286 results about "Vascular structure" patented technology

Methods and apparatus are provided for selective surgical removal of tissue, e.g., for enlargement of diseased spinal structures, such as impinged lateral recesses and pathologically narrowed neural foramen. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. Once the sharp tip of the needle is in the epidural space, it is converted to a blunt tipped instrument for further safe advancement. A specially designed epidural catheter that is used to cover the previously sharp needle tip may also contain a fiberoptic cable. Further embodiments of the current invention include a double barreled epidural needle or other means for placement of a working channel for the placement of tools within the epidural space, beside the epidural instrument. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. In one variation, a tissue removal device is provided including a thin belt or ribbon with an abrasive cutting surface. The device may be placed through the neural foramina of the spine and around the anterior border of a facet joint. Once properly positioned, a medical practitioner may enlarge the lateral recess and neural foramina via frictional abrasion, i.e., by sliding the tissue removal surface of the ribbon across impinging tissues. A nerve stimulator optionally may be provided to reduce a risk of inadvertent neural abrasion. Additionally, safe epidural placement of the working barrier and epidural tissue modification tools may be further improved with the use of electrical nerve stimulation capabilities within the invention that, when combined with neural stimulation monitors, provide neural localization capabilities to the surgeon. The device optionally may be placed within a protective sheath that exposes the abrasive surface of the ribbon only in the area where tissue removal is desired. Furthermore, an endoscope may be incorporated into the device in order to monitor safe tissue removal. Finally, tissue remodeling within the epidural space may be ensured through the placement of compression dressings against remodeled tissue surfaces, or through the placement of tissue retention straps, belts or cables that are wrapped around and pull under tension aspects of the impinging soft tissue and bone in the posterior spinal canal.

A two-dimensional slice formed of pixels (376) is extracted from the angiographic image (76) after enhancing the vessel edges by second order spatial differentiation (78). Imaged vascular structures in the slice are located (388) and flood-filled (384). The edges of the filled regions are iteratively eroded to identify vessel centers (402). The extracting, locating, flood-filling, and eroding is repeated (408) for a plurality of slices to generate a plurality of vessel centers (84) that are representative of the vascular system. A vessel center (88) is selected, and a corresponding vessel direction (92) and orthogonal plane (94) are found. The vessel boundaries (710) in the orthogonal plane (94) are identified by iteratively propagating (704) a closed geometric contour arranged about the vessel center (88). The selecting, finding, and estimating are repeated for the plurality of vessel centers (84). The estimated vessel boundaries (710) are interpolated (770) to form a vascular tree (780).

Restenosis or neointimal formation may occur following angioplasty or other trauma to an artery such as by-pass surgery. This presents a major clinical problem which narrows the artery. The invention provides a device and a method whereby vascular cells in the area of the artery subjected to the trauma are subjected to irreversible electroporation which is a non-thermal, non-pharmaceutical method of applying electrical pulses to the cells so that substantially all of the cells in the area are ablated while leaving the structure of the vessel in place and substantially unharmed due to the non-thermal nature of the procedure.

The subcutaneously implantable vascular access port has two parts including a body and a wing. The body supports a chamber covered by a septum, with a septum held in place over the chamber by a collar. The chamber is coupleable to a vascular structure, such as through tubing extending from the body, for delivery of medical preparations. The body is preferably elongate in form. The wing is configured to be adjustable in width. In one embodiment the wing rotates relative to the body and has an elongate form similar to that of the body. When the wing is rotated it extends laterally from the body and enhances a stability of the body. In another embodiment, the wing is provided as a deformable wing which can expand laterally out of side openings of a cavern in the body into which the deformable wing is inserted.

To produce a black body angiographic image representation of a subject (42), an imaging scanner (10) acquires imaging data that includes black blood vascular contrast. A reconstruction processor (38) reconstructs a gray scale image representation (100) from the imaging data. A post-acquisition processor (46) transforms (130) the image representation (100) into a pre-processed image representation (132). The processor (46) assigns (134) each image element into one of a plurality of classes including a black class corresponding to imaged vascular structures, bone, and air, and a gray class corresponding to other non-vascular tissues. The processor (46) averages (320) intensities of the image elements of the gray class to obtain a mean gray intensity value (322), and replaces (328) the values of image elements comprising non-vascular structures of the black class with the mean gray intensity value.

Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

A catheter with valve for implantation in a vascular structure of a living being. The catheter is in the general shape of a "T" with the top of the "T" implanted within the lumen of a vascular structure, and the leg of the "T" extending out of the vascular structure through an incision in the vascular structure. The lumen of the implanted portion of the catheter completely occupies the lumen of the vascular structure, causing all blood flow through the vascular structure to be directed through the implanted portion of the catheter. A valve is placed in the wall of the implanted portion of the catheter which opens into the lumen of the leg of the "T" of the catheter upon application of sufficient differential pressure between the lumens of the two portions of the catheter. The leg of the "T" is connected to the side wall of the implant portion of the catheter at an angle, such that the axis of the lumen of the leg of the "T" intersects the axis of the lumen of the implanted portion of the catheter at approximately a 45 degree angle.

Methods and apparatus are provided for selective surgical removal of tissue. In one variation, tissue may be ablated, resected, removed, or otherwise remodeled by standard small endoscopic tools delivered into the epidural space through an epidural needle. The sharp tip of the needle in the epidural space, can be converted to a blunt tipped instrument for further safe advancement. The current invention includes specific tools that enable safe tissue modification in the epidural space, including a barrier that separates the area where tissue modification will take place from adjacent vulnerable neural and vascular structures. A nerve stimulator may be provided to reduce a risk of inadvertent neural abrasion.

Electrode configurations for reducing invasiveness and/or enhancing neural stimulation efficacy, and associated methods, are disclosed. A method in accordance with one embodiment of the invention for treating a brain disorder includes identifying a target neural structure within a patient's skull and implanting an electrode device within the patient's skull so that an axis that is generally normal to the skull proximate to the electrode device and that passes through at least one electrical contact of the electrode device is offset from the target neural structure. The method further includes stimulating the target neural structure by applying an electrical signal to the at least one electrical contact. In particular embodiments, the electrode device can be positioned between, along, across, or adjacent to a fissure, recess, groove, and/or vascular structure of the patient's brain.

The invention relates to a method for acquiring and evaluating vascular examination data, comprising: acquisition of IVUS images of a vessel to be examined using an IVUS catheter; simultaneous acquisition of angiography data of the IVUS catheter having at least one angiography marker; acquisition of OCT images of the same point of the vessel to be examined using an OCT catheter; simultaneous acquisition of angiography data of the OCT catheter having at least one angiography marker; registering the IVUS and OCT images; determination of contours of the structures of the vessel under examination based on the OCT images; arithmetic histological analysis of the co-registered IVUS and OCT images using the information about the contours; and display the results.

A simulated physiological structure includes an image layer configured to enhance a visual appearance of the simulated physiological structure. The image layer includes a substrate onto which an image has been printed. Preferably, the substrate is a relatively thin layer, compared to other layers of material in the simulated physiological structure. Where the simulated physiological structure includes surface irregularities, the substrate is preferably sufficiently thin so as to be able to readily conform to the surface irregularities. Particularly preferred substrates include fabrics, fibrous materials, meshes, and plastic sheets. The image, which can be of an actual anatomical element, or a rendering of an anatomical element, is transferred onto the substrate using conventional printing technologies, including ink jet printing. Particularly preferred images illustrate vascular structures and disease conditions. Preferably, the substrate is coupled to an elastomeric material that forms at least part of the simulated physiological structure.

An implantable vascular access device includes a housing having an inlet, an outlet, an interior chamber defined therein and a valve positioned between the inlet and the interior chamber. The valve is subcutaneously manipulated between an open position, in which fluid can flow between the inlet and the interior chamber, and a closed position in which the valve occludes the inlet. The device may include any combination of multiple inlets, outlets and/or interior chambers. In the preferred embodiment, the housing includes two separate interior chambers suitable for the inflow and outflow of a typical hemodialysis procedure. A method for accessing a vascular structure is provided which includes the steps of subcutaneously implanting the device connecting one end of a cannula to the outlet of the device and another end of the cannula to a selected vascular structure. The valve of the device is manipulated to permit fluid communication between the inlet of the device and the selected vascular structure. A needle is introduced through the inlet opening to access the selected vascular structure.

A vascular access port is disclosed for subcutaneous implantation. The port is particularly adapted to be affixed to a bone to securely hold the port in position, to assist medical personnel in finding the port and to decrease a visibility of the port. The port has a chamber therein which is accessed by a needle through a septum adjacent the chamber. The chamber is placed into fluid communication with the vascular structure of the patient, such as through catheter tubing. The chamber is surrounded by a body with an outer surface which is preferably fitted with threads to facilitate secure but removable attachment of the port within a hole in the bone where the port is to be implanted.

A filtering method and apparatus for selectively filtering a gray scale angiographic image volume (54) that images vascular structures and that also contains extraneous non-vascular contrast is disclosed. A minimum vessel width parameter W_min (70) is selected. A maximum vessel width parameter W_max (132) is selected. A range of widths (66) are selected such that each vessel width parameter W_i (194) lies between W_min (70) and W_max (132) inclusive. For each W_i (194), an image I_i(x,y,z) (198) is generated that selectively retains imaged vascular structures of diameter W_i (194). The images I_i(x,y,z) (198) are combined to form a filtered image I_F(x,y,z) (64) that selectively images the vascular structures.