WO2004007014A1 - Systeme de fil guide de thermodilution a temps de transit pour mesure de la vitesse de flux sanguin coronaire - Google Patents

Systeme de fil guide de thermodilution a temps de transit pour mesure de la vitesse de flux sanguin coronaire Download PDF

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Publication number
WO2004007014A1
WO2004007014A1 PCT/IB2002/002692 IB0202692W WO2004007014A1 WO 2004007014 A1 WO2004007014 A1 WO 2004007014A1 IB 0202692 W IB0202692 W IB 0202692W WO 2004007014 A1 WO2004007014 A1 WO 2004007014A1
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WO
WIPO (PCT)
Prior art keywords
coronary
guidewire
flow velocity
blood flow
measuring
Prior art date
Application number
PCT/IB2002/002692
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English (en)
Inventor
Karima H. Khalil
Hassan Khalil
Original Assignee
Khalil Karima H
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Khalil Karima H filed Critical Khalil Karima H
Priority to PCT/IB2002/002692 priority Critical patent/WO2004007014A1/fr
Priority to AU2002329507A priority patent/AU2002329507A1/en
Publication of WO2004007014A1 publication Critical patent/WO2004007014A1/fr

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • 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
    • A61B5/6851—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • 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
    • A61B5/026—Measuring blood flow
    • A61B5/0275—Measuring blood flow using tracers, e.g. dye dilution
    • A61B5/028—Measuring blood flow using tracers, e.g. dye dilution by thermo-dilution
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/09—Guide wires
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2210/00—Anatomical parts of the body
    • A61M2210/12—Blood circulatory system
    • A61M2210/125—Heart

Definitions

  • the present invention generally relates to intravascular medical devices used to measure blood flow velocity. More specifically, the present invention relates to intravascular diagnostic devices used to evaluate the state of coronary blood flow and velocity at basal conditions and after induced coronary hyperemia as well as the early and late outcome of coronary intervention procedures.
  • the present invention represents a significant advance in the state of the art. Among other advantages, it offers high degrees of accuracy, safety, and speed of use, cost-to- benefit value and the potential for wider application in other cardiovascular fields.
  • Coronary flow measures have also been measured by X-ray densitometry, which is based on the mean transit time of a contrast medium between a proximal site and a distal site of the vessel.
  • the application of this measurement technique to the coronary artery is complicated by technical problems arising from the continuous motion of the coronary artery, requiring manually positioned windows for the video-densitometric measuring device.
  • determination of the front velocities of the contrast medium required in repeated injections by means of an ECG triggered power injector, during three to five phases of different cardiac cycles and their reconstruction to provide the flow rate pattern during a single cardiac cycle.
  • thermodilution has long been a promising technique in the study of circulation.
  • Fegler in 1957 obtained simultaneous thermodilution curves from two catheter- mounted thermal sensors at the arch and bifurcation of the aorta by injecting room temperature saline solution into the right atrium.
  • thermodilution techniques have rarely been applied to diagnostics of the coronary arteries.
  • the present invention represents both a significant refinement of tested thermodilution techniques, and a promising new method for measurement of coronary velocity and flow.
  • the present invention is a potentially cost effective intravascular guidewire system that is capable of quickly and accurately measuring coronary flow velocity and coronary reserve.
  • the device generates these parameters by establishing the transit time of a thermal signal as it passes downstream with the coronary artery blood flow.
  • the proposed thermodilution guidewire includes an elongated shaft with a floppy tip that is inserted into a segment of interest in the mammalian coronary arteries for purposes of guiding an intervention catheter, scope or other medical device.
  • the preferred embodiment includes several thermal sensors, three of which are described in the present embodiment, consisting of thermocouple measuring junctions, mounted in sequential order at equal predetermined intervals along the terminal segment of the guidewire shaft, at a distance of 10, 25 or 50 mm, proximal to its spring tip.
  • thermocouple Two respective insulated electrical paths of the same materials as the thermal junctions extend from each thermocouple in a helical winding along the length of the guidewire shaft to its proximal end, where each electrical path is joined to one of six separate sleeve electrodes.
  • the shaft and its added components are sheathed in an insulating material suitable for smooth introduction into a human vessel.
  • Each of the six sleeve electrodes located at the guidewire's proximal end is electrically connectable through external cables to its respective reference junction that is maintained at a constant temperature medium.
  • the electrodes are also electrically connected to three separate thermocouple amplifiers, a fast sweep multiple channel color coded monitor, an online programmed computer and a printer.
  • an upstream thermal indicator is introduced at the ostium of the coronary artery in the form of a steady, slow infusion of room temperature saline at 22 degree centigrade over 10-15 second period. This infusion is similar to the standard procedure of flushing a guiding catheter with room temperature saline during coronary interventions.
  • Each temperature oscillation is sequentially detected by the three serially mounted thermal sensors as three consecutive rectified sine waves with a phase shift between them.
  • the degree of phase shift between consecutive waves is an expression of the transit time of blood flow between sequential thermal sensors.
  • This value which is inversely related to the average phasic velocity is directly determined by an online computer programmed to calculate the average flow velocity from the transit time between successive phase shifts.
  • An online multiple channel color coded monitor with adjustable sweep velocity also displays these successive oscillations during the measuring time. The monitor's sweep velocity may be increased to match the fast average phasic velocity met with during measures of fast flow velocity of coronary reserve, and calibrated to give a real-time direct digital readout of these values.
  • the system can determine values for coronary flow volume when the angiographically measured diameter of the segment of interest of the coronary artery is supplied to the computer.
  • the present invention may also determine coronary reserve, which is of particular value during decision making in cases with intermediate coronary stenosis, as well as in determining the immediate and late results of intervention procedures.
  • coronary reserve For the device to determine coronary flow reserve, the value of blood flow velocity is first obtained at basal conditions, and then after inducing maximal coronary flow hyperemia.
  • the rate of return of the trailing end of temperature drop to its original baseline level provides an indirect evaluation of transmyocardial flow velocity.
  • the transit-time guidewire described in the present invention may also be modified to suit the size and flow velocity of the cerebral carotid, renal and other peripheral arteries to provide valuable data on flow velocity and reserve in these vessels.
  • FIG's. 1 a and 1 b are an enlarged side elevational view illustrating (a) the distal segment of the guidewire and its radio opaque spring tip, showing three sequentially positioned thermal sensors with helically wound wires leading from them to (b) the proximal segment of the guidewire showing six sleeve electrodes.
  • FIG. 2 is an enlarged longitudinal sectional view illustrating one of the flattened thermal sensors shown in FIG. 1 and shows the positions of a radio opaque marker along the guidewire shaft and of insulating materials.
  • FIG. 3a is a side plan view of the guidewire showing serially mounted thermal sensors at the side of the radio opaque markers, a spring tip on the distal segment, and six sleeve electrodes on the proximal segment.
  • FIG. 3b is a schematic circuit diagram of the thermal sensors showing the successive position of the three thermal sensors, their associated sleeve electrodes, three thermocouple connectors, three external cables, three reference junctions and three thermocouple DC amplifiers.
  • FIG. 4a is a perspective view of a clamp connector which is located at the proximal end of the guidewire and shows three spring clamp thermocouple connectors electrically connected to respective copper and constantan electrodes mounted on the guidewire.
  • FIG. 4b is a top plan view of the thermocouple connectors shown in FIG. 4b.
  • FIG. 5 is a schematic circuit diagram illustrating the external components that comprise the measuring system of the present invention and shows how a guiding catheter is introduced through the femoral artery of a recumbent patient until the ostium of the coronary artery, with a saline infusion pump connected to the external proximal segment of the guiding catheter.
  • FIG. 6 is a cross-sectional view of one embodiment of the guidewire system, wherein the circuitry of helically coiled wires shown in FIG. 1 is replaced by alternating layers of copper and constantan films with insulating ink film between them and with one interval between two thermal sensors.
  • FIG. 7 is a cross-sectional view of another embodiment of the guidewire system wherein the circuitry of helically coiled wires shown in FIG. 1 is replaced by alternating layers of copper and constantan films with insulating ink film between them and shows two intervals between three thermal sensors.
  • FIG. 8 is a graph of an ECG waveform above one of three predicted ranges of biphasic temperature wave shifts as detected by three serially mounted temperature sensors under different conditions.
  • FIG. 9 is a graph of another one of three predicted ranges of biphasic temperature wave shifts as detected by three serially mounted temperature sensors under different conditions.
  • FIG. 10 is a graph of third one of three predicted ranges of biphasic temperature wave shifts as detected by three serially mounted temperature sensors under different conditions.
  • the preferred embodiment of the present invention comprises an insulated elongated guidewire shaft 10 measuring about 70 inches (180 cm) long and 0.008 inches (0.20 mm) outside diameter (O.D.) Of spring steel wire or an alloy with a degree of flexibility and steerability that is suitable for a coronary artery intervention guidewire.
  • a distal segment of about 1.3 inches (3 cms) in length is tapered to about 0.003 inches (0.075 mm) O.D.
  • a radio opaque spring coil 37 (FIGS. 1 and 3) surrounds this distal segment and is attached at both of its ends to the guidewire shaft by welding or soldering as indicated at 14 and 16.
  • three radio opaque reference markers 18, 20 and 22 are affixed at equal intervals of 15, 25 or 50 mm along the distal segment of the guidewire shaft 10, beginning at a distance of about 5 to 10 mm proximal to its spring tip 12.
  • This segment of the guidewire shaft is then coated to a thickness of about 0.0008 inch (0.020 mm) with a flexible medical grade adhesive polymer coating to serve as an electric insulating spacer 24 (FIG. 2).
  • each of the three thermal sensors comprises of a flattened thermal measuring junction of copper-constantan thermocouple (Type T). These miniature thermal sensors do not obstruct the flow in small vessels and are considered ideal for measuring changes in localized body areas. Their extremely small mass provides an accurate, fast response thermal sensor that is not affected by pressure changes.
  • the thermal sensors may be formed by fusing, electron beam welding or simply by soldering together the two adjacent wires with a high quality solder, conductive silver ink or silver epoxy to form a common junction 34 (FIG. 2).
  • This soldering joint should preferably extend for about 2 to 3 mm along the two adjacent wires, to cover the wires' circumferential winding around the thermally and electrically insulated stainless steel wire shaft 10 and radio opaque marker 12 (FIG. 2).
  • the high thermal conductivity of silver-containing solder helps to convey the average temperature level around the guidewire to the site of the thermal sensor common junctions.
  • FIG. 2 For an enlarged view of one of these thermal junctions, showing its placement over a radio opaque marker, the application of insulating materials and the circumferential winding of the wires jointed at the thermal junction, refer to FIG. 2.
  • Two insulated conductor lead wires extend from each thermal junction as adjacent helical coils which spiral the length of the guidewire shaft 10.
  • the guidewire shaft and the helical lead wires 36-46 are first coated with two thin layers of medical grade polymer 24 and 48 (FIGS. 1 and 2), starting beyond the proximal sleeve electrodes and ending before the distal segment. Coating the helical coil wires levels out the grooves between the wires.
  • this coating acts as a thin tube, adding pushability and steerability to the thin guidewire shaft.
  • the proximal segment is then coated with a close fit insulated hypotube or sheath with a wall thickness less than 0.0015 inch (0.04 mm) 50 (FIGS. 1a, 6 and 7), and extending as a thin hydrophilic, silicone or a polytetrafluoroethylene (PTFE) coating over the distal, more flexible section 66 (FIGS. 1 a, 6 and 7).
  • PTFE polytetrafluoroethylene
  • Sliding a hypotube 65 over the proximal section offers further protection to the helical lead wires by reducing their exposure to damaging abrasions, and provides additional pushability and steerability for advancing the guidewire into the coronary vasculature.
  • the distal flexible coating provides a smoothly gliding surface over the distal segment of the guide-wire shaft carrying the helical lead wires and the three thermal sensors.
  • the lead wires 36-46 terminate at the proximal 15 cm end segment of the guidewire shaft as three paired electrodes of copper and constantan E 54 C and E 56 K, E 58 C and E 60 K, and E 62 C and E 64 K (FIGS. 1 , 3a and 4).
  • these electrode pairs take the form of sleeve electrodes as shown in FIGS. 4a and b, with each pair spaced to match a prospective clip-on electrode connector plates 64P, 66P and 68P (FIG. 4b).
  • An alternative type of electrode connector 70 is envisaged in FIGS. 1 b, 3a, 6 and 7.
  • the six sleeve electrodes E 54 C and E 56 K, E 58 C and E 60 K, and E 62 C and E 64 K are externally connectable through extension cables 72,74 and 76 (FIGS. 3b and 5) to three respective reference junctions 78, 80 and 82 (FIG. 3b) that are maintained at a constant temperature medium.
  • FIG. 5 Further external connections of the device are illustrated in FIG. 5. These include a servomotor-driven infusion pump 84 which feeds into the guiding catheter 86 used to position the guidewire within the coronary artery. The pump is adjusted to inject a slow steady infusion of 1 -3 ml/sec room temperature saline at the ostium of the coronary artery over a period of 10-15 seconds.
  • the external connections of the device preferably should also include a manual or automatic feedback circuit 88 to adjust the rate of saline or other miscible infusion so as to produce a standard average temperature gradient, whether at basal conditions or during measures of coronary flow reserve.
  • thermocouple amplifiers 90, 92 and 94 (FIGS. 3b and 5), a high speed color-coded monitor 96 (FIG. 5), a recorder 98, and an online programmed microprocessor, or computer 100 with its associated printer 102.
  • the computer should be programmed to calculate various values derived from the measured transmit time of coronary blood flow passing between each pair of thermal sensors, according to the formulae described below.
  • a push button, electronically calculated standard 104 serves to calibrate the temperature gradient induced by the saline infusion.
  • electrocardiographic, intra-aortic pressure and blood pressure tracings, as well as the patient's breathing, should be continuously monitored throughout the procedure described below.
  • thermodilution guidewire is introduced through a Judkin's guiding catheter 86 (FIG. 5) into the ostium of the coronary artery, and the guidewire's distal segment is steered forward through the coronary branch of interest. If there is a segment with suspected coronary stenosis, the flexible radio opaque spring tip of the guidewire 37 is gently manipulated through this segment and pushed forward for 3-5 cms to reach the distal coronary branches.
  • Baseline temperature level of blood flow through the coronary artery is first detected by the three sequentially mounted thermal sensors T 26, T 28 and T 30, which are electrically connected to their three respective D.C. amplifiers 90, 92 and 94. Output from these amplifiers appears as three separate tracings on the color monitor 96, which should preferably be a fast-sweep monitor with adjustable speed up to 1000 mm/sec. A manual or automatic zero suppress adjusts the three readings closer together.
  • Use of the push button predetermined standard 104 which is connected online with the three thermal sensor amplifiers, produces a standard deflection equivalent to 0.1-1.0 degrees centigrade below baseline temperature level of coronary blood flow.
  • Rhythmic changes of the phasic pulsatile coronary blood flow with each phase of the cardiac cycle modulate the degree of thermodilution induced by the steady slow infusion, creating periodic oscillations of temperature, gradient.
  • These oscillations that are produced by the characteristic biphasic coronary flow pattern with its large diastolic and small systolic components, simulate rectified sine waves, as illustrated by TW 26, TW 28 and TW 30 in FIGS. 8, 9 and 10.
  • These cyclical temperature changes reflect the different degrees of dilution of the cool saline infusion in the relatively warm coronary blood during the different phases of the cardiac cycle with the less diluted diastolic phase producing warmer temperatures than that of the more fully diluted systolic phase.
  • the size of these waves do not affect the accuracy of the proposed method, since the method is based on the transit time or the phase shift between successive waves as detected by the sequentially located thermal sensors.
  • the length of intervals between the diastolic and systolic components provides a useful indication of the relative size of the two components.
  • Each phase of the simulated rectified sine waves of temperature gradients is detected in sequence by the three serially mounted thermal sensors T 26, T 28 and T 30 as it arrives at the site where the sensor is mounted.
  • these waves are expressed as three consecutive rectified sine waves FIG. 8, with two equal transit times between them expressed as phase shifts.
  • the degree of phase shift between recorded waves is an expression of the transit time of the average peak flow velocity of coronary flow at the time of measurement.
  • the online computer 100 uses this formula to generate the mean blood flow velocity during a single cardiac cycle. Since room temperature infusion extends over a predetermined measuring time of 10-15 seconds covering several cardiac cycles, the average peak flow velocity during the measuring procedure is also determined.
  • Values of volume flow may be calculated when the angiographically determined vessel diameter is supplied to the online programmed microprocessor according to the following equation:
  • the thermal time constant of the fast response thermal sensors in a running fluid medium such as the bloodstream is less than 20 milliseconds. This thermal time constant affects all the consecutive oscillations equally and therefore has no effect on the transit time of the phase shift between them. Thorough mixing of the infused saline and the coronary flow is not essential since it is the transit time between identical phases and not the degree of temperature gradient which is of crucial value. Similarly, insignifcant thermal conduction through the arterial walls does not affect the transit time of temperature changes.
  • Determination of coronary flow reserve may be carried out by repeating room temperature saline infusion after increasing the rate of coronary flow by means of pharmacologically - induced maximal dilatation of the coronary arteries.
  • normal coronary flow velocity induces a standard range of transit time between consecutive waves, and is accurately calculated from the degree of phase shift between consecutive waves (FIG. 8).
  • the increased flow velocity produces narrow phase shifts denoting short transit times. The degree of narrowing is inversely proportional to the size of coronary flow reserve.
  • the increased rate of coronary flow is also expressed by smaller temperature gradients, since the infused, room temperature saline is diluted in the increased volume of coronary flow reserve.
  • Post stenotic reduction of the mean velocity prolongs the transit time between successive waves and is expressed by widening of the phase shifts between them (FIG. 10).
  • Evaluation of the degree of coronary stenosis which is a valuable parameter in decision making is determined by the degree of widening of the phase shift at basal conditions and during measures of coronary reserve. For optimal patient care, this procedure may be repeated to evaluate the immediate and late outcome of coronary intervention.
  • the forward direction of coronary flow is indicated by the order of colors shown on the color coded monitor 96.
  • the order of colors would be reversed in certain types of coronary stenosis with reversed flow from adjacent collateral vessels.
  • FIG. 1 illustrates that copper and constantan lead wires 36-46 may also extend beyond the thermal sensors T 26, T 28 and T 30 distally in a continued helical coil winding until the beginning of the spring tip 12.
  • These extensions of the helical coil lead wires beyond the thermal sensors serve to maintain the smooth surface of the distal segment of the guidewire to assist easy introduction of the guidewire through the distal branches of the coronary artery.
  • these distal extensions may help to secure the thermal sensors in position during the winding process.
  • the extensions have no electric function and do not interfere with the function of the thermal sensors. After the thermal sensors and adjacent wires leads have been fixed to the insulated stainless steel shaft, the distal extensions may be electrically interrupted by any cutting instrument.
  • the terminal comprising 3 mm of these helical coils and the proximal end of the radio opaque spring tip may be fixed to the guidewire shaft with an anchor ring 40 (FIG.1 ) of epoxy resin or Polytetrafluoroethylene (PTFE).
  • anchor ring 40 (FIG.1 ) of epoxy resin or Polytetrafluoroethylene (PTFE).
  • a more complex guidewire could comprise three intervals between four thermal sensors.
  • this configuration would provide the advantage of determining simultaneously the blood flow velocity both proximal from and distal to a coronary stenotic segment.
  • the middle interval could provide further information about the velocity of blood flow through the stenosed segment.
  • Type T copper and constantan thermocouples are used as thermal sensors.
  • Other types of thermal sensors may be used when preferred.
  • a significant advantage of using thermocouples is that they require no electric current to be introduced along the lead wires. This is an important consideration, given the unpredictable flow velocity which a stenosed segment of the coronary artery may experience, and its sensitivity to the heat generated by the electric current utilized by other types of thermal sensors.
  • Alternate types of thermal sensors may take the form of thin film of platinum foil, or of suitable sized thermistors configured as resistor thermal sensors over one arm of a three lead thermometer bridge.
  • the most distal of the three sequentially mounted thermal sensors is located just proximal to the terminal radio opaque spring criz.
  • this thermal sensor may be placed at the tip of the radio opaque spring coil (not shown). This location of the distal thermal sensor at the extreme tip of the guidewire offers the advantage of providing values of average flow velocity along more distal coronary branches and collateral vessels, but it may limit the guidewire's much-needed high degree of flexibility.
  • FIGS. 6 and 7 illustrate one type of alternative conductor paths applied to both two and three sensor configurations of the device. In this version, alternative successive copper and constantan conductor film coatings would be painted, sprayed or printed over an insulated guidewire shaft.
  • Each conduction film would be insulated from the next by a thin film of insulating ink, except at both ends of the conductor film, where they would form sequentially placed thermal sensors at the guidewire's distal segment F 118, F 120, F 122 and sleeve electrodes E 124C, E 126K, E 128C, E 130K, E 132C, E 134K at its proximal segment.
  • each of the conductor films and their insulating layers do not exceed 0.01 mm, they would have a total thickness of 0.06 mm adding 0.12 mm on both sides of an insulated guidewire shaft about 0.15 mm O.D. giving a total thickness of 0.27 mm.
  • a close fit thin coating of 0.04 mm thickness 65 giving a total thickness of 0.35 mm (0.014 inch) to the guidewire, would protect these films over most of their length, except the distal 25 mm segment, where the hypotube would be extended as a thin flexible polymer coating 66. If practicable, this arrangement would offer considerable advantages in ease of manufacturing.

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Abstract

L'invention concerne un procédé et un dispositif de mesure de vitesse de flux sanguin coronaire par thermodilution, le dispositif comprenant un fil guide comportant plusieurs capteurs espacés. Un milieu d'infusion, notamment une solution saline, est administré à température ambiante et le décalage de phase de la température sanguine est suivi, donnant une valeur du temps de transit entre les capteurs, valeur inversement proportionnelle à la vitesse de flux de pic moyen lors d'un cycle cardiaque unique.
PCT/IB2002/002692 2002-07-17 2002-07-17 Systeme de fil guide de thermodilution a temps de transit pour mesure de la vitesse de flux sanguin coronaire WO2004007014A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/IB2002/002692 WO2004007014A1 (fr) 2002-07-17 2002-07-17 Systeme de fil guide de thermodilution a temps de transit pour mesure de la vitesse de flux sanguin coronaire
AU2002329507A AU2002329507A1 (en) 2002-07-17 2002-07-17 Transmit time thermodilution guidewire system for measuring coronary blood flow velocity background of the invention

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/IB2002/002692 WO2004007014A1 (fr) 2002-07-17 2002-07-17 Systeme de fil guide de thermodilution a temps de transit pour mesure de la vitesse de flux sanguin coronaire

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JP2007203044A (ja) * 2006-01-30 2007-08-16 Pulsion Medical Systems Ag 希釈測定場所を設定するための装置
WO2012164481A1 (fr) * 2011-06-01 2012-12-06 Koninklijke Philips Electronics N.V. Système de débitmétrie sanguine répartie
EP2853280A1 (fr) * 2013-09-25 2015-04-01 Asahi Intecc Co., Ltd. Fil guide
US9333326B2 (en) 2013-09-25 2016-05-10 Asahi Intecc Co., Ltd. Guidewire
US20170290517A1 (en) * 2012-10-24 2017-10-12 Makaha Medical, Llc. Systems and methods for assessing vasculature health and blood clots
US10039904B2 (en) 2013-09-25 2018-08-07 Asahi Intecc Co., Ltd. Guide wire
CN109788921A (zh) * 2016-09-28 2019-05-21 皇家飞利浦有限公司 用于确定血流量的系统
GB2577472A (en) * 2018-07-16 2020-04-01 Medsolve Ltd An intracoronary wire, system and method for evaluating intracoronary flow
CN111683589A (zh) * 2018-02-05 2020-09-18 迈迪瑞股份公司 具有导管和传感器的设备
US11076808B2 (en) 2016-03-26 2021-08-03 Makaha Medical, LLC Flexible medical device with marker band and sensor
GB2610076A (en) * 2018-07-16 2023-02-22 Cerebria Ltd An intracoronary wire, system and method for evaluating intracoronary flow

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