Identification of elastic lamina to guide interventional therapy

• US 10,130,386 B2
• Filed: 07/08/2014
• Issued: 11/20/2018
• Est. Priority Date: 07/08/2013
• Status: Active Grant

• Current Assignee: Avinger Inc.
• Original Assignee: Avinger Inc.
• Inventors: Simpson, John B., He, Xuanmin, Radjabi, Ryan, Newhauser, Richard R.
• Primary Examiner(s): Miles, Jonathan
• Application Number:
  US14/899,893
• Publication Number:
  US 20160135832A1
• Time in Patent Office: 1,596 Days
• CPC Class Codes: A61B 17/3207 Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016
• CPC Class Codes: A61B 17/320783 through side-hole, e.g. sliding or rotating cutter inside catheter
• CPC Class Codes: A61B 2017/00119 alarm; indicating an abnormal situation
• CPC Class Codes: A61B 2017/22071 Steering
• CPC Class Codes: A61B 2017/320791 with cutter extending outside the cutting window
• CPC Class Codes: A61B 2034/107 Visualisation of planned trajectories or target regions
• CPC Class Codes: A61B 2090/08021 of the patient or his organs
• CPC Class Codes: A61B 2090/3735 Optical coherence tomography [OCT]
• CPC Class Codes: A61B 90/361 Image-producing devices, e.g. surgical cameras

Abstract

Described herein is a system and method for identifying elastic lamina during interventional procedures, such as atherectomy. Such identification can be used to avoid trauma to the external elastic lamina during the procedure.

Claims

1. A method of performing atherectomy, comprising:

inserting an atherectomy device into a vessel;

gathering optical coherence tomography (OCT) images using an imaging sensor on the device;

automatically identifying an external elastic lamina in the OCT images with a controller;

automatically highlighting the external elastic lamina in the OCT images with the controller after the identifying step; and

cutting tissue in the vessel based upon the identification.

2. The method of claim 1, wherein the OCT images are a toroidal view of the vessel.

3. The method of claim 2, wherein identifying an external elastic lamina comprises identifying an outer-most bright line in the toroidal view.

4. The method of claim 1, wherein cutting tissue in the vessel based upon the identification comprises adjusting a depth of cut based upon the identification.

5. The method of claim 4, wherein adjusting a depth of cut comprises moving the cutter from an active mode to a passive mode.

6. The method of claim 5, wherein the device further includes a balloon configured to inflate or deflate to expose or cover the cutter, and wherein moving the cutter from an active mode to a passive mode comprises at least partially deflating the balloon.

7. The method of claim 4, wherein the adjusting step is performed automatically.

8. The method of claim 1, wherein cutting tissue in the vessel based upon the identification comprises reorienting a distal tip of the device based upon the identification.

9. The method of claim 1, wherein reorienting the distal tip comprises using a marker in the OCT images to reorient the tip.

10. The method of claim 1, wherein cutting tissue in the vessel comprises not cutting through the external elastic lamina.

11. The method of claim 1, further comprising determining a distance between the cutter and the external elastic lamina.

12. The method of claim 11, further comprising activating an alarm if the distance is below a threshold value.

13. The method of claim 11, further comprising stopping the cutting if the distance is below a threshold value.