Occlusion-crossing devices, atherectomy devices, and imaging
Described herein are methods for producing and identifying characteristic (“crescent shaped”) regions indicative of an atherectomy plaque within a vessel, and systems and devices adapted to take advantage of this characteristic region.
1. A method of identifying an atherectomy plaque mass within a vessel, the method comprising:
inserting an atherectomy device into a vessel, the device applying a circumferential radial force within the vessel;
flushing the vessel with a fluid to clear blood from the vessel;
imaging the cleared vessel with a sensor of the device to create an image;
identifying in the image first and second dark crescent-shaped structures created by the fluid, each of the first and second dark crescent-shaped structures extending radially and continuously from a central circumferential dark portion;
determining a position of a plaque mass within the vessel relative to the device by identifying a light amorphous structure in the image that is positioned circumferentially between the identified first and second dark crescent-shaped structures;
orienting a cutter of the atherectomy catheter towards the determined position of the plaque mass such that the cutter is positioned between tips of the first and second dark crescent-shaped structures; and
activating the cutter to remove the plaque mass.
2. The method of claim 1 , wherein imaging the vessel with a sensor of the device comprises imaging the vessel with an optical coherence tomography sensor.
3. The method of claim 1 , wherein the sensor is attached to the device.
4. The method of claim 1 , wherein determining a position of a plaque mass is further based upon an orientation of the identified crescent-shaped structures.
5. The method of claim 4 , wherein determining a position of the plaque mass comprises identifying a location between the first and second dark crescent-shaped structures in which tips of the first and second dark crescent-shaped structures point towards one another.
6. The method of claim 1 , further comprising rotating the sensor to obtain the image.
7. A method of identifying an atherectomy plaque mass within a vessel, the method comprising:
inserting an atherectomy device into a vessel, the device applying a circumferential radial force within the vessel;
flushing the vessel with a fluid to clear blood from the vessel;
imaging the vessel with a sensor of the device to create an image;
identifying in the image first and second crescent-shaped structures, each of the first and second crescent-shaped structures extending radially and continuously from a central circumferential portion to a pointed tip;
determining a position of a plaque mass within the vessel relative to the device by identifying an amorphous structure in the image that is positioned circumferentially between the identified first and second crescent-shaped structures in which the radial outermost tips of the first and second crescent-shaped structures point towards one another;
orienting a cutter of the atherectomy catheter towards the determined position of the plaque mass such that the cutter is positioned between the tips of the first and second crescent-shaped structures; and
activating the cutter to remove the plaque mass.
8. The method of claim 7 , wherein imaging the vessel with a sensor of the device comprises imaging the vessel with an optical coherence tomography sensor.
9. The method of claim 7 , wherein the sensor is attached to the device.
10. The method of claim 7 , further comprising rotating the sensor to obtain the image.
11. A method of identifying an atherectomy plaque mass within a vessel, the method comprising:
inserting an atherectomy device into a vessel, the device applying a circumferential radial force within the vessel;
flushing the vessel with a fluid to clear blood from the vessel;
imaging the vessel with a sensor of the device to create an image;
identifying in the image first and second crescent-shaped structures created by the fluid, each of the first and second crescent-shaped structures extending radially and continuously from a central circumferential portion;
determining a position of a plaque mass within the vessel relative to the device by identifying an amorphous structure in the image that is positioned circumferentially between the identified first and second crescent-shaped structures;
orienting a cutter of the atherectomy catheter towards the determined position of the plaque mass such that the cutter is positioned between tips of the first and second crescent-shaped structures; and
activating the cutter to remove the plaque mass.