Time-division multiplexing for cable reduction in ultrasound imaging catheters

In ultrasound imaging catheter applications, gathering the data from multi-element transducer arrays is difficult as there is a restriction on cable count due to the diameter of the catheter. In such applications, CMUT-on-CMOS technology allows for 2D arrays with many elements to be designed and bonded directly onto CMOS circuitry. This allows for complex electronics to be placed at the tip of the catheter which leads to the possibility to include electronic multiplexing techniques to greatly reduce the cable count required for a large element array. Current approaches to cable reduction tend to rely on area and power hungry circuits to function, making them unsuitable for use in catheters. Furthermore the length requirement for catheters and lack of power available to on-chip cable drivers leads to limited signal strength at the receiver end. In this paper an alternative approach using Analogue Time Division Multiplexing (TDM) is presented, which addresses the cable restrictions of the catheter and, using a novel digital demultiplexing technique, allows for a reduction in the number of analogue signal processing stages required

Merging boundaries, techniques and experiences

An international urban design workshop was conducted with students from a US and a Turkish Universities for 15 days in a waterfront village on Bosporus, Istanbul Bosphorus, a crooked and curved strait dividing the city into two, has traditionally been used mostly for enjoying scenery and nature with its location away from the main trade docks and industrial areas concentrated around the old city center, namely historic peninsula. The strait housed small settlements until the 18th century, during when the royal family started populating the coast with palaces and summer mansions and private gardens and celebrated various festivities. It was a special ritual (Hamadeh, 2009) to experience mansions (yali’s, which are perched on the very edge of the bank with boat houses and access) and palaces, mostly timber-frame ornamental structures, and gardens while sailing on the Bosphorus. Later, public spaces, coffee houses, fountains and parks were added to the waterfront development, improving the public’s participation in the pastoral culture and transforming these small settlements into connected villages. The pleasure of experiencing the Bosphorus was shared with the whole public through songs, poems, novels and paintings. There were even traditional evening excursions and singing on the boats –caiques- on Bosphorus. Hence, for centuries, Bosphorus has been a socializing space and a sensual experience for many. Despite the fact the quality of the built environment and the way of living has dramatically changed due to the spatial and social transformation in the following centuries, the yalı’s and some other contemporary buildings added have continued the dwelling tradition of close proximity to the water. On the other hand, Bosphorus, where used to be a meditative place in the past, has become a natural part of the hectic urban life and architecture. Focusing on spatial experience, the students attempted to understand and propose solutions to urban disconnect in the urban fabric especially between historic waterfront and inland village. The workshop provided an opportunity for each student to formalize his/her opinion of the place based on individual filters and sensual experiences. This method helped to identify a rich set of perceptual characteristics of the site and resulted in diverse and unique exploration and representation techniques. The workshop included a guided tour of the historic peninsula and a trip to various waterfront villages on the both sides of the strait, listening to historic and contemporary Turkish music, discussions, and readings such as Tschumi’s (1995) ideas on program, movement, and contradiction as well as Sancar’s article (2001) on the people’s attachment to place through lyrics. This paper consists of a brief description of the place in question, its changing daily life and architecture, and how the students responded to all of these through design and representation.publisher versio

Direct Digital Demultiplexing of Analog TDM Signals for Cable Reduction in Ultrasound Imaging Catheters.

In real-time catheter based 3D ultrasound imaging applications, gathering data from the transducer arrays is difficult as there is a restriction on cable count due to the diameter of the catheter. Although area and power hungry multiplexing circuits integrated at the catheter tip are used in some applications, these are unsuitable for use in small sized catheters for applications like intracardiac imaging. Furthermore, the length requirement for catheters and limited power available to on-chip cable drivers leads to limited signal strength at the receiver end. In this paper an alternative approach using Analog Time Division Multiplexing (TDM) is presented which addresses the cable restrictions of ultrasound catheters. A novel digital demultiplexing technique is also described which allows for a reduction in the number of analog signal processing stages required. The TDM and digital demultiplexing schemes are demonstrated for an intracardiac imaging system that would operate in the 4 MHz to 11 MHz range. A TDM integrated circuit (IC) with 8:1 multiplexer is interfaced with a fast ADC through a micro-coaxial catheter cable bundle, and processed with an FPGA RTL simulation. Input signals to the TDM IC are recovered with -40 dB crosstalk between channels on the same micro-coax, showing the feasibility of this system for ultrasound imaging applications

Front-end electronics for cable reduction in Intracardiac Echocardiography (ICE) catheters

3-D imaging ICE catheters with large element counts present design challenges in achieving simultaneous data readout from all elements while significantly reducing cable count for a small catheter diameter. Current approaches such as microbeamformer techniques tend to rely on area and power hungry circuits, making them undesirable for ICE catheters. In this paper, a system which uses are an efficient real-time programmable on-chip transmit (TX) beamformer circuitry to reduce the cable count on the TX side and analog 8/1 Time Division Multiplexing (TDM) with Direct Digital Demodulation (DDD) to reduce the cable count on the receive (RX) side is presented

Single-Chip Reduced-Wire CMUT-on-CMOS System for Intracardiac Echocardiography

CMUT-on-CMOS integration is particularly suitable for catheter based ultrasound imaging applications, where electronics integration enables multiplexing capabilities to reduce the number of electrical connections leading to smaller catheter cable profiles. Here, a single-chip CMUT-on-CMOS system for intracardiac echocardiography (ICE) is presented. In this system, a 64 element 1-D CMUT array is fabricated over an application specific integrated circuit (ASIC) that features a programmable transmit beamformer with high voltage (HV) pulsers and receive circuits using 8:1 time division multiplexing (TDM). Integration of pitch matched 64 channel front-end circuits with CMUT arrays in a single-chip configuration allows for implementation of catheter probes with miniaturization, reduced number of cables, and better mechanical flexibility. The ASIC is implemented in 60 V 0.18 μm HV process. It occupies 2.6×11 mm 2 which can fit in the catheter size of 9F, and reduces the number of wires from more than 64 to 22. This system is used for B-mode imaging of imaging phantoms and its potential application for 2D CMUT-on-CMOS arrays is discussed

Long-term follow-up of incomplete stent apposition in patients who received sirolimus-eluting stent for de novo coronary lesions: an intravascular ultrasound analysis.

BACKGROUND: Incomplete stent apposition (ISA) has been previously documented after sirolimus-eluting stent (SES) implantation. The aim of this study was to investigate the long-term intravascular ultrasound (IVUS) findings of ISA in patients who received SES. METHODS AND RESULTS: A total of 13 patients who received SES and showed ISA at follow-up IVUS (follow-up I) were investigated. IVUS was performed on all of these patients 12 months later (follow-up II). Quantitative ISA area measurement was also performed at follow-up I and II. No vascular remodeling was observed in the vessel segment with ISA; external elastic membrane area was 19.4+/-6.6 versus 19.5+/-6.4 mm2 at follow-up I and II, respectively. There was also no significant change in external elastic membrane area between vessel segment with ISA and without ISA (+1.5% versus -3.0%, respectively; P=0.27) at late follow-up. The ISA area, either including (2.5+/-1.7 versus 3.8+/-6.3 mm2; P=NS) or excluding (2.5+/-1.8 versus 2.4+/-1.7 mm2; P=NS) a single patient with aneurysm formation, was not significantly different between follow-up I and II. One patient manifested a coronary aneurysm in the stented segment at late follow-up that was probably present at the initial follow-up but masked by thrombus. It was successfully treated with a covered stent. All patients were asymptomatic, and no patient experienced late thrombotic occlusion. CONCLUSIONS: Vessel dimensions and area of ISA did not change over time, except for 1 coronary aneurysm that became apparent. ISA after implantation of a SES was not associated with adverse events at late follow-up

Single-Chip Reduced-Wire Active Catheter System with Programmable Transmit Beamforming and Receive Time-Division Multiplexing for Intracardiac Echocardiography

Intracardiac echocardiography (ICE) provides real-time ultrasound imaging of the heart anatomy from inside, guiding interventions like valve repair, closure of atrial septal defects (ASD) and catheter-based ablation to treat atrial fibrillation. With its better image quality and ease of use, ICE is becoming the preferred imaging modality over transesophageal echography (TEE) for structural heart interventions. The existing commercial ICE catheters, however, offer a limited 2-D or 3-D field of view despite catheters utilizing large number of wires. In these catheters, each element in the ICE array is connected to the backend data-acquisition channel with a separate wire, which is a critical barrier for improving image quality and widening the field of view. In order to use ICE catheters under MRI instead of the ionizing X-ray radiation-based angiography, the number of interconnect wires in the catheter should be minimized to reduce RF-induced heating. Furthermore, reducing the number of wires improves the flexibility and lowers the cost of the single-use ICE catheters

Intravascular ultrasound findings in the multicenter, randomized, double-blind RAVEL (RAndomized study with the sirolimus-eluting VElocity balloon- expandable stent in the treatment of patients with de novo native coronary artery Lesions) trial

BACKGROUND: The goal of this intravascular ultrasound investigation was to provide a more detailed morphological analysis of the local biological effects of the implantation of a sirolimus-eluting stent compared with an uncoated stent. METHODS AND RESULTS: In the RAVEL trial, 238 patients with single de novo lesions were randomized to receive either an 18-mm sirolimus-eluting stent (Bx VELOCITY stent, Cordis) or an uncoated stent (Bx VELOCITY stent). In a subset of 95 patients (sirolimus-eluting stent=48, uncoated stent=47), motorized intravascular ultrasound pullback (0.5 mm/s) was performed at a 6-month follow-up. Stent volumes, total vessel volumes, and plaque-behind-stent volumes were comparable. However, the difference in neointimal hyperplasia (2+/-5 versus 37+/-28 mm3) and percent of volume obstruction (1+/-3% versus 29+/-20%) at 6 months between the 2 groups was highly significant (P<0.001), emphasizing the nearly complete abolition of the proliferative process inside the drug-eluting stent. Analysis of the proximal and distal edge volumes showed no significant difference between the 2 groups in external elastic membrane or lumen and plaque volume at the proximal and distal edges. There was also no evidence of intrastent thrombosis or persisting dissection at the stent edges. Although there was a higher incidence of incomplete stent apposition

Persistent inhibition of neointimal hyperplasia after sirolimus-eluting stent implantation: long-term (up to 2 years) clinical, angiographic, and intravascular ultrasound follow-up

BACKGROUND: Early results of sirolimus-eluting stent implantation showed a nearly complete abolition of neointimal hyperplasia. The question remains, however, whether the early promising results will still be evident at long-term follow-up. The objective of our study was to evaluate the efficiency of sirolimus-eluting stent implantation for up to 2 years of follow-up. METHODS AND RESULTS: Fifteen patients with de novo coronary artery disease were treated with 18-mm sirolimus-eluting Bx-Velocity stents (Cordis) loaded with 140 microg sirolimus/cm2 metal surface area in a slow release formulation. Quantitative angiography (QCA) and intravascular ultrasound (IVUS) were performed according to standard protocol. Sirolimus-eluting stent implantation was successful in all 15 patients. During the in-hospital course, 1 patient died of cerebral hemorrhage after periprocedural administration of abciximab, and 1 patient underwent repeat stenting after 2 hours because of edge dissection that led to acute occlusion. Through 6 months and up to 2 years of follow-up, no additional events occurred. QCA analysis revea