Angiosome-based perfusion monitoring system

• US 10,383,533 B2
• Filed: 10/13/2017
• Issued: 08/20/2019
• Est. Priority Date: 07/06/2012
• Status: Active Grant

• Current Assignee: Covidien LP (Medtronic Plc)
• Original Assignee: Covidien LP (Medtronic Plc)
• Inventors: McPeak, Thomas
• Primary Examiner(s): Mallari, Patricia
• Assistant Examiner(s): Portillo, Jairo H
• Application Number:
  US15/783,076
• Publication Number:
  US 20180035904A1
• Time in Patent Office: Days
• Field of Search: None
• CPC Class Codes: A61B 2562/17 Comprising radiolucent components
• CPC Class Codes: A61B 5/02007 Evaluating blood vessel condition, e.g. elasticity, compliance
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/0261 using optical means, e.g. infrared light
• CPC Class Codes: A61B 5/0295 using plethysmography, i.e. measuring the variations in the volume of a body part as modified by the circulation of blood therethrough, e.g. impedance plethysmography
• CPC Class Codes: A61B 5/14551 for measuring blood gases
• CPC Class Codes: A61B 5/7246 using correlation, e.g. template matching or determination of similarity
• CPC Class Codes: A61B 5/7282 Event detection, e.g. detecting unique waveforms indicative of a medical condition A61B5/4094, A61B5/4818, A61B5/349, A61B5/0823 take precedence

Abstract

A compression device includes at least one pressurizable bladder to substantially occlude blood flow into skin capillary beds adjacent to the at least one pressurizable bladder, and a plurality of perfusion sensors. In operation a first-angiosome sensor detects the perfusion parameter of a skin capillary bed in a first angiosome of the limb, and a second-angiosome sensor detects the perfusion parameter of a skin capillary bed in a second angiosome of the limb that is different from the first angiosome. A control circuit maps sensor signals from the first-angiosome sensor to the first angiosome or a first artery of the limb, and maps sensor signals from the second-angiosome sensor to the second angiosome or a second artery of the limb different from the first artery of the limb. For each perfusion sensor, the control circuit determines whether the received sensor signals are indicative of peripheral artery disease.

Claims

1. An angiosome-based perfusion monitoring system comprising:

a compression device sized and shaped for placement on a limb of a subject, the compression device including;

at least one pressurizable bladder configured to exert a suitable compressive force on the limb of the subject when pressurized to substantially occlude blood flow into skin capillary beds adjacent to the at least one pressurizable bladder; and

a plurality of spaced apart perfusion sensors located generally adjacent the at least one bladder, each perfusion sensor of the plurality configured to detect a perfusion parameter of skin capillary beds adjacent the perfusion sensor for quantifying skin capillary bed perfusion and generate a signal indicative of the perfusion parameter,

wherein each perfusion sensor of the plurality is configured to generate a unique identifier signal that indicates a location on the compression device corresponding to the perfusion sensor.

2. The monitoring system of claim 1, further comprising a control circuit configured to map each perfusion sensor of the plurality to an artery based on the identifier signal generated by the respective perfusion sensor.

3. The monitoring system of claim 1, further comprising a control circuit configured to identify an artery that is occluded based on the perfusion parameter detected by a particular perfusion sensor of the plurality of perfusion sensors and the location of the particular perfusion sensor indicated by the respective identifier signal.

4. The monitoring system of claim 1, wherein the at least one pressurizable bladder comprises a plurality of bladders.

5. The monitoring system of claim 4, wherein bladders of the plurality of bladders are selectively inflatable.

6. The monitoring system of claim 4, wherein each bladder of the plurality of bladders is associated with a respective angiosome, and wherein, for each perfusion sensor of the plurality of perfusion sensors, the unique identifier signal generated by the perfusion sensor further indicates the angiosome associated with a respective bladder of the plurality of bladders.

7. The monitoring system of claim 1, further comprising:

a pressure sensor that indicates a pressure of the at least one pressurizable bladder; and

a control circuit configured to pressurize the at least one pressurizable bladder based on the pressure indicated by the pressure sensor.

8. The monitoring system of claim 1, wherein the plurality of perfusion sensors comprise plethysmography sensors.

9. The monitoring system of claim 1, wherein the plurality of perfusion sensors comprise ultra-sound sensors.

10. The monitoring system of claim 1, wherein the plurality of perfusion sensors comprise pulse oximetry sensors.

11. The monitoring system of claim 1, wherein the plurality of perfusion sensors comprise metabolic indicators.

12. The monitoring system of claim 1, wherein the plurality of perfusion sensors comprise bioimpedance sensors.

13. The monitoring system of claim 1, wherein each perfusion sensor of the plurality is configured to send the identifier signal within the signal indicative of the perfusion parameter.

14. The monitoring system of claim 1, further comprising a control device, the control device comprising:

a source of pressurized fluid for introducing into the compression device; and

a control circuit configured to;

pressurize the at least one pressurizable bladder when the compression device is placed on the limb of the subject to substantially occlude blood perfusion in skin capillary beds adjacent to the at last one pressurizable bladder, and depressurize the at least one pressurizable bladder at a first controlled rate after pressurizing the at least one pressurizable bladder,

receive separate sensor signals from the plurality of perfusion sensors during depressurization of the at least one pressurizable bladder, wherein the sensor signals are indicative of perfusion parameters of skin capillary beds adjacent the respective perfusion sensors,

map sensor signals from a first perfusion sensor of the plurality of perfusion sensors to at least one of a first angiosome or a first artery of the limb,

map sensor signals from a second perfusion sensor of the plurality of perfusion sensors to at least one of a second angiosome or a second artery of the limb different from the first artery of the limb, and

determine, for each perfusion sensor, whether the received sensor signals are indicative of peripheral artery disease.

15. An angiosome-based perfusion monitoring system comprising:

a control device including;

a source of pressurized fluid for introducing into a compression device that is configured to be placed on a limb of a subject; and

a control circuit configured to;

pressurize at least one pressurizable bladder of the compression device with the pressurized fluid when the compression device is placed on the limb of a subject to substantially occlude blood perfusion in skin capillary beds adjacent to the at least one pressurizable bladder, and depressurize the at least one pressurizable bladder at a first controlled rate after pressurizing the at least one pressurizable bladder,

receive separate sensor signals from a plurality of perfusion sensors of the compression device during depressurization of the at least one pressurizable bladder, wherein each perfusion sensor of the plurality of perfusion sensors is located generally adjacent the at least one pressurizable bladder and each perfusion sensor of the plurality of perfusion sensors is configured to generate a unique identifier signal that indicates a location on the compression device corresponding to the perfusion sensor, and wherein the sensor signals are indicative of a perfusion parameter of skin capillary beds adjacent the perfusion sensor for quantifying skin capillary bed perfusion,

map sensor signals from a first sensor of the plurality of perfusion sensors to a first artery of the limb,

map sensor signals from a second sensor of the plurality of perfusion sensors to a second artery of the limb, wherein the second artery is different from the first artery, and

determine, for each perfusion sensor, whether the received sensor signals are indicative of peripheral artery disease.

16. The monitoring system of claim 15, wherein the control circuit is further configured to pressurize the at least one pressurizable bladder to a predetermined threshold pressure for a predetermined amount of time.

17. The monitoring system of claim 15, further comprising a user interface display, wherein the control circuit is configured to determine at least one received signal of the received signals is indicative of peripheral artery disease, determine a location of the determined peripheral artery disease based on one or more unique identifier signals from the one or more perfusion sensors that generated the at least one received signal, and generate a graphical rendering of the limb and identify on the graphical rendering the location of the determined peripheral artery disease.

18. The monitoring system of claim 17, wherein the location of the determined peripheral artery disease is within the first artery, wherein the control circuit is configured to generate a name of the first artery on the user interface display.

19. The monitoring system of claim 15, wherein the at least one pressurizable bladder comprises a plurality of bladders, each bladder of the plurality of bladders being associated with a respective angiosome, and wherein, for each perfusion sensor of the plurality of perfusion sensors, the unique identifier signal generated by the perfusion sensor further indicates the angiosome associated with a respective bladder of the plurality of bladders.

20. A method of monitoring for peripheral artery disease, the method comprising:

pressurizing at least one pressurizable bladder of a compression device that is placed on a limb of a subject so as to substantially occlude blood flow into skin capillary beds adjacent the at least one pressurizable bladder;

depressurizing the at least one pressurizable bladder at a controlled rate after pressurizing the at least one pressurizable bladder;

receiving, by a control circuit and during the depressurizing of the at least one pressurizable bladder, a sensor signal from a perfusion sensor of the compression device, the perfusion sensor being located generally adjacent the at least one pressurizable bladder and the sensor signal being indicative of a perfusion parameter of a skin capillary bed located adjacent an artery of the limb;

receiving, by the control circuit, a unique identifier signal from the perfusion sensor, the unique identifier signal indicating a location on the compression device corresponding to the perfusion sensor;

mapping, by the control circuit and using the location as identified by the unique identifier signal, the sensor signal to the artery; and

determining, by the control circuit, the sensor signal is indicative of peripheral artery disease.

21. The method of claim 20, further comprising:

generating, by the control circuit, a graphical rendering of the limb; and

identifying, by the control circuit and on the graphical rendering, the artery as possibly occluded in response to determining that the sensor signal is indicative of peripheral artery disease.

22. The method of claim 21, further comprising generating, by the control circuit, a name of the artery on the graphical rendering.

23. The method of claim 20, wherein the perfusion sensor is a first perfusion sensor, the artery is a first artery, the skin capillary bed is a first skin capillary bed, the sensor signal is a first sensor signal, the unique identifier signal is a first unique identifier signal, and the location is a first location, further comprising:

receiving, by the control circuit and during the depressurizing of the at least one pressurizable bladder, a sensor signal from a second perfusion sensor of the compression device, the second perfusion sensor being located generally adjacent the at least one pressurizable bladder, wherein the second sensor signal is indicative of a perfusion parameter of a second skin capillary bed located adjacent a second artery of the limb that is different from the first artery of the limb;

receiving, by the control circuit, a second unique identifier signal from the second perfusion sensor, the second unique identifier signal indicating a second location on the compression device corresponding to the second perfusion sensor; and

mapping, by the control circuit and using the second location as identified by the second unique identifier signal, the second sensor signal to the second artery.

24. The method of claim 23, further comprising:

determining, by the control circuit, that the second sensor signal is not indicative of peripheral artery disease; and

indicating, by the control circuit, that the second artery is not determined to have possible blockage in response to determining that the second sensor signal is not indicative of peripheral artery disease.

25. The method of claim 20, wherein the at least one pressurizable bladder comprises a plurality of bladders, each bladder of the plurality of bladders being associated with a respective angiosome, and for each perfusion sensor of the plurality of perfusion sensors, the unique identifier signal generated by the perfusion sensor further indicates the angiosome associated with a respective bladder of the plurality of bladders.