DWELLING TREATMENT MONITORING FOR ENDOLUMINAL THERAPY PROCEDURES
20230114323 · 2023-04-13
Inventors
- Torre Michelle Bydlon (Melrose, MA, US)
- Alvin CHEN (CAMBRIDGE, MA, US)
- Lara Molly FLEXMAN (MELROSE, MA, US)
- James David CEZO (COLORADO SPRINGS, CO, US)
Cpc classification
Y02A90/10
GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
A61B34/20
HUMAN NECESSITIES
G16H20/40
PHYSICS
A61B90/37
HUMAN NECESSITIES
G16H40/40
PHYSICS
A61B2034/2061
HUMAN NECESSITIES
A61B18/245
HUMAN NECESSITIES
A61B17/3207
HUMAN NECESSITIES
International classification
Abstract
Various embodiments of the present disclosure encompass an endoluminal therapy system employing an endoluminal therapy device (21) and an endoluminal therapy monitoring controller (10). In support an endoluminal procedure, the endoluminal therapy device (21) is controlled to treat a site to be treated within a lumen. The controller (10) is operated to synchronize an activated dwell timing of the endoluminal therapy device (21) within the lumen to a tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen. The controller (10) is further operated to monitor the site to be treated within the lumen induced by the endoluminal therapy device (21) during the synchronization by the controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
Claims
1. An endoluminal therapy system, comprising: an endovascular therapy device (21) controllable to implement an endoluminal treatment; and an endovascular therapy monitoring controller (10) for monitoring an endoluminal treatment induced by the endoluminal therapy device (21), wherein the endoluminal therapy monitoring controller (10) is configured to synchronize an activated dwell timing of the endoluminal therapy device (21) within a lumen to a tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and wherein the endoluminal therapy monitoring controller (10) is further configured to monitor the endoluminal treatment induced by the endoluminal therapy device (21) during a synchronization by the endoluminal therapy monitoring controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated.
2. The endoluminal therapy system of claim 1, wherein the endoluminal therapy monitoring controller (10) is configured to synchronize the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes: the endoluminal therapy monitoring controller (10) being configured to synchronize one a clock signal or a time stamp associated the activated dwell timing of the endoluminal therapy device (21) within the lumen to one of a clock signal or a time stamp associated with the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the vlumen.
3. The endoluminal therapy system of claim 1, further comprising: an optical shape sensor operable to generate sensing data indicative of the activated dwell timing of the endoluminal therapy device (21) within the lumen; and wherein the endoluminal therapy monitoring controller (10) is configured to synchronize the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes: the endoluminal therapy monitoring controller (10) being configured to synchronize the sensing data indicative of the activated dwell timing of the endoluminal therapy device (21) within the lumen to one of a clock signal or a time stamp associated with the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
4. The endoluminal therapy system of claim 1, wherein the endoluminal therapy monitoring controller (10) is further configured to monitor the treatment of the site to be treated within the lumen induced by the endoluminal therapy device (21) during the synchronization by the endoluminal therapy monitoring controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes: the endoluminal therapy monitoring controller (10) being configured to calculate an activated dwell time of the endoluminal therapy device (21) within the lumen at a tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and the endoluminal therapy monitoring controller (10) being configured to assess a treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen.
5. The endoluminal therapy system of claim 4, wherein the endoluminal therapy monitoring controller (10) being configured to assess a treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes: the endoluminal therapy monitoring controller (10) being configured to define the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an optimally-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being at least one of greater than an under-treated threshold representative of a minimum therapeutic dwell time and less than an over-treated threshold representative of a maximum therapeutic dwell time.
6. The endoluminal therapy system of claim 4, wherein the endoluminal therapy monitoring controller (10) being configured to assess a treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes: the endoluminal therapy monitoring controller (10) being configured to define the treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an under-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being less than an under-treated threshold representative of a minimum therapeutic dwell time.
7. The endoluminal therapy system of claim 4, wherein the endoluminal therapy monitoring controller (10) being configured to assess a treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes: the endoluminal therapy monitoring controller (10) being configured to define the treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an over-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being greater than an over-treated threshold representative of a maximum therapeutic dwell time.
8. The endoluminal therapy system of claim 1, wherein the endoluminal therapy device (21) is one of an atherectomy catheter or an angioplasty catheter.
9. An endoluminal therapy monitoring controller (10) for monitoring a treatment of a site to be treated within a lumen induced by an endoluminal therapy device (21), the endoluminal therapy monitoring controller (10) comprising: a non-transitory machine-readable storage medium encoded with instructions for execution by the processor, the non-transitory machine-readable storage medium including the instructions to: synchronize an activated dwell timing of the endoluminal therapy device (21) within the lumen to a tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and monitor the treatment of the site to be treated within the lumen induced by the endoluminal therapy device (21) during a synchronization by the endoluminal therapy monitoring controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
10. The endoluminal therapy monitoring controller (10) of claim 9, wherein the instructions to synchronize the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes instructions to: synchronize one a clock signal or a time stamp associated the activated dwell timing of the endoluminal therapy device (21) within the lumen to one of a clock signal or a time stamp associated with the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
11. The endoluminal therapy monitoring controller (10) of claim 9, wherein the instructions to synchronize the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes instructions to: synchronize sensing data indicative of the activated dwell timing of the endoluminal therapy device (21) within the lumen to one of a clock signal or a time stamp associated with the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
12. The endoluminal therapy monitoring controller (10) of claim 9, wherein the instructions to monitor the treatment of the site to be treated within the lumen induced by the endoluminal therapy device (21) during the synchronization by the endoluminal therapy monitoring controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes instructions to: calculate an activated dwell time of the endoluminal therapy device (21) within the lumen at a tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and assess a treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen.
13. The endoluminal therapy monitoring controller (10) of claim 12, wherein the instructions to assess the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes instructions to: define the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an optimally-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being at least one of greater than an under-treated threshold representative of a minimum therapeutic dwell time and less than an over-treated threshold representative of a maximum therapeutic dwell time.
14. The endoluminal therapy monitoring controller (10) of claim 12, wherein the instructions to assess the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes instructions to: define the treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an under-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being less than an under-treated threshold representative of a minimum therapeutic dwell time.
15. The endoluminal therapy monitoring controller (10) of claim 12, wherein the instructions to assess the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes instructions to: define the treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an over-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being greater than an over-treated threshold representative of a maximum therapeutic dwell time.
16. The endoluminal therapy system of claim 1 is an endovascular therapy system, wherein the lumen is a vascular vessel, and wherein the system is arranged to implement said treatment, this treatment being the treatment of a blockage at the site to be treated within the vascular vessel.
17. An endoluminal therapy monitoring method for an endoluminal therapy monitoring controller (10) to monitor a treatment of a site to be treated within a lumen induced by an endoluminal therapy device (21), the endoluminal therapy monitoring method comprising: synchronizing, by the endoluminal therapy monitoring controller (10), an activated dwell timing of the endoluminal therapy device (21) within the lumen to a tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and monitoring, by the endoluminal therapy monitoring controller (10), the treatment of the site to be treated within the lumen induced by the endoluminal therapy device (21) during the synchronizing by the endoluminal therapy monitoring controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
18. The endoluminal therapy monitoring method of claim 17, wherein the synchronizing, by the endoluminal therapy monitoring controller (10), of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes at least one of: synchronizing, by the endoluminal therapy monitoring controller (10), one a clock signal or a time stamp associated the activated dwell timing of the endoluminal therapy device (21) within the lumen to one of a clock signal or a time stamp associated with the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and synchronizing, by the endoluminal therapy monitoring controller (10), sensing data indicative of the activated dwell timing of the endoluminal therapy device (21) within the lumen to one of the clock signal or the time stamp associated with the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.
19. The endoluminal therapy monitoring method of claim 16, wherein the monitoring, by the endoluminal therapy monitoring controller (10), of the treatment of the site to be treated within the lumen induced by the endoluminal therapy device (21) during the synchronization by the endoluminal therapy monitoring controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen includes: calculating, by the endoluminal therapy monitoring controller (10), an activated dwell time of the endoluminal therapy device (21) within the lumen at a tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen; and assessing, by the endoluminal therapy monitoring controller (10), a treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen.
20. The endoluminal therapy monitoring method of claim 17, wherein the assessing, by the endoluminal therapy monitoring controller (10), of the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes instructions includes: defining, by the endoluminal therapy monitoring controller (10), the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an optimally-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being at least one of greater than an under-treated threshold representative of a minimum therapeutic dwell time and less than an over-treated threshold representative of a maximum therapeutic dwell time.
21. The endoluminal therapy monitoring method of claim 17,, wherein the assessing, by the endoluminal therapy monitoring controller (10), of the treatment of the area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen based on the activated dwell time of the endoluminal therapy device (21) within the lumen includes instructions includes at least one of: defining, by the endoluminal therapy monitoring controller (10), the treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an under-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being less than an under-treated threshold representative of a minimum therapeutic dwell time; and defining, by the endoluminal therapy monitoring controller (10), the treatment of an area of the lumen corresponding to the tracked position of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen as an over-treated area responsive to the activated dwell time of the endoluminal therapy device (21) within the lumen being greater than an over-treated threshold representative of a maximum therapeutic dwell time.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] The present disclosure will present in detail the following description of exemplary embodiments with reference to the following figures wherein:
[0017]
[0018]
[0019]
[0020]
[0021]
[0022]
[0023]
[0024]
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0025] The present disclosure is applicable to endovascular therapy procedures for diagnosing and treating a vascular condition, typically through the use of guidewires and catheters to access vascular vessels (e.g., arteries and veins). Examples of vascular conditions related to a blockage of a vascular vessel include, but are not limited to, a carotid artery disease, a cardiovascular disease (e.g., atherosclerosis), a stroke deep vein thrombosis, pulmonary embolism and renal vascular disease. Now the present application can be applicable to other types of endoluminal therapy procedures.
[0026] Typically as known in the art of the present disclosure, subsequent to a diagnosis of a vascular condition, an endovascular therapy procedure involves an imaging and/or a tracking of an endovascular therapy device within the vascular vessel to facilitate the treatment of the vascular condition, such as, for example, a removal of a blockage within the vascular vessel (e.g., a clot or plaque).
[0027] The present disclosure improves upon the prior art of endovascular therapy procedures by providing unique embodiments of a dwell treatment monitoring for endovascular therapy procedures in accordance with the present disclosure by providing controllers, systems and methods for monitoring an activated dwell timing of an endovascular therapy devices within a vascular vessel with respect to a tracked positioning of the endovascular therapy device contiguous with the blockage within the vascular vessel for purposes of therapy assessment and/or feedback of a treatment of the blockage within the vascular vessel.
[0028] To facilitate an understanding of the present disclosure, the following description of
[0029] Referring to
[0030] For purposes of describing and claiming the present disclosure, the term “endovascular therapy apparatus” encompasses all apparatuses, as known in the art of the present disclosure and hereinafter conceived, including one or more endovascular therapy devices 21 for implementing a treatment of a blockage of a vascular vessel (e.g., a removal of a clot or a drilling/a cracking a hole through plaque). Examples of an endovascular therapy device 21 include, but are not limited to, a laser atherectomy catheter, an orbital atherectomy catheter, a directional atherectomy catheter, a rotational atherectomy catheter, an angioplasty balloon catheter and an angioplasty stent catheter.
[0031] In practice, endovascular therapy apparatus 20 includes an activation controller 22 (e.g., programmed hardware and/or application specific integrated circuit) for controlling a manual or a robotic activation/deactivation of endovascular therapy device(s) 21 as known in the art of the present disclosure.
[0032] Still referring to
[0033] In one exemplary embodiment, tracking sensor(s) 31 are optical shape sensor(s) (OSS) as known in the art the present disclose that utilize light along a multicore optical fiber for device localization and navigation during an endovascular therapy procedure. The principle involved makes use of distributed strain measurement in the optical fiber using characteristic Rayleigh backscatter or controlled grating patterns (e.g., Fiber Bragg Gratings). The shape along the optical fiber begins at a specific point along the optical shape sensor, known as the launch or z=0, and the subsequent shape position and orientation are relative to that point. In practice, the optical shape sensor(s) may integrated into an endovascular therapy device 21 or another relevant device (e.g., a guidewire) in order to provide live guidance of the device during the endovascular therapy procedure without the need for radiation. The integrated fiber provides the position and orientation of the entire device. A non-limiting example of optical shape sensors include the FORS commercially offered by Philips Medical.
[0034] In practice of this embodiment, spatial tracking apparatus 30 includes a OSS based tracking controller 32 (e.g., programmed hardware and/or application specific integrated circuit) for directing light through the optical fiber and for executing distributed strain measurements in the optical fiber as known in the art of the present disclosure.
[0035] For this embodiment, the OSS based tracking controller 32 may concurrently or alternatively execute temperature measurements of a portion of the optical fiber adjacent the endovascular therapy device 21 as known in the art of the present disclosure to thereby monitor the activation of the endovascular therapy device 21. Such temperature measurements facilitates optical shape sensor(s) systematically synchronizing an activated dwell timing of the endovascular therapy device 21 within the vascular vessel to a tracked positioning of the endovascular therapy device 21 contiguous with the blockage within the vascular vessel.
[0036] In a second exemplary embodiment, tracking sensor(s) 31 are electromagnetic (EM) sensors as known in the art of the present disclosure for detecting a magnetic field to facilitate a measurement of a position and/or an orientation of the EM sensor(s) within the magnetic field. A non-limiting example of a EM based spatial tracking apparatus is the AURORA electromagnetic tracking system commercially offered by NDI, Inc.
[0037] In practice of this embodiment, spatial tracking apparatus 30 includes a EM based tracking controller 32 (e.g., programmed hardware and/or application specific integrated circuit) for controlling a generation of the magnetic field and measuring a position and/or an orientation of the EM sensor(s) within the magnetic field as known in the art of the present disclosure.
[0038] Still referring to
[0039] In practice, imaging apparatus 40 includes imaging controller 41 (e.g., programmed hardware and/or application specific integrated circuit) for controlling an activation/deactivation of medical imager 41 (e.g., an X-ray C-arm, an ultrasound probe, etc.) to systematically direct energy into an anatomy via operator-generated commands and/or image guided procedural-generated commands for the purposes of generating images of the anatomy as known in the art of the present disclosure.
[0040] Still referring to
[0041] In practice, recording apparatus 50 may include or have access to one or more diagnostic program(s) 52 for purposes of performing diagnostic analytics on one or more records as known in the art of the present disclosure.
[0042] Still referring to
[0043] In practice, navigation apparatus 60 includes a navigation controller 62 (e.g., programmed hardware and/or application specific integrated circuit) for controlling the planning of an endovascular therapy and the navigating of an endovascular therapy device 21 within a patient in accordance with the plan as known in the art of the present disclosure.
[0044] Still referring to
[0045] In practice, robot apparatus 70 includes a robot controller 72 (e.g., programmed hardware and/or application specific integrated circuit) for controlling a movement of medical robot 71 in accordance with the plan as commanded by a physician via an input device (e.g., a telemanipulator) or by navigation controller 62.
[0046] Still referring to
[0047] In practice, endovascular therapy monitoring controller 10 may be (1) installed within one of the apparatuses 20, 30, 40, 50, 60 and 70, (2) distributed among one or more of the apparatuses 20, 30, 40, 50, 60 and 70, or (3) installed within a separate device, such as, for example, a tablet, laptop or workstation.
[0048] For purposes of describing and claiming the present disclosure, the term “endovascular therapy monitoring controller” encompasses all structural configurations, as understood in the art of the present disclosure and as exemplary described in the present disclosure, of a main circuit board or an integrated circuit for controlling an application of various principles of the present disclosure for monitoring an activated dwell timing of an endovascular therapy devices within a vascular vessel with respect to a tracked positioning of the endovascular therapy device contiguous with the blockage within the vascular vessel for purposes of therapy assessment and/or feedback of a treatment of a blockage within the vascular vessel. The structural configuration of the endovascular therapy monitoring controller may include, but is not limited to, processor(s), computer-usable/computer readable storage medium(s), an operating system, application module(s), peripheral device controller(s), slot(s) and port(s).
[0049] For purposes of describing and claiming the present disclosure, the term “application module” broadly encompasses an application incorporated within or accessible by a controller consisting of an electronic circuit (e.g., electronic components and/or hardware) and/or an executable program (e.g., executable software stored on non-transitory computer readable medium(s) and/or firmware) for executing a specific application associated monitoring an activated dwell timing of an endovascular therapy devices within a vascular vessel with respect to a tracked positioning of the endovascular therapy device within the vascular vessel for purposes of therapy assessment and/or feedback of a treatment of a blockage within the vascular vessel.
[0050] For purposes of describing and claiming the present disclosure, the term “activated dwell timing” broadly encompasses one or more time periods corresponding to an activation of an endovascular therapy device 21 within a vascular vessel, and the term “tracked positioning” broadly encompasses a determination of one or more spatial positions of an endovascular therapy device 21 within a vascular vessel.
[0051] Still referring to
[0052] In practice, synchronizing process 11 involves endovascular therapy monitoring controller 10 inputting activation data 23 from activation controller 22 and tracking data 33 from tracking controller 32.
[0053] Activation data 23 is informative of the activated dwell timing of the endovascular therapy device 21 within the vascular vessel. In one exemplary embodiment, activation data 23 includes a one-digit binary code representative of an activation state or a deactivation state of an endovascular therapy device 21. In a second exemplary embodiment, activation data 23 includes a multi-digit binary code representative of various levels of an activation state of an endovascular therapy device 21 relative to a deactivation state of the endovascular therapy device 21
[0054] Tracking data 33 is informative of the tracked positioning of endovascular therapy device 21 within the vascular vessel (e.g., optical shape sensing tracking or electromagnetic tracking). In one exemplary embodiment, tracking data 33 includes data generated by tracking sensor(s) 31 whereby endovascular therapy monitoring controller 10 processes the sensor data to determine a spatial position of endovascular therapy device 21 within a registered coordinate system as known in the art of the disclosure. In a second exemplary embodiment, tracking controller 10 processes the sensor data to determine a spatial position of endovascular therapy device 21 to determine a spatial position of endovascular therapy device 21 within a registered coordinate system as known in the art of the disclosure and tracking data 33 includes the determined spatial position.
[0055] Still referring to
[0056] In one embodiment of synchronizing process 11, activation controller 22 further transmits clock signal(s) or time stamp(s) within activation data 23 to endovascular therapy monitoring controller 10 that is associated with an activated dwell timing of the endovascular therapy device 21 within the vascular vessel, and tracking controller 32 transmits clock signal(s) or time stamp(s) within tracking data 32 to endovascular therapy monitoring controller 10 that is associated with the tracked positioning of endovascular therapy device 21 contiguous with the blockage within the vascular vessel, whereby endovascular therapy monitoring controller 10 temporally aligns the clock signals or the time stamps to synchronize activation data 23 and tracking date 33.
[0057] In a second embodiment of synchronizing process 11, tracking controller 32 transmits clock signal(s) or time stamp(s) within tracking data 32 to endovascular therapy monitoring controller 10 the tracked positioning of endovascular therapy device 21 contiguous with the blockage within the vascular vessel, and further transmits sensing data tracking data 32 to endovascular therapy monitoring controller 10 that is informative of measurable effect(s) of activation(s) of endovascular therapy device 21 upon tracking sensor(s) 31 (e.g., a deformation, contortion or distortion in a shape or dimensions of tracking sensor(s) 31; a strain measurement or a temperature measurement of tracking sensor(s) 31, etc.). The measurable activation effect(s) in essence equates to time stamp(s) associated with an activated dwell timing of the endovascular therapy device 21 within the vascular vessel, whereby endovascular therapy monitoring controller 10 temporally aligns the clock signals or the time stamps to synchronize activation data 23 to the tracking date 33.
[0058] Still referring to
[0059] For purposes of describing and claiming the present disclosure, the phrase “monitor(ing) the treatment of the blockage within the vascular vessel induced by the endovascular therapy device” broadly encompasses a comparison of an activated dwell time per position to an under-treated threshold representative of a minimum therapeutic dwell time of the endovascular therapy device at a given position necessary to effect sufficient treatment of the blockage within the vascular vessel (e.g., minimal removal of clot to facilitate healthy blood flow through the vascular vessel, or minimal drilling/cracking of plague to facilitate healthy blood flow through the vascular vessel), and/or broadly encompasses a comparison of an activated dwell time per position to an over-treated threshold representative of a maximum therapeutic dwell time of the endovascular therapy device at a given position that may inflict damage to the vascular vessel.
[0060] In practice, the minimum therapeutic dwell time and the maximum therapeutic dwell time of an activated endovascular therapy device may be a function of a localized temperature measurement of the activated endovascular therapy device (e.g., a localized temperature measurement of an activated endovascular laser catheter via an optical shape sensor). More particularly, the minimum therapeutic dwell time and the maximum therapeutic dwell time of the activated endovascular therapy device may be decreased for temperature measurements of the activated endovascular therapy device exceeding a standard temperature threshold associated within the treatment. Conversely, the minimum therapeutic dwell time and the maximum therapeutic dwell time of the activated endovascular therapy device may be increased for temperature measurements of the activated endovascular therapy device less than the standard temperature threshold associated within the treatment.
[0061] Also in practice, an activated dwell time per position is derived from the synchronization of the activation data 23 to the tracking date 33.
[0062] For example, if the endovascular therapy device 21 is intermittently navigated through the vascular vessel and the endovascular therapy device 21 is discretely activated at each static position of endovascular therapy device 21 contiguous with the blockage within the vascular vessel, then the activated dwell time per position is directly ascertainable from the synchronization of the activation data 23 to the tracking date 33.
[0063] By further example, if the endovascular therapy device 21 is continually navigated through the vascular vessel and the endovascular therapy device 21 is continuously activated within the vascular vessel, then the activated dwell time per position may be calculated as an average derived from total activated dwelling time divided by total distance navigated by endovascular therapy device 21 during the continuously activation of endovascular therapy device 21 within the vascular vessel.
[0064] Also in practice, an operating specification of the endovascular therapy device may delineate the under-treated threshold and/or the over-treated threshold that are used by endovascular therapy monitoring controller 10, or a physician may delineate the under-treated threshold and/or the over-treated threshold to be used by endovascular therapy monitoring controller 10.
[0065] Still referring to
[0066] Further in practice, endovascular therapy monitoring controller 10 may also provide feedback 64 to navigation controller 62 to thereby guide physicians in where to initially deploy an endovascular therapy device 21 and where to repeat deployment of therapy. For the repeat scenario, this may also include an indicator to let the physician know they have successfully gone to the right position.
[0067] Additionally in practice, endovascular therapy monitoring controller 10 may also provide robot commands 63 or feedback 64 to robot controller 72 to serve as input to robotically control a movement of an endovascular therapy device 21 and/or other device (e.g., an optical shape sensed guidewire).
[0068] In one exemplary embodiment, endovascular therapy monitoring controller 10 generates a dwell time map 80a as shown in
[0069] Under-treated areas 82a and 82b identify gaps is anatomy where dwell time was insufficient whereby endovascular therapy monitoring controller 10 provides dwell time map to the physician as a guide for which anatomical areas need to be re-treated. More particularly, the positions of under-treat areas 82a requiring re-treatment should be saved and when the physician navigates endovascular therapy device 21 back to that position, a feedback indicator may be activated to let the physician know that endovascular therapy device 21 has been navigated to the right position. Thereafter, an additional indication may be given to the physician when an under-treated areas 82a is optimally treated based on the prior attempt and the repeat attempt. Additionally, endovascular therapy monitoring controller 10 may provide feedback to robot controller 73 in a form of a control signal representing a position that the endovascular therapy device 21 should be taken back to.
[0070] Over-treated areas 82a and 82b identify areas whereby the dwell time for a given position as exceeds a maximum threshold that indicates a position may have been over-treated. Over-treated areas 82a and 82b, endovascular therapy monitoring controller 10 automatically stops the activation of endovascular therapy device 21 or provides a feedback signal to activation controller 22 to stop the activation of endovascular therapy device 21 and to disable endovascular therapy device 21 from being reactivated until endovascular therapy device 21 has been navigated to a new position in need of treatment or has been under-treated. Concurrently or alternatively, a warning signal could be given to the physician via navigation controller 62 to stop activation of endovascular therapy device 21.
[0071] In a second exemplary embodiment, endovascular therapy monitoring controller 10 generates a dwell time map 90 as shown in
[0072] In practice, endovascular therapy monitoring controller 10 may generate dwell maps (e.g., dwell maps 80a, 80b and 90) in real-time as an endovascular therapy device 21 is navigated within the vascular vessel or after an entire navigation sequence as a post-assessment map for the physician. In the case of a balloon based endovascular therapy device 21, the dwell time may also have an associated pressure of inflation attached to it (e.g. via shape sensing, via pressure inflator, via entry by the staff). Additionally, endovascular therapy monitoring controller 10 may translate a dwell map to a velocity map.
[0073] To facilitate a further understanding of the present disclosure, the following description of
[0074] Referring to
[0075] More particularly, the planning of the laser atherectomy as known in the art of the present disclosure is pre-operatively accomplished via workstation 61a based on an X-ray imaging by a X-ray imager 21a of the blockage BL of vascular vessel VV. A positioning of laser atherectomy catheter 21a contiguous with plaque blockage BL at any given position is accomplished via a catheter robot 71 a as known in the art of the present disclosure and/or manually by a physician with visual guidance or haptic guidance as known in the art of the present disclosure. The tracked positioning of laser atherectomy catheter 21 a contiguous with plaque blockage BL at an X number of positions is accomplished via an optical shape sensing guidewire 31a as known in the art of the present disclosure.
[0076] The tracked position of laser atherectomy catheter 21a may be a single point along laser atherectomy catheter 21a, a single point at a distal tip of laser atherectomy catheter 21a, or multiple points along a particular section(s) of laser atherectomy catheter 21a.
[0077] In one exemplary tracked positioning embodiment, a Unicath hub (not shown) may be attached to the proximal end of laser atherectomy catheter 21a as known in the art of the present disclosure, whereby knowing a length from the Unicath hub to the point(s) of laser atherectomy catheter 21a, which can be determined via a registration step, enables continuous tracking of the position of laser atherectomy catheter 21a along optical shape sensing guidewire 31a.
[0078] In a second exemplary racked positioning embodiment, an activation of laser atherectomy catheter 21a along optical shape sensing guidewire 31a induces a change in a strain or a temperature of optical shape sensing guidewire 31a as known in the art of the present disclosure, which facilitates a determination of the position of the distal tip of laser atherectomy catheter 21a.
[0079] Optical shape sensing guidewire 31a is registered to the X-ray image(s) as known in the art of the present disclosure, whereby a coordinate system of optical shape sensing guidewire 31a aligns with a coordinate system of X-ray imager 21a. Thus, knowing the position of laser atherectomy catheter 21a along optical shape sensing guidewire 31a via a Unicath hub or strain inducement defines the registration of laser atherectomy catheter 21a to the X-ray image(s).
[0080] In one exemplary synchronization embodiment, endovascular therapy monitoring controller 10a receives a clock signal or time stamps via activation data 23a and tracking data 33a, whereby endovascular therapy monitoring controller 10a aligns the clock signals or time stamps.
[0081] In a second exemplary synchronization embodiment, endovascular therapy monitoring controller 10a receives a clock signal or time stamps via tracking data 33a, and measures the strain induced feature of optical shape sensing guidewire 31a when laser atherectomy catheter 21a is activated. For example, when the strain or the temperature of the optical shape sensing guidewire 31a rises above a certain threshold, the timestamps from that tracking frame and all frames above the threshold may be saved to calculate the activated dwell time of when laser atherectomy catheter 21a.
[0082] In operation, the plan encompasses laser atherectomy catheter 21a being intermittently navigated within vascular vessel VV, via catheter robot 71a as known in the art of the present disclosure and/or manually by a physician with visual guidance or haptic guidance as known in the art of the present disclosure, to each position DP contiguous with blockage BL whereby a laser treatment LT of blockage BL is monitored by endovascular therapy monitoring controller 10a.
[0083] For example as shown in
[0084] During the laser treatments, endovascular therapy monitoring controller 10a manages a database table 13a including a record for each laser treatment LT. Each record includes an indexing of the laser treatment LT, the corresponding tracked dwell position DP of laser atherectomy catheter 21a, the corresponding activation dwell time DT of laser atherectomy catheter 21a, and a treatment assessment TA of whether that particular laser treatment LT was an optimal treatment, an under-treatment or an over-treatment. Each record may further include a temperature being measured/monitored by OSS guidewire 31a.
[0085] Endovascular therapy monitoring controller 10a utilizes database table 13a to generate and communicate a dwell map to workstation 61 via assessment data 63b that highlights optimally-treated areas, an under-treated areas or an over-treated areas as previously described in the present disclosure.
[0086] For any under-treated area, endovascular therapy monitoring controller 10a may provide feedback 74a to the robot controller of catheter robot 74a to return to the tracked dwell position DP of laser atherectomy catheter 21a corresponding to the under-treated area, and/or provide feedback to the navigation controller of therapy workstation 61a to assist a physician in performing manual navigation of returning laser atherectomy catheter 21a to the tracked dwell position DP of corresponding to the under-treated area.
[0087] For any over-treated area, endovascular therapy monitoring controller 10a may send a deactivation signal 24a to the activation controller when the dwell time equals the maximum therapeutic dwell time. Additionally, endovascular therapy monitoring controller 10a may provide feedback 74a to the robot controller of catheter robot 71a to precede to the next tracked dwell position DP of laser atherectomy catheter 21a, if any, and/or may provide feedback to the navigation controller of therapy workstation 61a to assist a physician in performing manual navigation of laser atherectomy catheter 21a to the next tracked dwell position DP, if any.
[0088] Upon completion of the laser atherectomy, endovascular therapy monitoring controller 10a transmits the database table 53b to a EMR server 51a.
[0089] Referring to
[0090] More particularly, the planning of the balloon angioplasty as known in the art of the present disclosure is pre-operatively accomplished via workstation 61a based on an X-ray imaging by a X-ray imager 21b of the blockage BL of vascular vessel VV. A positioning of balloon angioplasty catheter 21b contiguous with plaque blockage BL at any given position is accomplished via a catheter robot 71a as known in the art of the present disclosure. The tracked positioning of balloon angioplasty catheter 21b contiguous with plaque blockage BL at an X number of positions is accomplished via an optical shape sensing guidewire 31a as known in the art of the present disclosure.
[0091] The tracked position of balloon angioplasty catheter 21b may be a single point along balloon angioplasty catheter 21b, a single point at a distal tip of balloon angioplasty catheter 21b, or multiple points along a particular section(s) of balloon angioplasty catheter 21b.
[0092] In one exemplary tracked positioning embodiment, a Unicath hub (not shown) may be attached to the proximal end of balloon angioplasty catheter 21b as known in the art of the present disclosure, whereby knowing a length from the Unicath hub to the point(s) of balloon angioplasty catheter 21b, which can be determined via a registration step, enables continuous tracking of the position of balloon angioplasty catheter 21b along optical shape sensing guidewire 31a.
[0093] In a second exemplary racked positioning embodiment, an activation of balloon angioplasty catheter 21b along optical shape sensing guidewire 31a includes a change in the curvature shape of balloon angioplasty catheter 21b as known in the art of the present disclosure, which facilitates a determination of the position of the balloon angioplasty catheter 21b along optical shape sensing guidewire 31a. Further, an amount of curvature shape change is also reflective of the inflation pressure of the balloon angioplasty catheter 21b
[0094] Optical shape sensing guidewire 31a is registered to the X-ray image(s) as known in the art of the present disclosure, whereby a coordinate system of optical shape sensing guidewire 31a aligns with a coordinate system of X-ray imager 21b. Thus, knowing the position of balloon angioplasty catheter 21b along optical shape sensing guidewire 31a via a Unicath hub or curvature inducement defines the registration of balloon angioplasty catheter 21b to the X-ray image(s).
[0095] In one exemplary synchronization embodiment, endovascular therapy monitoring controller 10b receives a clock signal or time stamps via activation data 23b and tracking data 33b, whereby endovascular therapy monitoring controller 10b aligns align the clock signals or time stamps.
[0096] In a second exemplary synchronization embodiment, endovascular therapy monitoring controller 10b receives a clock signal or time stamps via tracking data 33b, and measures the curvature induced feature of optical shape sensing guidewire 31a when balloon angioplasty catheter 21b is activated. For example, when a curvature of optical shape sensing guidewire 31a rises above a certain threshold, the timestamps from that tracking frame and all frames above the threshold may be saved to calculate the activated dwell time of when balloon angioplasty catheter 21b.
[0097] In operation, the plan encompasses balloon angioplasty catheter 21b being intermittently navigated within vascular vessel VV via catheter robot 71a to each position DP contiguous with blockage BL whereby a balloon treatment BT of blockage BL is monitored by endovascular therapy monitoring controller 10b.
[0098] For example as shown in
[0099] During the laser treatments, endovascular therapy monitoring controller 10b manages a database table 13b including a record for each balloon treatment BT. Each record includes an indexing of the balloon treatment BT, the corresponding tracked dwell position DP of balloon angioplasty catheter 21b, the corresponding activation dwell time DT of balloon angioplasty catheter 21b, and a treatment assessment TA of whether that particular balloon treatment BT was an optimal treatment, an under-treatment or an over-treatment.
[0100] Endovascular therapy monitoring controller 10b utilizes database table 13b to generate and communicate a dwell map to workstation 61 via assessment data 63a that highlights optimally-treated areas, an under-treated areas or an over-treated areas as previously described in the present disclosure.
[0101] For any under-treated area, endovascular therapy monitoring controller 10b may provide feedback 74b to the robot controller of catheter robot 74b to return to the tracked dwell position DP of balloon angioplasty catheter 21b corresponding to the under-treated area and/or provide feedback to the navigation controller of therapy workstation 61a to assist a physician in performing manual navigation of returning balloon angioplasty catheter 21b to the tracked dwell position DP of corresponding to the under-treated area.
[0102] For any over-treated area, endovascular therapy monitoring controller 10b may send a deactivation signal 24b to the activation controller when the dwell time equals the maximum therapeutic dwell time. Additionally, endovascular therapy monitoring controller 10b may provide feedback 74b to the robot controller of catheter robot 71a to precede to the next tracked dwell position DP of balloon angioplasty catheter 21b, if any, and/or may provide feedback to the navigation controller of therapy workstation 61a to assist a physician in performing manual navigation of balloon angioplasty catheter 21b to the next tracked dwell position DP, if any.
[0103] Upon completion of the laser atherectomy, endovascular therapy monitoring controller 10b transmits the database table 53b to EMR server 51a.
[0104] To facilitate a further understanding of the present disclosure, the following description of
[0105] Referring to
[0106] Each processor 111 may be any hardware device, as known in the art of the present disclosure or hereinafter conceived, capable of executing instructions stored in memory 112 or storage or otherwise processing data. In a non-limiting example, the processor(s) 111 may include a microprocessor, field programmable gate array (FPGA), application-specific integrated circuit (ASIC), or other similar devices.
[0107] The memory 112 may include various memories, as known in the art of the present disclosure or hereinafter conceived, including, but not limited to, L1, L2, or L3 cache or system memory. In a non-limiting example, the memory 112 may include static random access memory (SRAM), dynamic RAM (DRAM), flash memory, read only memory (ROM), or other similar memory devices.
[0108] The user interface 113 may include one or more devices, as known in the art of the present disclosure or hereinafter conceived, for enabling communication with a user such as an administrator. In a non-limiting example, the user interface may include a command line interface or graphical user interface that may be presented to a remote terminal via the network interface 114.
[0109] The network interface 114 may include one or more devices, as known in the art of the present disclosure or hereinafter conceived, for enabling communication with other hardware devices. In a non-limiting example, the network interface 114 may include a network interface card (NIC) configured to communicate according to the Ethernet protocol. Additionally, the network interface 114 may implement a TCP/IP stack for communication according to the TCP/IP protocols. Various alternative or additional hardware or configurations for the network interface 114 will be apparent.
[0110] The storage 115 may include one or more machine-readable storage media, as known in the art of the present disclosure or hereinafter conceived, including, but not limited to, read-only memory (ROM), random-access memory (RAM), magnetic disk storage media, optical storage media, flash-memory devices, or similar storage media. In various non-limiting embodiments, the storage 115 may store instructions for execution by the processor(s) 111 or data upon with the processor(s) 111 may operate. For example, the storage 115 may store a base operating system for controlling various basic operations of the hardware. The storage 115 also stores application modules 117 in the form of executable software/firmware for implementing the various functions of the endovascular therapy monitoring controller 110 as previously described in the present disclosure including, but not limited to, a treatment synchronizer 118a and a treatment accessor 118b for executing a flowchart 120 representative of an endovascular therapy monitoring method of the present disclosure as shown in
[0111] Referring to
[0112] If treatment synchronizer 118a ascertains endovascular therapy device has been activated at stage S122, then treatment synchronizer 118a proceeds to a stage S124 of flowchart 120 to calculate an activated dwell time for the current tracked position i.
[0113] From the calculation of stage S124, a stage S126 of flowchart encompasses treatment accessor 118b ascertaining if the endovascular therapy device overtreated the blockage within the vascular vessel at the current tracked position i.
[0114] If treatment accessor 118b ascertains the endovascular therapy device did overtreat the blockage within the vascular vessel at the current tracked position i during stage S126, then treatment accessor 118b proceeds to a state S 128 of flowchart 120 to communicate a warning feedback to an activation controller (e.g., a deactivation trigger), a physician (e.g., a deactivation warning) and/or a robot controller (e.g., a robot command to move the endovascular therapy device to the next position).
[0115] Thereafter, a stage S134 of flowchart 120 encompasses treatment accessor 118b to update a dwell map showing the overtreated area of the vascular vessel at the current position i, and flowchart 120 returning to stage S122 for the next position i + 1.
[0116] If treatment accessor 118b ascertains the endovascular therapy device did not overtreat the blockage of the vascular vessel at the current tracked position i during stage S126, then treatment accessor 118b proceeds to a stage S130 of flowchart 120 to ascertain if the endovascular therapy device undertreated the blockage within the vascular vessel at the current tracked position i.
[0117] If treatment accessor 118b ascertains the endovascular therapy device did undertreat the blockage within the vascular vessel at the current tracked position i during stage S 130, then treatment accessor 118b proceeds to a state S132 of flowchart 120 to communicate a retreatment feedback to an activation controller (e.g., a reactivation trigger for a time equating the maximum therapeutic dwell time less then calculated dwell time), and a physician (e.g., a reactivation text for a time equating the maximum therapeutic dwell time less then calculated dwell time). The retreatment may be accomplished during stage S132 or at a later time.
[0118] Thereafter, stage S134 of flowchart 120 encompasses treatment accessor 118b updating a dwell map showing the undertreated area of the vascular vessel at the current position i if retreatment is to occur at a later time and flowchart 120 returning to stage S122 for the next position i + 1.
[0119] If treatment accessor 118b ascertains the endovascular therapy device did not undertreat the blockage within the vascular vessel at the current tracked position i during stage S130 or an undertreat was immediately retreated to an optimal treatment, then stage S134 of flowchart 120 encompasses treatment accessor 118b updating the dwell map showing the optimally-treated area of the vascular vessel at the current position i and flowchart 120 returning to stage S122 for the next position i + 1.
[0120] During the execution of flowchart 120, a database manager 119 maintains a database table of the monitoring of the endovascular therapy procedure.
[0121] Flowchart 120 may be terminated/interrupted at any time, particularly upon execution of the planned endovascular therapy procedure. Referring to
[0122] Further, as one having ordinary skill in the art will appreciate in view of the teachings provided herein, structures, elements, components, etc. described in the present disclosure/specification and/or depicted in the Figures may be implemented in various combinations of hardware and software, and provide functions which may be combined in a single element or multiple elements. For example, the functions of the various structures, elements, components, etc. shown/illustrated/depicted in the Figures can be provided through the use of dedicated hardware as well as hardware capable of executing software in association with appropriate software for added functionality. When provided by a processor, the functions can be provided by a single dedicated processor, by a single shared processor, or by a plurality of individual processors, some of which can be shared and/or multiplexed. Moreover, explicit use of the term “processor” or “controller” should not be construed to refer exclusively to hardware capable of executing software, and can implicitly include, without limitation, digital signal processor (“DSP”) hardware, memory (e.g., read only memory (“ROM”) for storing software, random access memory (“RAM”), non-volatile storage, etc.) and virtually any means and/or machine (including hardware, software, firmware, combinations thereof, etc.) which is capable of (and/or configurable) to perform and/or control a process.
[0123] Moreover, all statements herein reciting principles, aspects, and embodiments of the invention, as well as specific examples thereof, are intended to encompass both structural and functional equivalents thereof. Additionally, it is intended that such equivalents include both currently known equivalents as well as equivalents developed in the future (e.g., any elements developed that can perform the same or substantially similar function, regardless of structure). Thus, for example, it will be appreciated by one having ordinary skill in the art in view of the teachings provided herein that any block diagrams presented herein can represent conceptual views of illustrative system components and/or circuitry embodying the principles of the invention. Similarly, one having ordinary skill in the art should appreciate in view of the teachings provided herein that any flow charts, flow diagrams and the like can represent various processes which can be substantially represented in computer readable storage media and so executed by a computer, processor or other device with processing capabilities, whether or not such computer or processor is explicitly shown.
[0124] The terms “signal”, “data” and “command” as used in the present disclosure broadly encompasses all forms of a detectable physical quantity or impulse (e.g., voltage, current, or magnetic field strength) as understood in the art of the present disclosure and as exemplary described in the present disclosure for transmitting information and/or instructions in support of applying various inventive principles of the present disclosure as subsequently described in the present disclosure. Signal/data/command communication between various components of the present disclosure may involve any communication method as known in the art of the present disclosure including, but not limited to, signal/data/command transmission/reception over any type of wired or wireless datalink and a reading of signal/data/commands uploaded to a computer-usable/computer readable storage medium.
[0125] Having described preferred and exemplary embodiments of the various and numerous inventions of the present disclosure (which embodiments are intended to be illustrative and not limiting), it is noted that modifications and variations can be made by persons skilled in the art in light of the teachings provided herein, including the Figures. It is therefore to be understood that changes can be made in/to the preferred and exemplary embodiments of the present disclosure which are within the scope of the embodiments disclosed herein.
[0126] Moreover, it is contemplated that corresponding and/or related systems incorporating and/or implementing the device/system or such as may be used/implemented in/with a device in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure. Further, corresponding and/or related method for manufacturing and/or using a device and/or system in accordance with the present disclosure are also contemplated and considered to be within the scope of the present disclosure.