Systems and methods for guidance of intraluminal devices within the vasculature
Inventors
Sganga, Jake Anthony • Bell, David James • Fredrickson, Benjamin • Kahn, Gregory
Assignees
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Publication Number
US-11246667-B2
Publication Date
2022-02-15
Expiration Date
Abstract
System for guiding an instrument within a vascular network of a patient are disclosed. In some embodiments, the system receives a medical image from a medical imaging device and identifies a distal tip and a direction the instrument in the image. The system may then determine a waypoint for the distal tip of the instrument based at least in part on the position and direction of the distal tip of the instrument. The system may then generate a trajectory command for moving the instrument through the vascular network from the current position to the waypoint. The system may operate in a closed loop. The system may provide the trajectory command to a robotic medical system configured to move the instrument according to the command.
Core Innovation
The invention provides a computer-implemented method for guiding an instrument within a vascular network of a patient during an endovascular procedure. The method causes a medical imaging device to capture medical images that include a representation of at least a portion of the vascular network and a view of the distal tip of the instrument, and vessels are identified within the medical image while a target location within the vascular network is determined relative to the medical image.
Based on a first position of the distal tip relative to the medical image, the identified vessels, and the target location, the method determines a vessel roadmap comprising a sequence of at least some of the identified vessels extending from the first position to the target location. A waypoint path is then determined for the distal tip based at least in part on the first position and the vessel roadmap, where the waypoint path comprises a plurality of waypoints positioned along the vessel roadmap.
Trajectory commands are determined for navigation from a current position toward a next waypoint and transmitted to the robotic medical system so the robotic medical system executes the trajectory commands to move the instrument toward the next waypoint. The method operates iteratively in a closed-loop manner by causing the medical imaging device to capture a new medical image after execution, determining the current position of the distal tip in the new medical image, and continuing to determine and transmit trajectory commands toward subsequent waypoints, while stopping movement of the instrument upon determination of an unsafe condition.
Claims Coverage
The provided material contains two independent claims covering an imaging-driven endovascular guidance method with vessel roadmap generation, waypoint path generation, iterative trajectory-command execution, and stopping based on an unsafe condition. Dependent claims further refine waypoint modification by user interaction and, in some cases, determine an unsafe condition using an insertion-force measure from a force sensor, including remote user operation and example user device types.
Closed-loop vessel roadmap guidance from distal-tip imaging to a target location
Causing a medical imaging device to capture a medical image of the patient that includes a representation of at least a portion of the vascular network and a view of the distal tip of the instrument; identifying one or more vessels within the medical image; determining a target location within the vascular network relative to the medical image; determining a first position of the distal tip relative to the medical image; and determining, based on the first position, the identified vessels, and the target location, a vessel roadmap that comprises a sequence of at least some of the identified vessels extending from the first position to the target location.
Waypoint path with transmitted trajectory commands for robotic motion toward successive waypoints
Determining a waypoint path for the distal tip based at least in part on the first position and the vessel roadmap, wherein the waypoint path comprises a plurality of waypoints positioned along the vessel roadmap; determining a trajectory command for navigation of the instrument from a current position toward a next waypoint, wherein the trajectory command comprises instructions for the robotic medical system; transmitting the trajectory command to the robotic medical system; and executing the trajectory command to move the instrument from the current position toward the next waypoint.
Iterative re-imaging, distal-tip position update, and stop on unsafe condition
Causing the medical imaging device to capture a new medical image after executing a trajectory command; determining the current position of the distal tip in the new medical image; and causing the robotic medical system to stop movement of the instrument upon determination of an unsafe condition.
Iterative multi-image command execution with unsafe-condition stopping
Receiving a first medical image including a representation of a vascular network, determining a target location relative to the first medical image, determining a first position of the instrument relative to the first medical image, identifying one or more vessels within the first medical image, and determining a vessel roadmap from the current position to the target location; determining a waypoint path based on the first position and the vessel roadmap; determining and transmitting trajectory command(s) to move the instrument toward a next sequential waypoint; receiving a second medical image captured after execution; determining a second position of a distal tip relative to the second medical image; determining and transmitting a second set of trajectory command(s) to move the instrument toward the next sequential waypoint; and causing the robotic medical system to stop movement upon determination of an unsafe condition.
Across the independent claims, the core coverage is an imaging-driven workflow that identifies vessels, computes a vessel roadmap to a target location, determines a waypoint path, iteratively sends trajectory commands to move a robotic endovascular instrument toward successive waypoints while updating instrument position using newly captured medical images, and stops movement when an unsafe condition is determined.
Stated Advantages
The robotic medical system stops movement of the instrument upon determination of an unsafe condition.
Documented Applications
Endovascular procedures including ischemic stroke, such as mechanical thrombectomy, are described as applications.
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