Patent Application
20200113448
The present invention is in the field of hemodynamic sensing, especially in the sensing of blood flow related parameters. In particular, it relates to an intravascular blood flow sensor for measuring blood flow inside a blood vessel, to an intravascular blood flow sensor system, and to a method for operating an intravascular blood flow sensor system.
US 2014/0276137 A1 describes systems and methods for determining coronary flow reserve (CFR) using a flow reserve index obtained at rest and during hyperemia. A method described therein includes obtaining a resting value for a flow reserve index from a patient, obtaining a hyperemic value for the flow reserve index from the patient, computing the coronary flow reserve based on the resting value and the hyperemic value, and providing the coronary flow reserve to a user.
It would be desirable to provide an alternative way for determination of a blood flow quantity.
According to a first aspect of the present invention an intravascular flow sensor is provided. The intravascular flow sensor comprises:
The direction in which the flagellum is elastically deformable, and which is perpendicular to the main direction of intravascular blood flow is hereinafter referred to as direction of deformability.
The intravascular blood flow sensor of the first aspect of the invention is advantageously configured to provide a vibration sensor signal that comprises a vibration sensor signal component caused by blood flow oscillations of intravascular blood flow.
The vibration sensor comprises a flagellum. The flagellum of the vibration sensor extends from the catheter or guidewire of the intravascular blood flow sensor in the main direction of intravascular blood flow and is elastically deformable in the direction perpendicular to the main direction of intravascular blood flow by the blood flow oscillations. The flagellum is elastically deformable, or in other words, floppy, so as not to pose any risk of damage to vascular tissue.
In the following, embodiments of the first aspect of the present invention will be described. These different embodiments are based on different techniques for providing the vibration sensor signals. In particular embodiments, the intravascular blood flow sensor is suitable for generating and providing a vibration sensor signal in response to blood flow oscillations generated by vortices propagating along a main direction of intravascular blood flow.
The blood flow in the coronary arteries has a reported Reynolds number between 50 and 1000. The subject embodiments make use of the per-se known fact that fluids having Reynolds numbers typically larger than 50 tend to exhibit vortex shedding when the fluid moves past a suitably shaped bluff barrier. Such a barrier can form a part of the intravascular blood flow sensor. In some embodiments, such suitably shaped part is a bluff or a barrier on or in its body. In other embodiments, such a bluff barrier is formed by the whole body of the intravascular blood flow sensor. However, this is not a necessary requirement. In other embodiments, however, the intravascular blood flow sensor has a body of streamlined shape. In some such embodiments, causes for generating blood flow oscillations are not related to the shape of the blood flow sensor. In particular, naturally-occurring non-streamlined parts of a blood vessel including narrowings or turns of the blood vessel can create blood-flow oscillations, and also vortices. Since no naturally-occurring blood vessel is shaped perfectly straight, some vortex shedding is expected to occur in nearly every blood vessel used for intravascular measurements.
Vortex shedding, as mentioned, describes a periodic formation of vortices, also known as Kármán vortices, behind the bluff, wherein “behind” refers to a view in a main direction of blood flow. The vortices propagate along a main direction given by the blood flow direction. At any given time, the vortices are distributed showing a respective spatial distribution. Generally, vortex-generated blood flow oscillations of intravascular blood flow can be detected in a direction substantially perpendicular to a main direction of blood flow along the blood vessel.
As mentioned, in some embodiments of the intravascular blood flow sensor, the guidewire or catheter comprises a bluff part that is shaped for generation of vortices propagating along the main direction of intravascular blood flow. The presence of the bluff part thus further enhances the generation of vortices in the intravascular blood flow. The bluff part may in different embodiments be a part of an intravascular micro-catheter.
The intravascular blood flow sensor can be implemented as an add-on device that can be mechanically and electrically mounted to a guidewire or catheter shaft. In preferred embodiments of intravascular guidewires or catheters comprising the bluff part, however, the bluff part forms an integral part of the guidewire or catheter body.
In some embodiments, the flagellum is less deformable in a second direction perpendicular to the main direction of intravascular blood flow than in the direction of deformability. The flagella of these embodiments therefore have a preferred direction of deformability among the directions that are perpendicular to the intravascular blood flow. In some of these embodiments, the flagellum, in a non-deformed state, has a flat shape with a thickness in the direction of deformability that is smaller than a length extension in the main direction of intravascular blood flow and smaller than a width extension in a direction perpendicular to the direction of deformability and to the main direction of intravascular blood flow. By having a flat shape, wherein the thickness of the flagellum is smaller than its width and its length, the flagellum shows a preferred direction of deformability as a response to the generated vortices. Thus, a rotation of a flat flagellum around an axis of rotation determined by longitudinal direction of the catheter or guidewire has an influence on the vibration sensor signal. Preferably, in some of these embodiments, the length of the flagellum in the main direction of intravascular blood flow is at least five times longer than its width, which in turn is at least five times longer than its thickness.
In one group of embodiments of the intravascular blood flow sensor, the flagellum is made of an electro-active polymer material. A flagellum of this kind is configured to generate and provide the vibration sensor signal in the form of a time-varying electrical signal having an amplitude depending on a current deformation amount in the direction perpendicular to the main direction of intravascular blood flow. From the oscillating amplitude of this electrical signal as a function of time, a frequency of the oscillation can be determined.
Alternatively, an optoelectronic solution can be employed to measure the oscillation frequency. An example of embodiments of this kind has an optical fiber segment forming the flagellum, configured to receive and guide light to and from a reflective fiber-segment tip. Thus, a modulation of light intensity reflected from the fiber-segment tip provides an electrical vibration sensor signal that can be used for evaluation of the oscillation frequency of the blood flow oscillations.
In some embodiments, for creating vortex-generated blood flow oscillations, the bluff part preferably comprises a barrier section that protrudes from the guidewire or catheter in the direction perpendicular to the main direction of intravascular blood flow. In particular embodiments, the barrier section forms a bluff body section, such as a ball-shaped body section. Generally, any non-streamlined shape can be used to encourage the formation of the vortices.
According to a second aspect of the present invention, an intravascular blood flow sensor system is provided. The intravascular blood flow sensor system comprises an intravascular blood flow sensor according to the first aspect of the invention or any of its embodiments and a signal processing unit for determining a value of a blood flow quantity characterizing blood flow inside a blood vessel. The signal processing unit comprises:
The signal processing unit for determining a value of a blood flow quantity characterizing blood flow inside a blood vessel allows a particularly fast, easy, and reliable determination of a blood flow quantity. This applies not only, but in particular, to those embodiments where the blood flow oscillations are vortex-generated blood flow oscillations.
The signal processing unit of the blood flow sensor system of the second aspect of the invention is based on the recognition that blood flow quantities can be determined using a vibration sensor signal, and in particular a vibration sensor signal component that is caused by vortex-generated blood flow oscillations of intravascular blood flow. With a suitable intravascular device that influences the flow pattern and velocity of blood flow, turbulences in the blood flow are caused which are indicated by the vibration sensor signal component. While known principles of flow sensor operation try to minimize this effect by using streamlined shapes and minimizing the size of the intravascular device, the inventor found out that it is in fact possible to use vibration sensor signals indicative of such disturbances in the blood flow caused by the intravascular device or (and) the vessel structure to determine blood flow quantities such as a blood flow velocity with the aid of the signal processing unit of the blood flow sensor system of the second aspect of the invention.
The flow determination of particular embodiments makes use of the fact that the frequency of blood flow oscillations, in particular in the case of vortex shedding, is a measurable quantity that is related to the flow velocity by parameters known as the Strouhal number and the characteristic size of the blood vessel guiding the blood flow.
In particular, the signal processing unit receives, at a vibration sensor signal input, the vibration sensor signal from a vibration sensor of the intravascular blood flow sensor. The vibration sensor is not part of the signal processing unit. It may form a part of an external blood flow sensor that provides the vibration sensor signal to the signal processing unit. In the signal processing unit, the blood flow determination unit is connected to the vibration sensor signal input and determines, using the vibration sensor signal, the vibration sensor signal component that is caused by the blood flow oscillations of intravascular blood flow. Blood flow oscillations that are suitably generated inside the vessel, not only those generated by the vortices, cause a vibration sensor signal component of the vibration sensor signal. Other signal components include those caused for example by blood flow alterations due to heartbeat, or by relative movement of the intravascular blood flow sensor with respect to the living being in whose vessel the sensor is located.
The blood flow determination unit also determines, using the vibration sensor signal component, an oscillation frequency of the blood flow oscillations, and further determines and provides the value of the blood flow quantity, using the determined oscillation frequency.
Thus, a new source of information on blood flow quantities is opened up by the by signal processing unit of the present invention. In the following, embodiments of the signal processing unit will be described.
In the following, embodiments of the intravascular blood sensor system of second aspect of the present invention will be described. These embodiments share the respective advantages of the corresponding embodiments of the first aspect of the invention.
Several blood flow quantities are known, which can be determined using the signal processing unit of the blood flow sensor system of the second aspect of the invention. For instance, a volume flow quantity, given for instance in units of in ml/s, or a flow velocity quantity, expressed in units of m/s, or a coronary flow reserve (CFR) can be determined.
In some embodiments of the intravascular blood flow sensor system, the blood flow determination unit of the signal processing unit comprises a signal transformation unit, which is configured to determine a frequency-domain representation of the vibration sensor signal received during a predetermined measuring time span and to determine the oscillation frequency of the (vortex-generated or other) blood flow oscillations using the frequency-domain representation. The frequency-domain representation can be determined and provided for instance by a signal transformation unit applying a Fourier transform, suitably a Fast Fourier Transform (FFT) of the received vibration sensor signal.
For vortex-generated oscillations and typical coronary flows and geometry, an oscillation frequency associated with the vortices of a few 100 Hz is to be expected. However, this will be superimposed with other frequencies caused by heart beat (around 1 Hz) or other disturbances. In preferred embodiments, therefore, the blood flow determination unit of the signal processing unit comprises a filter unit configured to filter out frequency components of the vibration sensor signal that are associated with a heartbeat frequency. In one example, after subjecting the vibration sensor signals to an FFT all frequency components of the vibration sensor signal smaller than 100 Hz are attenuated or fully eliminated from the vibration sensor signal by the filter unit. The remaining vibration sensor signal components in the desired frequency range can then be used to identify a frequency component associated with the oscillations. Suitably, the vibration sensor signal component having the strongest amplitude to the remaining filtered signal comprising frequency components above 100 Hz can be identified as that associated with the blood flow oscillations of interest, such as vortex-generated blood flow oscillations. Thus, by providing a frequency filtering, it is made sure that the frequencies significant for determination of the blood flow quantity are identified and selected for further signal processing.
In order to provide an absolute value of a blood flow velocity as the value of the blood flow quantity, geometrical data such as a characteristic size of the blood vessel at a measurement position of the vibration sensor is provided in some embodiments. In such embodiments, the blood flow determination unit is preferably further configured to hold or receive the geometrical data indicative of the characteristic size of the blood vessel at the intravascular position of the vibration sensor. In general, for intravascular applications, the can be characteristic size is equivalent to a hydraulic diameter, which is a common quantity used in the characterization of flow in channels of non-circular cross section. For blood vessels of nearly circular diameter, the hydraulic diameter can be approximated by the diameter of the tube or channel.
In some embodiments, the blood flow determination unit is further configured to hold or receive geometrical data indicative of a characteristic size of the blood vessel at a current intravascular position of the vibration sensor during measurement. The geometrical data is in some embodiments held or stored in a storage unit, whereas in other embodiments, the geometrical data is received by an input unit. The input unit may for instance be a user interface allowing manual input of the geometrical data. In yet other embodiments, the geometrical data is provided by an external image-processing device configured to determine the characteristic size from image data taken of the blood vessel in-situ, i.e., at the current intravascular position of an intravascular blood flow sensor comprising the vibration sensor.
In some of these embodiments, the blood flow determination unit is configured to determine and provide, using the determined oscillation frequency of the vortex-generated blood flow oscillation and the geometrical data, the value of the blood flow quantity as a flow velocity according to:
wherein
v is the flow velocity;
f is the determined oscillation frequency of the vortex-generated blood flow oscillation;
d is the characteristic size of the blood vessel; and
S is a constant representing the Strouhal number applicable to blood flow in the given blood vessel.
The Strouhal number is a dimensionless number that describes oscillating flow mechanisms. For a range of Reynolds number covering the interval applicable for blood, the Strouhal number is suitably approximated by a constant value, suitably a value of 0.2. At this value of the Strouhal number, oscillations in fluid flow are characterized by a buildup and subsequent rapid shedding of vortices in the presence of a bluff inside the blood vessel, such as a suitably shaped blood flow sensor according to the first aspect of the invention.
Experimental data obtained by the inventor show that the above equation is a useful approximation also in situations where blood flow oscillations are not caused by a bluff part on the catheter or guidewire, but for instance by bluffs formed by non-streamlined parts of a blood vessel, such as narrowings or turns of the blood vessel. Also in such cases the oscillation frequency exhibits an approximately linear dependence on the flow velocity.
Other embodiments of the intravascular blood flow sensor system of the second aspect make use of the recognition of the present invention that relative changes in blood flow over time allow determining values of a flow velocity ratio despite an unknown geometry and size of the blood vessel, in which the blood flow is to be measured. In particular, the invention has recognized that use can be made of the fact that the parameters required for determining the value of the blood flow quantity the characteristic size of the blood vessel, are sufficiently stable over time, even if not known in absolute values, as long as the intravascular device is not moved during the measurement. This recognition opens up embodiments of blood flow measurements, in which the vibration sensor provides respective vibration sensor signals comprising the vibration sensor signal component caused by vortex-generated or other blood flow oscillations of intravascular blood flow measured at two different measuring times. In such embodiments, the signal processing unit, which receives the vibration sensor signals, is configured to determine respective oscillation frequencies of the blood flow oscillations at at least two different measuring times and to determine and provide as an output a frequency ratio of the determined oscillation frequencies at the two measuring times as the value of the blood flow quantity. The determination of a frequency ratio (r) of the determined oscillation frequencies at the two measuring times, allows direct conclusions on blood flow quantities such as a flow velocity ratio or, in particular embodiments, a coronary flow reserve (CFR) with particular ease and reliability. In particular, based on the applicability of the assumptions explained above, the flow velocity ratio is identical to the ratio of the measured oscillation frequencies at two different times, as it is show in the following equation:
wherein
vA and vB are values of blood flow velocities of blood inside the vessel at two different times A and B; and
fA and fB are oscillation frequencies determined at the two different times.
Such blood flow quantities provide important information regarding the current physiological state of a blood vessel, and advantageously assist in particular in the identification and quantitative characterization of a stenosis or of the coronary microcirculation.
As mentioned, the signal processing unit of one embodiment is configured to determine a value of a coronary flow reserve (CFR) from the frequency ratio, using respective received vibration sensor signals at a first measuring time corresponding to a state of normal blood flow, in particular at a time of rest of the patient, and at a second measuring time corresponding to a state of hyperemia. The blood flow determination unit is configured to determine and output, in particular display a value of a coronary flow reserve from the frequency ratio the CFR value by determining the ratio between the oscillation frequencies determined for the two different states. However, this is only a special example. Any other flow velocity ratio may be determined using corresponding measurements at any two different states, generally referred to as a state A and a state B.
In some of these embodiments, the blood flow determination unit is configured to determine the frequency ratio of the determined oscillation frequencies at the two measuring times as an average value from frequency ratios of the determined oscillation frequencies at respective two measuring times of a plurality of measurement iteration cycles. This can be done by measuring the vibration sensor signal over one heart cycle or multiple heart cycles or in a time resolved way. Generally, and especially where the CFR shall be determined and state A is a state of normal blood flow and state B a state of hyperemia, it is better for the patient to induce each state only once and perform a respective plurality of measurements for obtaining a suitable number of frequency samples in each of the two states A and B. If circumstances allow, the measurements may be determined by performing two or more iteration cycles, i.e., iteratively changing between the states A and B.
To provide a user with a possibility to control the individual measuring times, the signal processing unit of some embodiments additionally comprises a user interface. The user interface is preferably configured to allow a user triggering a measurement and providing a first vibration sensor signal associated with a first measuring time. The blood flow determination unit, in response to receiving the user input, is configured to receive a sequence of vibration sensor signals at different measuring times, and to determine and provide the frequency ratio of the determined oscillation frequencies for the given measuring times with respect to the oscillation frequency determined from the first vibration sensor signal. Typically, in operation of signal processing unit, a user such as medical staff selects the first measuring time and from then on the signal processing unit provides the current value of the blood flow quantity as relative values. In other embodiment, the user marks both measuring times corresponding to states A and B by suitable user input.
In some of these embodiments, the signal processing unit is further configured to provide relative changes in blood flow over time in comparison with a user-defined reference point in time. In such embodiments, the signal processing unit, in response to receiving the user input, is suitably configured to receive a sequence of vibration sensor signals, beginning at the user-defined first measuring time and then at subsequent measuring times after the first measuring time, which may be quasi-continuous or determined automatically by a preset sampling frequency. The signal processing unit determines and provides the respective frequency ratio of the determined oscillation frequencies for the different measuring times with respect to the oscillation frequency determined from the first vibration sensor signal. In other words, the user can select the first measuring time or first measuring time span for which the blood flow is to be considered 100%, and the signal processing unit will after that determine and provide current blood flow as relative values with reference to the blood flow at that selected first measuring time.
In other embodiments, the intravascular blood flow sensor system further comprises a signal communication unit configured to receive the vibration sensor signals and to transmit the vibration sensor signals via a wireless carrier signal to the signal processing unit. In these embodiments, the signal processing unit is further configured to extract the vibration sensor signals from the carrier signal.
The signal processing unit is preferably located outside a guidewire or catheter comprised by the intravascular blood flow sensor. When implemented as such a unit of an external control and/or evaluation device that is not for intravascular insertion, the signal processing unit is suitably provided in the form of a programmed processor unit and configured to be in communicative connection with the vibration sensor during intravascular operation for receiving the vibration sensor signals via a wired or wireless communication channel, implementations of which are per se known in the art. Thus the intravascular part of the intravascular blood flow sensor also comprises suitable communication unit for wired or wireless communication of the vibration sensor signals.
Thus, in some of these embodiments, the intravascular blood flow sensor additionally comprises a signal communication unit that is configured to receive the vibration sensor signals and to transmit the vibration sensor signals as a wired or wireless, i.e., electrical or electromagnetic signal to the signal processing unit, in particular using a suitable carrier signal where useful. In these embodiments, the signal processing unit is further configured to extract the vibration sensor signals from the carrier signal. Different embodiments make use of different wireless communication techniques, such as those based on any of the IEEE 802.11 standards (WiFi, WLAN), ZigBee, Bluetooth, wireless communication in an infrared frequency band, etc. The choice of the wireless communication technique inter alia depends on whether the signal communication unit is for intravascular use or for use outside the living being. In the former case, wireless radio communication techniques such are preferred. In the latter case, other wireless communication techniques such as those based on infrared data transmission may also be used.
In other embodiments, the intravascular blood flow sensor is arranged on or embedded in an intravascular ultrasound device for intravascular ultrasound imaging.
In some embodiments of the intravascular blood flow sensor system of the second aspect in which the intravascular blood flow sensor comprises an optical fiber segment configured to receive and guide light to and from a reflective fiber-segment tip, the intravascular blood flow sensor system further includes:
Thus, a modulation of light intensity reflected from the fiber-segment tip provides an electrical vibration sensor signal that can be used for evaluation of the oscillation frequency of the blood flow oscillations.
According to a fourth aspect of the present invention, a method for controlling operation of an intravascular blood flow sensor system for determining a value of a blood flow quantity characterizing blood flow inside a blood vessel is provided. The method comprises:
The method of the fourth aspect shares the advantages signal processing unit of the first aspect and of the intravascular blood flow sensor of the second aspect of the invention.
The method of the fourth aspect is in particular embodiments applied in the control of an intravascular blood flow sensor system that determines the value of the blood flow quantity based on a vibration sensor signal component caused by vortex-generated blood flow oscillations of intravascular blood flow.
A fifth aspect of the present invention is formed by a computer program comprising executable code for performing a method of the fourth aspect of the invention when executed by a programmable processor of a computer.
It shall be understood that the intravascular blood flow sensor of claim 1, the intravascular blood flow sensor system of claim 8 and the method for operating a signal processing unit for determining a value of a blood flow quantity characterizing blood flow inside a blood vessel of claim 15 have similar and/or identical preferred embodiments, in particular, as defined in the dependent claims.
It shall be understood that a preferred embodiment of the present invention can also be any combination of the dependent claims or above embodiments with the respective independent claim.
These and other aspects of the invention will be apparent from and elucidated with reference to the embodiments described hereinafter.
In the following drawings:
Generally, vortex shedding is known per se as an oscillating flow that occurs under suitable circumstances when a fluid flows past a bluff body. The parameters relevant for vortex shedding to occur comprise a viscosity of the fluid, a flow velocity, as well as a size and shape of the object. The former can be characterized, for example, by a Reynolds number. The vortex shedding induced by the presence of the bluff body 100.b in the blood flow 102 generates a so-called Kármán vortex street 104.b downstream of the bluff body 100.b. Existing vortices propagate to positions further away from the bluff body along the main direction of blood flow indicated by the arrows 102, while new vortices are generated close to the body 100.b. Vortices are generated at alternating sides of the body and are associated with oscillations in the blood flow in a direction perpendicular to the main flow direction. At a given time, the vortices generated are distributed as exemplarily shown in
It is noted that the use of vortex-generated blood flow oscillations forms an advantageous embodiment. However, blood flow oscillation generated by other causes can be used to the same effect in other embodiments. The generation of such blood flow oscillations may be due to the inserted guidewire or catheter, or it may be due to intrinsic causes such as the geometry of the blood vessel. The present description of embodiments with reference to the drawings focuses in some parts on the example of vortex-generated oscillations without intention to thereby restrict the scope of the invention to such cases.
The guidewire body 204 may have a rotational symmetry along its longitudinal direction, which in
The tip section 204.1 includes a vibration sensor 206. The vibration sensor 206 comprises a flagellum 206.1 extending from a front surface of the tip section 204.1 in the main direction L of the intravascular blood flow. The flagellum 206.1 is elastically deformable in a direction P perpendicular to L which in the present example are the two mutually opposite directions P. An oscillating bending motion of the flagellum 206.1 in the direction P is driven by the vortex-generated oscillating motion of blood, as explained with reference to
In a real 3D vessel, more complex vortex configurations are possible that cannot be faithfully represented in a 2D illustration such as
The flagellum 206.1 is shown in
The flagellum 206.1 comprised by the vibration sensor 206 can be made of an electro-active polymer material and configured to generate and provide the vibration sensor signal in the form of a time-varying electrical signal having an amplitude depending on a deformation amount in the direction perpendicular to the main direction of intravascular blood flow.
In other blood flow sensors, the flagellum is an optical fiber segment configured to receive and guide light to and from a reflective fiber-segment tip
The intravascular blood flow sensor system 200 also comprises a signal processing unit 208 for determining a value of a blood flow quantity characterizing blood flow inside a blood vessel. The signal processing unit comprises a vibration sensor signal input 211 receives the vibration sensor signals from the vibration sensor of the intravascular blood flow sensor. The vibration sensor signal comprises a vibration sensor signal component caused by vortex-generated blood flow oscillations of intravascular blood flow. In general, the vibration sensor signal component caused by the vortex-generated blood flow oscillations is a component in a direction perpendicular to the main direction of blood flow. The signal processing unit 208 further comprises a blood flow determination unit 213 with is configured to determine the vibration sensor signal component using the vibration sensor signal, to determine the oscillation frequency of the vortex-generated blood flow oscillations using the vibration sensor signal component, and to determine and provide the value of the blood flow quantity using the determined oscillation frequency. In this exemplary signal processing unit 208 these three distinct tasks are performed by three respective units 213.1, 213.2 and 213.3. In other signal processing units, the three described tasks are performed by a processor.
Some signal processing units include a blood flow determination unit that additionally comprises a signal transformation unit (212), which is configured to determine a frequency-domain representation of the vibration sensor signal received during a predetermined measuring time span and to determine the oscillation frequency of the vortex-generated blood flow oscillations using the frequency-domain representation. To this end, the signal transformation unit 212 receives the vibration sensor signals from the vibration sensor signal input over a predetermined measuring time span associated with a given measuring time. The signal transformation unit 212 determines the oscillation frequency for the given measuring time using a frequency-domain representation of the vibration sensor signal during the respective measuring time span. Suitably, the signal transformation unit 212 is a Fast Fourier Transform unit that determines the Fourier Transform of the vibration sensor signal. From the transformed vibration sensor signal, an oscillation frequency can be determined in a simple manner as a frequency of a Fourier component having a maximum amplitude in an expected oscillation frequency range above 100 Hz, typically in the range of a few hundred Hz.
To make detection of the oscillation frequency easier, some signal processing units of the present embodiment further comprises a filter unit 214 that is configured to filter out frequency components from the vibration sensor signal that are associated with heart beat frequency. The heart beat frequency range is typically below 100 Hz.
Some signal processing unit further determines a frequency ratio of the determined oscillation frequencies at two measuring times. This way, blood flow quantities can be determined. Such blood flow quantities provide important information regarding the current physiological state of a blood vessel, and assist in the identification and quantitative characterization of a stenosis. For calculation and output of the CFR value, the measurements are made in a state of hyperemia and in a state of normal blood flow (e.g., at rest). The coronary flow reserve (CFR) is then determined and provided by the signal-processing unit with particular ease and reliability as the frequency ratio of respective vibration sensor signals at the measuring time corresponding to the state of hyperemia and at the measuring time corresponding to the state of normal blood flow.
In some signal processing units, a user interface 210 is provided for user input of control signals, such as for triggering the oscillation measurements by controlling the operation of the vibration sensor signal input, and for output of the value of the blood flow quantity determined. The user interface is in some embodiments used to provide geometrical data indicative of a characteristic size of the blood vessel at a current intravascular position of the intravascular blood flow sensor, which is required to provide a value of a flow velocity according to:
wherein
v is the flow velocity;
f is the determined oscillation frequency of the vortex-generated blood flow oscillation;
d is the characteristic size of the blood vessel; and
S is a constant representing the Strouhal number applicable to blood flow in the given blood vessel.
In other signal processing units, the geometrical data is locally stored in a storage unit 215 which is accessed by the blood flow determination unit 213 for determining the value of the flow velocity v.
In other embodiments, the signal processing unit receives the geometrical data from an external imaging device or an external image processing device that is configured to image the blood vessel at a current intravascular position of the intravascular blood flow sensor and to determine and provide the geometrical data at that position.
As another mode of operation, which is available to a user as an alternative to the CFR determination, the signal processing unit 208 determines and provides relative changes in blood flow over time from a sequence of measurements, as compared to a first measurement of the sequence that can be triggered by user input.
The flagellum 306 comprised by the vibration sensor 303 is an optical fiber segment 320 configured to receive and guide light to and from a reflective fiber-segment tip. The signal processing unit 308 of this particular intravascular flow sensors system 300 also comprises a light source 322 that is configured to provide light for coupling into the fiber segment and a light sensor 324 arranged to receive light reflected from the fiber-segment tip and modulated in intensity by oscillating deformation of the fiber segment. The light sensor is configured to provide the vibration sensor signal in the form of an electronic light-sensor signal indicative of a time-varying reflected light intensity.
A further variant of the intravascular blood flow sensor of
The blood flow sensor 403 further comprises a signal communication unit 408 that is configured to receive the vibration sensor signals from the vibration sensor 406 and to perform wireless transmission of the vibration sensor signals to the signal processing unit 410 using a carrier signal. The signal processing unit 410 has a corresponding signal communication unit, of which only an antenna 411 is shown, that is configured to receive the carrier signal and to extract the vibration sensor signals from the carrier signal. The signal processing unit 410 then determines the oscillation frequencies of vortex-generated blood flow oscillations and determines and provides the value of the blood flow quantity using the determined oscillation frequency of the vortex-generated blood flow oscillations. A user may interact with the blood flow sensor 403 via a user interface 412, as explained above. The user input may also be provided using wireless communication.
As shown in
In summary, an alternative intravascular blood flow sensor has been disclosed, comprising a guidewire or catheter for intravascular insertion having a bluff part that is shaped for generation of vortices propagating along a main direction of intravascular blood flow, and a vibration sensor arranged and configured to provide vibration sensor signal indicative of an oscillation frequency of vortex-generated blood flow oscillations. The vibration sensor comprises a flagellum that extends from the catheter or guidewire in the main direction of intravascular blood flow and is elastically deformable in the direction perpendicular to the main direction of intravascular blood flow by the vortex-generated blood flow oscillations.
Other variations to the disclosed embodiments can be understood and effected by those skilled in the art in practicing the claimed invention, from a study of the drawings, the disclosure, and the appended claims.
In the claims, the word “comprising” does not exclude other elements or steps, and the indefinite article “a” or “an” does not exclude a plurality.
A computer program may be stored/distributed on a suitable medium, such as an optical storage medium or a solid-state medium, supplied together with or as part of other hardware, but may also be distributed in other forms, such as via the Internet or other wired or wireless telecommunication systems.
Any reference signs in the claims should not be construed as limiting the scope.
| Number | Date | Country | Kind |
|---|---|---|---|
| 17162723.5 | Mar 2017 | EP | regional |
| Filing Document | Filing Date | Country | Kind |
|---|---|---|---|
| PCT/EP2018/056644 | 3/16/2018 | WO | 00 |
