WO2013066992A1 - Systems and methods for a wireless vascular pressure measurement device - Google Patents
Systems and methods for a wireless vascular pressure measurement device Download PDFInfo
- Publication number
- WO2013066992A1 WO2013066992A1 PCT/US2012/062777 US2012062777W WO2013066992A1 WO 2013066992 A1 WO2013066992 A1 WO 2013066992A1 US 2012062777 W US2012062777 W US 2012062777W WO 2013066992 A1 WO2013066992 A1 WO 2013066992A1
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- WIPO (PCT)
- Prior art keywords
- measuring system
- sensor
- connector
- display
- guide wire
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Classifications
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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
- A61B5/02—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
- A61B5/021—Measuring pressure in heart or blood vessels
- A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
-
- 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
Definitions
- the present invention relates to a system and methods for a vascular pressure measurement device.
- a typical construction of a pressure wire involves a radio opaque spring tip in the distal end, a housing or holder for the pressure sensor itself a few centimeters proximal to the distal end and a lumen, which is a hollow channel, to accommodate the electrical conductors or optical fibers depending on whether the pressure sensor is electrical or optical in its theory of operation.
- an electrical interface is typically provided for signal acquisition, processing and display. Some user input interface can also be provided.
- the electrical interface where the pressure signal is acquired and/or processed also needs to be removable when the pressure wire is to be used as a guide wire for delivery of other interventional devices.
- a culprit lesion that is responsible for the symptoms that bring the patient into the catheterization laboratory in the first place is often times one that has a severe narrowing of the vessel lumen. Many physicians may see no need to further measure the pressure gradient caused by that culprit lesion to assess its hemo-dynamic significance. In addition, it would be challenging to deploy a pressure wire there since it usually will not perform as well as one designed to be a primary guide wire. [0014] On the other hand, if there are multiple lesions, one may appear to be only marginally constrictive from the appearance of the angiogram. The decision to intervene will then be based upon the hemo-dynamic of the lesion and pressure gradient measurement will be very helpful.
- the pressure wire is also tethered to a non-sterile electronic equipment which as described above will acquire and process the signal from the sensor.
- the electronic equipment typically will also have a user input device to facilitate the procedure and provide a display for the signal as well as any processed results.
- U.S. Patent 7,724, 148 provides a wireless interface which is attached at the proximal end of the pressure wire. Pressure signals are processed and transmitted from the proximal end of the pressure wire wirelessly to a wireless receiver in the non-sterile area.
- the size is such that while it can function as a handle for the pressure wire, it is too large to function adequately like a torque device, known sometimes as a torquer, commonly used to manipulate a 0.014" guide wire.
- the position of the wireless transceiver is also fixed by the location of the electrical contacts on the pressure wire and would not allow the operator to manipulate the guide wire in a way that is similar to a torque device.
- a regular torque device can be used at an arbitrary position along the proximal region of the guide wire according to personal preference and the requirement of the anatomy involved at the procedure.
- This desire to measure pressures at two locations requires a pullback operation to move the sensor from a location distal to a lesion in a coronary vessel to a location proximal to the lesion. Having multiple sensors would typically increase the number of transmission lines and can be a difficult task given the small space of a guide wire form factor.
- an improved pressure measuring device that includes one or more of the following improvements: (i) elimination of the hollow lumen in the body of the guide wire, (ii) wireless transmission, (iii) multiple sensors and (iv) stand-alone micro-catheter compatible with primary guide wires, resulting in better handling characteristics, better measurements, and shortened invasive procedures.
- a system and method for measuring at least one physiological parameter of at least one location inside a human is provided.
- a wireless vascular pressure measurement device for measuring parameter(s) at one or more vascular locations inside a human is provided.
- the vascular measuring system includes an elongated sleeve configured to be delivered over a standard guide wire configured to be threaded into a vascular pathway of the human, and may include at least one sensor operatively coupled to a distal end of the sleeve, wherein the at least one sensor is configured to measure the at least one physiological parameter of the human.
- the at least one sensor may be located at the distal end of a guide wire without a sleeve.
- the system may include a connector operatively coupled to the proximal end of the sleeve or guide wire.
- the connector is configured to receive the at least one measured parameter from the at least one sensor, and display the result of processing from the at least one parameter from the at least one location.
- the connector may also include a wireless transmitter and is adequately light weight such that it can be attached onto the guide wire in substantially arbitrary location along a proximal portion of the guide wire thereby enabling the connector to function like a torque device for manipulating the guide wire inside the vascular pathway of the human.
- Figure 1 is a schematic showing the key components making up a pressure wire measurement system
- Figure 2 is a schematic showing the conductors between the sensor and proximal electrical contacts in a prior art embodiment
- Figure 3 illustrates one preferred embodiment of the electrically conductive structures of the present invention
- Figure 4 illustrates the cross-sectional view of Figure 3
- FIGS 5 a, b, c and d illustrate a torque device in accordance to one embodiment of the invention
- Figure 6 illustrates one preferred embodiment of the pressure wire to provide a guiding mechanism so that the torque device will engage the conductive traces at the appropriate orientation
- Figure 7 illustrates another preferred embodiment of the pressure wire measurement system where there are two sensors deployed on a sleeve that can be delivered over a traditional guide wire, 110, not shown, and a torque device can wirelessly activate the sensors and shows the results from the signals return by these two sensors; and
- Figure 8 illustrates another embodiment where the stand alone sleeve catheter with two sensors is in a rapid exchange catheter configuration with guide wire, 1 10, and a catheter handle, 810, now serving as the display for either the waveforms from the two sensors or the results after processing of the two waveforms or both, depending on the display size available. Two switches to control the electronics in the handle are also shown in this illustration.
- Figure 1 shows one embodiment of a pressure wire measurement system, 100, not to scale. It includes a pressure wire, 1 10.
- the distal end, designated 118 is usually radio-opaque to allow for visualization under X-ray and is usually implemented as a coil to make it floppy and atraumatic.
- the pressure sensor is designated 1 16 and is often followed by another coil section 1 14 for desired stiffness.
- the remaining body of the pressure wire often has a hollow lumen to accommodate the electrical transmission lines (not shown) connecting the sensor 116 with the electrical contacts 112 at the proximal end.
- the hollow lumen in the proximal portion of the pressure wire designed to accommodate the electrical or optical transmission conductors reduces the fidelity of the torque transmission due to the reduced rigidity of the body of the pressure wire.
- System 100 addresses this issue by having thin conductive traces on the central core wire.
- Figure 1 also shows a connector 140 that couples to the proximal end of the pressure wire 110.
- connector 140 Internal to connector 140, there are electrical contacts 141 that mate with the counterpart 1 12 on the pressure wire.
- the connector 140 being non-sterile needs to be enclosed with a sterile barrier, 142, typically a sterile bag, to prevent contamination of the sterile field during the PCI procedure.
- sterile barrier 142 may not be needed. However, if long transmission lines are used as a consequence of having a long pressure wire, signal quality may be degraded.
- the connector 140 is coupled to an electronic equipment, 120, where the signals from the sensor can be acquired, processed and display with the display 122. If user input is needed, an input device 124 can also be located on the electronic equipment 120.
- a wireless transceiver 145 is coupled to the pressure wire such that the electrical contacts, 141, in the transceiver 145, mates with the electrical contact 112 on the pressure wire 1 10.
- the signals are then wirelessly received by a wireless transceiver 146 which can then display the information on a display 152 or couple to the electronic equipment 150 which may take the form of an Intravenous pole with a display 154 and an input device 156.
- Figure 2 shows a close up view of the sensor 116 with the electrical transmission conductors 210. These conductors terminate at the electrical contacts 112 at the proximal end of the pressure wire 110.
- the mating connector whether in the form of a connector 140, or in the form of a wireless transceiver 145 is located at the proximal end of the pressure wire 1 10 where the electrical contacts 112 are located on the pressure wire 110.
- This arrangement for the wireless transceiver 145 can be an impediment to the work flow as transceiver should be smaller and light weight and ideally should perform like a torque device.
- a torque device not shown, also needs to be able to be positioned anywhere proximal to where the pressure wire exits the human body and not be constrained to the proximal end or a particular fixed location.
- the traces are terminated in pads, 303, which are connected to pads, 301, on the sensor chip via wire bonding with gold wires, 302.
- pads, 303 which are connected to pads, 301, on the sensor chip via wire bonding with gold wires, 302.
- Other connection schemes known to persons skilled in the art are also possible.
- the traces 304 are distinguished from one another by the number of insulating layers 305 as well as the circumferential locations as indicated in the cross- sectional representation in Figure 4.
- Shielding layers can also be implemented to improve the electrical performance of these conductive traces if needed.
- These traces 304 can be metallization via various depositing process or conductive polymer and the insulating layers 305 can be various insulating polymers, like polyimide film.
- multiple conductive traces can reside in the same layer underneath one insulating layer if they can be separated adequately apart. This may be an advantage in the case of multiple sensor chips.
- One sensor chip can have its conductive traces residing in one layer, while the other can have its conductive traces in another layer.
- FIG. 5a an exemplary torque device 500, is shown with a cap 501 and collet 502, an arrangement where as the cap is advanced, the fingers 503 of the collet 502 will close on and grip on the pressure wire 1 10. Pressure wire 1 10 is not shown.
- some of the fingers have a tapered tip 510, capable of penetrating the insulation layers 305, and making contact with the appropriate traces 304, thereby forming electrical connection(s).
- a tapered tip 510 capable of penetrating the insulation layers 305, and making contact with the appropriate traces 304, thereby forming electrical connection(s).
- Different shape and arrangement for the finger 503 to make electrical contacts with the conductive traces 304 are also possible.
- Different fingers 503 can have different length tapered tip 510 capable of penetrating to the correct depth to make contact with the conductive trace 304 through the various insulating layers 305.
- Figures 5b and 5c show two close up views of one embodiment of a finger with a tapered tip configuration designed to simultaneously penetrate two insulating layers 305 to make contact with conductive traces 304 lying at two different depths.
- the configuration is such that while making contact with the deeper layer, it avoids shorting with the shallower layer.
- tapered tips are useful where multiple sensor chips 1 16 are present at the distal end of the pressure wires and the conductive traces are embedded in separate layers at different depths. Different length tapered tip 510 can engage different sensor chip signals at different depth levels with no ambiguity. Even if the number of conductive traces is small enough to fit with in the
- FIG. 5d a view from B-B of Figure 5a, the body of the collet 502 has a guiding track 520 to guide the insertion of the torque device such that the orientation of the fingers 503 remain aligned with the conductive traces 305 correctly.
- the portion of the pressure wire 1 10 that accepts the torque device has a corresponding guiding ridge 610 that allows the torque device to slide along it once the guiding track 520 is aligned with the guiding ridge 610.
- Using a visible strip marking on the guide wire for aligning with a counterpart marking on the torque device is an example of a visual means for achieving correct alignment.
- a display 504 is also shown, where result derived from the sensor can be made available to the user of the torque device.
- This torque device being able to make electrical connection with the sensor 1 16 can now provide the needed signal acquisition, processing and wireless transmission to a receiver outside the sterile area of the catheterization laboratory.
- the transceiver unit small and light weight as well as being able to position freely along a much larger range in the proximal portion of the pressure wire and behave like a torque device.
- some parts of the acquisition and processing are partitioned off the transceiver 145 and locate on the pressure wire body proper.
- the constraint is to maintain the profile such that the diameter of the entire pressure wire can still accept delivery of other device designed to be delivered over a guide wire, e.g. balloon and stent, usually 0.014 inch in diameter.
- a piece of signal processing component can be interposed and embedded in the envelope of the proximal portion of the pressure wire such that a partially processed signal emerges on the continuation of a conductive trace.
- transceiver 145 only sends out the processed results for display without the pressure signals derived from the sensor chip 1 16.
- the proximal portion of the pressure wire 1 10 is more tolerant of having any stiff sections that are required to implement signal conditioning and processing components. These components are being off-loaded from the torque device to enable a smaller form factor for the torque device that also doubles as a transceiver.
- the pressure sensing can also be implemented in the form of a stand-alone sleeve that is delivered over the preferred guide wire that the user has chosen.
- This approach of performing the pressure measurement differs from the approach of implementing a pressure wire.
- the advantage of this approach is that the operator can use his preferred guide wire without any possible compromise on the wire performance but with the possible disadvantage that an additional catheter, however small, needs to be delivered over the guide wire and subsequently removed to allow for other device to be delivered over the same guide wire again for the next steps in the procedure.
- FIG. 7 illustrates the concept of this embodiment where sensor 701 and sensor 702 are located on a sleeve and are in communication, wireless or wired, with torque device 500.
- a display 504 is also shown on the torque device 500.
- This torque device 500 can also optionally communicate, via a wireless receive 146, with equipment 150 with its display 154 and input device 156 or a stand alone remote display.
- sensors 701 and 702 are wireless. Sensor 701 is distal to a stenosis in a coronary artery, sensor 702 is in the aorta. Together, they provide two independent pressure measurements that are transmitted to the torque device 500.
- the display, 504, on the torque device can then, as an example, display the measured Fractional Flow Reserve value which is a ratio of the mean of the distal pressure over the mean of the proximal pressure.
- the torque device 500 itself can activate the two sensors, 701 and 702, as indicated in Figure 7.
- Sensor 701 is deployed distal to a stenosis in the coronary artery while sensor 702 remains in the aorta such that upon activation by the torque device via an electromagnetic wave, they send out their respective pressure measurement signals wirelessly. These signals are received by the torque device and any computation result based on these two measurement signals is then shown on the display 504. No other capital equipment in required and both pressure signals needed to generate the ratio for Fractional Flow Reserve (FFR) is obtained simultaneously without the need for a pullback.
- FFR Fractional Flow Reserve
- MEMS Microwave Systems
- they can be piezo-resistive or capacitive in their principle of operation. It is also possible to implement the sensor using piezo-electric polymer or ceramic.
- piezo-electric polymer is of particular value since it does not require the use of rigid sensor chip and can be conformable to the shape of a guide wire geometry.
- the senor 701 is implemented with a piezoelectric polymer that generates a voltage when experience a change in pressure.
- the capacitance of sensor 701 can also be a function of pressure as it changes dimension. This voltage or capacitance change is measured via conductive traces or other wired transmission means to a proximal sensor 702 which resides in the aorta.
- Sensor 702 itself senses pressure at the aorta as well as handling any needed conditioning and processing of pressure signal from sensor 701 and together wirelessly provides the result or partial result to the torque device 500 on its display 504.
- this invention is applicable to physiological parameters other than pressure.
- One characteristics of this invention is the use of a low cost, disposable transceiver. It can be made small if the data rate and power consumption are low - which dictates the kind of information and type of signal acquisition and processing that can be accomplished.
- Physiologic parameters like pressure, temperature, pH value, etc., are slow varying parameters that can be acquired with low sampling frequency, simple processing, if any, and low data transmission rate. The power consumption is also correspondingly low.
- the improvement described here affords a better torque transmission as it removes the need to have a lumen to accommodate the electrical or optical transmission lines.
- the electrical connection scheme also improves the electrical performance as the parasitic capacitance is reduced by increasing the separation of the transmission lines.
- the improved construction also allows for better integration of multiple sensors.
- the improvement with a wireless transfer of the physiologic signal allows for a more compatible operation with how a guide wire is used in the PCI procedure.
- a wireless embodiment also improves the work flow and avoids the need to have a large instrument near the patient's bed during the procedure.
- Wireless communication between the sensor and the torque device also makes for a compact system when a simple display on the torque device is adequate for the procedure.
- a stand alone embodiment allows pressure measurement with an existing primary guide wire and eliminates the need for a wire exchange procedure.
- the distance between the two sensors, 701 and 702 can be made variable to accommodate different lesion locations in the coronary arteries while keeping the proximal sensor in the aorta..
- the sleeve can also be constructed such that a guide wire exit port allows for a rapid exchange catheter configuration as described in US patent 5451233 "Angioplasty Apparatus Facilitating Rapid Exchanges" by Paul Yock.
- the sleeve in the above configuration can now have a catheter handle, as opposed to a torque device, where a larger display can be accommodated.
- This larger display can display both waveforms and numerical results from processing of the waveforms.
- connection between the sensors (701, 702) and the electronics in the handle, 810 will not require embedding the conductors in insulating layers and are self contained within the stand-alone sleeve catheter.
- Having the sensors implemented on the sleeve itself allows for integration with other interventional devices that could benefit from a pressure measurement to monitor the progress of the interventional procedure. For example, if this pressure measuring sleeve is integrated with a Chronic Total Occlusion (CTO) device, the pressure monitoring can indicate when the CTO device has succeeded in entering the distal true lumen as opposed to entering a false lumen in the intima of the vessel wall. This can reduces the use contrast medium and radiation from the angiogram.
- Other applications can include integration with percutaneous valve implantation where the reduction of the pressure gradient across the valve is an important parameter. Having a sleeve approach for pressure measurement allows for relatively easy integration with such percutaneous valve devices.
- the present invention provides a system and methods for an improved pressure measurement device.
- the advantages of such a system include the ability to manipulate the pressure wire more like a guide wire and perform the pressure measurement in a way more compatible with other catheterization laboratory procedures.
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Priority Applications (9)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP12844914.7A EP2773260A4 (en) | 2011-11-01 | 2012-10-31 | Systems and methods for a wireless vascular pressure measurement device |
BR112014010484A BR112014010484A2 (en) | 2011-11-01 | 2012-10-31 | measuring system to measure at least one parameter of a human |
JP2014540035A JP2015501193A (en) | 2011-11-01 | 2012-10-31 | System and method for wireless vascular pressure measuring device |
CN201280053832.9A CN103945757A (en) | 2011-11-01 | 2012-10-31 | Systems and methods for a wireless vascular pressure measurement device |
CA 2853189 CA2853189A1 (en) | 2011-11-01 | 2012-10-31 | Systems and methods for a wireless vascular pressure measurement device |
RU2014122045/14A RU2014122045A (en) | 2011-11-01 | 2012-10-31 | SYSTEM FOR MEASURING VASCULAR PRESSURE USING A WIRELESS DEVICE (OPTIONS) |
KR20147014829A KR20140089561A (en) | 2011-11-01 | 2012-10-31 | Systems and methods for a wireless vascular pressure measurement device |
US13/840,505 US20130274619A1 (en) | 2011-11-01 | 2013-03-15 | Systems and methods for a low-profile vascular pressure measurement device |
IN975MUN2014 IN2014MN00975A (en) | 2011-11-01 | 2014-05-22 |
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161554227P | 2011-11-01 | 2011-11-01 | |
US61/554,227 | 2011-11-01 | ||
US13/664,357 | 2012-10-30 | ||
US13/664,357 US20130109980A1 (en) | 2011-11-01 | 2012-10-30 | Systems and methods for a wireless vascular pressure measurement device |
Publications (1)
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WO2013066992A1 true WO2013066992A1 (en) | 2013-05-10 |
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Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
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PCT/US2012/062777 WO2013066992A1 (en) | 2011-11-01 | 2012-10-31 | Systems and methods for a wireless vascular pressure measurement device |
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US (1) | US20130109980A1 (en) |
EP (1) | EP2773260A4 (en) |
JP (1) | JP2015501193A (en) |
KR (1) | KR20140089561A (en) |
CN (1) | CN103945757A (en) |
BR (1) | BR112014010484A2 (en) |
CA (1) | CA2853189A1 (en) |
CR (1) | CR20140252A (en) |
IN (1) | IN2014MN00975A (en) |
RU (1) | RU2014122045A (en) |
WO (1) | WO2013066992A1 (en) |
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2012
- 2012-10-30 US US13/664,357 patent/US20130109980A1/en not_active Abandoned
- 2012-10-31 RU RU2014122045/14A patent/RU2014122045A/en not_active Application Discontinuation
- 2012-10-31 CN CN201280053832.9A patent/CN103945757A/en active Pending
- 2012-10-31 EP EP12844914.7A patent/EP2773260A4/en not_active Withdrawn
- 2012-10-31 KR KR20147014829A patent/KR20140089561A/en not_active Application Discontinuation
- 2012-10-31 CA CA 2853189 patent/CA2853189A1/en not_active Abandoned
- 2012-10-31 JP JP2014540035A patent/JP2015501193A/en active Pending
- 2012-10-31 BR BR112014010484A patent/BR112014010484A2/en not_active IP Right Cessation
- 2012-10-31 WO PCT/US2012/062777 patent/WO2013066992A1/en active Application Filing
-
2014
- 2014-05-22 IN IN975MUN2014 patent/IN2014MN00975A/en unknown
- 2014-05-27 CR CR20140252A patent/CR20140252A/en unknown
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Also Published As
Publication number | Publication date |
---|---|
RU2014122045A (en) | 2015-12-10 |
CR20140252A (en) | 2014-08-22 |
KR20140089561A (en) | 2014-07-15 |
JP2015501193A (en) | 2015-01-15 |
BR112014010484A2 (en) | 2017-04-25 |
CN103945757A (en) | 2014-07-23 |
EP2773260A1 (en) | 2014-09-10 |
IN2014MN00975A (en) | 2015-04-24 |
CA2853189A1 (en) | 2013-05-10 |
EP2773260A4 (en) | 2015-06-03 |
US20130109980A1 (en) | 2013-05-02 |
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