The invention relates to a device for measuring pressure, temperature and/or flow velocity. It includes a sensor (6) with a sensor support body (13) provided with a diaphragm (15) covering a cavity (14) formed in the support body (13). A pressure sensitive element (41) is mounted on the diaphragm, for recording pressure. Furthermore, a temperature sensitive resistor (42) is mounted in the vicinity of the pressure sensitive resistor and has a known temperature dependence, for recording temperature. It also includes an electrical circuit (43, 44, 45, 46) selectively outputting signals from either of the pressure sensitive element and the temperature sensitive resistor.

Patent
   RE39863
Priority
Jan 30 1996
Filed
Jan 30 1997
Issued
Oct 02 2007
Expiry
Jan 30 2017
Assg.orig
Entity
Large
63
19
all paid
27. A device for biological pressure and temperature measurements, comprising:
a guide wire;
a pressure sensor mounted on the guide wire;
a temperature sensor mounted on the guide wire in the vicinity of the pressure sensor; and
an electronic circuit to generate and output an indication of temperature based on signals from the temperature sensor.
1. A device for determining pressure, temperature and a flow parameter of a flowing fluid, comprising
i) a sensor support body (13) mounted for insertion into a vessel of a living body and having a diaphragm (15) covering a cavity (14) formed in said support body (13);
ii) a pressure sensitive element (41), having a known temperature dependence, mounted on said diaphragm (15), and providing an output indicative of a pressure;
iii) a temperature sensitive resistor (42) mounted in the vicinity of said pressure sensitive element (41) and having a known temperature dependence, providing an output signal indicative of a temperature, said resistor (42) also functioning as a temperature reference means for said pressure sensitive element (41); and
iv) an electrical circuit (43, 44, 45, 46), connected to the pressure sensitive element and to the temperature sensitive resistor, for calculation of a flow parameter of said flowing fluid on the basis of the temperature signals.
19. A method of determining pressure, temperature and a flow parameter of fluid flowing in vessels, comprising the following steps:
a) providing a pressure sensitive element and a resistor on a sensor element at a measurement site in a vessel of a living body, said pressure sensitive element and said resistor being part of an electric circuit yielding a pressure indicative output and a temperature indicative output, said pressure sensitive element and said resistor having known temperature dependencies, whereby the resistor is used as a reference for the pressure sensitive element;
b) subjecting said sensor element to flowing fluid and monitoring the pressure and temperature of said fluid by continuously recording said pressure indicative output and said temperature indicative output from said electric circuit;
c) subjecting said resistor to a changed thermal environment;
d) registering the change in said temperature indicative output resulting from said changed thermal environment; and
e) calculating a flow parameter from said change in said temperature indicative output.
14. A guide wire and sensor assembly for determining pressure, temperature and a flow parameter of a fluid flowing in a vessel, comprising
i) a guide wire (2) having a distal and a proximal end;
ii) a sensor element (6) provided at the distal end of said guide wire, said sensor element comprising
a) a sensor support body (13) provided with a diaphragm (15) covering a cavity formed in said support body (13);
b) a pressure sensitive element (41) having a known temperature dependence and mounted on said diaphragm (15), recording pressure; and
c) a temperature sensitive resistor (42) mounted in the vicinity of said pressure sensitive element and having a known temperature dependence, recording temperature, said resistor also functioning as a temperature reference for the pressure sensitive element and to provide temperature signals for calculation of a flow parameter; and
iii) an electrical circuit selectively recording output signals from either of said pressure sensitive element and said resistor, said circuit comprising a wheatstone bridge (51, 52, 53, 54), wherein the output from the bridge is indicative of pressure, and the total impedance of the bridge is indicative of temperature.
24. A method of diagnosing small vessel disease, comprising performing a measurement at a site in a vessel distally of a suspected stricture according to the following steps:
a) providing a pressure sensitive element and a resistor on a sensor element at a measurement site, said pressure sensitive element and said resistor being part of an electric circuit yielding a pressure indicative output and a temperature indicative output, said pressure sensitive element and said resistor having known temperature dependencies, whereby the resistor is used as a reference for the pressure sensitive element;
b) subjecting said sensor element to flowing fluid and monitoring the pressure and temperature of said fluid by continuously recording said pressure indicative output and said temperature indicative output from said electric circuit;
c) subjecting said resistor to a changed thermal environment;
d) registering the change in said temperature indicative output resulting from said changed thermal environment; and
e) calculating a flow parameter from said change in said temperature indicative output; and
f) comparing the calculated flow parameter and the measured pressure with corresponding quantities representative of a healthy patient.
13. A guide wire and sensor assembly for determining pressure, temperature and a flow parameter of a fluid flowing in a living body, comprising
i) a guide wire (2) having a distal and a proximal end;
ii) a sensor element (6) provided at the distal end of said guide wire, said sensor element comprising
a) a sensor support body (13) provided with a diaphragm (15) covering a cavity (14) formed in said support body;
b) a pressure sensitive element (41) having a known temperature dependence and mounted on said diaphragm (15), recording pressure; and
c) a temperature sensitive resistor (42) mounted in the vicinity of said pressure sensitive element (41) and having a known temperature dependence, recording temperature, said resistor (42) also functioning as a temperature reference for the pressure sensitive element (41) and to provide temperature signals for calculation of a flow parameter; and
iii) an electrical circuit comprising a double wheatstone bridge, including a first (42, 43, 44, 46) and a second (41, 42, 45, 46) bridge, said two bridges together comprising six resistive elements, said double wheatstone bridge having two resistors in common, whereby the second bridge includes said pressure sensitive element (41) and said temperature sensitive resistor (42), and the first bridge includes the temperature sensitive resistor (42).
26. A method of diagnosing small vessel disease, comprising performing measurements at a site in a vessel distally of a suspected stricture according to the following steps:
a) providing a pressure sensitive element and a resistor on a sensor element at a measurement site, said pressure sensitive element and said resistor being part of an electric circuit yielding a pressure indicative output and a temperature indicative output, said pressure sensitive element and said resistor having known temperature dependencies, whereby the resistor is used as a reference for the pressure sensitive element;
b) subjecting said sensor element to flowing fluid and monitoring the temperature of said fluid by continuously recording said temperature indicative output from said electric circuit;
c) subjecting said resistor to a changed thermal environment;
d) registering the change in said temperature indicative output resulting from said changed thermal environment;
e) calculating a flow parameter (Qrest) from said change in said temperature indicative output;
f) injecting a vaso dilating drug in said vessel to simulate a work condition;
g) monitoring the pressure (Pwork,dist) and temperature of said fluid by continuously recording said pressure indicative output and said temperature indicative output from said electric circuit;
h) subjecting said resistor to a changed thermal environment;
i) registering the change in said temperature indicative output resulting from said changed thermal environment;
j) calculating a flow parameter (Qwork) from said change in said temperature indicative output;
k) determining the proximal pressure (Pprox,work);
l) calculating

CFR=Qwork/Qrest and

FFR=Pdist,work/Pprox,work
j) comparing the calculated CFR and FFR with corresponding quantities representative of a healthy patient.
2. The device of claim 1, wherein said electrical circuit comprises a double wheatstone bridge, including a first (42, 43, 44, 46) and a second (41, 42, 45, 46) bridge, said two bridges having two resistors in common, whereby the first bridge comprises said temperature sensitive resistor (42), and the second bridge comprises the pressure sensitive element (41) and said temperature sensitive resistor (42).
3. The device as claimed in claim 1, comprising a wheatstone bridge, wherein the output from the bridge is indicative of pressure, and the total impedance of the bridge is indicative of temperature.
4. The device as claimed in claim 1, wherein both the pressure sensitive element (41) and the temperature sensitive resistor (42) are located on said diaphragm (15).
5. The device as claimed in claim 1, wherein only the pressure sensitive element (41) is located on said diaphragm (15) and the temperature sensitive resistor (42) is located on said sensor support body (13).
6. The device as claimed in claim 1, wherein the temperature sensitive resistor (42) is mounted on a dummy diaphragm, having essentially the same properties as the diaphragm (15) on which the pressure sensitive element is located.
7. The device as claimed in claim 1, attached at the distal end of a guide wire having a proximal and a distal end.
8. The device as claimed in claim 1, further comprising means for temperature compensation in the pressure measurement mode, such that the recorded potential representing a pressure is modified by adding or subtracting from said recorded potential, a known off set potential value depending on temperature.
9. The device as claimed in claim 1, wherein the pressure sensitive element (41) is of a piezoresistive type.
10. The device as claimed in claim 1, wherein the pressure sensitive element (41) is of a capacitive type.
11. The device as claimed in claim 1, wherein the pressure sensitive element (41) is a mechanically resonant sensor.
12. The device of claim 1, further including a selective power supply power connected to said temperature sensitive resistor to heat the temperature sensitive resistor to a predetermined temperature, and a temperature deviation determinator.
15. The method of claim 14 19, wherein the flow of fluid comprises a primary and a secondary fluid, divided up in two sequential flows having different temperatures, the primary flow comprising blood, and the secondary flow being a fluid of substantially lower temperature than the blood.
16. The method of claim 15 19, wherein a temperature profile is obtained by the continuous measurement of the temperature, and wherein the width at half height of said temperature profile is used as said flow parameter.
17. The method of claim 15 19, wherein the time for the cold fluid to pass the sensor element is used as said flow parameter.
18. The method of claim 15 19, wherein the time of transit of the cold fluid from the a time of injection until it reaches said sensor element is used as said flow parameter.
20. The method of claim 19, including achieving said changed thermal environment by said fluid causing a temperature drop in said resistor, said flow parameter being a quantity proportional to the volume flow.
21. The method of claim 20, wherein the volume flow is calculated by integrating the temperature over time using the equation Q = V / t0 t 1 ( T m / T l ) t V / t 0 t 1 ( T o - T m ) t ( 1 )
wherein
V is the volume of injected liquid
Tm is the measured temperature
T1 is the temperature of injected liquid
T0 is the temperature of the blood, i.e. 37° C.
Q is the volume flow
t0 is the point in time where a temperature change is detected
t1 is the point in time where the temperature is regarded as having reached normal temperature.
22. The method of claim 19, wherein said changed thermal environment is achieved by said resistor being heated by passing a current through it, whereby said fluid cools said resistor such that the actual temperature of said resistor is lower than the expected temperature, that would have been obtained, had said resistor not been subjected to said flowing fluid, and calculating a flow parameter from said deviation from said expected temperature value, said flow parameter being a quantity proportional to the flow velocity.
23. The method of claim 22, wherein the flow velocity is calculated using the equation

V=(h−C0)2/C1
wherein

h=I2Rw/A(Tw−Tf)
wherein
I=wire current
Rw=wire resistance
Tw=wire temperature
Tf=temperature of a flowing fluid
h=film coefficient of heat transfer
A=heat transfer area
V=flow velocity.
25. The method of claim 24, wherein said comparing step f) comprises comparing a flow parameter in a rest condition with a flow parameter in a work condition, and the pressure distally of a stenosis with the proximal pressure in a work condition.
28. A device as set forth in claim 27, further comprising a sensor support body and wherein the pressure sensor and the temperature sensor are both mounted to said sensor support body.
29. A device as set forth in claim 27, further comprising a chip and wherein the pressure sensor and the temperature sensor are both mounted to said chip.
30. A device as set forth in claim 27, further comprising a silicon chip and wherein the pressure sensor and the temperature sensor are both mounted to said silicon chip.
31. A device as set forth in claim 27, further comprising a substrate and wherein the pressure sensor and the temperature sensor are both mounted to said substrate.
32. A device as set forth in claim 27, wherein the pressure sensor senses pressure at the same time the temperature sensor senses temperature.
33. A device as set forth in claim 27, wherein the pressure sensor includes a diaphragm.
34. A device as set forth in claim 33, wherein the temperature sensor is located off of the diaphragm.
35. A device as set forth in claim 27, wherein the electronic circuit also generates a profile of temperature versus time.
36. A device as set forth in claim 35, wherein the electronic circuit also generates flow information based on said profile.

The present invention relates generally to pressure, temperature and flow measurements, in particular in the medical field, and especially to in situ measurements of the intracoronary pressure, distally of a stricture, using a guide wire having a pressure sensor mounted at its distal end.

In particular it concerns a combined flow, pressure and temperature sensor.

In order to determine or assess the ability of a specific coronary vessel to supply blood to the heart muscle, i.e. the myocardium, there is known a method by which the intracoronary pressure distally of a stricture in combination with the proximal pressure is measured. The method is a determination of the so called Fractional Flow Reserve (see “Fractional Flow Reserve”, Circulation, Vol. 92, No. 11, Dec. 1, 1995, by Nico H. j. Pijls et al.). Briefly FFRmyo is defined as the ratio between the pressure distally of a stricture and the pressure proximal of a stricture, i.e. FFRmyo=Pdist/Pprox. The distal pressure is measured in the vessel using a micro-pressure transducer, and the proximal pressure is the arterial pressure.

A limitation in measuring only the blood pressure and the pressure gradient, alternatively the Fractional Flow Reserve, is that there is no control of the flow in the coronary vessel. As an example, a vessel having a significant stricture would not yield any pressure drop if the myocardium is defective and has no ability to receive blood. The diagnosis will incorrectly show that the coronary vessel is healthy, when instead the conclusion should have been that the myocardium and possibly the coronary vessel are ill.

A diagnosis method for diagnosing small vessel disease is performed as follows:

The Fractional Flow Reserve is determined. If the FFR is <0.75 the coronary vessel should be treated.

If FFR is >0.75 there are two possibilities:

a) either the patient is healthy with respect to the actual coronary vessel (the most plausible), or

b) there is a low blood flow distally of the distal pressure measurement due to either an additional stricture or a sickly myocardium.

In order to investigate whether alternative b) is at hand, it is desirable to obtain knowledge regarding the health status of the myocardium, by measuring Coronary Flow Reserve (CFR), or in the alternative the Coronary Velocity Reserve (CVR). The idea is to determine by how many times a patient is able to increase his/her blood flow during work. A healthy patient should be able to increase the blood flow by 2.5-5 times, depending on the patient's age. Work is simulated by the addition of a so called vaso dilating pharmaceutical/medicament, e.g. Adenosine, Papaverin or the like. This medicament dilates the capillaries which increases the blood flow. The same medicament is used for determining FFR.

CFV is defined as CFV = Q work / Q rest = Q during vaso dilation / Q rest
(Q is the flow).

This being a ratio and assuming that the cross sectional area is constant during one velocity measurement, it will suffice to measure the velocity.

CFR is defined as
CFR=Qwork/Qrest=[Vwork*K]/[Vrest*K]=Vwork/Vrest

Since the desired parameter is a flow increase, it will be sufficient to obtain it as a relative quantity
CFR=[K*Vwork]/[K*Vrest]
wherein K is a constant.

Researchers have devised methods where the pressure and flow velocity in the coronary vessel are measured, the results being presented as so called “pressure-velocity loops” (di Mario). Thereby it becomes possible to distinguish patients suffering from the so called “small vessel disease” from others. In patients with “small vessel disease” the pressure gradient, corresponding to a low FFR, and the velocity of flow will be low, whereas healthy patients will have a low pressure gradient, corresponding to a high FFR, and a high flow.

In some investigations the applicant's system for pressure measurements in vivo, Pressure Guide™ (Radi Medical Systems) and the flow sensor sold under the trade name Flowmap™ (Cardiometrics) have been tested.

It is a great drawback to have to introduce two sensors into the coronary vessel, compared to a situation where both sensors are mounted on a “guide wire”. Thus, it has been suggested to provide a guide wire with two sensors, but this presents several technical problems with the integration of two sensors in a thin guide wire.

The object of the invention is therefor to make available means and methods for carrying out such combined pressure and flow measurements with a single unit, thus facilitating investigations of the outlined type, and making diagnosing more reliable.

The object outlined above is achieved according to the invention with the sensor as defined in claim 1, whereby the problems of the prior art have been overcome. The key is to use the temperature sensitive element for obtaining a flow parameter. Thus, there is provided a single sensor having the ability to measure both the pressure and to determine the velocity of flow or the volume flow. A great advantage with such a solution is that only one electrical circuit needs to be provided in a guide wire.

In a preferred embodiment, the sensor is an electrical sensor of a piezoresistive type. However it is contemplated that other pressure sensitive devices may be used, e.g. capacitive devices, or mechanically resonating sensors.

In accordance with the invention there is also provided a method of determining pressure, temperature and flow in a coronary vessel, as defined in claim 20.

Further scope of applicability of the present invention will become apparent from the detailed description given hereinafter.

However, it should be understood that the detailed description and specific examples, while indicating preferred embodiments of the invention are given by way of illustration only, since various changes and modifications within the spirit and scope of the invention will become apparent to those skilled in the art from this detailed description.

The present invention, will become more fully understood from the detailed description given herein below and the accompanying drawings which are given by way of illustration only, and thus not limitative of the present invention, and wherein

FIGS. 1a and 1b show a microphone for recording extremely small eddies in turbulent gas flows;

FIG. 2 shows a sensor/guide assembly to be used together with the invention;

FIG. 3 shows a top view of a pressure sensor chip and the electric circuitry schematically illustrated;

FIG. 4 shows schematically the circuit of a “double” Wheatstone bridge for use in the invention;

FIG. 5 is an illustration of a Wheatstone bridge used in a second embodiment of the invention;

FIG. 6 shows temperature profiles obtained in a thermodilution type measurement;

FIG. 7 is a schematic illustration showing how transit time is used to obtain the desired parameter.

With reference to FIGS. 1a and 1b there is shown a prior art device disclosed in a publication entitled “A Small-Size Microphone for Measurements in Turbulent Gas Flows” in Sensors and Actuators A, 1994. It comprises a microphone for recording extremely small eddies in turbulent gas flows. It is based on piezoresistive techniques for transducing pressure fluctuations into electrical signals.

The microphone comprises a silicon substrate 100, and a cavity 102 in said substrate. A diaphragm of polysilicon 104 covers the cavity 102. On the diaphragm a polysilicon piezoresistor 106 is attached. Etch holes 108 and etch channels 110 are provided for manufacturing purposes. Vent channels 112 are also provided. On the substrate 100 there are metal conductors 114 and bond pads 116 for connecting cabling to external devices.

Now turning to FIG. 2 there is shown a sensor/guide device comprising a solid wire 1 which is machined by so called centering grinding, and inserted into a proximal tube portion 2. The wire 1 forms the distal portion of the guide, and extends beyond the distal end of the proximal tube portion 2 where said tube is connected to or integrally formed with a spiral portion 3. On the distal end of the wire 1 there is mounted a pressure sensor 6. Between the wire 1 and the spiral portion 3, electrical leads 4 from the electronic circuitry run parallel with said wire 1. The sensor 6 is protected by a short section of a tube 7 having an aperture 8 through which surrounding media act on the pressure sensor. At the very distal end of the entire device there is a radio opaque coil 9, e.g. made of Pt, and used for location purposes, and a safety wire 10 for securing the distal part of the spiral 9.

To minimize the number of electrical leads, the wire or tube may be used as one of the electrical leads.

The proximal tubing 2 and the spiral 3 may be coupled such as to be utilized as an electrical shield, in which case it of course cannot be used as an electrical lead.

Now embodiments of the pressure sensor will be described with reference to FIGS. 3-4.

The sensor is based on the small size silicon microphone mentioned above, which is designed for detecting extremely small eddies in turbulent gas flows. It has been fully described for that application in said publication “Sensors and Actuators A”, 1994 (incorporated herein in its entirety by reference). However, it has been modified in accordance with the present invention in the way described below. In order to further miniaturize the external dimensions of the microphone to meet the requirements of the invention, the external dimensions for accommodating the lead pattern on the sensor should be no more than 0.18 mm×1.3 mm×0.18 mm, preferably no more than 0.14 mm×1.3 mm×0.1 mm.

An unexpected advantage of miniaturizing is that the thermal mass, and thereby the thermal time constant, is low, i.e. the entire chip including its resistors heats up and cools down very quickly. In fact it is thereby possible to monitor dynamic changes in the domain 1 Hz and faster. For the purpose of studying flow in blood vessels, the variation of flow velocity or volume flow during a heart cycle is easily detected, and therefor anomalies in the blood flow may be detected.

The sensor (see FIG. 3) comprises a sensor support body in the form of a silicon chip 13 in which there is a cavity 14 made e.g. by etching. Across the cavity there is formed a polysilicon diaphragm 15 having a thickness of e.g. 0.4-1.5 μm or possibly up to 5 μm, and a side length of 100 μm. Within the cavity a vacuum of less than 1000 Pa, preferably less than 30 Pa prevails. In contact with said diaphragm there is mounted a piezoresistive element 41. A pressure acting on the diaphragm 15 will cause a deflection thereof and of the piezoresistive element 41, which yields a signal that may be detected.

In order to attach the cabling 4 to the chip, bond pads 19 are required. These bond pads must have a certain dimension (e.g. 100×75 μm), and must be spaced apart a certain distance, respect distance approximately 125 μm. Since the dimensional adaptation entails narrowing the chip, the consequence is that in order to be able to meet the mentioned requirements, the bond pads have to be located in a row, one after the other, as shown in FIG. 3.

It is also preferred for temperature compensation purposes to have a reference resistor 42 mounted on the sensor. This reference resistor 42 may be located on different points on the sensor chip.

In one embodiment it is placed on the diaphragm 15. This is preferred since identical environments to both the active, piezoresistive element 41 and the reference resistor 42 will be provided. Thereby the active element, i.e. the piezoresistive element 41, is mounted such that it will be affected by a longitudinal tension 41 when it is subjected to a pressure. The reference resistor 42 is preferably mounted perpendicularly with respect to the active element 41 and along the border of the diaphragm 15, i.e. at the periphery of the cavity 14 present underneath the diaphragm 15.

However, it is possible to locate the reference resistor on the silicon substrate 13 adjacent the diaphragm. This is an advantage since the reference resistance thereby will be pressure independent.

Another possibility is to locate the reference resistor on a “dummy” diaphragm adjacent the real diaphragm 15, in order to provide the same mechanical and thermal environment for the active element 41 and the reference resistor 42.

With reference to FIG. 4, an embodiment of the electrical circuit and its operation and function will now be described.

As schematically is shown in FIG. 4, one embodiment of the sensor circuit comprises six resistors 41 . . . 46, two of which 41, 42 are mounted on the diaphragm, as previously mentioned (resistor 41 corresponds to resistor 41 in FIG. 3, and resistor 42 corresponds to resistor 42 in FIG. 3). Resistor 41 is a piezoresistive element, and resistor 42 is only temperature sensitive. The remaining resistors 43, 44, 45, 46 are located externally of the entire sensor/guide assembly, and do not form part of the sensor element.

In this embodiment the resistors are coupled as a “double” Wheatstone bridge, i.e. with resistors 42, 43, 44, 46 forming one bridge (for temperature compensation and flow calculation), resistors 41, 42, 42, 46 forming the second bridge for pressure measurement. Thus, resistors 45 and 46 are shared by the bridges. Thereby it is possible to measure the temperature (across B-C) and pressure (across A-C) independently of each other. From the measured temperature values the flow velocity or volume flow may be calculated.

In another embodiment there are four resistors (51, 52, 53, 54) connected as shown in FIG. 5, i.e. as a simple “single” Wheatstone bridge. If at least one of the four resistors, say 51, has a temperature coefficient ≠0, then temperature changes may be measured as follows:

If the voltage V applied is maintained constant, the current I through the circuit may be measured and is a measure of the temperature, since the total impedance (resistance) of the circuit will change with temperature.

Alternatively the current I may be maintained constant, and in this case the voltage over the bridge will be temperature dependent.

By means of the shown circuit, the CFR can be determined by registering the temperature drop due to a passing liquid having a lower temperature than the body temperature, as will be discussed in detail below.

For the flow determination the principle of so called hot-wire and hot-film anemometers may be employed (reference is made to “Measurement Systems”, 3rd edition, pp 506-, by Doebelin, 1983), in which case a flow velocity may be obtained.

Alternatively the principle of thermo-dilution may be employed in which case the volume flow may be obtained.

Both principles will be discussed below beginning with hot-wire anemometers.

Hot-wire anemometers commonly are made in two basic forms: the constant current type and the constant temperature type. Both utilize the same physical principle but in different ways. In the constant current type, a fine resistance wire carrying a fixed current is exposed to the fluid flowing at a certain velocity. The wire attains an equilibrium temperature when the i2R heat is essentially constant; thus the wire temperature must adjust itself to change the convective loss until equilibrium is reached. Since the convection film coefficient is a function of flow velocity, the equilibrium wire temperature is a measure of velocity. The wire temperature can be measured in terms of its electrical resistance. In the constant temperature form, the current through the wire is adjusted to keep the wire temperature (as measured by its resistance) constant. The current required to do this then becomes a measure of flow velocity.

For equilibrium conditions we can write an energy balance for a hot wire as
I2Rw=hA(Tw−Tf)
where

It can be written generally on the form

 h=C0+C1√{square root over (V)}

where V is the flow velocity, and C0 and C1, are constants. For a more detailed account of the theory for hot-wire anemometers reference is made to the cited publication.

In pressure measurement mode the resistors in the circuit (FIG. 4) are supplied with 1-10 V (AC or DC), and the potential difference between A and B is registered as a signal representing the pressure. Unless the resistors 41 and 42 are identical in terms of their temperature dependence, this potential difference will be temperature dependent, i.e. one has to know a quantity representative of the temperature at which the measurement takes place in order to obtain a correct pressure value, and therefore the bridge has to be calibrated. This is achieved by recording the potential difference between A and B (see FIG. 4) as a function of the potential difference between A and C at different temperatures, e.g. in a controlled temperature oven or in a water bath. Thus, an “off set” vs temperature dependence curve is obtained, that is used to compensate the pressure signal (A-B) for a given temperature. Namely, at a given temperature it is known from the calibration curve how much should be subtracted from or added to the actual registered signal in order to obtain a correct pressure. It would be advantageous if resistors 41 and 42 have identical or at least a very similar temperature dependence. This is in fact also the case, since they are made in practice at the same time during manufacture of the chip itself. Thus, material composition and properties are in practice identical. Nevertheless the above outlined compensation is necessary in most cases.

The actual compensation process is built into the software of the electronic system, and implementation thereof requires only ordinary skill.

The inventors have now realized that it is possible to make use of the temperature dependent resistor in a pressure bridge as described above, for flow measurements, using the principle of the hot-wire anemometer.

Thus, the temperature sensitive resistor 42 (FIG. 4) having a known temperature behavior as a function of the current supplied to it, is fed with a current that in a static situation (i.e. no flowing fluid surrounding it) would yield a certain temperature, as reflected in its resistance. If there is a difference in the measured resistance compared to what would have been expected in the static situation (i.e. no flow), it can be concluded that a cooling of the resistor is taking place, and thus that there is a flow of fluid. The measurement is made over B-C in the figure. On the basis of this information, the theory indicated above for anemometers may be applied, and a flow velocity calculated.

The CFR value may be obtained in the following way using the anemometer principle:

During the same procedure the FFR (Fractional Flow Reserve) may also be obtained by measuring the distal and proximal pressures and calculating FFR=Pdist/Pprox.

Now the embodiment utilizing the principle of thermodilution will be described.

The principle of thermo-dilution involves injecting a known amount of cooled liquid, e.g. physiological saline in a blood vessel. After injection the temperature is continuously recorded with a temperature sensor attached to the tip of a guide wire that is inserted in the vessel. A temperature change due to the cold liquid passing the measurement site, i.e. the location of the sensor, will be a function of the flow (see FIG. 5).

There are various methods of evaluating the temperature signal for diagnostic purposes. Either one may attempt to calculate the volume flow, or one may use a relative measure, where the flow in a “rest condition” is compared with a “work condition”, induced by medicaments.

The latter is the simpler way, and may be carried out by measuring the width at half height of the temperature change profile in the two situations indicated, and forming a ratio between these quantities (see FIG. 6).

Another way of obtaining a ratio would be to measure the transit time from injection and until the cold liquid passes the sensor, in rest condition and in work condition respectively. The relevant points of measurement are shown in FIG. 7.

The former method, i.e. the utilization of the volume flow parameter as such, requires integration of the temperature profile over time (see FIG. 6) in accordance with the equations given below Q rest = V / t 0 t 1 ( T r , m / T r , l ) t V / t 0 t 1 ( T r , 0 - T r , m ) t ( 1 ) Q work = V / t0 t 1 ( T w , m / T w , l ) t V / t 0 t 1 ( T w , 0 - T w , m ) t ( 1 )
wherein

These quantities may then be used directly for assessment of the condition of the coronary vessels and the myocardium of the patient, or they may be ratioed as previously to obtain a CFR, i.e. CFR=Qwork/Qrest.

A method of diagnosing small vessel disease, using the device of the invention comprises performing measurements at a site in a vessel distally of a suspected stricture. Thus, a pressure sensitive element and a resistor on a sensor element is provided at a measurement site, by inserting through a catheter. The pressure sensitive element and said resistor are part of an electric circuit yielding a pressure indicative output and a temperature indicative output, and have known temperature dependencies. The resistor is used as a reference for the pressure sensitive element. At the site the sensor element will be subjected to flowing fluid, i.e. blood, and the temperature of said fluid is monitored by continuously recording said temperature indicative output from said electric circuit. Then said resistor is subjected to a changed thermal environment. The change in said temperature indicative output resulting from said changed thermal environment is registered. This change in temperature indicative output is used to calculate a flow parameter (Qrest). A vaso dilating drug is injected in said vessel to simulate a work condition, and the distal pressure (Pwork,dist) and temperature of said fluid is monitored by continuously recording said pressure indicative output and said temperature indicative output from said electric circuit. Again the resistor is exposed to a changed thermal environment, and the change in said temperature indicative output resulting from said changed thermal environment is registered. A flow parameter (Qwork) is calculated from said change in said temperature indicative output. The proximal pressure (Pprox,work) is determined, and CFR=Qwork/Qrest and FFR=Pdist,work/Pprox,work are calculated. Finally the calculated CFR and FFR are compared with corresponding quantities representative of a healthy patient.

The invention being thus described, it will be clear that the same may be varied in many ways. Such variations are not to be regarded as a departure from the spirit and scope of the invention, and all such modifications as would be clear to one skilled in the art are intended to be included within the scope of the following claims.

In particular it may find utility in other areas of the medical field, wherever it is desired to measure pressure, temperature and flow with one single device. It could also be used in non-medical fields.

Smith, Leif

Patent Priority Assignee Title
10070919, Dec 06 2012 St. Jude Medical, Atrial Fibrillation Division, Inc. Irrigant distribution system for electrodes
10080872, Nov 04 2014 Abbott Cardiovascular Systems Inc. System and method for FFR guidewire recovery
10130269, Nov 14 2013 Medtronic Vascular, Inc Dual lumen catheter for providing a vascular pressure measurement
10194812, Dec 12 2014 Medtronic Vascular, Inc. System and method of integrating a fractional flow reserve device with a conventional hemodynamic monitoring system
10201284, Jun 16 2014 Medtronic Vascular Inc. Pressure measuring catheter having reduced error from bending stresses
10226185, May 03 2012 ST JUDE MEDICAL COORDINATION CENTER BVBA Tube and sensor guide wire comprising tube
10258240, Nov 24 2014 Kaneka Corporation Optical fiber pressure sensor
10274351, May 12 2014 SCHNEIDER ELECTRIC SYSTEMS USA, INC Method of making a multivariable vortex flowmeter
10307070, Apr 04 2014 ST JUDE MEDICAL SYSTEMS AB Intravascular pressure and flow data diagnostic systems, devices, and methods
10327645, Oct 04 2013 PHYZHON HEALTH INC Imaging techniques using an imaging guidewire
10390768, Aug 20 2011 Imperial College of Science, Technology and Medicine Devices, systems, and methods for visually depicting a vessel and evaluating treatment options
10426404, Jun 30 2010 ST JUDE MEDICAL COORDINATION CENTER BVBA Sensor jacket
10470713, Oct 25 2013 ST. JUDE MEDICAL COORDINATION CENTER BVBA Sensor guide wire device and system including a sensor guide wire device
10506934, May 25 2012 Kaneka Corporation Optical fiber pressure sensor
10537255, Nov 21 2013 Kaneka Corporation Optical fiber pressure sensor
10646122, Apr 28 2017 Medtronic Vascular, Inc FFR catheter with covered distal pressure sensor and method of manufacture
10648918, Aug 03 2011 LIGHTLAB IMAGING, INC Systems, methods and apparatus for determining a fractional flow reserve (FFR) based on the minimum lumen area (MLA) and the constant
10660573, Mar 13 2013 ST JUDE MEDICAL SYSTEMS AB Sensor guide wire with shape memory tip
10702170, Jul 01 2013 ZURICH MEDICAL CORPORATION Apparatus and method for intravascular measurements
10835183, Jul 01 2013 ZURICH MEDICAL CORPORATION Apparatus and method for intravascular measurements
10898090, Feb 26 2015 ST JUDE MEDICAL COORDINATION CENTER BVBA Pressure sensor and guide wire with self wetting tube
10912463, Aug 20 2011 PHILIPS IMAGE GUIDED THERAPY CORPORATION; MEDSOLVE LIMITED; Imperial College of Science, Technology and Medicine Devices, systems, and methods for assessing a vessel
10973418, Jun 16 2014 Medtronic Vascular, Inc Microcatheter sensor design for minimizing profile and impact of wire strain on sensor
10973571, Dec 28 2010 St. Jude Medical, Atrial Fibrillation Division, Inc. Multi-rate fluid flow and variable power delivery for ablation electrode assemblies used in catheter ablation procedures
10987162, Dec 17 2010 St. Jude Medical, Atrial Fibrillation Division, Inc. Irrigated ablation electrode assemblies
11172833, May 25 2012 Kaneka Corporation Optical fiber pressure sensor guidewire
11185244, Aug 13 2018 Medtronic Vascular, Inc FFR catheter with suspended pressure sensor
11219741, Aug 09 2017 Medtronic Vascular, Inc. Collapsible catheter and method for calculating fractional flow reserve
11235124, Aug 09 2017 Medtronic Vascular, Inc. Collapsible catheter and method for calculating fractional flow reserve
11241154, May 31 2011 LightLab Imaging, Inc. Multimodal imaging system, apparatus, and methods
11272850, Aug 09 2016 Medtronic Vascular, Inc. Catheter and method for calculating fractional flow reserve
11298026, Oct 04 2013 PHYZHON HEALTH INC Imaging techniques using an imaging guidewire
11330989, Jun 16 2014 Medtronic Vascular, Inc. Microcatheter sensor design for mounting sensor to minimize induced strain
11330994, Mar 08 2017 Medtronic Vascular, Inc. Reduced profile FFR catheter
11389068, Jan 06 2011 MEDSOLVE LIMITED; Imperial College of Science, Technology and Medicine Apparatus and method of assessing a narrowing in a fluid filled tube
11399889, Dec 28 2010 St. Jude Medical, Atrial Fibrillation Division, Inc. Ablation electrode assemblies and methods for using same
11426514, Jun 03 2010 Medtronic, Inc. Implantable medical pump with pressure sensor
11471061, Jul 01 2013 ZURICH MEDICAL CORPORATION Apparatus and method for intravascular measurements
11547359, Jun 30 2010 ST. JUDE MEDICAL COORDINATION CENTER BVBA Sensor jacket
11559218, Apr 04 2014 ST. JUDE MEDICAL COORDINATION CENTER BVBA Intravascular pressure and flow data diagnostic systems, devices, and methods
11696692, Nov 21 2013 Kaneka Corporation Optical fiber pressure sensor
11701012, Jun 16 2014 Medtronic Vascular, Inc. Microcatheter sensor design for minimizing profile and impact of wire strain on sensor
11850030, Jun 16 2014 Medtronic Vascular, Inc. Pressure measuring catheter having reduced error from bending stresses
8397578, Jun 03 2010 Medtronic, Inc Capacitive pressure sensor assembly
8814857, Dec 17 2010 ST JUDE MEDICAL, ATRIAL FIBRILLATION DIVISION, INC Irrigated ablation electrode assemblies
8971993, Nov 19 2010 ST JUDE MEDICAL INTERNATIONAL HOLDING S À R L Systems and methods for navigating a surgical device
8979840, Dec 17 2010 ST JUDE MEDICAL, ATRIAL FIBRILLATION DIVISION, INC Irrigant distribution system for flexible electrodes
9066725, Dec 06 2012 ST JUDE MEDICAL, ATRIAL FIBRILLATION DIVISION, INC Irrigant distribution system for electrodes
9314584, Jun 27 2011 Bayer HealthCare LLC Method and apparatus for fractional flow reserve measurements
9332923, Jul 06 2010 ST JUDE MEDICAL COORDINATION CENTER BVBA Sensor element with an insulation layer
9339348, Aug 20 2011 Volcano Corporation Devices, systems, and methods for assessing a vessel
9526454, Mar 28 2012 ST JUDE MEDICAL COORDINATION CENTER BVBA Sensor guide wire comprising a polymer layer
9615755, Jun 27 2011 Bayer HealthCare LLC Method and apparatus for fractional flow reserve measurements
9737657, Jun 03 2010 Medtronic, Inc Implantable medical pump with pressure sensor
9757591, Feb 11 2013 Bayer HealthCare LLC Methods and systems for monitoring an automated infusion system
9763622, Jul 06 2010 ST. JUDE MEDICAL COORDINATION CENTER BVBA Sensor element with an insulation layer
9775524, Jan 06 2011 MEDSOLVE LIMITED; Imperial College of Science, Technology and Medicine Apparatus and method of assessing a narrowing in a fluid filled tube
9788891, Dec 28 2010 ST JUDE MEDICAL, ATRIAL FIBRILLATION DIVISION, INC Ablation electrode assemblies and methods for using same
9855094, Dec 28 2010 ST JUDE MEDICAL, ATRIAL FIBRILLATION DIVISION, INC Multi-rate fluid flow and variable power delivery for ablation electrode assemblies used in catheter ablation procedures
9877660, Nov 14 2013 MEDTRONIC VASCULAR GALWAY Systems and methods for determining fractional flow reserve without adenosine or other pharmalogical agent
9888970, Nov 19 2010 ST JUDE MEDICAL INTERNATIONAL HOLDING S À R L Systems and methods for navigating a surgical device
9901397, Dec 17 2010 St. Jude Medical, Atrial Fibrillation Division, Inc. Irrigated ablation electrode assemblies
9913585, Jan 15 2014 Medtronic Vascular, Inc.; MEDTRONIC VASCULAR GALWAY Catheter for providing vascular pressure measurements
Patent Priority Assignee Title
4023562, Sep 02 1975 Case Western Reserve University Miniature pressure transducer for medical use and assembly method
4274423, Dec 15 1977 Kabushiki Kaisha Toyota Chuo Kenkyusho Catheter tip pressure transducer
4622856, May 30 1983 Siemens Aktiengesellschaft Sensor with polycrystalline silicon resistors
4843445, May 21 1985 SWEMA INSTRUMENT AKTIEBOLAG, A SWEDISH JOINT-STOCK COMPANY Integrated semiconductor circuit and method for producing it, and use of such a circuit for providing a flow meter
4850358, Nov 14 1986 SciMed Life Systems, INC; Boston Scientific Scimed, Inc Method and assembly for introducing multiple devices into a biological vessel
5156052, Dec 20 1990 Honeywell Inc. Ribbed and bossed pressure transducer
5226423, Jul 11 1990 Radi Medical Systems AB Sensor guide construction and use thereof
5259248, Mar 19 1990 Hitachi Ltd. Integrated multisensor and static and differential pressure transmitter and plant system using the integrated multisensor
5404753, Jun 13 1992 Robert Bosch GmbH Mass flow sensor
5447073, Feb 04 1994 INVENSYS SYSTEMS INC FORMERLY KNOWN AS THE FOXBORO COMPANY Multimeasurement replaceable vortex sensor
5551301, Jun 19 1995 Volcano Corporation Piezoresistive pressure transducer circuitry accommodating transducer variability
5668320, Sep 03 1996 Volcano Corporation Piezoresistive pressure transducer circuitry accommodating transducer variability
5715827, Sep 02 1994 Volcano Corporation Ultra miniature pressure sensor and guide wire using the same and method
5728066, Dec 10 1996 Injection systems and methods
5761957, Feb 08 1996 Denso Corporation Semiconductor pressure sensor that suppresses non-linear temperature characteristics
5906636, Sep 20 1996 BOARD OF REGENTS OF THE UNIVERSITY OF TEXAS SYSTEM, THE Heat treatment of inflamed tissue
5935075, Sep 20 1995 BOARD OF REGENTS OF THE UNIVERSITY OF TEXAS SYSTEM, THE Detecting thermal discrepancies in vessel walls
DE4219454,
EP178368,
///
Executed onAssignorAssigneeConveyanceFrameReelDoc
Jan 30 1997Radi Medical Systems AB(assignment on the face of the patent)
Nov 27 2009Radi Medical Systems ABST JUDE MEDICAL SYSTEMS ABCHANGE OF NAME SEE DOCUMENT FOR DETAILS 0347960153 pdf
Sep 23 2014ST JUDE MEDICAL SYSTEMS ABST JUDE MEDICAL COORDINATION CENTER BVBAASSIGNMENT OF ASSIGNORS INTEREST SEE DOCUMENT FOR DETAILS 0351690705 pdf
Date Maintenance Fee Events
Jul 30 2009M1552: Payment of Maintenance Fee, 8th Year, Large Entity.
Jul 31 2009ASPN: Payor Number Assigned.
Jul 31 2009STOL: Pat Hldr no Longer Claims Small Ent Stat
Mar 14 2013M1553: Payment of Maintenance Fee, 12th Year, Large Entity.


Date Maintenance Schedule
Oct 02 20104 years fee payment window open
Apr 02 20116 months grace period start (w surcharge)
Oct 02 2011patent expiry (for year 4)
Oct 02 20132 years to revive unintentionally abandoned end. (for year 4)
Oct 02 20148 years fee payment window open
Apr 02 20156 months grace period start (w surcharge)
Oct 02 2015patent expiry (for year 8)
Oct 02 20172 years to revive unintentionally abandoned end. (for year 8)
Oct 02 201812 years fee payment window open
Apr 02 20196 months grace period start (w surcharge)
Oct 02 2019patent expiry (for year 12)
Oct 02 20212 years to revive unintentionally abandoned end. (for year 12)