Laser Catheter Ultrasound Feedback for Bubble Cloud-Guided Atherectomy
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Solution Overview
Problem
Current laser atherectomy procedures face challenges in controlling laser catheter movement and treatment efficacy due to limited visualization under X-ray guidance, leading to potential over-treatment or under-treatment of vessel blockages, especially in tortuous vessels.
Innovation Solution
A control system integrates ultrasound imaging with laser atherectomy systems to detect and measure bubble clouds generated by laser interaction with tissue, providing real-time feedback for optimal catheter movement and treatment parameters through a closed-loop control system.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Manufacturing precision
If laser catheter is moved slowly to ensure adequate treatment, then treatment completeness improves, but risk of over-treatment increases
Solution Approach 1:
The system employs real-time feedback through ultrasound imaging to monitor bubble cloud characteristics and catheter position, enabling dynamic adjustment of dwell time and laser parameters to achieve optimal treatment without over-treatment
Solution Approach 2:
The system dynamically changes laser parameters (fluence, pulse rate, dwell time) based on real-time ultrasound feedback and pre-programmed protocols specific to each catheter type, allowing precise control of treatment delivery
2Productivity
If laser catheter is moved quickly to increase efficiency, then productivity improves, but treatment completeness deteriorates
Solution Approach 1:
The system transitions from static, fixed-speed catheter movement to dynamic speed control that adapts in real-time to vessel anatomy and treatment requirements, optimizing both efficiency and completeness
Solution Approach 2:
Real-time ultrasound feedback on bubble cloud formation and catheter position enables continuous adjustment of movement speed to match treatment needs, preventing under-treatment while maintaining efficiency
3Measurement precision
If X-ray guidance is used for laser catheter treatment, then visualization of catheter position is improved, but information about vessel anatomy and treatment efficacy is limited
Solution Approach 1:
The system merges ultrasound imaging capabilities with laser atherectomy functionality, combining anatomical visualization with treatment monitoring in a single integrated system
Solution Approach 2:
The ultrasound system serves multiple functions: visualizing vessel anatomy, tracking catheter position, monitoring bubble cloud formation, and assessing treatment efficacy, replacing the limited information provided by X-ray
4Manufacturing precision
If each laser catheter has custom speed and activation time specifications, then treatment precision for that catheter improves, but system complexity increases
Solution Approach 1:
Catheter-specific protocols including optimal speeds and activation times are pre-programmed into the control system during setup, eliminating the need for complex real-time calculations and simplifying operator workflow
Solution Approach 2:
The system automatically adjusts laser parameters and catheter movement speed based on pre-programmed protocols specific to each catheter type, managing complexity through standardized parameter sets
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Enhances treatment precision by dynamically adjusting laser catheter parameters based on ultrasound imaging, ensuring consistent dwell times and effective vessel clearance while minimizing complications.
Implementation Method 1
detecting, in real-time, a bubble cloud extending from the distal tip that is a function of the laser catheter operation in the treatment area using the US imaging transducer
Implementation Method 2
detecting sonic reflections in tissue media that are generated by an interaction of the laser light and anatomy of the vessel
Implementation Method 3
laser light essentially drills a hole in the clot/plaque thereby making a passage in the vessel lumen
Implementation Method 4
detecting a bubble cloud extending from the distal tip that is a function of the laser catheter operation
Data Source
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AI summary
Systems and methods for laser catheter treatment in a vessel lumen. The method includes inserting the laser catheter within the vessel lumen to a location of a treatment area; presenting an image of the treatment area within the vessel lumen based on using an ultrasound (US) imaging system; and, detecting, in real-time, a bubble cloud that is a function of the laser catheter operation (at a prescribed speed and controlling a fluence and a pulse rate) in the treatment area. The method determines a vessel diameter, a real-time location and measurements of the bubble cloud, and estimates a dwell position and dwell time. A dynamic displayed image that is indicative of a progression of the laser catheter treatment is presented, and commands may be generated to modify the laser catheter parameters responsive to the estimated dwell position, the estimated dwell time, and a recommended treatment protocol.