies.
  • the hydrated hydrogel marker material ( 122 ) of carrier ( 120 ) may also be used to frame permanent marker ( 12 ).
  • the hypoechoic nature of the hydrated marker material ( 122 ) enables ultrasound visibility of the permanent marker ( 12 ) within the hydrogel hydrated marker material ( 122 ) because the permanent marker ( 12 ) is outlined as a specular reflector within a hypoechoic hydrated marker having a water-like nonreflective substrate.
  • FIGS. 2 and 3 show an exemplary marker delivery device ( 150 ) which includes an elongate outer cannula ( 162 ) having a marker exit, such as side opening ( 164 ) formed adjacent to, but spaced proximally from, the distal end of the cannula ( 162 ).
  • a grip ( 166 ) can be provided at the proximal end of cannula ( 162 ).
  • a push rod ( 168 ) can be provided, with push rod ( 168 ) extending coaxially in cannula ( 162 ) such that push rod ( 168 ) is configured to translate within cannula ( 162 ) to displace one or more markers through side opening ( 164 ) (see FIG. 3 ).
  • Rod ( 168 ) may have sufficient rigidity in compression to push a marker from an internal lumen ( 165 ) of cannula ( 162 ) out through opening ( 164 ), yet be relatively flexible in bending.
  • a plunger ( 170 ) is coupled at the proximal end of rod ( 168 ) for forcing rod ( 168 ) distally in cannula ( 162 ) to deploy a marker out of cannula ( 162 ).
  • a user may grasp grip ( 166 ) with two fingers, and may push on plunger ( 170 ) using the thumb on the same hand, so that marker delivery device ( 160 ) is operated by a user's single hand.
  • a spring (not shown) or other feature may be provided about rod ( 168 ) to bias rod ( 168 ) proximally relative to grip ( 166 ) and cannula ( 162 ).
  • FIG. 3 shows a cross-sectional view of a distal portion of the marker delivery device ( 160 ).
  • a biopsy marker ( 300 ) similar to marker ( 100 ) described above is disposed within internal lumen ( 165 ) of cannula ( 162 ).
  • marker ( 300 ) comprise a biodegradable or otherwise resorbable marker material ( 306 ), such as a generally cylindrically shaped body of collagen, hydrogel, or etc., and a metallic, generally radiopaque permanent marker or marker element ( 310 ) (shown in phantom) disposed within or otherwise carried by marker material ( 306 ).
  • Cannula ( 162 ) may be formed of any suitable metallic or non-metallic material.
  • cannula ( 162 ) is formed of a thin walled hollow tube formed of a suitable medical grade plastic or polymer.
  • a suitable material is a thermoplastic elastomer, such as Polyether block amide (PEBA), such as is known under the tradename PEBAX.
  • PEBAX Polyether block amide
  • Cannula ( 162 ) may be formed of PEBAX, and may be substantially transparent to visible light and X-ray.
  • Side opening ( 164 ) may be formed by cutting away a portion of the wall of cannula ( 162 ). Side opening ( 164 ) communicates with an internal lumen ( 165 ) of cannula ( 162 ). Side opening ( 164 ) may extend axially (in a direction parallel to the axis of lumen ( 165 )) from a proximal opening end ( 164 A) to a distal opening end ( 164 B), as illustrated in FIG. 3 .
  • distal tip ( 172 ) extends from the distal end of cannula ( 162 ) and is rounded as shown in FIG. 3 .
  • the distal end of cannula ( 162 ) is closed by a unitary endpiece ( 171 ), with a portion of endpiece ( 171 ) extending into internal lumen ( 165 ) of cannula ( 162 ).
  • Endpiece ( 171 ) may be a molded or cast component.
  • Endpiece ( 171 ) comprises a tip ( 172 ), a ramp ( 210 ) having a ramp surface ( 212 ), and a marker engaging element ( 240 ).
  • Ramp surface ( 212 ) aids in directing marker ( 300 ) from internal lumen ( 165 ) through side opening ( 164 ).
  • Marker engaging element ( 240 ) helps to retain marker ( 300 ) in internal lumen ( 165 ) until the user intends to deploy marker ( 300 ).
  • Marker engaging element ( 240 ) is disposed within internal lumen ( 165 ), and at least a portion of marker engaging element ( 240 ) is disposed distally of proximal end ( 164 A) of side opening ( 164 ). Marker engaging element ( 240 ) extends along a portion of the floor of cannula ( 162 ) under opening ( 164 ) such that marker engaging element ( 240 ) is positioned to reinforce the portion of cannula ( 162 ) in which opening ( 164 ) is formed. For instance, by positioning marker engaging element ( 240 ) underneath opening ( 164 ), as shown in FIG.
  • element ( 240 ) helps to stiffen cannula ( 162 ) in the region where wall of cannula ( 162 ) is cut to form opening ( 164 ). As shown in FIG. 3 , marker engaging element ( 240 ) extends from the proximal most portion of ramp surface ( 212 ), and does not extend proximally of side opening ( 164 ), though in other embodiments, a portion of element ( 240 ) may extend proximally of opening ( 164 ).
  • marker engaging element ( 240 ) is in the form of a step having a generally uniform thickness (T) along element's ( 240 ) axial length, except that element ( 240 ) has a tapered proximal end ( 242 ).
  • Tapered proximal end ( 242 ) forms an included angle with the longitudinal axis of lumen ( 165 ) (included angle with a horizontal line in FIG. 3 ) of about 45 degrees, while ramp surface ( 212 ) forms an included angle with the longitudinal axis of about 30 degrees.
  • any number of other suitable angles may be used.
  • an upwardly facing surface ( 244 ) (surface facing opening ( 164 )) of marker engaging element ( 240 ) extends distally to contact ramp surface ( 212 ), so that there is not a space or gap between surface ( 244 ) and ramp surface ( 212 ).
  • Such an arrangement is advantageous to reduce the possibility that marker ( 300 ), upon moving past marker engaging element ( 240 ), may become lodged between marker engagement element ( 240 ) and ramp ( 212 ).
  • marker engaging element ( 240 ), ramp ( 210 ), and/or tip ( 172 ) are formed of, or include, a material that is relatively more radiopaque than the wall of cannula ( 162 ).
  • endpiece ( 171 ) may include a radiopaque additive, such as barium sulfate.
  • endpiece ( 171 ) may be a component molded of PEBAX, with about 20 percent by weight barium sulfate added to the molten PEBAX mold composition.
  • the relatively more radiopaque marker engaging element ( 240 ), ramp ( 210 ), and tip ( 22 ) may be useful in distinguishing the position of those components using radiographic imaging.
  • the addition of a radiopaque material can help identify the position of opening ( 164 ), and the position of marker ( 300 ) relative to opening ( 164 ) before, during, or after deployment of marker ( 300 ).
  • marker delivery device ( 160 ) is used to deploy a marker ( 300 ) to mark a biopsy location within a patient.
  • a cannular biopsy needle ( 400 ) is shown having a closed distal end with piercing tip ( 402 ) and a lateral tissue receiving aperture ( 414 ).
  • Marker delivery device ( 160 ) is introduced to a biopsy site through biopsy needle ( 400 ), which may be the same needle ( 400 ) used to collect a tissue sample from the biopsy site.
  • Biopsy needle ( 400 ) may be of the type used with single insertion, multiple sample vacuum assisted biopsy devices. Several such biopsy devices are disclosed in the various patents and patent applications that have been referred to and incorporated by reference herein, though other biopsy devices may be used.
  • FIG. 4 shows the distal end of marker delivery device ( 160 ) disposed within needle ( 400 ).
  • Needle ( 400 ) may be positioned in tissue, and a biopsy sample may be obtained through lateral aperture ( 414 ), thereby providing a biopsy cavity adjacent lateral aperture ( 414 ). Then, after the tissue sample has been obtained and transferred proximally through needle ( 400 ), and without removing needle ( 400 ) from the patient's tissue, marker delivery device ( 160 ) is inserted into a proximal opening in needle ( 400 ).
  • FIG. 4 shows the distal end of marker delivery device ( 160 ) disposed within needle ( 400 ).
  • needle ( 400 ) and marker delivery device ( 160 ) are positioned such that opening ( 164 ) of cannula ( 162 ) and lateral aperture ( 414 ) of needle ( 400 ) are substantially aligned axially and circumferentially. Then, with marker delivery device ( 160 ) and needle ( 400 ) so positioned at the biopsy site, push rod ( 168 ) is advanced to deploy marker ( 300 ) up ramp surface ( 212 ), through opening ( 164 ), and then through lateral aperture ( 414 ), into the biopsy cavity.
  • a marker similar to marker ( 100 ) it may be desirable to include certain features within a marker similar to marker ( 100 ) to reduce a risk of the marker to migrate when placed within tissue. For instance, some markers may be prone to migration after placement of a biopsy site due to movement of tissue in the intervening time between marker placement and subsequent follow-up procedures. As a result, such markers may introduce challenges with identifying the biopsy site during subsequent follow-up procedures. Accordingly, it may be desirable to incorporate features into a marker similar to marker ( 100 ) to maintain the marker in a fixed position within tissue over time.
  • FIGS. 5 A- 5 C show an exemplary marker ( 500 ) that is generally configured to expand outwardly to thereby anchor marker ( 500 ) within tissue.
  • marker ( 500 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 500 ) of the present example includes a marker element ( 512 ).
  • marker element ( 512 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 512 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization over time.
  • marker ( 500 ) of the present example is generally configured as a bare marker such that marker ( 500 ) does not include a structure similar to carrier ( 120 ) described above.
  • marker element ( 512 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 512 ) of the present example is composed of nitinol.
  • marker element ( 512 ) is composed of a nitinol mesh, wire, or stint like material.
  • marker element ( 512 ) can be configured to promote tissue ingrowth.
  • marker element ( 512 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 512 ) to the tissue.
  • marker element ( 512 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • Marker element ( 512 ) of the present example is configured to have a general “V” shape.
  • marker element ( 512 ) of the present example comprises first arm ( 530 ) (also may be referred to as a “first portion”) and second arm ( 540 ) (also may be referred to as a “second portion”) joined along an edge and extending out, forming the “V” shape.
  • a first tine ( 535 ) is joined to first arm ( 530 ) to extend outwardly from first arm ( 530 ) and a second tine ( 545 ) is joined to second arm ( 540 ) to extend outwardly from second arm ( 540 ).
  • tines ( 535 , 545 ) may also be referred to as an anchor, a ground, and/or etc.
  • Each of arms ( 530 , 540 ) and tines ( 535 , 545 ) may have a thickness and width as required to maintain the shape of marker element ( 512 ).
  • tines ( 535 , 545 ) are configured to have rough or sharp edges to enhance tines ( 535 , 545 ) ability to grip surfaces such as tissue.
  • Marker element ( 512 ) is configured to be compressible so that the acute angle between first arm ( 530 ) and second arm ( 540 ) will become smaller when a force is applied inwardly to first arm ( 530 ) and/or second arm ( 540 ). Additionally, marker element ( 512 ) is resiliently biased such that marker element ( 512 ) is configured to transition from a compressed state ( FIG. 5 B ) to an extended state ( FIG. 5 C ) when the force is reduced or removed from first arm ( 530 ) and/or second arm ( 540 ). In other words, first arm ( 530 ) and second arm ( 540 ) are generally configured to be displaced outwardly when deployed at a biopsy site. As shown in FIG.
  • marker ( 500 ) can be initially confined within an outer cannula ( 550 ) or other means of confinement such as a tube, a carrier similar to carrier ( 120 ), or other structure prior to deployment to the biopsy site. While located in outer cannula ( 550 ) marker element ( 512 ) is in a compressed state. Upon deployment from outer cannula ( 550 ) into the biopsy site, marker element ( 512 ) returns to an extended state, wherein first arm ( 530 ) and second arm ( 540 ) extend away from each other.
  • first tine ( 535 ) and second tine ( 545 ) press into biopsy site wall ( 560 ), securing the marker element ( 512 ) to biopsy site wall ( 560 ).
  • the widened “V” shape of marker element ( 512 ) caused by the increased distance between first arm ( 530 ) and second arm ( 540 ) can act as an anchor to hold marker element ( 512 ) at a given position within tissue.
  • the movement of marker element ( 512 ) from the compressed state to the extended state can cause marker element ( 512 ) to anchor to tissue.
  • the rough or sharp edges of tines ( 535 , 545 ) improves tines ( 535 , 545 ) ability to grip the biopsy site wall ( 560 ). Additionally, the edges of arms ( 530 , 540 ) may also include rough or sharp edges to improve the gripping ability of marker ( 500 ).
  • marker element ( 512 ) of the present example is configured with a “V” shape
  • the shape of marker element ( 512 ) may be of an irregular shape referred to as a “target.”
  • marker element ( 512 ) may be formed of one or more wires defining two opposing tightly wound coils.
  • the two tightly wound coils may be aligned along a common axis with a loose coil joining the two opposing tightly wound coils together.
  • the tightly wound coils may be formed by the one or more wires being wound in circular or oval-shaped coils positioned closely together.
  • the loose coil may be a section of wire joining the two coils.
  • the loose coil itself may include one or more coils as it extends from one tightly wound coil to the other.
  • the tightly wound coils may appear as a circular or oval-shaped outline of the “target.”
  • the loose coil may appear as an S-shaped pattern extending from one side of the circular or oval-shaped outline to the other.
  • the loose coil may also include one or more thick or round portions to make the center of the “target” more readily identifiable.
  • the shape of marker element ( 512 ) may be of a “3D M” shape.
  • marker element ( 512 ) may be formed of a flat sheet material similar to the “V” shape described above.
  • the “3D M” shape may include two additional bends to form an M or W shape when viewed from one side.
  • a total of three bends may be used.
  • the three bends may together define a four discrete sections of material.
  • one or more sections may include one or more cut-outs, bores, or openings therein. Such a cut-out may be desirable to improve visualization from the top or bottom of the M-shaped pattern using an imaging medium such as x-ray where depth visualization may be difficult.
  • the shape of marker element ( 512 ) may be of a “double loop” shape.
  • marker element ( 512 ) may be formed of one or more wires.
  • the one or more wires may define two circular or oval-shaped loops joined together.
  • the two loops may be oriented at different angles.
  • a first loop may define a first plane and a second loop may define a second plane.
  • the first plane may be offset from the second plane by approximately 90 degrees. From above, this configuration may have the appearance of a cross.
  • the particular angle of offset may be varied such as the first plane and second plane being offset by approximately 45 degrees to have an X-shape when viewed from the top.
  • marker element ( 512 ) the shape of marker element ( 512 ) may be of a “funnel.”
  • marker element ( 512 ) may be formed of one or more wires.
  • the one or more wires may define a helical or spiral pattern, with the diameter of the helical or spiral pattern decreasing with each successive coil, thereby forming a frustoconical-shaped pattern.
  • such a configuration may have a 2 dimensional spiral appearance.
  • FIGS. 6 A and 6 B show an exemplary marker ( 600 ) that is generally configured to retract in length to thereby anchor marker ( 600 ) within tissue.
  • marker ( 600 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 600 ) of the present example includes a marker element ( 612 ).
  • marker element ( 612 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 612 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization.
  • marker element ( 612 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 612 ) of the present example is composed of nitinol.
  • marker element ( 612 ) is composed of a nitinol mesh, wire, or stint like material.
  • marker element ( 612 ) can be configured to promote tissue ingrowth.
  • marker element ( 612 ) can be composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 612 ) to the tissue.
  • marker element ( 612 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 612 ) of the present example is configured as non-absorbable.
  • marker element ( 612 ) of the present example includes multiple a marker materials ( 622 , 624 ).
  • Marker materials ( 622 , 624 ) of the present examples are generally configured to have varying material properties that effect the retraction and/or expansion thereof such that marker ( 600 ) can transition from a relatively large or extended volume to a relatively small volume.
  • an outer marker material ( 622 ) is disposed around a structure of inner marker material ( 624 ).
  • outer marker material ( 622 ) is generally configured to dissolve over time within a patient to thereby providing a means for rapidly retracting the length of marker ( 600 ).
  • outer marker material ( 622 ) may also expand before dissolving, in such examples, this material property may be used to expand inner marker material ( 624 ) initially to lodge one or more anchor features of inner marker material ( 624 ) into tissue to initially anchor marker element ( 612 ) within tissue.
  • Marker materials ( 622 , 624 ) are generally positioned in filled or layered arrangement. For instance, in some examples both marker materials ( 622 , 624 ) form a prolate spheroid shape when in a dehydrated condition. In this configuration, inner marker material ( 624 ) forms a structural wound spring core that is wrapped by a filler marker material ( 622 ) also with a prolate spheroid form. Thus, marker ( 600 ) generally defines an elongate prolate spheroid configuration. In the present configuration, inner marker material ( 624 ) is shown as being centrally positioned within filler marker material ( 622 ).
  • inner marker material ( 624 ) can have a variety of positions within filler marker material ( 622 ). Additionally, it should be understood that in other examples inner marker material ( 624 ) may be in the form of a rectangular spring, wherein both the marker material ( 622 , 624 ) form a mirrored wedge, with a profile as shown in FIGS. 6 A- 6 B .
  • filler marker material ( 622 ) is generally absorbable such that filler marker material ( 622 ) is configured to degrade over time within a patient.
  • Filler marker material ( 622 ) in the present example is formed of any suitable bioabsorbable material such as hydrogel, collagen, and/or etc. Additionally, such materials can be configured to have varying absorption properties. For instance, in some examples, filler marker material ( 622 ) can be configured to absorb relatively slowly over time leading to slow contraction of inner marker material ( 624 ). Yet in other examples, filler marker material ( 622 ) can be configured to absorb relatively quickly over time leading to rapid contraction of inner marker material ( 624 ).
  • marker ( 600 ) is initially placed as shown in FIG. 6 A .
  • filler marker material ( 622 ) dissolves or otherwise absorbs into tissue.
  • inner marker material ( 624 ) remains and begins to expand or contract in response to movement of filler marker material ( 622 ).
  • filler marker material ( 624 ) may initially expand as moisture is absorbed by filler marker material ( 624 ). This expansion may initially cause an anchor portion, barb, or other structure of inner marker material ( 624 ) to be driven into tissue by filler marker material ( 624 ) expanding the structure of inner marker material ( 624 ).
  • inner marker material ( 624 ) may then retract into the space left by absorption of filler marker material ( 622 ). Compression of inner marker material ( 624 ) can continue until inner marker material ( 624 ) transitions to the compressed configuration shown in FIG. 6 B .
  • marker ( 600 ) retracting in size results in marker ( 600 ) retracting in size.
  • the volume of marker ( 600 ) can retract to 2 / 3 to 1 / 2 size.
  • the retraction of outer marker material ( 622 ) can grip the biopsy cavity such that inner marker material ( 624 ) can act as an anchor to hold marker ( 600 ) at a given position within tissue. For instance, during retraction, folds of tissue can become trapped within the spaces defined by inner marker material ( 624 ) that were previously filled by filler marker material ( 622 ).
  • the approximate profile of marker ( 600 ) remains generally cylindrical and/or prolate spheroid in shape.
  • the shape of marker ( 600 ) after at least some hydration can be characterized as spring-shaped.
  • various other alternative profiles can be formed using the present configuration.
  • the initial geometry of outer marker material ( 622 ) can be varied to influence the profile of marker ( 600 ) after at least some hydration.
  • the particular shape and/or size of marker ( 600 ) can change throughout the course of hydration. For instance, marker ( 600 ) can start in the position shown in FIG. 6 A after initial hydration. As hydration completes, marker ( 600 ) can exhibit some additional expansion. Subsequently, filler marker material ( 622 ) can dissolve and inner marker material ( 624 ) can retract.
  • FIGS. 7 A and 7 B show an exemplary marker ( 700 ) that is generally configured to screw into biopsy site when deployed to thereby anchor marker ( 700 ) within tissue.
  • marker ( 700 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 700 ) of the present example includes a marker element ( 712 ).
  • marker element ( 712 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 712 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization.
  • marker ( 700 ) of the present example is configured as a bare marker such that a structure similar to carrier ( 120 ) is not included. As will be described in greater detail below, in some uses this bare configuration can be desirable to promote engagement between marker element ( 712 ) and tissue. However, in other examples, marker element ( 712 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 712 ) of the present example is composed of nitinol.
  • marker element ( 712 ) is composed of a nitinol mesh, wire, or stint like material.
  • marker element ( 712 ) can be configured to promote tissue ingrowth.
  • marker element ( 712 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 712 ) to the tissue.
  • marker element ( 712 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 712 ) of the present example is configured to be non-absorbable. However, unlike marker element ( 12 ), marker element ( 712 ) of the present example is configured to be screwed into tissue of biopsy site and includes an angled barb or tab ( 730 ) at one end of screw marker element ( 712 ) to prevent unscrewing or backout when placed in tissue.
  • Marker materials ( 722 ) of the present example is generally configured to have material properties that support the structure with sufficient rigidity that marker ( 700 ) can be screwed into tissue of biopsy site. Marker material ( 722 ) generally forms a helical or spiral shape to define marker element ( 712 ), as well as tab ( 730 ) at the end of the spiral form.
  • tab ( 730 ) is generally configured to enhance the grip of tissue by marker element ( 712 ).
  • Tab ( 730 ) of the present example can take on a variety of forms. For instance, as shown in FIG. 7 B , tab ( 730 ) can have a generally star-shaped cross-section. Alternatively, tab ( 730 ) can have a generally triangular-shaped cross-section, as will be described in greater detail below.
  • tab ( 730 ) is generally configured as a protrusion on an end surface of marker element ( 712 ) which extends radially outward. It should be understood that in other examples tab ( 730 ) can take on a variety of alternative shapes. For instance, in some examples, tabs ( 730 ) are rounded, squared, rectangular, and/or etc. In addition, or in the alternative, the particular shape of tab ( 730 ) can be extended to the remainder of marker element ( 712 ) such that marker element ( 712 ) has a continuous profile.
  • marker ( 730 ) of marker ( 700 ) can take on a variety of forms.
  • FIG. 7 C shows a marker ( 750 ) that is substantially similar to marker ( 700 ) described above, except marker ( 750 ) includes a tab ( 770 ) having a star-shaped cross-section.
  • marker ( 750 ) is identical to marker ( 700 ) described above.
  • marker ( 750 ) of the present example includes an elongate marker element ( 752 ) shaped in a helical or screw-shaped pattern with a tab ( 770 ) on one end.
  • tab ( 770 ) is generally configured to enhance the grip of tissue by marker element ( 752 ).
  • Tab ( 770 ) of the present example can take on a variety of forms. For instance, as shown in FIG. 7 C , tab ( 770 ) can have a generally star-shaped cross-section. Regardless of the particular shape of tab ( 770 ), tab ( 770 ) is generally configured as a protrusion on an end surface of marker element ( 752 ) which extends radially outward. It should be understood that in other examples tab ( 770 ) can take on a variety of alternative shapes. For instance, in some examples, tab ( 770 ) is rounded, squared, rectangular, and/or etc. In addition, or in the alternative, the particular shape of tab ( 770 ) can be extended to the remainder of marker element ( 752 ) such that marker element ( 752 ) has a continuous profile.
  • FIGS. 8 A and 8 B show an exemplary marker ( 800 ) that is generally configured to screw into biopsy site when deployed to thereby anchor marker ( 800 ) within tissue.
  • marker ( 800 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 800 ) of the present example includes a marker element ( 812 ).
  • marker element ( 812 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 812 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization.
  • marker ( 800 ) of the present example is configured as a bare marker such that a structure similar to carrier ( 120 ) is not included. As will be described in greater detail below, in some uses this bare configuration can be desirable to promote engagement between marker element ( 812 ) and tissue. However, in other examples, marker element ( 812 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 812 ) of the present example is composed of nitinol.
  • marker element ( 812 ) is composed of a nitinol mesh, wire, or stint like material.
  • marker element ( 812 ) can be configured to promote tissue ingrowth.
  • marker element ( 812 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 812 ) to the tissue.
  • marker element ( 812 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 812 ) of the present example is configured to be non-absorbable. However, unlike marker element ( 12 ), marker element ( 812 ) of the present example is configured to be screwed into tissue of biopsy site and includes an undercut tab ( 830 ) at one end of screw marker element ( 812 ) to prevent unscrewing or backout when placed in tissue.
  • Marker materials ( 822 ) of the present examples are generally configured to have material properties that support the structure with sufficient rigidity that marker ( 800 ) can be screwed into tissue of biopsy site. Marker material ( 822 ) generally forms a helical or coil shape to define marker element ( 812 ), as well as tab ( 830 ) at the end of the spiral form.
  • marker element ( 812 ) cross-section can be circular or triangular as best shown in FIG. 8 B . It should be understood that in other examples marker element ( 812 ) cross-section can take on a variety of alternative shapes.
  • tab ( 830 ) is generally configured to enhance the grip of tissue by marker element ( 812 ).
  • tab ( 830 ) of the present example has a generally triangular cross-section.
  • tab ( 830 ) can take on a variety of forms such as conical or pointed, as will be described in greater detail below.
  • tab ( 830 ) is generally angled from the helical axis defined by marker element ( 812 ) on an end surface of marker element ( 812 ). It should be understood that in other examples tab ( 830 ) can take on a variety of alternative shapes. For instance, in some examples, tabs ( 830 ) are rounded, squared, rectangular, and/or etc.
  • marker ( 830 ) of marker ( 800 ) can take on a variety of forms.
  • FIG. 8 C shows a marker ( 850 ) that is substantially similar to marker ( 800 ) described above, except marker ( 850 ) includes a tab ( 870 ) having a conical or circular cross-section.
  • marker ( 850 ) is identical to marker ( 800 ) described above.
  • marker ( 850 ) of the present example includes an elongate marker element ( 852 ) shaped in a helical or screw-shaped pattern with a tab ( 870 ) on one end.
  • tab ( 870 ) is generally configured to enhance the grip of tissue by marker element ( 852 ).
  • Tab ( 870 ) of the present example can take on a variety of forms. For instance, as shown in FIG. 8 C , tab ( 870 ) can have a generally circular cross-section to form a conical pointed tip. Regardless of the particular shape of tab ( 870 ), tab ( 870 ) is generally configured as a protrusion on an end surface of marker element ( 852 ) which extends radially outward. It should be understood that in other examples tab ( 870 ) can take on a variety of alternative shapes. For instance, in some examples, tab ( 870 ) is rounded, squared, rectangular, and/or etc. In addition, or in the alternative, the particular shape of tab ( 870 ) can be extended to the remainder of marker element ( 852 ) such that marker element ( 852 ) has a continuous profile.
  • FIG. 9 shows an exemplary marker ( 900 ) that is generally configured to screw into biopsy site when deployed to thereby anchor marker ( 900 ) within tissue.
  • marker ( 900 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 900 ) of the present example includes a marker element ( 912 ).
  • marker element ( 912 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 912 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization over time.
  • marker element ( 912 ) can optionally be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 912 ) of the present example is composed of nitinol.
  • marker element ( 912 ) is composed of a nitinol mesh, wire, or stint like material.
  • marker element ( 912 ) can be configured to promote tissue ingrowth.
  • marker element ( 912 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 912 ) to the tissue.
  • marker element ( 912 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 912 ) of the present example is non-absorbable. However, unlike marker element ( 12 ), marker element ( 912 ) of the present example is configured to be screwed into tissue of biopsy site and includes serrated edge ( 930 ) along a helical edge of the marker element ( 912 ) to prevent unscrewing or backout when placed in tissue. Marker materials ( 922 ) of the present examples are generally configured to have material properties that support the structure with sufficient rigidity that marker ( 900 ) can be screwed into tissue of biopsy site.
  • Marker material ( 922 ) generally forms a helical cone shape to define marker element ( 912 ), as well as serrated edge ( 930 ) along the edges of the conical form as shown.
  • marker element ( 912 ) height and width can be any dimensions suitable for the biopsy procedure.
  • serrated edge ( 930 ) can be non-uniform and along a single edge. It should be understood that in other examples serrated edge ( 930 ) can take on a variety of alternative shapes, such as uniform serrations or multiple edges.
  • edge ( 930 ) is generally configured to enhance the grip of tissue by carrier ( 912 ).
  • Edge ( 930 ) of the present example is formed as generally pitched screw thread rising along the conical surface of marker element ( 912 ). It should be understood that in other examples edge ( 930 ) can take on a variety of alternative shapes. For instance, in some examples, tabs ( 930 ) are rounded, squared, rectangular, and/or etc.
  • FIGS. 10 A and 10 B show an exemplary marker ( 1000 ) that is generally configured to screw into biopsy site when deployed to thereby anchor marker ( 1000 ) within tissue.
  • marker ( 1000 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 1000 ) of the present example includes a marker element ( 1012 ).
  • marker element ( 1012 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 1012 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization.
  • marker element ( 1012 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 1012 ) of the present example is composed of nitinol.
  • marker element ( 1012 ) is composed of a nitinol mesh, wire, or stint like material.
  • marker element ( 1012 ) can be configured to promote tissue ingrowth.
  • marker element ( 1012 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 1012 ) to the tissue.
  • marker element ( 1012 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 1012 ) of the present example is configured to prevent absorption into a patient after placement of marker ( 1000 ).
  • marker element ( 1012 ) of the present example is configured to be attached to tissue of biopsy site and includes one or more barbs ( 1030 ) at one end of marker element ( 1012 ) to prevent migration of marker element ( 1012 ) when placed in tissue.
  • Marker materials ( 1022 ) of the present examples are generally configured to have material properties that support the structure with sufficient rigidity that marker ( 1000 ) can prevent migration of the marker element ( 1012 ) from the biopsy site.
  • Marker material ( 1022 ) generally forms a shaft ( 1040 ), an engagement body ( 1050 ) at a proximal end, and one or more barbs ( 1030 ) at a distal end.
  • shaft ( 1040 ) can be circular or triangular. It should be understood that in other examples shaft ( 1040 ) can take on a variety of alternative shapes.
  • the generally elongated shape of marker material ( 1022 ) is interrupted at a distal end by one or more barbs ( 1030 ).
  • barbs ( 1030 ) are generally configured to enhance the grip of tissue by marker element ( 1012 ).
  • Barbs ( 1030 ) of the present example are formed as generally pointed tips projecting in a direction from an end surface of marker element ( 1012 ) so as to engage the tissue of the biopsy site.
  • the generally elongated shape of marker material ( 1022 ) is interrupted at a proximal end by an engagement body ( 1050 ) configured to engage with a marker delivery probe.
  • marker element ( 1012 ) can take on a variety of forms.
  • marker element ( 1012 ) can alternatively comprise multiple barbs ( 1030 ) in a circular formation. It should be understood that in other examples barbs ( 1030 ) can take on a variety of alternative shapes that would be well known to one skilled in the art.
  • FIGS. 11 A and 11 B show an exemplary marker ( 1100 ) that is generally configured to attach to biopsy site when deployed to thereby anchor marker ( 1100 ) within tissue.
  • marker ( 1100 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 1100 ) of the present example includes a marker element ( 1112 ).
  • marker element ( 1112 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 1112 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization over time.
  • marker element ( 1112 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 1112 ) of the present example is composed of nitinol.
  • marker element ( 1112 ) is composed of a nitinol mesh, wire, or stint like material. Additionally, marker element ( 1112 ) can be configured to promote tissue ingrowth.
  • marker element ( 1112 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 1112 ) to the tissue.
  • marker element ( 1112 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 1112 ) of the present example is non-absorbable. However, unlike marker element ( 12 ), marker element ( 1112 ) of the present example is configured to deploy into tissue of biopsy site and hooks ( 1130 ) which uncoil from marker element ( 1112 ) to prevent migration of marker element ( 1112 ) when placed in tissue.
  • Marker materials ( 1122 ) of the present examples are generally configured to have material properties that support the structure with sufficient rigidity while allowing for uncoiling of hooks ( 1130 ). Marker material ( 1122 ) generally forms a center body to define marker element ( 1112 ), as well as hooks ( 1130 ) extending from marker element ( 1112 ).
  • the center body of marker material ( 1122 ) included one or more hooks ( 1130 ) coiled around the center body before marker element ( 1112 ) is deployed to biopsy site.
  • hooks ( 1130 ) are generally configured to enhance the grip of tissue by marker element ( 1112 ).
  • Hooks ( 1130 ) of the present example are formed as generally curved protrusions extending from the surface of marker element ( 1112 ) which uncoil from the pre-deployment position when placed in the biopsy site as shown in FIG. 11 B . It should be understood that in other examples hooks ( 1130 ) can take on a variety of alternative shapes.
  • FIGS. 12 A and 12 B show an exemplary marker ( 1200 ) that is generally configured to attach to biopsy site when deployed to thereby anchor marker ( 1200 ) within tissue.
  • marker ( 1200 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 1200 ) of the present example includes a marker element ( 1212 ).
  • marker element ( 1212 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 1212 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization over time.
  • marker element ( 1212 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 1212 ) of the present example is composed of nitinol.
  • marker element ( 1212 ) is composed of a nitinol mesh, wire, or stint like material. Additionally, marker element ( 1212 ) can be configured to promote tissue ingrowth.
  • marker element ( 1212 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 1212 ) to the tissue.
  • marker element ( 1212 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 1212 ) of the present example is configured to prevent absorption into a patient after placement of marker ( 1200 ).
  • marker element ( 1212 ) of the present example is configured to deploy into tissue of biopsy site and wings ( 1230 ) which open from marker element ( 1212 ) to prevent migration of marker element ( 1212 ) when placed in tissue.
  • Marker materials ( 1222 ) of the present examples are generally configured to have material properties that support the structure with sufficient rigidity while allowing for opening of wings ( 1230 ). Marker material ( 1222 ) generally forms a center body to define marker element ( 1212 ), as well as wings ( 1230 ) extending from marker element ( 1212 ).
  • the center body of marker material ( 1222 ) included one or more wings ( 1230 ) closed against the center body before marker element ( 1212 ) is deployed to biopsy site.
  • wings ( 1230 ) are generally configured to enhance the grip of tissue by marker element ( 1212 ).
  • Wings ( 1230 ) of the present example are formed as generally elongated protrusions extending from the surface of marker element ( 1212 ) which open from the pre-deployment position when placed in the biopsy site as shown in FIG. 12 B . It should be understood that in other examples wings ( 1230 ) can take on a variety of alternative shapes.
  • FIG. 13 shows an exemplary marker ( 1300 ) that is generally configured to attach to biopsy site when deployed to thereby anchor marker ( 1300 ) within tissue.
  • marker ( 1300 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 1300 ) of the present example includes a marker element ( 20 ).
  • marker element ( 1312 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 1312 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization.
  • marker element ( 1312 ) may be used with a carrier such as carrier ( 120 ) discussed above.
  • Marker element ( 1312 ) of the present example is composed of nitinol.
  • marker element ( 1312 ) is composed of a nitinol mesh, wire, or stint like material. Additionally, marker element ( 1312 ) can be configured to promote tissue ingrowth.
  • marker element ( 1312 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes marker element ( 1312 ) to the tissue.
  • marker element ( 1312 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • marker element ( 1312 ) of the present example is configured non-absorbable. However, unlike marker element ( 12 ), marker element ( 1312 ) of the present example is configured to deploy into tissue of biopsy site and a hook ( 1330 ) extending from marker element ( 1312 ) to prevent migration of marker element ( 1312 ) when placed in tissue.
  • Marker material ( 1322 ) of the present examples is generally configured to have material properties that support the structure with sufficient rigidity while allowing for gripping of hook ( 1330 ). Marker material ( 1322 ) generally forms an elongated body to define marker element ( 1312 ), as well as wings ( 1330 ) extending from marker element ( 1312 ).
  • marker element ( 1312 ) of varying shapes and/or materials can be used. Although the present example is shown and described as marker element ( 1312 ) itself forming gripping hook ( 1330 ), it should be understood that in other examples gripping hook ( 1330 ) can be formed of structures similar to carrier ( 120 ) described above. Thus, in such examples, gripping hook ( 1330 ) and/or the entire exterior of marker ( 1300 ) can be comprised of hydrogel, collagen, and/or etc.
  • the center body of marker material ( 1322 ) includes a hook ( 1330 ) extending from marker element ( 1312 ).
  • hook ( 1330 ) is generally configured to enhance the grip of tissue by marker element ( 1312 ).
  • Hook ( 1330 ) of the present example is formed as a generally elongated protrusions extending from the surface of marker element ( 1312 ) which provides and gripping tip. It should be understood that in other examples hook ( 1330 ) can take on a variety of alternative shapes.
  • FIGS. 14 A and 14 B show an exemplary marker ( 1400 ) that is generally configured to rapidly unroll to thereby anchor marker ( 1400 ) within tissue.
  • marker ( 1400 ) is substantially similar to marker ( 100 ) described above.
  • marker ( 1400 ) of the present example includes a marker element ( 1412 ).
  • marker element ( 1412 ) can be substantially similar to marker element ( 12 ) described above.
  • marker element ( 1412 ) can be generally configured as non-bioabsorbable and radiopaque and/or echogenic to enhance visualization.
  • Marker element ( 1412 ) of the present example is composed of nitinol.
  • marker element ( 1412 ) is composed of a nitinol mesh, wire, or stint like material. Additionally, marker element ( 1412 ) can be configured to promote tissue ingrowth. In some examples, marker element ( 1412 ) is composed of a nitinol mesh wherein the holes of the mesh are large enough so the tissue can grow through the holes, which fixes element marker ( 1412 ) to the tissue. Similarly, marker element ( 1412 ) can comprise a variety of materials such as metal, hard plastic, and/or etc.
  • Marker element ( 1412 ) can also take on a wide variety of shapes, and/or sizes.
  • marker element ( 1412 ) can have the shape of marker element ( 12 ) shown in FIG. 1 (e.g., a stylized “E” shape).
  • marker element ( 1412 ) can have a helical wire-shape.
  • marker element ( 1412 ) can have an irregular shape defining a plurality of reflective surfaces.
  • marker element ( 1412 ) can be shaped as curved clip.
  • multiple marker elements ( 1412 ) of varying shapes and/or materials can be used.
  • still other configurations for marker element ( 1412 ) may be apparent to those of ordinary skill in the art in view of the teachings herein.
  • carrier ( 1420 ) of the present example is configured for absorption into a patient after placement of marker ( 1400 ).
  • carrier ( 1420 ) of the present example includes multiple marker materials ( 1422 , 1424 , 1426 ).
  • Marker materials ( 1422 , 1424 , 1426 ) of the present examples are generally configured to have varying material properties that effect the material strength and time required for degradation thereof such that marker ( 1400 ) can unroll from a relatively small volume to a relatively large or extended volume.
  • an outer marker material ( 1422 ) is disposed on outside edges of carrier ( 1420 ).
  • a middle marker material ( 1424 ) lies inside of outer marker material ( 1422 ).
  • an inner marker material ( 1426 ) lies along the center of carrier ( 1420 ).
  • marker materials ( 1422 , 1424 , 1426 ) are generally configured to be flexible enough to allow the carrier ( 1420 ) to be in a pad form to be rolled prior to deployment, as shown in FIG. 14 B , thereby providing a means for rapidly unrolling the length of marker ( 1400 ).
  • the marker materials ( 1422 , 1424 , 1426 ) are collagen or hydrogel. Additionally, there may be as many marker materials ( 1422 , 1424 , 1426 ) as is suitable for the carrier ( 1420 ).
  • Marker materials ( 1422 , 1424 , 1426 ) are generally positioned in a layered arrangement, moving from an outer edge of carrier ( 1420 ) to a center. For instance, in some examples marker materials ( 1422 , 1424 , 1426 ) form a rolled pad when in a dehydrated condition before deployment. It should be understood that in other examples inner marker material ( 1426 ) can have a variety of positions within carrier ( 1420 ). Additionally, it should be understood that in other examples inner marker material ( 1426 ) may be in the form of a square surrounded by the middle marker material ( 1424 ), or wherein the carrier is rectangular are square in shape.
  • marker element ( 1412 ) of the present example is generally centered or substantially centered within inner marker material ( 1426 ). This central configuration can be desirable so that marker element ( 1412 ) remains centered within a biopsy site as marker materials ( 1422 , 1424 , 1426 ) degrade or absorb into tissue. However, it should be understood that marker element ( 1412 ) can be placed in various alternative positions either within inner marker material ( 1426 ) or partially within inner marker material ( 1426 ) and partially within middle marker material ( 1424 ) or outer marker material ( 1422 ).
  • FIG. 14 B shows marker ( 1400 ) in a deployed state after marker ( 1400 ) is positioned within tissue.
  • marker ( 1400 ) can be rolled to the position shown in FIG. 14 B from a natural state shown in FIG. 14 A .
  • carrier ( 1420 ) can unroll towards the natural state shown in FIG. 14 A as marker materials ( 1422 , 1424 , 1426 ) hydrate.
  • marker materials ( 1422 , 1424 , 1426 ) can be configured to affect the rate of unrolling and/or the shape during unrolling.
  • inner marker material ( 1426 ) can be configured to absorb moisture relatively quickly and thereby exhibit relatively high degradation or quick expansion.
  • middle marker material ( 1424 ) can be configured to expand relatively slowly to provide structural stability and/or durability.
  • outer marker material ( 1422 ) exhibits can be configured to absorb fluid rapidly to also drive unrolling of marker ( 1400 ).
  • the approximate profile of marker ( 1400 ) remains generally rectangular in shape upon deployment, but moves from the rolled to unrolled configuration.
  • various other alternative profiles can be formed using the present configuration.
  • the initial geometry of marker ( 1400 ) profile can be varied to influence the expansion of marker ( 1400 ) after unrolling and at least some hydration.
  • the particular shape and/or size of marker ( 1400 ) can change throughout the course of hydration.
  • marker ( 1400 ) can start in the position shown in FIG. 14 B after initial deployment.
  • marker ( 1400 ) can form a shape approximately corresponding to the shape shown in FIG. 14 A or another shape between the shapes shown in FIGS. 14 A and 14 B .
  • inner marker material ( 1426 ) can expand further before absorbing into tissue.
  • a biopsy site marker comprising: a marker element, wherein the marker element includes a first arm and a second arm, wherein the first arm comprises a first tine and the second arm comprises a second tine, wherein the first arm and the second arm are each configured to be displaced outwardly when deployed to a biopsy site, wherein the first tine and the second tine are configured to engage the tissue when the first arm and the second arm are displaced outwardly.
  • Example 1 The marker of Example 1, wherein the first and the second arm form a V-shape.
  • Example 5 The marker of Example 5, wherein the marker is configured to be compressible such that the acute angle between the first arm and the second arm will become smaller when a force is applied inwardly to the first arm or the second arm.
  • the marker of Example 8 wherein the marker is configured to transition from the compressed state to an expanded state when the marker is deployed from the outer cannula.
  • the marker element including a flat configuration defined by a sheet material being bent to form the first portion and the second portion of the marker element.
  • Example 12 The marker of Example 12, wherein the carrier comprises a first marker material configured to degrade over time in the presence of moisture.
  • Example 13 wherein the first marker material comprises collagen, wherein the marker element includes a second marker material, wherein the second marker material comprises hydrogel.
  • a biopsy site marker comprising a marker element having a resilient portion, wherein the resilient portion is configured to transition the marker element between a pre-deployment state and a deployment state, wherein the marker element is configured to grip tissue when in the deployment state.
  • the biopsy site marker of Example 16 wherein the marker element defines a first arm and a second arm that together form a V-shaped pattern, wherein the resilient portion is configured to flex the first arm and the second arm outwardly when transitioning from the pre-deployment state to the deployment state.
  • the biopsy site marker of Example 16 further comprising a carrier, the marker element forming a substantially helical pattern, the substantially helical pattern being disposed within a portion of the carrier.
  • Example 21 The biopsy site marker of Example 21, wherein the tab defines a triangular-shaped cross-section.
  • Example 21 The biopsy site marker of Example 21, wherein the tab defines a star-shaped cross-section.
  • Example 21 The biopsy site marker of Example 21, wherein the tab defines a circular-shaped cross-section.
  • a biopsy site marker comprising a carrier and a marker element disposed within a portion of the carrier, wherein the carrier includes a plurality of carrier elements configured in a layered arrangement, wherein the plurality of carrier elements are bioabsorbable, wherein at least one carrier element is configured to absorb at a different rate relative to another carrier element.
  • the biopsy site marker of any one or more of Examples 25 through 27, wherein the marker element includes resilient portion is configured to transition the marker element between a pre-deployment state and a deployment state.
  • biopsy site marker of any one or more of Examples 25 through 28, wherein the marker element defines a substantially helical shape.
  • a biopsy site marker comprising: a marker element, the marker element including a resilient portion and a first arm and a second arm extending outwardly from the resilient portion, the resilient portion being configured to transition the first arm and the second arm from a pre-deployment state to a deployment state.
  • a biopsy site marker comprising: a marker element, the marker element including a first portion and a second portion, the first portion and the second portion each being configured to be displaced outwardly when deployed to a biopsy site, the marker element further including one or more anchors being configured to engage tissue of the biopsy site when the first portion and the second portion are displaced outwardly.
  • the marker of claim 1 the first and second portions forming a V-shape.
  • the one or more anchors including a first tine and a second tine, the first tine being joined to the first portion to extent outwardly from the first portion and the second tine being joined to the second portion to extend outwardly from the second portion.
  • the marker of any one or more of Examples 32 through 34 one or more anchors including one or more rough edges configured to increase the grip of the one or more anchors.
  • the marker of any one or more of Examples 32 through 35 the marker defining an acute angle between the first portion and the second portion.
  • the marker of Example 36 the marker being configured to be compressible such that the acute angle between the first portion and the second portion will become smaller when a force is applied inwardly to the first portion or the second portion.
  • the marker of Example 37 the marker being configured to be expandable such that when the force is reduced or removed from the first portion or the second portion the acute angle between the first portion and the second portion becomes larger.
  • the marker of any one or more of Examples 32 through 38 the marker being configured to be positioned in an outer cannula in a compressed state.
  • the marker of Example 39 the marker being configured to transition from the compressed state to an expanded state when the marker is deployed from the outer cannula.
  • the marker of Example 40 the marker being configured for deployment from the outer cannula in the compressed state.
  • the marker of Example 32 the one or more anchors being configured to engage the tissue to thereby anchor the marker within the tissue.
  • the marker of any one or more of Examples 32 through 42 including a carrier, the marker element being positioned within the carrier.
  • the marker of Example 43 the carrier including a first marker material configured to degrade over time in the presence of moisture.
  • the marker of Example 44 the first marker material including collagen, the marker element including a second marker material, the second marker material including hydrogel.
  • the marker of Example 44 the first marker material comprises hydrogel.
  • a biopsy site marker comprising: a marker element, the marker element including a helical portion defined by a plurality of coils; and a carrier, the helical portion of the marker element being at least partially disposed within the carrier, the marker element further including an anchor extending beyond an exterior of the carrier.
  • the biopsy site marker of Example 47 the carrier including a hydrogel, the hydrogel being configured to expand upon being hydrated from moisture at a biopsy site.
  • the biopsy site marker of Example 48 the anchor being configured to move along at least one axis defined by the biopsy site marker in response to expansion of the hydrogel.
  • the biopsy site marker of Examples 48 or 49 the plurality of coils of the marker element being configured to drive movement of the anchor along the at least one axis in response to expansion of the hydrogel.
  • the biopsy site marker of any one or more of Examples 47 through 50 the anchor of the marker element including a barb.

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US17/943,363 2020-03-17 2022-09-13 Non-migrating biopsy site identifiers Pending US20230000587A1 (en)

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WO2021188479A1 (en) 2021-09-23
WO2021188481A2 (en) 2021-09-23
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JP2023520160A (ja) 2023-05-16
KR20220155306A (ko) 2022-11-22
CA3174681A1 (en) 2021-09-23
CN115697238A (zh) 2023-02-03
WO2021188481A3 (en) 2021-10-21
EP4099941A2 (de) 2022-12-14
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EP4099942A1 (de) 2022-12-14
JP2023518067A (ja) 2023-04-27

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