Renal Artery Hemodynamic Co-Registration for Guided Denervation
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current renal denervation (RDN) procedures for hypertension treatment have varying efficacy, with approximately 30% of patients showing no response or negative response due to physiological factors and inadequate therapy administration, lacking clear guidance on optimal treatment locations.
Innovation Solution
An RDN hemodynamics co-registration system that projects hemodynamic data onto fluoroscopic images during the procedure, using invasive measurements like iPWV to guide treatment device placement, predicting successful treatment locations and monitoring treatment progress.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If RDN procedure is performed without hemodynamic guidance, then procedure simplicity is maintained, but treatment efficacy decreases due to inability to predict successful treatment locations
Solution Approach 1:
The system performs preliminary hemodynamic measurements and co-registers them with angiographic images before and during the RDN procedure. This preliminary characterization of the renal artery hemodynamics allows the clinician to predict successful treatment locations in advance, enabling targeted intervention rather than blind treatment, thus improving reliability without requiring complex real-time adjustments during the procedure
Solution Approach 2:
The system introduces hemodynamic parameters (such as pulse wave velocity, stroke volume, and cardiac output) as intermediary metrics that bridge the gap between anatomical imaging and treatment outcome prediction. These hemodynamic metrics serve as mediators that translate physiological state into actionable guidance for treatment location selection, improving efficacy while maintaining procedural simplicity through automated analysis
2Measurement precision
If multiple treatment locations are evaluated, then treatment precision is improved, but measurement time increases
Solution Approach 1:
The system continuously performs hemodynamic measurements and co-registration throughout the RDN procedure rather than performing separate discrete assessments. The intravascular catheter continuously samples hemodynamic parameters while being pulled back through the renal artery, and the system continuously co-registers these measurements with angiographic images, maintaining useful action throughout the procedure to assess multiple locations efficiently without significant time loss
Solution Approach 2:
The system automatically performs the complex task of co-registering hemodynamic data with angiographic images and generating treatment guidance without requiring manual intervention. The automated co-registration algorithm processes the data streams in real-time, eliminating the need for time-consuming manual alignment and analysis, thus enabling precise multi-location assessment while minimizing time loss through self-service processing
Data Source
Figure 1A~1B
Figure 2
Figure 3
AI summary
An apparatus includes a processor in communication with an intravascular catheter or guidewire. The processor controls the catheter or guidewire to obtain intravascular sensor measurements within a renal artery of a patient, and calculates hemodynamic values based on the intravascular sensor measurements. The hemodynamic values are associated with a suitability of the patient for a renal denervation treatment or an expected responsiveness of the patient to the treatment. The processor also performs co-registration between the hemodynamic values and a first X-ray image of the renal artery obtained with a contrast fluid inside the renal artery, and outputs, to a display, a screen display configured to guide a user regarding the renal denervation treatment. The screen display includes the first X-ray image of the renal artery and a representation of at least one hemodynamic value positioned proximate to at least one corresponding location along the length of the renal artery.