Devices, systems, and methods for visually depicting a vessel and evaluating treatment options

• US 10,390,768 B2
• Filed: 11/21/2014
• Issued: 08/27/2019
• Est. Priority Date: 08/20/2011
• Status: Active Grant

• Current Assignee: Imperial College of Science Technology & Medicine (Imperial College London), Volcano Corporation (Koninklijke Philips N.V.)
• Original Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Inventors: Anderson, David, Davies, Justin
• Primary Examiner(s): Messersmith, Eric J
• Application Number:
  US14/550,369
• Publication Number:
  US 20150080749A1
• Time in Patent Office: 1,740 Days
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 2017/22001 Angioplasty, e.g. PCTA
• CPC Class Codes: A61B 2562/0247 Pressure sensors
• CPC Class Codes: A61B 5/015 By temperature mapping of body part
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/02014 Determining aneurysm
• CPC Class Codes: A61B 5/02055 Simultaneously evaluating both cardiovascular condition and temperature
• CPC Class Codes: A61B 5/0215 by means inserted into the body catheters A61M25/00
• CPC Class Codes: A61B 5/02158 provided with two or more sensor elements
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/6876 Blood vessel
• CPC Class Codes: A61B 5/7278 Artificial waveform generation or derivation, e.g. synthesising signals from measured signals A61B5/327 takes precedence
• CPC Class Codes: A61B 5/743 Displaying an image simultaneously with additional graphical information, e.g. symbols, charts, function plots
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders

Abstract

Devices, systems, and methods for visually depicting a vessel and evaluating treatment options are disclosed.

Claims

1. A method of evaluating a vessel of a patient, comprising:

introducing a first instrument into the vessel of the patient;

introducing a second instrument into the vessel of the patient;

moving the second instrument longitudinally through the vessel of the patient from a first position to a second position while maintaining the first instrument in a fixed longitudinal position with respect to the vessel;

obtaining pressure measurements from the first and second instruments while the second instrument is moved longitudinally through the vessel;

calculating pressure ratios of the pressure measurements obtained by the second instrument to the pressure measurements obtained by the first instrument;

visually depicting the pressure ratios on a display, wherein the visual depiction of the pressure ratios comprises a graph including a graphical representation of the pressure ratios; and

modifying the graph to simulate one or more treatment options, wherein modifying the graph comprises changing a shape of the graphical representation in the graph to simulate an increase in the pressure ratios resulting from the one or more treatment options.

2. The method of claim 1, wherein the first position is distal of at least one stenosis of the vessel.

3. The method of claim 2, wherein the second position is proximal of the at least one stenosis of the vessel such that moving the second instrument longitudinally through the vessel comprises a pullback.

4. The method of claim 1, wherein the first position is proximal of at least one stenosis of the vessel.

5. The method of claim 4, wherein the second position is distal of the at least one stenosis of the vessel.

6. The method of claim 1, wherein modifying the graph to simulate one or more treatment options comprises:

modifying the graph to simulate a first treatment option;

modifying the graph to simulate a second treatment option; and

evaluating the modified graphs to select either the first treatment option or the second treatment option.

7. The method of claim 6, further comprising performing the selected treatment option.

8. The method of claim 1, wherein the one or more treatment options are selected from the group of treatment options consisting of:

an angioplasty, a stent, a pharmaceutical, and combinations thereof.

9. The method of claim 1, wherein the pressure ratios are calculated by dividing the pressure measurements obtained from the second instrument by the pressure measurements obtained from the first instrument.

10. The method of claim 1, wherein visually depicting the pressure ratios includes graphing a total pressure differential between pressure measurements obtained from the first instrument and the pressure measurements obtained from the second instrument.

11. The method of claim 1, wherein visually depicting the pressure ratios includes graphing a localized pressure differential between pressure measurements obtained from the first instrument and the pressure measurements obtained from the second instrument.

12. The method of claim 11, wherein the localized pressure differentials are calculated based on points separated by a fixed amount of time.

13. The method of claim 11, wherein the localized pressure differentials are calculated based on points separated by a fixed length.

14. The method of claim 1, further comprising evaluating the one or more treatment options based on the modified graph.

15. The method of claim 14, wherein evaluating the one or more treatment options comprises determining whether the modified graph satisfies a predetermined requirement.

16. The method of claim 15, wherein the predetermined requirement is a threshold pressure differential.

17. The method of claim 16, wherein the threshold pressure differential is 0.80.

18. The method of claim 15, further comprising performing at least one of the one or more treatment options that satisfies the predetermined requirement.

19. The method of claim 18, wherein the at least one treatment option that is performed is selected from the group of treatment options consisting of:

an angioplasty, a stent, a pharmaceutical, and combinations thereof.

39. The method of claim 1, wherein modifying the graph to simulate the one or more treatment options comprises modifying the graph to simulate:

the one or more treatment options performed at a first region of interest of the vessel; and

the one or more treatment options performed at a second region of interest of the vessel.

40. The method of claim 1, wherein the graphical representation comprises a plot of pressure ratios along a length of the vessel based on the obtained pressure measurements, and wherein changing the shape of the graphical representation comprises changing the shape of the plot at a location of the plot corresponding to a region of interest in the vessel to simulate the one or more treatment options performed at the region of interest.

41. The method of claim 40, wherein changing the shape of the graphical representation comprises changing a slope at the location of the plot corresponding to the region of interest.

20. A system for evaluating a vessel of a patient, comprising:

a first instrument sized and shaped for introduction into the vessel of the patient;

a second instrument sized and shaped for introduction into the vessel of the patient;

a processing unit in communication with the first and second instruments, the processing unit configured to;

obtain pressure measurements from the first and second instruments while the second instrument is moved longitudinally through the vessel of the patient from a first position to a second position while the first instrument is maintained in a fixed longitudinal position with respect to the vessel;

calculate pressure ratios of the pressure measurements obtained by the second instrument to the pressure measurements obtained by the first instrument;

visually depict the pressure ratios on a display, wherein the visual depiction of the pressure ratios comprises a graph including a graphical representation of the pressure ratios; and

modify the graph to simulate one or more treatment options, wherein modifying the graph comprises changing a shape of the graphical representation in the graph to simulate an increase in the pressure ratios resulting from the one or more treatment options.

21. A method of evaluating a vessel of a patient, comprising:

introducing an instrument into the vessel of the patient;

moving the instrument longitudinally through the vessel of the patient from a first position to a second position;

obtaining pressure measurements from the instrument at a plurality of positions along the vessel as the instrument is moved longitudinally through the vessel;

calculating pressure ratios of the pressure measurements obtained by the instrument;

visually depicting the pressure ratios on a display, wherein the visual depiction of the pressure ratios comprises a graph including a graphical representation of the pressure ratios; and

modifying the graph to simulate one or more treatment options, wherein modifying the graph comprises changing a shape of the graphical representation in the graph to simulate an increase in the pressure ratios resulting from the one or more treatment options.

22. The method of claim 21, wherein the first position is distal of at least one stenosis of the vessel.

23. The method of claim 22, wherein the second position is proximal of the at least one stenosis of the vessel such that moving the instrument longitudinally through the vessel comprises a pullback.

24. The method of claim 21, wherein the first position is proximal of at least one stenosis of the vessel.

25. The method of claim 24, wherein the second position is distal of the at least one stenosis of the vessel.

26. The method of claim 21, wherein modifying the graph to simulate one or more treatment options comprises:

modifying the graph to simulate a first treatment option;

modifying the graph to simulate a second treatment option; and

evaluating the modified graphs to select either the first treatment option or the second treatment option.

27. The method of claim 26, further comprising performing the selected treatment option.

28. The method of claim 21, wherein the one or more treatment options are selected from the group of treatment options consisting of an angioplasty, a stent, a pharmaceutical, and combinations thereof.

29. The method of claim 21, wherein visually depicting the pressure ratios comprises graphing pressure differentials between sequential pressure measurements obtained from the instrument.

30. The method of claim 29, wherein the sequential pressure measurements are separated by a fixed amount of time.

31. The method of claim 30, wherein the sequential pressure measurements are separated by a fixed number of pressure measurements obtained from the instrument.

32. The method of claim 21, further comprising evaluating the one or more treatment options based on the modified graph.

33. The method of claim 32, wherein evaluating the one or more treatment options comprises determining whether the modified graph satisfies a predetermined requirement.

34. The method of claim 33, wherein the predetermined requirement is a threshold pressure differential.

35. The method of claim 34, wherein the threshold pressure differential is 0.80.

36. The method of claim 33, further comprising performing at least one of the one or more treatment options that satisfies the predetermined requirement.

37. The method of claim 36, wherein the at least one treatment option that is performed is selected from the group of treatment options consisting of an angioplasty, a stent, a pharmaceutical, and combinations thereof.

38. The method of claim 21, wherein the graph comprises a plot of numerical values of the pressure ratios, and wherein the one or more treatment options are simulated by modifying the numerical values of the plot.