Reconstruction methods and devices for coronary artery chronic total occlusion lesions

Abstract

This invention provides a method and apparatus for reconstructing chronically totally occluded coronary arteries (CTOs). The method includes: obtaining multiple first markers on a forward angiographic image of the CTO during interventional treatment, each first marker corresponding to the location of multiple markers; obtaining multiple second markers on a reverse angiographic image of the CTO, each second marker corresponding to the location of multiple markers; and reconstructing the occluded segment of the coronary artery between the proximal and distal segments based on the composite image to connect the proximal and distal segments, thereby obtaining a reconstructed angiographic image containing the intact lesion. This invention effectively solves the problems of requiring an additional vascular access and bidirectional angiography in interventional treatment of CTOs in related technologies, reducing the risks and surgical costs associated with these technologies.

Description

Technical Field

[0001] This invention relates to the field of coronary artery medical technology, and more specifically, to a method and apparatus for reconstructing chronically totally occluded coronary arteries. Background Technology

[0002] Chronic total occlusion (CTO) of the coronary arteries is the last line of defense in interventional treatment of coronary heart disease. Although the success rate of CTO interventional treatment has been increasing year by year with the development of medical devices, reaching up to 90%, the treatment is time-consuming, involves a large amount of contrast agent, and involves a large dose of radiation, posing a huge challenge to both clinicians and patients. During CTO intervention, because the occluded segment of the vessel obstructs the passage of contrast agent, antegrade angiography can only show the outline of the vessel near the occluded segment, not the outline of the vessel distal to the occluded segment. Relying solely on the antegrade interventional approach often results in a low success rate. In this case, retrograde angiography is necessary, allowing the contrast agent to fill the outline of the vessel distal to the occluded segment through collateral vessels, thus clarifying the vessel's course. After retrograde angiography, the operator can adjust the course of the antegrade guidewire based on the course of the distal vessel shown in the retrograde angiography, allowing the guidewire to enter the distal vessel. Currently, internationally, bidirectional angiography, using both antegrade and retrograde angiography, is used simultaneously in treatment to clarify the course of the distal vessel.

[0003] The application of bidirectional angiography has significantly improved the success rate of CTO treatment. However, bidirectional angiography requires the establishment of an additional vascular access outside the occluded segment of the vessel, necessitating repeated femoral or radial artery puncture and sheath placement, increasing patient discomfort, the risk of vascular complications, and medical costs. Secondly, bidirectional angiography uses a large contrast dose, further increasing the risk of contrast-induced nephropathy and renal failure. Summary of the Invention

[0004] The main objective of this invention is to provide a method and device for reconstructing coronary artery lesions with chronic total occlusion, in order to solve the problem that bidirectional angiography technology in related technologies requires the establishment of an additional vascular access outside the occluded segment of the vessel.

[0005] To achieve the above objectives, according to one aspect of the present invention, a method for reconstructing a chronically totally occluded coronary artery is provided, comprising: obtaining a plurality of first markers on a forward angiographic image of the chronically totally occluded coronary artery, the plurality of first markers corresponding to the positions of a plurality of markers; obtaining a plurality of second markers on a reverse angiographic image of the chronically totally occluded coronary artery, the plurality of second markers corresponding to the positions of a plurality of markers; obtaining a composite image based on the plurality of first markers and the plurality of second markers, wherein the composite image includes a set of proximal vessels from the forward angiographic image and distal vessels from the reverse angiographic image; and reconstructing the occluded segment of the vessel between the proximal and distal vessels based on the composite image to connect the proximal and distal vessels, thereby obtaining a reconstructed angiographic image containing the intact lesion vessel.

[0006] Furthermore, the step of obtaining the ensemble image based on multiple first markers and multiple second markers includes: superimposing the forward angiography image and the reverse angiography image, so that multiple second markers coincide with multiple first markers in a one-to-one correspondence, and retaining the proximal vessels in the forward angiography image and the distal vessels in the reverse angiography image to obtain the ensemble image.

[0007] Furthermore, the step of superimposing the forward and reverse contrast images includes: marking multiple first marks on the forward contrast image with different colors, marking multiple second marks on the reverse contrast image with different colors, and marking multiple first marks and multiple second marks with the same color in a one-to-one correspondence, so that the first and second marks of the same color correspond to the same marker.

[0008] Furthermore, prior to the step of obtaining multiple first markers on the antegrade angiographic image of the coronary artery chronic total occlusion lesion, where the multiple first markers correspond to the positions of multiple markers, the reconstruction method for the coronary artery chronic total occlusion lesion further includes: performing antegrade angiography on the coronary artery chronic total occlusion lesion to obtain an antegrade angiographic image containing the proximal vessel; and performing retrograde angiography on the coronary artery chronic total occlusion lesion to obtain a retrograde angiographic image containing the distal vessel.

[0009] Furthermore, in the steps of performing antegrade angiography and retrograde angiography of chronic total occlusion (CTO) coronary artery lesions, the antegrade and retrograde angiography processes are performed at the same angle of the same X-ray generator.

[0010] Furthermore, the angle is between 30 and 45 degrees.

[0011] Furthermore, the step of obtaining a retrograde angiography image containing a distal vessel includes: in the video image of the retrograde angiography, the frame in which the distal vessel closest to the occluded segment appears is the retrograde angiography image containing the distal vessel.

[0012] Furthermore, multiple markers include at least two of the following: guidewire, rib shadow, cardiac shadow, mediastinal shadow, diaphragmatic shadow, spinal shadow, and coronary sinus shadow.

[0013] Furthermore, the occluded segment of the vessel on the reconstructed imaging image includes an inner contour line and an outer contour line, wherein the inner contour line is a first arc line and the outer contour line is a second arc line, and the curvature of the first arc line is smaller than that of the second arc line; or, the inner contour line includes multiple third arc lines connected in sequence, and the outer contour line includes a straight line.

[0014] According to another aspect of the present invention, a reconstruction apparatus for a chronically totally occluded coronary artery is provided, comprising: a first image marker acquisition unit for acquiring multiple first markers on a forward angiographic image of the chronically totally occluded coronary artery, the multiple first markers corresponding to the positions of multiple markers; a second image marker acquisition unit for acquiring multiple second markers on a reverse angiographic image of the chronically totally occluded coronary artery, the multiple second markers corresponding to the positions of multiple markers; an aggregate image construction unit for acquiring an aggregate image based on the multiple first markers and the multiple second markers, wherein the aggregate image includes an aggregate of proximal vessels from the forward angiographic image and distal vessels from the reverse angiographic image; and a reconstruction angiographic image unit for reconstructing the occluded segment of the proximal and distal vessels based on the aggregate image, to connect the proximal and distal vessels, thereby obtaining a reconstruction angiographic image containing the intact lesion vessel.

[0015] According to the technical solution of the present invention, the method for reconstructing a chronically totally occluded coronary artery includes: obtaining multiple first markers on a forward angiographic image of the chronically totally occluded coronary artery, the multiple first markers corresponding to the positions of multiple markers; obtaining multiple second markers on a reverse angiographic image of the chronically totally occluded coronary artery, the multiple second markers corresponding to the positions of multiple markers; obtaining a composite image based on the multiple first markers and the multiple second markers, wherein the composite image includes a set of proximal vessels from the forward angiographic image and distal vessels from the reverse angiographic image; and reconstructing the occluded segment of the vessel between the proximal and distal vessels based on the composite image to connect the proximal and distal vessels, thereby obtaining a reconstructed angiographic image containing the intact lesion vessel. This surgical approach, creating a complete path through the diseased vessel, facilitates real-time visualization of the occluded and distal segments of the vessel during CTO intervention. It allows for sequential access through the proximal and occluded segments to reach the distal segment, eliminating the need for a separate vascular access during CTO intervention. This reduces complications and medical costs, and can replace bidirectional angiography, minimizing contrast agent usage and the risk of coronary artery damage. Therefore, the technical solution presented in this application effectively addresses the issue of requiring an additional vascular access outside the occluded segment in related bidirectional angiography techniques. Attached Figure Description

[0016] The accompanying drawings, which form part of this application, are used to provide a further understanding of the invention. The illustrative embodiments of the invention and their descriptions are used to explain the invention and do not constitute an undue limitation of the invention. In the drawings:

[0017] Figure 1 A flowchart illustrating an embodiment of a method for reconstructing coronary artery vessels with chronic total occlusion according to the present invention is shown;

[0018] Figure 2 A schematic diagram of an embodiment of a coronary artery reconstruction device for chronic total occlusion lesions according to the present invention is shown;

[0019] Figure 3 It shows Figure 2 An anterior angiographic image of a preferred example 1 of a coronary artery reconstruction device for chronic total occlusion lesions;

[0020] Figure 4 It shows Figure 2 Retrograde angiography image of a preferred example 1 of a coronary artery reconstruction device for chronic total occlusion lesions;

[0021] Figure 5 It shows Figure 2 An anteroposterior angiographic image containing proximal vessels and multiple first markers, of a preferred example 1 of a coronary artery chronic total occlusion reconstruction device.

[0022] Figure 6 It shows Figure 2 Retrograde angiography image containing distal vessels and multiple second markers, of preferred example 1 of a coronary artery chronic total occlusion reconstruction device;

[0023] Figure 7 It shows Figure 2 Reconstruction imaging of a preferred example 1 of a coronary artery reconstruction device for chronic total occlusion lesions;

[0024] Figure 8 It shows Figure 2 The preferred embodiment of the coronary artery chronic total occlusion lesion reconstruction device 1 uses a real-time correction unit to correct the display image of the distal vessel in real time.

[0025] Figure 9 It shows Figure 2 The preferred example of a reconstruction device for chronic total occlusion of coronary arteries is a display image of the proximal vessel and the distal vessel after real-time correction by a real-time correction unit.

[0026] Figure 10 It shows Figure 2An anterior angiographic image of a preferred example 1 of a coronary artery reconstruction device for chronic total occlusion lesions;

[0027] Figure 11 It shows Figure 2 Retrograde angiography image of preferred example 2 of a coronary artery reconstruction device for chronic total occlusion lesions;

[0028] Figure 12 It shows Figure 2 An anteroposterior angiographic image containing proximal vessels and multiple first markers, of a preferred example 2 of a coronary artery chronic total occlusion lesion reconstruction device.

[0029] Figure 13 It shows Figure 2 The preferred example 2 of the reconstruction device for chronic total occlusion of coronary arteries shows a retrograde angiography image containing distal vessels and multiple second markers.

[0030] Figure 14 It shows Figure 2 Reconstruction imaging images of preferred example 2 of a coronary artery reconstruction device for chronic total occlusion lesions;

[0031] Figure 15 It shows Figure 2 The preferred embodiment of the coronary artery chronic total occlusion lesion reconstruction device 2 has a real-time correction unit that corrects the display image of the distal vessel in real time.

[0032] Figure 16 It shows Figure 2 The preferred example 2 of the reconstruction device for chronic total occlusion of coronary arteries shows the proximal vessel and the display image after real-time correction of the distal vessel by the real-time correction unit.

[0033] Figure 17 It shows Figure 2 A preferred example of a reconstruction device for chronic total occlusion of coronary arteries, showing a guidewire deviating from a distal vessel in Example 2.

[0034] Figure 18 It shows Figure 2 The preferred example 2 of the coronary artery reconstruction device for chronic total occlusion lesions shows the guidewire being inserted into the distal vessel in the correct direction.

[0035] The above figures include the following reference numerals:

[0036] 1. First image marker acquisition unit; 2. Second image marker acquisition unit; 3. Image assembly construction unit; 4. Reconstructed image unit; 5. Real-time correction unit;

[0037] 11. Proximal vessel; 12. Distal vessel; 13. Occluded segment vessel; 21. Guide wire; 22. Cardiac shadow; 23. Rib shadow; 24. Spinal shadow; 25. Diaphragm shadow. Detailed Implementation

[0038] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. The following description of at least one exemplary embodiment is merely illustrative and is in no way intended to limit the present invention or its application or use. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0039] It should be noted that the terminology used herein is for the purpose of describing particular embodiments only and is not intended to limit the exemplary embodiments according to this application. As used herein, the singular form is intended to include the plural form as well, unless the context clearly indicates otherwise. Furthermore, it should be understood that when the terms "comprising" and / or "including" are used in this specification, they indicate the presence of features, steps, operations, devices, components, and / or combinations thereof.

[0040] Unless otherwise specifically stated, the relative arrangement, numerical expressions, and values ​​of the components and steps set forth in these embodiments do not limit the scope of the invention. It should also be understood that, for ease of description, the dimensions of the various parts shown in the drawings are not drawn to actual scale. Techniques, methods, and devices known to those skilled in the art may not be discussed in detail, but where appropriate, such techniques, methods, and devices should be considered part of the specification. In all examples shown and discussed herein, any specific values ​​should be interpreted as merely exemplary and not as limitations. Therefore, other examples of exemplary embodiments may have different values. It should be noted that similar reference numerals and letters in the following figures denote similar items; therefore, once an item is defined in one figure, it need not be further discussed in subsequent figures.

[0041] like Figures 1 to 18As shown, this embodiment provides a method for reconstructing a chronically totally occluded coronary artery lesion, comprising: S20, obtaining multiple first markers on a forward angiographic image of the chronically totally occluded coronary artery lesion, the multiple first markers corresponding to the positions of multiple markers; S30, obtaining multiple second markers on a reverse angiographic image of the chronically totally occluded coronary artery lesion, the multiple second markers corresponding to the positions of multiple markers; S40, obtaining a set image based on the multiple first markers and the multiple second markers, wherein the set image includes a set of proximal vessels 11 in the forward angiographic image and distal vessels 12 in the reverse angiographic image; S50, reconstructing the occluded segment vessel 13 between the proximal vessels 11 and the distal vessels 12 based on the set image, to connect the proximal vessels 11 and the distal vessels 12, to obtain a reconstructed angiographic image containing the complete lesion vessel.

[0042] By applying the technical solution of this embodiment, based on the aggregated images, the occluded segment of vessel 13 between the proximal vessel 11 and the distal vessel 12 is reconstructed to connect the proximal vessel 11 and the distal vessel 12, thereby obtaining a reconstructed imaging image containing the complete diseased vessel. This forms a surgical approach with a complete diseased vessel, facilitating real-time display of the occluded segment of vessel 13 and the distal vessel 12 during CTO interventional treatment. It allows for sequential access through the proximal vessel 11 and the occluded segment of vessel 13 to the distal vessel 12, enabling the CTO interventional procedure to utilize only one surgical path without the need for an additional vascular approach, reducing complications and medical costs. It can also replace bidirectional angiography, reducing contrast agent usage and the risk of coronary artery damage. Therefore, the technical solution of this embodiment effectively solves the problem in related technologies where bidirectional angiography requires an additional vascular approach outside the occluded segment of vessel. Furthermore, it can display the course of the occluded segment and the distal vessel during interventional treatment to guide the direction of interventional treatment.

[0043] It should be noted that "proximal vessel 11" refers to the segment of the vessel closest to the occluded segment 13 shown on the anteroposterior angiography image, and "distal vessel 12" refers to the segment of the vessel closest to the occluded segment 13 shown on the retrograde angiography image. The "vascular approach" mentioned above refers to the radial artery of the left or right hand, or the bony artery of the left or right leg.

[0044] like Figures 1 to 18 As shown, in order to facilitate the superposition of the forward and reverse angiography images so that the proximal vessel 11 in the forward angiography image and the distal vessel 12 in the reverse angiography image are on the same surgical path, the step of obtaining the composite image based on multiple first markers and multiple second markers includes: superimposing the forward and reverse angiography images so that multiple second markers coincide with multiple first markers in a one-to-one correspondence, and retaining the proximal vessel 11 in the forward angiography image and the distal vessel 12 in the reverse angiography image to obtain the composite image.

[0045] In this embodiment, the composite images can be superimposed based on either a forward contrast image or a reverse contrast image, but prioritizing the forward contrast image is preferred.

[0046] like Figures 1 to 18 As shown, in order to facilitate the overlaying of the forward and reverse contrast images, the steps of overlaying the forward and reverse contrast images include: marking multiple first marks on the forward contrast image with different colors, marking multiple second marks on the reverse contrast image with different colors, and marking multiple first marks and multiple second marks with the same color in a one-to-one correspondence, so that the first marks and second marks of the same color correspond to the same marker.

[0047] Before marking different markers with different colors, the reconstruction device for chronic total occlusion of coronary arteries can automatically adjust the contrast and brightness according to the colors of the forward and reverse angiographic images to increase the clarity of the markers.

[0048] like Figures 1 to 18 As shown, in order to obtain an antegrade angiography image containing the proximal vessel 11 and a retrograde angiography image containing the distal vessel 12, prior to the step of obtaining multiple first markers on the antegrade angiography image of the chronic total occlusion (CTO) lesion vessel, where the multiple first markers correspond to the positions of multiple markers, the reconstruction method for the CTO lesion vessel further includes: S10, performing antegrade angiography on the CTO lesion vessel to obtain an antegrade angiography image containing the proximal vessel 11; and performing retrograde angiography on the CTO lesion vessel to obtain a retrograde angiography image containing the distal vessel 12.

[0049] like Figures 1 to 18 As shown, in order to obtain images of coronary artery chronic total occlusion lesions completely filled with contrast agent, the antegrade and retrograde angiography procedures for coronary artery chronic total occlusion lesions are performed at the same angle from the same X-ray generator. The X-ray generator is preferably a digital subtraction angiography (DSA) machine.

[0050] like Figures 1 to 18 As shown, the angle is between 30 and 45 degrees. This selection of the projection angle allows for full expansion of the coronary arteries without overlap, enabling the injection of contrast agent into the chronic total occlusion lesion of the coronary artery. The preferred angles are RAO (right anterior oblique) 30 degrees, CRAN (cephalic view) 30 degrees, or LAO 45 degrees (left anterior oblique view).

[0051] Furthermore, in order to obtain a single frame image of the fully filled contrast agent as a retrograde angiography image containing the distal vessel 12, the step of obtaining the retrograde angiography image containing the distal vessel 12 includes: obtaining a single frame image of the distal vessel 12 that appears closest to the occluded segment of the vessel 13 in the retrograde angiography video image as the retrograde angiography image containing the distal vessel 12. The video images are manually played at 7.5 frames, 15 frames, or 30 frames per second.

[0052] In this embodiment, the frame of the forward angiography image in which the distal vessel 12 closest to the occluded segment 13 appears is the forward angiography image containing the proximal vessel 11.

[0053] like Figures 1 to 18 As shown, to facilitate the identification of multiple markers on the forward angiography image by the first image marker acquisition unit 1, and to facilitate the identification of multiple markers on the reverse angiography image by the second image marker acquisition unit 2, the multiple markers include at least two of the following: guidewire 21, rib shadow 23, cardiac shadow 22, mediastinal shadow, diaphragmatic shadow 25, spinal shadow 24, and coronary sinus shadow. Based on the multiple markers, multiple first markers and multiple second markers can be modified and corrected using a mouse in the form of points, lines, and surfaces.

[0054] like Figures 1 to 18 As shown, the occluded segment of vessel 13 in the reconstructed imaging image includes an inner contour line and an outer contour line. During CTO interventional treatment, to ensure the guidewire 21 has an accurate trajectory, the inner contour line is a first arc, and the outer contour line is a second arc, with the curvature of the first arc being smaller than that of the second arc. The inner and outer contour lines are manually interpreted and corrected.

[0055] In other embodiments, during CTO interventional treatment, to ensure accurate routing of the guidewire 21, the inner contour line includes multiple sequentially connected third arc segments, and the outer contour line includes a straight line. Specifically, the multiple third arc segments include a first outwardly convex segment, an inwardly concave segment, and a second outwardly convex segment connected in sequence.

[0056] This application also provides a reconstruction device for coronary artery chronic total occlusion lesions, used to perform the coronary artery chronic total occlusion lesion reconstruction method provided in the embodiments of this application. For example... Figures 2 to 18The reconstruction device for chronic total occlusion (CTO) lesions of the coronary arteries shown includes: a first image marker acquisition unit 1, a second image marker acquisition unit 2, an aggregated image construction unit 3, and a reconstructed imaging image unit 4. The first image marker acquisition unit 1 is used to obtain multiple first markers on the antegrade angiographic image of the CTO lesion, with each first marker corresponding to the position of multiple markers. The second image marker acquisition unit 2 is used to obtain multiple second markers on the retrograde angiographic image of the CTO lesion, with each second marker corresponding to the position of multiple markers. The aggregated image construction unit 3 is used to obtain an aggregated image based on the multiple first and second markers, wherein the aggregated image includes a set of the proximal vessel 11 from the antegrade angiographic image and the distal vessel 12 from the retrograde angiographic image. The reconstructed imaging image unit 4 is used to reconstruct the occluded segment 13 between the proximal vessel 11 and the distal vessel 12 based on the aggregated image, connecting the proximal vessel 11 and the distal vessel 12 to obtain a reconstructed imaging image containing the complete lesion vessel. Therefore, the technical solution using a reconstruction device for chronic total occlusion (CTO) coronary artery lesions greatly simplifies the CTO interventional treatment process, shortens the operation time and radiation exposure for both doctors and patients, and allows only one surgical path to be established during CTO surgery without the need for an additional vascular access, reducing complications and medical costs. It can also replace bidirectional angiography, reducing the amount of contrast agent used, lowering the risk of kidney damage or kidney failure and the risk of coronary artery damage, and solving the problem that bidirectional angiography requires the establishment of an additional vascular access outside the occluded segment.

[0057] Specifically, in this embodiment, after the first image marker acquisition unit 1 extracts the proximal blood vessel 11, it analyzes it and marks and outlines the first marker and the proximal blood vessel 11. After the second image marker acquisition unit 2 extracts the distal blood vessel 12, it analyzes it and marks and outlines the second marker and the distal blood vessel 12. The image assembly unit 3 analyzes the outlines of the first and second markers. The image assembly unit 3 superimposes the forward and reverse angiography images, so that multiple second markers correspond one-to-one with multiple first markers, and retains the proximal blood vessel 11 in the forward angiography image and the distal blood vessel 12 in the reverse angiography image. The reconstruction image unit 4 reconstructs a reconstruction image containing the complete lesion blood vessel based on the image assembly image constructed by the image assembly unit 3. During the interventional procedure, the course of the distal blood vessel 12 of the occluded segment blood vessel 13 needs to be corrected in real time according to the proximal blood vessel 11. This is operated by the real-time correction unit 5 in the reconstruction device for chronic total occlusion lesions of coronary arteries. The real-time correction unit 5 can integrate the functions of the first image marker acquisition unit 1, the second image marker acquisition unit 2, the image assembly unit 3, and the reconstruction imaging image unit 4. Based on the images during the interventional surgery, it can use the functions of the above three units to correct and display the course of the distal vessel 12 of the occluded segment vessel 13, and finally realize the circulation between units.

[0058] The following describes in detail, with reference to two specific preferred embodiments, the coronary artery chronic total occlusion lesion reconstruction device of this application for performing the coronary artery chronic total occlusion lesion reconstruction method provided in the embodiments of this application:

[0059] Preferred Example 1:

[0060] like Figure 3 The image shown is an angiographic image of a CTO lesion in the left anterior descending artery of a patient with coronary artery disease. First, an anteroposterior angiography was performed, and a projection angle was selected to fully expand the left anterior descending artery without overlap. Contrast agent was injected into the chronic total occlusion lesion of the coronary artery. The X-ray projection angle of this image is RAO 30 degrees and CRAN 30 degrees, and finally a complete anteroposterior angiographic image was obtained.

[0061] Figure 4 With the same X-ray projection angles of RAO30 degrees and CRAN30 degrees, retrograde angiography was performed through the right coronary artery to visualize the distal segment of the left anterior descending artery 12, ultimately obtaining a complete retrograde angiographic image of the left anterior descending artery CTO.

[0062] Figure 5The first image marking acquisition unit 1 automatically identifies and marks the proximal blood vessel 11 and the outline of multiple first marks according to the selected positive angiography vessel filling image. The multiple first marks correspond to multiple markers including cardiac shadow 22, rib shadow 23 and diaphragm shadow 25.

[0063] Figure 6 The second image marking acquisition unit 2 automatically identifies and marks the outlines of the distal blood vessel 12 and multiple second markings using different colors and second marking methods based on the selected reverse angiography image containing the distal blood vessel 12; wherein the multiple markings correspond to multiple markers including cardiac shadow 22, rib shadow 23 and diaphragm shadow 25.

[0064] Furthermore, the image construction unit 3 and the reconstructed image unit 4 will be based on Figure 5 and Figure 6 The outlines of the proximal vessel 11, the distal vessel 12, multiple first markers, and multiple second markers are superimposed to reconstruct the complete course of the diseased vessel, including the proximal vessel 11, the occluded segment vessel 13, and the distal vessel 12. Figure 7 The image shown is a reconstructed echo image of the left anterior descending branch CTO.

[0065] Furthermore, such as Figure 8 As shown, the operator is attempting to perform CTO intervention in the left anterior descending artery via the antegrade approach. The real-time correction unit 5 of the coronary artery chronic total occlusion lesion reconstruction device displays the distal vessel 12 on the display screen in real time, helping the operator determine the course of the guidewire 21.

[0066] Furthermore, such as Figure 9 As shown, the operator is attempting CTO interventional treatment of the left anterior descending artery via the antegrade approach. At this time, the injection of contrast agent via the antegrade approach reveals the proximal vessel 11. The real-time correction unit 5 of the coronary artery chronic total occlusion lesion reconstruction device of this application corrects the course of the distal vessel 12 according to the contrast agent injection correction process and displays it on the display screen in real time, updating the position of the distal vessel 12 in a timely manner.

[0067] Preferred Example 2:

[0068] like Figure 10 The image shown is an angiographic image of a CTO lesion in the right coronary artery of a patient with coronary heart disease. First, an anteroposterior angiography was performed, and a projection angle was selected to fully expand the right coronary artery without overlap. Contrast agent was injected into the chronic total occlusion lesion of the coronary artery. The X-ray projection angle of this image is LAO45 degrees, and a complete anteroposterior angiographic image was finally obtained.

[0069] Figure 11With the same X-ray projection angle of LAO45 degrees, retrograde angiography was performed through the left coronary artery to visualize the distal segment 12 of the right coronary artery, ultimately obtaining a complete retrograde angiographic image of the right coronary artery CTO.

[0070] Figure 12 The first image marking acquisition unit 1 automatically identifies and marks the outlines of the proximal blood vessel 11 and multiple first markings based on the selected orthogonal angiography image containing the proximal blood vessel 11, using different colors and first marking methods; among which, the multiple markings corresponding to the multiple first markings include guide wire 21, cardiac shadow 22, rib shadow 23, spinal shadow 24 and diaphragm shadow 25.

[0071] Figure 13 The second image marking acquisition unit 2 automatically identifies and marks the outlines of the distal blood vessel 12 and multiple second markings using different colors and second marking methods based on the selected reverse angiography image containing the distal blood vessel 12; among which the multiple markings correspond to multiple markers including cardiac shadow 22, rib shadow 23, spinal shadow 24 and diaphragm shadow 25.

[0072] Furthermore, the image construction unit 3 and the reconstructed image unit 4 will be based on Figure 12 and Figure 13 The outlines of the proximal vessel 11, the distal vessel 12, multiple first markers, and multiple second markers are superimposed to reconstruct the complete course of the diseased vessel, including the proximal vessel 11, the occluded segment vessel 13, and the distal vessel 12. Figure 14 The image shown is an angiographic image of a reconstructed CTO in the right coronary artery.

[0073] Furthermore, such as Figure 15 As shown, the operator is attempting to perform CTO intervention on the right coronary artery via the antegrade approach. The real-time correction unit 5 of the coronary artery chronic total occlusion lesion reconstruction device displays the occluded segment vessel 13 and the distal segment vessel 12 on the display screen in real time, helping the operator determine the course of the guidewire 21.

[0074] Furthermore, such as Figure 16 As shown, the operator is attempting to perform CTO interventional treatment on the right coronary artery via the antegrade approach. At this time, the injection of contrast agent via the antegrade approach reveals the proximal vessel 11. The real-time correction unit 5 of the coronary artery chronic total occlusion lesion reconstruction device of this application corrects the course of the distal vessel 12 according to the contrast agent injection correction process and displays it on the display screen in real time, updating the position of the distal vessel 12 in a timely manner.

[0075] Furthermore, such as Figure 17As shown, the operator is attempting CTO intervention in the right coronary artery via the antegrade approach. The guidewire 21 is not in the correct lumen. At this time, the injection of contrast agent via the antegrade approach shows the proximal vessel 11. The real-time correction unit 5 of this application corrects the course of the distal vessel 12 according to the contrast agent injection correction procedure and displays it on the display screen in real time, updating the position of the distal vessel 12 in a timely manner and helping the operator to find that the guidewire 21 is misaligned and deviates from the distal vessel 12. At this time, the course of the guidewire 21 needs to be readjusted.

[0076] Ultimately Figure 18 As shown, with the help of a reconstruction device for chronic total occlusion (CTO) lesions of the coronary artery, the operator guided guidewire 21 into the lumen of the distal vessel in the correct direction and successfully treated the CTO lesion.

[0077] The first image marker acquisition unit, the second image marker acquisition unit, the combined image construction unit, the reconstructed image unit, and the real-time correction unit of the present invention can be specifically implemented in the following forms: a completely hardware implementation, a completely software implementation (including firmware, resident software, microcode, etc.), or a combination of hardware and software implementations, collectively referred to herein as a "circuit," "module," or "system." Furthermore, in some embodiments, the first image marker acquisition unit, the second image marker acquisition unit, the combined image construction unit, the reconstructed image unit, and the real-time correction unit of the present invention can also be implemented as a computer program product in one or more computer-readable media, the computer-readable medium containing computer-readable program code. The implementation of the methods and / or systems of the embodiments of the present invention can involve performing or completing selected tasks manually, automatically, or in a combination thereof.

[0078] For example, the hardware for performing selected tasks according to embodiments of the invention can be implemented as a chip or circuit. As software, the selected tasks according to embodiments of the invention can be implemented as a plurality of software instructions executed by a computer using any suitable operating system. In exemplary embodiments of the invention, one or more tasks as described herein according to exemplary embodiments of the method and / or system are performed by a first image marker acquisition unit, a second image marker acquisition unit, an image assembly unit, a reconstructed image unit, and a real-time correction unit, such as a computing platform for executing multiple instructions. Optionally, the first image marker acquisition unit, the second image marker acquisition unit, the image assembly unit, the reconstructed image unit, and the real-time correction unit include volatile storage for storing instructions and / or data and / or non-volatile storage for storing instructions and / or data, such as magnetic hard disks and / or removable media. Optionally, a network connection is also provided. Optionally, a display and / or user input device, such as a keyboard or mouse, are also provided.

[0079] One or more computer-readable combinations may be used. A computer-readable medium can be a computer-readable signal medium or a computer-readable storage medium. A computer-readable storage medium can be, for example—but not limited to—an electrical, magnetic, optical, electromagnetic, infrared, or semiconductor system, apparatus, or device, or any combination thereof. More specific examples (a non-exhaustive list) of computer-readable storage media will include the following:

[0080] An electrical connection having one or more wires, a portable computer disk, a hard disk, random access memory (RAM), read-only memory (ROM), erasable programmable read-only memory (EPROM or flash memory), optical fiber, portable compact disc read-only memory (CD-ROM), optical storage device, magnetic storage device, or any suitable combination thereof. In this document, a computer-readable storage medium can be any tangible medium containing or storing a program that can be used by or in conjunction with an instruction execution system, apparatus, or device.

[0081] The program code contained on the computer-readable medium can be transmitted using any suitable medium, including (but not limited to) wireless, wired, optical fiber, RF, etc., or any suitable combination thereof. For example, computer program code for performing operations for various aspects of the present invention can be written using any combination of one or more programming languages, including object-oriented programming languages ​​such as Java, Smalltalk, C++, and conventional procedural programming languages ​​such as the "C" programming language or similar languages. The program code can be executed entirely on the user's computer, partially on the user's computer, as a standalone software package, partially on the user's computer and partially on a remote computer, or entirely on a remote computer or server. In cases involving remote computers, the remote computer can be connected to the user's computer via any type of network, including a local area network (LAN) or a wide area network (WAN), or it can be connected to an external computer (e.g., via the Internet using an Internet service provider).

[0082] Each block of the flowcharts and / or block diagrams of this application, as well as combinations of blocks in the flowcharts and / or block diagrams, can be implemented by computer program instructions. These computer program instructions can be provided to a processor of a general-purpose computer, a special-purpose computer, or other programmable data processing apparatus to produce a machine such that, when executed by a processor of a computer or other programmable data processing apparatus, these computer program instructions create means for implementing the functions / actions specified in one or more blocks of the flowcharts and / or block diagrams.

[0083] The above description is merely a preferred embodiment of the present invention and is not intended to limit the invention. Various modifications and variations can be made to the present invention by those skilled in the art. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the scope of protection of the present invention.

Claims

1. A method of revascularization of a coronary artery chronic total occlusion lesion, characterized by, The method comprises: obtaining a plurality of first marks on a forward angiography image of a coronary artery chronic total occlusion lesion vessel, the plurality of first marks corresponding to positions of a plurality of markers; obtaining a plurality of second marks on a reverse angiography image of the coronary artery chronic total occlusion lesion vessel, the plurality of second marks corresponding to positions of the plurality of markers; obtaining a combined image according to the plurality of first marks and the plurality of second marks, wherein the combined image comprises a proximal segment vessel (11) of the forward angiography image and a distal segment vessel (12) of the reverse angiography image; reconstructing an occlusion segment vessel (13) between the proximal segment vessel (11) and the distal segment vessel (12) according to the combined image to connect the proximal segment vessel (11) and the distal segment vessel (12) to obtain a reconstructed angiography image containing a complete lesion vessel; wherein the step of obtaining a combined image according to the plurality of first marks and the plurality of second marks comprises: superimposing the forward angiography image and the reverse angiography image, so that the plurality of second marks and the plurality of first marks coincide one by one, and the proximal segment vessel (11) of the forward angiography image and the distal segment vessel (12) of the reverse angiography image are retained to obtain the combined image.

2. The method of revascularization of a chronic total occlusion lesion of a coronary artery according to claim 1, characterized in that, The step of superimposing the forward angiography image and the reverse angiography image comprises: marking the plurality of first marks on the forward angiography image as different colors, marking the plurality of second marks on the reverse angiography image as different colors, and marking the plurality of first marks and the plurality of second marks one by one as the same color, so that the first marks and the second marks of the same color correspond to the same marker.

3. The method of revascularization of a chronic total occlusion lesion of a coronary artery according to claim 1, characterized in that, Before the step of obtaining a plurality of first marks on a forward angiography image of a coronary artery chronic total occlusion lesion vessel, the plurality of first marks corresponding to positions of a plurality of markers, the method for reconstructing a coronary artery chronic total occlusion lesion vessel further comprises: performing forward angiography on a coronary artery chronic total occlusion lesion vessel to obtain a forward angiography image containing a proximal segment vessel (11); performing reverse angiography on the coronary artery chronic total occlusion lesion vessel to obtain a reverse angiography image containing a distal segment vessel (12).

4. The method of revascularization of a chronic total occlusion lesion of a coronary artery according to claim 3, characterized in that, In the steps of performing the forward angiography on the coronary artery chronic total occlusion lesion vessel and performing the reverse angiography on the coronary artery chronic total occlusion lesion vessel, the forward angiography process and the reverse angiography process are operated under the same angle of a same ray generator.

5. The method of revascularization of a chronic total occlusion lesion of a coronary artery according to claim 4, characterized in that, The angle is between 30 degrees and 45 degrees.

6. The method of revascularization of a chronic total occlusion lesion of a coronary artery according to claim 3, wherein, The step of obtaining a reverse angiography image containing the distal segment vessel (12) comprises: a frame image of the distal segment vessel (12) closest to an occlusion segment vessel (13) in a video image of the reverse angiography is the reverse angiography image containing the distal segment vessel (12).

7. The method of revascularization of a chronic total occlusion lesion of a coronary artery according to claim 1, wherein, The plurality of markers comprises at least two of a guide wire (21), a rib shadow (23), a heart shadow (22), a mediastinum shadow, a diaphragm muscle shadow (25), a spine shadow (24), and a coronary sinus shadow.

8. The method of claim 1, wherein the occluded segment vessel (13) on the reconstructed angiogram comprises an inner contour line and an outer contour line. The inner contour line is a first arc line, and the outer contour line is a second arc line, wherein the first arc line has a smaller curvature than the second arc line; or the inner contour line comprises a plurality of third arc lines connected in sequence, and the outer contour line comprises a straight line. The device for performing the method of any one of claims 1 to 8, the device for reconstructing a coronary chronic total occlusion vessel comprises:

9. A device for revascularization of a coronary artery chronic total occlusion lesion, comprising: a first image marker acquisition unit (1) configured to obtain a plurality of first markers on an anterograde angiogram of a coronary chronic total occlusion vessel, wherein the plurality of first markers correspond to positions of a plurality of markers; a second image marker acquisition unit (2) configured to obtain a plurality of second markers on a retrograde angiogram of the coronary chronic total occlusion vessel, wherein the plurality of second markers correspond to the positions of the plurality of markers; a set image construction unit (3) configured to obtain a set image according to the plurality of first markers and the plurality of second markers, wherein the set image comprises a proximal segment vessel (11) of the anterograde angiogram and a distal segment vessel (12) of the retrograde angiogram; a reconstructed angiogram unit (4) configured to reconstruct an occluded segment vessel (13) between the proximal segment vessel (11) and the distal segment vessel (12) according to the set image, to connect the proximal segment vessel (11) and the distal segment vessel (12), and to obtain a reconstructed angiogram comprising a complete lesion vessel. ​

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