Integrated Ultrasonic Sensors for In-Situ Stent, Graft, or Stent-Graft Patency Monitoring

该博士项目将开发用于血管支架和支架/移植物的微型超声波传感设备。其目标是生产一种能够持续监测支架或支架/移植物状态的设备，检测植入物的通畅性，并监测可能的狭窄、血栓、错位或渗漏。背景和动机-尽管医疗保健服务有了显著改善，心血管疾病(CVD)仍是世界上头号死亡原因。欧洲联盟因心血管疾病造成的经济负担估计超过1960亿欧元。这项提议试图建立一种智能支架或支架/移植设备，可以使用现有的手术和插管程序进行部署，同时提供先进的技术能力，预计将降低患者的发病率和死亡率。一种可以相互作用并报告自己血管状态的植入物，例如血管泄漏、重新堵塞或血栓的时候，将是变革性的。在这个项目中，我们将研究如何在支架/移植物部署前将微型超声换能器放置在支架/移植物上，以帮助监测血管和其中的支架/移植物的健康状况。目前对智能支架的研究包括使用超声(US)设备来监测血流速度或设备的电特性，这些特性会随着植入物周围组织的积聚而变化。此外，我们建议的US传感器将允许对植入物和血管进行超声波检查，提供进一步的诊断信息。这为血管内泄漏检测提供了可能性，可以监测任何阳性血管重塑或植入物周围积聚的任何材料的数量和组成，狭窄或血栓，提供关键的临床数据，告知是否需要进一步干预。传感方法-通过将超声换能器集成到心血管植入物上，我们将能够连续测量血管的两个物理属性中的一个或两个；首先是作为多普勒频移血流计的血流速度，其次是血管的物理解剖，使用超声波作为类似于介入性血管内超声(IVUS)的成像方法给出血管闭塞的百分比和组成，其他可能包括在植入物内放置表面声波(SAW)设备，它可以检测其周围的物质堆积。设备放置-可以将微型传感设备放置在支架或支架/移植物内，因为建议部署类似的智能设备，或者随着超声波轻松穿过血管/设备壁，它可以放置在血管外部或多腔移植物的层之间；其他智能血管传感器也建议进行这种定位。

This PhD project will develop miniaturised ultrasonic sensing devices for vascular stents and stents/grafts. The goal is to produce a device that can continually monitor the state of the stent or stent/graft, detecting the implant's patency and monitoring for possible stenosis, thrombosis, malposition or leak. Background and motivation - Despite significant improvements in healthcare provision, cardiovascular disease (CVD) remains the number one cause of death in the World. The economic burden to the European Union for cardiovascular disease is estimated at over 196 Billion EUR. This proposal attempts to build towards a smart stent or stent/graft device that can be deployed using existing surgical and catheterisation procedures, yet provides advanced technological abilities that are predicted to reduce patient morbidity and mortality. An implant which can interact and report on its own vessel status, such as when the vessel leaks, re-blocks or clots would be transformative. In this project we will investigate how placing a miniature ultrasonic transducer onto the stent/graft before it is deployed could help to monitor the health of the vessel and the stent/graft within it. Current research on smart stents includes using ultrasound (US) devices for monitoring blood flow velocity or the electrical properties of the device which change in response with the build-up of tissue around the implant. In addition, our proposed US sensor will allow the ultrasonic interrogation of the implant and vessel providing further diagnostic information. This opens up the possibility of endovascular leak detection, monitoring any positive vessel remodelling or the amount and composition of any material building up around the implant, stenosis or thrombosis, giving key clinical data informing on whether further intervention is necessary. Sensing methods - with an ultrasonic transducer integrated onto a cardiovascular implant we will be able to continually measure one or both of two physical properties of the vessel; first the blood flow rate as a Doppler shift flow meter and second the physical anatomy of the vessel, giving the percentage and composition of the occlusion of the vessel using the ultrasonic waves as an imaging method similar to interventional intravascular ultrasound (IVUS) modalities, other possibilities include placing Surface Acoustic Wave (SAW) devices within the implant which could detect material building up in their vicinity. Device placement - a miniaturised sensing device could be placed inside the stent or stent/graft as similar smart devices are proposed to be deployed or with the ultrasound passing through the vessel/device wall easily it could be placed outside the vessel or between the layers of a multi-lumen graft; positioning that has also been proposed for other smart vascular sensors.