JP7171663B2 - ステント内再狭窄予測のためのデバイス、システム、及び方法 - Google Patents
ステント内再狭窄予測のためのデバイス、システム、及び方法 Download PDFInfo
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- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/12—Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/0059—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence
- A61B5/0082—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes
- A61B5/0084—Measuring for diagnostic purposes; Identification of persons using light, e.g. diagnosis by transillumination, diascopy, fluorescence adapted for particular medical purposes for introduction into the body, e.g. by catheters
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- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
- A61B5/02007—Evaluating blood vessel condition, e.g. elasticity, compliance
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
- A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
- A61B5/6852—Catheters
- A61B5/6853—Catheters with a balloon
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B8/04—Measuring blood pressure
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- A—HUMAN NECESSITIES
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- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
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- A61B8/065—Measuring blood flow to determine blood output from the heart
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- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
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- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0833—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
- A61B8/085—Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures for locating body or organic structures, e.g. tumours, calculi, blood vessels, nodules
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- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0883—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of the heart
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/08—Detecting organic movements or changes, e.g. tumours, cysts, swellings
- A61B8/0891—Detecting organic movements or changes, e.g. tumours, cysts, swellings for diagnosis of blood vessels
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/46—Ultrasonic, sonic or infrasonic diagnostic devices with special arrangements for interfacing with the operator or the patient
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/52—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/5215—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data
- A61B8/5223—Devices using data or image processing specially adapted for diagnosis using ultrasonic, sonic or infrasonic waves involving processing of medical diagnostic data for extracting a diagnostic or physiological parameter from medical diagnostic data
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/82—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/844—Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents folded prior to deployment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/95—Instruments specially adapted for placement or removal of stents or stent-grafts
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/44—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device
- A61B8/4444—Constructional features of the ultrasonic, sonic or infrasonic diagnostic device related to the probe
- A61B8/445—Details of catheter construction
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Description
Claims (16)
- ステント留置組立体を含むカテーテルを血管の内腔内の病変の部位に位置付け、前記ステント留置組立体を作動させて、ステントを前記血管の前記内腔内の前記病変の前記部位に留置することにより、患者内の血管を治療するためのシステムの作動方法であって、前記方法は、
前記血管内に位置付けられた血管内超音波(IVUS)撮像トランスデューサと通信する処理デバイスが、再狭窄の可能性があるかどうかを決定するステップであって、
前記処理デバイスが、前記IVUS撮像トランスデューサを制御して、超音波を放射し、前記超音波と関連するエコーを受信することと、
前記処理デバイスが、受信した前記エコーに基づいて、前記病変の前記部位における前記ステントのIVUS撮像データを得ることと、
前記処理デバイスが、前記IVUS撮像データを処理して、前記血管の直径及び前記ステントの展開サイズを計算することと、
前記処理デバイスが、計算された前記ステントの前記展開サイズを、計算された前記血管の前記直径と比較することと、
を含む、再狭窄の可能性があるかどうかを決定するステップと、
再狭窄の可能性があることを決定することに応じて、前記処理デバイスに結合されたディスプレイが、前記再狭窄の可能性があることを示す告知を臨床医に伝えるステップと、
を含む、方法。 - 前記IVUS撮像データを得ることは、前記IVUS撮像トランスデューサが前記血管を通って引き戻される際に、前記IVUS撮像トランスデューサを用いて前記IVUS撮像データを得ることを含む、請求項1に記載の方法。
- 前記IVUS撮像データは、組織の情報を含む、請求項2に記載の方法。
- 前記再狭窄の可能性があるかどうかを決定するステップは、
前記部位における組織の種類、
前記部位におけるプラークの存在、
前記ステントの種類、
前記血管内における前記ステントの部位、又は
圧力測定値若しくは流量測定値の少なくとも一方に基づく前記ステントの性能
のうちの少なくとも1つを決定することを更に含む、請求項1に記載の方法。 - 前記計算された前記ステントの展開サイズを、前記計算された前記血管の直径と比較することは、前記計算された前記血管の直径に対する前記ステントの展開サイズを百分率で計算することを含み、前記再狭窄の可能性があるかどうかを決定するステップは、前記ステントの前記百分率で計算された展開サイズが閾値を超えるかどうかを決定することを含む、請求項1に記載の方法。
- 前記告知は、視覚的告知又は音声告知のうちの少なくとも一方を含む、請求項5に記載の方法。
- 前記再狭窄の可能性があるかどうかを決定するステップは、前記病変の前記部位における前記ステントの展開不足を検出することを含む、請求項1に記載の方法。
- 前記ディスプレイが、前記ステントを再展開することにより前記病変の前記部位における前記ステントの前記展開不足に対処することの推奨を前記臨床医に提供するステップを更に含む、請求項7に記載の方法。
- 前記ディスプレイが、切除デバイスにより前記病変の前記部位からプラークの一部を除去する切除プロセスにより前記ステントの前記展開不足に対処することの推奨を前記臨床医に提供するステップを更に含む、請求項7に記載の方法。
- 前記IVUS撮像データを処理して、前記ステントの前記展開サイズを計算することは、前記ステントの断面積を計算することを含み、前記再狭窄の可能性があるかどうかを決定するステップは、前記ステントの前記断面積に基づいて、前記再狭窄の可能性があるかどうかを決定することを含む、請求項1に記載の方法。
- 命令を記憶するための非一時的コンピュータ可読媒体と、
前記非一時的コンピュータ可読媒体及び血管内超音波(IVUS)撮像カテーテルと通信する処理デバイスとを備える、医療診断及び治療システムであって、前記処理デバイスは、
患者の血管の内腔内のステントの留置部位にある前記IVUS撮像カテーテルによって得られるIVUS撮像データを受信することであって、前記留置部位は前記血管の病変の位置に対応する、受信することと、
受信された前記血管の前記内腔内の前記ステントのIVUS撮像データに基づいて、前記血管の直径及び前記ステントの展開サイズを計算することと、
計算された前記ステントの前記展開サイズを、計算された前記血管の前記直径と比較することと、
前記ステントの前記展開サイズの前記計算された前記血管の直径との比較に基づいて、再狭窄の可能性があるかどうかを決定することと、
前記処理デバイスに結合されたディスプレイに、前記再狭窄の可能性があるかどうかを通信する情報を前記医療診断及び治療システムの操作者に送信することと、
を含む動作を遂行するための前記命令を実行する、医療診断及び治療システム。 - 前記ディスプレイを更に備える、請求項11に記載の医療診断及び治療システム。
- 前記動作が、
前記ステントが展開不足かどうかを決定することと、
前記ステントが展開不足であると決定されると、前記ディスプレイに、推奨されるインターベンションを表示させることと、
を更に含む、請求項11に記載の医療診断及び治療システム。 - 前記再狭窄の可能性があるかどうかを決定することは、前記IVUS撮像カテーテルの非撮像センサによって得られた非撮像データを受信することを更に含み、前記非撮像データは、前記血管内の血液の圧力又は流量のうちの少なくとも一方を表す、請求項11に記載の医療診断及び治療システム。
- 前記再狭窄の可能性があるかどうかを通信する前記情報は、定量的記述又は定性的記述のうちの少なくとも一方を含む、請求項11に記載の医療診断及び治療システム。
- 前記処理デバイスが、前記ステントの直径を計算することにより前記ステントの前記展開サイズを計算することを含む前記動作を遂行し、
前記血管の前記直径は、前記病変の近傍の直径、前記病変の近位の直径、又は前記病変の遠位の直径のうちの少なくとも1つを含み、
前記ステントの前記直径は、近位端部直径又は遠位端部直径のうちの少なくとも一方を含む、請求項11に記載の医療診断及び治療システム。
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US11980778B2 (en) | 2023-05-02 | 2024-05-14 | Histosonics, Inc. | Histotripsy systems and methods |
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EP4230262A3 (en) | 2015-06-24 | 2023-11-22 | The Regents Of The University Of Michigan | Histotripsy therapy systems for the treatment of brain tissue |
WO2016207762A1 (en) | 2015-06-25 | 2016-12-29 | Koninklijke Philips N.V. | Interactive intravascular procedure training and associated devices, systems, and methods |
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