Occlusion-crossing devices, atherectomy devices, and imaging

• US 9,345,406 B2
• Filed: 11/13/2012
• Issued: 05/24/2016
• Est. Priority Date: 11/11/2011
• Status: Active Grant

• Current Assignee: Avinger Inc.
• Original Assignee: Avinger Inc.
• Inventors: Spencer, Maegan K., Simpson, John B., Davies, Stephen C.
• Primary Examiner(s): Le, Long V
• Assistant Examiner(s): Weatherby, Ellsworth
• Application Number:
  US13/675,867
• Publication Number:
  US 20130123615A1
• Time in Patent Office: 1,288 Days
• US Class Current: 1/1
• CPC Class Codes: A61B 17/00234 for minimally invasive surgery A61B17/0218, A61B17/0469, A61B17/12013, A61B17/1285, A61B17/29, A61B17/320016 take precedence
• CPC Class Codes: A61B 17/320725 with radially expandable cutting or abrading elements A61B17/32075 takes precedence
• CPC Class Codes: A61B 17/320758 with a rotating cutting instrument, e.g. motor driven A61B17/320725, A61B17/32075 and A61B17/320783 take precedence; for removing intra-ocular material A61F9/00763; endoscopic rotatable cutting instruments A61B17/32002
• CPC Class Codes: A61B 2017/00296 mounted on an endoscope
• CPC Class Codes: A61B 2017/22068 Centering
• CPC Class Codes: A61B 2034/2055 Optical tracking systems
• CPC Class Codes: A61B 2034/2065 Tracking using image or pattern recognition
• CPC Class Codes: A61B 2090/306 using optical fibres
• CPC Class Codes: A61B 2090/3614 using optical fibre
• CPC Class Codes: A61B 2090/3735 Optical coherence tomography [OCT]
• CPC Class Codes: A61B 2217/007 with irrigation system
• CPC Class Codes: A61B 2562/0233 Special features of optical sensors or probes classified in A61B5/00
• CPC Class Codes: A61B 34/20 Surgical navigation systems; Devices for tracking or guiding surgical instruments, e.g. for frameless stereotaxis
• CPC Class Codes: A61B 5/0062 Arrangements for scanning
• CPC Class Codes: A61B 5/0066 Optical coherence imaging
• 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 5/6852 Catheters
• CPC Class Codes: A61B 6/12 Arrangements for detecting or locating foreign bodies
• CPC Class Codes: A61B 6/487 involving fluoroscopy
• CPC Class Codes: A61B 90/37 : Surgical systems with images on a monitor during operation
• CPC Class Codes: A61B 90/39 : Markers, e.g. radio-opaque or breast lesions markers

Abstract

Described herein are methods for producing and identifying characteristic (“crescent shaped”) regions indicative of an atherectomy plaque within a vessel, and systems and devices adapted to take advantage of this characteristic region.

Claims

1. A method of identifying a plaque mass within a vessel, the method comprising:

inserting a device into the vessel, the device applying a force on the vessel to cause the vessel wall to stretch away from the device;

imaging the vessel to create an image;

identifying a location and orientation of a plurality of pointed crescent-shaped structures extending radially from a substantially semi-circular central portion in the image, the substantially semi-circular central portion having a substantially rounded portion and a substantially linear portion, each pointed crescent-shaped structure extending from a junction of the substantially rounded portion and the substantially linear portion; and

determining a position of the plaque mass within the vessel relative to the device based upon the identified location and orientation of the pointed crescent-shaped structures in the image.

2. The method of claim 1, wherein imaging the vessel comprises imaging the vessel with optical coherence tomography.

3. The method of claim 1, wherein imaging the vessel comprises imaging with an imaging sensor attached to the device.

4. The method of claim 3, further comprising orienting the device within the vessel based on the location and orientation of the crescent-shaped structures.

5. The method of claim 4, wherein orienting the device comprises pointing a directional cutter of the device at the position of the plaque mass.

6. The method of claim 4, wherein orienting the device comprises directing the device based upon the relationship between markers in the image created by a portion of the device and the location and orientation of the crescent-shaped structures.

7. The method of claim 3, further comprising rotating the imaging sensor to obtain the image.

8. The method of claim 1, wherein identifying a location and orientation of a plurality of pointed crescent-shaped structures comprises determining which direction a tip of each crescent-shaped structure points.

9. The method of claim 8, wherein determining a position of the plaque mass comprises identifying a location between two pointed crescent-shaped structures in which the tips of the two pointed crescent-shaped structures point towards one another.