EP-4734860-A1 - ATHEROSCLEROTIC TISSUE CHARACTERIZATION BASED ON ENDOVASCULAR TREATMENT DYNAMICS

Abstract

A system to provide endovascular support for patients. The system includes a processor configured to receive, from a medical imaging device, a pre-treatment vessel roadmap and medical images acquired in response to an endovascular therapy performed on a patient, and obtain endovascular treatment parameters, including image-based endovascular treatment parameters based on features of the medical images. Such endovascular treatment parameters include a geometry and location of an endovascular therapy device within a vessel of the patient. The processor is further configured to predict tissue characteristics of a first lesion based on the endovascular treatment parameters and generate a map of the first lesion based on the pre-treatment vessel roadmap and the predicted tissue characteristics of the first lesion.

Inventors

• TORJESEN, ALYSSA
• SALEHI, Leili
• PAI RAIKAR, VIPUL SHRIHARI
• VARBLE, Nicole
• UBACHS, Rene Leonardus Jacobus Marie
• HENDRIKS, BERNARDUS HENDRIKUS WILHELMUS

Assignees

• Koninklijke Philips N.V.

Dates

Publication Date

20260506

Application Date

20240618

Claims (15)

1. 1. An endovascular support system, comprising: a processor; and a memory communicatively coupled to the processor, the memory storing instructions which, when executed by a processor, cause the processor to: receive, from a medical imaging device, a pre-treatment vessel roadmap and medical images acquired in response to an endovascular therapy performed on a patient, obtain endovascular treatment parameters, including image-based endovascular treatment parameters based on features of the medical images, wherein the endovascular treatment parameters include a geometry and location of an endovascular therapy device within a vessel of the patient, predict tissue characteristics of a first lesion based on the endovascular treatment parameters, and generate a map of the first lesion based on the pre-treatment vessel roadmap and the predicted tissue characteristics of the first lesion.
2. 2. The endovascular support system of claim 1, wherein the instructions, when executed by the processor, further to cause the processor to provide procedure guidance to a user based on the pre-treatment vessel roadmap and the predicted tissue characteristics of the first lesion.
3. 3. The endovascular support system of claim 1, wherein the instructions, when executed by the processor, further to cause the processor to: predict tissue characteristics of a second lesion based on the endovascular treatment parameters, and generate the map to include both the first lesion and the second lesion.
4. 4. The endovascular support system of claim 3, wherein the instructions, when executed by the processor, further to cause the processor to: predict a first confidence level associated with the first lesion and a second confidence level associated with the second lesion, and present the first confidence level and the second confidence level on the map as a first region associated with the first lesion and a second region associated with the second lesion.
5. 5. The endovascular support system of claim 1, wherein the endovascular therapy device comprises an angioplasty balloon, wherein the endovascular treatment parameters include balloon inflation geometry measurements taken at a plurality of discrete locations along the angioplasty balloon and taken at a plurality of degrees of inflation, and wherein the endovascular treatment parameters include one or more of a balloon type, a balloon size, or inflation pressure.
6. 6. The endovascular support system of claim 1 , wherein the endovascular treatment parameters include a dynamic geometry of an endovascular therapy device within a vessel of the patient, wherein the endovascular therapy device comprises an atherectomy catheter.
7. 7. The endovascular support system of claim 1, further comprising: a display communicatively coupled to the processor, the display configured to present the map to a user.
8. 8. A method for endovascular support, the method comprising: receiving, from a medical imaging device, a pre-treatment vessel roadmap and medical images acquired in response to an endovascular therapy performed on a patient, obtaining endovascular treatment parameters, including image-based endovascular treatment parameters based on features of the medical images, wherein the endovascular treatment parameters include a geometry and location of an endovascular therapy device within a vessel of the patient, predicting tissue characteristics of a first lesion based on the endovascular treatment parameters, and generating a map of the first lesion based on the pre-treatment vessel roadmap and the predicted tissue characteristics of the first lesion.
9. 9. The method of claim 8, further comprising providing procedure guidance to a user based on the pre-treatment vessel roadmap and the predicted tissue characteristics of the first lesion.
10. 10. The method of claim 8, further comprising: predicting tissue characteristics of a second lesion based on the endovascular treatment parameters, and generating the map to include both the first lesion and the second lesion.
11. 11. The method of claim 8, further comprising: predicting a first confidence level associated with the first lesion and a second confidence level associated with the second lesion, and presenting the first confidence level and the second confidence level on the map as a first region associated with the first lesion and a second region associated with the second lesion.
12. 12. The method of claim 8, wherein the endovascular therapy device comprises an angioplasty balloon, wherein the endovascular treatment parameters include balloon inflation geometry measurements taken at a plurality of discrete locations along the angioplasty balloon and taken at a plurality of degrees of inflation, and wherein the endovascular treatment parameters include one or more of a balloon type, a balloon size, or inflation pressure.
13. 13. The method of claim 8, wherein the endovascular treatment parameters include a dynamic geometry of an endovascular therapy device within a vessel of the patient, wherein the endovascular therapy device comprises an atherectomy catheter.
14. 14. The method of claim 8, further comprising presenting the map to a user via a display.
15. 15. A non-transitory machine-readable storage medium storing a computer program comprising instructions which, when executed by a processor, cause the processor to: receive, from a medical imaging device, a pre-treatment vessel roadmap and medical images acquired in response to an endovascular therapy performed on a patient, obtain endovascular treatment parameters, including image-based endovascular treatment parameters based on features of the medical images, wherein the endovascular treatment parameters include a geometry and location of an endovascular therapy device within a vessel of the patient, predict tissue characteristics of a first lesion based on the endovascular treatment parameters, and generate a map of the first lesion based on the pre-treatment vessel roadmap and the predicted tissue characteristics of the first lesion.

Description

ATHEROSCLEROTIC TISSUE CHARACTERIZATION BASED ON ENDOVASCULAR TREATMENT DYNAMICS FIELD [0001] The following relates generally to medical tissue characterization. More particularly, embodiments herein relate to atherosclerotic tissue characterization based on endovascular treatment dynamics. BACKGROUND [0002] In peripheral artery disease (PAD) and coronary artery disease (CAD), narrowing of blood vessels due to atherosclerotic plaque forming in the wall of the artery impedes blood flow and perfusion distal to the plaque. Lack of tissue perfusion can lead to many complications including loss of tissue function, non-healing wounds, amputation, or heart failure. There are numerous types of atherosclerotic plaque, which can include varying amounts of fatty, fibrotic, calcified, or necrotic tissues. [0003] There are numerous endovascular methods to treat atherosclerosis, including balloon angioplasty (plain, drug-coated, scoring balloons, etc.) or atherectomy (rotational, laser, directional, orbital, etc.). Balloon angioplasty is a common treatment for peripheral and coronary artery disease. Balloon angioplasty may be used in combination with other treatments depending on the characteristics of a lesion in a patient. Such balloon angioplasty involves inflating a balloon inside the diseased vessel for a short time to try to increase the flow through the vessel by expanding the lumen. Additionally, or alternatively, atherectomy involves passing a device through the lesion that mechanically removes some of the plaque. [0004] Deciding on the right therapy or set of therapies to treat a particular lesion is complex. Multiple treatments may be applied to a vessel sequentially to try to optimally restore blood flow. Deciding on which devices to use is largely dependent on the interventionalist’s perception of the tissue types that make up the plaque being treated; however, plaque composition is not easily quantified using standard Xray-based vascular imaging methods. [0005] The following discloses certain improvements to overcome problems that exist in such treatments. SUMMARY [0006] As discussed above, it is currently challenging to decide which devices to use as such decisions are largely dependent on the interventionalist’s perception of the tissue types that make up the plaque being treated, while plaque composition is not easily quantified using existing x-ray based vascular imaging methods. [0007] For example, in PAD, it can be difficult to determine at what point a lesion has been treated enough to restore blood flow sufficiently. Treatment may require multiple passes of different types of therapy devices to open the vessel sufficiently to restore blood flow. Assessing the effect of the treatment often requires a digital subtraction angiography (DSA) run. Disadvantageously, such a digital subtraction angiography (DSA) run delivers both contrast and radiation to the patient. [0008] Advantageously, in some implementations herein, by dynamically tracking therapy delivery parameters, information about the composition of the tissue or plaque are inferred, without additional digital subtraction angiography (DSA) runs. Such information about the tissue composition are used to determine if sufficient treatment has already been delivered, or to help determine the optimal devices to use if subsequent treatment is necessary. [0009] As will be described in greater detail below, the degree of balloon inflation is influenced by tissue response due to the characteristics of the lesion, such as the amount of fatty, fibrotic, or calcific tissue present. In some implementations discussed herein, by tracking the borders of the balloon in fluoroscopy, the inflation dynamics can be assessed and used to infer information about the tissue stiffness and composition. Information about the tissue characteristics can be used to determine if additional therapy is required after balloon angioplasty deployment. [0010] For example, in some implementations discussed herein, 2D fluoroscopy sequences are received from an imaging system (e.g., an interventional X-ray imaging system or the like) during endovascular treatment (e.g., balloon angioplasty, atherectomy procedures, or the like) and performs the following actions: tracking the geometry and location of the therapy delivery as function of time, inferring tissue characteristics based on therapy device dynamics, and/or mapping the inferred tissue characteristics to a vessel roadmap. [0011] In one aspect, an endovascular support system includes a processor and a memory communicatively coupled to the processor. The memory stores instructions which, when executed by the processor, cause the processor to receive, from a medical imaging device, a pre-treatment vessel roadmap and medical images acquired in response to an endovascular therapy performed on a patient; and obtain endovascular treatment parameters, including image-based endovascular treatment parameters based on features of the med