INTRAVASCULAR OPTICAL DEVICE
20220225880 · 2022-07-21
Inventors
- Manfred Mueller (Eindhoven, NL)
- Drazenko Babic (Best, NL)
- Gerhardus Wilhelmus Lucassen (Eindhoven, NL)
- Aditee KURANE (MAPLE GROVE, MN, US)
Cpc classification
A61B5/0084
HUMAN NECESSITIES
A61B5/02007
HUMAN NECESSITIES
A61B5/0075
HUMAN NECESSITIES
International classification
Abstract
The present invention relates to an intravascular device (10). The device comprises an elongate member (20), an optical fiber (30), and at least one optical interaction element (40). At least a part of the elongate member is configured to be inserted into a part of a vascular system of a patient. At least a part of the optical fiber is located within the elongate member. The optical fiber is configured to transmit optical wavelength radiation. The intravascular device is configured to emit optical wavelength radiation out of the elongate member in at least two optical radiation beams for being scattered and/or reflected by a portion of the vascular system. The emission of the at least two optical radiation beams comprises interaction of the transmitted optical wavelength radiation with the at least one optical interaction element. The intravascular device is configured to collect at least some of the scattered and/or reflected optical wavelength radiation and couple the at least some of the scattered and/or reflected optical wavelength radiation into the optical fiber comprising utilization of the at least one optical interaction element.
Claims
1. An intravascular device, comprising: an elongate member; an optical fiber; and at least one optical interaction element; wherein at least a part of the elongate member is configured to be inserted into a part of a vascular system of a patient; wherein at least a part of the optical fiber is located within the elongate member; wherein, the optical fiber is configured to transmit optical wavelength radiation; wherein the intravascular device is configured to emit a portion of the optical wavelength radiation out of the elongate member in at least two optical radiation beams for being scattered and/or reflected by a portion of the vascular system, wherein the emission of the at least two optical radiation beams comprises interaction of the transmitted optical wavelength radiation with the at least one optical interaction element; and wherein the intravascular device is configured to collect at least some of the scattered and/or reflected optical wavelength radiation and to couple the at least some of the scattered and/or reflected optical wavelength radiation into the optical fiber comprising utilization of the at least one optical interaction element.
2. The device according to claim 1, wherein the at least two optical radiation beams comprises a first optical radiation beam emitted out of a side wall of the elongate member.
3. The device according to claim 2, wherein the at least two optical radiation beams comprises a second optical radiation beam emitted out of the side wall of the elongate member.
4. The device according to claim 3, wherein a wavelength range of the first optical radiation beam is different from a wavelength range of the second optical radiation beam.
5. The device according to claim 3, wherein the first optical radiation beam is emitted out of the elongate member at a first longitudinal position of the elongate member and the second optical radiation beam is emitted out of the elongate member at a second longitudinal position of the elongate member different to the first longitudinal position.
6. The device according to claim 2, wherein the at least two optical radiation beams comprises an optical radiation beam emitted out of an end wall of the elongate member.
7. The device according to claim 6, wherein a wavelength range of the first optical radiation beam is different from a wavelength range of the optical radiation beam emitted out of the end wall of the elongate member.
8. The device according to claim 7, wherein a wavelength range of the second optical radiation beam is different to from the wavelength range of the optical radiation beam emitted out of the end of the elongate member.
9. The device according to claim 1, wherein the at least one optical interaction element comprises a wavelength selective element.
10. The device according to claim 1, wherein a portion of the optical fiber at a distal end of the optical fiber is fixedly connected to the elongate member; and wherein the at a least a part of the optical fiber located within the elongate member other than the fixed distal end is not fixedly connected to the elongate member.
11. An intravascular device, comprising: an elongate member; an optical fiber; and at least one optical interaction element; wherein at least a part of the elongate member is configured to be inserted into a part of a vascular system of a patient; wherein at least a part of the optical fiber is located within the elongate member; wherein the optical fiber is configured to transmit optical wavelength radiation; wherein the intravascular device is configured to emit at least a portion of the optical wavelength radiation out of the elongate member in an optical radiation beam that forms an annular emission profile substantially perpendicular to a longitudinal axis of the elongate member for being scattered and/or reflected by a portion of the vascular system, wherein the emission of the optical radiation beam comprises interaction of the transmitted optical wavelength radiation with the at least one optical interaction element; and wherein the intravascular device is configured to collect at least some of the scattered and/or reflected optical wavelength radiation and couple the at least some of the scattered and/or reflected optical wavelength radiation into the optical fiber comprising utilization of the at least one optical interaction element.
12. An intravascular microcatheter and guidewire device, comprising: a microcatheter; and an intravascular device according to claim 1; wherein at least a part of the microcatheter is configured to be inserted into the part of the vascular system of the patient; wherein the microcatheter comprises at least one optically-transmitting wall portion; wherein the intravascular device is configured to slide within the microcatheter along a longitudinal axis of the microcatheter; and wherein the microcatheter and intravascular device are configured such that when the intravascular guidewire is positioned at one or more longitudinal positions along the longitudinal axis of the microcatheter, optical wavelength radiation is emitted out of the microcatheter through the at least one optically-transmitting wall portion of the microcatheter and scattered and/or reflected optical wavelength radiation enters the microcatheter through the at least one optically-transmitting wall portion of the microcatheter.
13. An intravascular investigation system, comprising: an intravascular device according to claim 1; a optical radiation source; a optical radiation detector; and a processing unit; wherein, the optical radiation source is configured to generate optical wavelength radiation over a broadband range and couple it into the optical fiber; wherein, the optical radiation detector is configured to generate at least one detection signal on the basis of the scattered and/or reflected optical wavelength radiation; wherein, the processing unit is configured to determine at least one spectrally resolved data set on the basis of the at least one detection signal; and wherein, the processing unit is configured to determine information about a blood clot on the basis of the at least one spectrally resolved data set.
14. A method of intravascular investigation with an intravascular investigation system according to claim 13, wherein the method comprises: generating optical wavelength radiation over a broadband range with the optical radiation source; coupling the broadband optical wavelength radiation into the optical fiber of the intravascular device or the intravascular microcatheter and guidewire device; collecting scattered and/or reflected optical wavelength radiation from a vascular structure of the patient with the intravascular device or the intravascular microcatheter and guidewire device; generating by the optical wavelength radiation detector at least one detection signal on the basis of the scattered and/or reflected optical wavelength radiation; determining by the processing unit at least one spectrally resolved data set on the basis of the at least one detection signal; and determining by the processing unit information about a blood clot on the basis of the at least one spectrally resolved data set.
15. A system for determining the composition of a peripheral venous clot, comprising: an intravascular device for determining blood clot composition in the peripheral vasculature comprising; an elongate member; and an optical fiber; wherein at least a part of the elongate member is configured to be inserted into a part of a vascular system of a patient; wherein at least a part of the optical fiber is located within the elongate member; wherein, the optical fiber is configured to transmit optical wavelength radiation; wherein the intravascular device is configured to emit a portion of the optical wavelength radiation out of the elongate member for being scattered and/or reflected by a portion of the vascular system; wherein the intravascular device is configured to collect at least some of the scattered and/or reflected optical wavelength radiation and to couple the at least some of the scattered and/or reflected optical wavelength radiation into the optical fiber; and the system further comprises: an optical radiation source; an optical radiation detector; and a processing unit; wherein the optical radiation source is configured to generate optical wavelength radiation over a broadband range and couple it into the optical fiber; wherein the optical radiation detector is configured to generate at least one detection signal on the basis of the scattered and/or reflected optical wavelength radiation; wherein the processing unit is configured to determine at least one spectrally resolved data set on the basis of the at least one detection signal; wherein the at least one spectrally resolved data set comprises a spectrum corresponding to collagen; and wherein the processing unit is configured to determine a collagen content from the spectrum corresponding to collagen and to determine information about a blood clot on the basis of the collagen content.
16. A method of determining the collagen content of a peripheral vascular clot with a system for determining the composition of a peripheral venous clot according to claim 15 for use in determining blood clot composition in the peripheral vasculature the method comprising: generating optical wavelength radiation over a broadband range with the optical radiation source; coupling the broadband optical wavelength radiation into the optical fiber of the intravascular device or the intravascular microcatheter and guidewire device; collecting scattered and/or reflected optical wavelength radiation from a vascular structure of the patient with the intravascular device or the intravascular microcatheter and guidewire device; generating by the optical wavelength radiation detector at least one detection signal on the basis of the scattered and/or reflected optical wavelength radiation; determining by the processing unit at least one spectrally resolved data set on the basis of the at least one detection signal, the at least one spectrally resolved data set comprising a spectrum corresponding to collagen; and determining by the processing unit a collagen content from the spectrum corresponding to collagen, and information about a blood clot on the basis of the collagen content.
17. A non-transitory computer-readable storage medium having stored a computer program comprising instructions, which, when executed by a processor, cause the processor to carry out the method of claim 14.
18. A non-transitory computer-readable storage medium having stored a computer program comprising instructions, which, when executed by a processor, cause the processor to carry out the method of claim 16.
19. (canceled)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0083] Exemplary embodiments will be described in the following with reference to the following drawings:
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DETAILED DESCRIPTION OF EMBODIMENTS
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[0100] In an example, the optical wavelength radiation is generated by an optical radiation source that emits broadband optical radiation simultaneously. In an example, the optical wavelength radiation is generated by an optical radiation source that emits narrowband optical radiation and scans the emitted optical wavelengths over a wavelength range to generate broadband optical radiation that is transmitted by the optical fiber.
[0101] In an example, the at least one optical interaction element comprises at least one optically-transmitting wall portion 50 of the elongate member, and emitted optical wavelength radiation is directed out of the elongate member through the at least one optically-transmitting wall portion and a portion of the scattered and/or reflected optical wavelength radiation enters back through the at least one optically-transmitting wall portion. Thus, the window can protect the optical fiber, and can be a wavelength sensitive filter, thus providing a convenient manner to select probing wavelength ranges, and where exit windows for different beams can have different passband wavelength ranges, providing an efficient manner to provide beams having different wavelength ranges. These windows can be at side walls of the elongate member, and a window can be at the end wall of the elongate member if required.
[0102] In an example, the intravascular device is a guidewire.
[0103] In an example, the intravascular device is a microcatheter.
[0104] In an example, the elongate member comprises a radio opaque marker.
[0105] In an example, the elongate member is a tube.
[0106] In an example, the optical fiber comprises a radio opaque marker.
[0107] In this manner, an operator can determine in what specific direction or directions optical wavelength radiation will be emitted in order to maximize the overlap between a blood clot being examined and the spectroscopic sensing volume.
[0108] According to an example, the at least two optical radiation beams comprises a first optical radiation beam emitted out of a side wall of the elongate member.
[0109] In an example, the first optical radiation beam is emitted out of the side wall of the elongate member at least 3 centimeters from an end of the elongate member.
[0110] In an example, the first optical radiation beam is emitted in a direction perpendicular to a longitudinal axis of the elongate member.
[0111] In an example, the at least one optical interaction element comprises a beam splitter.
[0112] In an example, the at least one optical interaction element comprises a 45 degree beam splitter.
[0113] In an example, the at least one optical interaction element comprises a region of the optical fiber exhibiting total internal reflection.
[0114] In an example, the at least one optical interaction element comprises an optical wavelength filter.
[0115] In an example, the at least one optical interaction element comprises a Bragg fiber grating.
[0116] According to an example, the at least two optical radiation beams comprises a second optical radiation beam emitted out of the side wall of the elongate member.
[0117] In an example, the second optical radiation beam is emitted out of the side wall of the elongate member at least 3 centimeters from an end of the elongate member.
[0118] In an example, the second optical radiation beam is emitted in a direction perpendicular to the longitudinal axis of the elongate member.
[0119] In an example, the at least one optical interaction element comprises a beam splitter.
[0120] In an example, the at least one optical interaction element comprises a 45 degree beam splitter.
[0121] In an example, the at least one optical interaction element comprises a Bragg fiber grating.
[0122] In an example, the at least one optical interaction element comprises a wavelength passband filter.
[0123] In an example, the at least one optical interaction element comprises a wavelength selective window.
[0124] According to an example, a wavelength range of the first optical radiation beam is different to a wavelength range of the second optical radiation beam.
[0125] According to an example, the first optical radiation beam is emitted out of the elongate member at a first longitudinal position of the elongate member and the second optical radiation beam is emitted out of the elongate member at a second longitudinal position of the elongate member different to the first longitudinal position.
[0126] According to an example, the at least two optical radiation beams comprises a optical radiation beam emitted out of an end wall of the elongate member.
[0127] In an example, the optical radiation beam emitted out of the end wall of the elongate member is emitted in a direction parallel to the longitudinal axis of the elongate member.
[0128] According to an example, a wavelength range of the first optical radiation beam is different to a wavelength range of the optical radiation beam emitted out of the end wall of the elongate member.
[0129] According to an example, a wavelength range of the second optical radiation beam is different to the wavelength range of the optical radiation beam emitted out of the end of the elongate member.
[0130] According to an example, the at least one optical interaction element comprises a wavelength selective element.
[0131] In an example, the at least one wavelength selective element comprises a Bragg fiber grating.
[0132] In an example, the at least one wavelength selective element comprises a wavelength passband filter.
[0133] In an example, the at least one wavelength selective element comprises a wavelength selective window. Thus, a wavelength selective window can be placed at a or in the wall of the elongate member, at the side wall and/or the front wall and provides an efficient manner to provide for optical wavelength radiation that is used to interrogate material via optical wavelength radiation that is transmitted through that element only to have a certain specific wavelength range.
[0134] According to an example, a portion of the optical fiber at a distal end of the optical fiber is fixedly connected to the elongate member. The at least a part of the optical fiber located within the elongate member other than the fixed distal end is not fixedly connected to the elongate member.
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[0136] In an example, the annular optical wavelength radiation emission is emitted out of the side wall of the elongate member at least 3 centimeters from an end of the elongate member.
[0137] Thus, an interventionist can bend the tip of the guidewire as required to provide for example a probing beam out of the end of the guidewire at a correct angle, without affecting the lateral transmission beam or beams.
[0138] In an example, one or more optical interaction element of the at least one optical interaction element is rotationally symmetric about a longitudinal axis of the elongate member.
[0139] In an example, the one or more of the at least one optical interaction element that is rotationally symmetric comprises a conical structure.
[0140] In an example, the at least one optical interaction element comprises at least one optically-transmitting wall portion 50 of the elongate member, and emitted optical wavelength radiation is directed out of the elongate member through the at least one optically-transmitting wall portion and a portion of the scattered and/or reflected optical wavelength radiation enters back through the at least one optically-transmitting wall portion. Thus, the window can protect the optical fiber, and can be a wavelength sensitive filter, thus providing a convenient manner to select probing wavelength ranges, and where exit windows for different beams can have different passband wavelength ranges, providing an efficient manner to provide beams having different wavelength ranges. These windows can be at side walls of the elongate member, and a window can be at the end wall of the elongate member if required.
[0141] In an example, the at least one optical interaction element is configured to emit a further optical radiation beam sideways out of the elongate member at a different longitudinal position to the annular emission profile. The optical radiation beam can have a smaller angular spread than the annular emission profile. Thus, the annular emission profile (or doughnut shaped emission) probing can be used to quickly find the location of a clot, then the second optical radiation beam can be moved to that location, and through rotation of the guidewire the optical radiation beam can be used to interrogate the blood clot with a high signal to noise because the signal can be limited to the blood clot and not have background vascular system information.
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[0144] In an example, the optical radiation source is configured to scan a narrowband or monochromatic optical wavelength radiation over a broadband and the at least one optical radiation signal comprises scattered and/or reflected optical radiation for each wavelength step of that scanning.
[0145] In an example, the optical radiation source is configured to provide broadband optical wavelength radiation in one beam, and the detector and processing unit can be part of a spectrometer that determines a “one shot” detection signal and spectrally resolved data set.
[0146] In an example, the processing unit is configured to provide an output indicating that spectra from vessel walls are detected.
[0147] In this way, a feedback loop is provided to the interventionist, who then knows when a blood clot is not being interrogated and can move the guidewire, either rotationally or longitudinally as required in order to interrogate the blood clot.
[0148] Associated with the system 200 is a method of intravascular investigation with an intravascular investigation system. The method comprises:
[0149] generating optical wavelength radiation over a broadband range with the optical radiation source;
[0150] coupling the broadband optical wavelength radiation into the optical fiber of the intravascular device or the intravascular microcatheter and guidewire device;
[0151] collecting scattered and/or reflected optical wavelength radiation from a vascular structure of the patient with the intravascular device or the intravascular microcatheter and guidewire device;
[0152] generating by the optical radiation detector at least one detection signal on the basis of the scattered and/or reflected optical wavelength radiation;
[0153] determining by the processing unit at least one spectrally resolved data set on the basis of the at least one detection signal; and
[0154] determining by the processing unit information about a blood clot on the basis of the at least one spectrally resolved data set.
[0155] The intravascular devices, intravascular microcatheter and guidewire device, intravascular investigation system, and method of intravascular investigation are now described in more detail with respect to specific embodiments, where reference is made to
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[0158] Thus, for a state-of-the art tissue sensing guidewire, with the sensing occurring at the tip of the guidewire as shown in
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[0165] Thus, the system enables different sensing volumes to be interrogated by using different wavelengths or wavelengths ranges for each sensing volume. For example a wavelength range of approximately 450 nm to 900 nm may be used, this being predominantly visible optical radiation, to discriminate between different types of blood clots in one sensing volume, and a wavelength range of approximately 1000-1600 nm, this being near infrared, i.e. NIR, optical radiation, to simultaneously discriminate between different types of blood clots in a second sensing volume. The same, or similar wavelengths may alternatively be used, for example one could use wavelengths of 520 nm, 830 nm, 1270 nm, and 1450 nm to discriminate between different types of blood clot in one sensing volume while simultaneously using wavelengths of 525 nm, 835 nm, 1275 nm and 1455 nm to discriminate between different types of blood clots in a second sensing volume. Also, one can use wavelength selective elements integrated into the wire to ensure that sensing volume E is illuminated with optical wavelength radiation having different wavelengths to sensing volume H. Different types of wavelength-selective elements can be used. For example one could use a wavelength-selective element like a Fiber Bragg Grating, i.e. FBG, to couple optical wavelength radiation within a predetermined wavelength range out of the fiber. A depiction of this shown in
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[0167] Thus, in summary the above disclosure relates to an intravascular device, with an associated optical wavelength radiation generation and spectral data generation system. The intravascular device may have one or more of the following features: i) at least one optical fiber intended to emit optical wavelength radiation into biological tissue inside or adjacent to a blood vessel and to collect part of the optical wavelength radiation reflected by the tissue; ii) part of the optical wavelength radiation being emitted and received in a direction perpendicular to the main axis of the intravascular device; iii) part of the optical wavelength radiation emitted and received significantly proximally from the tip of the intravascular device (significantly proximally from the tip can mean more than 3 centimeters away from the tip, and if the intravascular device comprises a functional tip with a coil, proximally from the length covered by the coil; a coil being a standard design element in medical guidewires to achieve the desired mechanical properties wherein the tip of a guidewire typically has to be more flexible than the shaft; coils thus being used to provide the desired “floppiness”); iv) a tip that is optimized for its mechanical properties and not for its optical or sensing properties, v) emitting and receiving optical wavelength radiation from/to the tip, which can involve use of a wavelength-selective element, such that different optical wavelengths are emitted/received at different sensing volumes, vi) emitting and receiving optical wavelength radiation from/to a sideways direction, which can involve the use of a wavelength-selective element for emitting/receiving different optical wavelengths at different sensing volumes, vii) emitting and receiving optical wavelength radiation from/to a sideways direction in an annulus or doughnut shape, such that rotation or torqueing of the guidewire is not required in order to provide rotational sensitivity, viii) an intravascular microcatheter that is optically transparent at a predetermined length from the tip, with a lumen suitable to receive a guidewire, such that the intravascular device can measure from within the catheter through the catheter wall, ix) a (radiopaque) marker (or other feedback mechanism) that helps torqueing of the intravascular device to maximize the overlap between blood clot and the spectroscopic sensing volume.
[0168] An intravascular device for use in determining blood clot composition in the peripheral vasculature shares many of the features described above with reference to
[0169] an elongate member 20; and
[0170] an optical fiber 30;
[0171] wherein at least a part of the elongate member 20 is configured to be inserted into a part of a vascular system of a patient;
[0172] wherein at least a part of the optical fiber 30 is located within the elongate member 20;
[0173] wherein, the optical fiber is configured to transmit optical wavelength radiation;
[0174] wherein the intravascular device is configured to emit a portion of the optical wavelength radiation out of the elongate member for being scattered and/or reflected by a portion of the vascular system; and
[0175] wherein the intravascular device is configured to collect at least some of the scattered and/or reflected optical wavelength radiation and to couple the at least some of the scattered and/or reflected optical wavelength radiation into the optical fiber.
[0176] In the device for use in determining blood clot composition in the peripheral vasculature, optionally:
[0177] In one example, the optical wavelength radiation is generated by an optical radiation source that emits broadband optical radiation simultaneously.
[0178] In one example, the optical wavelength radiation is generated by an optical radiation source that emits narrowband optical radiation and scans the emitted optical wavelengths over a wavelength range to generate broadband optical radiation that is transmitted by the optical fiber.
[0179] In another example, the intravascular device is a guidewire.
[0180] In another example, the intravascular device is a microcatheter.
[0181] In another example, the elongate member comprises a radio opaque marker.
[0182] In another example, the elongate member is a tube.
[0183] In another example, the optical fiber comprises a radio opaque marker.
[0184] In another example, the optical wavelength radiation may be emitted axially from an end wall of the elongate member, as illustrated with reference to
[0185] In another example, the optical wavelength radiation may be emitted radially from the elongate member, for example in the form of a conical emission profile as may be provided by a beam redirector in the form of a region of the optical fiber exhibiting total internal reflection; or a beam redirector in the form of a mirror, or a beamsplitter, arranged transversally with respect to a longitudinal axis of optical fiber 30.
[0186] In another example, the optical wavelength radiation may be emitted radially from the elongate member in the form of an annular emission profile, for example by providing the optical fiber 30 with a beam redirector in the form of a distal tip having a conical shape as illustrated with reference to
[0187] In another example the radial emission may be in a direction perpendicular to a longitudinal axis of the elongate member.
[0188] In another example the radial emission may be provided at a position at least 3 centimeters from an end of the elongate member.
[0189] In another example, the intravascular device for use in determining blood clot composition in the peripheral vasculature may be incorporated into a microcatheter 110 as illustrated with reference to
[0190] An intravascular investigation system 200 for use in determining blood clot composition in the peripheral vasculature is now described with reference to
[0191] As described in more detail below, the presence of collagen in a peripheral vascular clot is a sign of advanced clot differentiation and age. In these clots, fibroblasts have had time to infiltrate the clot and to start the process of forming an endothelial layer covering the surface of the clot. In these chronic clots, t-PA and other thrombolytic agents may not be able to penetrate the thrombus depending on the degree of endothelialization. Therefore a blood clot with a significant collagen content may resist thrombolysis. In fact, attempting thrombolysis on these kind of clot may put the patient in danger, as the blood clot may become mobile and cause acute damage downstream, e.g. in the form of lung embolism. Therefore determining the collagen content of a peripheral vascular clot in this manner may be informative to a medical practitioner and allow them to choose the best mode of treatment for each patient.
Blood Clot Differentiation
[0192] The following provides details on the differentiation between a first blood clot type that is rich in red blood cells and a second type of blood clot that is rich in fibrin, which can comprise a determination of the amount of red blood cells present and/or the amount of fibrin present. In other words, graduations between on the one hand a “rich in red blood cell clot” and a “rich in fibrin clot” can take into account that real blood clots can exist between being a rich in red blood cell clot and a rich in fibrin clot, and could exist as a blood clot half way between the these two.
[0193] As discussed above the presently described system includes an intravascular device or microcatheter for optically interrogating a part of an intravascular system of a patient. Broadband optical wavelength radiation extending across a plurality of optical wavelengths may be used in the optical interrogation. Thus, a true broadband optical source may for example be used. Broadband optical wavelength radiation may also be provided in the form of a tunable laser, or in the form of a plurality of narrowband optical radiation sources such as LEDs or lasers emitting narrowband optical radiation simultaneously or sequentially. Thus, in an example the optical radiation source and detector can operate as a spectral resolving unit, where broadband optical wavelength radiation coupled into the optical fibre of the intravascular device involves the tuneable laser operating over a range of wavelengths and this optical wavelength radiation is scattered and/or reflected back from the patient and detected to provide a spectrally resolved data set. In another example, a one shot broadband optical wavelength radiation beam can be coupled into the fibre and collected and analyzed, for example by a spectrometer to provide the spectrally resolved data set.
[0194] The present described system enables the graduation in the actual form of the blood clot to be determined. The differentiation between a first blood clot type and a second blood clot type can comprise a determination of at least one physiological parameter, wherein the at least one physiological parameter comprises one or more of: amount of haemoglobin; haemoglobin oxygen saturation; an amount of scattering; a vessel packaging parameter; water content; and the amount of at least one haemoglobin derivative. The at least one physiological parameters can determined, for example, by fitting an optical model derived from diffusion theory to the measured spectra. In an example, fitting the spectra to an optical model can include taking into account a wavelength dependent absorption coefficient and a wavelength dependent reduced scattering coefficient. In an example, a double power law can be used to describe the wavelength dependence of the reduced scattering, where a first law corresponds to the contribution of Mie scattering and a second power law corresponds to the contribution of Rayleigh scattering. The reduced scattering μ.sub.s′ expressed in wavenumbers, i.e. cm.sup.−1, as a function of wavelength λ can be written as
[0195] Where, λ.sub.0 is a normalization wavelength, that in an example can be set to 800 nm, and the parameter a corresponds to the reduced scattering amplitude at this exemplar wavelength. The reduced scattering corresponds to the sum of Mie and Rayleigh scattering and ρ.sub.MR is defined as the Mie-to-Rayleigh fraction of the scattering. The reduced scattering slope of the Mie scattering is denoted b, and is related to the particle size.
[0196] More detail on the determination of the physiological parameters can be found in the following two papers: R. Nachabé, B. H. W. Hendriks, A. E. Desjardins, M. van der Voort, M. B. van der Mark, and H. J. C. M. Sterenborg, “Estimation of lipid and water concentrations in scattering media with diffuse optical spectroscopy from 900 to 1600 nm”, J. Biomed. Opt. 15, (2010); and Rami Nachabé, Benno H. W. Hendriks, Marjolein van der Voort, Adrien E. Desjardins, and Henricus J. C. M. Sterenborg, “Estimation of biological chromophores using diffuse optical spectroscopy: benefit of extending the UV-VIS wavelength range to include 1000 to 1600 nm”, Optics Express 18 (2010) p1432.
[0197] The determination of the at least one physiological parameter can comprises one or more of: a fitting of an optical model to the at least one spectrally resolved data set; application of at least one multivariate analysis tool to the at least one spectrally resolved data set; a partial least squares discriminant analysis of the at least one spectrally resolved data set; application of support vector machines to the at least one spectrally resolved data set; application of a k nearest neighbor analysis; and application of deep learning algorithms to the at least one spectrally resolved data set. The at least one multivariate analysis tool comprises principle component analysis, PCA. The differentiation between the first blood clot type and the second blood clot type can comprise utilization of a look-up-table.
[0198] In the above-described intravascular investigation system 200 for use in determining blood clot composition in the peripheral vasculature, a similar optical analysis technique may be used to determine a collagen content. In the system 200, a spectrally resolved data set is generated. The spectrally resolved data set comprises a spectrum corresponding to collagen. The processing unit is configured to determine a collagen content from the spectrum corresponding to collagen and to determine information about a blood clot on the basis of the collagen content.
[0199] In peripheral vascular disease it has been found that a discrimination between recently-formed (i.e. acute) and older (i.e. chronic) blood clots can be made on the basis of the collagen content of the clot. This is because the collagen content increases as the clot ages. The age of the clot is a useful factor for use by a medical practitioner to use to determine which of multiple treatment options are most suitable for the clot, for example whether to perform a thrombectomy or a thrombolysis, and consequently which of the various treatment devices to use. In one example implementation the collagen content can be determined by fitting the aforementioned optical model to the measured spectra, as described for a diffuse reflectance spectroscopy technique with reference to Equation 4 and
[0200] In order to demonstrate that the Collagen content could be accurately determined using the Diffuse Reflectance Spectroscopy technique, various blood clot “analogue” samples were prepared from Collagen and Fibrin and their spectra were measured using a spectrophotometer. Collagen in the analogue sample is representative of the Collagen in the blood clot, and Fibrin was added as the counterpart of the blood clot analogue samples in order represent the Fibrin that is typically also present in a real blood clot, and also to demonstrate that Collagen could be measured in the presence of the relatively close spectral signature characteristics of Fibrin.
[0201] Thereto,
[0202] The collagen content “Predictor” was subsequently determined using the aforementioned optical model for the spectra of
[0203] Various alternative optical arrangements are also suitable for the measurement of collagen content including Raman spectroscopy which is a molecular specific technique with unique spectral features useful for the detection of collagen.
[0204] A corresponding method of determining the collagen content of a peripheral vascular clot with the aforementioned intravascular investigation system 200 for use in determining blood clot composition in the peripheral vasculature may include the steps of:
[0205] generating optical wavelength radiation over a broadband range with the optical radiation source;
[0206] coupling the broadband optical wavelength radiation into the optical fiber of the intravascular device or the intravascular microcatheter and guidewire device;
[0207] collecting scattered and/or reflected optical wavelength radiation from a vascular structure of the patient with the intravascular device or the intravascular microcatheter and guidewire device;
[0208] generating by the optical wavelength radiation detector at least one detection signal on the basis of the scattered and/or reflected optical wavelength radiation;
[0209] determining by the processing unit at least one spectrally resolved data set on the basis of the at least one detection signal, the at least one spectrally resolved data set comprising a spectrum corresponding to collagen; and
[0210] determining by the processing unit a collagen content from the spectrum corresponding to collagen, and information about a blood clot on the basis of the collagen content.
[0211] In another exemplary embodiment, a computer program or computer program element is provided that is characterized by being configured to execute the method steps of the method according to one of the preceding embodiments, on an appropriate system.
[0212] The computer program element might therefore be stored on a computer unit, which might also be part of an embodiment. This computing unit may be configured to perform or induce performing of the steps of the method described above. Moreover, it may be configured to operate the components of the above described apparatus and/or system. The computing unit can be configured to operate automatically and/or to execute the orders of a user. A computer program may be loaded into a working memory of a data processor. The data processor may thus be equipped to carry out the method according to one of the preceding embodiments. The computer program or the output unit may be integrated into an imaging or a navigation system.
[0213] This exemplary embodiment of the invention covers both, a computer program that right from the beginning uses the invention and computer program that by means of an update turns an existing program into a program that uses invention.
[0214] Further on, the computer program element might be able to provide all necessary steps to fulfill the procedure of an exemplary embodiment of the method as described above.
[0215] According to a further exemplary embodiment of the present invention, a computer readable medium, such as a CD-ROM, USB stick or the like, is presented wherein the computer readable medium has a computer program element stored on it which computer program element is described by the preceding section.
[0216] A computer program may be stored and/or distributed on a suitable medium, such as an optical storage medium or a solid state medium supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the internet or other wired or wireless telecommunication systems.
[0217] However, the computer program may also be presented over a network like the World Wide Web and can be downloaded into the working memory of a data processor from such a network. According to a further exemplary embodiment of the present invention, a medium for making a computer program element available for downloading is provided, which computer program element is arranged to perform a method according to one of the previously described embodiments of the invention.
[0218] It has to be noted that embodiments of the invention are described with reference to different subject matters. In particular, some embodiments are described with reference to method type claims whereas other embodiments are described with reference to the device type claims. However, a person skilled in the art will gather from the above and the following description that, unless otherwise notified, in addition to any combination of features belonging to one type of subject matter also any combination between features relating to different subject matters is considered to be disclosed with this application. However, all features can be combined providing synergetic effects that are more than the simple summation of the features.
[0219] While the invention has been illustrated and described in detail in the drawings and foregoing description, such illustration and description are to be considered illustrative or exemplary and not restrictive. The invention is not limited to the disclosed embodiments. Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing a claimed invention, from a study of the drawings, the disclosure, and the dependent claims.
[0220] In the claims, the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality. A single processor or other unit may fulfill the functions of several items re-cited in the claims. The mere fact that certain measures are re-cited in mutually different dependent claims does not indicate that a combination of these measures cannot be used to advantage. Any reference signs in the claims should not be construed as limiting the scope.