Stent planning device for stenosis lesion blood vessel and computer readable storage medium

Abstract

According to the stent planning device for the narrow lesion blood vessels and the computer readable storage medium provided by the embodiment of the invention, the following stent planning method can be realized: the blood flow influence degrees of two narrow lesions are respectively obtained, and the first narrow lesion with the relatively large blood flow influence degree and the second narrow lesion with the relatively small blood flow influence degree are obtained; placing a first virtual stent in the first stenotic lesion; and when the vascular function evaluation index does not reach the preset condition after the first virtual stent is implanted, implanting a second virtual stent in the second stenosis lesion. According to the embodiment, firstly, the blood flow influence degrees of the two stenosis lesions are obtained, and then the virtual stent is built in the stenosis lesion with the large blood flow influence degree preferentially; stenosis lesions with large influence degree of untreated blood flow under the condition of manual operation of doctors are avoided; the virtual stent is implanted into a narrow lesion with a large blood flow influence degree, better treatment benefits can be generally obtained, and the length of the virtual stent is as short as possible on the premise that the expected treatment effect is achieved.

Description

Technical Field

[0001] The present application relates to the technical field of vascular stents, and in particular to a stent planning device for stenotic diseased blood vessels and a computer-readable storage medium. Background Art

[0002] For blood vessels with stenosis (e.g., coronary arteries), an optional treatment option is to implant a stent at the stenosis. The selection of the stent length and the implantation location are the focus of clinical attention. In an optional embodiment, the doctor can select a virtual stent with various specifications and parameters before surgery and implant it into the stenosis area of the three-dimensional model of the blood vessel, and obtain the corresponding simulated postoperative vascular function evaluation index (e.g., FFR). The doctor can then obtain the specifications of the virtual stent that can achieve the expected treatment effect through the above-mentioned simulated surgery, and select a stent with corresponding specifications and parameters for surgery.

[0003] Some patients' blood vessels will have serial lesions, that is, there are more than two focal lesions, or there is one diffuse lesion and at least one focal lesion. In this case, the virtual stent may not need to cover all the stenotic lesions to achieve the desired therapeutic effect; optionally, the doctor needs to select one or more of the stenotic lesions to implant the virtual stent, with the goal of achieving the desired therapeutic effect, such as FFR>0.9. There may be multiple options for implanting virtual stents in different stenotic lesions to achieve the desired therapeutic effect, but the required lengths of the virtual stents are different; the above process relies on the doctor's manual selection, consumes the doctor's energy, and it is difficult to ensure that the shortest possible virtual stent is used while achieving the desired therapeutic effect. Summary of the Invention

[0004] The embodiments of the present application provide a vascular stent planning device and a computer-readable storage medium, which provide a virtual stent implantation plan in the case of tandem lesions, so that the length of the virtual stent is as short as possible.

[0005] In a first aspect of an embodiment of the present application, a stent planning apparatus for a stenotic lesion vessel is provided, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor. When the stenotic lesion vessel has two stenotic lesions connected in series, the processor executes the computer program to implement the following stent planning method:

[0006] respectively obtaining blood flow influences of the two stenotic lesions to obtain a first stenotic lesion with a greater blood flow influence and a second stenotic lesion with a smaller blood flow influence;

[0007] implanting a first virtual stent in the first stenosis lesion, and obtaining a vascular function evaluation index after implantation of the first virtual stent;

[0008] When the vascular function evaluation index after the placement of the first virtual stent does not meet a preset condition, a second virtual stent is placed in the second stenosis lesion.

[0009] In a second aspect of an embodiment of the present application, a stent planning device for a stenotic lesion vessel is provided, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor. When the stenotic lesion vessel has two stenotic lesions connected in series, and the two stenotic lesions are respectively a diffuse lesion and a focal lesion, the processor implements the following stent planning method when executing the computer program:

[0010] respectively obtaining the blood flow impact of the two stenotic lesions;

[0011] When the blood flow impact of the diffuse lesion is greater, a first virtual stent is placed in the diffuse lesion, and a vascular function evaluation index after the placement of the virtual stent is obtained; when the vascular function evaluation index after the placement of the first virtual stent does not meet a preset condition, a second virtual stent is placed in the focal lesion;

[0012] When the blood flow impact of the focal lesion is large, a second virtual stent is placed in the focal lesion, and a vascular function evaluation index after the placement of the virtual stent is obtained; when the vascular function evaluation index after the placement of the second virtual stent does not meet the preset conditions, a first virtual stent is placed in the diffuse lesion.

[0013] According to a third aspect of the embodiments of the present application, a computer-readable storage medium is provided, wherein the computer-readable storage medium is used to store the above-mentioned computer program.

[0014] This embodiment first obtains the blood flow impact of the two stenotic lesions, and then preferentially inserts a virtual stent into the stenotic lesion with the larger blood flow impact; when the vascular function evaluation index after the virtual stent is inserted into the stenotic lesion with the larger blood flow impact does not reach the preset condition, another virtual stent is inserted into the stenotic lesion with the smaller blood flow impact; this avoids the situation where a doctor manually inserts a virtual stent into the stenotic lesion with the smaller blood flow impact while not treating the stenotic lesion with the larger blood flow impact; implanting a virtual stent into the stenotic lesion with the larger blood flow impact can usually achieve better treatment benefits, so that the length of the virtual stent is as short as possible while achieving the expected treatment effect. BRIEF DESCRIPTION OF THE DRAWINGS

[0015] In order to more clearly illustrate the embodiments of the present application or the technical solutions in the prior art, the following briefly introduces the drawings required for use in the embodiments or the description of the prior art. Obviously, the drawings described below are only some embodiments of the present application. For those skilled in the art, other drawings can be obtained based on these drawings without expending creative labor.

[0016] Figure 1 This is a flow chart of the stent planning method according to the first embodiment of the present application;

[0017] Figure 2 This is a flow chart of a stent planning method according to a seventh embodiment of the present application;

[0018] Figure 3 This is a flow chart of a stent planning method according to a third embodiment of the present application;

[0019] Figure 4 This is a flowchart of a stent planning method according to a fifth embodiment of the present application;

[0020] Figure 5 This is a flowchart of a stent planning method according to a ninth embodiment of the present application;

[0021] Figure 6 This is a flowchart of placing a first virtual stent in the diffuse lesion according to the ninth embodiment of the present application;

[0022] Figure 7 This is an image of a blood vessel with a stenotic lesion;

[0023] Figure 8 This is an image of a blood vessel with focal lesions;

[0024] Figure 9 This is an image of a vascular segment with diffuse and focal lesions in series. DETAILED DESCRIPTION

[0025] The technical solution of the present invention will be described in detail below in conjunction with the accompanying drawings and specific embodiments. It should be understood that these embodiments are only used to illustrate the present invention and are not used to limit the scope. After reading the present invention, modifications of various equivalent forms of the present invention by those skilled in the art all fall within the scope defined in this application.

[0026] The following will be combined Figures 1 to 9 This specification explains and illustrates a stent planning device and computer-readable storage medium for stenosed blood vessels according to embodiments of the present invention. It should be noted that, in the embodiments of the present invention, identical reference numerals denote identical components. For the sake of brevity, detailed descriptions of identical components will be omitted in different embodiments, and descriptions of identical components may be cross-referenced and referenced.

[0027] For blood vessels with stenosis (e.g., coronary arteries), an optional treatment option is to implant a stent at the stenosis. The selection of the stent length and the implantation location are the focus of clinical attention. In an optional embodiment, the doctor can select a virtual stent with various specifications and parameters before surgery and implant it into the stenosis area of the three-dimensional model of the blood vessel, and obtain the corresponding simulated postoperative vascular function evaluation index (e.g., FFR). The doctor can then obtain the specifications of the virtual stent that can achieve the expected treatment effect through the above-mentioned simulated surgery, and select a stent with corresponding specifications and parameters for surgery.

[0028] However, in some cases, the length of the stenosis lesion is long, such as diffuse lesions, and the virtual stent may not need to cover all the stenosis lesions to achieve the expected therapeutic effect; what is expected is that the length of the virtual stent is as short as possible under the premise of achieving the expected therapeutic effect. The virtual stent with the same specifications and parameters has different implantation positions, and the simulated postoperative vascular function evaluation indicators obtained are also different; placing the virtual stent in a more appropriate position can enable the virtual stent to exert a better therapeutic effect; thereby, under the premise of achieving the expected therapeutic effect, the length of the virtual stent is made as short as possible. In the above embodiment, the implantation position and length of the virtual stent depend on the manual selection of the doctor, which consumes the doctor's energy, and it is difficult to ensure that the virtual stent is implanted in a suitable position and to select the shortest possible virtual stent under the premise of achieving the expected therapeutic effect.

[0029] The first embodiment of the present application provides a stent planning device for a stenotic diseased blood vessel, comprising a memory, a processor, and a computer program stored in the memory and operable on the processor, wherein the processor executes the computer program to implement Figure 1 Stent planning method shown:

[0030] S1. Obtaining stenosis boundaries at both ends of a stenotic diseased vessel segment in a blood vessel image, as well as a stenosis extreme point in the stenotic diseased vessel segment; the blood vessel image may be obtained using existing technology or technology developed after the date of application, and this application does not limit this; for example, the blood vessel image may be obtained by using a medical imaging device, such as a CT scan, to obtain two-dimensional images of the blood vessels from multiple angles and synthesize the corresponding three-dimensional images;

[0031] S2. An initial virtual stent is placed in the stenotic diseased vascular segment, and a vascular function evaluation index after the initial virtual stent is placed is obtained; the initial virtual stent is located between the stenosis boundaries at both ends of the stenotic diseased vascular segment; the initial virtual stent is configured to cover the stenosis extreme; when the vascular function evaluation index meets a preset condition, the information of the initial virtual stent is used as a recommended treatment plan, and the following steps S3 and S4 are no longer performed;

[0032] The vascular function evaluation indicators in the embodiments of the present application may be existing ones or may appear in the future, and the present application does not impose any restrictions thereon; for example, the Fractional Flow Reserve (FFR), the quantitative flow fraction QFR, the flow fraction FFR based on coronary angiography angio , coronary angiography blood flow reserve fraction caFFR, FFR based on coronary CTA (Computed Tomographic Angiography) (i.e. FFR CT ), FFR based on intravascular ultrasound (IVUS) IVUS ), FFR (ie OFR) based on optical coherence tomography (OCT), the distal pressure of the stenotic vascular segment; the FFR used in the embodiment of the present application can also be QFR, FFR angio ,caFFR,FFR CT 、FFR IVUS , OFR replacement;

[0033] S3. When the vascular function evaluation index does not meet the preset condition, extending and updating the initial virtual stent, and obtaining the vascular function evaluation index after implantation of the extended initial virtual stent;

[0034] S4. Repeat step S3 until the vascular function evaluation index reaches a preset condition, or both ends of the initial virtual stent reach the stenosis boundary of the corresponding end.

[0035] In the embodiment of the present application, the preset condition of the vascular function evaluation index can adopt any of the above indicators and set an appropriate threshold to evaluate whether the expected therapeutic effect is achieved after the initial virtual stent is implanted in the stenotic vascular segment; for example, the vascular function evaluation index is FFR, and the preset condition is FFR ≥ 0.9;

[0036] The method for obtaining the vascular function evaluation index after the initial virtual stent is implanted can be obtained through existing technology (for example, CN106539622A) or technology after the application date. This application does not limit it and does not elaborate on it.

[0037] In the above embodiment, an initial virtual stent is automatically placed in the stenotic diseased blood vessel segment, and the initial virtual stent is configured to cover the stenosis extreme; by gradually extending the initial virtual stent and obtaining corresponding vascular function evaluation indicators, a virtual stent with the shortest possible length that can achieve the expected treatment effect is obtained.

[0038] In step S1, the stenosis boundaries at both ends of the stenotic diseased vessel segment in the blood vessel image are obtained. The stenosis diseased vessel segment can be obtained from other equipment or manually and then input into the computer of this embodiment, with the two ends of the stenosis diseased vessel segment serving as the stenosis boundaries. Alternatively, when the computer program is executed on the computer, the computer is caused to execute the following method: first, a blood vessel image is obtained, and the stenosis diseased vessel segment therein is determined based on the blood vessel image. This can be obtained using existing technology or technology that will be applied later.

[0039] In an optional embodiment, acquiring stenosis boundaries at both ends of the stenotic lesion vessel segment in the blood vessel image includes:

[0040] Acquiring a corresponding normal blood vessel image in a state without stenosis according to the blood vessel image;

[0041] Obtaining a ratio of a diameter at each position of the blood vessel image to a diameter at a corresponding position of the normal blood vessel image;

[0042] When the ratio of the adjacent locations is less than a preset ratio threshold, the region of the adjacent locations is defined as a stenotic diseased vessel segment, and the locations at both ends of the stenotic diseased vessel segment are defined as stenosis boundaries. The adjacent locations may be continuous or discrete points.

[0043] When the vascular image includes two stenotic lesion vascular segments, and the distance between adjacent stenotic boundaries of the two stenotic lesion vascular segments is less than a preset threshold, for example, the interval between the two stenotic lesions is less than 0.5 mm, they can be regarded as one stenotic lesion, and the two stenotic lesion vascular segments can be merged into one stenotic lesion vascular segment.

[0044] The above-mentioned implementation manner is only for facilitating understanding of the technical solution of the present application, and the present application does not limit the solution of obtaining a narrow boundary.

[0045] In step S1, the stenosis point with the greatest stenosis in the stenotic lesion vessel segment is obtained. The present application provides the following optional implementation schemes:

[0046] Solution 1: Obtain the withdrawal pressure drop gradient curve dFFR / ds of the stenotic lesion segment, and take the point where dFFR / ds is the maximum as the stenosis extreme; where s is the length vector of the stenotic lesion segment; dFFR / ds is the derivative of FFR with respect to s, and the derivative interval can be selected according to the situation, for example, 0.5 mm;

[0047] The withdrawal pressure drop gradient curve dFFR / ds is used to characterize the instantaneous FFR change per unit length along the lumen centerline path; a larger dFFR / ds indicates a greater impact of the lesion location on FFR;

[0048] like Figure 7 The image shown is of a blood vessel with a stenotic lesion. The light spots arranged perpendicular to the vessel represent the dFFR / ds value at that location. The location with the most light spots is the extreme stenosis. Moreover, the change in the dFFR / ds value in the stenotic lesion vessel segment may be irregular.

[0049] Option 2: The point with the smallest diameter of the stenotic diseased blood vessel segment is taken as the extreme point of stenosis.

[0050] Option 3:

[0051] Acquiring a corresponding normal blood vessel image according to the stenotic diseased blood vessel segment;

[0052] The ratio of the diameter of each position of the stenotic diseased blood vessel segment to the diameter of the corresponding position of the normal blood vessel image is obtained, and the position where the ratio has the minimum value is taken as the extreme point of stenosis.

[0053] The extreme stenosis refers to the location within the vascular segment with the most severe stenosis and the location with the greatest impact on vascular function evaluation indicators. Therefore, it has the highest priority for stent treatment. The above embodiments are intended to facilitate understanding of the technical solution of this application. This application does not limit the method for obtaining the extreme stenosis. The extreme stenosis can also be obtained through other existing technologies or technical evaluations after the application is filed.

[0054] In step S2, the initial virtual stent is configured to cover the stenosis extreme point, so that the initial virtual stent supports the stenosis extreme point; optionally, the midpoint of the initial virtual stent is located at the stenosis extreme point.

[0055] In step S2, the length of the initial virtual stent placed in the stenotic vascular segment should not be too long, for example, not greater than 8 mm.

[0056] In a first optional implementation of step S3, extending and updating the initial virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial virtual stent include:

[0057] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent;

[0058] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent;

[0059] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from both ends to obtain a third extended virtual stent, and obtaining a vascular function evaluation index after implantation of the third extended virtual stent; wherein the length extended from the distal end and the length extended from the proximal end may be the same or different, or may be extended using multiple length distribution ratios;

[0060] Wherein, the lengths of the first extended virtual bracket, the second extended virtual bracket, and the third extended virtual bracket are the same;

[0061] The one among the first lengthened virtual stent, the second lengthened virtual stent, and the third lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial virtual stent.

[0062] For example, the length of the initial virtual stent in step S2 is 8 mm;

[0063] In step S3, the initial virtual stent is extended by 2 mm from the proximal end to obtain a first extended virtual stent, and the FFR after the first extended virtual stent is placed is obtained to be 0.78;

[0064] Extending the initial virtual stent by 2 mm from the distal end to obtain a second extended virtual stent, and obtaining an FFR of 0.81 after implantation of the second extended virtual stent;

[0065] The initial virtual stent is extended from the proximal end by 1 mm, and from the distal end by 1 mm to obtain a third extended virtual stent, and the FFR after the third extended virtual stent is placed is 0.8; the initial virtual stent can also be extended from the proximal end by 0.5 mm, and from the distal end by 1.5 mm to obtain a third extended virtual stent, and the FFR after the third extended virtual stent is placed is 0.79; or both of the above three third extended virtual stents are used;

[0066] The FFR value after placement of the second extended virtual stent is the highest, so the second extended virtual stent is used as the updated initial virtual stent.

[0067] In a second optional implementation of step S3, extending and updating the initial virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial virtual stent include:

[0068] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent;

[0069] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent;

[0070] Wherein, the lengths of the first extended virtual bracket and the second extended virtual bracket are the same;

[0071] The one of the first lengthened virtual stent and the second lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial virtual stent.

[0072] In a third optional implementation of step S3, extending and updating the initial virtual stent includes:

[0073] The initial virtual stent position is maintained, and the length of the initial virtual stent is extended from the proximal end and the distal end respectively to obtain a lengthened virtual stent, and the lengthened virtual stent is used as the updated initial virtual stent.

[0074] In this embodiment, the length extended from the distal end and the length extended from the proximal end can be the same or different. For example, the lengthened virtual stent can be obtained by extending the proximal end by 1 mm and the distal end by 1 mm.

[0075] Alternatively, under the premise that the total extended length remains unchanged, the length extended from the distal end and the length extended from the proximal end can adopt multiple length distribution ratios, and the one with the best corresponding vascular function evaluation index is selected as the updated initial virtual stent.

[0076] In step S3, the initial virtual stent is extended. However, the degree of stenosis of the distal and proximal vessels of the initial virtual stent may be different. Therefore, the therapeutic effects of extending the initial virtual stent from the distal end, extending the initial virtual stent from the proximal end, and extending the initial virtual stent from both ends may differ, and it is necessary to find an optimal extension scheme. An optional implementation of the above step S3 is to extend the initial virtual stent from the distal end, extending the initial virtual stent from the proximal end, and extending the initial virtual stent from both ends, and obtain corresponding vascular function evaluation indicators for comparison to obtain the optimal extension scheme.

[0077] When one end of the initial virtual stent reaches the corresponding stenosis boundary, but the other end does not reach the corresponding stenosis boundary, extending the initial virtual stent from the end that reaches the corresponding stenosis boundary can foreseeably have extremely low therapeutic benefits for the stenosis lesion. Therefore, optionally, in this case, in the three optional implementations of the above step S3, extending and updating the initial virtual stent includes:

[0078] The initial virtual stent position is maintained, and the length of the initial virtual stent is extended from the other end that has not reached the corresponding narrow boundary to obtain a lengthened virtual stent, and the lengthened virtual stent is used as the updated initial virtual stent.

[0079] In the above embodiment, the length of each extension of the initial virtual stent can be set as needed, but for the accuracy of adjustment, it may not be greater than 2 mm.

[0080] Before current vascular stent surgery, doctors will also diagnose the type of lesions in the stenotic diseased blood vessels, including focal lesions and diffuse lesions. Figure 7 Shown is a diffuse lesion. Figure 8 The image shows a section of a blood vessel with a focal lesion. Both focal and diffuse lesions can be diagnosed and treated using the device described in the above embodiment. However, for focal lesions, due to their short length, doctors currently typically select a stent of the corresponding size to support the entire section of the vessel.

[0081] Therefore, optionally, before step S1, the method further includes:

[0082] Obtaining the lesion type of the stenotic lesion vessel segment in the vascular image; the lesion type includes focal lesions and diffuse lesions;

[0083] When the lesion type of the stenotic lesion vessel segment is diffuse lesion, steps S1, S2, S3, and S4 are executed;

[0084] When the lesion type of the stenotic lesion vessel segment is focal lesion, the following steps are performed:

[0085] A virtual stent is placed in the stenotic diseased blood vessel segment, and a vascular function evaluation index after the placement of the virtual stent is obtained; the virtual stent basically covers the stenotic diseased blood vessel segment. The basic coverage in the embodiment of the present application means that a stent close to the length of the stenotic diseased blood vessel segment can be selected based on the actual stent specifications. For example, if the length of the stenotic diseased blood vessel segment is 20mm, a 20mm stent is preferred; if the hospital is not equipped with a 20mm stent and the stent sizes it has include 18mm and 22mm, then either an 18mm stent or a 22mm stent can be selected.

[0086] The lesion type of the stenotic vascular segment may be determined by other equipment or manually input into the computer. Alternatively, when the computer program is run on the computer, the computer is caused to execute one of the following optional methods:

[0087] Method 1:

[0088] Obtaining a pullback pressure gradient (PPG) index of the stenotic lesion vessel segment; when the PPG is greater than a preset PPG threshold, determining that the stenotic lesion vessel segment is a focal lesion; when the PPG is less than the preset PPG threshold, determining that the stenotic lesion vessel segment is a diffuse lesion;

[0089] in,

[0090] PPG=((MaxPPG l / ΔFFR vessel )+(1-Length disease / Length total )) / 2

[0091] Among them: MaxPPG l is the maximum FFR drop value of any vessel in the length interval l on the FFR withdrawal curve; l can be set as needed, for example, 20mm;

[0092] ΔFFR vessel It is the FFR decrease value in the total vessel length interval on the FFR withdrawal curve;

[0093] Length disease The sum of the lengths of all blood vessels in the intervals on the FFR retracement curve where the FFR decrease value is greater than the preset decrease threshold. The preset decrease threshold can be determined based on experience, such as 0.0015 / mm.

[0094] Length total is the total vessel length described by the FFR pullback curve.

[0095] Method 2:

[0096] The lesion length of the stenotic diseased vessel segment is obtained. When the lesion length is greater than a preset length threshold, the stenotic diseased vessel segment is judged to be a diffuse lesion; when the lesion length is less than the preset length threshold, the stenotic diseased vessel segment is judged to be a focal lesion. The preset length threshold can be set according to the situation, for example, set to 30 mm.

[0097] The above two methods for obtaining the lesion type of the stenotic diseased blood vessel are only examples, and other determination methods may also be used, which are not limited in this application.

[0098] A second embodiment of the present application provides a computer-readable storage medium, wherein the computer-readable storage medium is used to store the above-mentioned computer program.

[0099] Some patients' blood vessels will have serial lesions, that is, there are more than two focal lesions, or there is one diffuse lesion and at least one focal lesion. In this case, the virtual stent may not need to cover all the stenotic lesions to achieve the desired therapeutic effect; optionally, the doctor needs to select one or more of the stenotic lesions to implant the virtual stent, with the goal of achieving the desired therapeutic effect, such as FFR>0.9. There may be multiple options for implanting virtual stents in different stenotic lesions to achieve the desired therapeutic effect, but the required lengths of the virtual stents are different; the above process relies on the doctor's manual selection, consumes the doctor's energy, and it is difficult to ensure that the shortest possible virtual stent is used while achieving the desired therapeutic effect.

[0100] In this regard, a third embodiment of the present application provides a stent planning device for a stenotic diseased blood vessel, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor; when the stenotic diseased blood vessel has a first stenotic lesion and a second stenotic lesion connected in series, the processor executes the computer program to implement the following Figure 3 Stent planning method shown:

[0101] S1. Implanting a first virtual stent in the first stenotic lesion of the stenotic lesion blood vessel in an initial state, and obtaining a vascular function evaluation index after implantation of the first virtual stent;

[0102] When the vascular function evaluation index after the first virtual stent is placed reaches a preset condition, step S1 is ended;

[0103] When the vascular function evaluation index after the first virtual stent is placed does not meet a preset condition, the step S1 further includes placing a second virtual stent in the second stenosis lesion;

[0104] S2. Implanting a third virtual stent in the second stenotic lesion of the stenotic lesion blood vessel in the initial state, and obtaining a vascular function evaluation index after implantation of the third virtual stent;

[0105] When the vascular function evaluation index after implantation of the third virtual stent reaches a preset condition, step S2 is terminated;

[0106] When the vascular function evaluation index after the placement of the third virtual stent does not meet the preset condition, step S2 further includes placing a fourth virtual stent in the first stenosis lesion.

[0107] For example, in the first case, the patient's blood vessels included a first 20mm stenosis lesion and a second 10mm stenosis lesion in series. In Plan 1, a 20mm dummy stent was first implanted in the first stenosis, but this did not achieve the desired therapeutic effect. Therefore, a 10mm dummy stent was implanted in the second stenosis to achieve the desired therapeutic effect. In Plan 2, a 10mm dummy stent was first implanted in the second stenosis, achieving the desired therapeutic effect. Therefore, the total length of the dummy stent in Plan 1 is 30mm, while the total length of the dummy stent in Plan 2 is 10mm.

[0108] As can be seen, while both of the above solutions achieve the desired therapeutic effect, the lengths of the virtual stents used are different. This embodiment can provide information on multiple implantation options, allowing for a more optimal solution; for example, selecting a solution with a shorter total virtual stent length. Manual intervention by a physician, however, may result in an inferior solution being selected, with no guarantee of a superior choice.

[0109] The device of this embodiment automatically executes multiple implantation plans for tandem lesions for comparison. One plan involves first implanting a first virtual stent in the first stenotic lesion. If the vascular function evaluation index does not meet a preset condition, a second virtual stent is then implanted in the second stenotic lesion. Another plan involves first implanting a third virtual stent in the second stenotic lesion. If the vascular function evaluation index does not meet a preset condition, a fourth virtual stent is then implanted in the first stenotic lesion. The device of this embodiment automatically executes these plans, providing corresponding virtual stent information for the physician's reference, enabling the physician to determine a plan with a shorter total virtual stent length.

[0110] The information of the virtual stents in the above two solutions can be provided to the doctor, who can then compare and select a better solution; for example, a solution with a shorter total length of virtual stents can be selected.

[0111] Alternatively, the device of this embodiment can also directly recommend a better plan to the doctor. Optionally, the processor implements the following method when executing the computer program: obtain the sum of the stent lengths of the first virtual stent and the second virtual stent, and obtain the sum of the stent lengths of the third virtual stent plus the fourth virtual stent, and use the step with the shorter sum of the stent lengths as the recommended treatment plan.

[0112] A fourth embodiment of the present application provides a computer-readable storage medium, which is used to store the computer program of the third embodiment.

[0113] The fifth embodiment of the present application provides a stent planning device for a stenotic diseased blood vessel, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor. When the stenotic diseased blood vessel has two stenotic lesions connected in series, the processor executes the computer program to implement the following Figure 4 Stent planning method shown:

[0114] Obtaining the blood flow influence of the two stenotic lesions to obtain a first stenotic lesion with a greater blood flow influence and a second stenotic lesion with a smaller blood flow influence;

[0115] implanting a first virtual stent in the first stenosis lesion, and obtaining a vascular function evaluation index after implantation of the first virtual stent;

[0116] When the vascular function evaluation index after the placement of the first virtual stent does not meet a preset condition, a second virtual stent is placed in the second stenosis lesion.

[0117] The blood flow impact in this embodiment refers to the ability of the stenosis to affect the degree of blood flow obstruction; it can be evaluated using existing or future related parameters. The blood flow impact is not limited to the implementation methods provided in the embodiments of this application.

[0118] The obtaining of the blood flow impact of the two stenotic lesions includes at least one of the following:

[0119] Obtaining the withdrawal pressure drop gradient curves dFFR / ds for each of the two stenotic lesions, and using the maximum value of dFFR / ds in each stenotic lesion as the blood flow impact of the stenotic lesion; wherein s is the length vector of the vascular segment of the stenotic lesion; dFFR / ds is the derivative of FFR with respect to s; the stenotic lesion with the larger maximum value of dFFR / ds is defined as the first stenotic lesion, and the stenotic lesion with the smaller maximum value of dFFR / ds is defined as the second stenotic lesion;

[0120] Obtaining the FFR decrease values ΔFFR of the two stenotic lesions respectively, and using the ΔFFR of each stenotic lesion as the blood flow impact of the stenotic lesion; wherein ΔFFR = P2 / Pa - P1 / Pa, where P2 represents the pressure proximal to the stenotic lesion, P1 represents the pressure distal to the stenotic lesion, and Pa represents the aortic pressure at the coronary ostium; the stenotic lesion with the larger ΔFFR is regarded as the first stenotic lesion, and the stenotic lesion with the smaller ΔFFR is regarded as the second stenotic lesion;

[0121] Obtain the stenosis degree N of the two stenosis lesions respectively, and use the N of each stenosis lesion as the blood flow impact of the stenosis lesion; where N = 1-2D min / (D1+D2), Dmin represents the minimum diameter of the stenotic lesion, D1 represents the diameter of the proximal end of the stenotic lesion, and D2 represents the diameter of the distal end of the stenotic lesion; the stenotic lesion with a larger N is regarded as the first stenotic lesion, and the stenotic lesion with a smaller N is regarded as the second stenotic lesion.

[0122] In the case of serial lesions, this embodiment first obtains the blood flow influence of the two stenotic lesions, obtains the first stenotic lesion with a larger blood flow influence, and the second stenotic lesion with a smaller blood flow influence, and then preferentially inserts the first virtual stent into the first stenotic lesion with a larger blood flow influence; when the vascular function evaluation index after the insertion of the first virtual stent does not meet the preset conditions, the second virtual stent is inserted into the second stenotic lesion with a smaller blood flow influence; this avoids the situation where a doctor manually inserts a virtual stent into the stenotic lesion with a smaller blood flow influence while not treating the stenotic lesion with a larger blood flow influence; implanting a virtual stent into the stenotic lesion with a larger blood flow influence can usually achieve better treatment benefits, so that the length of the virtual stent is as short as possible while achieving the expected treatment effect.

[0123] A sixth embodiment of the present application provides a computer-readable storage medium for storing the computer program of the fifth embodiment.

[0124] There is a situation in which the serial lesions of a blood vessel have a diffuse lesion and at least one focal lesion. In this case, the virtual stent may not need to cover all the stenotic lesions to achieve the desired therapeutic effect. In an optional embodiment, in addition to choosing to implant a virtual stent only in focal lesions, implant a virtual stent only in diffuse lesions, or implant a virtual stent in focal lesions and diffuse lesions respectively, the doctor also needs to consider the position and length of the virtual stent implanted in the diffuse lesion, with the goal of achieving the desired therapeutic effect, such as FFR>0.9. There may be multiple options that can achieve the desired therapeutic effect, but the required lengths of the virtual stents are different. These treatment options all rely on the doctor to make a choice. On the one hand, it consumes the doctor's time, and on the other hand, it is difficult to ensure that the length of the virtual stent is as short as possible while achieving the desired therapeutic effect.

[0125] The seventh embodiment of the present application provides a stent planning device for a stenotic diseased blood vessel, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor. When the stenotic diseased blood vessel has diffuse lesions and focal lesions connected in series, the processor executes the computer program to implement the following Figure 2 Stent planning method shown:

[0126] S1. Obtain an initial vascular image of the stenotic lesion vessel; the initial vascular image includes a focal lesion vessel segment and a diffuse lesion vessel segment; obtain focal boundaries at both ends of the focal lesion vessel segment; obtain diffuse boundaries at both ends of the diffuse lesion vessel segment, and the stenosis extreme of the diffuse lesion vessel segment; the initial vascular image can be obtained using existing technology or technology after the filing date, and this application does not impose any limitation thereto; for example, the initial vascular image is obtained by using a medical imaging device, such as a CT scan, to obtain two-dimensional images of the vessel from multiple angles and synthesize the corresponding three-dimensional images;

[0127] S2. Place a first virtual stent in the focal lesion vessel segment in the initial vascular image, and obtain a vascular function evaluation index after placement of the first virtual stent; the first virtual stent substantially covers an area between the focal boundaries at both ends of the focal lesion vessel segment;

[0128] When the vascular function evaluation index after the first virtual stent is placed reaches a preset condition, step S2 is ended;

[0129] When the vascular function evaluation index after the placement of the first virtual stent does not meet the preset condition, the step S2 further includes placing a second virtual stent in the diffusely affected vascular segment, including:

[0130] - S202, when the vascular function evaluation index does not meet the preset condition, extending and updating the initial second virtual stent, and obtaining the vascular function evaluation index after implantation of the extended initial second virtual stent;

[0131] S203, repeating step S202 until the vascular function evaluation index reaches a preset condition, or both ends of the initial second virtual stent reach the diffusion boundaries of the corresponding ends, thereby obtaining the second virtual stent;

[0132] S3, placing a third virtual stent in the diffusely diseased blood vessel segment in the initial blood vessel image, comprising:

[0133] S301, placing an initial third virtual stent in the diffusely affected vascular segment, and obtaining a vascular function evaluation index after placement of the initial third virtual stent; the initial third virtual stent is located between the diffuse boundaries at both ends of the diffusely affected vascular segment; the extreme stenosis is located within the coverage of the initial third virtual stent, for example, the midpoint of the initial third virtual stent is located at the extreme stenosis; the length of the initial third virtual stent should not be too long, for example, not greater than 8 mm;

[0134] S302: When the vascular function evaluation index does not meet the preset condition, extending and updating the initial third virtual stent, and obtaining the vascular function evaluation index after implantation of the extended initial third virtual stent;

[0135] S303, repeating step S302 until the vascular function evaluation index reaches a preset condition, or both ends of the initial third virtual stent reach the diffusion boundaries of the corresponding ends, thereby obtaining the third virtual stent;

[0136] When the third virtual stent is placed and the vascular function evaluation index reaches the preset condition, step S3 ends;

[0137] When both ends of the third virtual stent reach the diffusion boundaries of the corresponding ends, and the vascular function evaluation index does not meet the preset conditions, step S3 further includes:

[0138] A fourth virtual stent is placed in the focal lesion vascular segment, and a vascular function evaluation index after the placement of the fourth virtual stent is obtained; the fourth virtual stent basically covers the area between the focal boundaries at both ends of the focal lesion vascular segment.

[0139] The vascular function evaluation indicators in the embodiments of the present application may be existing ones or may appear in the future, and the present application does not impose any restrictions thereon; for example, the Fractional Flow Reserve (FFR), the quantitative flow fraction QFR, the flow fraction FFR based on coronary angiography angio , coronary angiography blood flow reserve fraction caFFR, FFR based on coronary CTA (Computed Tomographic Angiography) (i.e. FFR CT ), FFR based on intravascular ultrasound (IVUS) IVUS ), FFR (ie OFR) based on optical coherence tomography (OCT), the distal pressure of the stenotic vascular segment; the FFR used in the embodiment of the present application can also be QFR, FFR angio ,caFFR,FFR CT 、FFR IVUS , OFR replacement.

[0140] In this embodiment, the preset condition of the vascular function evaluation index can adopt any of the above-mentioned indicators and set an appropriate threshold value to evaluate whether the expected treatment effect is achieved after the initial virtual stent is implanted in the stenotic vascular segment; for example, the vascular function evaluation index is FFR, and the preset condition is FFR ≥ 0.9;

[0141] The method for obtaining the vascular function evaluation index after the initial virtual stent is implanted can be obtained through existing technology (for example, CN106539622A) or technology after the application date. This application does not limit it and does not elaborate on it.

[0142] In this embodiment, "basic coverage" refers to the ability to select a stent that approximates the length of the stenotic vessel segment based on the available stent specifications. For example, if the stenotic vessel segment is 20 mm long, a 20 mm stent is preferred. If a hospital does not have a 20 mm stent and has 18 mm and 22 mm stents, either an 18 mm or 22 mm stent can be selected.

[0143] In this embodiment, the order of step S2 and step S3 can be swapped, and step S2 does not necessarily have to be performed before step S3.

[0144] For example, in the first case, the patient's blood vessels included a 30mm diffuse lesion and a 10mm focal lesion. In Plan 1, a 30mm dummy stent was first implanted in the diffuse lesion. If this did not achieve the desired therapeutic effect, a 10mm dummy stent would be implanted in the focal lesion. In Plan 2, a 10mm dummy stent was first implanted in the focal lesion. If this did not achieve the desired therapeutic effect, a 10mm dummy stent would be implanted in the diffuse lesion to achieve the desired therapeutic effect. The total length of the dummy stent in Plan 1 is 40mm, and the total length of the dummy stent in Plan 2 is 20mm.

[0145] In the second case, the patient's vessels included a 30mm diffuse lesion and a 10mm focal lesion. In Plan 1, a 20mm dummy stent was first implanted in the diffuse lesion, achieving the desired therapeutic effect. In Plan 2, a 10mm dummy stent was first implanted in the focal lesion, but this did not achieve the desired therapeutic effect. Therefore, a 15mm dummy stent was implanted in the diffuse lesion to achieve the desired therapeutic effect. The total length of the dummy stent in Plan 1 was 20mm, and the total length of the dummy stent in Plan 2 was 25mm.

[0146] As can be seen, the total length of the resulting virtual stents may vary depending on the order in which the virtual stents are implanted in diffuse and focal lesions. This embodiment can provide information on multiple implantation plans, enabling the selection of a more optimal plan; for example, selecting a plan with a shorter total virtual stent length. Manual intervention by a physician, however, may result in the selection of an inferior plan, with no guarantee of optimal selection.

[0147] The device of this embodiment automatically executes two implantation schemes for comparison: in the first scheme, after first implanting a first virtual stent in the focal lesion vessel segment, if the vascular function evaluation index does not meet the preset condition, an initial second virtual stent covering the extreme stenosis is implanted in the diffuse lesion vessel segment, and the initial second virtual stent is extended until the vascular function evaluation index meets the preset condition or both ends of the initial second virtual stent reach the diffuse boundary at the corresponding end; in the second scheme, first implanting an initial third virtual stent covering the extreme stenosis in the diffuse lesion vessel segment, and the initial third virtual stent is extended until the vascular function evaluation index meets the preset condition or both ends of the initial third virtual stent reach the diffuse boundary at the corresponding end; when both ends of the third virtual stent reach the diffuse boundary at the corresponding end and the vascular function evaluation index does not meet the preset condition, a fourth virtual stent is implanted in the focal lesion vessel segment;

[0148] Secondly, an initial virtual stent is automatically placed in the stenotic lesion vessel segment, the initial virtual stent being configured to cover the extreme point of stenosis; and by gradually extending the initial virtual stent and obtaining corresponding vascular function evaluation indicators, a virtual stent is obtained that is as short as possible while achieving the desired treatment effect.

[0149] The above solution is automatically executed by the device of this embodiment, thereby providing corresponding virtual stent information for the doctor's reference, and obtaining a solution with a shorter total length of the virtual stent used.

[0150] The information of the virtual stents in the above two solutions can be provided to the doctor, who can then compare and select a better solution; for example, a solution with a shorter total length of virtual stents can be selected.

[0151] Alternatively, the device of this embodiment can also directly recommend a better plan to the doctor. Optionally, the processor implements the following method when executing the computer program: obtain the sum of the stent lengths of the first virtual stent and the second virtual stent, and obtain the sum of the stent lengths of the third virtual stent plus the fourth virtual stent, and use the step with the shorter sum of the stent lengths in step S2 and step S3 as the recommended treatment plan.

[0152] In step S1, the focal boundaries at both ends of the focal lesion vessel segment are obtained; the diffuse boundaries at both ends of the diffuse lesion vessel segment are obtained. This can be done by obtaining a stenotic lesion vessel segment from other equipment or manually and then inputting it into the computer of this embodiment, with the two ends of the stenotic lesion vessel segment being used as stenotic boundaries. Alternatively, when the computer program is run on the computer, the computer is caused to execute the following method:

[0153] acquiring a stenotic diseased blood vessel segment according to the initial blood vessel image;

[0154] Determining the lesion type of the stenotic diseased vascular segment to obtain a focal diseased vascular segment and a diffuse diseased vascular segment;

[0155] The positions of both ends of the focal lesion blood vessel segment are taken as focal boundaries, and the positions of both ends of the diffuse lesion blood vessel segment are taken as diffuse boundaries.

[0156] Optionally, acquiring a stenotic diseased blood vessel segment according to the initial blood vessel image includes:

[0157] Acquiring a corresponding normal blood vessel image in a state without stenosis according to the initial blood vessel image;

[0158] Obtaining a ratio of a diameter at each position of the initial blood vessel image to a diameter at a corresponding position of the normal blood vessel image;

[0159] When the ratio of the adjacent locations is less than a preset ratio threshold, the region of the adjacent locations is defined as a stenotic diseased vessel segment, and the locations at both ends of the stenotic diseased vessel segment are defined as stenosis boundaries. The adjacent locations may be continuous or discrete points.

[0160] Optionally, when the initial vascular image includes two stenotic lesion vessel segments, and the distance between adjacent stenotic boundaries of the two stenotic lesion vessel segments is less than a preset distance threshold, for example, the distance between the two stenotic lesions is less than 0.5 mm, the two stenotic lesions can be considered as one stenotic lesion, and the two stenotic lesion vessel segments can be merged into one stenotic lesion vessel segment. Therefore, the distance between the adjacent focal boundaries and the diffuse boundaries is greater than the preset distance threshold.

[0161] The above-mentioned implementation manner is only for facilitating understanding of the technical solution of the present application, and the present application does not limit the solution of obtaining a narrow boundary.

[0162] The determination of the lesion type of the stenotic vascular segment may be performed by other equipment or manually input into the computer; or the determination may be performed by causing the computer to execute one of the following optional methods when the computer program is executed on the computer:

[0163] Method 1:

[0164] Obtaining a pullback pressure gradient (PPG) index of the stenotic lesion vessel segment; when the PPG is greater than a preset PPG threshold, determining that the stenotic lesion vessel segment is a focal lesion; when the PPG is less than the preset PPG threshold, determining that the stenotic lesion vessel segment is a diffuse lesion;

[0165] in,

[0166] PPG=((MaxPPG l / ΔFFR vessel )+(1-Length disease / Length total )) / 2

[0167] Among them: MaxPPG l is the maximum FFR drop value of any vessel in the length interval l on the FFR withdrawal curve; l can be set as needed, for example, 20mm;

[0168] ΔFFR vessel It is the FFR decrease value in the total vessel length interval on the FFR withdrawal curve;

[0169] Length disease The sum of the lengths of all blood vessels in the intervals on the FFR retracement curve where the FFR decrease value is greater than the preset decrease threshold. The preset decrease threshold can be determined based on experience, such as 0.0015 / mm.

[0170] Length total is the total vessel length described by the FFR pullback curve.

[0171] Method 2:

[0172] The lesion length of the stenotic diseased vessel segment is obtained. When the lesion length is greater than a preset length threshold, the stenotic diseased vessel segment is judged to be a diffuse lesion; when the lesion length is less than the preset length threshold, the stenotic diseased vessel segment is judged to be a focal lesion. The preset length threshold can be set according to the situation, for example, set to 30 mm.

[0173] The above two methods for obtaining the lesion type of the stenotic diseased blood vessel are only examples, and other determination methods may also be used, which are not limited in this application.

[0174] Regarding obtaining the extreme stenosis point of the diffusely affected vascular segment in step S1, the present application provides the following optional implementation schemes:

[0175] Solution 1: Obtain the withdrawal pressure drop gradient curve dFFR / ds of the diffusely affected vascular segment, and use the point where dFFR / ds is the maximum as the stenosis extreme; where s is the length vector of the diffusely affected vascular segment; dFFR / ds is the derivative of FFR with respect to s, and the derivative interval can be selected according to the situation, for example, 0.5 mm;

[0176] The withdrawal pressure drop gradient curve dFFR / ds is used to characterize the instantaneous FFR change per unit length along the lumen centerline path; a larger dFFR / ds indicates a greater impact of the lesion location on FFR;

[0177] like Figure 9 The image shown is of a vascular segment with diffuse and focal lesions connected in series. The light spots arranged perpendicular to the vessels represent the dFFR / ds value at that location. The location with the most light spots is the extreme point of stenosis. Moreover, the changes in the dFFR / ds value in the vascular segment with stenosis may be irregular.

[0178] Option 2: The point with the smallest diameter of the diffusely diseased vascular segment is taken as the extreme point of stenosis.

[0179] Option 3:

[0180] acquiring a corresponding normal blood vessel image according to the diffusely diseased blood vessel segment;

[0181] The ratio of the diameter of each position of the diffusely affected vascular segment to the diameter of the corresponding position of the normal vascular image is obtained, and the position where the ratio has the minimum value is taken as the extreme point of stenosis.

[0182] The extreme stenosis refers to the location within the vascular segment with the most severe stenosis and the location with the greatest impact on vascular function evaluation indicators. Therefore, it has the highest priority for stent treatment. The above embodiments are intended to facilitate understanding of the technical solution of this application. This application does not limit the method for obtaining the extreme stenosis. The extreme stenosis can also be obtained through other existing technologies or technical evaluations after the application is filed.

[0183] In a first optional implementation of step S202, extending and updating the initial second virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial second virtual stent include:

[0184] Maintaining the initial second virtual stent position, extending the length of the initial second virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent;

[0185] Maintaining the initial second virtual stent position, extending the length of the initial second virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent;

[0186] Maintaining the initial second virtual stent position, extending the initial second virtual stent from both ends to obtain a third extended virtual stent, and obtaining a vascular function evaluation index after implantation of the third extended virtual stent; wherein the length extended from the distal end and the length extended from the proximal end may be the same or different, or may be extended using multiple length distribution ratios;

[0187] Wherein, the lengths of the first extended virtual bracket, the second extended virtual bracket, and the third extended virtual bracket are the same;

[0188] The one with the best vascular function evaluation index among the first lengthened virtual stent, the second lengthened virtual stent, and the third lengthened virtual stent is used as the updated initial second virtual stent;

[0189] For example, the length of the initial second virtual stent in step S201 is 8 mm;

[0190] In step S202, the initial second virtual stent is extended from the proximal end by 2 mm to obtain a first extended virtual stent, and the FFR after the first extended virtual stent is placed is obtained to be 0.78;

[0191] Extending the initial second virtual stent by 2 mm from the distal end to obtain a second extended virtual stent, and obtaining an FFR of 0.81 after implantation of the second extended virtual stent;

[0192] The initial second virtual stent is extended from the proximal end by 1 mm, and from the distal end by 1 mm to obtain a third extended virtual stent, and the FFR after the third extended virtual stent is placed is 0.8; the initial second virtual stent can also be extended from the proximal end by 0.5 mm, and from the distal end by 1.5 mm to obtain a third extended virtual stent, and the FFR after the third extended virtual stent is placed is 0.79; or both of the above three third extended virtual stents are used;

[0193] The FFR value after placement of the second extended virtual stent is the highest, so the second extended virtual stent is used as the updated initial second virtual stent.

[0194] In a first optional implementation of step S302, extending and updating the initial third virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial third virtual stent include:

[0195] Maintaining the initial third virtual stent position, extending the length of the initial third virtual stent from the proximal end to obtain a fourth lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the fourth lengthened virtual stent;

[0196] Maintaining the initial third virtual stent position, extending the length of the initial third virtual stent from the distal end to obtain a fifth extended virtual stent, and obtaining a vascular function evaluation index after implantation of the fifth extended virtual stent;

[0197] Maintaining the initial third virtual stent position, extending the initial third virtual stent from both ends to obtain a sixth extended virtual stent, and obtaining a vascular function evaluation index after implantation of the sixth extended virtual stent; wherein the length extended from the distal end and the length extended from the proximal end may be the same or different, or may be extended using multiple length distribution ratios;

[0198] The fourth extended virtual bracket, the fifth extended virtual bracket, and the sixth extended virtual bracket are of the same length;

[0199] The one among the fourth lengthened virtual stent, the fifth lengthened virtual stent, and the sixth lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial third virtual stent.

[0200] In a second optional implementation of step S202, extending and updating the initial second virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial second virtual stent include:

[0201] Maintaining the initial second virtual stent position, extending the length of the initial second virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent;

[0202] Maintaining the initial second virtual stent position, extending the length of the initial second virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent;

[0203] Wherein, the lengths of the first extended virtual bracket and the second extended virtual bracket are the same;

[0204] The one of the first lengthened virtual stent and the second lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial second virtual stent.

[0205] In a second optional implementation of step S302, extending and updating the initial third virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial third virtual stent include:

[0206] Maintaining the initial third virtual stent position, extending the length of the initial third virtual stent from the proximal end to obtain a fourth lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the fourth lengthened virtual stent;

[0207] Maintaining the initial third virtual stent position, extending the length of the initial third virtual stent from the distal end to obtain a fifth extended virtual stent, and obtaining a vascular function evaluation index after implantation of the fifth extended virtual stent;

[0208] The fourth extended virtual bracket and the fifth extended virtual bracket have the same length;

[0209] The one of the fourth lengthened virtual stent and the fifth lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial third virtual stent.

[0210] In a third optional implementation of step S202, extending and updating the initial second virtual bracket includes:

[0211] The position of the initial second virtual stent is maintained, and the length of the initial second virtual stent is extended from the proximal end and the distal end respectively to obtain a third extended virtual stent, and the third extended virtual stent is used as the updated initial second virtual stent.

[0212] In this embodiment, the lengths extended from the distal end and the lengths extended from the proximal end can be the same or different. For example, a 1 mm extension from the proximal end and a 1 mm extension from the distal end can be used to obtain an extended virtual stent. Alternatively, while maintaining the same total length, the lengths extended from the distal end and the lengths extended from the proximal end can be distributed in various ratios, and the one that best reflects the vascular function evaluation index can be selected as the updated initial virtual stent.

[0213] In a third optional implementation of step S302, extending and updating the initial third virtual bracket includes:

[0214] The initial third virtual stent position is maintained, and the length of the initial third virtual stent is extended from the proximal end and the distal end respectively to obtain a sixth extended virtual stent, and the sixth extended virtual stent is used as the updated initial third virtual stent.

[0215] In step S202, the initial second virtual stent is extended. However, the degree of stenosis of the distal and proximal blood vessels of the initial second virtual stent may be different. Therefore, the therapeutic effects of extending the initial second virtual stent from the distal end, extending the initial second virtual stent from the proximal end, and extending the initial second virtual stent from both ends may be different, and it is necessary to find an optimal extension scheme. An optional implementation method of the above step S3 is to extend the initial second virtual stent from the distal end, extending the initial second virtual stent from the proximal end, and extending the initial second virtual stent from both ends, and obtain corresponding vascular function evaluation indicators for comparison, so as to obtain the optimal extension scheme.

[0216] In step S302, the initial third virtual stent is extended. However, the degree of stenosis of the distal and proximal blood vessels of the initial third virtual stent may be different. Therefore, the therapeutic effects of extending the initial third virtual stent from the distal end, extending the initial third virtual stent from the proximal end, and extending the initial third virtual stent from both ends may be different, and it is necessary to find an optimal extension scheme. An optional implementation method of the above step S3 is to extend the initial third virtual stent from the distal end, extending the initial third virtual stent from the proximal end, and extending the initial third virtual stent from both ends, and obtain corresponding vascular function evaluation indicators for comparison, so as to obtain the optimal extension scheme.

[0217] When one end of the virtual stent reaches the corresponding stenosis boundary and the other end does not reach the corresponding stenosis boundary, extending the virtual stent from the end that reaches the corresponding stenosis boundary can be expected to have a very low therapeutic benefit for the stenosis lesion; therefore

[0218] In step S202, when one end of the initial second virtual stent reaches the corresponding narrow boundary and the other end does not reach the corresponding narrow boundary, extending and updating the initial second virtual stent includes:

[0219] The initial second virtual stent position is maintained, and the length of the initial second virtual stent is extended from the other end that does not reach the corresponding narrow boundary to obtain a seventh extended virtual stent, and the seventh extended virtual stent is used as the updated initial second virtual stent.

[0220] In step S302, when one end of the initial third virtual bracket reaches the corresponding narrow boundary and the other end does not reach the corresponding narrow boundary, extending and updating the initial third virtual bracket includes:

[0221] The initial third virtual bracket position is maintained, and the length of the initial third virtual bracket is extended from the other end that does not reach the corresponding narrow boundary to obtain an eighth extended virtual bracket, and the eighth extended virtual bracket is used as the updated initial third virtual bracket.

[0222] In the above embodiment, the length of each extension of the initial second virtual bracket and the initial third virtual bracket can be set as needed, but for the accuracy of adjustment, it may not be greater than 2 mm.

[0223] An eighth embodiment of the present application provides a computer-readable storage medium for storing the computer program of the seventh embodiment.

[0224] The ninth embodiment of the present application provides a stent planning device for a stenotic lesion vessel, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor. When the stenotic lesion vessel has two stenotic lesions in series, and the two stenotic lesions are respectively a diffuse lesion and a focal lesion, the processor executes the computer program to implement the following: Figure 5 Stent planning method shown:

[0225] respectively obtaining the blood flow impact of the two stenotic lesions;

[0226] When the blood flow impact of the diffuse lesion is greater, a first virtual stent is placed in the diffuse lesion, and a vascular function evaluation index after the placement of the virtual stent is obtained; when the vascular function evaluation index after the placement of the first virtual stent does not meet a preset condition, a second virtual stent is placed in the focal lesion;

[0227] When the blood flow impact of the focal lesion is large, a second virtual stent is placed in the focal lesion, and a vascular function evaluation index after the placement of the virtual stent is obtained; when the vascular function evaluation index after the placement of the second virtual stent does not meet the preset conditions, a first virtual stent is placed in the diffuse lesion.

[0228] The blood flow impact in this embodiment refers to the ability of the stenosis to affect the degree of blood flow obstruction; it can be evaluated using existing or future related parameters. The blood flow impact is not limited to the implementation methods provided in the embodiments of this application.

[0229] The obtaining of the blood flow impact of the two stenotic lesions includes at least one of the following:

[0230] Obtaining the withdrawal pressure drop gradient curves dFFR / ds for each of the two stenotic lesions, and using the maximum value of dFFR / ds in each stenotic lesion as the blood flow impact of the stenotic lesion; wherein s is the length vector of the vascular segment of the stenotic lesion; dFFR / ds is the derivative of FFR with respect to s; the stenotic lesion with the larger maximum value of dFFR / ds is defined as the first stenotic lesion, and the stenotic lesion with the smaller maximum value of dFFR / ds is defined as the second stenotic lesion;

[0231] Obtaining the FFR decrease values ΔFFR of the two stenotic lesions respectively, and using the ΔFFR of each stenotic lesion as the blood flow impact of the stenotic lesion; wherein ΔFFR = P2 / Pa - P1 / Pa, where P2 represents the pressure proximal to the stenotic lesion, P1 represents the pressure distal to the stenotic lesion, and Pa represents the aortic pressure at the coronary ostium; the stenotic lesion with the larger ΔFFR is regarded as the first stenotic lesion, and the stenotic lesion with the smaller ΔFFR is regarded as the second stenotic lesion;

[0232] Obtain the stenosis degree N of the two stenosis lesions respectively, and use the N of each stenosis lesion as the blood flow impact of the stenosis lesion; where N = 1-2D min / (D1+D2), D min represents the minimum diameter of the stenotic lesion, D1 represents the diameter of the proximal end of the stenotic lesion, and D2 represents the diameter of the distal end of the stenotic lesion; the stenotic lesion with a larger N is regarded as the first stenotic lesion, and the stenotic lesion with a smaller N is regarded as the second stenotic lesion.

[0233] This embodiment first obtains the blood flow impact of the two stenotic lesions, and then preferentially inserts a virtual stent into the stenotic lesion with the larger blood flow impact; when the vascular function evaluation index after the virtual stent is inserted into the stenotic lesion with the larger blood flow impact does not reach the preset condition, another virtual stent is inserted into the stenotic lesion with the smaller blood flow impact; this avoids the situation where a doctor manually inserts a virtual stent into the stenotic lesion with the smaller blood flow impact while not treating the stenotic lesion with the larger blood flow impact; implanting a virtual stent into the stenotic lesion with the larger blood flow impact can usually achieve better treatment benefits, so that the length of the virtual stent is as short as possible while achieving the expected treatment effect.

[0234] Optionally, a second virtual stent is placed in the focal lesion so that the virtual stent basically covers the area between the stenosis boundaries at both ends of the stenotic lesion vessel segment. The basic coverage in the embodiment of the present application means that a stent close to the length of the stenotic lesion vessel segment can be selected based on the actual stent specifications. For example, if the length of the stenotic lesion vessel segment is 20mm, a 20mm stent is preferred; if the hospital is not equipped with a 20mm stent and the stent sizes it has include 18mm and 22mm, then either an 18mm stent or a 22mm stent can be selected.

[0235] Optionally, a first virtual stent is placed in the diffuse lesion, such as Figure 6 Shown, including:

[0236] S1. Obtaining the narrow boundaries at both ends of the diffuse lesion and the narrow extreme point in the diffuse lesion;

[0237] S2. An initial virtual stent is placed in the diffuse lesion, and a vascular function evaluation index after the initial virtual stent is placed is obtained; the initial virtual stent is located between the stenosis boundaries at both ends of the diffuse lesion; the initial virtual stent is configured to cover the stenosis extreme; when the vascular function evaluation index meets a preset condition, the information of the initial virtual stent is used as a recommended treatment plan, and the following steps S3 and S4 are no longer performed;

[0238] The vascular function evaluation indicators in the embodiments of the present application may be existing ones or may appear in the future, and the present application does not impose any restrictions thereon; for example, the Fractional Flow Reserve (FFR), the quantitative flow fraction QFR, the flow fraction FFR based on coronary angiography angio , coronary angiography blood flow reserve fraction caFFR, FFR based on coronary CTA (Computed Tomographic Angiography) (i.e. FFR CT ), FFR based on intravascular ultrasound (IVUS) IVUS ), FFR (ie OFR) based on optical coherence tomography (OCT), the distal pressure of the stenotic vascular segment; the FFR used in the embodiment of the present application can also be QFR, FFR angio ,caFFR,FFR CT 、FFR IVUS , OFR replacement;

[0239] S3. When the vascular function evaluation index does not meet the preset condition, extending and updating the initial virtual stent, and obtaining the vascular function evaluation index after implantation of the extended initial virtual stent;

[0240] S4. Repeat step S3 until the vascular function evaluation index reaches a preset condition, or both ends of the initial virtual stent reach the stenosis boundary of the corresponding end, and use the corresponding initial virtual stent as the first virtual stent.

[0241] In this embodiment, the preset condition of the vascular function evaluation index can adopt any of the above-mentioned indicators and set an appropriate threshold value to evaluate whether the expected treatment effect is achieved after the initial virtual stent is implanted in the stenotic vascular segment; for example, the vascular function evaluation index is FFR, and the preset condition is FFR ≥ 0.9;

[0242] The method for obtaining the vascular function evaluation index after the initial virtual stent is implanted can be obtained through existing technology (for example, CN106539622A) or technology after the application date. This application does not limit it and does not elaborate on it.

[0243] In this embodiment, when the initial stent is placed in the diffuse lesion, the initial virtual stent is configured to cover the extreme stenosis; by gradually extending the initial virtual stent and obtaining corresponding vascular function evaluation indicators, a virtual stent with the shortest possible length that can achieve the expected treatment effect is obtained.

[0244] In a first optional implementation of step S3, extending and updating the initial virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial virtual stent include:

[0245] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent;

[0246] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent;

[0247] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from both ends to obtain a third extended virtual stent, and obtaining a vascular function evaluation index after implantation of the third extended virtual stent; wherein the length extended from the distal end and the length extended from the proximal end may be the same or different, or may be extended using multiple length distribution ratios;

[0248] Wherein, the lengths of the first extended virtual bracket, the second extended virtual bracket, and the third extended virtual bracket are the same;

[0249] The one among the first lengthened virtual stent, the second lengthened virtual stent, and the third lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial virtual stent.

[0250] For example, the length of the initial virtual stent in step S2 is 8 mm;

[0251] In step S3, the initial virtual stent is extended by 2 mm from the proximal end to obtain a first extended virtual stent, and the FFR after the first extended virtual stent is placed is obtained to be 0.78;

[0252] Extending the initial virtual stent by 2 mm from the distal end to obtain a second extended virtual stent, and obtaining an FFR of 0.81 after implantation of the second extended virtual stent;

[0253] The initial virtual stent is extended from the proximal end by 1 mm, and from the distal end by 1 mm to obtain a third extended virtual stent, and the FFR after the third extended virtual stent is placed is 0.8; the initial virtual stent can also be extended from the proximal end by 0.5 mm, and from the distal end by 1.5 mm to obtain a third extended virtual stent, and the FFR after the third extended virtual stent is placed is 0.79; or both of the above three third extended virtual stents are used;

[0254] The FFR value after placement of the second extended virtual stent is the highest, so the second extended virtual stent is used as the updated initial virtual stent.

[0255] In a second optional implementation of step S3, extending and updating the initial virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial virtual stent include:

[0256] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent;

[0257] Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent;

[0258] Wherein, the lengths of the first extended virtual bracket and the second extended virtual bracket are the same;

[0259] The one of the first lengthened virtual stent and the second lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial virtual stent.

[0260] In a third optional implementation of step S3, extending and updating the initial virtual stent includes:

[0261] The initial virtual stent position is maintained, and the length of the initial virtual stent is extended from the proximal end and the distal end respectively to obtain a lengthened virtual stent, and the lengthened virtual stent is used as the updated initial virtual stent.

[0262] In this embodiment, the length extended from the distal end and the length extended from the proximal end can be the same or different. For example, the lengthened virtual stent can be obtained by extending the proximal end by 1 mm and the distal end by 1 mm.

[0263] Alternatively, under the premise that the total extended length remains unchanged, the length extended from the distal end and the length extended from the proximal end can adopt multiple length distribution ratios, and the one with the best corresponding vascular function evaluation index is selected as the updated initial virtual stent.

[0264] In step S3, the initial virtual stent is extended. However, the degree of stenosis of the distal and proximal vessels of the initial virtual stent may be different. Therefore, the therapeutic effects of extending the initial virtual stent from the distal end, extending the initial virtual stent from the proximal end, and extending the initial virtual stent from both ends may differ, and it is necessary to find an optimal extension scheme. An optional implementation of the above step S3 is to extend the initial virtual stent from the distal end, extending the initial virtual stent from the proximal end, and extending the initial virtual stent from both ends, and obtain corresponding vascular function evaluation indicators for comparison to obtain the optimal extension scheme.

[0265] When one end of the initial virtual stent reaches the corresponding stenosis boundary, but the other end does not reach the corresponding stenosis boundary, extending the initial virtual stent from the end that reaches the corresponding stenosis boundary can foreseeably have extremely low therapeutic benefits for the stenosis lesion. Therefore, optionally, in this case, in the three optional implementations of the above step S3, extending and updating the initial virtual stent includes:

[0266] The initial virtual stent position is maintained, and the length of the initial virtual stent is extended from the other end that has not reached the corresponding narrow boundary to obtain a lengthened virtual stent, and the lengthened virtual stent is used as the updated initial virtual stent.

[0267] In the above embodiment, the length of each extension of the initial virtual stent can be set as needed, but for the accuracy of adjustment, it may not be greater than 2 mm.

[0268] In step S1, the diffuse boundaries at both ends of the diffuse diseased vascular segment are obtained by obtaining the stenotic diseased vascular segment from other equipment or manually and inputting it into the computer of this embodiment, and taking the two ends of the stenotic diseased vascular segment as the stenotic boundaries; or when the computer program is run on the computer, the computer is caused to execute the following method: comprising

[0269] Acquiring a blood vessel image of the stenotic diseased blood vessel;

[0270] acquiring a stenotic diseased blood vessel segment according to the blood vessel image;

[0271] determining the lesion type of the stenotic diseased vascular segment to obtain a diffuse diseased vascular segment;

[0272] The positions at both ends of the diffusely affected vascular segment are taken as stenosis boundaries.

[0273] Optionally, acquiring a stenotic diseased blood vessel segment according to the blood vessel image includes:

[0274] Acquiring a corresponding normal blood vessel image in a state without stenosis according to the blood vessel image;

[0275] Obtaining a ratio of a diameter at each position of the blood vessel image to a diameter at a corresponding position of the normal blood vessel image;

[0276] When the ratio of the adjacent multiple positions is less than a preset ratio threshold, the region of the multiple positions is regarded as a stenotic lesion blood vessel segment. The multiple positions can be continuous points or discrete points.

[0277] Optionally, when the initial vascular image includes two stenotic lesion vessel segments, and the distance between adjacent stenotic boundaries of the two stenotic lesion vessel segments is less than a preset distance threshold, for example, the distance between the two stenotic lesions is less than 0.5 mm, the two stenotic lesions can be considered as one stenotic lesion, and the two stenotic lesion vessel segments can be merged into one stenotic lesion vessel segment. Therefore, the distance between the adjacent focal boundaries and the diffuse boundaries is greater than the preset distance threshold.

[0278] The above-mentioned implementation manner is only for facilitating understanding of the technical solution of the present application, and the present application does not limit the solution of obtaining a narrow boundary.

[0279] The determination of the lesion type of the stenotic vascular segment may be performed by other equipment or manually input into the computer; or the determination may be performed by causing the computer to execute one of the following optional methods when the computer program is executed on the computer:

[0280] Method 1:

[0281] Obtaining a pressure gradient index (PPG) of the stenotic lesion vessel segment; when the PPG is greater than a preset PPG threshold, determining that the stenotic lesion vessel segment is a focal lesion; and when the PPG is less than the preset PPG threshold, determining that the stenotic lesion vessel segment is a diffuse lesion;

[0282] in,

[0283] PPG=((MaxPPG l / ΔFFR vessel )+(1-Length disease / Length total )) / 2

[0284] Among them: MaxPPG l is the maximum FFR drop value of any vessel in the length interval l on the FFR withdrawal curve; l can be set as needed, for example, 20mm;

[0285] ΔFFR vessel It is the FFR decrease value in the total vessel length interval on the FFR withdrawal curve;

[0286] Length disease The sum of the lengths of all blood vessels in the intervals on the FFR retracement curve where the FFR decrease value is greater than the preset decrease threshold. The preset decrease threshold can be determined based on experience, such as 0.0015 / mm.

[0287] Length total is the total vessel length described by the FFR pullback curve.

[0288] Method 2:

[0289] The lesion length of the stenotic diseased vessel segment is obtained. When the lesion length is greater than a preset length threshold, the stenotic diseased vessel segment is judged to be a diffuse lesion; when the lesion length is less than the preset length threshold, the stenotic diseased vessel segment is judged to be a focal lesion. The preset length threshold can be set according to the situation, for example, set to 30 mm.

[0290] The above two methods for obtaining the lesion type of the stenotic diseased blood vessel are only examples, and other determination methods may also be used, which are not limited in this application.

[0291] Regarding obtaining the stenosis extreme of the diffuse lesion in step S1, the present application provides the following optional implementation schemes:

[0292] Solution 1: Obtain the withdrawal pressure drop gradient curve dFFR / ds of the diffuse lesion, and use the point where dFFR / ds is the maximum as the stenosis extreme; where s is the length vector of the diffuse lesion vessel segment; dFFR / ds is the derivative of FFR with respect to s, and the derivative interval can be selected according to the situation, for example, 0.5 mm;

[0293] The withdrawal pressure drop gradient curve dFFR / ds is used to characterize the instantaneous FFR change per unit length along the lumen centerline path; the larger the dFFR / ds, the greater the impact of the lesion location on FFR.

[0294] Option 2: The point with the smallest diameter of the diffuse lesion is taken as the extreme point of stenosis.

[0295] Solution 3: obtaining a corresponding normal blood vessel image based on the diffuse lesion;

[0296] The ratio of the diameter of each position of the stenosis lesion to the diameter of the corresponding position of the normal blood vessel image is obtained, and the position where the ratio has the minimum value is taken as the extreme point of stenosis.

[0297] The extreme stenosis refers to the location within the vascular segment with the most severe stenosis and the location with the greatest impact on vascular function evaluation indicators. Therefore, it has the highest priority for stent treatment. The above embodiments are intended to facilitate understanding of the technical solution of this application. This application does not limit the method for obtaining the extreme stenosis. The extreme stenosis can also be obtained through other existing technologies or technical evaluations after the application is filed.

[0298] In step S2, the initial virtual stent is configured to cover the stenosis extreme point, so that the initial virtual stent supports the stenosis extreme point; optionally, the midpoint of the initial virtual stent is located at the stenosis extreme point.

[0299] In step S2, the length of the initial virtual stent placed in the stenotic vascular segment should not be too long, for example, not greater than 8 mm.

[0300] A tenth embodiment of the present application provides a computer-readable storage medium, wherein the computer-readable storage medium is used to store the computer program described in the ninth embodiment.

[0301] In the above embodiments, all or part of the embodiments may be implemented by software, hardware, firmware, or any combination thereof. When implemented using software, all or part of the embodiments may be implemented in the form of a computer program product. The computer program product includes one or more computer instructions. When the computer program instructions are loaded and executed on a computer, the process or function described in this application is generated in whole or in part. The computer may be a general-purpose computer, a special-purpose computer, a computer network, or other programmable device. The computer instructions may be stored in a computer-readable storage medium or transmitted from one computer-readable storage medium to another computer-readable storage medium. For example, the computer instructions may be transmitted from one website, computer, server, or data center to another website, computer, server, or data center via a wired (e.g., coaxial cable, optical fiber, digital subscriber line) or wireless (e.g., infrared, wireless, microwave, etc.) method. The computer-readable storage medium may be any available medium that a computer can access or a data storage device such as a server or data center that includes one or more available media integrated therein. The available medium may be a magnetic medium (e.g., a floppy disk, a hard disk, a tape), an optical medium (e.g., a DVD), or a semiconductor medium (e.g., a solid-state drive (SSD)).

[0302] It should be noted that, in this specification, the terms "first," "second," and so on are used solely for descriptive purposes and to distinguish similar objects. There is no order of precedence between the two, nor should they be construed as indicating or implying relative importance. Furthermore, in this specification, unless otherwise specified, "plurality" means two or more. The step numbers in this specification are for ease of description only and do not limit the chronological order of the steps.

[0303] The above embodiments are intended only to illustrate the technical concepts and features of this application. Their purpose is to enable those familiar with the art to understand the content of this application and implement it accordingly. They are not intended to limit the scope of protection of this application. Any equivalent changes or modifications made in accordance with the spirit of this application shall be included in the scope of protection of this application.

[0304] It should be understood that the above description is for illustration and not for limitation. Many embodiments and applications beyond the examples provided will be apparent to those skilled in the art upon reading the above description. For comprehensive purposes, all articles and references, including disclosures of patent applications and publications, are incorporated herein by reference.

Claims

1. A stent planning device for a stenotic diseased blood vessel, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein: When the stenotic lesion vessel has two stenotic lesions connected in series, the processor implements the following stent planning method when executing the computer program: respectively obtaining blood flow influences of the two stenotic lesions to obtain a first stenotic lesion with a greater blood flow influence and a second stenotic lesion with a smaller blood flow influence; implanting a first virtual stent in the first stenosis lesion, and obtaining a vascular function evaluation index after implantation of the first virtual stent; When the vascular function evaluation index after the placement of the first virtual stent does not meet a preset condition, a second virtual stent is placed in the second stenosis lesion.

2. The device according to claim 1, wherein The step of respectively obtaining the blood flow impact of the two stenotic lesions includes at least one of the following: Obtaining the withdrawal pressure drop gradient curves dFFR / ds for each of the two stenotic lesions, and using the maximum value of dFFR / ds in each stenotic lesion as the blood flow impact of the stenotic lesion; wherein s is the length vector of the vascular segment of the stenotic lesion; dFFR / ds is the derivative of FFR with respect to s; the stenotic lesion with the larger maximum value of dFFR / ds is defined as the first stenotic lesion, and the stenotic lesion with the smaller maximum value of dFFR / ds is defined as the second stenotic lesion; Obtaining the FFR decrease values ΔFFR of the two stenotic lesions respectively, and using the ΔFFR of each stenotic lesion as the blood flow impact of the stenotic lesion; wherein ΔFFR = P2 / Pa - P1 / Pa, where P2 represents the pressure proximal to the stenotic lesion, P1 represents the pressure distal to the stenotic lesion, and Pa represents the aortic pressure at the coronary ostium; the stenotic lesion with the larger ΔFFR is regarded as the first stenotic lesion, and the stenotic lesion with the smaller ΔFFR is regarded as the second stenotic lesion; Obtain the stenosis degree N of the two stenosis lesions respectively, and use the N of each stenosis lesion as the blood flow impact of the stenosis lesion; where N = 1-2D min / (D1+D2), D min represents the minimum diameter of the stenotic lesion, D1 represents the diameter of the proximal end of the stenotic lesion, and D2 represents the diameter of the distal end of the stenotic lesion; the stenotic lesion with a larger N is regarded as the first stenotic lesion, and the stenotic lesion with a smaller N is regarded as the second stenotic lesion.

3. A stent planning device for a stenotic diseased blood vessel, comprising a memory, a processor, and a computer program stored in the memory and executable on the processor, characterized in that: When the stenotic lesion vessel has two stenotic lesions connected in series, and the two stenotic lesions are respectively a diffuse lesion and a focal lesion, the processor implements the following stent planning method when executing the computer program: respectively obtaining the blood flow impact of the two stenotic lesions; When the blood flow impact of the diffuse lesion is greater, a first virtual stent is placed in the diffuse lesion, and a vascular function evaluation index after the placement of the virtual stent is obtained; when the vascular function evaluation index after the placement of the first virtual stent does not meet a preset condition, a second virtual stent is placed in the focal lesion; When the blood flow impact of the focal lesion is large, a second virtual stent is placed in the focal lesion, and a vascular function evaluation index after the placement of the virtual stent is obtained; when the vascular function evaluation index after the placement of the second virtual stent does not meet the preset conditions, a first virtual stent is placed in the diffuse lesion.

4. The device according to claim 3, characterized in that The step of respectively obtaining the blood flow impact of the two stenotic lesions includes at least one of the following: Obtaining the two stenotic lesion withdrawal pressure gradient curves dFFR / ds, and taking the maximum value of dFFR / ds in each stenotic lesion as the blood flow impact of the stenotic lesion; wherein s is the length vector of the stenotic lesion vessel segment; and dFFR / ds is the derivative of FFR with respect to s; Obtaining the FFR decrease values ΔFFR of the two stenotic lesions respectively, and using the ΔFFR of each stenotic lesion as the blood flow impact of the stenotic lesion; wherein ΔFFR = P2 / Pa - P1 / Pa, P2 represents the pressure proximal to the stenotic lesion, P1 represents the pressure distal to the stenotic lesion, and Pa represents the aortic pressure at the coronary ostium; Obtain the stenosis degree N of the two stenosis lesions respectively, and use the N of each stenosis lesion as the blood flow impact of the stenosis lesion; where N = 1-2D min / (D1+D2), D min represents the minimum diameter of the stenotic lesion, D1 represents the diameter of the proximal end of the stenotic lesion, and D2 represents the diameter of the distal end of the stenotic lesion.

5. The device according to claim 3, wherein The step of placing a first virtual stent in the diffuse lesion comprises: S1. Obtaining the stenosis boundaries at both ends of the diffuse lesion and the stenosis extreme in the diffuse lesion; S2. placing an initial virtual stent in the diffuse lesion and obtaining a vascular function evaluation index after the placement of the initial virtual stent; the initial virtual stent is located between the stenosis boundaries at both ends of the diffuse lesion; the initial virtual stent is configured to cover the stenosis extreme; S3. When the vascular function evaluation index does not meet the preset condition, extending and updating the initial virtual stent, and obtaining the vascular function evaluation index after implantation of the extended initial virtual stent; S4. Repeat step S3 until the vascular function evaluation index reaches a preset condition, or both ends of the initial virtual stent reach the stenosis boundary of the corresponding end, and use the corresponding initial virtual stent as the first virtual stent.

6. The device according to claim 5, characterized in that The extending and updating the initial virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial virtual stent include: Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent; Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent; Maintaining the initial virtual stent position, extending the length of the initial virtual stent from both ends to obtain a third lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the third lengthened virtual stent; Wherein, the lengths of the first extended virtual bracket, the second extended virtual bracket, and the third extended virtual bracket are the same; The one among the first lengthened virtual stent, the second lengthened virtual stent, and the third lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial virtual stent.

7. The device according to claim 5, characterized in that The extending and updating the initial virtual stent and obtaining a vascular function evaluation index after implantation of the extended initial virtual stent include: Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the proximal end to obtain a first lengthened virtual stent, and obtaining a vascular function evaluation index after implantation of the first lengthened virtual stent; Maintaining the initial virtual stent position, extending the length of the initial virtual stent from the distal end to obtain a second extended virtual stent, and obtaining a vascular function evaluation index after implantation of the second extended virtual stent; Wherein, the lengths of the first extended virtual bracket and the second extended virtual bracket are the same; The one of the first lengthened virtual stent and the second lengthened virtual stent that corresponds to the best vascular function evaluation index is used as the updated initial virtual stent.

8. The device according to claim 5, wherein The extending and updating the initial virtual bracket includes: The initial virtual stent position is maintained, and the length of the initial virtual stent is extended from the proximal end and the distal end respectively to obtain a lengthened virtual stent, and the lengthened virtual stent is used as the updated initial virtual stent.

9. The device according to any one of claims 5 to 8, characterized in that When one end of the initial virtual stent reaches the corresponding narrow boundary and the other end does not reach the corresponding narrow boundary, extending and updating the initial virtual stent includes: The initial virtual stent position is maintained, and the length of the initial virtual stent is extended from the other end that has not reached the corresponding narrow boundary to obtain a lengthened virtual stent, and the lengthened virtual stent is used as the updated initial virtual stent.

10. The device according to claim 5, wherein The obtaining of the narrow boundaries at both ends of the diffuse lesion includes Acquiring a blood vessel image of the stenotic diseased blood vessel; acquiring a stenotic diseased blood vessel segment according to the blood vessel image; Determining the lesion type of the stenotic diseased vascular segment to obtain a diffuse diseased vascular segment; The positions at both ends of the diffusely affected vascular segment are taken as stenosis boundaries.

11. The device according to claim 10, wherein The step of acquiring a stenotic diseased blood vessel segment according to the blood vessel image includes: Acquiring a corresponding normal blood vessel image in a state without stenosis according to the blood vessel image; Obtaining a ratio of a diameter at each position of the blood vessel image to a diameter at a corresponding position of the normal blood vessel image; When the ratio of the adjacent multiple positions is less than a preset ratio threshold, the region of the multiple positions is regarded as a stenotic diseased blood vessel segment.

12. The device according to claim 10, wherein When the distance between adjacent stenosis boundaries of two stenotic diseased blood vessel segments is less than a preset distance threshold, the two stenotic diseased blood vessel segments are merged into one stenotic diseased blood vessel segment.

13. The device according to claim 10, wherein Determining the lesion type of the stenotic vascular segment includes: Obtaining a pressure gradient index (PPG) of the stenotic lesion vessel segment; when the PPG is greater than a preset PPG threshold, determining that the stenotic lesion vessel segment is a focal lesion; and when the PPG is less than the preset PPG threshold, determining that the stenotic lesion vessel segment is a diffuse lesion; or, The lesion length of the stenotic lesion vessel segment is obtained. When the lesion length is greater than a preset length threshold, the stenotic lesion vessel segment is judged to be a diffuse lesion; when the lesion length is less than the preset length threshold, the stenotic lesion vessel segment is judged to be a focal lesion.

14. The device according to claim 5, wherein Obtaining the extreme point of stenosis in the diffuse lesion includes: Obtaining the withdrawal pressure drop gradient curve dFFR / ds of the diffuse lesion, and taking the maximum dFFR / ds point as the stenosis extreme; wherein s is the length vector of the diffuse lesion vascular segment; dEER / ds is the derivative of FFR with respect to s; or, The point with the smallest diameter of the diffuse lesion is taken as the extreme point of stenosis; or, acquiring a corresponding normal blood vessel image according to the diffuse lesion; The ratio of the diameter of each position of the stenosis lesion to the diameter of the corresponding position of the normal blood vessel image is obtained, and the position where the ratio has the minimum value is taken as the extreme point of stenosis.

15. The device according to claim 5, wherein The midpoint of the initial virtual stent in step S2 is located at the extreme point of stenosis.

16. The device according to claim 5, wherein: In step S2, the length of the initial virtual stent placed in the stenotic lesion blood vessel segment is no more than 8 mm.

17. The device according to claim 5, wherein: In step S3, the extension length of the initial virtual stent is no more than 2 mm.

18. The device according to claim 3, wherein: The vascular function evaluation index is FFR, QFR, FFR angio ,caFFR,FFR CT 、FFR IVUS or OFR.

19. A computer-readable storage medium, characterized in that The computer-readable storage medium is used to store the computer program according to any one of claims 1 to 18.

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