System and method of adventitial tissue characterization

• US 9,592,027 B2
• Filed: 03/14/2014
• Issued: 03/14/2017
• Est. Priority Date: 03/14/2013
• Status: Active Grant

• Current Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Original Assignee: Volcano Corporation (Koninklijke Philips N.V.)
• Inventors: Nair, Anuja
• Primary Examiner(s): Lefkowitz, Sumati
• Assistant Examiner(s): Wang, Carol
• Application Number:
  US14/212,451
• Publication Number:
  US 20140270430A1
• Time in Patent Office: 1,096 Days
• Field of Search: None
• US Class Current: 1/1
• CPC Class Codes: A61B 17/22 Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for dilators A61M29/00
• CPC Class Codes: A61B 18/1492 having a flexible, catheter-like structure, e.g. for heart ablation A61B18/1477 takes precedence
• CPC Class Codes: A61B 2017/22094 for crossing total occlusions, i.e. piercing
• CPC Class Codes: A61B 2018/0041 Removal of thrombosis
• CPC Class Codes: A61B 2018/00577 Ablation
• CPC Class Codes: A61B 2018/00982 combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes
• CPC Class Codes: A61B 8/085 for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
• CPC Class Codes: A61B 8/0891 for diagnosis of blood vessels
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61B 8/463 characterised by displaying multiple images or images and diagnostic data on one display composite display in devices for short-range imaging with acoustic waves G01S7/52074
• CPC Class Codes: A61B 8/5215 involving processing of medical diagnostic data
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Disclosed herein is a system and method for characterizing adventitial tissue. In one aspect, a system and method is disclosed that characterizes tissue types within the adventitial tissue including nerve bundles and blood vessels. In a further aspect, the adventitia is imaged and characterized to provide guidance for crossing lesions within an occluded vessel.

Claims

1. A method, comprising:

inserting an intravascular imaging device into a lumen of a vessel;

receiving, at a computing device in communication with the intravascular imaging device, imaging data representative of the vessel including surrounding adventitial tissue after therapy within the vessel, the imaging data obtained by the intravascular imaging device while positioned in the lumen of the vessel;

performing, using the computing device, tissue characterization to identify therapeutically treated tissue and one or more tissue characteristics within the adventitial tissue resulting from the therapy by comparing and matching signal properties of the imaging data to pre-determined signal properties of a plurality of tissue components including therapeutically treated tissue characteristics, wherein the therapeutically treated tissue characteristics include a plurality of ablation levels; and

outputting, to a display device in communication with the computing device, an image of the vessel to a user, wherein the outputting includes displaying, within the image of the vessel, the therapeutically treated tissue and the one or more tissue characteristics within the adventitial tissue resulting from the therapy.

2. The method of claim 1, wherein the tissue characterization includes identifying nerve bundles within the adventitial tissue.

3. The method of claim 2, wherein imaging includes imaging the adventitia and the perivascular tissue surrounding an artery, and the identifying includes identifying nerve bundles within the perivascular tissue.

4. The method of claim 1, wherein the displaying includes displaying an axial cross section of the vessel showing tissue characterization within the adventitial tissue.

5. The method of claim 1, wherein displaying includes displaying a longitudinal cross sectional view of the vessel showing tissue characterization within the adventitial tissue.

6. The method of claim 1, further including identifying areas of adventitial tissue impacted by the therapy.

7. The method of claim 6, wherein said areas include nerve bundles.

8. The method of claim 1, further including performing a first imaging of the vessel and first tissue characterization of the adventitial tissue of the vessel, conducting a therapy on the vessel, performing a second imaging of the vessel and second tissue characterization of the adventitial tissue of the vessel, comparing the first and second tissue characterizations and displaying the differences to the user.

9. The method of claim 1, wherein the tissue characterization includes identifying vasa vasorum in the adventitial tissue of the vessel.

10. The method of claim 9, wherein the displaying includes displaying an axial cross section of the vessel showing the vasa vasorum within the adventitial tissue.

11. The method of claim 9, wherein displaying includes displaying a longitudinal cross sectional view of the vessel showing the vasa vasorum within the adventitial tissue.

12. The method of claim 9, further including displaying tissue characteristic information for other portions of the vessel.

13. The method of claim 12, wherein the other tissue characteristics include plaque within the artery.

14. The method of claim 9, further including providing information to the user on the length of enhanced vasa vasorum growth along the length of the blood vessel.

15. The method of claim 14, further including determining a stent length at least in part of the detected vasa vasorum growth adjacent a lesion.

16. The method of claim 9, further including imaging a vessel including a stent, characterizing the adventitial tissue adjacent the stent to determine vasa vasorum growth, and evaluating vessel health adjacent the stent based on the vasa vasorum growth.

17. The method of claim 1, wherein the tissue characterization includes identifying muscle tissue within the adventitial tissue of the vessel.

18. The method of claim 17, wherein the displaying includes displaying an axial cross section of the vessel showing the muscle tissue within the adventitial tissue.

19. The method of claim 17, wherein the displaying includes displaying a longitudinal cross sectional view of the vessel showing the muscle tissue within the adventitial tissue.

20. The method of claim 17, wherein the tissue characterization includes identifying a border between the adventitial tissue and overlying muscle tissue.

21. The method of claim 1, further including imaging a stent disposed in the vessel and comparing the sensed image data to a data base of know stent patterns.

22. The method of claim 21, further including subtracting a stent image from the vessel image to permit better display of tissue characterization.

23. The method of claim 21, further including comparing stent image return echoes to a data base of known stent patterns and displaying detected deviations between the sensed stent image and the data base stent patterns.

24. The method of claim 23, wherein the stent includes one or more bioresorbable materials and displaying detected deviations includes displaying changes based in the resorbable stent material.

25. The method of claim 21, further including evaluating the stent for the development of plaques on the stent and displaying the detected plaques to a user.

26. The method of claim 21, further including evaluating the placement of stent struts against the interior of the vessel.

27. The method of claim 1, wherein the pre-determined signal properties includes at least two or more of:

a first signal property representative of minimally ablated tissue, a second signal property representative of moderately ablated tissue, a third signal property representative of majorly ablated tissue, or a fourth signal property representative of completely ablated tissue.

28. The method of claim 1, wherein the outputting further includes displaying a graphical representation of the tissue characterization including the therapeutically treated tissue characteristics.

29. A system for adventitial tissue characterization, the system including:

a data base of known signal properties representative of tissue components including therapeutically treated tissue characteristics within a vessel including an adventitia, wherein the therapeutically treated tissue characteristics include a plurality of ablation levels;

an intravascular imaging device sized and shaped to be positioned in a lumen of a vessel, the intravascular imaging device including a sensor for collecting imaging data from the vessel including the adventitia; and

a processor in communication with the data base and the intravascular imaging device, the processor configured to;

compare the imaging data obtained while the intravascular imaging device is positioned in the lumen of the vessel after therapy within the vessel to the data base of known signal properties representative of tissue components including therapeutically treated tissue characteristics within the vessel including the adventitia;

determine therapeutically treated tissue and tissue characteristics within the adventitia resulting from the therapy based on the comparison, wherein the therapeutically treated tissue is determined based on one of the therapeutically treated tissue characteristics;

evaluate health of the vessel based on the therapeutically treated tissue and the tissue characteristics within the adventitia resulting from the therapy; and

output, to a display device in communication with the processor, an image of the vessel including the therapeutically treated tissue and the tissue characteristics within the adventitia resulting from the therapy.

30. The system of claim 29, wherein the processor is configured to determine the therapeutically treated tissue by matching a signal property of the imaging data with one of the known signal properties of the tissue components that include one of the therapeutically treated tissue characteristics.

31. The system of claim 30, wherein the known signal properties includes at least two or more of:

a first signal property representative of minimally ablated tissue, a second signal property representative of moderately ablated tissue, a third signal property representative of majorly ablated tissue, or a fourth signal property representative of completely ablated tissue.

32. A method for utilizing tissue characterization in image guided therapy, comprising:

positioning an intravascular imaging device within the lumen of a vessel;

obtaining first imaging data of the vessel including adventitial tissue surrounding at least a portion of the lumen;

performing a first tissue characterization on the first imaging data to identify tissue characteristics within the adventitial tissue;

displaying a first image of the vessel including the tissue characteristics within the adventitial tissue to a user;

obtaining second imaging data of the vessel after therapy is performed on the at least a portion of the lumen, the second imaging data including therapeutically treated tissue and the adventitial tissue surrounding the at least a portion of the lumen;

performing a second tissue characterization on the second imaging data to identify the therapeutically treated tissue and changes in the tissue characteristics within the adventitial tissue resulting from the therapy by comparing and matching signal properties of the second imaging data to pre-determined signal properties of a plurality of tissue components including therapeutically treated tissue characteristics, wherein the therapeutically treated tissue is identified based on one of the therapeutically treated tissue characteristics, wherein the therapeutically treated tissue characteristics include a plurality of ablation levels; and

displaying the second image of the vessel including the therapeutically treated tissue and the changes in the tissue characteristics within the adventitial tissue resulting from the therapy.

33. The method of claim 32, further including:

positioning a therapy device within the lumen of the vessel;

defining a longitudinal direction of the therapy device; and

alerting to the user to the presence of adventitial tissue in the longitudinal direction of the therapy device.

34. The method of claim 32, further comprising changing a longitudinal direction of the device in response to the displaying the first image of the vessel including the tissue characteristics within the adventitial tissue.

35. The method of claim 34, wherein the therapy device is an ablation device and the changing includes changing a longitudinal position or a radial position of the ablation device within the vessel in response to the adventitial tissue characteristics.