Renal Nerve Co-Registration With X-Ray for Precise Denervation
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Solution Overview
Problem
Current renal denervation (RDN) procedures lack precise guidance for locating optimal treatment sites due to limited information on renal nerve bundle morphology and surrounding tissues, leading to variable treatment efficacy.
Innovation Solution
A system for co-registering renal nerve bundle data from intravascular imaging with fluoroscopic images, using advanced imaging techniques like IVUS or OCT, to provide real-time guidance for RDN procedures, identifying suitable treatment locations and monitoring treatment success.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If fluoroscopic guidance is used for renal denervation procedures, then the procedure can be performed with simple equipment, but the precision of locating treatment sites is insufficient
Solution Approach 1:
The patent combines fluoroscopic images with intravascular imaging data (IVUS or OCT) to create a co-registered composite image. This merging of two different imaging modalities allows the system to maintain the simplicity of fluoroscopy while adding the precision of intravascular imaging for locating nerve bundles and treatment sites.
Solution Approach 2:
The patent uses intravascular ultrasound or optical coherence tomography imaging as an intermediary to provide detailed information about nerve bundle locations and tissue characteristics. This intermediary imaging modality bridges the gap between simple fluoroscopy and the need for precise anatomical guidance, enabling accurate treatment site identification without requiring complex standalone systems.
2Loss of information
If only fluoroscopic imaging is used, then the imaging system remains simple, but information about nerve bundle morphology and surrounding tissues is insufficient
Solution Approach 1:
The system merges fluoroscopic images that show arterial anatomy with intravascular imaging data that reveals nerve bundle morphology and tissue characteristics. This combination eliminates information loss by integrating complementary data from both imaging modalities into a unified guidance system.
Solution Approach 2:
The patent adds a new dimension of information by overlaying intravascular imaging data onto the two-dimensional fluoroscopic image. This creates a multi-dimensional representation that includes both the macroscopic arterial structure visible on fluoroscopy and the microscopic nerve bundle details from intravascular imaging, providing comprehensive anatomical information.
3Measurement precision
If advanced imaging techniques like IVUS or OCT are used, then treatment location accuracy is improved, but the procedure time increases
Solution Approach 1:
The patent performs intravascular imaging and co-registration of images before the actual renal denervation treatment. This preliminary action allows treatment locations to be identified and planned in advance, ensuring high accuracy while minimizing the time required during the actual treatment phase, as the system is already prepared with precise anatomical information.
Solution Approach 2:
The system provides real-time feedback by displaying co-registered images that show the position of the treatment device relative to identified nerve bundles and treatment sites. This feedback mechanism allows operators to make immediate adjustments, reducing the need for repeated imaging and minimizing overall procedure time while maintaining high accuracy.
Data Source
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AI summary
An apparatus includes a processor configured for communication with an intravascular imaging catheter. The processor is configured to control the intravascular imaging catheter to obtain a plurality of intravascular images during movement of the catheter along a length of a renal artery, where the plurality of intravascular images depicts one or more nerve bundles for targeting during a renal denervation treatment. The processor performs co-registration between a plurality of nerve bundle data points representative of the nerve bundles and associated with a treatment location along the length of the renal artery for the renal denervation treatment; and a first X-ray image of the renal artery obtained with a contrast fluid inside the renal artery. The processor outputs, to a display, a screen display based on the co-registration and configured to guide a user regarding the renal denervation treatment.