ABLATION AND TEMPERATURE MEASUREMENT DEVICES
20220240788 · 2022-08-04
Inventors
- J. Christopher Flaherty (Auburndale, FL, US)
- John T. Garibotto (Marblehead, MA, US)
- R. Maxwell Flaherty (Auburndale, FL, US)
- William J. Gorman (South Hamilton, MA, US)
Cpc classification
A61B2090/3784
HUMAN NECESSITIES
A61B18/1492
HUMAN NECESSITIES
A61B2018/0212
HUMAN NECESSITIES
International classification
A61B5/01
HUMAN NECESSITIES
Abstract
A temperature measurement probe for a patient is provided. The probe includes a sensor assembly and produces a temperature map comprising temperature information for multiple patient locations.
Claims
1. A temperature measurement apparatus for a patient, the apparatus comprising: a transmission conduit configured to rotate and translate relative to collect infrared energy from a tissue surface; at least one infrared fiber arranged within the transmission conduit and configured transmit infrared signals corresponding to the collected infrared energy; and a sensor assembly configured to process the infrared signals to calculate a temperature of the tissue surface.
2. The apparatus of claim 1, wherein the tissue surface is an esophagus of a patient, and the transmission conduit is configured to rotate 360° to measure an internal circumference of the tissue surface of the esophagus.
3. The apparatus of claim 1, wherein the transmission conduit is configured to rotate and translate in a reciprocating motion.
4. The apparatus of claim 3, wherein the transmission conduit is configured to translate and rotate in the reciprocating motion to collect the infrared energy across an area of the tissue surface and the sensor assembly is configured to combine the infrared signals collected across the area of the tissue surface and produce a temperature map indicating the temperature within the area of the tissue surface.
5. The apparatus of claim 1, wherein the transmission conduit includes a lens configured to direct the infrared energy from the tissue surface toward the at least one infrared fiber.
6. The apparatus of claim 1, wherein the at least one infrared fiber is configured to remain stationary relative to the rotating and translation transmission conduit.
7. The apparatus of claim 1, wherein the at least one infrared fiber includes an infrared fiber.
8. The apparatus of claim 1, wherein the sensor assembly is configured to continuously process the infrared signals to calculate and update the temperature of the tissue surface.
9. A temperature measurement apparatus for a patient, the apparatus comprising: a transmission conduit configured to rotate and translate relative to collect infrared energy longitudinally and circumferentially across an area of a tissue surface; at least one infrared fiber arranged within the transmission conduit and configured transmit infrared signals corresponding to the collected infrared energy; a sensor assembly configured to process the infrared signals to calculate a temperature of the tissue surface and generate temperature information across the area of the tissue surface; and a display unit configured to display the temperature information.
10. The apparatus of claim 9 , wherein the temperature information includes a temperature map indicative of a temperature of multiple locations across the area of the tissue surface.
11. The apparatus of claim 10, wherein the sensor assembly is configured to combine the infrared signals collected across the area of the tissue surface and to produce the temperature map indicating the temperature within the area of the tissue surface.
12. The apparatus of claim 11, wherein the sensor assembly is configured to continuously process the infrared signals to calculate and update the temperature map.
13. The apparatus of claim 9, wherein the display unit includes a transducer configured to alert a user in response to the temperature information exceeding a desired temperature.
14. The apparatus of claim 13, wherein the transducer includes at least one of an audible transducer and a visual transducer.
15. The apparatus of claim 1, wherein the at least one infrared fiber is configured to remain stationary relative to the rotating and translation transmission conduit.
16. The apparatus of claim 1, wherein the at least one infrared fiber includes an infrared fiber.
17. A method of measuring temperature of an esophagus of a patient, the method including: rotating and translating a transmission conduit within the esophagus of the patient to collect infrared energy from a tissue surface of the esophagus; transmitting infrared signals corresponding to the collected infrared energy by at least one infrared fiber arranged within the transmission conduit; and processing the infrared signals to calculate a temperature of the tissue surface.
18. The method of claim 17, wherein rotating and translating the transmission conduit includes rotating and translating the transmission conduit the reciprocating motion to collect the infrared energy across an area of the tissue surface.
19. The method of claim 18, further comprising combining the infrared signals collected across the area of the tissue surface and produce a temperature map indicating the temperature within the area of the tissue surface.
20. The method of claim 19 further comprising continuously processing the infrared signals to calculate and update the temperature map.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0058] The accompanying drawings, which are incorporated in and constitute a part of this specification, illustrate various embodiments of the present inventive concepts, and together with the description, serve to explain the principles of the inventive concepts. In the drawings:
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DETAILED DESCRIPTION
[0082] Reference will now be made in detail to the present embodiments of the inventive concepts, examples of which are illustrated in the accompanying drawings. Wherever possible, the same reference numbers will be used throughout the drawings to refer to the same or like parts.
[0083] Provided herein is a temperature measurement probe for producing a temperature map for multiple locations, such as a surface of tissue for a patient. The probe may include one or more sensors, such as infrared light detectors or other infrared sensors. The probe may include a reusable portion, and one or more disposable portions. The probe may include an elongate member, and measure temperature at multiple locations positioned at the side of the elongate member and/or forward of the distal end of the elongate member.
[0084] Referring now to
[0085] Sensor assembly 120 is positioned at the distal end of shaft 110 and is configured to provide temperature information for multiple patient locations, such as multiple tissue locations. In one embodiment, sensor assembly 120 is configured to gather, measure and/or process infrared signals to determine temperature information, such as when device 100 comprises a passive or active infrared detector or detector array. Sensor assembly 120 may comprise a lens assembly such that infrared or other energy can be directed toward a sensor located at another location in device 100 and/or electronic module 150. Typical sensors used to measure the temperature information include but are not limited to: infrared sensors such as active or passive infrared sensors or sensor arrays; thermocouple or thermocouple arrays, thermopiles such as a bolometer; therm isters; thermochromic elements; pyrometers; liquid crystal temperature detectors such as thermotropic liquid crystals; fluorescent sensors; and sensors including leuco dyes and combinations of these.
[0086] Alternatively or additionally, device 100 and sensor assembly 120 are configured to detect a non-temperature tissue change, such that system 10 can process this tissue change information to produce a temperature map for multiple patient locations. These tissue changes include but are not limited to: tissue color changes; cellular structure changes such as cellular expansion; tissue conductivity changes; tissue density changes; and combinations of these. These non-temperature signals may correlate to an absolute temperature of tissue or a change in temperature of tissue.
[0087] Alternatively or additionally, device 100 and sensor assembly 120 are configured to detect a substance produced by tissue, such that system 10 can process this substance production information to produce a temperature map for multiple patient locations. Substance production information may include but are not limited to: one or more substances associated with cellular damage; gas production; smoke production; and combinations of these.
[0088] Sensor assembly 120 may include various optical components to focus, transmit, split, reduce, filter, communicate or otherwise handle light such as infrared light. Typical components include but are not limited to: lenses; mirrors; filters; fiber optic cable; prisms; amplifiers; refractors; splitters; polarizer; and other optical components well known to those of skill in the art. In one embodiment, optical components focus infrared light on a sensor or sensor array integral to sensor assembly 120. The one or more optical components may be fixedly mounted in device 100 or may be moved such as with rotational, translational, reciprocal, orbital and/or other movement assemblies such as MEMS assemblies.
[0089] Sensor assembly 120 provides temperature information to electronic module 150. This information may be transmitted by one or more conductors such as wires or fiber optic cables, or may be transmitted wirelessly. In a particular embodiment, sensor assembly 120 provides temperature information in the form of infrared light which is transmitted through shaft 110 (e.g. deflected with a series of mirrors) to an infrared sensor array in a proximal portion of device 100 and/or within electronic module 150. In another embodiment, sensor assembly 120 is connected to a fiber optic cable, such as a cable that is of low impedance or transparent (zero impedance) to infrared light or a band of infrared light, and connected to a lens or other optical component assembly which directs the infrared light to an infrared sensor array in a proximal portion of device 100 and/or within electronic module 150. In yet another embodiment, sensor assembly 120 includes an infrared sensor array, and one or more electrical conductors such as wires travel proximally in shaft 110 and communicate temperature information to electronic module 150.
[0090] Device 100 may include a visible light camera constructed and arranged to provide a visible picture of one or more patient locations, such as one or more locations in the patient's esophagus. In a particular embodiment, a visible light picture is provided on display 155 of the same or similar multiple patient locations that are recorded by sensor assembly 120.
[0091] Proximate sensor assembly 120 is port 116, such as a port configured to deliver fluid to sensor assembly 120 or tissue proximate sensor assembly 120. Shaft 110 may include one or more lumens, not shown but fluidly or otherwise operably connected to cable 112, port 105a or port 105b, such as to provide inflation fluid such as to inflate a balloon, to deliver one or more agents such as a cooling or warming fluid or a drug to port 116, or to slidingly receive a fiber or fiber bundle such as a cable linkage, an optical fiber or fiber bundle, or a conductor or conductor bundle.
[0092] Device 100 may include one or more functional elements, such as functional element 160 located proximate sensor assembly 120. Functional element 160 is typically a sensor or a transducer, such as an element selected from the group consisting of: an electrode; a drug delivery element; an electromagnetic transducer; a heating or cooling element; and combinations of these. Functional element 160 may be a sensor, such as a thermocouple or other temperature sensor. In a particular embodiment, functional element 160 is a temperature sensor configured to be used in a calibration of sensor assembly 120.
[0093] Located at the proximal end of shaft 110 are ports 105a and 105b. Ports 105a and 105b are operably connected to one or more lumens of shaft 110, not shown but preferably providing a connection to one or more locations along shaft 110, such as port 116, functional element 160 and/or sensor assembly 120. Ports 105a and/or 105b may be attachable to a fluid delivery device, such as an infusion pump or a syringe, such that fluid such as saline can be used to clean a portion of device 100, heat or warm tissue proximate sensor assembly 120, and/or provide another function.
[0094] Device 100 may include one or more stabilization portions, not typically located near the proximal end of shaft 110 or along cable 112 and configured to position and/or prevent undesired motion of device 100. Typical stabilization portions may include a clip, a mouth piece such as a mouth piece used to position shaft 110 in the esophagus of the patient, a vacuum assembly, and combinations of these.
[0095] Electronic module 150 receives signals from sensor assembly 120 of device 100. These signals represent a temperature map of multiple patient locations in proximity to sensor assembly 120. Sensor assembly 120 may produce electrical signals such as signals received from electronics integral to sensor assembly 120, not shown but preferably electronics common to visible light and infrared camera products. Alternatively or additionally, the signals may be optical signals such as infrared signals received from sensor assembly 120 and transmitted via optical fibers included in shaft 110 and cable 112. In one embodiment, connector 111 may include an electronic assembly which converts optical signals to electrical signals, such as when connector 111 receives optical signals from a fiber bundle contained within shaft 110, and transmits electrical signals to electronic module 150 through wires in cable 112.
[0096] Electronic module 150 processes the signals received from sensor assembly 120 to produce information representing a temperature map of the multiple patient locations viewed by sensor assembly 120. The temperature information may be presented on display 155 such as via signals transmitted through cable 113 such that temperature map 156 is shown on display 155. Alternatively or additionally, temperature information may be transmitted to display 155 via a wireless transceiver. Temperature map 156 may be presented in a number of forms including but not limited to a tabular display of alphanumeric values representing the temperature of the multiple patient locations, or a graphical picture such as a color picture in which temperatures are represented by color shades or hues.
[0097] Electronic module 150 may include alarm transducer 157, such as a transducer selected from the group consisting of: an audible transducer, a visible transducer such as a light emitting diode (LED), a tactile transducer, or other element configured to alert an operator of a condition such as an alarm, alert, warning, or other condition (hereinafter “alarm”) in which an operator of the system is to be notified. Module 150 may process the information received from sensor assembly 120 to determine when a condition exists in which alarm transducer is to be activated. Alarm conditions may be adjustable, such as via a user interface, not shown, but integral to electronic module 150 or another component of system 10. In one embodiment, the condition is determined by comparison to a threshold, such as a threshold adjustable by an operator of system 10. Alarm conditions may be based on the current temperature map and/or a cumulative or other mathematically processed representation of values of the temperature map such as cumulative historic values of multiple patient locations. In a particular embodiment, system 10 provides current and historic temperature information for multiple patient locations, the information including but not limited to: current temperature; average temperature; maximum temperature; minimum temperature; slope of temperature change; and integration of temperature over time. The various types and forms of recorded and calculated temperature information can be presented to the operator via display 155, another display or memory component. Alternatively or additionally, the various types and forms of recorded and calculated temperature information can be compared to one or more alarm thresholds such as to activate alarm transducer 157. In a particular embodiment, when an alarm condition is entered, system 10 or a separate system may be controlled by system 10, such as to cease power delivery when a maximum temperature is achieved.
[0098] Electronic module 150 may include a memory storage module, such as a module configured to store temperature and/or other types of information including but not limited to: historic information such as temperature versus time information, pre-determined threshold information such as information related to maximum temperatures allowable for a particular tissue or tissue type, calculated information such as an integration of time at temperature for a tissue location; calibration information such as historic calibration information and data used to perform a calibration procedure; alarm information such as historic alarm conditions or data used to determine when system 100 has entered an alarm state; and other information.
[0099] Electronic module 150 may include a signal analyzer, such as a signal analyzer which may be used or modified by the operator. Inputs and outputs of the signal analyzer may be shown on display 155, such as in displaying temperature information for a particular tissue location. The signal analyzer may allow zooming, such as to zoom into a particular site of tissue, and the site location may be manipulated by the operator, such as through a user interface (not shown).
[0100] System 10 may include visualization instrument 210, such as a visualization instrument selected from the group consisting of: an MRI, a Ct scanner, a fluoroscope or other x-ray instrument; and combinations of these. In one embodiment, visualization instrument 210 is an MRI, and system 10 is used to detect heat, such as undesired heat, caused by the interaction between an MRI and one or more pieces of metal implanted in a patient.
[0101] Alternative or in addition to device 100, system 10 includes tool 300 which is connected to electronic module 150 via cable 301. Tool 300 includes sensor assembly 320, a forward looking infrared sensor assembly configured to visualize multiple patient locations, such as a surface of bone or other tissue being treated by tool 300. Tool 300 may be a tool selected from the group consisting of: a laparoscopic tool such as a laparoscopic radiofrequency (RF) energy ablation tool; a bone cutting tool such as a bone cutting saw; a drill; and combinations of these. In a typical application, the multiple patient locations is bone being drilled or cut into, and system 10 is configured to prevent overheating of patient tissue.
[0102] System 10 typically includes both disposable and reusable components. In one embodiment, device 100 including shaft 110, sensor assembly 120, and cable 112 are disposable (e.g. used for a single patient procedure only), while electronic module 150 and display 155 are reusable. In another embodiment, cable 112 is reusable. In another embodiment, a disposable sheath surrounds a reusable device 100 including reusable shaft 110 and reusable sensor assembly 120.
[0103] Referring now to
[0104] System 10 includes device 100 which has been inserted into the esophagus of patient P by a clinician. System 10 includes display 155 which provides temperature map 156 of multiple locations within patient P's esophagus. Temperature map 156 and other information provided on display 155 or another display device (not shown), may utilize various alphanumeric or other graphical properties to differentiate temperature or other information. In a preferred embodiment, different temperatures are differentiated through the change in one or more of: color; shade; contrast; hue; saturation; and brightness. Alternatively or additionally, alphanumeric information may be differentiated by varying one or more of: boldness; font type and size. Information such as temperature information may be correlated to one or more characteristics such as color. In a particular embodiment, the correlation algorithm is adjusted by a clinician. For example, the clinician may set a particular shade of red to a particular temperature level. Alternatively or additionally, sound may be used to represent temperature information, such as sound that changes in pitch or volume as temperature changes, and the correlation between temperature level and a sound parameter may be adjustable by a clinician.
[0105] In addition to temperature map 156, system 10 may provide numerous forms of information provided by the sensor assembly of device 100 or one or more other sensors or functional elements of device 100. Such information may be information that is processed by one or more algorithms of system 10, such as by electronic module 150 of
[0106] Also depicted in
[0107] Referring now to
[0108] Referring now to
[0109] Shaft 110 further includes port 116, configured to deliver one or more fluids from shaft 110. Fluids may be delivered from port 116 to cool or warm tissue being monitored by sensor assembly 120, such as fluids delivered manually or automatically by system 10 when one or more patient locations exceed one or more temperature thresholds. Alternatively or additionally, fluids such as saline may be delivered from port 116 to remove debris covering lens 122.
[0110] Referring now to
[0111] The distal end of shaft 110 further includes an electrode, functional element 160, which is typically configured to deliver energy such as RF energy. Alternatively or additionally, functional element 160 may deliver energy selected from the group consisting of: laser energy; cryogenic energy such as energy delivered by flowing cryogenic fluid such as liquid nitrogen proximate the tissue to be ablated; microwave energy; mechanical energy; chemical energy; electromagnetic energy; and combinations of these.
[0112] Lens 122 and sensors 121 are constructed and arranged to provide a temperature map for the tissue proximate functional element 160 prior to, during, and after delivery of energy by functional element 160.
[0113] Referring now to
[0114] In one embodiment, sensor 121 includes multiple sensors configured to measure temperature at multiple patient locations such as locations extending radially out from sensor 121 and covering a circumference of 10.degree. or more, typically 90.degree. or greater, and more typically greater than 180.degree. In a particular embodiment, sensor 121 records temperature information at patient locations located at a full circumference (i.e.) 360.degree. at a range of locations at sensor 121 that are perpendicular to shaft 110. Alternatively or additionally, drive assembly 170 may rotate shaft 123 and sensor 121, such as a full 360.degree. rotation or a partial rotation less than 360.degree., typically 180.degree. or less or 90.degree. or less, as is described in reference to
[0115] Sensor 121 is attached to drive shaft 123 and is shown in a retracted position. Device 100 includes linear drive assembly 170 which includes drive gear 171 and lead screw 172. Drive assembly 170 is configured to advance and/or retract shaft 123 and sensor 121 at one or more velocities.
[0116] Referring now to
[0117] Referring now to
[0118] Sensor assembly 120 is mechanically attached to and rotated by drive shaft 123 which is centrally positioned within the lumen of shaft 110 by guide bushing 129. Drive shaft 123 is rotated by rotational drive assembly 175. Shaft 123 is typically rotated a full 360.degree., however partial rotations of 180.degree. or less, or 90.degree. or less may be performed. While being spun, sensor assembly 120 records a temperature map of the tissue surrounding sensor assembly 120, such as the wall tissue of a lumen of a patient, such as esophageal wall tissue.
[0119] Referring now to
[0120] The distal end of fiber optic bundle 130 is arranged at an angle such that infrared or other radiation passing through lens 122 is received by the beveled end of each fiber 125. The bevel angle may be chosen to maximize absorption of the received radiation. In a particular embodiment, a 45.degree. bevel angle is used. Fiber bundle 130 may be rotated, such as a full 360.degree. rotation, by one or more rotating drive assemblies (e.g. drive assemblies used in medical imaging products device industry to rotate fibers or fiber bundles), not shown. Alternatively, partial rotations of 180.degree. or less, or 90.degree. or less may be performed such as to create a less than full circumferential view of a lumen such as the esophagus of a patient.
[0121] In communication with fiber bundle 130 is a sensor assembly, not shown but typically proximal to shaft 110 or included in a proximal portion of shaft 110. The sensor assembly, typically an infrared sensor assembly comprising an array of infrared sensors, receives the radiation signals passed through lens 122 into fiber optic bundle 130. Lens 122 is shown as a circumferential ring that directs, focuses or otherwise lets radiation pass through lens 122 onto the beveled end of fiber optic bundle 130.
[0122] Referring now to
[0123] Sensor assembly 120 includes an array of infrared sensors, typically an infrared CCD array or other array configured to record infrared light information. Infrared arrays may be configured to produce temperature maps based on an array of pixels, such as an array with a minimum of 10 pixels by 10 pixels. Arrays of 100 by 100 or more pixels may be used, such as to represent an area of esophageal tissue with a length of one inch or more at an area proximate a patient's heart. Sensor assembly 120 may include integrated circuitry, such as to perform one or more of the following functions: process signals received by sensor assembly 120; multiplex signals; filter signals; combine signals; amplify signals; and convert electrical signals to optical signals for fiber optic transmission.
[0124] Sensor assembly 120 mechanically connects to shaft 124 such as to position sensor assembly relative to lens 122. Lens 122 may be used to magnify or demagnify a viewed location, and may be used to expand the field of view. Lens 122 may be configured to be focused, manually or automatically, in a similar configuration used in visible light cameras. Additionally, shaft 124 may be configured to act as an information transmission conduit to the proximal portion of device 100. For example, shaft 124 may be used to send and/or receive information and/or power to or from sensor assembly 120. Typically, shaft 124 includes a bundle of wires that communicate with sensor assembly 120. However, in an alternative embodiment, shaft 124 may include optical fibers and sensor assembly 120 includes electronics configured to convert sensor information into optical data.
[0125] In yet another embodiment, shaft 124 may rotate a full 360.degree. rotation, by one or more rotating drive assemblies, not shown. Alternatively, partial rotations of 180.degree. or less, or 90.degree. or less may be performed. Here, lens 122 would typically be 360.degree. or a sufficient circumferential sector to accommodate the motion of sensor assembly 120.
[0126] Referring now to
[0127] Sensor 120 is optically aligned with a proximal end of fibers 125 while lens 122 is arranged along the beveled distal end of fibers 125. This arrangement enables lens 122 to view to the side or forward depending upon the particular construction and positioning.
[0128] Referring now to
[0129] Lens 122 in combination with fibers 125 cooperate to view surrounding tissue (e.g. tissue to be ablated and tissue proximate tissue to be ablated such as tissue intended not to be damaged) so that the clinician may be alerted if target tissue has reached a desired temperature and/or the non-target tissue is not exceeding a desired temperature. For example, when ablating a tumor, if the tumor has not been entirely ablated, cancer may reoccur or spread post-procedure. This may occur when a tumor is near a blood vessel, which acts as a heat sink preventing the tumor from reaching a desired temperature.
[0130] Referring now to
[0131] Mirror 126 may be configured to move in a longitudinal path or rotate by means of a movement assembly, not shown. Additionally or alternatively, device 100 may have multiple mirrors.
[0132] A partial circumferential lens 122 is positioned relative to sensor assembly 120. In an alternative embodiment, lens 122 is a full circumferential (e.g. 360.degree.) lens, such as when sensor assembly 120 is a full 360.degree. viewing sensor.
[0133] Additionally, this illustration includes an electromechanically attachable design via connector 111 as described in
[0134] Referring now to
[0135] Balloon 185 includes multiple sensors 121 on its surface. In a preferred embodiment, sensors 121 are thermocouples occupying the entire surface of balloon 185. Alternatively, sensors 121 may occupy a portion of balloon 185. Typically, balloon 185 includes approximately ten sensors 121, and more typically, 100 sensors 121. In a preferred embodiment, sensors 121 are spaced substantially equidistant from one another with a separation distance of less than 0.2 mm. Alternatively, sensors 121 may be spaced less than 1.0 mm from adjacent sensor 121.
[0136] Malleable member 119 may be located on the outer surface of shaft 100 and/or embedded within the inner and outer wall of shaft 110. Malleable member 119 allows plastic deformation of the distal portion of device 100. For instance, the clinician may bend device 100 to accommodate the anatomy of the patient, e.g. patient's esophagus.
[0137] Referring now to
[0138] Ablation system 250 includes ablation catheter 253 which comprises ablation elements such as electrodes, cryogenic balloons, ultrasound crystals, and the like. System 250 further includes monitor 255 which may show ablation catheter information, EKG information, energy delivery information, and other information. In addition, display 155 shows temperature map 156 information, described in
[0139] Ablation system 250 further comprises energy delivery unit 251 which may deliver various types of energy including: radiofrequency (RF) energy; laser energy; cryogenic energy; subsonic energy; acoustic energy; ultrasound energy; microwave energy; chemical energy; and combinations of these. Energy delivery unit 251 includes user interface 252 which may comprise one or more controls used in cooperation with device 100 and ablation catheter 253. Additionally, a signal analyzer may be integrated into unit 251 and device 100 and/or another device. User interface 252 includes adjustable controls, e.g. emergency shut-off of unit 251 and/or an alarm system, and data generated by a signal analyzer are as described in
[0140] Alternatively or additionally, all components of system 10 may include a memory storage device for recording of historic data, such as historic values of multiple patient locations, also described in
[0141] Referring now to
[0142] Expandable cage 185′ may be attached to outer sheath 115 such that applying force in the proximal direction tensions luminal wall tissue to create a uniform tissue surface reduce, e.g. to eliminate one or more crevices hidden within the portion of tissue and therefore outside the view of lens 122 and sensor assembly 120. Additionally or alternatively, cages 185 and/or 185′ may radially tension a patient's tissue. Additionally or alternatively, cages 185 and/or 185′ specifically position lens 122 and sensor assembly 120 within a lumen of a patient, e.g. the center of a lumen.
[0143] Expandable cage 185 and/or 185′ may be arranged in numerous forms while remaining configured to contact a patient's tissue such that force applied between shaft 110 and outer sheath 115 tensions the tissue between cages 185 and/or 185′. For example, cages 185 and/or 185′ may include a balloon, which may expand by filling with a gas such as air or a liquid, such as saline. Also, cages 185 and/or 185′ may be a stent or opposing fingers, spokes or other projections. Additionally or alternatively, cages 185 and/or 185′ may include a shape memory device.
[0144] In this embodiment, a partial circumferential lens 122 is positioned relative to sensor assembly 120. In an alternative embodiment, lens 122 is a full circumferential (e.g. 360.degree.) lens, such as when sensor assembly 120 is a full 360.degree. viewing sensor.
[0145] Device 100 includes lumen 118, which may be used to carry fluid from a proximal portion of device 100 to ports on the proximal end of device 100, such as ports 105a and/or 105b of
[0146] In an alternative embodiment, a sensor may be placed within expandable cage 185 and/or 185′ to measure temperature, pressure, pH, and/or other physiologic parameters of a patient.
[0147] In yet another embodiment, outer sheath 115 and expandable cage 185′ may be a separate device working in cooperation with the remaining components of device 100.
[0148] Referring now to
[0149] Device 100 may also include a tissue temperature modifying assembly, which is configured to cool or warm multiple patient locations. An endothermic reaction will occur to cool the tissue, while an exothermic reaction will occur to warm the tissue.
[0150] Additionally or alternatively, a fluid may exit ports 116a and/or 116b to cool or warm the tissue, e.g. via heated saline. Also, a Peltier component may be included to cool or warm fluid prior to exiting ports 116a and/or 116b.
[0151] In an alternative embodiment, a separate catheter device including fluid injection ports 116a and 116b may be included on the distal portion of device 100.
[0152] Referring now to
[0153] Cleaning assembly 180, in cooperation with edge 181, may be used to clean debris, such as mucus, blood, or other biological material or non-biological contaminants from lens 122, such as when device 100 is placed into a body location such as the esophagus or other body lumen. Components of a sensor assembly, such as mirrors, lenses such as lens 122, and/or one or more arrays of infrared sensors, not shown but described in detail in reference to other figures included herein, may be adversely impacted by debris on lens 122 and may require at least one cleaning during use.
[0154] Cleaning assembly 180 and edge 181 perform a wiping function such as by advancing cleaning assembly 180, as shown in
[0155] In an alternative embodiment, device 100 may include multiple cleaning assemblies 180, wherein each cleaning assembly is disposable. For example, first cleaning assembly may be utilized for a single patient and the second utilized for the same patient or a different patient.
[0156] In yet another embodiment, cleaning assembly 180 may be removable from device 100. Additionally or alternatively, cleaning assembly 180 may have a longitudinal slit 183 enabling lateral attachment to shaft 110 while shaft 110 is placed into a lumen of a patient, and one or more cleaning assemblies 180 may be laterally attached to shaft 110 one or more times during a single procedure.
[0157] Referring now to
[0158] Device 100 may include a second cleaning assembly. For example, a second port may be connected to lumen 118 or a different lumen, such as to clean debris from another portion of lens 122 or another portion of device 100.
[0159] Referring now to
[0160] Device 100 of
[0161] Shaft 110 is positioned within outer sheath 115 in a thermos-like construction to maintain one or more components of and spaces within device 100 in a relatively isothermal condition. The outer surface of shaft 110 and/or the inner surface of outer sheath 115 may have a mirrored or other reflective surface. Shaft 110 may comprise a glass material with a mirrored surface, common to thermos devices and used to avoid heat transfer to or from shaft 110.
[0162] Alternatively or additionally, device 100 may be configured to allow a fluid to pass through space 131A and space 131B between shaft 110 and outer sheath 115 and exit thru-hole 132 at the distal end of device 100, such as to maintain shaft 110, lens 122 and/or mirror 126 in a stable, constant temperature state. Fluid may be delivered around shaft 110 such as to warm or cool shaft 110 or another component of device 100. Heating and/or cooling assemblies (e.g. Peltier components) may be used to increase, decrease and/or stabilize temperature of the fluid or a component of device 100. In one embodiment, temperature is maintained above or below body temperature.
[0163] Device 100 includes temperature sensors 163, typically ring-shaped, configured to monitor temperature of outer sheath 115, shaft 110 and/or a fluid traveling through outer sheath 115 and shaft 110. Additionally, sensors 163 may monitor the temperature of the environment in which device 100 is placed, e.g. patient tissue surrounding device 100. Sensors 163 may be used to provide temperature information fed back to the fluid delivery device or a heat exchanging device such that closed loop temperature control can be achieved. Alternatively or additionally, one or more sensors 163 may sense a parameter other than temperature, such as a sensor configured to measure a pressure, an electromagnetic condition, a physiologic parameter, or other condition.
[0164] A potential advantage of integrating a temperature stabilizing assembly within device 100 is that the performance of device 100 is improved by reducing the adverse effects of varied and varying temperatures of any component or a portion of any component of device 100, such as temperature variations within shaft 110, lens 122, mirror 126 and/or another component or portion of shaft 110.
[0165] Referring now to
[0166] The system may include manual or automatic panning and zooming functions. For example, an auto-zoom feature enables the clinician to zoom into an area where tissue temperature has increased. In one embodiment, if a temperature of an area outside the periphery of the display or along the boundary of the display increases, the display may automatically reposition and/or zoom out with or without operate input. In another embodiment, if a tissue area monitored by the device includes a temperature change that is not currently being viewed, the displayed information may automatically change such as via zooming out or repositioning at the same zoom.
[0167] An additional analytical feature of the system includes an alert detection component where the clinician may be alerted if tissue rises or falls outside a desired or expected temperature and/or outside a range of desired or expected temperatures. For example, if the desired tissue temperature is 37.degree. C., and one or more tissue locations reach 50.degree. C., the clinician may be alerted. Alternatively or additionally, one or more alerts may be included based on mathematical or other processing of temperature information, such as an algorithm which integrates temperature over time for one or more tissue locations.
[0168] The data analysis of the device may comprise an error checking algorithm that is configured to detect inconsistencies, such as one or more readings that are outside of one or more pre-determined boundary conditions. For example, if 10,000 data points are reading 37.degree. C., and one data point is reading 50.degree. C., the system will detect and alert the clinician that 50.degree. C. is inaccurate.
[0169] As described in reference to
[0170] Alternatively or additionally, a visible transducer may be included within the system, such as an LED. Here, a light may blink if the tissue temperature exceeds a desired temperature, or a pattern of blinking and/or light intensity may represent temperature related information.
[0171] The system may further comprise a noise reduction algorithm wherein the system may filter out known sources of noise, e.g. known infrared radiation sources.
[0172] The system may also comprise a calibration assembly, which may include a subroutine integral to a start-up or other system condition (e.g. for each new patient use). Additionally or alternatively, a calibration assembly may use a calibration standard proximate the device or within the device.
[0173] In addition to a temperature map, additional information may be processed and/or analyzed. For example, information received from a visible light sensor (e.g. a CCD camera), an ultrasound imaging device, and the like, may be analyzed and processed by the system.
[0174] In addition to displaying a temperature map, a control signal may be produced based on the analysis and/or processing of temperature information received from the sensor assembly in accordance with the present inventive concepts. In one embodiment, a feedback circuit may be included to control an energy delivery unit, e.g. an energy delivery unit used to prove ablation energy to a device positioned to ablate the heart of a patient. For example, a particular result from the data analysis may cease or modify, e.g. increase or decrease, the amount of energy delivered from an energy delivery unit. In one embodiment, the energy delivery device is unable to deliver energy to the system if it is not attached to the device or system. Additionally or alternatively, a feedback circuit may control a cooling and/or warming assembly, such as a cooling or warming assembly configured to cool or warm tissue when a measured temperature rises above or below, respectively, a threshold.
[0175] Referring now to
[0176] In one embodiment, drive shaft 123 rotates sensor 121 enabling sensor 121 to view through a partial circumferential lens 122, e.g. a lens covering 90.degree. or 180.degree. of the circumference of sheath 115. The rotation of sensor 121 may be continuous in a circular path, i.e. spin past the partial circumference of the lens 122, leaving a void in the viewing window. Alternatively, the rotation of sensor 121 may be reciprocating, i.e. in a back and forth motion to maintain view within the partial circumference of lens 122, such as to translate over a distance of at least 1 mm, typically between 10 mm and 80 mm, more typically at least 20 mm. Alternatively, lens 122 is wider, e.g. 360.degree., and sensor 121 would have continuous viewing capabilities as sensor 121 is rotated continuously by shaft 121.
[0177] In a typical embodiment, linear drive assembly 170 is operably connected to shaft 123, which rotates and moves axially in a forward and back motion; this technology is currently used in intravascular ultrasound 3-D imaging products. In this particular embodiment, sensor 121 is capable of viewing through substantially all of the surface area of lens 122.
[0178] In a particular embodiment, device 100 includes positioning members 185, as discussed in
[0179] While the preferred embodiments of the devices and methods have been described in reference to the environment in which they were developed, they are merely illustrative of the principles of the inventive concepts. Modification or combinations of the above-described assemblies, other embodiments, configurations, and methods for carrying out the inventive concepts, and variations of aspects of the inventive concepts that are obvious to those of skill in the art are intended to be within the scope of the claims. In addition, where this application has listed the steps of a method or procedure in a specific order, it may be possible, or even expedient in certain circumstances, to change the order in which some steps are performed, and it is intended that the particular steps of the method or procedure claim set forth herebelow not be construed as being order-specific unless such order specificity is expressly stated in the claim.