Robotic image control system

Abstract

This disclosure involves the use of X-ray markers that appear in fluoroscopic images and are detected by image processing software to partially or fully automate or assist in the performance of one or more of the steps of a percutaneous interventional procedure typically involving a catheter device.

What is claimed is: 
     
         1 . A process for mapping the three dimensional configuration of a blood vessel of a human subject comprising:
 providing an elongated percutaneous device;   providing a system for measuring advancement and retraction of the elongated percutaneous device;   providing a fluoroscopic imaging system which provides a two dimensional image of a portion of the elongated percutaneous device in the blood vessel;   advancing or retracting the elongated percutaneous device within the blood vessel;   obtaining a first fluoroscopic image when the portion of the elongated percutaneous device is at a first location within the blood vessel and a second fluoroscopic image when the portion of the elongated percutaneous device is at a second location within the blood vessel;   measuring a first distance that the elongated percutaneous device has advanced or retracted when the first fluoroscopic image is taken;   measuring a second distance that the elongated percutaneous device has advanced or retracted between the first fluoroscopic image and the second fluoroscopic image;   correlating the fluoroscopic images with the distance measurements to provide an indication of the travel of the elongated percutaneous device out of the plane of the fluoroscopic image.   
     
     
         2 . The process of  claim 1  wherein the blood vessel is an artery. 
     
     
         3 . The process of  claim 2  wherein a general map of the artery system of which the blood vessel is part is used to aid in the correlation. 
     
     
         4 . The process of  claim 2  wherein anatomical observation is used to aid in the correlation. 
     
     
         5 . The process of  claim 1  wherein the elongated percutaneous device is a robotically driven guide wire with an X-ray marker located at its tip which has been advanced out of the distal end of a guide catheter which is positioned in the heart of the subject. 
     
     
         6 . The process of  claim 1  wherein the elongated percutaneous device is a guide wire with an X-ray marker located at its tip. 
     
     
         7 . The process of  claim 6  wherein a second set of fluoroscopic images of the X-ray marker of the guide wire taken in a plane orthogonal to the plane of the first set of fluoroscopic images is used to aid in the correlation. 
     
     
         8 . The process of  claim 6  wherein a fluoroscopic image is taken each time a predetermined length of guide wire is advanced into the guide catheter. 
     
     
         9 . The process of  claim 1  wherein a fluoroscopic image is taken at predetermined time intervals and a length measurement is made at the same time. 
     
     
         10 . The process of  claim 1  wherein the length measurement is taken after removing any slack in the elongated percutaneous device. 
     
     
         11 . The process of  claim 10  wherein the slack is removed by first advancing the elongated percutaneous device into the blood vessel and then partially withdrawing it. 
     
     
         12 . The process of  claim 1  wherein the three dimensional mapping is used to aid in the placement of a working catheter. 
     
     
         13 . The process of  claim 12  wherein the working catheter is being placed to deliver an interventional device to a lesion in the blood vessel. 
     
     
         14 . The process of  claim 13  wherein the device is one or more balloons or a stent. 
     
     
         15 . A process to optimize the plane of a fluoroscopic image used to monitor a percutaneous interventional procedure on a human subject involving a blood vessel comprising:
 providing an elongated percutaneous device;   providing a system for measuring advancement and retraction of the elongated percutaneous device;   providing a fluoroscopic imaging system which provides a two dimensional image of a portion of the elongated percutaneous device in the blood vessel;   advancing the elongated percutaneous device into or retracting the elongated percutaneous device out of the blood vessel;   obtaining a first fluoroscopic image when the portion of the elongated percutaneous device is at a first location within the blood vessel and a second fluoroscopic image when the portion of the elongated percutaneous device is at a second location within the blood vessel;   measuring a first distance that the elongated percutaneous device has advanced or retracted when the first fluoroscopic image is taken;   measuring a second distance that the elongated percutaneous device has advanced or retracted between the first fluoroscopic image and the second fluoroscopic image;   correlating the fluoroscopic images with the length measurements to provide an indication of the travel of the elongated percutaneous device out of the plane of the fluoroscopic image; and   adjusting the plane of the fluoroscopic image to minimize the amount of travel of the elongated percutaneous device out of the plane of the fluoroscopic image.   
     
     
         16 . The process of  claim 15  wherein the elongated percutaneous device is a robotically driven guide wire with an X-ray marker located at its tip which has been advanced out of the distal end of a guide catheter which is positioned in the heart of the subject. 
     
     
         17 . The process of  claim 15  wherein a fluoroscopic image is taken either each time a predetermined length of the elongated percutaneous device is advanced into or retracted from the blood vessel or at predetermined time intervals and a length measurement is made at the same time. 
     
     
         18 . An apparatus for mapping the three dimensional configuration of a blood vessel of a human subject comprising:
 a guide catheter configured to have its distal end positioned at the ostium of a blood vessel;   a fluoroscopic imaging system which provides a two dimensional image of the blood vessel;   a robotically driven guide wire carrying an X-ray marker;   a measuring mechanism which reports the distance the guide wire has been advanced into the guide catheter; and   a control mechanism which captures fluoroscopic images of the X-ray marker of the guide wire when the X-ray marker is at various distances from the distal end of the guide catheter and correlates them to the distances that the guide wire has been advanced into the guide catheter.   
     
     
         19 . The apparatus of  claim 18  wherein the blood vessel is an artery and the distal end of the guide catheter is positioned in the heart of the subject. 
     
     
         20 . The apparatus of  claim 18  wherein the control mechanism causes a fluoroscopic image to be taken either each time a predetermined length of guide wire is advanced into the guide catheter or at predetermined time intervals and causes a length measurement to be made at the same time.