• 专利附录
  • 专利说明
  • 权利要求
  • 类似技术
  • 同族专利
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    • 专利摘要:
    The present invention relates to a medical device. In particular, the present invention deals with a medical device that can be detected by means of magnetic resonance imaging (MRI).
    公开号:BR112013009470B1
    申请号:R112013009470-2
    申请日:2011-10-18
    公开日:2021-04-20
    发明作者:Klaus Düring；Joachim Georg Pfeffer
    申请人:Marvis Interventional Gmbh；
    IPC主号:
    专利说明:

    The present invention relates to a rod-shaped body and a medical device. In particular, the present invention deals with a device for medical use that can be detected by means of magnetic resonance imaging (MRI).
    WO 2007/000148 A2 discloses a rod-shaped body that serves for the construction of medical devices such as catheters or guide wires. This rod-shaped body consists of one or more filaments and a non-ferromagnetic matrix material surrounding the filaments. A doping agent made from particles that create MRI artifacts is embedded in the matrix material.
    A detailed explanation of MRI can be found on the Internet at http://en.wikipedia.org/wiki/Magnetic_Resonance_lmaging.
    DE 101 07 750 A1 describes a guidewire which is supposed to be suitable for MRI. This guidewire comprises a core made of a metallic distal part. Wires made of a non-electrically conducting polymeric material are disposed between an outer shell and the core. This polymeric material is supposed to be reinforced with glass fibers or carbon fibers. Carbon fibers, however, are electrical conductors, so they cannot be used in MRI.
    Other medical devices are disclosed in EP 1 206 945 A1. These are equipped with paramagnetic metal compounds and/or a paramagnetic metal so that they are visible on MRI.
    EP 0 659 056 B1 discloses a contrast agent adapted for MRI of a sample. This contrast agent comprises a suspension of particles having positive magnetic susceptibility characteristics and particles having negative magnetic susceptibility characteristics. The relative amounts of these two species of particles are adjusted so that the positive magnetic susceptibility outweighs the negative magnetic susceptibility to such an extent that the resulting suspension has a magnetic susceptibility substantially equal to zero. This eliminates virtually all image artifacts and delimits the signal or artifact, respectively, almost clearly to the object itself.
    WO 87/02893 discloses polychelating substances for image enhancement and spectral enhancement for MRI. These substances comprise different complexes in which metal ions, in particular gadolinium ions, are immobilized.
    The relativity of gadolinium complexes (III) is explained in chapter 1.6.1 of the doctoral thesis (Inaugural Dissertation) by Daniel Storch, entitled "Neue, radioaktiv markierte Magnet-Resonanz-aktive Somatostatinanaloga zur besserén Diagnose und zielgerichteten Radionuklidinentherapie" , Basel, 2005. The paramagnetic relaxation of water molecules located around the gadolinium(III) ion is the result of the dipole-dipole interaction between the nuclear spin and the floating local magnetic field of the MRI scanner, caused by the unpaired electrons of the gadolinium ion (I±I). The magnetic field around the paramagnetic center, ie, the gadolinium(III) ion, decreases the greater the distance. Therefore, it is essential to locate the protons in close proximity to the metal ion. For gadolinium(III) complexes, this means that the 5 water molecules must be transported to the first coordination sphere of the metal ion. These "inner sphere" HjO molecules are exchanged with the surrounding water molecules and thus transmit the paramagnetic effect. DE 100 40 381 Cl discloses fluoroalkyl-containing complexes with residual sugars. These complexes can be provided with paramagnetic metal ions so that they can serve as contrast agents in magnetic resonance imaging. These metal ions are, in particular, the divalent and trivalent ions of the elements of atomic numbers 21 to 29, 42, 44 and 58 to 70. Suitable ions include, for example, the chromium(lll), iron(II), ions. cobalt(II), nickel(II), copper(II), praseodymium(III), neodymium(III), samarium(III) and ytterbium(III). Gadolinium(III), erbium(III), dysprosium(III), holmium(III), erbium(III), iron(III) and manganese(II) ions are particularly preferred because of their strong magnetic moment.
    EP 1 818 054 A1 discloses the use of gadolinium chelates for the purpose of cell labeling.
    Document US 6,458,088 B1 describes a guidewire designed for MRI, this guidewire comprising a body of glass. The glass body is provided with a protective layer, this one made of polymeric material and can even be reinforced with fibers. The distal end of the guidewire can be produced from a section of metal such as nitinol. This metal section should have a length that is clearly less than the wavelength of the magnetic resonance field.
    WO 2005/120598 A1 discloses a catheter guidewire comprising a PEEK core. This core is covered with a coating. The coating contains a contrast agent. The contrast agent is iron powder with a grain size less than 10 µm.
    WO 97/17622 discloses a medical device comprising a non-energy conductive body that is covered by an ultra-thin coating made of an electrically conductive material so that the medical device is visible on the MRI without unduly affecting the image.
    WO 99/060920 A2 and WO 2002/022186 A1 describe a coating for a medical device comprising a paramagnetic ion which is complexed in the coating. The paramagnetic ion in particular is gadolinium. This coating is visible on MRI.
    WO 2009/141165 A2 discloses a medical device that can be inserted into a human or animal body. The medical device has a body comprising at least one rod-shaped body having poor electrical conductivity and being formed of a matrix material and non-metallic filaments. These rod-shaped bodies correspond to the same extent as described in WO 2007/000148 A2.
    The rod-shaped body is doped with X-ray marker particles and the medical device additionally comprises an MRI marker. The MR marker can be provided by means of an additional thaz body or by means of an active MR marker immobilized on the surface area of the medical device.
    Such rod-shaped bodies are very advantageous for use in medical devices that can be readily produced by incorporating one or more of these rod-shaped bodies in a coating polymer, the rod-shaped bodies may contain different doping materials. By using different types of rod-shaped bodies, it is possible to design and produce medical devices with different doping materials (markers). Therefore, these have different properties regarding their visibility in X-rays or MRI exams. These different medical devices can be produced using exactly the same production method and consecutively in the same production sequence by simply changing one of the rods or several of them. Therefore, even if these medical devices are produced in small quantities, it is still possible to cost-effectively manufacture different types of medical devices.
    In Shu Chen et al.; "Engineered Biocompatible Nanoparticles for in Vivo Imaging Applications"; American Chemical Society 2010, 132, 15022—15029, the use of nanoparticles FePt as a contrast agent for MRI is described.
    An object of the present invention is to further improve such rod-shaped bodies to be embedded in a matrix material of a medical device.
    Another object of the present invention is to provide such a rod-shaped body or a medical device comprising at least one said rod-shaped body which can be more safely employed than known medical devices.
    A further object of the present invention is to provide such a rod-shaped body or a medical device containing optimized markers.
    Yet another object of the present invention is to provide a medical device that can be inserted into a human or animal body and that is quite versatile in its use in MRI examinations.
    Another object of the present invention is a medical device having a coating stably connected to the external surface.
    The subject of independent claims solves one or more of these objectives. Advantageous modalities are indicated in the sub-claims.
    Throughout the entire descriptive report, the term "medical device" is used in a broad sense to designate any device, tool, instrument or other object of medical use. The medical devices of the present invention are particularly useful as any type of guidewire, catheter (including vascular and non-vascular, esophageal, peritoneal, epidural, nephrostomic catheters), tubes, mandrels, stylets, stents, implants, grafts, needles. biopsy, puncture needles, cannulas, intraluminal medical devices, endotracheal tubes and ablation devices. They can be introduced or implanted into a "target" or "target object".
    The target or target object consists of the entire human or animal body, or part of it. The medical device of the present invention particularly can be placed in the target (object) cavities. These cavities particularly include blood vessels, neuronal pathways, any organ (whole or part) or tissue (whole or part). 0 device. The physician of the present invention can also be used as an accessory part offering functionality and/or applicability of MRI to other medical devices.
    According to a first aspect, a rod-shaped body 10 comprises: - one or more non-metallic filaments, and - a non-ferromagnetic matrix material, wherein the matrix material surrounds and/or binds the filaments, and marker particles to generate a signal in an X-ray or magnetic resonance imaging process, wherein at least one of said non-metallic filaments is an ht fiber.
    An ht fiber is a high tenacity fiber. Typical examples of high tenacity fibers are aramid fibers and UHMWPE fibers (very high molecular weight polyethylene fibers). High tenacity fibers have a tensile strength of at least 20 cN/tex. Optionally, the high tenacity fibers have a tensile strength (tenacity) of at least 23 cN/tex, and in particular of at least 30 cN/tex.
    An ht fiber is highly flexible and offers high tensile strength. Thus, even if the rod breaks in the human or animal body during the medical intervention, 30 it is guaranteed that the broken parts are still connected by the high tenacity fiber and can still be removed safely.
    Furthermore, the ht fiber provides a certain rigidity to the stem. However, glass fibers are stiffer than ht fibers, making a shank containing both ht fibers and glass fibers to be preferred. Such a rod can be adjusted to the ideal in terms of stiffness versus flexibility and in relation to torsional stiffness.
    According to a second aspect of the present invention, a rod-shaped body comprises: - one or more non-metallic filaments, and - a non-ferromagnetic matrix material, wherein the matrix material surrounds and/or binds the filaments, and marker particles to generate a signal in an X-ray or MRI process. This rod-shaped body is characterized by the fact that the one or more non-metallic filaments extend over most of the rod-shaped body.
    Such long filaments provide a high strength in the longitudinal direction to the rod-shaped bodies.
    Non-metallic filaments are non-energy-conductive filaments, which makes it possible to use them during RI measurements. In conclusion, the term "non-metallic filaments", as used in this text, excludes any electrically conductive filaments, such as a thin metallic wire or a carbon filament.
    Preferably, the filaments form a spin which comprises several filaments being arranged parallel to each other.
    However, it is also possible for the filaments of a rod-shaped body to form a strand, which means that the filaments are perforated and/or braided.
    According to another aspect of the present invention, a medical device comprises one or more rod-shaped bodies, each comprising: - one or more non-metallic filaments, and - a non-ferromagnetic matrix material, wherein the matrix material surrounds and/or agglutinates the filaments and marker particles to generate a signal in a: magnetic resonance or X-ray imaging process, and a coating polymer in which the one or more rod-shaped bodies are embedded, in which a strand it is embedded in either the matrix material or the coating polymer, the strand being more flexible than non-metallic filaments.
    The rigidity of medical devices, and therefore of rod-shaped bodies in the lateral direction, needs to be in a certain range that allows to easily guide the medical device through a particular cavity of the human or animal body, for example a blood vessel . Therefore, lateral stiffness is limited and, under extreme conditions, it may occur that the non-metallic filament(s) in the rod(s) may break. In such a case, the broken parts of the rod(s) are still connected by the cord, so that the coating polymer still remains intact. The medical device can still be safely removed as a part of the body cavity without the risk of parts lost in the blood stream or body tissue. Thus, the cord represents a means to increase the safety of medical devices.
    The cord is preferably a thin cord with a high tensile strength. Suitable strands include, for example, polyamide filaments, high tenacity fibers, poly(ethylene terephthalate) filaments, rayon filaments (for example HL fiber), cotton filaments or hemp filaments with a diameter preferably of 0. 05mm to 0.2mm. If the strand comprises one or more high tenacity fibers, these high tenacity fibers can simultaneously act as the non-metallic filaments of the rod-shaped body. Of course, it is possible to provide the cord in the medical device independent of the rod-shaped bodies of said device.
    According to another aspect of the present invention, a medical device comprises a plurality of rod-shaped bodies, each comprising: - one or more non-metallic filaments, and - a non-ferromagnetic matrix material, wherein the matrix material surrounds and/ or agglutinates the filaments and marker particles to generate a signal in an X-ray or magnetic resonance imaging process, and a coating polymer in which the rod-shaped bodies are embedded, in which the rod-shaped bodies are arranged in different positions relative to the center of the medical device and the rod-shaped bodies which are positioned closer to the center of the medical device comprise non-metallic filaments with a greater modulus of tension than the non-metallic filaments of the bodies in rod shape that are positioned farther away from the center of the medical device.
    Such a medical device containing non-metallic filaments with greater strength in the rods in its central section than the strength of non-metallic filaments in the rods in the most peripheral section combines high flexibility with high strength.
    According to another aspect, the medical device comprises an elongated body, such as a guidewire, catheter or tube, made of a polymeric material, and the polymeric material involves a passive negative MRI marker consisting of marker particles to generate an artifact. 15 in a magnetic resonance imaging process, in which the passive negative MRI marker is located only in a central section of the medical device.
    As the marker is located in a central section, it is covered by a circumferential section that does not contain any MRI markers. Therefore, there is a certain distance between the MRI marker and the outer surface of the medical device. In use, the MRI tag is held at this distance from the water molecules surrounding the medical device. The greater this distance, the smaller the artifacts in the MRI imaging process will be.
    The distance of the passive negative MRI marker to the outer surface of the medical device is preferably at least 0.1 mm, more preferably at least 0.2 mm, or at least 0.3 mm.
    Such medical device may comprise non-metallic filaments and said polymeric material forms a non-ferromagnetic matrix material surrounding and/or bonding the filaments.
    Such medical device may also comprise the rod-shaped bodies described above containing said MRI marker.
    Such a medical device may be a guidewire containing a rod-shaped body comprising a passive negative MRI marker and being positioned at the center of the guidewire.
    Such a device may also be a catheter or tube containing at least one rod-shaped body comprising a passive negative MRI marker and being positioned in the inner section of the catheter or tube, or is provided with at least two concentric layers, wherein only the innermost layer comprises a negative-passive MRI marker.
    If the medical device is incorporated as said catheter or tube having at least two concentric layers, one of said layers may be reinforced by non-metallic filaments being twisted, braided or and intertwined in a spatial structure. Such spatial structure is particularly preferable in combination with high tenacity fibers. A.S high tenacity fibers are flexible and have high tensile strength. Since in such a spatial structure the filaments are extending in different directions in the body of the medical device, the high tensile strength also generates a high stiffness of the composite material consisting of the fibers and matrix material.
    According to another aspect of the present invention, a medical device comprises: - a plurality of rod-shaped bodies for reinforcing the medical device, and - a coating polymer in which the rod-shaped bodies are embedded, wherein the medical device comprises marker particles to generate an artifact in an MRI process, and the coating polymer is a soft polymer or rubber or PVC material.
    The rod-shaped bodies in accordance with that aspect of the invention may be incorporated in accordance with the other aspects of the present invention and/or the non-metallic reinforcing filaments may be glass fibres.
    Markers can be incorporated into the rods and/or coating polymer. The specific coating polymer according to that additional aspect of the present invention has a relaxation time significantly less than that of water, but distinctly greater than that of a rigid polymer such as epoxy resin. Therefore, unlike rigid polymers, with appropriate parameter settings and a short echo time (preferably < 100 ms, more preferably < 50 ms, even more preferably 10 ms and most preferably < 1 ms), this coating polymer can be visualized in an MRI process. In particular, the protons of this coating polymer can be detected with an MRI echo time that is different from that used to detect water protons.
    Therefore, by using two different echo times, it is possible to record two different images of the same object with the same view, in which one image clearly visualizes the medical device (by measuring the relaxation of protons in the coating polymer) and the other image the body tissue (by measuring the relaxation of protons in water and the lipids contained in body tissue or blood). Both images can be overlaid so that the clinician gets information combined into one image. Due to the detection of protons in the polymer may rather than in the water molecules surrounding the medical device, a more confined and significantly more pronounced artifact can be obtained, which is practically limited to the actual diameter of the medical device.
    Such a coating polymer preferably has a relaxation time TI of from 1 to 100 ms, more preferably from 1 to 500 ms, and more preferably from 1 to 1000 ms, and a relaxation time T2 of preferably 0.1 to 1 ms, more preferably from 0.1 to 5 ms and even more preferably from 0.1 to 10 ms.
    In a further embodiment of the present invention, the medical device has a coating stably attached to its outer surface. This coating is preferably slippery. The stably connected coating material is obtained by composing the coating polymer with one or more chemical compounds containing functional groups, preferably carboxy groups or amino groups.
    The incorporation of the rods in this modified coating polymer is preferably carried out by an extrusion process. Subsequently, surface functional groups, preferably carboxy groups, amino groups, are reacted with other functional groups, preferably with amino groups/carboxy groups, respectively, to obtain a covalent bond, preferably an amide bond. Residual functional groups (eg, the remaining carboxy/amine groups) are then chemically cross-linked by a cross-linker.
    The different aspects of the invention described above can be combined with each other.
    The invention will now be exemplified in more detail based on the embodiments illustrated in the drawings, in which:
    Figure la shows a rod-shaped body according to the invention in a perspective view.
    Figure 1b shows the rod-shaped body according to figure la in a cross-sectional view.
    Figure 2a, 2b show guidewires according to the present invention in cross-sectional views, Figure 3a, 3b show catheters according to the present invention in cross-sectional views, Figures 4a to 4h show images that were created by the test using MR or X-ray imaging, Figure 5 list of medical devices,
    Figures 6 and 7 show images that were created using the test samples or combinations of the test samples via MR imaging.
    Some of the present prototypes are made with aramid fibers. In the following detailed description of the present invention, the terms "aramid fiber" and "aramid filaments" are used as synonyms for high tenacity fibers. Aramid fibers were chosen because of their tensile strength. Thus, it is clear to any person with general knowledge in the art that aramid fibers can be replaced by other electrically non-conductive fibers with an equal or even greater tensile strength.
    The first aspect of the present invention relates to a rod-shaped body 1 (in the following: rod) which. forms an intermediate product for the production of medical devices. The rod-shaped body according to the present invention is a further development of the rod-shaped bodies as described in WO 2007/000148 A2 and in WO 2009/141165 A2. Therefore, full reference is made to the disclosure of these documents and these documents are incorporated herein for reference purposes.
    Stem 1 comprises one or more non-metallic filaments 2 and a non-ferromagnetic matrix material 3 (hereinafter: matrix). Non-metallic filaments 2 are electrically non-conductive filaments. The electrically conductive filaments would lead to the conduction of electrical current and the heating of the guide wire induced by the magnetic and RF fields during MR imaging. Such rods may comprise metal particles, but these particles must be separated from each other so that they do not create electrically conductive sections of more than 10 to 15 cm, preferably no more than 5 to 10 cm. The matrix material surrounds and/or binds the filaments. Rods 1 are usually doped with marker particles to generate a signal in an MRI or X-ray imaging process. These particles are embedded in matrix 3. However, it may also be desirable to have an undoped rod 1 without any marker particles.
    A basic feature and advantage of rods 1 is that different rods 1 can be doped with different marker particles, whereas in a medical device, differently doped and/or non-doped rods 1 can be incorporated. This will be explained in more detail below in the description of the different versions of the medical devices according to the present invention. Simply by using differently doped rods, various medical devices with different characteristics in X-ray or MR imaging processes 15 can be easily and cost-effectively manufactured by the same process by replacing one rod with another .
    Figure la schematically shows a rod 1 in a perspective view. Filaments 2 of shank 1 are 20 long filaments 2 that are directed in the longitudinal direction of shank 1. These filaments 2 extend along most of shank 1. This means that the length of filaments 2 is at least half the length of stem 1. Preferably, the length of the 25 filaments 2 extends along the entire length of the stems 1 or at least 80% of the total length of the stems 1.
    Such long filaments 2 provide a high strength to the rods 1 in the longitudinal direction. Medical devices 30 comprising such rods are generally designed to be introduced into a blood vessel, an organ (eg, the heart, liver, kidney or lung) or the brain. Therefore, considerable force can be applied to these medical devices in the longitudinal direction during the introduction of these devices into the body cavity or during their removal. This force is absorbed by rods 1.
    On the other hand, medical devices need to offer some flexibility to advance them along the 10 curves of the body cavity. By arranging the filaments 2 in the longitudinal direction of the rods 1, rods with high stability/strength in the longitudinal direction and appropriate flexibility in the lateral direction are obtained.
    Filaments 2 are usually made of fiberglass. It is also possible for the reinforcing fibers to be ceramic, polyamide or aramid fibers, for example Kevlar® fibers, provided the fibers provide the necessary strength in the longitudinal and lateral direction. It is still possible to use other types of fibers as long as the fibers do not provide electrical conductivity. Long fibers of electrically conductive material cannot be incorporated into medical devices being used in an MRI process.
    Glass fibers are available in different qualities. These different qualities are called E-glass (E=electric), S-glass (S=strength), R-glass (R=strength), M-glass (M=module), D-glass (D=dielectric), C-glass (C=corrosion), ECR-glass (30 corrosion resistant E-glass). The tensile strength, tensile modulus and elongation to failure of E-glass, D-glass, and R- or S-glass is illustrated in the following table:

    Saint-Gobain offers, under the trade name Quartzel®, a fiberglass with an even greater strength, namely a tensile strength of 6000 MPa, a tensile modulus of 78 GPa and an elongation to failure of 7, 7%.
    A group of several filaments 2 being arranged parallel to each other is called a spinning. Rod 1 is produced using the micro-pultrusion process. Thus, such spinning is pultruded together with the matrix material in which the marker particles can be contained. The amount of filaments has a strong influence on the mechanical properties of the rods.
    Yarns can be used instead of spinning for the production of rods 1. In such yarns, filaments 2 are drilled or braided. However, spins are preferred as the perforated or braided structure of the wires can cause a corresponding structure on the surface of the rods. Stems that have a smooth surface rather than such a structured surface are preferred as it is easier to use them in a subsequent extrusion process to obtain a smooth surface of the respective medical device.
    Glass fibers are usually quantified and characterized in "Tex", which means g/m. The filaments 2 used in rods 1 are generally in the range from 10 to 100 tex, more preferably from 30 to 70 tex. The diameter of the rods is usually in the range of 0.10 mm to 0.30 mm.
    The amount of matrix material, which is preferably epoxy resin, defines the capacity for embedded marker particles. Therefore, it is preferred to have several filaments evenly distributed or preferably located in the circumferential section of the shank to provide the shank with high mechanical strength without occupying a very large part of the shank's cross-sectional area. The smaller the number of filaments, the weaker the mechanical strength of the rod. The same applies if the smaller number of filaments is compensated by a larger diameter of the filaments. Therefore, it is preferred that the number of filaments is at least four, or more, for example at least six or at least ten.
    According to another aspect of the present invention, the rod 1 comprises, in addition to the filaments 2, a strand 4. The strand 4 is embedded in the matrix material 3. The strand 4 consists of a material with greater flexibility than the filaments 2, such as such as polyamide filaments, aramid filaments, poly(ethylene terephthalate) (PET) filaments, rayon filaments (eg HI> fiber), cotton filaments, or hemp filaments. The cord 4 extends along the entire shank and is directed in the longitudinal direction of the shank. Such a cord does not break if it is bent. On the other hand, the longitudinal strength of such a strand 4 with the same cross-sectional area of a filament 2 is generally weaker than the longitudinal strength of filaments 2.
    If rod 1 or a medical device incorporating such rod 1 breaks, the broken parts still remain connected by means of cord 4. Thus, even if such break occurs in the human or animal body during the medical intervention, there is the assurance that the broken parts can be safely removed. The cord 4 is advantageously arranged in the center of the rod 1.
    Aramid filaments provide the functions of both strand and non-metallic filaments. Thus, a medical device comprising a shank with an aramid filament that is arranged in parallel, twisted, braided, braided or in another type of construction is preferred. The twisted, braided and braided filaments form a spatial structure that is preferred in combination with a flexible filament such as aramid filaments.
    Aramid filaments are flexible and have high tensile strength. Since in such a spatial structure the filaments are extending in different directions in the body of the medical device, the high tension stiffness of the filaments also generates a high rigidity of the composite material consisting of the fibers or filaments, respectively, and the matrix material.
    Next, the mechanical structure of medical devices comprising several rods 1 will be explained:
    Figures 2a and 2b each show a guidewire 5 in a cross-sectional view. Such a guidewire 5 is a medical device that is often inserted into a blood vessel, whereby preferably a flexible tip at the distal end of the guidewire supports easy access to a certain location in a human or animal body. If the guidewire position is correct, then other medical devices can be advanced along the guidewire.
    The medical device, particularly the guidewire, according to the present invention comprises a plurality of rods 1 and a coating polymer 6. The coating polymer 6 is preferably a biocompatible material. Such biocompatible materials are available on the market, for example, under the trade names Mediprene® or Te.cofJ.ex™. Tecoflex™ is an elastic polymeric material that is based on polyurethane (PU). Mediprene® is a thermoplastic elastomer made from SEES (styrene-ethylene-butylene-styrene elastomer) which is mainly used for medical purposes. Mediprene is offered by Elasto AB, Sweden. Other suitable polymers include, for example, polyethylene, polypropylene, EVA, PVP and silicone. The coating polymer can also be made from other biocompatible materials, such as a soft biocompatible polymeric material, a soft rubber or PVC material.
    The flexible and elastic coating polymer 6 gives a certain shape to the medical device and surrounds the rods. Therefore, medical devices consist of a multi-compound material comprising the rods 1 as a kind of reinforcing material and the coating polymer 6 as an embedding and binding material. The mechanical properties of a medical device are mainly defined by the mechanical properties, number, dimensions and arrangement of the rods 1.
    In a preferred embodiment, the coating polymer is modified by composition, i.e., by mechanically mixing it with chemical compounds containing one or more functional groups, preferably amino and/or carboxy groups. Such chemical compounds are preferably polycarboxylic acids (eg polyacrylic acids), polyvinylamine, polyethyleneimine, acrolein-acrylic acid copolymer or polyallylamine.
    Particularly preferred is a compound of Mediprene® and polycarboxylic acid. More preferably, a polycarboxylic acid sodium salt solution (eg POC AS 5060, Evonik Industries, Essen, Germany) is combined with Mediprene® polymer to obtain a concentration of 5, 10, 15, 20, 30 or 40 or more than 40% (w/w) POC in Mediprene®.
    All concentrations in between are also suitable and can be used. This modified coating polymer is then used in an extrusion process to embed and bond the rods. After extrusion, the free carboxy groups on the surface are preferably reacted with polyvinylamine or other polyamino polymers to result in an amide bond. The remaining free amino groups are then cross-linked, preferably with a hydrophilic short-chain homobifunctional alpha-omega cross-linker (eg, Ci-C6) to provide the stably connected, preferably oily, coating on the surface of the medical device. These modified surfaces are suitable for incorporating passive positive markers as defined and described below (eg, gadolinium (Gd) ions or complexes, or cerium (Ce) ions or complexes, praseodymium (Pr), neodymium (Nd), promethium ( Pm), samarium (Sm), eoropium (Eu), terbium (Tb), dysprosium (Dy), holmium (Ho), erbium (Er), thulium (Tm), ytterbium (Yb) and lutetium (Lu)). and according to the embodiment illustrated in Figure 2a, there is a central rod 1/1 and peripheral rods 1/2. The central rod is positioned at the center of the guidewire 5. The peripheral rods 1/2 are positioned circumferentially to the central rod 1 /1 and the lateral surface of the guidewire 5. The embodiment comprises six peripheral rods 1/2 which are equally spaced apart. The filament content of the 1/1 central stem is 6 6 Tex. The diameter of the central rod is approximately 0.20 mm to 0.30 mm. The filament content of the peripheral rods 1/2 is 33 Tex and the diameter is about 0.17 to 0.20 mm. The diameter of guidewire 5 is approximately 0.81 mm (0.032 inch). In a stiffer version of this guidewire, the guidewire diameter is increased to approximately 0.88 mm (0.035 inch). The filament content can be increased up to at least 100 Tex for the central rod % and up to at least 45 Tex for the peripheral rods 1/2.
    The embodiment illustrated in Figure 2a further comprises two strands 4 which are embedded in the coating polymer 6. These strands 4 have the same purpose and function as the strands 4 which are embedded in the rods 1 as described above. Having the strands 4 embedded in the coating polymer 6, it is not necessary to use rods 1 containing such strand 4.
    Providing the strands 4 in the coating polymer 6 allows the use of strands 4 with a larger diameter than the strands that are included in the rods 1. However, it is more difficult to produce medical devices containing cords in addition to the rods. Such medical devices are produced by co-extrusion, in which the coating polymer 6 is extruded 5 together with the rods 1 and the cords 4.
    Figure 2b shows another embodiment of a guidewire 5 comprising a central rod 1/1 and three peripheral rods 1/2. In this guidewire 5, three strands 4 are embedded in the coating polymer 6. The central rod 10 1/2 has a filament content of 33 Tex and has a diameter of about 0.20 mm. The 1/2 peripheral rods also have a filament content of 33 Tex, but have a smaller diameter of about 0.17 mm. The overall diameter of guidewire 5 is 0.81 mm. The guidewire 5 according to the embodiment of Figure 2b has a lower stiffness compared to the guidewire of Figure 2a. The filament content can be reduced to at least 12 Tex or less for the central shank 1/1 and for the peripheral shanks 1/2.
    The embodiments illustrated in figures 2a and 2b are merely examples. An advantage of the present invention is that, due to the composite structure of medical devices, the mechanical properties, eg guidewires, can be individually adapted to the interventional application required by varying the geometries (i.e., number, dimensioning and positioning of the 1/1 and el/2) rods Furthermore, the guide wires may not contain a 1/1 central rod, but only the peripheral 1/2 rods. At a minimum, a guidewire contains only one rod.
    In fact, there are the following classes of guidewires that are classified only according to their mechanical properties: 1) Rigid or super-rigid guidewires A rigid or super-rigid guidewire has a diameter of 0.88 to 0.97 mm (0.035 to 0.038 inch). The 5 1/2 central rod has a fiber content of 66 Tex or greater, where up to about 100 Tex may be appropriate. At least five, preferably at least 6 or more peripheral rods 1/2 are provided. The fiber content of the rods is in the range of 20 to 40 Tex. Coating polymer 6 is preferably made of a polymer with a shore hardness of at least 40D, preferably 60D and more preferably 72D. 2) Standard guidewire The standard guidewire typically has a diameter in the range of 0.81 to 0.88 mm (0.032 to 0.035 inch). The central rod preferably has a fiber content of 20 to 40 Tex. The standard guidewire preferably comprises 2 to 4 1/2 peripheral rods. The peripheral rods preferably have a fiber content of 20 to 40 Tex. The coating polymer 20 can be made of a soft, medium or hard polymeric material. The softer the coating polymer, the stiffer the 1/1, 1/2 rods will need to be designed. Due to the peripheral position of the peripheral rods 1/2, a small increase in the stiffness of the peripheral rods 25 significantly increases the overall stiffness of the guidewire. Therefore, the overall stiffness of the guidewire can easily be adapted over a wide range by selecting different peripheral rods. A standard micro guidewire has a diameter of about 0.36 to 0.41 mm (0.014 to 0.016 inch). The central rod has a fiber content preferably from 15 to 33 Tex, more preferably from 20 to 25 Tex. The micro guidewire 5 preferably comprises 1 to 3 peripheral rods. The fiber content of the peripheral rods is preferably from about 10 to 20 Tex. The coating polymer is preferably made of a polymeric material with a shore hardness of less than 72D, more preferably less than 1060D, and most preferably less than 40D. According to another embodiment, the micro, standard guidewire comprises only one rod with a fiber content preferably from 50 to 100 Tex, more preferably from 55 to 80 Tex. This rod comprises a passive positive MRI 15 marker, such as iron (Fe) particles. The concentration of the passive positive MRI marker in the matrix is in the range of 1:10 to 1:100, it is preferably in the range of 1:40 to 1:60. The particle size of the passive positive MRI marker particle is preferably from about 40 µm to about 65 µm. 4) Super flexible micro guidewire The super flexible micro guidewire has a diameter of about 0.25 to 0.36 mm (0.010-0.014 inch) and preferably from 0.28 to 0.33 mm (0.011 to 0.013 inch). 25 It does not have a central rod. It comprises 2 or 3 peripheral rods. The peripheral rods preferably have a fiberglass content of 10 to 20 Tex. The coating polymer is preferably made of a polymer with a shore hardness of less than 60D and more preferably less than 40D. . 5) Micro rigid guidewire
    A rigid micro guidewire has a diameter of about 0.25 to 0.46 mm (0.010 to 0.018 inches). It consists of a rod 1 without any polymer coating. The fiber content of the rod is preferably from about 30 to 120
    Tex, and in particular from 60 to 100 Tex. To avoid breaking a broken guidewire, it is preferable that it comprise at least one aramid filament. The rigid micro guidewire preferably comprises at least one aramid filament and at least one glass fiber, in particular, several aramid filaments and several glass fibers. Such a combination of different filaments in one rod ensures that the rod does not break after breakage and has a sufficiently high stiffness resulting from the glass fibers.
    These classes of guidewires are typical examples. As mentioned above, reinforcing fibers for the rods, particularly glass fibers, are available in different qualities. If glass fibers with a stiffness 20 or greater strength, respectively, are used, then the stiffness can be adapted correspondingly by the mechanical properties resulting from the other materials of the guidewire, or the number of rods, or the arrangement of the rods, or the modality of the rods 25 (particularly in relation to the fiber content and the diameter of the rods). The examples above demonstrate that, due to the multi-compound structure, medical devices can be designed with a wide range of mechanical properties. These are independent of visibility in an X-ray and/or MR imaging process, as described in more detail below.
    If a guidewire having a central rod and peripheral rods is bent, then the peripheral rods are more elongated and compressed than the central rod. To improve the flexibility of the guidewire, it is appropriate to have more extensible glass fibers on the peripheral rods than on the central rod, i.e. the glass fibers of the peripheral rods have a lower tension modulus than the glass fibers of the central rod . This means that the central rod provides high rigidity and the peripheral rods provide high elasticity so that the guidewire has the necessary flexibility and stiffness.
    A medical device, particularly a guidewire, in accordance with the present invention may comprise a flexible tip. Such a flexible tip can be produced separately and connected to the medical device by polymer welding. The flexible tip produced separately is made of an elastic, weldable polymer, eg polyurethane. The elastic tip is connected to the rod by chemical welding or thermal welding. The stiffness of the flex tip can increase from the end that is connected to the medical device, eg guidewire, to the other (distal) end of the flex tip. Preferably, the stiffness at the connected end is similar to the stiffness of the medical device, eg the guidewire. This can be achieved, for example, by reducing the flexible tip diameter in the direction from the connected end to the distal end.
    In another embodiment, the flexible tip of a medical device, especially a guidewire, is . preference is done by the following steps: - Crushing a circumferential layer of the guidewire at one end so that at least an outer part of the coating polymer is removed in that crushed section of the guidewire. Peripheral rods or a part of a central rod can also be removed by grinding. If the guidewire does not have a polymer coating, at least a portion of the rod is ground off. - The crushed part of the guidewire is coated with a flexible polymeric material to form the flexible tip. The flexible polymeric material can extend distally beyond the crushed section so that the flexible tip comprises a very soft end and an intermediate section that is reinforced by the stem material. The flexible polymer can be any kind of flexible polymer, for example, PEBAX 3533 SA01 med.
    The length of the distal flexible tip is preferably from 5 to 30 cm, more preferably from 8 to 20 cm, and particularly preferably from 10 to 15 cm.
    Regardless of whether the flexible tip is produced separately and connected to the stem or produced by coating a core portion of the stem, it is preferable that the flexible tip be shaped like a cone with a diameter decreasing from the connected end to the distal end. The flexible tip can be supplied with an X-ray and/or MRI marker. The marker may be one of the passive markers described below, which is either combined with the tip material or which is coated on the tip.
    The concentration of the MRI markers can be . designed in such a way that the flexible tip generates MRI artifacts with an intensity greater than, equal to or less than the residual part of the medical device.
    In general, in the medical devices according to the present invention, no electrically conductive parts are used, as they generate large artifacts during MRI and lead to heating of the medical device. However, it may be appropriate to provide metallic particles or a metallic core in the flexible tip, because then, due to the artifacts, the tip can be clearly distinguished from the residual part of the medical device. Of course, one has to accept that tip artifacts disturb the image around the tip. Therefore, it may also be appropriate to have, at the flexible tip, a combination of the markers according to the modalities described below. The tip can also be reinforced using short glass fibers.
    Soft tip gradient and stiffness can also be realized by reducing the diameter of a soft tip central core, where the core is made of a material that is stiffer than the soft tip core material.
    Each of Figures 3a and 3b shows a cross-sectional view of a catheter 7. Such catheter 7 is in the form of a tube, wherein the wall of the catheter is made of composite material 25 comprising rods 1 and coating polymer 6 As the rods 1 are placed further away from the center of the catheter when compared to the arrangement on guide wire 5, a smaller number of rods 1 or fewer rigid rods 1 is sufficient to obtain the same resistance in the lateral direction as in the wire -guide x I . corresponding 5. The embodiment according to Figure 3a comprises three rods 1, each having a filament content of 33 Tex and a diameter of about 0.17 mm to 0.20 mm. The embodiment of Figure 3b comprises six rods 1. In both embodiments, at least one strand 4 is embedded in the coating polymer 6. The design of the catheters according to the present invention can be classified into the following two groups: 1) Standard Catheters (5F to 6F) The diameter of catheters is generally defined by the "French" unit, where 3 French corresponds to 1 mm. A catheter having a diameter of 5F to 6F (1.66 to 2.00 mm) in accordance with the present invention is incorporated with a wall thickness in the range of 0.20 to 0.30 mm. It comprises rods with a fiber content of about 20 to 40 Tex, and preferably 25 to 35 Tex. The number of nails is in the range of 3 to 8, and preferably 3, 5 or 6. 2) Micro catheters (2F to 4F) 20 A micro catheter has a diameter of 2F to 4F (0.66 to 1, 33 mm) and the wall thickness is in the range of 0.10 to 0.25 mm. The rods have a fiber content of about 10 to 20 Tex.
    In a catheter, the rods are spaced further apart 25 apart than in a guidewire. Therefore, the act of flexing a catheter causes the nails to bend more forcefully than a guidewire. The rods of a catheter, therefore, must have satisfactory elastic properties. The fibers for the rods of a catheter are preferably made of a material, particularly a fiberglass, with a high modulus of tension (module E) of at least 65 GPa, and preferably, of at least 70 GPa.
    An alternative embodiment of the catheter contains the strands braided in the polymer coating.
    Another alternative embodiment of a tube or catheter comprises at least two concentric layers, the different layers may have the same thickness or a different thickness, and at least two layers consist of different polymers or classes of polymers. These polymers can be chosen from any polymeric materials, eg Mediprene®, polyurethane (eg Tecoflex™), polyethylene, polypropylene, EVA, PVP, silicone, PEBAX or PEEK. Such a tube or catheter comprises at least one MRI marker. One of the layers may be provided with a passive negative MRI marker. Preferably, only the innermost layer comprises a passive negative MRI tag. Alternatively, the inner layer and/or the outer layer can be coated with a passive positive MRI marker.
    This modality can optionally be provided with non-metallic filaments. The filaments can be twisted, braided, interwoven with a spatial structure, particularly with a tube-like structure that is embedded in the polymeric material. With such a spatial structure, it is preferred that the filaments comprise fibers of high tenacity. A combination of high tenacity fibers and glass fibers allows to adjust the rigidity of the catheter or tube over a wide range. Figure 5 shows a table in which various medical devices are listed. This table contains four columns. In the first column, the medical device type is defined. In the second column, the structure of the device is described. The structure of the device is defined by the number and characteristics of the rods and the description of the coating polymer. In the third column, the filament content of the rods and the corresponding diameters are specified. The fourth column presents examples for intervention applications appropriate for the corresponding medical device.
    The medical devices listed in the table in Figure 5 provide certain mechanical properties defined by the construction of the device and the construction of the rods, as shown in this table. The visibility of medical devices can be adjusted individually and independent of mechanical properties by doping the rods and/or coating polymer with suitable marker particles, as disclosed below.
    This table reveals, in addition to guide wires and catheters, also puncture needles which are short, thin hollow needles. The puncture needle (B) does not necessarily comprise a rod, but can be incorporated as a thin hollow tube made of epoxy resin and reinforced with fiberglass. Such a puncture needle can be considered as a hollow rod, and this puncture needle can be doped in the same way as the rods described above. Spins comprising a plurality of long glass fibers arranged in parallel can be flattened before being embedded in the epoxy resin to form a punch needle. This makes it possible to obtain a very small wall thickness.
    Punching needles can also be produced by embedding thin rods in a rigid die. Such a matrix can be, for example, an epoxy resin. Thin rods and epoxy resins are co-incropultruded to produce punching needles.
    Regardless of whether the punch needle is incorporated as a thin hollow tube made of epoxy resin and reinforced with glass fibers or whether it is produced by co-micropultrusion of flattened glass fibers in epoxy resin, the wall at the distal end of the needle The punch is preferably provided with a thin, sharp edge. This edge can be provided by a rigid layer of polymer, eg a distinctly rigid epoxy resin, covering the end of the punch needle. Under this layer, the glass fibers of the punch needle are securely covered and protected.
    The rods, matrix material and/or fiberglass reinforced epoxy resin may be doped by any marker described in the examples of rods and medical devices as disclosed below. Also, any combination of markers is possible. Similarly, puncture needles can be provided with the coating described above containing gadolinium ions on their outer surface. Such a coating may also be provided on the inner surface of the hollow punch needle. The coating polymer of the medical devices described above is made of a biocompatible material, such as an elastic polymeric material which is based on . polyurethane (PU) or in a thermoplastic elastomer made from SEBS (styrene-ethylene-butylene-styrene elastomer). Other suitable polymers include, for example, polyethylene, polypropylene, EVA, PVP and silicone. As described in detail below, softer polymeric materials may be advantageous in combination with MRI tags. If a softer polymeric material is used as the coating polymer, then the rods need to be designed with more rigidity to compensate for the softer coating polymer. In the following, the X-ray markers that were tested in the prototypes are explained: • Type 1: Doping of the 1/1 rod of guidewire 5 or a rod of catheter 7 or other device with 15 nanoparticles of tungsten . • Type 2: Doping the coating polymer with 5 to 80% barium sulphate, preferably 20% to 40% barium sulphate, more preferably 40% barium sulphate. • Type 3; combination of types 1 and 2 2 0 The weight ratio of doping particles and matrix material 3, preferably epoxy resin, in the case of tungsten nanoparticles, is preferably 1:1 to 2:1, and in the case of nanoparticles of iron, preferably is from 1:5 to 1:00, more preferably from 1:10 to 1:70, most preferably from 1:30 to 1:60, if not otherwise specified, and in the case of microparticles of tungsten, preferably is from 1:1 to 4:1, more preferably from 2:1 to 3:1. In the following, the weight ratio of matrix material 3 and doping particles 30 is called "concentration". _ Tungsten microparticles can also be provided in the coating polymer. With tungsten microparticles as an X-ray marker, a coating polymer is better able to maintain its elasticity and becomes less brittle than when doped with barium sulfate. Therefore, tungsten microparticles are very advantageous if they are used to dope a coating polymer, for example a polyurethane, with an X-ray marker. 10 X-ray markers can be included in all medical devices listed above to gain visibility into X-ray angiography and similar X-ray imaging procedures comparable to current medical devices on the market that contain, for example, nuclei. 15 metal or metal interlocks. The concentration of X-ray markers is dependent on the structure of the device, in particular the volume of the epoxy resin for Type 1 and the polymer coating 5 for Type 2, or a combination thereof, respectively. For visualization on computed tomography (CT) 20 a smaller amount of marker particles and/or less strong radiopaque marker particles are recommended. For example, a doped rod with a 2:1 concentration of tungsten nanoparticles alone proved to be sufficient for CT on 25 guidewire prototypes. An image of a single rod doped with tungsten nanoparticles with a concentration of 2:1 and having a diameter of 0.20 mm placed in a water phantom is illustrated in figure 4a. This image shows a clear and sharp image of the rod.
    Examples of X-ray angiography markers, eg for catheter guidewires: 1) tungsten nanoparticles with a concentration of 2:1 to 1:1 in one or more rods and 40% barium sulfate in coating polymer ; 2) tungsten nanoparticles with a concentration of 2:1 to 1:1 in one or more rods and 20% barium sulfate in coating polymer;
    Other suitable X-ray markers are Barium (Ba), tantalum (Ta), osmium (Os), praseodymium (Pr), platinum (Pt), gold (Au) and lead (Pb).
    Figure 4b shows images that were taken by X-ray angiography using a water phantom. Images are assigned numbers 1-4, where the images show the following samples or devices:
    Image 1: a single rod doped with tungsten nanoparticles with a concentration of 2:1 and a diameter of 0.20 mm.
    Image 2: a guide wire with 40% barium sulfate in the coating polymer and a central rod (33 Tex) doped with 2:1 tungsten nanoparticles with a diameter of 0.20 mm and three peripheral rods (33 Tex) doped with iron microparticles (<150 μm) with a concentration of 1:10 and a diameter of 0.17 mm; the guidewire diameter is 0.81 mm (0.032 inch).
    Image 3: a Terumo reference guidewire with a nitinol core and a polymeric coating (specification: REF-GA32263M); the diameter is 0.81 mm (0.032 inch).
    Image 4: a guidewire with 40% barium sulfate in the coating polymer, an undoped central rod with a diameter of 0.20 mm and three peripheral rods (33 Tex) being doped with iron microparticles (<150 μm ) at a concentration of 1:10. The peripheral rods have a diameter of 0.17 mm and the guidewire has a diameter of 0.81 mm (0.032 inch).
    Pictures 2 to 4 show the respective guidewire clearly and precisely. The rod image is quite vague. This shows that tungsten nanoparticles are not sufficient for a single X-ray exposure in the way that X-ray angiography does. However, the contribution of the tungsten-doped rod to the signal intensity in X-ray angiography is significant and useful.
    In what follows, the MRI markers that were tested in the prototypes are explained:
    The MRI markers used for doping rods and/or coating polymer are ferromagnetic, paramagnetic and diamagnetic particles. Ferromagnetic and paramagnetic particles have positive magnetic susceptibility characteristics. Such particles are called, hereinafter, passive positive markers. Diamagnetic particles have negative magnetic susceptibility characteristics and are therefore called passive negative markers. Passive negative markers include, for example, lead and barium sulfate. Positive passive markers include iron (Fe), iron oxide (FeO, Fe2O3, Fe3O4), cobalt (Co), nickel (Ni), molybdenum (Mo), zirconium (Zr), titanium (Ti), manganese (Mn) , rubidium (Rb), aluminum (Al), palladium
    These markers, due to their susceptibility characteristics, have an influence on the magnetic field in the direct vicinity of the rods or medical devices. This local magnetic field influences the relaxation time of protons contained in adjacent water molecules. In the literature, there are also other classifications of MRI markers. For example, reference is made to it by Kanischka Ratnayaka et al., in the analysis "Interventional cardiovascular magnetic resonance: still tantalizing"; Journal of Cardiovascular Magnetic Resonance, December 29, 2008, where MRI markers are defined by their effects on the image, whether they cause negative contrast through local magnetic field distortions (dark spots) or positive contrast through enhanced local signal (light spots) However, to describe the present invention, it is preferred to define the MRI markers according to physical characteristics, viz., susceptibility characteristics.
    In addition, iron-platinum alloy particles (FePt NPs) can be used as passive negative MRI markers. In Shu Chen et al. ; "Engineered Biocompatible Nanoparticles for in Vivo Imaging Applications"; the use of FePt NPs as a contrast agent for MRI is described.
    Passive MRI markers cause either negative contrast through local magnetic field distortions (dark spots) or positive contrast through enhanced local signal (light spots). Ferromagnetic and paramagnetic particles, for example, iron, iron oxide, nickel, aluminum, and others, are called passive negative markers, which generate signal gaps from intentional magnetic susceptibility artifacts. Gadolinium, dysprosium and similar metals are positive passive markers in that they reduce the proton spin relaxation time of associated water molecules. Due to specific characteristics and influences on the magnetic properties (in particular the relaxation time) of protons in water molecules located directly adjacent to rods or medical devices, these MRI markers can be detected by 10 common MRI sequences adjusted for protons of Water.
    Prototypes of the rods and medical devices were tested in MRI systems. In these tests, the rods and medical devices were placed in a bain-marie (water phantom) so that they were completely surrounded and covered with water. This water phantom was placed in the magnetic field of an MRI scanner. There are standard measurement conditions ("RM sequences") in MRI systems for detecting the position and properties of water protons in the local magnetic field. With these 20 standard sequences, rods and medical devices containing different MRI markers were tested. The standard MRI sequences employed in a Siemens Magnetom Symphony 1.5 Tesla MR scanner essentially were: 1) TI 25 SE 2D weighted sequence, TR/TE = 420/14 ms, slice thickness: 2.0 mm, FOV - 400x400 mm, array: 512x256, phase FOV: 100%, sampling percentage: 50%, bandwidth: 90 Hz/px, tilt angle: 90", TA = 111 s, total number of slices: 15, spacing between slices : 2.2 mm (10%), 30 phase coding steps: 256 2) T2 weighted sequence TSE (SE) 2D, TR/TE = 3690/104 ms, slice thickness: 1.9 mm, FOV = 400x400 mm, matrix: 512x307, phase FOV: 100%, sampling percentage: 60%, bandwidth: 130 Hz/px, tilt angle: 180°, TA = 90 s, total number of slices: 15, spacing between slices: 2.09 mm (10%), phase coding steps: 345 (307), acceleration factor duration (turbo factor): 15 3) VIBE GRE/FLASH 3D sequence, TR TE = 4.3/ 2.05 ms, slice thickness: 1.0 mm, FOV = 400x300 mm, matrix: 256x 134, averages: 2, FOV Phase: 75%, Sampling Percentage: 69.79%, Bandwidth: 490 Hz/px, Tilt Angle: 12°, TA — 14 s, Total Number of Slices: 16, Phase Coding Steps: 134 , plate thickness: 16 4) gradient-echo sequence (GRE) GRE/FLASH 2D, TR/TE = 700/12 ms, slice thickness: 2.5 mm, FOV = 400x400 mm, matrix: 512x256, phase FOV : 100%, sampling percentage: 50%, bandwidth: 65 Hz/px, tilt angle: 30°, TA = 179 s, total number of slices: 15, spacing between slices: 2.75 mm (10 %), phase coding steps: 256. 5) 2D SSFP real-time sequence, > 1 frame/s, TR/TE = 2.2/4.7 ms, would thickness: 5 mm, FOV = 224x224 mm , matrix: 224x224, tilt angle: 60°, voxel size 1 x 1 mm
    Figure 4c shows four images A1, A2, Bl and B2 that were taken with a T2-weighted sequence using a water phantom. Images Al and A2 show a single rod doped with iron oxide nanoparticles at a concentration of 1:20 and images Bl and B2 show a guidewire with a central rod (33 Tex) doped with tungsten nanoparticles at a concentration 2:1 and having a diameter of 0.20 mm and three peripheral rods (33 Tex) doped with iron oxide nanoparticles (<50 nm) at a concentration of 1:20 with a diameter of 0.17 mm. The diameter of the guidewire is approximately 0.81 mm (0.032 inch). In images Al and Bl, the rod or guidewire, respectively, is arranged orthogonally to the Bo magnetic field. Images A2 and B2 were taken with the rod or guidewire, respectively, arranged parallel to the BO magnetic field. The rod and guidewire artifact in images A2 and B2 is very weak, in contrast to images A1 and B2. Therefore, when arranged orthogonally to the magnetic field Ba of the RM scanner, they gave satisfactory results. However, if the rods or guidewires containing nanoparticles are arranged parallel to the Bo magnetic field of the RM scanner, they do not provide any reasonable signal except for a displacement artifact. The nanoparticles are evenly distributed in the matrix material of the rods. Due to the high number of small nanoparticles, the distance between adjacent nanoparticles is very small. It is assumed that, due to this small distance, the magnetic moments are coupled to each other, causing all the nanoparticles to act as a magnetized bar that extends in the longitudinal direction of the rods or medical devices. If this is the case, then the magnetic field in the direct vicinity of the rods or medical device containing the rods is only influenced to a very low degree by the magnetism of the nanoparticles, as the magnetic field is concentrated within the rods or medical device. However, if the medical device is arranged orthogonally to the magnetic field Bo of the RM scanner, then the magnetic nanoparticles are also coupled together and can be considered as virtual magnet bars. However, then the magnetized bars are arranged laterally with respect to the longitudinal direction of the rods. At the end of each virtual magnetized bar, the magnetic field is concentrated so that, in the direct vicinity of the rods or medical device, the magnetic field is strongly influenced by the magnetism of the nanoparticles. Therefore, a rod doped with nanoparticles, in particular iron oxide nanoparticles, is only visible if it is arranged orthogonally to the magnetic field Bo of the MR scanner. Medical devices containing such rods can be used in magnet MR scanners open, because in these, medical devices are mainly used in a direction orthogonal to the Bo magnetic field. Such rods or such a medical device produce a very sharp and accurate image with virtually no artifacts on an open magnet MR scanner.
    However, today, most installed MR scanners are based on magnets and a ring in which medical devices must also be detectable if they are arranged parallel to the magnetic field (Bt). Therefore, the distance between the individual marker particles must be high enough to avoid such coupling and also to generate satisfactory signals in the direction parallel to the Bo magnetic field. To obtain such distances and have a sufficiently high doping effect, the size of the marker particles must be larger.
    Rods doped with iron particles with a diameter of 4 to 6 µm and with iron particles were sieved with a 150 µm mesh, respectively, and guidewire test samples containing such rods were tested. These guidewire test samples consisted of a polymeric tube into which rods are placed to simulate a guidewire in an imaging process. The guidewire test samples additionally comprised a rod doped with tungsten nanoparticles (2:1 concentration, 0.20 mm diameter).
    The images resulting from these tests are presented in figure 4d and in figure 4e. The images in figure 4d show a rod doped with iron particles with a diameter of 4 to 6 μm (image Al, A2) and the rod doped with iron particles was sieved with a 150 μm mesh (image Bl, B2). In images Al and Bl, the test samples were arranged orthogonally to the BQ magnetic field. In images A2 and B2, the test samples were arranged parallel to the Bo magnetic field. Tests were performed with a T2-weighted sequence in a water phantom. Figure 4e shows corresponding images of a guidewire test sample containing a rod doped with iron microparticles (4 to 6 µm, 1:10 concentration, 0.17 mm diameter) in images Al and A2 and a sample of guidewire test containing a rod doped with iron microparticles sieved with a 150 μm mesh (concentration 1:10, diameter 0.17 mm) in images Bl and B2.
    These images were taken by applying a real-time sequence and using an aortic phantom. On images Al and Bl, the guidewire test samples were arranged orthogonally to the Bo magnetic field and on the A2 and B2 images 5 in parallel to the Bo magnetic field. As can be seen from the images, the test samples were visible regardless of whether they were arranged orthogonally or parallel to the BO magnetic field. Iron is strongly ferromagnetic. Therefore, it makes the protons in the 10 water molecules surrounding the medical device visible in an MRI sequence tuned for water protons. Iron creates strong artifacts, and thereby generates images of the device that are much larger than the device itself. This is particularly the case if the medical device 15 or the rods, respectively, are arranged orthogonally to the magnetic field Bo of the MRI imaging system.
    In relation to doping with passive MRI markers, the objective is to obtain a) a strong signal and b) a confined and sharp signal. However, the stronger the signal, the greater the artifacts that reduce image sharpness. Preferably, the signal in the parallel (strong enough) and orthogonal (not so wide) direction should be balanced reasonably.
    The following effects were found capable of influencing the intensity and accuracy of the signal: - The higher the concentration of markers, the stronger the signal. - The larger the particles, the better the balance between the image in the parallel and orthogonal directions. However, the particle size is limited by the rod production process and/or the medical device. Particle sizes in the range of 1 µm to 150 µm are most suitable. Preferably, the particles have a size of at least 1 µm, 2 µm 5 µm, 10 µm or 50 µm. Satisfactory results are also achieved with particles that are sieved with a 150 µm mesh. Furthermore, a mesh of around 80 to 130 µm is also suitable. - A plurality of doped rods provides a stronger signal than just a single rod comprising the same amount of marker particles or an even greater amount. Figure 4f shows a guidewire test sample comprising a rod doped with tungsten nanoparticles at a concentration of 2:1 and a diameter of 0.20 mm and three rods (picture B1, B2) doped with iron particles sieved with a 150 μm mesh at a concentration of 1:10 and a diameter of 0.17 mm and another guidewire test sample comprising the same type of rods but with only one rod doped with tungsten and One rod doped with iron particles (image l, A2). Figure 4g shows images of a guidewire test sample containing a rod doped with tungsten nanoparticles sieved with a 150 μm mesh (concentration 1:10, diameter 0.17 mm), in images Al and A2, and a guidewire test sample containing one rod doped with tungsten nanoparticles (2:1 concentration, 0.20 mm diameter) and three rods doped with iron microparticles sieved with a 150 μm mesh (1:100 concentration, diameter 0.17 mm) in images Bl and B2. These images were taken by applying a real-time sequence and using an aortic phantom. Although the highly doped rod according to images A1 and A2 of figure 4g contains ten times the amount of marker particles than the lower doped rods according to images B1 and B2 of figure 4g, the three lower doped rods together generate a signal stronger than the most doped rod alone. This can be explained by the fact that the plurality of doped rods are located farther away from the medical device, causing the influencing range in the magnetic field to cover a wider area. Therefore, more voxels (which are detected by the RM scanner) are influenced by the plurality of rods. In conclusion, a greater number of voxels is darkened compared to a guidewire containing only one doped rod. More dim voxels means a visually wider and stronger signal.
    The distance of the marker particles or rods, respectively, to the surrounding water molecules influences the accuracy and strength of the signal. The greater the distance between the marker particles and adjacent water molecules, the weaker the influence of the magnetic field on these water molecules. In other words, the thicker the layer of a coating polymer with which the rods are coated on the medical device, the more accurate the signal. Thus, the position of the rods in the medical device has a strong influence on the accuracy of the signal.
    Figure 6 shows images A and B that were taken with a T2-weighted sequence using a water phantom. Figure 7 shows similar images A and B, which were taken with a gradient-echo sequence (GR.E). Images A and B in both figures show the following samples numbered 1 to 7: 5 1. rod-shaped body, 33 Tex, OD 0.17 mm ( = Outside Diameter) (without coating polymer); 2. rod-shaped body, 66 Tex, OD 0.24mm (Without polymer coating); 3. rigid guidewire, OD 0.88mm; 10 4. standard guidewire, OD 0.81mm; 5. micro guidewire, OD 0.31mm; 6. standard guidewire, OD 0.81mm; inserted into a tube with ID 1.5mm (=Internal Diameter) and OD 2.3mm; 7. standard guidewire, OD 0.81mm; inserted into a tube 15 with ID 0.94 mm and OD 1.45 mm; All guidewire samples contain rods doped with 40 to 63 µm iron particles at a concentration of 1:50. The standard guidewire comprises a 33 Tex fiberglass central rod. The rigid guidewire comprises a center rod with 66 Tex fiberglass. The micro guidewire comprises a 66 Tex fiberglass rod covered with a thin coating polymer (PU). It should be noted that the amount of matrix material is approximately proportional to the amount of glass fibers. 25 Therefore, rods containing 6 Tex fiberglass comprise more matrix material than rods containing 33 Tex fiberglass. As the concentration of the marker in the matrix material is always the same, the 66 Tex fiberglass rods contain absolutely 30 more marker particles than the rods containing 33 Tex fiberglass.
    Samples 6 and 7 comprise a guidewire being inserted into a tube. The tubes are sealed so that water cannot penetrate the air gap between the guide wire and the tube wall. Sample 6 includes a considerable air gap. In sample 7, the air gap between the tube and the guidewire is small.
    In image A, the samples are arranged longitudinally to the magnetic field Bo and, in image B, orthogonally to the magnetic field Bo.
    Stems (Samples 1 and 2) have a large artifact. The micro guidewire (sample 5) containing only a thin-coated polymer also has a large artifact. The artifacts generated by the standard and rigid guidewires are significantly smaller.
    The larger air gap of sample 6 generates a dark artifact that joins the MRI marker artifact, causing the sample image to be darker compared to sample 7 with a small air gap.
    Comparing samples 4 and 7, it can be seen that the tube covering the guidewire with only a small air gap reduces the width of the artifact.
    These results demonstrate that the polymer coating of the guidewires (sample 3 and 4) and that of the tube (sample 7) reduces the width of artifacts compared to the respective rods. This is caused by the greater distance between the water molecules surrounding the respective sample and the passive negative MRI marker particles. The greater the distance, the smaller the artifact.
    As rod-shaped bodies in a medical device are mostly arranged in different positions relative to the center of the medical device, it is preferred that rod-shaped bodies positioned further away from the medical device do not contain any MRI markers. 5 negative passive. This principle is incorporated into a guidewire, preferably in such a way that the rod-shaped body containing a passive negative MRI marker is located in the center of the guidewire. If the guidewire comprises several rod-shaped bodies, then it is useful if the rod-shaped bodies 10 that are not in the center do not comprise passive negative MRI markers.
    This principle can also be applied to a catheter. If a catheter comprises at least one rod-shaped body containing a passive negative MRI marker, then this rod-shaped body is positioned in the inner section of the catheter. Stem-shaped bodies that do not contain any passive negative MRI markers can be positioned closer to the circumferential surface of the catheter. Such a catheter or tube may also be provided with at least two concentric layers, only the innermost layer comprising a passive negative MRI marker.
    The width of the artifact is primarily determined by the distance of the passive negative MRI marker to the circumferential surface of the medical device, as the magnetic influence of the marker on the surrounding water molecules detected on the MRI depends on this distance. This is also true for catheters and tubes, as the water molecules surrounding the outer surface of the medical device determine the outer edge - of the artifacts and not the water molecules in the inner lumen of a catheter or tube. The distance between the section containing a passive negative MRI marker and the outer circumferential surface of the medical device is preferably at least 0.1 mm, more preferably at least 0.2 mm, and most preferably, of at least 0.3 mm.
    These effects can be exploited in different combinations to achieve the goal of a strong and accurate 10 signal, as mentioned above. Basically, the particle size must be large enough to balance the detected signals in the longitudinal and orthogonal direction with the Bo magnetic field of the MR scanner. A strong, relatively confined and accurate signal can be obtained when the absolute amount of marker particles is kept low and distributed over several peripheral rods.
    Another possibility is to incorporate, to the medical device, a central rod or rods 20 positioned closer to the center of the medical device being doped with a passive MRI marker and containing non-doped peripheral rods (which do not contain any passive MRI marker) or doped rods with an X-ray marker. Figure 4h comprises an image A and B, in 25 in which, in each image, three individual rods 1, 2, 3 are shown, each one being doped with iron microparticles (150 μm, concentration 1:10, diameter 0.17 mm). Stem 2 is uncovered. Stem 1 is covered with a thin layer of epoxy resin so that the total diameter of this sample is 0.9 mm. Stem 3 is covered with a thicker layer of polyurethane polymer. The total diameter of this sample is also approximately 0.9 mm. Image A shows the rods arranged orthogonally to the magnetic field Bo and image B parallel to the magnetic field Bo. In image A, it is clearly visible that the uncovered rod generates a much wider signal than the two other covered rods. Since rods 1 and 3 are covered with a polymer coating, the distortion of the magnetic field outside the medical device is attenuated. As a result, only a relatively small layer of surrounding water molecules is influenced by the iron particles on the rod, compared to a reasonably thicker layer when the marker particles are located on the peripheral rods near the outer edge of the medical device. The thicker the layer of influenced water molecules, the wider the resulting signal / artifact. In conclusion, the MR image of the medical device has a multiple of its actual diameter. In the case of a medical device in which the central rod comprises the MRI marker particles, a sufficiently strong and sharp image is obtained, having a diameter only slightly larger than the actual diameter of the device.
    These medical device constructions are based on the influence of the magnetic field caused by the negative passive marker particles on the protons in the water molecules present in the direct surroundings of the medical device.
    Another approach to getting a strong, confined, and accurate signal is to adjust the MR sequence. If relaxation echoes from the protons in the coating polymer and not those from the surrounding water molecules are detected, it is possible to obtain a very sharp image limited practically to the actual diameter of the medical device. This is most preferable, for example, for the tips of puncture or biopsy needles, where absolutely precise operation of the device is required to target small regions, for example, cancerous tissues. Rigid polymeric materials, such as epoxy resins or the polyurethane or thermoplastic elastomer mentioned above made of SEBS, contain a plurality of protons, but the relaxation times for these protons are too short in rigid polymers due to the rigidity of the materials to be detected with the 15 currently established MR sequences and scanners. Instead of these relatively rigid polymeric materials, it is possible to use softer polymeric materials as a coating polymer for the medical devices according to the invention. In softer polymers, protons are a little more flexible and have somewhat longer relationship times. As a result, they can be detected with current MR scanners and MR sequencing software, eg PVC or rubber materials are suitable for this purpose. Rubber materials, due to the cross-linked polymer chains, offer a sufficiently high stability, but the protons of rubber materials still have a sufficiently long relaxation time. The use of such rubber materials in an MR scanner is described in R. Umathum et al., Rubber 30 Materials for Active Device Tracking, abstract from the 16th ISMRM 2008 Congress in Toronto (The International Society for Magnetic Resonance in Medicine). Such rubber materials can also be extruded, the vulcanization of the rubber material being carried out after extrusion.
    There are also known solid rubber-like hydrogels, such as PVA-H, which provide excellent visibility. However, the strength of such hydrogels is low. Another construction of the guidewire comprises a core of such a solid rubber-like hydrogel that is enveloped by the coating polymer. In the coating polymer, one or more rods can be integrated. In such a guidewire, the mechanical stability is mainly defined by the tube-type coating polymer. In an MR scanner, the guidewire core provides a signal. This signal can be influenced by doping the core of the guidewire or by means of rods doped in the coating polymer.
    An advantage of using a soft polymer or rubber polymer as the coating polymer of a medical device 20 or of using a core made of a soft polymer, rubber or solid rubber-like hydrogel is that the relaxation time is long enough to be detected on an RM scanner. As the relaxation time differs significantly from the relaxation time of water, these 25 materials can be detected for a shorter echo time than for water, resulting in two images that can be superimposed. Thereby, the medical device can be presented distinctly, for example, in a specifically chosen color, and different from body tissue or blood, which is presented in the conventional manner in black, white and shades of gray. Furthermore, the user can individually select one of the two images to be separately displayed on the screen. Therefore, it is possible to control the position of the medical device on the body by superimposing both images, but it is also possible to have an image of the body tissue separately without suffering interference from the medical device.
    Another advantage for visualization of medical devices in MRI guided interventions can be obtained if, for example, a guidewire comprises a softer polymer as described above as the coating polymer, but a corresponding catheter used comprises a more rigid polymer than the coating polymer. than the wall-forming polymer. In this case, the guidewire is detected with a short echo time, resulting in an accurate signal that more precisely delineates its boundaries. The catheter is detected with a longer echo time, detecting artifact resulting from surrounding water molecules. The two devices can be displayed in different colors, which makes it easier to distinguish the catheter from the guidewire.
    The following MRI marker particles were used for doping the rods and coating polymer: • Tungsten nanoparticles: American Elements; Tungsten nanopowder, 99% < 100 µm (typically 40 to 60 nm), spherical; product code: W-M-01-NP • Tungsten microparticles: Sigma-Aldrich; Tungsten, powder, 99.9%, 12 µm; product code: 267511 • Iron microparticles: Riedel de Haen (Sigma-Aldrich), <150 μm; product code: 12312 - • Iron microparticles: Roth, 4 to 6 μm; product code: 3718.0 • Iron oxide nanoparticles; Sigma-Aldrich, <50 nm; product code: 544884 5 • Barium sulphate (eg in the commercially available "Teco flex with Ba.SO4" or "Mediprene with BaSÕ4" ) The following materials were used for the production of the rods and medical devices: • Epoxy resin high temperature resistant 10 • Tecoflex™ is an elastic polymer based on polyurethane (PU). • Mediprene® is a thermoplastic elastomer made from SEBS (Styrene-Ethylene-Butylene-Styrene Elastomer) that is primarily used for medical purposes. 0 Mediprene is offered by Elasto AB, Sweden. • Glass fibers • Aramid fibers Medical devices were produced by co-extrusion, in which the coating polymer is extruded 20 along with the rods. Since the rods must not be deformed during co-extrusion, the rods are made of a high temperature resistant material. However, if the coating polymer is based on a rubber material, then the extrusion temperature can be reduced so that the temperature requirements for the matrix material are consequently reduced and other resin materials in addition to the resistant epoxy resin high temperature are suitable. These other resin materials can be common epoxy resin, PVC or synthetic rubber. Numerical Reference List: 1 Stem Body 1/1 Center Stem 1/2 Peripheral Stem 5 2 Filament 3 Matrix Polymer 4 Bead 5 Guide Wire 6 Coating Polymer 10 7 Catheter
    权利要求:
    Claims (19)
    [0001]
    1. Medical device characterized in that the medical device comprises an elongated body made of a polymeric material and the polymeric material involves a passive negative MRI marker consisting of marker particles to generate an artifact in a magnetic resonance imaging process, in that the passive negative MRI marker is located only in a central section of the medical device such that the passive MRI marker has a certain distance to a circumferential surface of the medical device so that a confined artifact is obtained, in which distance of the passive negative MRI marker to the external surface of the medical device is at least 0.1 mm.
    [0002]
    2. Medical device according to claim 1, characterized in that it comprises a rod-shaped body (1) which is embedded in the polymeric material and in which the polymeric material is denoted below as an envelope polymer (6 ), wherein the rod-shaped body (1) comprises: - one or more non-metallic filaments (2) and - a non-ferromagnetic matrix material, wherein the matrix material surrounds and/or binds the filaments ( 2) and marker particles for generating a signal in an X-ray or magnetic resonance imaging process, and at least one of said non-metallic filaments (2) is a high tenacity fiber (ht fiber) with a toughness to tension of at least 20 cN/tex.
    [0003]
    3. Medical device according to claim 2, characterized in that the non-metallic filaments (2) comprise at least one glass fiber, and preferably several glass fibers and several high tenacity fibers (fibers ht) having a tensile strength of at least 20 cN/tex.
    [0004]
    4. Medical device according to any one of claims 1 to 3, characterized in that it comprises a rod-shaped body (1) and an envelope polymer (6) in which the rod-shaped bodies (1) are embedded, wherein the rod-shaped body (1) comprises - one or more non-metallic filaments (2) and - a non-ferromagnetic matrix material, where the matrix material surrounds and/or binds the filaments (2 ) and marker particles to generate a signal in a magnetic resonance or X-ray imaging process, in which the one or more non-metallic filaments (2) extend over most of the rod-shaped body (1 ), and/or the length of the non-metallic filaments is at least half the length of the rods (1).
    [0005]
    5. Medical device, according to any one of claims 2 to 4, characterized in that the non-metallic filaments (2) are arranged in parallel with each other; and the non-metallic filaments (2) comprise at least one of glass fibers, polyamide and aramid fibers.
    [0006]
    6. Medical device according to any one of claims 1 to 5, characterized in that it comprises one or more rod-shaped bodies (1) and a coating polymer (6) in which the rod-shaped bodies ( 1) are embedded, wherein each rod-shaped body (1) comprises - one or more non-metallic filaments (2), and - a non-ferromagnetic matrix material, wherein the matrix material encloses and/or binds together filaments and marker particles to generate a signal in a magnetic resonance or X-ray imaging process, in which a strand (3) is embedded in the matrix material, with the strand (3) being more flexible than the non-metallic filaments (2).
    [0007]
    7. Medical device according to any one of claims 1 to 5, characterized in that it comprises one or more rod-shaped bodies (1) and a coating polymer (6) in which the rod-shaped bodies ( 1) are embedded, wherein each rod-shaped body (1) comprises - one or more non-metallic filaments (2), and - a non-ferromagnetic matrix material, wherein the matrix material encloses and/or binds together the filaments and marker particles to generate a signal in a magnetic resonance or X-ray imaging process, in which a strand (3) is embedded in the coating polymer (6), with the strand (3) being more flexible than non-metallic filaments (2).
    [0008]
    8. Medical device according to any one of claims 1 to 7, characterized in that it comprises several rod-shaped bodies (1), each comprising: - one or more non-metallic filaments (2) and - one non-ferromagnetic matrix material, in which the matrix material surrounds and/or binds the filaments (2) and marker particles to generate a signal in a magnetic resonance or X-ray imaging process, and a coating polymer ( 6) in which the rod-shaped bodies (1) are embedded, wherein the rod-shaped bodies (1) are arranged in different positions relative to the center of the medical device, and the rod-shaped bodies (1) which are arranged closer to the center of the medical device comprise non-metallic filaments (2) with a greater modulus of tension than the non-metallic filaments (2) of rod-shaped bodies (1) which are positioned further away from the center of the medical device.
    [0009]
    9. Medical device according to any one of claims 1 to 8, characterized in that it comprises rod-shaped bodies (1), each comprising - one or more of said non-metallic filaments (2) and - one non-ferromagnetic matrix material, wherein said matrix material surrounds and/or binds the filaments (2) and marker particles to generate a signal in a magnetic resonance or X-ray imaging process, and a polymer of casing (6) in which the rod-shaped bodies (1) are embedded, wherein the rod-shaped bodies (1) are arranged in different positions relative to the center of the medical device, and the rod-shaped bodies ( 1) positioned further away from the center of the medical device are free of passive negative MRI marker.
    [0010]
    10. Medical device according to any one of claims 1 to 9, characterized in that the medical device is one of a guidewire (5), containing a rod-shaped body (1) comprising an MRI marker negative passive and being positioned in the center of the guidewire (5); and a catheter (7) or tube-like structure, containing at least one rod-shaped body (1) comprising a negative passive MRI marker and being positioned in the inner section of the catheter (7).
    [0011]
    11. Medical device according to any one of claims 1 to 9, characterized in that the medical device is one of a guidewire (5), containing a rod-shaped body (1) comprising an MRI marker negative passive and being positioned in the center of the guidewire (5); and a catheter-like structure (7) or tube provided with at least two concentric layers, containing at least one rod-shaped body (1) comprising a negative passive MRI marker, wherein only the innermost layer comprises an MRI marker. Negative passive MRI.
    [0012]
    12. Medical device according to claim 11, characterized in that the medical device is incorporated as said catheter (7) having at least two concentric layers, one of said layers being reinforced by non-metallic filaments (2) being of a type between twisted, braided and woven into a spatial structure, wherein the non-metallic filaments (2) comprise high strength fibers (ht fibers) with a tensile strength of at least 20 cN/tex.
    [0013]
    13. Medical device according to any one of claims 1 to 12, characterized in that the MRI marker is selected from the group of ferromagnetic and paramagnetic particles.
    [0014]
    14. Medical device according to claim 13, characterized in that the MRI marker is selected from the group of ferromagnetic and paramagnetic particles, with particle sizes in the range of 1 μm to 150 μm.
    [0015]
    15. Medical device according to claim 13, characterized in that the MRI marker is selected from the group of ferromagnetic and paramagnetic particles, with iron microparticles with particle sizes in the range of 1 μm to 150 μm.
    [0016]
    16. Medical device according to any one of claims 1 to 15, characterized in that it comprises: - several rod-shaped bodies (1) to reinforce the medical device, and - a coating polymer (6) in which the rod-shaped bodies (1) are embedded, in which the medical device comprises marker particles to generate an artifact in a magnetic resonance imaging process, and - coating polymer (6) is a material among soft polymer, material of rubber and PVC.
    [0017]
    17. Medical device according to any one of claims 1 to 16, characterized in that it is a guide wire (5) comprising a flexible tip, in which a metallic core is contained in the flexible tip.
    [0018]
    18. Medical device according to any one of claims 1 to 16, characterized in that it is a guide wire (5) comprising a flexible tip, in which metallic particles are contained in the flexible tip.
    [0019]
    19. Medical device according to claim 18, characterized in that the MRIs are incorporated in the flexible tip of the device to cause MRI artifacts with a greater intensity than the MRI markers in the rest of the medical device.
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    法律状态:
    2020-10-20| B06U| Preliminary requirement: requests with searches performed by other patent offices: procedure suspended [chapter 6.21 patent gazette]|
    2020-11-10| B25A| Requested transfer of rights approved|Owner name: KLAUS DUERING (DE) |
    2020-12-01| B25A| Requested transfer of rights approved|Owner name: MARVIS INTERVENTIONAL GMBH (DE) |
    2020-12-08| B06F| Objections, documents and/or translations needed after an examination request according [chapter 6.6 patent gazette]|
    2021-02-09| B09A| Decision: intention to grant [chapter 9.1 patent gazette]|
    2021-04-20| B16A| Patent or certificate of addition of invention granted|Free format text: PRAZO DE VALIDADE: 20 (VINTE) ANOS CONTADOS A PARTIR DE 18/10/2011, OBSERVADAS AS CONDICOES LEGAIS. |
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    EP10187863.5|2010-10-18|
    PCT/EP2011/005230|WO2012052159A1|2010-10-18|2011-10-18|Rod shaped body and medical device|
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