Method of locating lower extremity arterial lesions using intravascular ultrasound combined with intraoperative angiography

Abstract

The present invention relates to a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, and belongs to the field of biomedical technology. The method includes using an intravascular ultrasound diagnostic instrument to perform intravascular ultrasound detection on the diseased segment of the blood vessel, marking the position of the lesion on the ultrasound image when the lesion site is observed by the ultrasound catheter, and observing the anatomical position of the ultrasound catheter on the screen of the digital subtraction angiography machine by angiography at the same time; the position of the ultrasound catheter is the accurate anatomical position of the lesion site; the present invention can be combined with intraoperative angiography when using intravascular ultrasound to evaluate lower extremity arterial vascular lesions, accurately locating the anatomical position of the lesion and the position of the proximal and distal normal blood vessels, facilitating the selection of a balloon or stent of a suitable size to treat the lesion, and providing a more accurate reference for clinical decision-making.

Description

Technical Field

[0001] The invention relates to a method for locating lower limb artery lesions by combining intravascular ultrasound with intraoperative angiography, and belongs to the technical field of biomedicine. Background Art

[0002] At present, with the progress of population aging, the incidence of lower extremity arterial lesions is getting higher and higher. In order to more accurately evaluate the nature of the lesions and measure the diameter of the diseased blood vessels, the application of intravascular ultrasound is becoming more and more extensive. Compared with angiography, intravascular ultrasound can dynamically observe the nature of the lesions and more accurately measure the diameter of the blood vessels, providing a more accurate reference value for the selection of balloons and stents for the clinical intracavitary treatment of vascular lesions. However, its disadvantage is that intravascular ultrasound can only observe the existence of lesions, but cannot accurately locate the anatomical position of the lesions, which affects the proximal and distal positioning of the subsequent further use of balloons or stents for treatment, thereby affecting the clinical effect. Therefore, how to accurately locate the anatomical position of diseased blood vessels and proximal and distal normal blood vessels is a technical difficulty that urgently needs to be solved in this technical field. Summary of the invention

[0003] The purpose of the present invention is to solve the technical problem of how to accurately locate the diseased blood vessel and the anatomical position of the proximal and distal ends of the diseased blood vessel.

[0004] In order to solve the above technical problems, the present invention provides a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, comprising the following steps:

[0005] Step 1: Turn on the intravascular ultrasound diagnostic instrument and adjust it to the intravascular ultrasound mode;

[0006] Step 2: Perform angiography on the affected limb, ensuring that the affected segment and the proximal and distal blood vessels are included in the angiography. After angiography, keep the operating table and the digital subtraction angiography machine unchanged.

[0007] Step 3: Insert the ultrasound catheter into the proximal end of the vascular lesion and record the intravascular ultrasound image; push the intracavity ultrasound catheter from the proximal end of the lesion to the distal end of the lesion, and when the ultrasound catheter observes the narrowest part of the lesion, mark the position of the lesion on the intravascular ultrasound image, and observe the anatomical position of the ultrasound catheter on the screen of the digital subtraction angiography machine through angiography; mark the anatomical position on the limb blood vessels displayed on the screen of the digital subtraction angiography machine, so that the lesion site observed by the ultrasound catheter can be accurately located on the angiography image;

[0008] Step 4: Similarly, mark the normal blood vessels proximal to the lesion, the normal blood vessels distal to the lesion, and the positions of the proximal and distal ends of the lesion on the screen of the digital subtraction angiography machine and the intravascular ultrasound diagnostic instrument.

[0009] Step 5: withdraw the intracavitary ultrasound catheter, measure the normal blood vessel diameter marked in step 4 on the intravascular ultrasound diagnostic instrument, and select a balloon or stent of appropriate size based on the diameter. The length of the balloon and stent is determined by the length between the proximal and distal ends of the lesion marked on the screen of the digital subtraction angiography machine;

[0010] Step 6: After the lesion is treated, the intracavitary ultrasound catheter is reintroduced in the same way to observe whether the stenosis at the proximal and distal ends of the diseased vessel just marked and at the narrowest part of the lesion is relieved; if the treatment is not satisfactory, the position of the residual lesion is relocated for treatment; if the treatment is satisfactory, the intracavitary ultrasound catheter is withdrawn and the operation is completed.

[0011] Preferably, in step 3, the speed at which the intracavitary ultrasound catheter is pushed from the proximal end of the lesion to the distal end of the lesion is 0.5 cm / s.

[0012] Preferably, in step 3, the ultrasound catheter is delivered into the proximal end of the vascular lesion by using a guide wire with a nominal diameter of 0.014 in.

[0013] The present invention provides a system constructed by a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, and the system includes a program for executing the above method.

[0014] The present invention provides a storage device, wherein the storage medium stores a plurality of instructions, and the instructions execute the steps in the above-mentioned method for locating the position of lower limb artery lesions by combining intravascular ultrasound with intraoperative angiography.

[0015] Compared with the prior art, the present invention has the following beneficial effects:

[0016] 1. The method provided by the present invention can more accurately perform anatomical localization of lower extremity arterial vascular lesions.

[0017] 2. The method provided by the present invention can more accurately measure the normal blood vessel diameters at the proximal and distal ends of the balloon and stent, which facilitates further selection of balloons and stents of appropriate specifications. DETAILED DESCRIPTION

[0018] In order to make the present invention more clearly understood, the preferred embodiments are described in detail as follows:

[0019] The present invention provides a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, comprising the following steps:

[0020] Step 1: Turn on the intravascular ultrasound diagnostic instrument and adjust it to the intravascular ultrasound mode;

[0021] Step 2: Perform angiography on the affected limb, ensuring that the affected segment and the proximal and distal blood vessels are included in the angiography. After angiography, keep the operating table and the digital subtraction angiography machine unchanged.

[0022] Step 3: Insert the ultrasound catheter into the proximal end of the vascular lesion and record the intravascular ultrasound image; push the intracavity ultrasound catheter from the proximal end of the lesion to the distal end of the lesion, and when the ultrasound catheter observes the narrowest part of the lesion, mark the position of the lesion on the intravascular ultrasound image, and observe the anatomical position of the ultrasound catheter on the screen of the digital subtraction angiography machine through angiography; mark the anatomical position on the limb blood vessels displayed on the screen of the digital subtraction angiography machine, so that the lesion site observed by the ultrasound catheter can be accurately located on the angiography image;

[0023] Step 4: Similarly, mark the normal blood vessels proximal to the lesion, the normal blood vessels distal to the lesion, and the positions of the proximal and distal ends of the lesion on the screen of the digital subtraction angiography machine and the intravascular ultrasound diagnostic instrument.

[0024] Step 5: withdraw the intracavitary ultrasound catheter, measure the normal blood vessel diameter marked in step 4 on the intravascular ultrasound diagnostic instrument, and select a balloon or stent of appropriate size based on the diameter. The length of the balloon and stent is determined by the length between the proximal and distal ends of the lesion marked on the screen of the digital subtraction angiography machine;

[0025] Step 6: After the lesion is treated, the intracavitary ultrasound catheter is reintroduced in the same way to observe whether the stenosis at the proximal and distal ends of the diseased vessel just marked and at the narrowest part of the lesion is relieved; if the treatment is not satisfactory, the position of the residual lesion is relocated for treatment; if the treatment is satisfactory, the intracavitary ultrasound catheter is withdrawn and the operation is completed.

[0026] In the above step 3, the speed of pushing the intracavitary ultrasound catheter from the proximal end of the lesion to the distal end of the lesion is 0.5 cm / s.

[0027] In the above step 3, the ultrasound catheter is delivered to the proximal end of the vascular lesion by using a guide wire with a nominal diameter of 0.014 in.

[0028] The present invention provides a system constructed by a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, and the system includes a program for executing the above method.

[0029] The present invention provides a storage device, wherein the storage medium stores a plurality of instructions, and the instructions execute the steps in the above-mentioned method for locating the position of lower limb artery lesions by combining intravascular ultrasound with intraoperative angiography.

[0030] The present invention can be used to accurately locate the anatomical position of the lesion and the position of the proximal and distal normal blood vessels when using intravascular ultrasound to evaluate lower limb arterial vascular lesions, combined with intraoperative angiography, to provide a more accurate reference for clinical decision-making.

[0031] The present invention can obtain the principle of application:

[0032] 1) Intravascular ultrasound catheters can be clearly visualized under X-rays;

[0033] 2) Compared with angiography, intravascular ultrasound can more accurately determine the nature and severity of lesions;

[0034] 3) After intravascular ultrasound identifies the presence of the lesion, angiography can accurately locate the anatomical position of the ultrasound catheter in the entire lower limb, that is, the anatomical site of the lesion.

[0035] The advantages of the present invention are:

[0036] The intravascular ultrasound diagnostic device is used in conjunction with intraoperative digital subtraction angiography to accurately locate the specific anatomical position of the lesion; the normal blood vessel diameters at the proximal and distal ends of the lesion are accurately measured to guide the selection of stent or balloon specifications and proximal and distal positioning, thereby improving clinical results.

[0037] Example

[0038] 1) Turn on the intravascular ultrasound diagnostic instrument (such as Volcano), adjust it to the intravascular ultrasound mode, and enter the patient's basic information and operator information;

[0039] 2) After successful puncture of the common femoral artery, a 5F short sheath is inserted and replaced with a 6F short sheath (ipsilateral puncture) or a 6F reverse sheath (contralateral puncture);

[0040] 3) Angiography of the limb on the affected side, ensuring that the affected segment and the proximal and distal vessels of the affected area are included in the angiography. After the angiography, the operating table and the digital subtraction angiography (DSA) machine should not be moved.

[0041] 4) Use the catheter and the guide wire to pass through the lesion segment, and replace the 0.014 guide wire; open the intravascular ultrasound catheter, connect the end of the intravascular ultrasound catheter to the intravascular ultrasound diagnostic instrument, and then use the 0.014 guide wire to send the ultrasound catheter to the proximal end of the lesion, click the "ring down" button on the intravascular ultrasound diagnostic instrument at a relatively normal blood vessel site, and wait;

[0042] 5) Click the "recording" button on the intravascular ultrasound diagnostic instrument to start recording the intravascular ultrasound image. Slowly push the intravascular ultrasound catheter from the proximal end of the lesion to the distal end of the lesion at a speed of about 0.5 cm / s. When the ultrasound catheter observes the narrowest part of the lesion, click the "mark" button on the intravascular ultrasound diagnostic instrument to mark the position of the lesion in the intravascular ultrasound image. At the same time, observe the anatomical position of the ultrasound catheter on the DSA screen by contrast imaging. The assistant uses a marker to mark this anatomical position on the limb blood vessels displayed on the DSA screen. In this way, the lesion observed by the ultrasound catheter can be accurately located on the contrast imaging image.

[0043] 6) Using the same method, mark the normal blood vessels proximal to the lesion, the normal blood vessels distal to the lesion, and the locations proximal and distal to the lesion on the DSA screen and the intravascular ultrasound diagnostic machine.

[0044] 7) Withdraw the intravascular ultrasound catheter and measure the normal blood vessel diameter marked in the previous step on the intravascular ultrasound diagnostic machine. Based on this, select a balloon or stent of appropriate size to treat the lesion. The length of the balloon and stent is determined by the length between the proximal and distal ends of the lesion marked on the DSA screen.

[0045] 8) After the lesion is treated, the intracavitary ultrasound catheter is reintroduced in the same way to observe whether the stenosis at the proximal and distal ends of the lesion vessel just marked and the narrowest part of the lesion is relieved. If the treatment is not satisfactory, the position of the residual lesion is relocated for treatment; if the treatment is satisfactory, the intracavitary ultrasound catheter and 0.014 guide wire are withdrawn, and the puncture point is bandaged with pressure. The operation is over.

[0046] The above is only a preferred embodiment of the present invention, and is not any formal or substantial limitation of the present invention. It should be pointed out that ordinary technicians in this technical field can make several improvements and supplements without departing from the present invention, and these improvements and supplements should also be regarded as the protection scope of the present invention. Any technician familiar with this profession, without departing from the spirit and scope of the present invention, can make some changes, modifications and equivalent changes made by using the technical content disclosed above, which are equivalent embodiments of the present invention; at the same time, any changes, modifications and evolutions of any equivalent changes made to the above embodiments based on the essential technology of the present invention are still within the scope of the technical solution of the present invention.

Claims

1. A system constructed by combining intravascular ultrasound with intraoperative angiography to locate lower extremity arterial lesions, characterized in that: The system includes a program for executing a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, and the method includes the following steps: Step 1: Turn on the intravascular ultrasound diagnostic instrument and adjust it to the intravascular ultrasound mode; Step 2: Perform angiography on the affected limb, ensuring that the affected segment and the proximal and distal blood vessels are included in the angiography. After angiography, keep the operating table and the digital subtraction angiography machine unchanged. Step 3: Insert the ultrasound catheter into the proximal end of the vascular lesion and record the intravascular ultrasound image; push the intracavity ultrasound catheter from the proximal end of the lesion to the distal end of the lesion, and when the ultrasound catheter observes the narrowest part of the lesion, mark the position of the lesion on the intravascular ultrasound image, and observe the anatomical position of the ultrasound catheter on the screen of the digital subtraction angiography machine through angiography; mark the anatomical position on the limb blood vessels displayed on the screen of the digital subtraction angiography machine, so that the lesion site observed by the ultrasound catheter can be accurately located on the angiography image; Step 4: Similarly, mark the positions of the normal blood vessels proximal to the lesion, the normal blood vessels distal to the lesion, and the proximal and distal ends of the lesion on the screen of the digital subtraction angiography machine and the intravascular ultrasound diagnostic instrument; Step 5: withdraw the intracavitary ultrasound catheter, measure the normal blood vessel diameter marked in step 4 on the intravascular ultrasound diagnostic instrument, and select a balloon or stent of appropriate size based on the diameter. The length of the balloon and stent is determined by the length between the proximal and distal ends of the lesion marked on the screen of the digital subtraction angiography machine; Step 6: After the lesion is treated, the intracavitary ultrasound catheter is reintroduced in the same way to observe whether the stenosis at the proximal and distal ends of the diseased vessel just marked and at the narrowest part of the lesion is relieved; if the treatment is not satisfactory, the position of the residual lesion is relocated for treatment; if the treatment is satisfactory, the intracavitary ultrasound catheter is withdrawn and the operation is completed.

2. A system constructed by combining intravascular ultrasound with intraoperative angiography to locate lower extremity arterial lesions as claimed in claim 1, characterized in that: In step 3, the speed of pushing the intracavitary ultrasound catheter from the proximal end of the lesion to the distal end of the lesion is 0.5 cm / s.

3. A system constructed by combining intravascular ultrasound with intraoperative angiography to locate lower extremity arterial lesions as claimed in claim 1, characterized in that: In step 3, the ultrasound catheter is delivered to the proximal end of the vascular lesion by using a guide wire with a nominal diameter of 0.014 in.

4. A storage device, characterized in that: The storage medium stores a plurality of instructions, and the instructions execute steps in a method for locating the position of lower extremity arterial lesions by combining intravascular ultrasound with intraoperative angiography, including: Step 1: Turn on the intravascular ultrasound diagnostic instrument and adjust it to the intravascular ultrasound mode; Step 2: Perform angiography on the affected limb, ensuring that the affected segment and the proximal and distal blood vessels are included in the angiography. After angiography, keep the operating table and the digital subtraction angiography machine unchanged. Step 3: Insert the ultrasound catheter into the proximal end of the vascular lesion and record the intravascular ultrasound image; push the intracavity ultrasound catheter from the proximal end of the lesion to the distal end of the lesion, and when the ultrasound catheter observes the narrowest part of the lesion, mark the position of the lesion on the intravascular ultrasound image, and observe the anatomical position of the ultrasound catheter on the screen of the digital subtraction angiography machine through angiography; mark the anatomical position on the limb blood vessels displayed on the screen of the digital subtraction angiography machine, so that the lesion site observed by the ultrasound catheter can be accurately located on the angiography image; Step 4: Similarly, mark the positions of the normal blood vessels proximal to the lesion, the normal blood vessels distal to the lesion, and the proximal and distal ends of the lesion on the screen of the digital subtraction angiography machine and the intravascular ultrasound diagnostic instrument; Step 5: withdraw the intracavitary ultrasound catheter, measure the normal blood vessel diameter marked in step 4 on the intravascular ultrasound diagnostic instrument, and select a balloon or stent of appropriate size based on the diameter. The length of the balloon and stent is determined by the length between the proximal and distal ends of the lesion marked on the screen of the digital subtraction angiography machine; Step 6: After the lesion is treated, the intracavitary ultrasound catheter is reintroduced in the same way to observe whether the stenosis at the proximal and distal ends of the diseased vessel just marked and at the narrowest part of the lesion is relieved; if the treatment is not satisfactory, the position of the residual lesion is relocated for treatment; if the treatment is satisfactory, the intracavitary ultrasound catheter is withdrawn and the operation is completed.

5. A storage device as claimed in claim 4, characterized in that: In step 3, the speed of pushing the intracavitary ultrasound catheter from the proximal end of the lesion to the distal end of the lesion is 0.5 cm / s.

6. A storage device as claimed in claim 4, characterized in that: In step 3, the ultrasound catheter is delivered to the proximal end of the vascular lesion by using a guide wire with a nominal diameter of 0.014 in.