The present disclosure relates to pressure sensing, more specifically, to a flexible pulsation sensor (FPS) device, including a FPS and a flexible circuit, that provides wireless monitoring capability and method for using the FPS device.
Detecting blood flow and blood pressure within a conduit (e.g., a natural vessel or a vascular graft) can help physicians determine the health and safety of the conduit and/or the patient having the conduit. Hypertension (HTN) has been called the silent killer, causing consequences such as vascular disease and end-organ failure in multiple systems. Having a better, more exact, way to detect blood flow and blood pressure may reduce the effects of HTN. Moreover, over one million vascular grafts are implanted in the United States every year to help with many applications, including vascular bypass, vascular access for hemodialysis, etc. However, vascular grafts are vulnerable to failure (e.g., due to intimal hyperplasia where endothelial cell migration leads to reduced diameter in the graft lumen, blood clotting, reduced graft blood flow, and eventual graft occlusion). Detecting blood flow and/or blood pressure within the vascular grafts would help to detect the potential for failure before the failure happens. Testing of blood flow and/or blood pressure would also have utility for microvascular reconstruction where autogenous tissue is harvested from one part of the body with its feeding vessels intact with the intent of reconstructing a defect in another part of the body. The autograft is positioned in the defect and its arteries and veins are then anastomosed to recipient vessels in close proximity to the defect.
Provided herein is a flexible pulsation sensor (FPS) device, including a FPS and a flexible circuit, that provides wireless monitoring capability and methods for using the FPS device. The FPS device can be placed around the outside of conduit (e.g., a vessel, a vascular graft, or the like) and flex with an increase/decrease in blood (or other fluid) pressure within the conduit and also may detect the rate of blood flow within the conduit. The FPS device is superior to previous sensors to detect a change in blood (or other fluid) pressure and/or blood flow because the FPS need not be within the lumen of the conduit.
In one aspect, the present disclosure includes an apparatus (a FPS device). The apparatus includes a FPS configured to wrap around a measurement target (e.g., a conduit, such as a vessel, a vascular graft, or the like) and a flexible circuit board. The flexible circuit board includes a sensor interface circuit on the flexible circuit board configured to collect data related to displacement of the FPS related to a pressure of and/or within the measurement target; and a wireless transmitter on the flexible circuit board configured to transmit the data related to the pressure of and/or within the measurement target wirelessly to an external device.
In another aspect, the present disclosure includes a method for using a FPS device. The method includes wrapping the FPS device around a measurement target; detecting, by the FPS device, a change of a pressure on and/or within the measurement target; and sending, by a wireless transmitter of the FPS device, data related to the change in the pressure to an external device.
The foregoing and other features of the present disclosure will become apparent to those skilled in the art to which the present disclosure relates upon reading the following description with reference to the accompanying drawings, in which:
Unless otherwise defined, all technical terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which the present disclosure pertains.
As used herein, the singular forms “a,” “an” and “the” can also include the plural forms, unless the context clearly indicates otherwise.
As used herein, the terms “comprises” and/or “comprising,” can specify the presence of stated features, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, steps, operations, elements, components, and/or groups.
As used herein, the term “and/or” can include any and all combinations of one or more of the associated listed items.
As used herein, the terms “first,” “second,” etc. should not limit the elements being described by these terms. These terms are only used to distinguish one element from another. Thus, a “first” element discussed below could also be termed a “second” element without departing from the teachings of the present disclosure. The sequence of operations (or acts/steps) is not limited to the order presented in the claims or figures unless specifically indicated otherwise.
As used herein, the term “flexible pulsation sensor (FPS)” can refer to a piezoresistive implantable strain sensor that can be wrapped around a measurement target. For example, the strain sensor can be made of a piezoresistive elastomer composite (e.g., with conductive particles, like conductive nanoparticles, within the elastomer).
As used herein, the term “piezoresistive” can refer to a change in electrical resistance that occurs when an external force is applied. The change affects a material's electrical resistivity.
As used herein, the term “strain sensor” can refer to a sensor whose resistance varies with applied force. The strain sensor can convert force, pressure, tension, weight, etc., into a change in electrical resistance, which can then be measured. The term “pressure sensor” can be used herein interchangeably with “strain sensor” with pressure being but one factor that can change the electrical resistance.
As used herein the term “measurement target” can refer to at least a portion of a conduit from which a parameter can be detected.
As used herein, the term “conduit” can refer to a channel configured to transport a fluid. In some instances, the conduit can have a generally cylindrical or tubular shape. Example conduits include a vascular graft, a vessel, or the like. Other cylindrical or tubular structures may include anything that can be similarly instrumented to measure strain or movement, for example, bones, intestines, or synthetic musculoskeletal implants, or the like for example, bones, intestines, or synthetic musculoskeletal implants, or the like
As used herein the term “vascular graft” can refer to a non-native tissue, a synthetic material, or an autograft, allograft, or xenograft, that is surgically implanted to reconnect blood vessels in order to redirect blood flow from one area to another.
As used herein the term “vessel” can refer to a vein or an artery that naturally forms part of the blood circulation system of the body. In some instances, a vessel may be one or more vessels that are a port of and feed a microvascular free flap that has been moved as an autograft from one part of the body to another.
As used here, the term “composite” can refer to something made up of various parts (e.g., an elastomer composite can be made of an elastomer and particles within the elastomer).
As used herein, the term “elastomer” can refer to a natural or synthetic polymer having elastic properties.
As used herein, the term “particle” can refer to a small piece of a larger material. For example, the particle can be a microparticle (on the micro-scale or less), a nanoparticle (on the nano-scale or less), or even smaller (e.g., a femto particle, on the femto-scale or less).
As used herein, the term “flexible pulsation sensor (FPS) device” can refer to something made or adapted to transmit data recorded by a FPS to an external device. The FPS device can include at least a wireless transmitter or transceiver to communicate with the external device.
As used herein, the term “flexible circuit” can refer to a thin insulating film having conductive circuit patterns affixed thereto (e.g., connecting to a filter, an amplifier, an interface, a wireless transmitter, an analog-to-digital convertor, etc.) and typically supplied with a thin polymer coating to protect the conductor parts.
As used herein, the term “biocompatible” can refer to something that is not harmful to living tissue.
Described herein is a biocompatible flexible pulsation sensor (FPS) device that can be placed/wrapped around a measurement target to monitor a characteristic, such as blood pressure, blood flow, or the like. The measurement target can be a portion of a conduit, like a vessel, a vascular graft, or the like. In some instances, the FPS device can provide continuous monitoring of the characteristic. The FPS device integrates a FPS with a flexible wireless transmitter for real-time data recording and readout. The FPS device can have outstanding flexibility, being made of a conductive polymer sensing layer (e.g., constructed of a piezoresistive elastomer composite) attached to a flexible circuit (e.g., constructed on a flexible polyimide circuit board) with the wireless transmitter (e.g., provided by a low-power microcontroller). The FPS device can be fully encapsulated with polydimethylsiloxane (PDMS) to maintain flexibility and biocompatibility.
Provided herein is an apparatus that provides a flexible sensor (e.g., a flexible pulsation sensor (FPS) 12) device with wireless monitoring capability. The apparatus can be referred to as a FPS device 10. In some instances, the FPS device 10 can transmit data wirelessly to an external device (not shown) for continuous monitoring of blood pressure, blood flow, or the like within a conduit (e.g., vessel, a graft, or the like). In some instances, the FPS device 10 can be configured to wrap around a measurement target (e.g., a portion of a conduit). The size and geometry of the FPS device 10 can be adapted according to a given application and surface of the measurement target.
The FPS device 10 can include a FPS 12 and a flexible circuit 14. The FPS device 10 can be biocompatible with a biocompatible coating (e.g., a layer of polydimethylsiloxane (PDMS)) over both the FPS 12 and the flexible circuit 14. However, any similar biocompatible coating may be used. It should be noted that the flexible circuit 14 can be in any location on or next to the FPS 12. Additionally, the flexible circuit may be continuous and/or may include one or more holes (the holes may include at least a portion of the flexible circuit 14 in some examples).
The FPS 12 can be made of a piezoresistive elastomer composite (shown in the blown out portion of
As one example, the conductive particles 16 can include a matrix of multi-walled carbon nanotubes (MWCNT) dispersed in PDMS. In an example, the FPS 12 can be configured to exhibit an isotropic compliance along a given direction with respect to a direction transverse to the given direction. For instance, the FPS 12 can be strain-sensitive along one direction and exhibit compliance up to about 20% (or greater) in another (strain sensitive) direction such that the FPS 12 is elastically deformable along the direction, but is non-deformable in the other transverse direction. In some instances, the FPS 12 can include the conductive particles 16 (e.g., micron or sub-micron sized, like nanoparticles) dispersed throughout the elastomer 18 to impart a piezoresistive effect and then a conductive polymer placed in one or more layers within a non-conductive polymer to form the FPS 12.
The FPS 12 can be connected to one or more pads of the flexible circuit 14. The flexible circuit 14, as shown in
As shown in
In some instances, the sensor interface 24 can include a bridge circuit that is on the flexible circuit board 22 to measure the displacement of the FPS caused by the pressure of and/or within the measurement target. In some instances, the sensor interface 24 can perform additional data processing tasks on the data received from the FPS 12 and/or the data determined by another sensor mounted on the circuit board, e.g. a pressure sensor. The sensor interface 26 can send the processed data to the wireless transmitter 26.
The wireless transmitter 26 can be configured for data transmission (and in some instances, reception). In other words, the wireless transmitter 26 can always be configured to transmit data to an external device, but in some instances, can be configured to receive instructions from the external device. For example, the wireless transmitter 26 can be configured for short range transmission (or reception). For example, the wireless transmitter 26 may be implemented as an inductive communications link or according to another wireless technology, such as 802.11x Wi-Fi, Bluetooth, ZigBee, cellular or the like that can communicate the data to external device. For example, the external device may be smart phone, server or other wireless receiver.
The circuit elements of
As shown in
As shown in
In some instances, the wireless transmitter can be bi-directional and receive instructions from the external device. As an example, the instructions can be related to a sleep/wake characteristic of the FPS device 10. The sleep/wake signal 54 can be received and the sensor interface 24 and microcontroller 52 can begin recording the pressure detected by the FPS 12 (until receiving a stop or sleep signal). In some instances, the sleep/wake signal 54 can conserve battery of the FPS device 10.
Referring now to
The following description refers to the conduit 60 being a synthetic graft. It should be noted that the FPS device 10 is flexible such that the FPS device 10 can be applied separately from the graft and allows use on native vessels because the FPS device 10 can be applied operatively without crushing the vessel or during graft implantation procedures to remain implanted. To realize such capabilities, the FPS device 10 includes piezoresistive elastomer composites as the FPS 12 transduction material (e.g., a composite of PDMS and conductive nanoparticles can provide a robust piezoresistive strain response). The flexible circuit 14 can provide for wireless transmission on a flexible circuit board 22. The flexible circuit 14 can be bonded to the conductive PDMS composite.
In
For example, the graft includes a sidewall that extends cylindrically between two ends. In this example, the FPS device 10 can be mounted around the sidewall as to circumscribe (partially or wholly) the graft. The FPS device 10 may be mounted to the graft such that a radially inner surface (e.g., bottom layer) of the FPS device 10 approximates the outer diameter of the sidewall. The FPS 12 can have a compliance that is commensurate with or greater than the compliance of the sidewall of the graft or the vessel. In this way, deformation of the sidewall, such as occurs in the pulsation of blood flow therethrough, results in corresponding deformation of the FPS 12.
As another example, the circumference of the FPS device 10 that engages the graft sidewall corresponds to a length of the apparatus that can be wrapped around or otherwise mounted to the sidewall (e.g., by sutures, an adhesive or the attachment mechanism). Since the FPS device 10 is fixed externally to the graft, the sensor apparatus can monitor graft motion based on the electrical resistance of the conductive layer, which changes based on deformation. As mentioned, the substrate and conductive layers may be anisotropically compliant to enable radial or circumferential deformation but prevent deformation in the axial dimension (along its width). As a result, the deformation causes a change in resistance that correlates to flow rate and/pressure through the graft. As a result, the FPS device 10 can enable detection of graft dysfunction without adversely affecting blood flow through the graft. In other examples, one or more FPS devices 10 can be attached to the sidewall of other tissue to monitor other tissue function. A compliant covering of a compliant biocompatible material further may be applied over the sensor apparatus and a portion of the adjacent sidewall.
Graft wall motion can be monitored based on the data measured by the FPS device 10. In response to detecting an increase or a decrease in graft wall motion above or below an established threshold, an occurrence of a dysfunction may be determined, such as an occlusion, stenosis or other physiological condition. An alert can be generated (e.g., by the external device) in response to determining the dysfunction. The alert may be communicated to the patient and/or one or more caregivers. In this way, additional testing may be performed to determine if an intervention may be required to avoid graft failure and extend graft patency.
The following description refers to the conduit 60 being any vessel, such as an artery, a vein, or an autograft, as described herein. The FPS device 10 can be applied operatively to the vessel without crushing the vessel, or otherwise impeding blood or fluid flow, by wrapping the FPS at least partially around the vessel. If the FPS device 10 is wrapped all the way around the vessel, then the two ends of the FPS device can be brought into apposition and attaching them together (e.g., threading sutures through holes on one or both ends of the FPS device, an adhesive to connect the two ends, a mechanical attachment, including a button, a ratchet, other types of mechanisms, or the like). If the FPS device 10 is wrapped only partially around the vessel, then the device may be attached to the vessel with any known means (adhesive, operative, mechanical, etc.). It should be noted that the FPS device 10 that is placed on a vessel has a commensurate or greater compliance than the vessel it is placed on so that the FPS device 10 can wrap around the vessel without causing constriction. An FPS device 10 that is wrapped around a vessel is about 2 times, 4 times, 6 times, 8 times, or 10 times or more flexible than an FPS device 10 that is placed on a synthetic graft. To realize such capabilities, the FPS device 10 includes piezoresistive elastomer composites as the FPS 12 transduction material (e.g., a composite of PDMS and conductive nanoparticles can provide a robust piezoresistive strain response). The flexible circuit 14 can provide for wireless transmission on a flexible circuit board 22. The flexible circuit 14 can be bonded to the conductive PDMS composite.
In
Similar to the graft example discussed above, the FPS device 10 can circumscribe (partially or wholly) the vessel with a radially inner surface (e.g., bottom layer) of the FPS device approximating the outer diameter of a sidewall of the vessel. Because the FPS device 10, and FPS 12, has a compliance that is commensurate or greater than the compliance of the vessel it will not crush the vessel and can correspondingly deform with the sidewall based on the blood flow through the vessel. The piezoresistive nature of the FPS device 10 is important for more accurate measurements of blood pressure and/or heart rate than capacitive sensors can manage because the small capacitance changes created by the pulsatile flow of blood in an vessel past a capacitive sensor are difficult to near impossible to measure accurately due to the parasitic capacitance of the lead itself.
The FPS device 10 and the FPS 12 can be used for many applications, including monitoring hypertension, blood pressure, and other anatomical pressures. The FPS device 10 can be used as a standalone sensor for monitoring blood pressure, as an example. As another example, the FPS device 10 can be used to monitor pressure after endovascular surgery, transplant, hemodialysis vascular access, or the like. As a further example, the FPS device 10 can be used as a diagnostic. As an example, the FPS 12 can be used diagnostically as a long term Holter monitor replacement for patients with difficult to diagnose heart ailments, such as an arrhythmia or other electrical abnormality. The FPS device 10, as another example, can measure aspects of pulse pressure waves, such that physiologic activity can be indirectly gauged from the sensor.
Additionally, as a further example, the FPS device 10 can have GI applications, like measuring intestinal peristaltic pressure and may be applicable in devices that limit gastric emptying or as part of a device that is intended to go around the lower esophageal sphincter to limit gastro-esophageal reflux.
Another aspect of the present disclosure can include an example method 70 (shown in
At step 72, a FPS device can be wrapped around a measurement target (e.g., as shown, for example, in
At 74, a change of a pressure on and/or within the measurement target can be detected (e.g., by the FPS device 10). As noted, the change of the pressure (or the pulsation) can be reflected in a displacement of the FPS. At 76, data related to the change in the pressure can be sent to an external device (e.g., by a wireless transmitter 26 of the FPS device 10).
The following experiment shows that a flexible pulsation sensor (FPS) device can be integrated with a flexible wireless transmitter for real-time data readout to form a “FPS device”. A conductive polymer sensing layer was attached to a flexible circuit board and then encapsulated by polydimethylsiloxane (PDMS) for biocompatibility. Due to the FPS' outstanding flexibility in comparison to natural arteries, veins, and synthetic vascular grafts, the FPS device can be wrapped around target conduits to monitor blood pressure for short-term surgical and long-term implantation purposes. In this experiment, the power spectrum of the FPS data was analyzed to determine the ideal bandwidth of the wireless FPS device to preserve heart rate and hemodynamic waveforms while rejecting noise. The following experimental results are shown for the purpose of illustration only and are not intended to limit the scope of the appended claims.
The power spectrum of previously collected FPS data was analyzed to determine the ideal bandwidth of the wireless FPS device to preserve heart rate and hemodynamic waveforms while rejecting noise. By analyzing the power spectrum density of data collected previously, signals below 2 Hz contained more than 95% of the power (
The FPS interface amplifier (
Wireless readout from the sensor was enabled using a low-power microcontroller with integrated analog-to-digital converter (ADC) and data signal modulator peripheral (DSM). The FPS resistance change was measured by a bridge circuit, amplified and filtered, and digitized by the ADC to 8-bit resolution at 100 samples/s. A digital decimation filter reduced the data rate to 33 Hz. Data were then transmitted every 100 ms to save power; each transmission included 3 sequential samples within a data packet. Transmission used Manchester-encoded on-off-keying of a 4 MHz carrier using the DSM. A resonant LC circuit with a matching capacitor was used to enable short-range inductive communication to an external data receiver.
The microcontroller software was designed to transmit data continuously for 15 minutes before entering a low-power sleep state. The wireless FPS was activated from sleep by applying a large RF pulse which was received by the inductive antenna to trigger a wake-from-sleep interrupt. This activation system is needed to save power in an implanted application. However, for demonstration in wired leads were soldered to the device instead of a battery.
The fabrication process of the conductive PDMS sensing layer was modified in order to connect the FPS to the flexible circuit board. First, a pure PDMS substrate (Ecoflex 00-10) was fabricated on a flexible transparency film. Complete degassing was needed in this step to ensure there were no air bubbles in the substrate. Next, a rectangular hole with the same size of the flexible circuit board was cut into the substrate. The flexible circuit board was designed with circuitry on the front side and connection pads for the FPS on the back; electroless nickel followed by immersion gold plating was used to provide a gold contact layer to the conductive sensor composite. The flexible circuit board was placed in the rectangular hole with the side of FPS contact pads facing up. A stencil was then placed and aligned on the PDMS substrate and conductive PDMS paste was cast over the stencil. After removing the stencil and curing for 30 minutes at 80° C., another layer of pure PDMS was applied and cured over the FPS and flexible circuit board. The sandwich structure was carefully peeled off, flipped and placed on a glass slide. At this time, the conductive sensing layer was reliably connected to the flexible circuit board and the other side of the board was exposed for the soldering of electronic components. Solder paste (Indium 8.9E) was then applied under microscope using a dispensing tool (Nordson EFD X100), following by component placement and reflow soldering (Puhui T-962). Two stainless steel wires were soldered to the board for connections to a power supply (BK Precision 1550). Then, small drops of medical grade epoxy (Loctite EA M-121 HP) were applied to the soldering joints to mechanically protect the soldering and to act as moisture barriers. Finally, another layer of pure PDMS was cast over the flexible board as the encapsulation. Pictures of the prototype device in different fabrication stages are shown in
After fabrication, the FPS was connected to a 3 V power supply and wrapped around a 6-mm silicone tube simulating a peripheral blood vessel for testing (
The prototype was tested under different pressure settings by changing the driven voltage of the diaphragm pump from 4-10 V, producing flow rates of 200-700 mL/minute and systolic-diastolic pressures of 70-190 mmHg in the vascular phantom.
As demonstrated in the Second Experiment described below, a flexible pulsation sensor (FPS) can accurately measure changes in blood pressure.
A cadaveric adult Yucatan minipig weighing approximately 30 kg was used in this experiment. The neck of the minipig was dissected to expose the carotid arteries and the carotid sinus nerve (shown in
The pulsatile pump was connected to the artery with a silicon tube, which was connected to the artery with a barbed coupler up-stream of the FPS's location. The silicon tubing was approximately 2.2 m long, with a pressure reference sensor (to measure reference pressure) located approximately 20 cm up-stream of the barbed coupler.
A wireless data transmitter was attached to the FPS and positioned near the artery (
Example data was recorded that showed correlations in flow- and heart-rate measures from the reference pressures sensor and the FPS on the internal carotid artery, graphs include filtered and not filtered data (
There was a high correlation between data collected from the pressure reference sensor on the tubing and the data collected from the FPS. Because the FPS data was not calibrated it was expressed in arbitrary units (AU). A modeled heart rate could be clearly distinguished by the FPS. Additionally, lower FPS sensitivity would be due to the FPS being too tightly wrapped around the artery.
From the above description, those skilled in the art will perceive improvements, changes and modifications. Such improvements, changes and modifications are within the skill of one in the art and are intended to be covered by the appended claims. All patents, patent applications, and publications cited herein are incorporated by reference in their entirety.
This application claims the benefit of U.S. Provisional Application No. 63/077,808, entitled “FLEXIBLE PRESSURE SENSOR WITH WIRELESS MONITORING CAPABILITY”, filed 14 Sep. 2020 and U.S. Provisional Application No. 63/223,653, entitled “FLEXIBLE PRESSURE SENSOR WITH WIRELESS MONITORING CAPABILITY”, filed 20 Jul. 2021. The entirety of these provisional applications is hereby incorporated by reference in its entirety.
Filing Document | Filing Date | Country | Kind |
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PCT/US2021/050282 | 9/14/2021 | WO |
Number | Date | Country | |
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63077808 | Sep 2020 | US | |
63223653 | Jul 2021 | US |