Apparatus and method for delivery and monitoring of ablation therapy

Patent metadata

Field	Value
Publication number	US-10098692-B2
Application number	US-201314092718-A
Country	US
Kind code	B2
Filing date	Nov 27, 2013
Priority date	Nov 30, 2012
Publication date	Oct 16, 2018
Grant date	Oct 16, 2018

Abstract

Methods are provided for monitoring and controlling tissue ablation using RF energy delivered by an imaging ablation catheter under direct visualization, using the control and modulation of a set of ablation parameters based on direct optical imaging of the tissue surface via the imaging ablation catheter, where a set of optical image-derived parameters modulates the setting of a subset of Radio Frequency dosing parameters. The ablation dosing algorithms based on image-derived information can be implemented manually or in semi-automated or automated forms.

First claim

What is claimed is:

1. A method comprising:
with an ablation probe, delivering Radio Frequency (RF) energy for tissue ablation to a tissue region in a subject anatomy;
with an optical image capture device associated with the ablation probe, capturing real-time images of the tissue region while delivering the RF energy to the tissue region;
with a computer in communication with the ablation probe, measuring at least one blanching parameter of the tissue region based on the real-time images; and
with the computer, during the delivering, causing the ablation probe to adjust a dosing parameter of the RF energy based on the measured blanching parameter, the dosing parameter being at least one of:
a. ablation power for a current ablation
b. initial ablation power for a next ablation
c. ablation duration for the current ablation
d. ablation duration for a next ablation
e. catheter flow rate for the current ablation
f. catheter flow rate for a next ablation.

2. A method comprising:
with an ablation probe, delivering of controlling delivery of Radio Frequency (RF) energy for tissue ablation to a tissue region in a subject anatomy;
with an optical image capture device associated with the ablation probe, capturing real-time images of the tissue region while delivering the RF energy to the tissue region;
with a computer in communication with the ablation probe, measuring at least one blanching parameter of the tissue region based on the real-time images; and
with the computer, during the delivering, causing the ablation probe to adjust a dosing parameter of the RF energy based on the measured blanching parameter.

3. The method of claim 2 , where the blanching parameter is a rate of change in tissue color within a pre-defined portion of one of the real-time images.

4. The method of claim 3 , where the pre-defined portion of one of the real-time images is a proportion of a catheter aperture diameter.

5. The method of claim 3 , where the pre-defined portion of one of the real-time images is based on area of a region of the image.

6. The method of claim 2 , where the blanching parameter is a time to attain a pre-determined extent of change in tissue color within a pre-defined portion of one of the real-time images.

7. The method of claim 6 , where the pre-defined portion of one of the real-time images is a proportion of a catheter aperture diameter.

8. The method of claim 6 , where the pre-defined portion of one of the real-time images is based on area of a region of one of the real-time images.

9. A method comprising:
with an ablation probe, delivering of controlling delivery of Radio Frequency (RF) energy for tissue ablation to a tissue region in a subject anatomy;
with an optical image capture device associated with the ablation probe, capturing real-time images of the tissue region while delivering the RF energy to the tissue region;
with a computer in communication with the ablation probe, measuring at least one blanching parameter of the tissue region and a number of feedback values associated with the tissue region; and
with the computer, during the delivering, causing the ablation probe to adjust a dosing parameter of the RF energy based on the measured blanching parameter and the number of feedback values;
wherein, the feedback values comprise (i) a time to attain a pre-defined change in color within a specified fraction of aperture diameter, and (ii) an observation of microbubbles, thrombus formation, or steam explosions in at least one of the real-time images.

10. A method comprising:
with an ablation probe, delivering of controlling delivery of Radio Frequency (RF) energy for tissue ablation to a tissue region in a subject anatomy;
with an optical image capture device associated with the ablation probe, capturing real-time images of the tissue region while delivering the RF energy to the tissue region;
with a computer in communication with the ablation probe, measuring at least one blanching parameter of the tissue region and feedback information associated with the tissue region; and
with the computer, during the delivering, causing the ablation probe to adjust a dosing parameter of the RF energy based on the measured blanching parameter and the feedback information;
wherein, the adjusting comprises making adjustments to at least one of:
a. an initial power setting
b. a catheter flow rate
c. an intended duration of the ablation
d. a position of a catheter tip
e. a pressure applied to a catheter tip.

11. The method of claim 10 , where at least one element of the feedback information includes an adverse ablation effect comprising at least one of microbubble formation, thrombus formation, and steam explosions.

12. The method of claim 10 , where the adjustments made to the dosing parameter are made between ablations so as to define starting parameters for a next ablation.

13. The method of claim 10 , where the adjustments made to the dosing parameter are made during an ablation in order to avoid an adverse ablation effect comprising at least one of microbubble formation, thrombus formation, and steam explosions.

14. A method comprising:
ablating tissue using RF energy delivered by an imaging ablation catheter under direct visualization; and
modulating a set of ablation parameters for the ablation catheter during the ablating based on a blanching parameter measured from a set of optical image derived parameters derived from direct optical imaging of a tissue surface via the imaging ablation catheter;
wherein the modulating comprises adjusting a subset of Radio Frequency dosing parameters.

15. The method of claim 14 , where a determination of the dosing parameters is made by an operator based on visual image-based feedback and algorithmic guidance.

16. The method of claim 14 , where a determination of at least a subset of the dosing parameters is made algorithmically by a computer and suggested to an operator as recommendations.

17. The method of claim 14 , where a determination of at least a subset of the dosing parameters is made algorithmically by a computer and implemented automatically.

Assignees

• Intuitive Surgical Operations

Inventors

• Allison John B
• Pageard Jean-Luc
• Pedersen Brian
• Escobedo Celina

Classifications

• A61B18/1492 Primary

  having a flexible, catheter-like structure, e.g. for heart ablation (A61B18/1477 takes precedence) · CPC title

• A61B90/361

  Image-producing devices, e.g. surgical cameras · CPC title

• A61B2018/00982

  combined with or comprising means for visual or photographic inspections inside the body, e.g. endoscopes · CPC title

• A61B2017/00061

  spectrum · CPC title

• A61B2017/00057

  Light · CPC title