Angiographic Guidance for Chronic Total Occlusion
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Solution Overview
Problem
Current methods for treating chronic total occlusions (CTOs) in vascular procedures are challenging due to the inability to visualize the occluded region directly, leading to difficulties in guiding wires through the occlusion without causing vessel rupture or subintimal derivation.
Innovation Solution
A device comprising an image supply, a data processor, and an output is provided to generate guidance image data. The data processor analyzes a sequence of angiographic images to detect total occlusions, determine images showing vessel segments next to the occlusion, and generate guidance image data based on these images.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If contrast agent injection is used to visualize vascular structures, then visibility of patent vessel segments is improved, but total occluded regions remain invisible and cannot be visualized
Solution Approach 1:
The system performs preliminary analysis of the angiographic sequence to identify the occlusion start and end points before the clinician needs to navigate. By pre-detecting the occlusion boundaries and pre-identifying the distal vessel segment, the system prepares guidance information in advance, allowing the clinician to proceed with confidence without needing to manually search through the entire sequence during the procedure.
Solution Approach 2:
The system introduces an intermediary processing layer that analyzes the angiographic sequence to extract and highlight the critical distal vessel segment. This intermediary analysis acts as a mediator between the raw contrast images and the clinician's decision-making, providing synthesized guidance information that bridges the gap between visible and invisible regions.
2Loss of information
If the clinician manually examines angiograms to identify faint distal segments, then information about the occlusion can be obtained, but the process is tedious and time-consuming
Solution Approach 1:
The system performs self-service by automatically analyzing the angiographic sequence to identify occlusion boundaries and distal vessel segments without requiring manual clinician intervention. The automated detection algorithm processes the images, extracts relevant information, and presents it in a ready-to-use format, freeing the clinician from tedious manual examination while maintaining accurate identification of critical structures.
Solution Approach 2:
The system replaces the manual mechanical process of visual inspection with an automated computational analysis system. Instead of the clinician manually examining each frame of the angiographic sequence, the system uses automated image processing and pattern recognition to identify the distal vessel segment, significantly reducing the time required while maintaining or improving accuracy.
3Ease of operation
If the clinician navigates the guide wire through the occluded region without direct visualization, then the procedure can be performed, but the risk of vessel rupture or subintimal derivation increases
Solution Approach 1:
The system provides preliminary visualization of the distal vessel segment and occlusion boundaries before the clinician attempts wire navigation. By pre-displaying the target area and path information, the clinician can plan the navigation strategy in advance, reducing the risk of accidental vessel rupture or subintimal derivation during the actual procedure.
Solution Approach 2:
The system provides feedback information about the occlusion characteristics and distal vessel anatomy to guide the clinician's navigation decisions. This feedback loop allows the clinician to adjust the navigation strategy based on the visualized information, improving safety by avoiding high-risk maneuvers that could cause vessel damage.
Data Source
AI summary
The present invention relates to a guidance for treatment of a chronic total occlusion. In order to provide improved guidance information for chronic total occlusion treatment, a device (10) for guidance for treatment of a chronic total occlusion is provided that comprises an image supply (12), a data processor (14) and an output (16). The image supply provides a sequence of angiographic images comprising a vascular structure. The data processor detects at least one portion of the vascular structure indicating a total occlusion of a vessel based on the sequence of angiographic images; and determines an image of the sequence of images that shows at least one segment of the vessel next to the total occlusion; and generates guidance image data based on the determined image. The output provides the generated guidance image data. Thus, additional information relating to spatial aspects is provided to the user based on 2D image data.