High speed elastographic property mapping of lumens utilizing micropalpation delivered from an OCT-equipped catheter tip

• US 9,138,148 B2
• Filed: 10/31/2011
• Issued: 09/22/2015
• Est. Priority Date: 04/13/2011
• Status: Active Grant

• Current Assignee: St Jude Medical Incorporated (Abbott Laboratories Incorporated)
• Original Assignee: St Jude Medical Incorporated (Abbott Laboratories Incorporated)
• Inventors: Sliwa, John, Liu, Yu
• Primary Examiner(s): EVOY, NICHOLAS LANE
• Application Number:
  US13/285,167
• Publication Number:
  US 20120265061A1
• Time in Patent Office: 1,422 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 5/0053 by applying pressure, e.g. compression, indentation, palpation, grasping, gauging
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 8/485 involving measuring strain or elastic properties
• CPC Class Codes: A61M 25/007 Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked

Abstract

A method for performing elastographic deformation mapping of tissues and plaques comprises: introducing a distal portion of a catheter to an interior of an interior body of a patient; applying, from a palpator in the distal portion, one of a directed fluid or a mechanical indenter to produce a surface-applied palpation force to a target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface and subsurface tissues and plaques; and directing and delivering an OCT (optical coherence tomography) beam, from an OCT imaging sensor in the distal portion, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

Claims

1. A method for performing elastographic deformation mapping of tissues and plaques, the method comprising:

introducing a distal portion of a catheter to an interior of an interior body of a patient, the catheter including an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis, the catheter body including the distal portion at the distal end and a catheter lumen from the proximal end to the distal end, the distal portion including a supporting member;

applying, from a palpator in the distal portion, a mechanical indenter pin, to move the mechanical indenter pin axially along a longitudinal axis of the mechanical indenter pin relative to the distal portion, to contact the target area of the interior body, to produce a surface-applied palpation force to the target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface or subsurface tissues or plaques; and

directing and delivering an OCT (optical coherence tomography) beam, from an OCT imaging sensor in the distal portion, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area;

wherein the mechanical indenter pin is moved axially along the longitudinal axis of the mechanical indenter pin, relative to the distal portion, by the supporting member in the distal portion.

2. The method of claim 1,

wherein the OCT beam emanates from an opening along the longitudinal axis of the mechanical indenter pin.

3. The method of claim 1,

wherein the palpation force has a palpation force vector, and the palpation force vector and the OCT beam are substantially concentric.

4. The method of claim 1, further comprising:

providing a closed balloon around the distal portion, filling the closed balloon with a liquid that is transparent to OCT wavelengths, and inflating the closed balloon against a surface of the interior body.

5. The method of claim 4,

wherein the applying and the directing and delivering are performed through a balloon wall of the balloon.

6. The method of claim 1, further comprising:

inflating a balloon to bias the mechanical indenter pin against the target area of the interior body.

7. The method of claim 1, further comprising:

performing, from an acoustic imaging transducer in the distal portion, ultrasonic imaging of the target area.

8. The method of claim 1, further comprising:

synchronizing the palpation force and the OCT beam to perform OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the one or more surface or subsurface tissues or plaques.

9. The method of claim 1, further comprising:

determining displacement of the target area resulting from delivery of the palpation force.

10. The method of claim 1, further comprising:

performing OCT deformation detection in a manner which takes into account any simultaneous deformations due to blood flow or perfusion.

11. The method of claim 1, wherein directing and delivering the OCT beam for OCT deformation detection produces optical spectroscopic information including elastographic deformation measurement, the method further comprising:

implementing an additional optical analytical modality utilizing at least some common portion of the OCT beam'"'"'s optical path to produce additional optical spectroscopic information.

12. The method of claim 11, further comprising:

providing compositional mapping of the target area using both the elastographic deformation measurement and the additional optical spectroscopic information in combination.

13. The method of claim 1, further comprising:

changing orientation of the OCT beam and the palpation force to be directed to different target areas of the interior body.

14. The method of claim 13, further comprising:

providing three dimensional mapping of the one or more surface or subsurface tissues or plaques of the interior body based on OCT deformation detection including elastographic deformation measurement by the OCT imaging sensor of the different target areas of the interior body.

15. The method of claim 1,

wherein deformations detected in the OCT deformation detection include both temporary deformations and permanent plastic deformations, the temporary deformations being at least one of elastic or viscoelastic.

16. A method for performing elastographic deformation mapping of tissues and plaques, the method comprising:

introducing a catheter to an interior of an interior body of a patient, the catheter including an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis;

applying, from the catheter, a mechanical indenter pin, to move the mechanical indenter pin axially along a longitudinal axis of the mechanical indenter pin relative to the catheter body, to contact the target area of the interior body, to produce a surface-applied palpation force to the target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface or subsurface tissues or plaques; and

directing and delivering an OCT (optical coherence tomography) beam, from the catheter, for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area;

wherein the mechanical indenter pin is moved axially along the longitudinal axis of the mechanical indenter pin, relative to the catheter body, by a pressure activated membrane in the catheter body.

17. The method of claim 16,

wherein the OCT beam emanates from an opening along the longitudinal axis of the mechanical indenter pin.

18. An optical coherence tomography (OCT) catheter for performing elastographic deformation mapping of tissues and plaques of an interior body, the OCT catheter comprising:

a catheter having an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis, the catheter body including a distal portion at the distal end and a catheter lumen from the proximal end to the distal end, the distal portion including a supporting member;

a mechanical indenter pin disposed in the distal portion, the mechanical indenter pin being movable axially along a longitudinal axis of the mechanical indenter pin relative to the distal portion, by the supporting member in the distal portion, to contact a target area of the interior body, to produce a surface-applied palpation force to the target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface or subsurface tissues or plaques; and

an OCT imaging sensor, disposed in the distal portion, to direct and deliver an OCT beam for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

19. The OCT catheter of claim 18, further comprising:

a closed balloon disposed around the distal portion and being filled with a liquid that is transparent to OCT wavelengths;

wherein the closed balloon is inflatable against a surface of the interior body.

20. The OCT catheter of claim 18, further comprising:

a balloon which is inflatable to bias the mechanical indenter pin against the target area of the interior body.

21. The OCT catheter of claim 18,

wherein the mechanical indenter pin includes an opening along the longitudinal axis of the mechanical indenter pin through which the OCT imaging sensor directs the OCT beam.

22. An optical coherence tomography (OCT) catheter for performing elastographic deformation mapping of tissues and plaques of an interior body, the OCT catheter comprising:

a catheter having an elongated catheter body extending longitudinally between a proximal end and a distal end along a longitudinal axis, the catheter body including a distal portion at the distal end and a catheter lumen from the proximal end to the distal end;

a mechanical indenter pin disposed in the distal portion, the mechanical indenter pin being movable axially along a longitudinal axis of the mechanical indenter pin relative to the catheter body, by a pressure activated membrane in the catheter body, to contact a target area of the interior body, to produce a surface-applied palpation force to the target area of the interior body to mechanically displace the interior body and cause elastographic deformation of the target area of one or more surface or subsurface tissues or plaques; and

an OCT imaging sensor, disposed in the distal portion, to direct and deliver an OCT beam for OCT deformation detection including elastographic deformation measurement to provide elastographic mapping of the target area.

23. The OCT catheter of claim 22, further comprising:

a closed balloon disposed around the distal portion and being filled with a liquid that is transparent to OCT wavelengths;

wherein the closed balloon is inflatable against a surface of the interior body.

24. The OCT catheter of claim 22,

wherein the mechanical indenter pin includes an opening along the longitudinal axis of the mechanical indenter pin through which the OCT imaging sensor directs the OCT beam.