Identification of elastic lamina to guide interventional therapy

Patent metadata

Field	Value
Publication number	US-11944342-B2
Application number	US-202017075548-A
Country	US
Kind code	B2
Filing date	Oct 20, 2020
Priority date	Jul 8, 2013
Publication date	Apr 2, 2024
Grant date	Apr 2, 2024

Abstract

Described herein is a system and method for identifying elastic lamina during interventional procedures, such as atherectomy. Such identification can be used to avoid trauma to the external elastic lamina during the procedure.

First claim

The invention claimed is:

1. A method of performing atherectomy, comprising:
inserting an atherectomy device into a vessel of a patient;
gathering optical coherence tomography (OCT) images using an imaging sensor on the device;
identifying an external elastic lamina (EEL) of a wall of the vessel in the OCT images;
orienting a cutter of the atherectomy device away from the EEL based upon the identifications;
adjusting a depth of cut based upon the identification; and
removing plaque from the wall of the vessel with the cutter while the cutter is oriented away from the EEL;
wherein the device further includes a balloon configured to inflate or deflate to expose or cover the cutter, and wherein moving the cutter from an active mode to a passive mode comprises at least partially deflating the balloon.

2. The method of claim 1 , wherein orienting the cutter of the atherectomy device away from the EEL comprises moving the cutter from a direction normal to the EEL to a direction towards the plaque.

3. The method of claim 1 , further comprising determining from the OCT images whether trauma to the EEL has occurred.

4. The method of claim 3 , further comprising adjusting a treatment plan to mitigate an inflammatory cascade caused by the trauma to the EEL.

5. The method of claim 4 , wherein adjusting the treatment plan comprises implanting a drug coated stent in the vessel, implanting a drug eluting balloon in the vessel, or providing an oral medication to the patient.

6. The method of claim 1 , wherein the OCT images are a toroidal view of the vessel.

7. The method of claim 6 , wherein the step of identifying an EEL further comprises identifying an outer-most bright line in the toroidal view.

8. The method of claim 1 , wherein the adjusting step is performed automatically.

9. The method of claim 1 , further comprising determining a distance between the cutter and the EEL.

10. The method of claim 9 , further comprising activating an alarm if the distance is below a threshold value.

11. The method of claim 9 , further comprising stopping removing plaque if the distance is below a threshold value.

Assignees

• Avinger Inc

Inventors

• Simpson John B
• He Xuanmin
• Radjabi Ryan
• Newhauser Richard R

Classifications

• A61B17/3207 Primary

  Atherectomy devices {working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions (A61B17/32037 takes precedence; endoscopic cutting instruments A61B17/320016)} · CPC title

• A61B17/320783 Primary

  through side-hole, e.g. sliding or rotating cutter inside catheter · CPC title

• A61B90/361

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

• A61B2017/00119

  alarm; indicating an abnormal situation · CPC title

• A61B2017/22071

  Steering · CPC title