Simulated Bilateral Coronary Injection via Sequential Imaging
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Solution Overview
Problem
Current methods for diagnosing and planning retrograde navigation in coronary arteries with chronic total occlusions are complex due to the difficulty in visualizing the length and shape of completely blocked arteries, as contrast agent injected into a completely blocked artery cannot flow past the occlusion, and simultaneous bilateral injection of contrast agents into interconnected coronary arteries is challenging to synchronize.
Innovation Solution
A system and method that simulate bilateral injection of contrast agent by acquiring and processing image sets from x-ray imaging, using a controller to generate composite images that depict both coronary arteries in the same cardiac phase, correcting for geometric differences and combining high- and low-frequency components to create a synchronized video feed that appears as simultaneous injection.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If contrast agent is injected into a completely blocked coronary artery, then the shape of the artery up to the occlusion is revealed, but the length and size of the occlusion and the shape downstream cannot be determined
Solution Approach 1:
The system performs preliminary actions by acquiring image sets from both coronary arteries sequentially before processing. By capturing all necessary imaging data in advance and then combining them through image processing algorithms, the system eliminates the need for complex real-time simultaneous bilateral injection while still providing complete information about the occluded artery's shape, occlusion boundaries, and downstream anatomy.
2Loss of information
If simultaneous bilateral injection of contrast agents is performed, then both coronary arteries are visualized, but the procedure complexity increases due to difficulty in synchronizing two catheters
Solution Approach 1:
The system segments the bilateral injection procedure into two separate sequential acquisitions - one for each coronary artery. Each artery is imaged independently with its own catheter and contrast injection, then the image sets are combined through processing. This segmentation eliminates the operational complexity of simultaneously managing two catheters while still achieving complete visualization of both arteries in a synchronized composite display.
3Ease of operation
If staggered contrast injections are performed, then two separate video sequences are obtained, but the cardiac phases are unsynchronized making it difficult to view collateral artery connections
Solution Approach 1:
The system uses feedback mechanisms by acquiring ECG gating signals during the sequential image acquisition process. These electrical signals provide timing information about the cardiac cycle, allowing the system to synchronize the image sets from both arteries to corresponding cardiac phases. The ECG feedback ensures that when the image sets are combined, they represent the same point in the cardiac cycle, making collateral artery connections clearly visible.
4Loss of information
If side-by-side video feeds are used to display both coronary arteries, then both arteries are visible, but the unsynchronized cardiac phases make it difficult to identify collateral artery connection sites
Solution Approach 1:
The system merges the two separately acquired image sets into a single synchronized composite display. By combining the image data from both coronary arteries and aligning them to the same cardiac phase using ECG gating, the system produces a unified visualization where both arteries appear in their correct anatomical positions and phases. This merging allows precise identification of collateral artery connection sites since the images represent the same moment in the cardiac cycle.
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
This approach improves visualization of collateral artery connections and simplifies the planning of guidewire paths for retrograde navigation by providing a synchronized image of both coronary arteries, reducing the complexity of managing multiple catheters and enhancing the workflow for treating chronic total occlusions.
Implementation Method 1
recording the flow of the contrast agent within the coronary arteries via x-ray imaging
Data Source
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AI summary
A system for simulating bilateral injection of contrast agent into a patient is provided. The system includes an x-ray imaging device and a controller. The controller is operative to: acquire a first image set of a first blood vessel having contrast agent therein via the x-ray imaging device; acquire a second image set of a second blood vessel having contrast agent therein via the x-ray imaging device; and generate a third image set based at least in part on the first image set and the second image set. The third image set includes at least one composite image that depicts both the first blood vessel and the second blood vessel.