Computer-aided vacuum thrombectomy systems and methods for controlled clot aspiration
An aspiration thrombectomy system includes an aspiration catheter having a distal end, connection tubing, controllable valves to control a level of pressure in the catheter, and pressure sensors downstream from the distal end of the aspiration catheter. A controller detects a first set of downstream pressure levels during an open flow state, detects a second set of downstream pressure levels during a partially occluded flow state, determines a vascular pressure level for a position in a patient's vasculature periodically or continuously during the partially occluded flow state based on the first and second sets of downstream pressure levels, and operates the aspiration thrombectomy system in a first operating mode until the partially occluded flow state changes to an open flow state.
1 . An aspiration thrombectomy system, comprising:
an aspiration catheter having a proximal end and a distal end, wherein the aspiration catheter is configured to accommodate fluid, and wherein the distal end is configured to interface with occlusive material in a vasculature of a patient;
connection tubing coupled to the aspiration catheter, wherein the connection tubing is configured to act as a common conduit for fluid communication between the aspiration catheter and a vacuum source;
one or more controllable valves, wherein each valve is operable to selectively open and close to control a level of pressure in the aspiration catheter;
one or more pressure sensors, wherein each pressure sensor is positioned at a downstream position within the aspiration thrombectomy system from the distal end of the aspiration catheter; and
a controller configured to, during operation of the aspiration thrombectomy system for an aspiration thrombectomy procedure:
detect, via one or more of the pressure sensors, during a period of time corresponding to an open flow state, a first set of downstream pressure levels;
detect, via one or more of the pressure sensors, during a period of time corresponding to a partially occluded flow state, a second set of downstream pressure levels;
determine, periodically or continuously during the partially occluded flow state, based at least in part on the first set of downstream pressure levels and the second set of downstream pressure levels, a vascular pressure level associated with one or more positions in the vasculature of the patient; and
operate the aspiration thrombectomy system in a first operating mode of a plurality of operating modes until the partially occluded flow state changes to an open flow state.
2 . The aspiration thrombectomy system of claim 1 , wherein the open flow state comprises one or more of the aspiration catheter or the connection tubing being substantially unobstructed by occlusive material, and wherein the partially occluded flow state comprises one or more of the aspiration catheter or the connection tubing being partially obstructed by occlusive material.
3 . The aspiration thrombectomy system of claim 1 , wherein the plurality of operating modes comprises:
an intermittent aspiration mode when the aspiration thrombectomy system is determined to be in the open flow state;
a continuous aspiration mode when the aspiration thrombectomy system is determined to be in the partially occluded flow state; and
a modulated aspiration mode when the aspiration thrombectomy system is determined to be in an occluded flow state.
4 . The aspiration thrombectomy system of claim 3 , wherein the first operating mode is the continuous aspiration mode.
5 . The aspiration thrombectomy system of claim 4 , wherein the controller operates the aspiration thrombectomy system in the continuous aspiration mode based at least in part on a determination that occlusive material in one or more of the aspiration catheter or connection tubing can be deformed and extracted by operating the aspiration thrombectomy system in the continuous aspiration mode.
6 . The aspiration thrombectomy system of claim 3 , wherein the controller is further configured to determine whether the aspiration thrombectomy system is in the open flow state, the partially occluded flow state, or the occluded flow state based at least in part on one or more waveforms generated by a cardiac cycle of the vasculature of the patient.
7 . The aspiration thrombectomy system of claim 6 , wherein determining that the aspiration thrombectomy system is in the partially occluded flow state is based at least in part on determining that at least a first waveform generated by the cardiac cycle of the vasculature of the patient is an attenuated waveform.
8 . The aspiration thrombectomy system of claim 7 , wherein determining that the aspiration thrombectomy system is in the open flow state is based at least in part on determining that at least a second waveform generated by the cardiac cycle of the vasculature of the patient is a non-attenuated waveform.
9 . The aspiration thrombectomy system of claim 6 , wherein the controller is further configured to determine that the one or more waveforms are associated with one or more waveform profiles indicative of a current status of the vasculature of the patient.
10 . The aspiration thrombectomy system of claim 9 , wherein the current status of the vasculature of the patient is a level of strain associated with a particular organ, portion of a particular organ, or a particular location in the vasculature of the patient.
11 . The aspiration thrombectomy system of claim 9 , wherein the current status of the vasculature of the patient is a level of change in a cardiac output associated with the vasculature of the patient.
12 . The aspiration thrombectomy system of claim 3 , wherein the controller is further configured to determine whether the aspiration thrombectomy system is in the open flow state, the partially occluded flow state, or the occluded state based at least in part on a determination of one or more system state scores, and wherein each of the one or more system state scores is indicative of a measure of occlusion in the aspiration catheter or the connection tubing.
13 . The aspiration thrombectomy system of claim 1 , wherein the controller is further configured to transmit, to a user of the aspiration thrombectomy system, during the aspiration thrombectomy procedure, one or more audio signals indicative of the determined vascular pressure level.
14 . The aspiration thrombectomy system of claim 1 , wherein the controller is further configured to transmit, to a user of the aspiration thrombectomy system, during the aspiration thrombectomy procedure, one or more haptics or tactile signals indicative of the determined vascular pressure level.
15 . The aspiration thrombectomy system of claim 1 , wherein the controller is further configured to transmit, to a display associated with the aspiration thrombectomy system, a representation of the determined vascular pressure level configured to be visually presented on the display.
16 . The aspiration thrombectomy system of claim 15 , wherein the aspiration thrombectomy system further comprises a vacuum source and a system console associated with the vacuum source, and wherein the display associated with the aspiration thrombectomy system is an electronic display associated with the system console.
17 . The aspiration thrombectomy system of claim 1 , wherein the controller is further configured to transmit, based at least in part on the determined vascular pressure level, to a communication device associated with the aspiration thrombectomy system, communication data indicative of one or more relative therapeutic benefits associated with continuing or discontinuing an aspiration thrombectomy procedure.
18 . The aspiration thrombectomy system of claim 1 , wherein determining the vascular pressure level comprises comparing the second set of downstream pressure levels with respect to the first set of downstream pressure levels.
19 . The aspiration thrombectomy system of claim 1 , wherein the vascular pressure level is determined using a machine-learning model.
20 . The aspiration thrombectomy system of claim 19 , wherein the machine-learning model is trained based on historical data associated with one or more of the patient, the aspiration thrombectomy system, or the aspiration thrombectomy procedure.