In the past, certain intravascular guidance of medical devices, such as guidewires and catheters for example, have used fluoroscopic methods for tracking tips of the medical devices and determining whether distal tips are appropriately localized in their target anatomical structures. However, such fluoroscopic methods expose patients and their attending clinicians to harmful X-ray radiation. Moreover, in some cases, the patients are exposed to potentially harmful contrast media needed for the fluoroscopic methods.
More recently, electromagnetic tracking systems have been used involving stylets. Generally, electromagnetic tracking systems feature three components: a field generator, a sensor unit and control unit. The field generator uses several coils to generate a position-varying magnetic field, which is used to establish a coordinate space. Attached to the stylet, such as near a distal end (tip) of the stylet for example, the sensor unit includes small coils in which current is induced via the magnetic field. Based on the electrical properties of each coil, the position and orientation of the medical device may be determined within the coordinate space. The control unit controls the field generator and captures data from the sensor unit.
Although electromagnetic tracking systems avoid line-of-sight reliance in tracking the tip of a stylet while obviating radiation exposure and potentially harmful contrast media associated with fluoroscopic methods, electromagnetic tracking systems are prone to interference. More specifically, since electromagnetic tracking systems depend on the measurement of magnetic fields produced by the field generator, these systems are subject to electromagnetic field interference, which may be caused by the presence of many different types of consumer electronics such as cellular telephones. Additionally, electromagnetic tracking systems are subject to signal drop out, depend on an external sensor, and are defined to a limited depth range.
Disclosed herein is a fiber optic shape sensing system and methods thereof, which is not subject to the disadvantages associated with electromagnetic tracking systems as described above and is capable in its current form of providing confirmation of tip placement or information passed/interpreted as an electrical signal. Further, inventive systems configured to and methods of determining an orientation of a stylet advancing within a patient's vasculature based at least partially on the information passed/interpreted as an electrical signal are disclosed. Additionally, such inventive systems and method that may perform or include operations of displaying information received from the fiber optic shape sensing system based on the determined orientation are disclosed.
Briefly summarized, embodiments disclosed herein are directed to systems, apparatus and methods for obtaining three-dimensional (3D) information (reflected light) corresponding to a trajectory and/or shape of a medical instrument, such as a catheter, a guidewire, or a stylet, during advancement through a vasculature of a patient, determining an orientation of the medical instrument relative to the patient, and generating and rendering a two-dimensional (2D) display of the medical instrument in real-time in accordance with the determined orientation.
More particularly, in some embodiments, the medical instrument includes a multi-core optical fiber, with each core fiber of the multi-core optical fiber is configured with an array of sensors (reflective gratings), which are spatially distributed over a prescribed length of the core fiber to generally sense external strain those regions of the core fiber occupied by the sensor. The multi-core optical fiber is configured to receive broadband light from a console during advancement through the vasculature of a patient, where the broadband light propagates along at least a partial distance of the multi-core optical fiber toward the distal end. Given that each sensor positioned along the same core fiber is configured to reflect light of a different, specific spectral width, the array of sensors enables distributed measurements throughout the prescribed length of the multi-core optical fiber. These distributed measurements may include wavelength shifts having a correlation with strain experienced by the sensor.
The reflected light from the sensors (reflective gratings) within each core fiber of the multi-core optical fiber is returned from the medical instrument for processing by the console. The physical state of the medical instrument may be ascertained based on analytics of the wavelength shifts of the reflected light. For example, the strain caused through bending of the medical instrument, and hence angular modification of each core fiber, causes different degrees of deformation. The different degrees of deformation alters the shape of the sensors (reflective grating) positioned on the core fiber, which may cause variations (shifts) in the wavelength of the reflected light from the sensors positioned on each core fiber within the multi-core optical fiber, as shown in
From this wavelength shifting, logic within the console may determine the physical state of the medical instrument (e.g., shape). Additionally, based on the wavelength shifting and anatomical constraints of the patient's body, the logic within the console may determine an orientation of the medical instrument relative to a known reference frame of the patient's body. Subsequently, the logic within the console is configured to generate a 2D display of the physical state of the medical instrument using the determined orientation of the medical instrument, where the reference frame of the 2D display mirrors the reference frame of the patient's body. Thus, the 2D display depicts a current physical state of the catheter displayed in such a manner as to be representative of the anatomical positioning and orientation relative to the patient's body, which enables a clinician to perceive the advancement of the medical instrument in an anatomically proper manner.
Specific embodiments of the disclosure include utilization of a stylet featuring a multi-core optical fiber and a conductive medium that collectively operate for tracking placement of a catheter or other medical device within a body of a patient. The stylet is configured to return information for use in identifying its physical state (e.g., shape length, shape, and/or form) of (i) a portion of the stylet (e.g., tip, segment of stylet, etc.) or a portion of a catheter inclusive of at least a portion of the stylet (e.g., tip, segment of catheter, etc.) or (ii) the entirety or a substantial portion of the stylet or catheter within the body of a patient (hereinafter, described as the “physical state of the stylet” or the “physical state of the catheter”). According to one embodiment of the disclosure, the returned information may be obtained from reflected light signals of different spectral widths, where each reflected light signal corresponds to a portion of broadband incident light propagating along a core of the multi-core optical fiber (hereinafter, “core fiber”) that is reflected back over the core fiber by a particular sensor located on the core fiber. One illustrative example of the returned information may pertain to a change in signal characteristics of the reflected light signal returned from the sensor, where wavelength shift is correlated to (mechanical) strain on the core fiber.
In some embodiments, the stylet includes a multi-core optical fiber, where each core fiber utilizes a plurality of sensors and each sensor is configured to reflect a different spectral range of the incident light (e.g., different light frequency range). Based on the type and degree of strain asserted on each core fiber, the sensors associated with that core fiber may alter (shift) the wavelength of the reflected light to convey the type and degree of stain on that core fiber at those locations of the stylet occupied by the sensors. The sensors are spatially distributed at various locations of the core fiber between a proximal end and a distal end of the stylet so that shape sensing of the stylet may be conducted based on analytics of the wavelength shifts. Herein, the shape sensing functionality is paired with the ability to simultaneously pass an electrical signal through the same member (stylet) through conductive medium included as part of the stylet.
More specifically, in some embodiments each core fiber of the multi-core optical fiber is configured with an array of sensors, which are spatially distributed over a prescribed length of the core fiber to generally sense external strain those regions of the core fiber occupied by the sensor. Given that each sensor positioned along the same core fiber is configured to reflect light of a different, specific spectral width, the array of sensors enables distributed measurements throughout the prescribed length of the multi-core optical fiber. These distributed measurements may include wavelength shifts having a correlation with strain experienced by the sensor.
According to one embodiment of the disclosure, each sensor may operate as a reflective grating such as a fiber Bragg grating (FBG), namely an intrinsic sensor corresponding to a permanent, periodic refractive index change inscribed into the core fiber. Stated differently, the sensor operates as a light reflective mirror for a specific spectral width (e.g., a specific wavelength or specific range of wavelengths). As a result, as broadband incident light is supplied by an optical light source and propagates through a particular core fiber, upon reaching a first sensor of the distributed array of sensors for that core fiber, light of a prescribed spectral width associated with the first sensor is reflected back to an optical receiver within a console, including a display and the optical light source. The remaining spectrum of the incident light continues propagation through the core fiber toward a distal end of the stylet. The remaining spectrum of the incident light may encounter other sensors from the distributed array of sensors, where each of these sensors is fabricated to reflect light with different specific spectral widths to provide distributed measurements, as described above.
During operation, multiple light reflections (also referred to as “reflected light signals”) are returned to the console from each of the plurality of core fibers of the multi-core optical fiber. Each reflected light signal may be uniquely associated with a different spectral width. Information associated with the reflected light signals may be used to determine a three-dimensional representation of the physical state of the stylet within the body of a patient. Herein, the core fibers are spatially separated with the cladding of the multi-mode optical fiber and each core fiber is configured to separately return light of different spectral widths (e.g., specific light wavelength or a range of light wavelengths) reflected from the distributed array of sensors fabricated in each of the core fibers. A comparison of detected shifts in wavelength of the reflected light returned by a center core fiber (operating as a reference) and the surrounding, periphery core fibers may be used to determine the physical state of the stylet.
During vasculature insertion and advancement of the catheter, the clinician may rely on the console to visualize a current physical state (e.g., shape) of a catheter guided by the stylet to avoid potential path deviations. As the periphery core fibers reside at spatially different locations within the cladding of the multi-mode optical fiber, changes in angular orientation (such as bending with respect to the center core fiber, etc.) of the stylet imposes different types (e.g., compression or tension) and degrees of strain on each of the periphery core fibers as well as the center core fiber. The different types and/or degree of strain may cause the sensors of the core fibers to apply different wavelength shifts, which can be measured to extrapolate the physical state of the stylet (catheter).
In order for the clinician to rely on the console to visualize the current physical state of the catheter, the console displays a visual representation, typically a 2D image, of the physical state of the catheter based on the reflected light. In generating the 2D image of the physical state of the catheter, the image must be displayed in such a manner as to be representative of the anatomical positioning relative to the patient's body. Thus, following analytics of the reflected light, logic of the console determines an orientation of the stylet relative to a known frame of reference of the patient's body. The logic then generates and renders a 2D display of the physical state of the catheter and a representation of the patient's body, with the display properly orienting the catheter relative to the patient's body based on the determined orientation of the stylet.
Although the reflected light provides a wealth of information capable of enabling extrapolation of the physical state of the stylet (catheter), such information lacks context as to the orientation of the stylet advancing within the patient's body. For instance, the wavelength shifts of the reflected light may indicate different degrees of deformation of each core fiber, which collectively may indicate a curvature of the stylet; however, the indication of such a curvature lacks context as to an orientation or direction with respect to the patient's body. Thus, the wavelength shifts of the reflected light, alone, do not enable the logic to generate a 2D display of the physical state of the catheter that is properly oriented within a visual representation of the patient's body.
Embodiments of the disclosure describe how the logic of the console utilizes the known anatomical constraints of the human body, a known insertion site of the stylet within the patient's body, and/or the wavelength shifts of the reflected light to determine an orientation of the stylet with respect to the patient's body. Additional embodiments further describe the generation of displays that illustrate the catheter within the patient's body based on the orientation of the stylet disposed within the catheter. Typically, such displays are 2D; however, as the wavelength shifts of the reflected light provide 3D information, generation of 3D displays has also been considered.
Some embodiments of the invention disclose a method for placing a medical device into a body of a patient comprising providing a broadband incident light signal to each of a plurality of reflective gratings distributed along a length of each of a plurality of core fibers of a multi-core optical fiber, the plurality of core fibers being spatially distributed to experience different degrees of strain, receiving reflected light signals of different spectral widths of the broadband incident light by each of the plurality of reflective gratings, processing the reflected light signals received from each of the plurality of reflective gratings associated with the plurality of core fibers to determine (i) a physical state of the multi-core optical fiber relating to the medical device including the multi-core optical fiber, and (ii) an orientation of the multi-core optical fiber relative to a reference frame of the body.
Some of the embodiments further include generating a display illustrating the physical state of the multi-core optical fiber based at least on the orientation determined during processing of the reflected light. Additionally, the display may be a two-dimensional representation of the physical state of the multi-core optical fiber in accordance with the orientation determined during processing of the reflected light.
In some embodiments, the physical state of the multi-core optical fiber relating to the medical device includes one or more of a length, a shape or a form as currently possessed by the multi-core optical fiber. In further embodiments, the different types of strain include compression and tension.
In some instances, determining the orientation of the multi-core optical fiber relative to the reference frame of the body includes establishing the reference frame of the body utilizing a coordinate system, establishing an initial direction of advancement along a first axis of the coordinate system for the multi-core optical fiber based on the multi-core optical fiber entering the body at a known insertion site, correlating initial reflected light signals to the initial direction of advancement along the first axis of the coordinate system, detecting a curve in the advancement of the multi-core optical fiber based on processing of the reflected light signals, and correlating reflected light signals corresponding to the curve in the advancement with a second direction of advancement along a second axis of the coordinate system, wherein the orientation is defined by (i) the initial reflected light signals correlated with the initial direction of advancement along the first axis of the coordinate system, and (ii) the reflected light signals corresponding to the curve in the advancement correlated with the second direction of advancement along the second axis of the coordinate system. The medical device may include an elongated shape and is inserted into a vasculature of the body of the patient. In some embodiments, the medical device is a stylet removably inserted into a lumen of a catheter assembly for placement of a distal tip of the catheter assembly in a superior vena cava of the vasculature. Further, at least two of the plurality of core fibers may be configured to experience different types of strain in response to changes in an orientation of the multi-core optical fiber. In some embodiments, each reflective grating of the plurality of reflective gratings alters its reflected light signal by applying a wavelength shift dependent on a strain experienced by the reflective grating.
Some embodiments of the invention disclose non-transitory computer-readable medium having stored thereon logic that, when executed by the one or more processors, causes operations including providing a broadband incident light signal to each of a plurality of reflective gratings distributed along a length of each of a plurality of core fibers of a multi-core optical fiber, the plurality of core fibers being spatially distributed to experience different degrees of strain, receiving reflected light signals of different spectral widths of the broadband incident light by each of the plurality of reflective gratings, processing the reflected light signals received from each of the plurality of reflective gratings associated with the plurality of core fibers to determine (i) a physical state of the multi-core optical fiber relating to the medical device including the multi-core optical fiber, and (ii) an orientation of the multi-core optical fiber relative to a reference frame of the body.
Some of the embodiments further include generating a display illustrating the physical state of the multi-core optical fiber based at least on the orientation determined during processing of the reflected light. Additionally, the display may be a two-dimensional representation of the physical state of the multi-core optical fiber in accordance with the orientation determined during processing of the reflected light.
In some embodiments, the physical state of the multi-core optical fiber relating to the medical device includes one or more of a length, a shape or a form as currently possessed by the multi-core optical fiber. In further embodiments, the different types of strain include compression and tension.
In some instances, determining the orientation of the multi-core optical fiber relative to the reference frame of the body includes establishing the reference frame of the body utilizing a coordinate system, establishing an initial direction of advancement along a first axis of the coordinate system for the multi-core optical fiber based on the multi-core optical fiber entering the body at a known insertion site, correlating initial reflected light signals to the initial direction of advancement along the first axis of the coordinate system, detecting a curve in the advancement of the multi-core optical fiber based on processing of the reflected light signals, and correlating reflected light signals corresponding to the curve in the advancement with a second direction of advancement along a second axis of the coordinate system, wherein the orientation is defined by (i) the initial reflected light signals correlated with the initial direction of advancement along the first axis of the coordinate system, and (ii) the reflected light signals corresponding to the curve in the advancement correlated with the second direction of advancement along the second axis of the coordinate system. The medical device may include an elongated shape and is inserted into a vasculature of the body of the patient. In some embodiments, the medical device is a stylet removably inserted into a lumen of a catheter assembly for placement of a distal tip of the catheter assembly in a superior vena cava of the vasculature. Further, at least two of the plurality of core fibers may be configured to experience different types of strain in response to changes in an orientation of the multi-core optical fiber. In some embodiments, each reflective grating of the plurality of reflective gratings alters its reflected light signal by applying a wavelength shift dependent on a strain experienced by the reflective grating.
Some embodiments of the invention disclose a medical device comprising a multi-core optical fiber having a plurality of core fibers, each of the plurality of core fibers including a plurality of sensors distributed along a longitudinal length of a corresponding core fiber and each sensor of the plurality of sensors being configured to (i) reflect a light signal of a different spectral width based on received incident light, and (ii) change a characteristic of the reflected light signal for use in determining a physical state of the multi-core optical fiber, and a console including one or more processors and a non-transitory computer-readable medium having stored thereon logic that, when executed by the one or more processors, causing performance of certain operations. These certain operations may include providing a broadband incident light signal to each of a plurality of reflective gratings distributed along a length of each of a plurality of core fibers of a multi-core optical fiber, the plurality of core fibers being spatially distributed to experience different degrees of strain, receiving reflected light signals of different spectral widths of the broadband incident light by each of the plurality of reflective gratings, processing the reflected light signals received from each of the plurality of reflective gratings associated with the plurality of core fibers to determine (i) a physical state of the multi-core optical fiber relating to the medical device including the multi-core optical fiber, and (ii) an orientation of the multi-core optical fiber relative to a reference frame of the body.
Some of the embodiments further include generating a display illustrating the physical state of the multi-core optical fiber based at least on the orientation determined during processing of the reflected light. Additionally, the display may be a two-dimensional representation of the physical state of the multi-core optical fiber in accordance with the orientation determined during processing of the reflected light.
In some embodiments, the physical state of the multi-core optical fiber relating to the medical device includes one or more of a length, a shape or a form as currently possessed by the multi-core optical fiber. In further embodiments, the different types of strain include compression and tension.
In some instances, determining the orientation of the multi-core optical fiber relative to the reference frame of the body includes establishing the reference frame of the body utilizing a coordinate system, establishing an initial direction of advancement along a first axis of the coordinate system for the multi-core optical fiber based on the multi-core optical fiber entering the body at a known insertion site, correlating initial reflected light signals to the initial direction of advancement along the first axis of the coordinate system, detecting a curve in the advancement of the multi-core optical fiber based on processing of the reflected light signals, and correlating reflected light signals corresponding to the curve in the advancement with a second direction of advancement along a second axis of the coordinate system, wherein the orientation is defined by (i) the initial reflected light signals correlated with the initial direction of advancement along the first axis of the coordinate system, and (ii) the reflected light signals corresponding to the curve in the advancement correlated with the second direction of advancement along the second axis of the coordinate system. The medical device may include an elongated shape and is inserted into a vasculature of the body of the patient. In some embodiments, the medical device is a stylet removably inserted into a lumen of a catheter assembly for placement of a distal tip of the catheter assembly in a superior vena cava of the vasculature. Further, at least two of the plurality of core fibers may be configured to experience different types of strain in response to changes in an orientation of the multi-core optical fiber. In some embodiments, each reflective grating of the plurality of reflective gratings alters its reflected light signal by applying a wavelength shift dependent on a strain experienced by the reflective grating.
These and other features of the concepts provided herein will become more apparent to those of skill in the art in view of the accompanying drawings and following description, which disclose particular embodiments of such concepts in greater detail.
Embodiments of the disclosure are illustrated by way of example and not by way of limitation in the figures of the accompanying drawings, in which like references indicate similar elements and in which:
Before some particular embodiments are disclosed in greater detail, it should be understood that the particular embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that a particular embodiment disclosed herein can have features that can be readily separated from the particular embodiment and optionally combined with or substituted for features of any of a number of other embodiments disclosed herein.
Regarding terms used herein, it should also be understood the terms are for the purpose of describing some particular embodiments, and the terms do not limit the scope of the concepts provided herein. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps in a group of features or steps, and do not supply a serial or numerical limitation. For example, “first,” “second,” and “third” features or steps need not necessarily appear in that order, and the particular embodiments including such features or steps need not necessarily be limited to the three features or steps. Labels such as “left,” “right,” “top,” “bottom,” “front,” “back,” and the like are used for convenience and are not intended to imply, for example, any particular fixed location, orientation, or direction. Instead, such labels are used to reflect, for example, relative location, orientation, or directions. Singular forms of “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise.
With respect to “proximal,” a “proximal portion” or a “proximal end portion” of, for example, a probe disclosed herein includes a portion of the probe intended to be near a clinician when the probe is used on a patient. Likewise, a “proximal length” of, for example, the probe includes a length of the probe intended to be near the clinician when the probe is used on the patient. A “proximal end” of, for example, the probe includes an end of the probe intended to be near the clinician when the probe is used on the patient. The proximal portion, the proximal end portion, or the proximal length of the probe can include the proximal end of the probe; however, the proximal portion, the proximal end portion, or the proximal length of the probe need not include the proximal end of the probe. That is, unless context suggests otherwise, the proximal portion, the proximal end portion, or the proximal length of the probe is not a terminal portion or terminal length of the probe.
With respect to “distal,” a “distal portion” or a “distal end portion” of, for example, a probe disclosed herein includes a portion of the probe intended to be near or in a patient when the probe is used on the patient. Likewise, a “distal length” of, for example, the probe includes a length of the probe intended to be near or in the patient when the probe is used on the patient. A “distal end” of, for example, the probe includes an end of the probe intended to be near or in the patient when the probe is used on the patient. The distal portion, the distal end portion, or the distal length of the probe can include the distal end of the probe; however, the distal portion, the distal end portion, or the distal length of the probe need not include the distal end of the probe. That is, unless context suggests otherwise, the distal portion, the distal end portion, or the distal length of the probe is not a terminal portion or terminal length of the probe.
The term “logic” may be representative of hardware, firmware or software that is configured to perform one or more functions. As hardware, the term logic may refer to or include circuitry having data processing and/or storage functionality. Examples of such circuitry may include, but are not limited or restricted to a hardware processor (e.g., microprocessor, one or more processor cores, a digital signal processor, a programmable gate array, a microcontroller, an application specific integrated circuit “ASIC”, etc.), a semiconductor memory, or combinatorial elements.
Additionally, or in the alternative, the term logic may refer to or include software such as one or more processes, one or more instances, Application Programming Interface(s) (API), subroutine(s), function(s), applet(s), servlet(s), routine(s), source code, object code, shared library/dynamic link library (dll), or even one or more instructions. This software may be stored in any type of a suitable non-transitory storage medium, or transitory storage medium (e.g., electrical, optical, acoustical or other form of propagated signals such as carrier waves, infrared signals, or digital signals). Examples of a non-transitory storage medium may include, but are not limited or restricted to a programmable circuit; non-persistent storage such as volatile memory (e.g., any type of random access memory “RAM”); or persistent storage such as non-volatile memory (e.g., read-only memory “ROM”, power-backed RAM, flash memory, phase-change memory, etc.), a solid-state drive, hard disk drive, an optical disc drive, or a portable memory device. As firmware, the logic may be stored in persistent storage.
Referring to
An exemplary implementation of the console 110 includes a processor 160, a memory 165, a display 170 and optical logic 180, although it is appreciated that the console 110 can take one of a variety of forms and may include additional components (e.g., power supplies, ports, interfaces, etc.) that are not directed to aspects of the disclosure. An illustrative example of the console 110 is illustrated in U.S. Publication No. 2019/0237902, the entire contents of which are incorporated by reference herein. The processor 160, with access to the memory 165 (e.g., non-volatile memory or non-transitory, computer-readable medium), is included to control functionality of the console 110 during operation. As shown, the display 170 may be a liquid crystal diode (LCD) display integrated into the console 110 and employed as a user interface to display information to the clinician, especially during a catheter placement procedure (e.g., cardiac catheterization). In another embodiment, the display 170 may be separate from the console 110. Although not shown, a user interface is configured to provide user control of the console 110.
For both of these embodiments, the content depicted by the display 170 may change according to which mode the stylet 120 is configured to operate: optical, TLS, ECG, or another modality. In TLS mode, the content rendered by the display 170 may constitute a two-dimensional (2D) or three-dimensional (3D) representation of the physical state (e.g., length, shape, form, and/or orientation) of the stylet 120 computed from characteristics of reflected light signals 150 returned to the console 110. The reflected light signals 150 constitute light of a specific spectral width of broadband incident light 155 reflected back to the console 110. According to one embodiment of the disclosure, the reflected light signals 150 may pertain to various discrete portions (e.g., specific spectral widths) of broadband incident light 155 transmitted from and sourced by the optical logic 180, as described below
According to one embodiment of the disclosure, an activation control 126, included on the stylet assembly 119, may be used to set the stylet 120 into a desired operating mode and selectively alter operability of the display 170 by the clinician to assist in medical device placement. For example, based on the modality of the stylet 120, the display 170 of the console 110 can be employed for optical modality-based guidance during catheter advancement through the vasculature or TLS modality to determine the physical state (e.g., length, form, shape, orientation, etc.) of the stylet 120. In one embodiment, information from multiple modes, such as optical, TLS or ECG for example, may be displayed concurrently (e.g., at least partially overlapping in time).
Referring still to
According to one embodiment of the disclosure, as shown in
The optical receiver 184 is configured to: (i) receive returned optical signals, namely reflected light signals 150 received from optical fiber-based reflective gratings (sensors) fabricated within each core fiber of the multi-core optical fiber 135 deployed within the stylet 120, and (ii) translate the reflected light signals 150 into reflection data (from repository 192), namely data in the form of electrical signals representative of the reflected light signals including wavelength shifts caused by strain. The reflected light signals 150 associated with different spectral widths may include reflected light signals 151 provided from sensors positioned in the center core fiber (reference) of the multi-core optical fiber 135 and reflected light signals 152 provided from sensors positioned in the periphery core fibers of the multi-core optical fiber 135, as described below. Herein, the optical receiver 184 may be implemented as a photodetector, such as a positive-intrinsic-negative “PIN” photodiode, avalanche photodiode, or the like.
As shown, both the light source 182 and the optical receiver 184 are operably connected to the processor 160, which governs their operation. Also, the optical receiver 184 is operably coupled to provide the reflection data (from repository 192) to the memory 165 for storage and processing by reflection data classification logic 190. The reflection data classification logic 190 may be configured to: (i) identify which core fibers pertain to which of the received reflection data (from repository 192) and (ii) segregate the reflection data stored with a repository 192 provided from reflected light signals 150 pertaining to similar regions of the stylet 120 or spectral widths into analysis groups. The reflection data for each analysis group is made available to shape sensing logic 194 for analytics.
According to one embodiment of the disclosure, the shape sensing logic 194 is configured to compare wavelength shifts measured by sensors deployed in each periphery core fiber at the same measurement region of the stylet 120 (or same spectral width) to the wavelength shift at a center core fiber of the multi-core optical fiber 135 positioned along central axis and operating as a neutral axis of bending. From these analytics, the shape sensing logic 194 may determine the shape the core fibers have taken in 3D space and may further determine the current physical state of the catheter 195 in 3D space for rendering on the display 170.
According to one embodiment of the disclosure, the shape sensing logic 194 may generate a rendering of the current physical state of the stylet 120 (and potentially the catheter 195), based on heuristics or run-time analytics. For example, the shape sensing logic 194 may be configured in accordance with machine-learning techniques to access a data store (library) with pre-stored data (e.g., images, etc.) pertaining to different regions of the stylet 120 (or catheter 195) in which reflected light from core fibers have previously experienced similar or identical wavelength shifts. From the pre-stored data, the current physical state of the stylet 120 (or catheter 195) may be rendered. Alternatively, as another example, the shape sensing logic 194 may be configured to determine, during run-time, changes in the physical state of each region of the multi-core optical fiber 135 based on at least: (i) resultant wavelength shifts experienced by different core fibers within the optical fiber 135, and (ii) the relationship of these wavelength shifts generated by sensors positioned along different periphery core fibers at the same cross-sectional region of the multi-core optical fiber 135 to the wavelength shift generated by a sensor of the center core fiber at the same cross-sectional region. It is contemplated that other processes and procedures may be performed to utilize the wavelength shifts as measured by sensors along each of the core fibers within the multi-core optical fiber 135 to render appropriate changes in the physical state of the stylet 120 (and/or catheter 195), especially to enable guidance of the stylet 120, when positioned at a distal tip of the catheter 195, within the vasculature of the patient and at a desired destination within the body.
The console 110 may further include electrical signaling logic 181, which is positioned to receive one or more electrical signals from the stylet 120. The stylet 120 is configured to support both optical connectivity as well as electrical connectivity. The electrical signaling logic 181 receives the electrical signals (e.g., ECG signals) from the stylet 120 via the conductive medium. The electrical signals may be processed by electrical signal logic 196, executed by the processor 160, to determine ECG waveforms for display.
Additionally, the console 110 includes a fluctuation logic 198 that is configured to analyze at least a subset of the wavelength shifts measured by sensors deployed in each of the core fibers 137. In particular, the fluctuation logic 198 is configured to analyze wavelength shifts measured by sensors of core fibers 137, where such corresponds to an analysis of the fluctuation of the distal tip of the stylet 120 (or “tip fluctuation analysis”). In some embodiments, the fluctuation logic 198 measures analyzes the wavelength shifts measured by sensors at a distal end of the core fibers 137. The tip fluctuation analysis includes at least a correlation of detected movements of the distal tip of the stylet 120 (or other medical device or instrument) with experiential knowledge comprising previously detected movements (fluctuations), and optionally, other current measurements such as ECG signals. The experiential knowledge may include previously detected movements in various locations within the vasculature (e.g., SVC, Inferior Vena Cava (IVC), right atrium, azygos vein, other blood vessels such as arteries and veins) under normal, healthy conditions and in the presence of defects (e.g., vessel constriction, vasospasm, vessel occlusion, etc.). Thus, the tip fluctuation analysis may result in a confirmation of tip location and/or detection of a defect affecting a blood vessel.
It should be noted that the fluctuation logic 198 need not perform the same analyses as the shape sensing logic 194. For instance, the shape sensing logic 194 determines a 3D shape of the stylet 120 by comparing wavelength shifts in outer core fibers of a multi-core optical fiber to a center, reference core fiber. The fluctuation logic 198 may instead correlate the wavelength shifts to previously measured wavelength shifts and optionally other current measurements without distinguishing between wavelength shifts of outer core fibers and a center, reference core fiber as the tip fluctuation analysis need not consider direction or shape within a 3D space.
In some embodiments, e.g., those directed at tip location confirmation, the analysis of the fluctuation logic 198 may utilize electrical signals (e.g., ECG signals) measured by the electrical signaling logic 181. For example, the fluctuation logic 198 may compare the movements of a subsection of the stylet 120 (e.g., the distal tip) with electrical signals indicating impulses of the heart (e.g., the heartbeat). Such a comparison may reveal whether the distal tip is within the SVC or the right atrium based on how closely the movements correspond to a rhythmic heartbeat.
In various embodiments, a display and/or alert may be generated based on the fluctuation analysis. For instance, the fluctuation logic 198 may generate a graphic illustrating the detected fluctuation compared to previously detected tip fluctuations and/or the anatomical movements of the patient body such as rhythmic pulses of the heart and/or expanding and contracting of the lungs. In one embodiment, such a graphic may include a dynamic visualization of the present medical device moving in accordance with the detected fluctuations adjacent to a secondary medical device moving in accordance with previously detected tip fluctuations. In some embodiments, the location of a subsection of the medical device may be obtained from the shape sensing logic 194 and the dynamic visualization may be location-specific (e.g., such that the previously detected fluctuations illustrate expected fluctuations for the current location of the subsection). In alternative embodiments, the dynamic visualization may illustrate a comparison of the dynamic movements of the subsection to one or more subsections moving in accordance with previously detected fluctuations of one or more defects affecting the blood vessel.
According to one embodiment of the disclosure, the fluctuation logic 198 may determine whether movements of one or more subsections of the stylet 120 indicate a location of a particular subsection of the stylet 120 or a defect affecting a blood vessel and, as a result, of the catheter 195, based on heuristics or run-time analytics. For example, the fluctuation logic 198 may be configured in accordance with machine-learning techniques to access a data store (library) with pre-stored data (e.g., experiential knowledge of previously detected tip fluctuation data, etc.) pertaining to different regions (subsections) of the stylet 120. Specifically, such an embodiment may include processing of a machine-learning model trained using the experiential knowledge, where the detected fluctuations serve as input to the trained model and processing of the trained model results in a determination as to how closely the detected fluctuations correlate to one or more locations within the vasculature of the patient and/or one or more defects affecting a blood vessel.
In some embodiments, the fluctuation logic 198 may be configured to determine, during run-time, whether movements of one or more subsections of the stylet 120 (and the catheter 195) indicate a location of a particular subsection of the stylet 120 or a defect affecting a blood vessel, based on at least (i) resultant wavelength shifts experienced by the core fibers 137 within the one or more subsections, and (ii) the correlation of these wavelength shifts generated by sensors positioned along different core fibers at the same cross-sectional region of the stylet 120 (or the catheter 195) to previously detected wavelength shifts generated by corresponding sensors in a core fiber at the same cross-sectional region. It is contemplated that other processes and procedures may be performed to utilize the wavelength shifts as measured by sensors along each of the core fibers 137 to render appropriate movements in the distal tip of the stylet 120 and/or the catheter 195.
Referring to
The optical logic 180 is configured to support graphical rendering of the catheter 130, most notably the integrated tubing of the catheter 130, based on characteristics of the reflected light signals 150 received from the catheter 130. The characteristics may include shifts in wavelength caused by strain on certain regions of the core fibers 137 integrated within (or along) a wall of the integrated tubing, which may be used to determine (through computation or extrapolation of the wavelength shifts) the physical state of the catheter 130, notably its integrated tubing or a portion of the integrated tubing such as a tip or distal end of the tubing to read fluctuations (real-time movement) of the tip (or distal end).
More specifically, the optical logic 180 includes a light source 182. The light source 182 is configured to transmit the broadband incident light 155 for propagation over the optical fiber(s) 147 included in the interconnect 145, which are optically connected to multiple core fibers 137 within the catheter tubing. Herein, the optical receiver 184 is configured to: (i) receive returned optical signals, namely reflected light signals 150 received from optical fiber-based reflective gratings (sensors) fabricated within each of the core fibers 137 deployed within the catheter 130, and (ii) translate the reflected light signals 150 into reflection data (from repository 192), namely data in the form of electrical signals representative of the reflected light signals including wavelength shifts caused by strain. The reflected light signals 150 associated with different spectral widths include reflected light signals 151 provided from sensors positioned in the center core fiber (reference) of the catheter 130 and reflected light signals 152 provided from sensors positioned in the outer core fibers of the catheter 130, as described below.
As noted above, the shape sensing logic 194 is configured to compare wavelength shifts measured by sensors deployed in each outer core fiber at the same measurement region of the catheter (or same spectral width) to the wavelength shift at the center core fiber positioned along central axis and operating as a neutral axis of bending. From these analytics, the shape sensing logic 190 may determine the shape the core fibers have taken in 3D space and may further determine the current physical state of the catheter 130 in 3D space for rendering on the display 170.
According to one embodiment of the disclosure, the shape sensing logic 194 may generate a rendering of the current physical state of the catheter 130, especially the integrated tubing, based on heuristics or run-time analytics. For example, the shape sensing logic 194 may be configured in accordance with machine-learning techniques to access a data store (library) with pre-stored data (e.g., images, etc.) pertaining to different regions of the catheter 130 in which the core fibers 137 experienced similar or identical wavelength shifts. From the pre-stored data, the current physical state of the catheter 130 may be rendered. Alternatively, as another example, the shape sensing logic 194 may be configured to determine, during run-time, changes in the physical state of each region of the catheter 130, notably the tubing, based on at least (i) resultant wavelength shifts experienced by the core fibers 137 and (ii) the relationship of these wavelength shifts generated by sensors positioned along different outer core fibers at the same cross-sectional region of the catheter 130 to the wavelength shift generated by a sensor of the center core fiber at the same cross-sectional region. It is contemplated that other processes and procedures may be performed to utilize the wavelength shifts as measured by sensors along each of the core fibers 137 to render appropriate changes in the physical state of the catheter 130.
Referring to
As shown, the section 200 is subdivided into a plurality of cross-sectional regions 2201-220N, where each cross-sectional region 2201-220N corresponds to reflective gratings 21011-21014 . . . 210N1-210N4. Some or all of the cross-sectional regions 2201 . . . 220N may be static (e.g., prescribed length) or may be dynamic (e.g., vary in size among the regions 2201 . . . 220N). A first core fiber 1371 is positioned substantially along a center (neutral) axis 230 while core fiber 1372 may be oriented within the cladding of the multi-core optical fiber 135, from a cross-sectional, front-facing perspective, to be position on “top” the first core fiber 1371. In this deployment, the core fibers 1373 and 1374 may be positioned “bottom left” and “bottom right” of the first core fiber 1371. As examples,
Referencing the first core fiber 1371 as an illustrative example, when the stylet 120 is operative, each of the reflective gratings 2101-210N reflects light for a different spectral width. As shown, each of the gratings 2101i-210Ni (1≤i≤M) is associated with a different, specific spectral width, which would be represented by different center frequencies of f1 . . . fN, where neighboring spectral widths reflected by neighboring gratings are non-overlapping according to one embodiment of the disclosure.
Herein, positioned in different core fibers 1372-1373 but along at the same cross-sectional regions 220-220N of the multi-core optical fiber 135, the gratings 21012-210N2 and 21013-210N3 are configured to reflect incoming light at same (or substantially similar) center frequency. As a result, the reflected light returns information that allows for a determination of the physical state of the optical fibers 137 (and the stylet 120) based on wavelength shifts measured from the returned, reflected light. In particular, strain (e.g., compression or tension) applied to the multi-core optical fiber 135 (e.g., at least core fibers 1372-1373) results in wavelength shifts associated with the returned, reflected light. Based on different locations, the core fibers 1371-1374 experience different types and degree of strain based on angular path changes as the stylet 120 advances in the patient.
For example, with respect to the multi-core optical fiber section 200 of
Referring to
For this embodiment of the disclosure, the multi-core optical fiber 135 is encapsulated within a concentric braided tubing 310 positioned over a low coefficient of friction layer 335. The braided tubing 310 may feature a “mesh” construction, in which the spacing between the intersecting conductive elements is selected based on the degree of rigidity desired for the stylet 120, as a greater spacing may provide a lesser rigidity, and thereby, a more pliable stylet 120.
According to this embodiment of the disclosure, as shown in
As further shown in
For example, where the cladding 300 features a circular cross-sectional area 305 as shown in
Referring still to
Referring to
Referring to
Referring to
According to one embodiment of the disclosure, the two lumens 540 and 545 have approximately the same volume. However, the septum 510 need not separate the tubing into two equal lumens. For example, instead of the septum 510 extending vertically (12 o'clock to 6 o'clock) from a front-facing, cross-sectional perspective of the tubing, the septum 510 could extend horizontally (3 o'clock to 9 o'clock), diagonally (1 o'clock to 7 o'clock; 10 o'clock to 4 o'clock) or angularly (2 o'clock to 10 o'clock). In the later configuration, each of the lumens 540 and 545 of the catheter 130 would have a different volume.
With respect to the plurality of micro-lumens 5301-5304, the first micro-lumen 5301 is fabricated within the septum 510 at or near the cross-sectional center 525 of the integrated tubing. For this embodiment, three micro-lumens 5302-5304 are fabricated to reside within the wall 500 of the catheter 130. In particular, a second micro-lumen 5302 is fabricated within the wall 500 of the catheter 130, namely between the inner surface 505 and outer surface 507 of the first arc-shaped portion 535 of the wall 500. Similarly, the third micro-lumen 5303 is also fabricated within the wall 500 of the catheter 130, namely between the inner and outer surfaces 505/507 of the second arc-shaped portion 555 of the wall 500. The fourth micro-lumen 5304 is also fabricated within the inner and outer surfaces 505/507 of the wall 500 that are aligned with the septum 510.
According to one embodiment of the disclosure, as shown in
Referring to
As an alternative embodiment of the disclosure, one or more of the micro-lumens 5301-5304 may be sized with a diameter that exceeds the diameter of the corresponding one or more core fibers 5701-5704. However, at least one of the micro-lumens 5301-5304 is sized to fixedly retain their corresponding core fiber (e.g., core fiber retained with no spacing between its lateral surface and the interior wall surface of its corresponding micro-lumen). As yet another alternative embodiment of the disclosure, all the micro-lumens 5301-5304 are sized with a diameter to fixedly retain the core fibers 5701-5704.
Referring to
Furthermore, each core fiber includes a plurality of sensors spatially distributed along its length between at least the proximal and distal ends of the catheter tubing. This array of sensors is distributed to position sensors at different regions of the core fiber to enable distributed measurements of strain throughout the entire length or a selected portion of the catheter tubing. These distributed measurements may be conveyed through reflected light of different spectral widths (e.g., specific wavelength or specific wavelength ranges) that undergoes certain wavelength shifts based on the type and degree of strain.
According to one embodiment of the disclosure, as shown in
Referring now to
Each analysis group of reflection data is provided to shape sensing logic for analytics (block 670). Herein, the shape sensing logic compares wavelength shifts at each outer core fiber with the wavelength shift at the center core fiber positioned along central axis and operating as a neutral axis of bending (block 675). From this analytics, on all analytic groups (e.g., reflected light signals from sensors in all or most of the core fibers), the shape sensing logic may determine the shape the core fibers have taken in three-dimensional space, from which the shape sensing logic can determine the current physical state of the catheter in three-dimension space (blocks 680-685).
Referring to
During advancement through a patient vasculature, the catheter tubing of the catheter 130 receives broadband incident light 155 from the console 110 via optical fiber(s) 147 within the interconnect 145, where the incident light 155 propagates along the core fibers 137 of the multi-core optical fiber 135 within the catheter tubing of the catheter 130. According to one embodiment of the disclosure, the connector 146 of the interconnect 145 terminating the optical fiber(s) 147 may be coupled to the optical-based catheter connector 144, which may be configured to terminate the core fibers 137 deployed within the catheter 130. Such coupling optically connects the core fibers 137 of the catheter 130 with the optical fiber(s) 147 within the interconnect 145. The optical connectivity is needed to propagate the incident light 155 to the core fibers 137 and return the reflected light signals 150 to the optical logic 180 within the console 110 over the interconnect 145. As described below in detail, the physical state of the catheter 130 may be ascertained based on analytics of the wavelength shifts of the reflected light signals 150.
Referring to
As seen in
Having knowledge of the orientation of the catheter relative to the patient's body is integral in generating and rendering a 2D display of the shape of the stylet (and/or catheter), as most, if not all, displays utilized in catheter tracking systems are 2D displays, e.g., such as the display 170. Thus, without an indication of the orientation of the catheter relative to the patient's body, a 2D display cannot be rendered that properly depicts the stylet on a display, e.g., the display 170, that is anatomically correct relative to the reference frame of the patient's body.
To further explain this problem,
Referring to now
Referring again to
Continuing the example, as the stylet advances toward the clavicle, the stylet eventually begins to curve toward the patient's rib cage (i.e., toward the center of the patient's body).
Referring again to
Thus, following detection of the curvature of the stylet, the frame reference establishment logic 196 establishes an orientation of the stylet, and thus, the catheter. By establishing a correlation between the initial reflected light and the positive direction along the y-axis and a correlation between reflected light corresponding to a curvature of the stylet, the frame reference establishment logic 196 can generate and render a 2D display illustrating a representation of the shape of the catheter during advancement through the vasculature of the patient having a proper anatomical orientation based on the reference frame of the patient's body. As the stylet continues its advancement, the shape sensing logic 194 in conjunction with the reference frame establishment logic 196 may generate a 2D display of the catheter by comparing the received reflected light with the orientation of the stylet defined by (i) the initial reflected light signals correlated with the positive direction along the y-axis of the reference frame of the patient, and (ii) the reflected light signals corresponding to the curve in the advancement correlated with the positive direction along the x-axis of the reference frame of the patient.
Referring now to
Thus, the method 900 begins when broadband incident light is received by and propagates along the multi-core optical fiber of the stylet. The broadband incident light is reflected by one or more gratings (sensors) of the multi-core optical fiber, such that the reflected light signals may include wavelength shifts that correlate with strain experienced by each sensor, as discussed above. The console receives the reflected optical signals (reflected light signals) from the gratings fabricated within each core fiber of the multi-core optical fiber deployed within the stylet (block 902).
The reflect light signals are then translated into reflection data being electrical signals representing wavelength shifts in each core fiber caused by strain on the core fiber during advancement of the stylet through the patient's vasculature (block 904). Analytics are then performed to compare the wavelength shifts of periphery core fibers to a center core fiber operating as a neutral axis of bending to determine the shape of core fibers (i.e., that which the stylet and the catheter) have taken in 3D space (block 906).
Following performance of analytics to determine a 3D shape of the catheter, a 2D display is generated and rendered to display a 2D representation of the shape of the catheter as the catheter advances through the patient's vasculature using an x,y coordinate system (block 908). The 2D display is rendered such that the initial advancement of the catheter is illustrated as being in the positive direction along the y-axis. As noted above, the x,y coordinate system of the display, such as the display 170 of
Referring now to
When a result of the determination is that the stylet has begun to curve (yes at block 912), an orientation of the stylet is established using the reference frame of the 2D display to match a reference frame of the patient's body (block 916). Specifically, the direction of the curve indicated by the reflected light signals is set to correlate with the positive direction along the x-axis of the 2D display. The orientation of the stylet with respect to the reference frame of the 2D display is established based on the direction of the initial advancement of the stylet being set to correlate with the positive direction along the y-axis and the direction of the curve being set to correlate with the positive direction along the x-axis. Thus, the logic of the console has established the orientation of the stylet (and catheter) such that display of the advancement of the catheter on the 2D display is illustrated in an anatomically proper manner with respect to the reference frame of the patient's body. The established orientation may be stored as the correlation of the reflected light signals (e.g., specific wavelength shifts) with a particular direction along a particular axis in the console, e.g., along with the reflect data 192 of
The 2D display is continually generated and rendered in order to illustrate advancement of the catheter based on received optical signals (light signals) utilizing the established orientation of the stylet (and catheter) with respect to the reference frame of the 2D display that matches that of the patient's body (block 918).
Referring to
During advancement, the stylet 120 receives broadband light 155 from the console 110 via interconnect 145, which includes the connector 146 for coupling to the console connector 144 for the stylet assembly 118. The reflected light 150 from sensors (reflective gratings) within each core fiber of the multi-core optical fiber 137 are returned from the stylet 120 over the interconnect 145 for processing by the console 110. The physical state of the stylet 120 may be ascertained based on analytics of the wavelength shifts of the reflected light 150. For example, the strain caused through bending of the stylet 120, and hence angular modification of each core fiber, causes different degrees of deformation. The different degrees of deformation alters the shape of the sensors (reflective grating) positioned on the core fiber, which may cause variations (shifts) in the wavelength of the reflected light from the sensors positioned on each core fiber within the multi-core optical fiber 137, as shown in
As discussed briefly above,
Referring to
Thus, the method 1100 begins when broadband incident light is received by and propagates along the multi-core optical fiber of the stylet. The broadband incident light is reflected by one or more gratings (sensors) of the multi-core optical fiber, such that the reflected light signals may include wavelength shifts that correlate with strain experienced by each sensor, as discussed above. The console receives the reflected optical signals (reflected light signals) from the gratings fabricated within each core fiber of the multi-core optical fiber deployed within the stylet (block 1102).
The reflect light signals are then translated into reflection data being electrical signals representing wavelength shifts in each core fiber caused by strain on the core fiber during advancement of the stylet through the patient's vasculature (block 1104). Analytics are then performed to compare the wavelength shifts of periphery core fibers to a center core fiber operating as a neutral axis of bending to determine the shape of core fibers (i.e., that which the stylet and the catheter) have taken in 3D space (block 1106).
Following performance of analytics to determine a 3D shape of the catheter, a 2D display is generated and rendered to display a 2D representation of the shape of the catheter as the catheter advances through the patient's vasculature using an x,y coordinate system relative to a reference frame of the patient as discussed above with respect to
Referring now to
Thus, based on results of the heuristics or run-time analytics, an orientation of the stylet is established relative to the reference frame of the patient's body, which is mirrored by the reference frame of the 2D (block 1112). Thus, the console has established the orientation of the stylet (and catheter) such that display of the advancement of the catheter on the 2D display is illustrated in an anatomically proper manner with respect to the reference frame of the patient's body. The 2D display is continually generated and rendered in order to illustrate advancement of the catheter based on received optical signals (light signals) utilizing the established orientation of the stylet (and catheter) with respect to the reference frame of the 2D display that matches that of the patient's body (block 1114).
While some particular embodiments have been disclosed herein, and while the particular embodiments have been disclosed in some detail, it is not the intention for the particular embodiments to limit the scope of the concepts provided herein. Additional adaptations and/or modifications can appear to those of ordinary skill in the art, and, in broader aspects, these adaptations and/or modifications are encompassed as well. Accordingly, departures may be made from the particular embodiments disclosed herein without departing from the scope of the concepts provided herein.
This application claims the benefit of priority to U.S. Provisional Application No. 63/045,667, filed Jun. 29, 2020, which is incorporated by reference in its entirety into this application.
Number | Name | Date | Kind |
---|---|---|---|
4813429 | Eshel et al. | Mar 1989 | A |
5099845 | Besz et al. | Mar 1992 | A |
5163935 | Black et al. | Nov 1992 | A |
5207672 | Roth et al. | May 1993 | A |
5211165 | Dumoulin et al. | May 1993 | A |
5275151 | Shockey et al. | Jan 1994 | A |
5423321 | Fontenot | Jun 1995 | A |
5454807 | Lennox et al. | Oct 1995 | A |
5517997 | Fontenot | May 1996 | A |
5622170 | Schulz | Apr 1997 | A |
5740808 | Panescu et al. | Apr 1998 | A |
5872879 | Hamm | Feb 1999 | A |
5873842 | Brennen et al. | Feb 1999 | A |
5879306 | Fontenot et al. | Mar 1999 | A |
5906579 | Vander Salm et al. | May 1999 | A |
6069698 | Ozawa et al. | May 2000 | A |
6081741 | Hollis | Jun 2000 | A |
6178346 | Amundson et al. | Jan 2001 | B1 |
6208887 | Clarke | Mar 2001 | B1 |
6319227 | Mansouri-Ruiz | Nov 2001 | B1 |
6343227 | Crowley | Jan 2002 | B1 |
6398721 | Nakamura et al. | Jun 2002 | B1 |
6485482 | Belef | Nov 2002 | B1 |
6564089 | Izatt et al. | May 2003 | B2 |
6593884 | Gilboa et al. | Jul 2003 | B1 |
6597941 | Fontenot et al. | Jul 2003 | B2 |
6650923 | Lesh et al. | Nov 2003 | B1 |
6685666 | Fontenot | Feb 2004 | B1 |
6687010 | Horii et al. | Feb 2004 | B1 |
6690966 | Rava et al. | Feb 2004 | B1 |
6701181 | Tang et al. | Mar 2004 | B2 |
6711426 | Benaron et al. | Mar 2004 | B2 |
6816743 | Moreno et al. | Nov 2004 | B2 |
6892090 | Verard et al. | May 2005 | B2 |
6895267 | Panescu et al. | May 2005 | B2 |
7132645 | Korn | Nov 2006 | B2 |
7273056 | Wilson et al. | Sep 2007 | B2 |
7344533 | Pearson et al. | Mar 2008 | B2 |
7366562 | Dukesherer et al. | Apr 2008 | B2 |
7366563 | Kleen et al. | Apr 2008 | B2 |
7396354 | Rychnovsky et al. | Jul 2008 | B2 |
7406346 | Kleen et al. | Jul 2008 | B2 |
7515265 | Alfano et al. | Apr 2009 | B2 |
7532920 | Ainsworth et al. | May 2009 | B1 |
7587236 | Demos et al. | Sep 2009 | B2 |
7603166 | Casscells, III et al. | Oct 2009 | B2 |
7729735 | Burchman | Jun 2010 | B1 |
7757695 | Wilson et al. | Jul 2010 | B2 |
7758499 | Adler | Jul 2010 | B2 |
7840253 | Tremblay et al. | Nov 2010 | B2 |
7992573 | Wilson et al. | Aug 2011 | B2 |
8032200 | Tearney et al. | Oct 2011 | B2 |
8054469 | Nakabayashi et al. | Nov 2011 | B2 |
8060187 | Marshik-Geurts et al. | Nov 2011 | B2 |
8073517 | Burchman | Dec 2011 | B1 |
8078261 | Imam | Dec 2011 | B2 |
8187189 | Jung et al. | May 2012 | B2 |
8267932 | Baxter et al. | Sep 2012 | B2 |
8369932 | Cinbis et al. | Feb 2013 | B2 |
8388541 | Messerly et al. | Mar 2013 | B2 |
8571640 | Holman | Oct 2013 | B2 |
8597315 | Snow et al. | Dec 2013 | B2 |
8700358 | Parker, Jr. | Apr 2014 | B1 |
8781555 | Burnside et al. | Jul 2014 | B2 |
8798721 | Dib | Aug 2014 | B2 |
8968331 | Sochor | Mar 2015 | B1 |
8979871 | Tyc et al. | Mar 2015 | B2 |
9060687 | Yamanaka et al. | Jun 2015 | B2 |
9360630 | Jenner et al. | Jun 2016 | B2 |
9504392 | Caron et al. | Nov 2016 | B2 |
9560954 | Jacobs et al. | Feb 2017 | B2 |
9622706 | Dick et al. | Apr 2017 | B2 |
9678275 | Griffin | Jun 2017 | B1 |
10231753 | Burnside et al. | Mar 2019 | B2 |
10327830 | Grant et al. | Jun 2019 | B2 |
10349890 | Misener et al. | Jul 2019 | B2 |
10492876 | Anastassiou et al. | Dec 2019 | B2 |
10568586 | Begin et al. | Feb 2020 | B2 |
10631718 | Petroff et al. | Apr 2020 | B2 |
10992078 | Thompson et al. | Apr 2021 | B2 |
11123047 | Jaffer et al. | Sep 2021 | B2 |
20020198457 | Tearney et al. | Dec 2002 | A1 |
20030092995 | Thompson | May 2003 | A1 |
20040242995 | Maschke | Dec 2004 | A1 |
20050033264 | Redinger | Feb 2005 | A1 |
20050261598 | Banet et al. | Nov 2005 | A1 |
20060013523 | Childlers et al. | Jan 2006 | A1 |
20060036164 | Wilson et al. | Feb 2006 | A1 |
20060189959 | Schneiter | Aug 2006 | A1 |
20060200049 | Leo et al. | Sep 2006 | A1 |
20060241395 | Kruger et al. | Oct 2006 | A1 |
20060241492 | Boese et al. | Oct 2006 | A1 |
20070156019 | Larkin et al. | Jul 2007 | A1 |
20070201793 | Askins et al. | Aug 2007 | A1 |
20070287886 | Saadat | Dec 2007 | A1 |
20070299425 | Waner et al. | Dec 2007 | A1 |
20080039715 | Wilson et al. | Feb 2008 | A1 |
20080082004 | Banet et al. | Apr 2008 | A1 |
20080172119 | Yamasaki et al. | Jul 2008 | A1 |
20080183128 | Morriss et al. | Jul 2008 | A1 |
20080285909 | Younge et al. | Nov 2008 | A1 |
20090062634 | Say et al. | Mar 2009 | A1 |
20090137952 | Ramamurthy et al. | May 2009 | A1 |
20090234328 | Cox et al. | Sep 2009 | A1 |
20090304582 | Rousso et al. | Dec 2009 | A1 |
20090314925 | Van Vorhis et al. | Dec 2009 | A1 |
20100016729 | Futrell | Jan 2010 | A1 |
20100030063 | Lee et al. | Feb 2010 | A1 |
20100114115 | Schlesinger et al. | May 2010 | A1 |
20100286531 | Ryan et al. | Nov 2010 | A1 |
20100312095 | Jenkins et al. | Dec 2010 | A1 |
20110144481 | Feer et al. | Jun 2011 | A1 |
20110166442 | Sarvazyan | Jul 2011 | A1 |
20110172680 | Younge et al. | Jul 2011 | A1 |
20110237958 | Onimura | Sep 2011 | A1 |
20110245662 | Eggers et al. | Oct 2011 | A1 |
20110295108 | Cox et al. | Dec 2011 | A1 |
20110313280 | Govari et al. | Dec 2011 | A1 |
20120046562 | Powers et al. | Feb 2012 | A1 |
20120101413 | Beetel et al. | Apr 2012 | A1 |
20120143029 | Silverstein et al. | Jun 2012 | A1 |
20120184827 | Shwartz et al. | Jul 2012 | A1 |
20120184955 | Pivotto et al. | Jul 2012 | A1 |
20120321243 | Younge et al. | Dec 2012 | A1 |
20130028554 | Wong et al. | Jan 2013 | A1 |
20130096482 | Bertrand et al. | Apr 2013 | A1 |
20130104884 | Vazales et al. | May 2013 | A1 |
20130188855 | Desjardins et al. | Jul 2013 | A1 |
20130204124 | Duindam et al. | Aug 2013 | A1 |
20130211246 | Parasher | Aug 2013 | A1 |
20130296693 | Wenzel et al. | Nov 2013 | A1 |
20130310668 | Young | Nov 2013 | A1 |
20130324840 | Zhongping et al. | Dec 2013 | A1 |
20140121468 | Eichenholz | May 2014 | A1 |
20140221829 | Maitland et al. | Aug 2014 | A1 |
20140275997 | Chopra et al. | Sep 2014 | A1 |
20150029511 | 'T Hooft | Jan 2015 | A1 |
20150031987 | Pameijer et al. | Jan 2015 | A1 |
20150080688 | Cinbis et al. | Mar 2015 | A1 |
20150099979 | Caves et al. | Apr 2015 | A1 |
20150119700 | Liang et al. | Apr 2015 | A1 |
20150190221 | Schaefer et al. | Jul 2015 | A1 |
20150209113 | Burkholz et al. | Jul 2015 | A1 |
20150209117 | Flexman et al. | Jul 2015 | A1 |
20150254526 | Denissen | Sep 2015 | A1 |
20150320977 | Vitullo et al. | Nov 2015 | A1 |
20160018602 | Govari et al. | Jan 2016 | A1 |
20160166326 | Bakker et al. | Jun 2016 | A1 |
20160166341 | Iordachita et al. | Jun 2016 | A1 |
20160184020 | Kowalewski et al. | Jun 2016 | A1 |
20160213432 | Flexman et al. | Jul 2016 | A1 |
20160354038 | Demirtas et al. | Dec 2016 | A1 |
20170020394 | Harrington | Jan 2017 | A1 |
20170079681 | Burnside et al. | Mar 2017 | A1 |
20170082806 | Van Der Mark et al. | Mar 2017 | A1 |
20170196479 | Liu et al. | Jul 2017 | A1 |
20170201036 | Cohen et al. | Jul 2017 | A1 |
20170215973 | Flexman et al. | Aug 2017 | A1 |
20170231699 | Flexman et al. | Aug 2017 | A1 |
20170273542 | Au | Sep 2017 | A1 |
20170273565 | Ma et al. | Sep 2017 | A1 |
20170273628 | Ofek et al. | Sep 2017 | A1 |
20170311901 | Zhao et al. | Nov 2017 | A1 |
20170319279 | Fish et al. | Nov 2017 | A1 |
20180095231 | Lowell et al. | Apr 2018 | A1 |
20180113038 | Janabi-Sharifi et al. | Apr 2018 | A1 |
20180140170 | Van Putten et al. | May 2018 | A1 |
20180235709 | Donhowe et al. | Aug 2018 | A1 |
20180239124 | Naruse et al. | Aug 2018 | A1 |
20180250088 | Brennan et al. | Sep 2018 | A1 |
20180264227 | Flexman et al. | Sep 2018 | A1 |
20180279909 | Noonan et al. | Oct 2018 | A1 |
20180289390 | Amorizzo et al. | Oct 2018 | A1 |
20180289927 | Messerly | Oct 2018 | A1 |
20180339134 | Leo | Nov 2018 | A1 |
20180360545 | Cole et al. | Dec 2018 | A1 |
20190059743 | Ramachandran et al. | Feb 2019 | A1 |
20190110844 | Misener et al. | Apr 2019 | A1 |
20190231272 | Yamaji | Aug 2019 | A1 |
20190237902 | Thompson et al. | Aug 2019 | A1 |
20190307331 | Saadat et al. | Oct 2019 | A1 |
20190321110 | Grunwald et al. | Oct 2019 | A1 |
20190343424 | Blumenkranz et al. | Nov 2019 | A1 |
20190357875 | Qi et al. | Nov 2019 | A1 |
20190374130 | Bydlon et al. | Dec 2019 | A1 |
20200046434 | Graetzel et al. | Feb 2020 | A1 |
20200054399 | Duindam et al. | Feb 2020 | A1 |
20200305983 | Yampolsky et al. | Oct 2020 | A1 |
20200315770 | Dupont et al. | Oct 2020 | A1 |
20210045814 | Thompson et al. | Feb 2021 | A1 |
20210068911 | Walker et al. | Mar 2021 | A1 |
20210298680 | Sowards et al. | Mar 2021 | A1 |
20210244311 | Zhao et al. | Aug 2021 | A1 |
20210268229 | Sowards et al. | Sep 2021 | A1 |
20210271035 | Sowards et al. | Sep 2021 | A1 |
20210275257 | Prior et al. | Sep 2021 | A1 |
20210401456 | Cox et al. | Dec 2021 | A1 |
20210401509 | Misener et al. | Dec 2021 | A1 |
20220011192 | Misener et al. | Jan 2022 | A1 |
20220034733 | Misener et al. | Feb 2022 | A1 |
20220096796 | McLaughlin et al. | Mar 2022 | A1 |
20220110695 | Sowards et al. | Apr 2022 | A1 |
20220152349 | Sowards et al. | May 2022 | A1 |
20220160209 | Sowards et al. | May 2022 | A1 |
20220172354 | Misener et al. | Jun 2022 | A1 |
20220211442 | McLaughlin et al. | Jul 2022 | A1 |
20220233246 | Misener et al. | Jul 2022 | A1 |
20220369934 | Sowards et al. | Nov 2022 | A1 |
20230081198 | Sowards et al. | Mar 2023 | A1 |
20230097431 | Sowards et al. | Mar 2023 | A1 |
20230101030 | Misener et al. | Mar 2023 | A1 |
20230108604 | Messerly et al. | Apr 2023 | A1 |
20230126813 | Sowards et al. | Apr 2023 | A1 |
20230243715 | Misener et al. | Aug 2023 | A1 |
20230248444 | Misener et al. | Aug 2023 | A1 |
20230251150 | Visener et al. | Aug 2023 | A1 |
Number | Date | Country |
---|---|---|
102016109601 | Nov 2017 | DE |
2240111 | Oct 2010 | EP |
3545849 | Oct 2019 | EP |
3705020 | Sep 2020 | EP |
20190098512 | Aug 2019 | KR |
9964099 | Dec 1999 | WO |
1999064099 | Dec 1999 | WO |
2006122001 | Nov 2006 | WO |
2009155325 | Dec 2009 | WO |
2011121516 | Oct 2011 | WO |
2011141830 | Nov 2011 | WO |
2011150376 | Dec 2011 | WO |
2012064769 | May 2012 | WO |
2015074045 | May 2015 | WO |
2016038492 | Mar 2016 | WO |
2016061431 | Apr 2016 | WO |
2016051302 | Apr 2016 | WO |
2018096491 | May 2018 | WO |
2019037071 | Feb 2019 | WO |
2019046769 | Mar 2019 | WO |
WO-2019070423 | Apr 2019 | WO |
2019230713 | Dec 2019 | WO |
2020182997 | Sep 2020 | WO |
2021030092 | Feb 2021 | WO |
2021108688 | Jun 2021 | WO |
2021108697 | Jun 2021 | WO |
2021138096 | Jul 2021 | WO |
2022031613 | Feb 2022 | WO |
2022081723 | Apr 2022 | WO |
2022150411 | Jul 2022 | WO |
2022164902 | Aug 2022 | WO |
2022245987 | Nov 2022 | WO |
2023043954 | Mar 2023 | WO |
2023049443 | Mar 2023 | WO |
2023055810 | Apr 2023 | WO |
2023076143 | May 2023 | WO |
Entry |
---|
PCT/US2018/026493 filed Apr. 6, 2018 International Search Report and Written Opinion dated Jun. 22, 2018. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Non-Final Office Action dated May 29, 2020. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Final Office Action dated Nov. 10, 2020. |
PCT/US2020/044801 filed Aug. 3, 2020 International Search Report and Written Opinion dated Oct. 26, 2020. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Non-Final Office Action dated Mar. 12, 2021. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Final Office Action dated Jun. 30, 2021. |
PCT/US2021/019713 filed Feb. 25, 2021 International Search Report and Written Opinion dated Jul. 6, 2021. |
PCT/US2021/020079 filed Feb. 26, 2021 International Search Report and Written Opinion dated Jun. 4, 2021. |
PCT/US2020/062396 filed Nov. 25, 2020 International Search Report and Written Opinion dated Mar. 2, 2021. |
PCT/US2020/062407 filed Nov. 25, 2020 International Search Report and Written Opinion dated Mar. 11, 2021. |
PCT/US2021/020732 filed Mar. 3, 2021 International Search Report and Written Opinion dated Jul. 5, 2021. |
PCT/US2021/038954 filed Jun. 24, 2021 International Search Report and Written Opinion dated Oct. 28, 2021. |
PCT/US2021/041128 filed Jul. 9, 2021 International Search Report and Written Opinion dated Oct. 25, 2021. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Non-Final Office Action dated Oct. 13, 2021. |
PCT/US2022/011347 filed Jan. 5, 2022 International Search Report and Written Opinion dated May 3, 2022. |
PCT/US2022/013897 filed Jan. 26, 2022 International Search Report and Written Opinion dated May 11, 2022. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Final Office Action dated Apr. 22, 2022. |
PCT/US2021/038899 filed Jun. 24, 2021 International Search Report and Written Opinion dated Oct. 6, 2021. |
PCT/US2021/044216 filed Aug. 2, 2021 International Search Report and Written Opinion dated Nov. 18, 2021. |
PCT/US2021/054802 filed Oct. 13, 2021 International Search Report and Written Opinion dated Feb. 2, 2022. |
U.S. Appl. No. 17/185,777, filed Feb. 25, 2021 Non-Final Office Action dated Feb. 9, 2022. |
PCT/US2020/062396 filed Nov. 25, 2020 International Preliminary Report on Patentability dated Jan. 29, 2021. |
PCT/US2020/062407 filed Nov. 25, 2020 International Preliminary Report on Patentability dated Jan. 25, 2021. |
U.S. Appl. No. 17/105,259, filed Nov. 25, 2020, Notice of Allowance dated Jul. 20, 2022. |
U.S. Appl. No. 17/357,561, filed Jun. 24, 2021 Non-Final Office Action dated Aug. 11, 2022. |
U.S. Appl. No. 17/371,993, filed Jul. 9, 2021 Non-Final Office Action dated Jul. 12, 2022. |
Jackle Sonja et al. “Three-dimensional guidance including shape sensing of a stentgraft system for endovascular aneurysm repair.” International Journal of Computer Assisted Radiology and Surgery, Springer DE. vol. 15, No. 6, May 7, 2020. |
PCT/US2022/029894 filed May 18, 2022, International Search Report and Written Opinion dated Sep. 1, 2022. |
PCT/US2022/043706 filed Sep. 16, 2022 International Search Report and Written Opinion dated Nov. 24, 2022. |
PCT/US2022/044696 filed Sep. 26, 2022 International Search Report and Written Opinion dated Jan. 23, 2023. |
PCT/US2022/045051 filed Sep. 28, 2022 International Search Report and Written Opinion dated Jan. 2, 2023. |
PCT/US2022/047538 filed Oct. 24, 2022 International Search Report and Written Opinion dated Jan. 26, 2023. |
U.S. Appl. No. 15/947,267, filed Apr. 6, 2018 Examiner's Answer dated Nov. 28, 2022. |
U.S. Appl. No. 17/357,561, filed Jun. 24, 2021 Notice of Allowance dated Dec. 9, 2022. |
U.S. Appl. No. 17/371,993, filed Jul. 9, 2021 Notice of Allowance dated Nov. 3, 2022. |
U.S. Appl. No. 17/392,002, filed Aug. 2, 2021, Non-Final Office Action dated Sep. 12, 2022. |
U.S. Appl. No. 17/392,002, filed Aug. 2, 2021, Notice of Allowance dated Jan. 19, 2023. |
Fiber Optic RealShape (FORS) technology—research. Philips. (Oct. 18, 2018). Retrieved Feb. 28, 2023, from https:// www.philips.com/a-w/research/research-programs/fors.html (Year: 2018). |
U.S. Appl. No. 16/984,104, filed Aug. 3, 2020 Restriction Requirement dated Mar. 13, 2023. |
U.S. Appl. No. 17/105,310, filed Nov. 25, 2020 Non-Final Office Action dated Feb. 22, 2023. |
U.S. Appl. No. 17/392,002, filed Aug. 2, 2021, Corrected Notice of Allowability dated Feb. 23, 2023. |
U.S. Appl. No. 17/500,678, filed Oct. 13, 2021 Non-Final Office Action dated Mar. 15, 2023. |
EP 20853352.1 filed Mar. 7, 2022 Extended European Search Report dated Jul. 27, 2023. |
PCT/US2023/019239 filed Apr. 20, 2023 International Search Report and Written Opinion dated Jul. 20, 2023. |
PCT/US2023/026487 filed Jun. 28, 2023 International Search Report and Written Opinion dated Sep. 6, 2023. |
U.S. Appl. No. 16/984,104, filed Aug. 3, 2020 Non-Final Office Action dated Jun. 22, 2023. |
U.S. Appl. No. 17/105,310, filed Nov. 25, 2020 Notice of Allowance dated Aug. 2, 2023. |
U.S. Appl. No. 16/984,104, filed Aug. 3, 2020 Final Office Action dated Sep. 21, 2023. |
U.S. Appl. No. 17/500,678, filed Oct. 13, 2021 Final Office Action dated Sep. 21, 2023. |
Number | Date | Country | |
---|---|---|---|
20210402144 A1 | Dec 2021 | US |
Number | Date | Country | |
---|---|---|---|
63045667 | Jun 2020 | US |