Methods and apparatus for the identification and stabilization of vulnerable plaque

• US 20030199747A1
• Filed: 04/19/2002
• Published: 10/23/2003
• Est. Priority Date: 04/19/2002
• Status: Abandoned Application

• Current Assignee: Jomed N. V.
• Original Assignee: Jomed N. V.
• Inventors: Michlitsch, Kenneth J., Cespedes, Eduardo Ignacio
• Application Number:
  US10/127,052
• Publication Number:
  US 20030199747A1
• Time in Patent Office: Days
• US Class Current: 600/407
• CPC Class Codes: A61B 1/00082 Balloons
• CPC Class Codes: A61B 1/24 for the mouth, i.e. stomatoscopes, e.g. with tongue depressors tongue depressors per se A61B13/00; Instruments for opening or keeping open the mouth combined with saliva removers A61C17/00; mouth openers for animals A61D15/00
• CPC Class Codes: A61B 5/0088 for oral or dental tissue
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/6853 with a balloon
• CPC Class Codes: A61B 5/6858 with a distal basket, e.g. expandable basket
• CPC Class Codes: A61B 5/6859 with multiple distal splines
• CPC Class Codes: A61B 5/7425 Displaying combinations of multiple images regardless of image source, e.g. displaying a reference anatomical image with a live image geometric transforms for image registration G06T3/14; enhancement using image fusion G06T5/50; algorithms for registration of images G06T7/30
• CPC Class Codes: A61B 8/06 Measuring blood flow measuring volume flow in general G01F, e.g. G01F1/66, G01F1/72; measuring speed of fluids in general G01P5/00
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00

Abstract

The present invention provides methods and apparatus for identifying and stabilizing vulnerable plaque via multi-functional catheters having both thermography and imaging capabilities. It is expected that correlating imaging and thermography data will facilitate improved identification of vulnerable plaque. Apparatus of the present invention may also be provided with optional stabilization elements for stabilizing vulnerable plaque. Methods of using apparatus of the present invention are provided.

Claims

1. Apparatus for identification of vulnerable plaque, the apparatus comprising:

a catheter having a distal region;

an imaging element disposed on the catheter in the distal region; and

a thermographer disposed on the catheter adjacent the imaging element.

2. The apparatus of claim 1, wherein the imaging element is chosen from the group consisting of ultrasound transducers, linear-array ultrasound transducers, phased-array ultrasound transducers, rotational ultrasound transducers, forward-looking ultrasound transducers, radially-looking ultrasound transducers, magnetic resonance imaging apparatus, angiography apparatus, optical coherence tomography apparatus, and combinations thereof.

3. The apparatus of claim 1, wherein the thermographer is chosen from the group consisting of thermocouples, thermosensors, thermistors, thermometers, spectrography devices, infrared thermographers, fiber optic infrared thermographers, ultrasound-based thermographers, spectroscopy devices, near infrared spectroscopy devices, and combinations thereof.

4. The apparatus of claim 1 further comprising a stabilization element.

5. The apparatus of claim 4, wherein the stabilization element is chosen from the group consisting of balloons, stents, coated stents, covered stents, stent grafts, eluting stents, drug-eluting stents, magnetic resonance stents, anastamosis devices, ablation devices, photonic ablation devices, laser ablation devices, RF ablation devices, ultrasound ablation devices, therapeutic ultrasound transducers, sonotheraphy elements, coronary bypass devices, myocardial regeneration devices, sonotherapy devices, drug delivery devices, gene therapy devices, atherectomy devices, heating devices, plaque rupture devices, secondary-substance modifiers, therapeutic agents, contrast agents, drug capsules, tissue-type tags, extreme lipid lowering agents, cholesterol acyltransferase inhibitors, matrix metalloproteinase inhibitors, anti-inflammatory agents, anti-oxidants, angiotensin-converting enzyme inhibitors, radiation elements, brachytherapy elements, local drug injection elements, gene therapy elements, photodynamic therapy elements, photoangioplasty elements, cryotherapy elements, and combinations thereof.

6. The apparatus of claim 4 further comprising a distal protection device.

7. The apparatus of claim 1, wherein the apparatus is adapted to perform a function chosen from the group consisting of elastography, palpography, and blood flow imaging.

8. The apparatus of claim 1 further comprising a graphical user interface for displaying imaging and thermography data obtained with the imaging element and thermographer, respectively.

9. The apparatus of claim 8, wherein the imaging and thermography data are coupled and displayed simultaneously.

10. The apparatus of claim 9, wherein the graphical user interface is adapted to display imaging and thermography data obtained along a cross-section of a patient'"'"'s vessel.

11. The apparatus of claim 9, wherein the graphical user interface is adapted to display imaging and thermography data obtained along a side-section of a patient'"'"'s vessel.

12. The apparatus of claim 1 further comprising position indication elements for determining the position of the imaging element and the thermographer.

13. The apparatus of claim 1 further comprising a pullback system coupled to the catheter.

14. The apparatus of claim 8, wherein the graphical user interface is further adapted to display data chosen from the group consisting of palpography data and blood flow data.

15. A method for identifying vulnerable plaque within a body lumen of a patient, the method comprising:

providing apparatus comprising a catheter having both an imaging element and a thermographer;

percutaneously advancing the catheter to a target region within the patient'"'"'s body lumen;

obtaining an image of the target region with the imaging element;

obtaining temperature data at the target region with the thermographer; and

comparing the image and the temperature data obtained at the target region to determine if vulnerable plaque is present at the target region

16. The method of claim 15, wherein an increase in temperature at the target region is indicative of vulnerable plaque.

17. The method of claim 15, wherein eccentric stenosis observed in the image is indicative of vulnerable plaque.

18. The method of claim 15, wherein echolucent zones observed in the image are indicative of vulnerable plaque.

19. The method of claim 15, wherein comparing the image and the temperature data further comprises coupling and simultaneously displaying the image and the temperature data.

20. The method of claim 15 further comprising obtaining additional data at the target region with the imaging element,

wherein comparing the image and the temperature data further comprises comparing the image, temperature and additional data obtained at the target region to determine if vulnerable plaque is present at the target region.

21. The method of claim 20, wherein obtaining additional data comprises obtaining additional data chosen from the group consisting of palpography data and blood flow data.

22. The method of claim 15 further comprising stabilizing the target region at locations where vulnerable plaque has been identified.

23. The method of claim 22 further comprising providing distal protection while stabilizing the target region at locations where vulnerable plaque has been identified.

25. The apparatus of claim 23, wherein the rotatable drive cable is coupled to a driver adapted to rotate the drive cable and side-viewing fiber optic, thereby providing the side-viewing fiber optic with a 360°

field of view.

26. The apparatus of claim 23 further comprising an imaging element.

27. The apparatus of claim 25, wherein the imaging element comprises an ultrasound imaging transducer coupled to the distal region rotatable drive cable.

28. The apparatus of claim 26, wherein the ultrasound imaging transducer is proximally coupled to an ultrasound imaging system.

29. The apparatus of claim 23 further comprising a stabilization element.

24. Apparatus for identification of vulnerable plaque, the apparatus comprising:

a catheter having proximal and distal ends, and a bore extending from the proximal end towards the distal end;

a rotatable drive cable having a distal region; and

a side-viewing fiber optic coupled to the distal region of the drive cable,

wherein the rotatable drive cable is disposed within the bore, and

wherein the side-viewing fiber optic is proximally coupled to an infrared thermography system.