Method and apparatus for performing intra-operative angiography

• US 8,892,190 B2
• Filed: 03/13/2012
• Issued: 11/18/2014
• Est. Priority Date: 09/24/1999
• Status: Expired due to Fees

• Current Assignee: Stryker European Operations Limited (Stryker Corporation)
• Original Assignee: National Research Council Canada
• Inventors: Docherty, John C., Mangat, Gurpreet, Flower, Robert W., Chari, Seshadri M., Hewco, Mark
• Primary Examiner(s): MEHTA, PARIKHA SOLANKI
• Application Number:
  US13/419,368
• Publication Number:
  US 20130053690A1
• Time in Patent Office: 980 Days
• Field of Search: 424/9.6, 600/431, 600/476
• US Class Current: 600/431
• CPC Class Codes: A61B 1/042 characterised by a proximal camera, e.g. a CCD camera
• CPC Class Codes: A61B 1/043 for fluorescence imaging
• CPC Class Codes: A61B 5/0036 including treatment, e.g., using an implantable medical device, ablating, ventilating
• CPC Class Codes: A61B 5/0071 by measuring fluorescence emission
• CPC Class Codes: A61B 5/0084 for introduction into the body, e.g. by catheters A61B5/1459 takes precedence
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0275 using tracers, e.g. dye dilution
• CPC Class Codes: A61B 5/4836 Diagnosis combined with treatment in closed-loop systems or methods A61B5/0036 takes precedence
• CPC Class Codes: A61B 5/4848 Monitoring or testing the effects of treatment, e.g. of medication
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61K 49/0034 Indocyanine green, i.e. ICG, cardiogreen
• CPC Class Codes: A61M 5/007 for contrast media

Abstract

Method for assessing the patency of a patient'"'"'s blood vessel, advantageously during or after treatment of that vessel by an invasive procedure, comprising administering a fluorescent dye to the patient; obtaining at least one angiographic image of the vessel portion; and evaluating the at least one angiographic image to assess the patency of the vessel portion. Other related methods are contemplated, including methods for assessing perfusion in selected body tissue, methods for evaluating the potential of vessels for use in creation of AV fistulas, methods for determining the diameter of a vessel, and methods for locating a vessel located below the surface of a tissue.

Claims

1. A method for assessing blood flow moving through a vessel graft anastomosed in fluid communication with an interconnected group of blood vessels in an animal, the vessel graft and at least a portion of the blood vessels being exposed during a surgical procedure on the animal, the method comprising the steps of:

(a) administering a fluorescent dye to the animal such that the dye enters the vessel graft and the interconnected group of blood vessels;

(b) exciting the fluorescent dye within the vessel graft and said exposed portion of the interconnected group of blood vessels with a source of illumination, thus causing the dye to emit radiation;

(c) capturing the radiation emitted by the fluorescent dye with a camera capable of imaging a series of angiographic images within the vessel graft and said exposed portion of the interconnected group of blood vessels, the images including at least an image of a fluorescent wavefront corresponding to an interface between the flowing blood that first contains the fluorescent dye introduced, such image being captured by the camera as the fluorescent wavefront transitions through the exposed vessel graft and interconnected croup of blood vessels; and

(d) evaluating the angiographic images to assess blood flow through the vessel graft relative to blood flow through the interconnected group of blood vessels.

2. The method of claim 1, further comprising:

modifying said anastomosed vessel graft based on results of said evaluating step, thereby improving resultant blood flow through said vessel graft.

3. A method for assessing blood flow moving through an vessel graft in an animal, the vessel graft being exposed during a surgical procedure on the animal, comprising the steps of:

(a) administering a fluorescent dye to the animal such that the dye enters the vessel graft;

(b) exciting the fluorescent dye within the vessel graft with a source of illumination, thus causing the dye to emit radiation, the fluorescent dye having a peak absorption and emission in the range of 800 to 850 nm;

(c) capturing the radiation emitted by the fluorescent dye with a camera capable of imaging a series of angiographic images of the vessel graft at a rate of at least 15 images per second while the subject'"'"'s heart is beating, the images including at least an image of a fluorescent wavefront corresponding to an interface between the flowing blood that first contains the fluorescent dye introduced, such image being captured by the camera as the fluorescent wavefront transitions through the exposed vessel graft; and

(d) evaluating the angiographic images to assess blood flow through the vessel graft relative to blood flow through a group of blood vessels interconnected to the vessel graft.