JP2017503585A - 動脈瘤修復に関連するエンドリークの検出 - Google Patents
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Abstract
Description
本願は、2014年1月10日に出願された米国仮特許出願第61/925,939号、及び2014年1月10日に出願された米国仮特許出願第61/925,996号について優先権の利益を主張するものであり、これら各文献の内容は、参照することにより本明細書に組み込まれる。
I型のエンドリークは、グラフトの取付け部位での不十分なシールの結果として発生する。これは、基端部又は先端部で起こり得る。血流が、グラフトに沿って動脈瘤嚢内に漏れる。それらI型のエンドリークは、大抵の場合、EVARの手術に適さない患者(動脈瘤)の選択や装置の選択の結果であるが、グラフトが移動する場合に発生することがあり得る。I型のリークは、それらI型のリークが自然に消散する傾向がないので、常に重要であるとみなされる。
瞬間無波比(iFR)は、診断分類における血流予備量比(FFR)に相当する冠動脈狭窄の血行動態重症度の血管拡張剤フリーの圧力のみの尺度である。
I型の漏れは、一般的に、検出されると直ぐに治療される。伸長カフ又は被覆されたステントは、シールを改善するために、グラフトの漏れが生じている端部に挿入することができ、又は接着剤又はコイルを用いて漏れ部位の塞栓生じさせることができる。まれに、EVARの手術中にこの漏れが検出された場合に、観血手術への変更は、漏れをシールする血管内の方法が不成功となった場合に、必要となり得る。
III型の漏れ(グラフト機械的な故障)は、自然治癒によって消散されないため、通常は追加のステントグラフト部品を用いて直ぐに治療される。
IV型の漏れ(グラフトの多孔度)は、装置の選択を改善すること以外に治療することができない。
特許公報、特許出願、特許公開公報、雑誌、書籍、論文、ウェブコンテンツ等の他の文献への参照及び引用について、本開示全体に亘って行ってきた。このような全ての文献は、全ての目的のためにそれら全体を参照することにより本明細書に組み込まれる。
本明細書に示し且つ説明したものに加えて、本発明の修正及び多くの更なる実施形態の修正は、本明細書に引用される科学文献及び特許文献への参照を含む本文書の全内容から当業者に明らかになるであろう。本明細書の主題は、その様々な実施形態及びその均等物において本発明の実施に応用することができる重要な情報、例示及びガイダンスを含む。
Claims (19)
- 大動脈手術のためのシステムであって、当該システムは、
大動脈から血管内画像データを取り込むように構成された撮像プローブと、
前記大動脈内の流体特性を測定するように構成されたセンサと、
前記血管内画像データ及び前記流体特性を位置合わせし、前記大動脈の断面及びその動脈内の流体の流動特性を表す出力を提供する制御システムであって、該制御システムは、前記位置合わせされた画像データ及び流体特性に基づいて、大動脈修復手術に関連したエンドリークを検出するようにさらに構成される、
システム。 - 前記制御システムは、前記測定した流体特性を期待値と比較して、前記エンドリークを検出するように構成される、
請求項1に記載のシステム。 - 前記期待値は、前記センサを用いて取得される、
請求項2に記載のシステム。 - 前記制御システムは、前記大動脈を含む血管造影像を受信するとともに、該血管造影像を、前記出力された前記大動脈の断面と位置合わせするようにさらに構成される、
請求項1に記載のシステム。 - 前記出力は、前記断面と、前記血管造影像と、前記流動特性と、前記断面、前記血管造影像、及び前記流動特性の間の少なくとも1つの空間的関係を示すしるしと、を含む表示を含む、
請求項4に記載のシステム。 - 表示は、前記断面、前記血管造影像、及び前記流動特性を含む表示を含み、前記表示は、前記断面、前記血管造影像、前記流動特性の間の空間的関係をさらに示す、
請求項4に記載のシステム。 - 前記撮像プローブは、血管内超音波(IVUS)トランスデューサを含む、
請求項1に記載のシステム。 - 前記撮像プローブは、15メガヘルツ(MHz)未満の周波数の超音波によって前記血管内画像データを取り込むように構成される、
請求項7に記載のシステム。 - 前記周波数は、9MHz〜11MHzの間であり、示される前記流動特性は、速度である、
請求項8に記載のシステム。 - 前記制御システムは、前記血管内画像データ及び測定値から、空間的及び時間的に前記大動脈及び前記流体の一部の位置を決定し、前記大動脈を表す4Dモデルを構築し、及び該4Dモデルを前記出力に含めるように構成される、
請求項1に記載のシステム。 - 大血管を検査する方法であって、当該方法は、
血管から血管内画像データを取得するステップと、
前記血管内の流体特性の測定データを取得するステップと、
コンピュータシステムを用いて、前記血管内画像データを前記測定データと位置合わせするステップと、
該位置合わせされた画像データ及び測定データに基づいて、大動脈の特徴及びその大動脈内の流体の流動特性を示す出力を提供するステップと、
前記位置合わせしたデータに基づいて、大動脈修復手術に関連したエンドリークを検出するステップと、を含む、
方法。 - 前記エンドリークを検出するステップは、測定値を予想される測定値と比較するステップを含む、
請求項11に記載の方法。 - 前記血管は大動脈であり、当該方法は、
前記大動脈を含む血管造影画像を取得するステップと、
該血管造影画像を前記出力に含めるステップと、をさらに含む、
請求項11に記載の方法。 - 前記血管内画像と、前記血管造影画像と、前記流動特性と、前記血管内画像、前記血管造影画像、及び前記流動特性の間の少なくとも1つ空間的関係を示すマーカーと、を表示させるステップをさらに含む、
請求項13に記載の方法。 - 前記血管内画像、前記血管造影画像、及び前記流動特性を表示するステップと、
前記血管内画像、前記血管造影画像、及び前記流動特性の間の空間的関係を示すステップと、をさらに含む、
請求項13に記載の方法。 - 前記血管は、大動脈であり、前記血管内画像データを取得するステップは、前記大動脈内で血管内超音波操作を行うステップを含む、
請求項11に記載の方法。 - 15MHz未満の周波数で前記超音波操作を行うステップをさらに含む、
請求項16に記載の方法。 - 前記周波数は、9MHz〜11MHzの間であり、前記流動特性は、速度である、
請求項17に記載の方法。 - 前記血管内画像データ及び測定値から、空間的に及び時間的に前記血管及び前記流体の一部の位置を決定し、前記血管を表す4Dモデルを構築し、及び該4Dモデルを前記出力に含めるステップをさらに含む、
請求項11に記載の方法。
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201461925996P | 2014-01-10 | 2014-01-10 | |
US201461925939P | 2014-01-10 | 2014-01-10 | |
US61/925,939 | 2014-01-10 | ||
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