Endovascular devices and methods of use

Abstract

An endovascular device includes an elongate body having a proximal end and a distal end, an endovascular electrogram lead, a balloon, a processor and a memory. The endovascular electrogram lead and the balloon are on the distal end of the elongate body. The balloon is expandable from a fully stowed configuration to an expanded configuration. The processor receives and processes an endovascular electrogram signal from the endovascular electrogram lead. The memory stores instructions which, when executed by the processor, cause the processor to: determine one or more electrogram features based on the endovascular electrogram signal; determine a position of the elongate body within the vasculature of the patient based on the one or more electrogram features; and initiate expansion of the balloon to the expanded configuration based on the determined position of the elongate body within the vasculature of the patient.

What is claimed is: 
     
         1 . An endovascular device, comprising:
 an elongate body having a proximal end and a distal end;   an endovascular electrogram lead on the distal end of the elongate body in a position such that, when the endovascular device is in a vessel of the vasculature of a patient, the endovascular electrogram lead is in contact with blood;   a balloon on the distal end of the elongate body adjacent to the endovascular electrogram lead, the balloon being configured to expand from a fully stowed configuration to an expanded configuration;   a processor configured to receive and process an endovascular electrogram signal from the endovascular electrogram lead; and   a memory configured to store instructions which, when executed by the processor, cause the processor to:
 determine one or more electrogram features based on the endovascular electrogram signal; 
 determine a position of the elongate body within the vasculature of the patient based on the one or more electrogram features; and 
 initiate expansion, based on the determined position of the elongate body within the vasculature of the patient, of the balloon to the expanded configuration. 
   
     
     
         2 . The endovascular device of  claim 1 , wherein:
 the processor is further configured to receive and process a second endovascular electrogram signal from the endovascular electrogram lead after the balloon is in the expanded configuration; and   the memory is further configured to store instructions which, when executed by the processor, cause the processor to:
 determine one or more second electrogram features based on the endovascular electrogram signal; and 
 determine cardiac function based on the one or more second electrogram features. 
   
     
     
         3 . The endovascular device of  claim 1 , wherein the memory is further configured to store instructions which, when executed by the processor, cause the processor to initiate stopping of the expansion of the balloon after the expansion of the balloon has been initiated. 
     
     
         4 . The endovascular device of  claim 1 , wherein the memory is further configured to store instructions which, when executed by the processor, cause the processor to initiate deflation of the balloon after the expansion of the balloon has been stopped. 
     
     
         5 . The endovascular device of  claim 1 , wherein the memory is further configured to store instructions which, when executed by the processor, cause the processor to initiate partial expansion of the balloon, such that blood flow within the vasculature of the patient carries the elongate body by pushing the partially expanded balloon. 
     
     
         6 . The endovascular device of  claim 1 , wherein the position of the elongate body within the vasculature of the patient is a pulmonary artery, a branch of the pulmonary artery, or a pulmonary artery wedge position. 
     
     
         7 . The endovascular device of  claim 1 , wherein the balloon is proximal to the endovascular electrogram lead on the distal end of the elongate body. 
     
     
         8 . The endovascular device of  claim 1 , wherein the one or more electrogram features include characteristics of the P-wave, the QRS complex, or the T-wave of one or more electrocardiograms of the endovascular electrogram signal. 
     
     
         9 . The endovascular device of  claim 8 , wherein the one or more electrogram features include a P-wave amplitude of the one or more electrocardiograms of the endovascular electrogram signal. 
     
     
         10 . The endovascular device of  claim 1 , wherein the elongate body is a catheter. 
     
     
         11 . The endovascular device of  claim 1 , further comprising a non-imaging ultrasound transducer on the distal end of the elongate body, the non-imaging ultrasound transducer being configured to transmit a first non-imaging ultrasound signal into the vessel of the vasculature of the patient and to receive a first reflected non-imaging ultrasound signal. 
     
     
         12 . The endovascular device of  claim 11 , wherein the non-imaging ultrasound transducer is distal to the endovascular electrogram lead on the distal end of the elongate body. 
     
     
         13 . The endovascular device of  claim 11 , wherein:
 the processor is further configured to receive and process a signal from the non-imaging ultrasound transducer; and   the memory is further configured to store instructions which, when executed by the processor, cause the processor to determine the position of the elongate body within the vasculature of the patient based on the one or more electrogram features and the signal from the non-imaging ultrasound transducer.   
     
     
         14 . The endovascular device of  claim 13 , wherein the processor is further configured to determine a first blood flow signature pattern based on the first reflected non-imaging ultrasound signal, the first blood flow signature pattern being different from the first reflected non-imaging ultrasound signal. 
     
     
         15 . The endovascular device of  claim 14 , wherein the first blood flow signature pattern includes first blood flow velocities or first pressure signature patterns. 
     
     
         16 . The endovascular device of  claim 15 , wherein the first blood flow velocities include a first blood flow velocity towards the non-imaging ultrasound transducer and a first blood flow velocity away from the non-imaging ultrasound transducer. 
     
     
         17 . The endovascular device of  claim 16 , wherein the first blood flow signature pattern includes a ratio of the first blood flow velocity towards the non-imaging ultrasound transducer and the first blood flow velocity away from the non-imaging ultrasound transducer. 
     
     
         18 . The endovascular device of  claim 15 , wherein the first pressure signature patterns include a first blood flow power spectrum towards the non-imaging ultrasound transducer and a first blood flow power spectrum away from the non-imaging ultrasound transducer. 
     
     
         19 . The endovascular device of  claim 13 , wherein:
 the processor is further configured to receive and process a second signal from the non-imaging ultrasound transducer after the balloon has initiated expansion; and   the memory is further configured to store instructions which, when executed by the processor, cause the processor to:
 determine that blood flow through the vessel of the vasculature of the patient has stopped based on the second signal from the non-imaging ultrasound transducer; and 
 initiate stopping of the expansion of the balloon while maintaining the stoppage of flow through the vessel in response to the determination that blood flow through the vessel of the vasculature of the patient has stopped. 
   
     
     
         20 . The endovascular device of  claim 11 , wherein the first non-imaging ultrasound signal is an A-mode ultrasound signal or a Doppler ultrasound signal.