Virtual Endoscopic View for Guide Wire Navigation in Occlusions
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Solution Overview
Problem
During percutaneous interventions for chronic total occlusion, navigating a guide wire through the occlusion is challenging due to limited navigational information, especially when the composition of the blockage is unclear, as traditional imaging methods like fluoroscopy and X-ray angiography struggle to visualize the plaque, increasing the risk of perforating the artery or dislodging plaque.
Innovation Solution
A navigation apparatus and method that processes volumetric medical imaging data to identify different types of tissue and render a virtual endoscopic view, allowing the visualization of the guide wire's position and the composition of the occlusion, enabling better navigation by distinguishing between hard and soft plaque.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Speed
If fluoroscopy or X-ray angiography is used to guide the guide wire, then real-time imaging is provided, but the composition of the blockage is not visible and limited navigational information is provided
Solution Approach 1:
The patent combines fluoroscopy (real-time 2D imaging) with CT angiography (detailed 3D anatomical and compositional imaging) into a hybrid imaging system. This merging allows the surgeon to simultaneously access real-time guidance and detailed plaque composition information, resolving the contradiction between real-time imaging capability and information completeness about the blockage
Solution Approach 2:
The patent transitions from 2D fluoroscopic imaging to 3D CT-based virtual endoscopic views. This dimensional enhancement provides depth perception and detailed visualization of plaque composition (calcified, soft, fibrous) that cannot be obtained from flat 2D images, thereby enriching navigational information while maintaining real-time guidance capability
2Object-affected harmful factors
If a small guide wire is pushed through the narrow passage in the occlusion, then the risk of perforating the artery is reduced, but very little navigational information is available to guide the wire
Solution Approach 1:
The system performs preliminary CT angiography scanning before the guide wire intervention to create detailed 3D models of the occlusion and virtual endoscopic views. This preliminary action provides comprehensive navigational information about plaque composition and vessel anatomy in advance, enabling the surgeon to plan the safest path for the small guide wire through the narrow passage
Solution Approach 2:
The patent creates virtual copies of the actual occlusion scene through CT imaging and renders virtual endoscopic views that replicate what the surgeon would see from inside the vessel. These virtual representations provide detailed navigational information about plaque composition and vessel geometry, guiding the physical guide wire through the narrow passage while minimizing perforation risk
3Ease of operation
If the surgeon attempts to navigate through soft component of the occlusion, then the guide wire may traverse the blockage, but the risk of dislodging plaque and causing infarction remains considerable
Solution Approach 1:
The patent uses CT density measurements to identify and differentiate local qualities of plaque (calcified, soft, fibrous) at specific locations within the occlusion. This local quality assessment allows the surgeon to identify regions with higher risk of plaque dislodgement and adjust the navigation strategy accordingly, choosing paths that minimize the risk of causing infarction while still achieving guide wire traversal
Data Source
AI summary
A navigation apparatus for assisting navigation of a device through tissue comprises processing circuitry configured to receive volumetric medical imaging data representative of an anatomical region, the anatomical region comprising a region of tissue to be traversed by a device; process the volumetric medical imaging data to identify different types of tissue in the region of tissue; determine a position of the device; and process the volumetric medical imaging data to obtain a virtual endoscopic view of at least part of the region of tissue, the virtual endoscopic view comprising a virtual representation of the device in its determined position; wherein the virtual endoscopic view is rendered such as to visually distinguish the identified different types of tissue, thereby assisting navigation of the device through the region of tissue.