Treatment of an occlusion of a blood vessel

Abstract

Apparatus and methods are described including sensing a phase of a cyclic activity of a subject. In a first cycle of the cyclic activity, at a given phase of the cycle, movement of a distal portion of a tool toward an occlusion in the subject's blood vessel is allowed. Following the given phase in the first cycle, and prior to an occurrence of the given phase in a subsequent cycle, movement of the tool is inhibited. In a second cycle of the cyclic activity, at the given phase of the cycle, the occlusion is at least partially penetrated by the tool, by allowing movement of the distal portion of the tool through at least a portion of the occlusion. Other applications are also described.

1 . (canceled) 
     
     
         2 . A method for use with a blood vessel of a subject that moves as a result of cyclic activity of a body system of the subject, the method comprising:
 sensing a phase of the cyclic activity;   in a first cycle of the cyclic activity, allowing movement of a distal portion of the tool toward an occlusion in the blood vessel, in response to sensing that the cyclic activity is at a first given phase thereof,   following the given phase in the first cycle, and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity, inhibiting the movement of the distal portion of the tool, and   in a second cycle of the cyclic activity, subsequent to the inhibiting of the movement of the tool, at least partially penetrating the occlusion with the tool, by allowing movement of the distal portion of the tool through at least a portion of the occlusion, in response to sensing that the second cycle of the cyclic activity is at the given phase thereof.   
     
     
         3 . The method according to  claim 2 , wherein the tool includes a guide wire, and wherein allowing movement of the distal portion of the tool comprises allowing movement of a distal portion of the guide wire. 
     
     
         4 . The method according to  claim 2 , wherein the cyclic activity includes a cardiac cycle of the subject, and wherein sensing that the cyclic activity is at the first given phase thereof comprises sensing that the subject's cardiac cycle is at a phase at which a cross section of the blood vessel is at its maximum. 
     
     
         5 . The method according to  claim 2 , wherein allowing movement of the distal portion of the tool comprises allowing movement of the distal portion of the tool in response to a user moving a control mechanism, the method further comprising providing force feedback to the user that is smoothened with respect to the cyclic activity. 
     
     
         6 . The method according to  claim 2 , wherein allowing movement of the distal portion of the tool comprises allowing movement of the distal portion of the tool in response to a user moving a control mechanism, the method further comprising providing force feedback to the user that does not vary with respect to the cyclic activity. 
     
     
         7 . The method according to  claim 2 , wherein the tool includes a jackhammer-like tool, and wherein allowing movement of the distal portion of the tool comprises allowing movement of a distal portion of the jackhammer-like tool. 
     
     
         8 . The method according to  claim 2 , wherein inhibiting the movement of the distal portion of the tool comprises inhibiting the movement of the distal portion of the tool using a self-locking clamp of a tool modulator. 
     
     
         9 . The method according to  claim 2 , further comprising:
 acquiring a plurality of images of the tool inside the blood vessel;   generating a stabilized image stream by stabilizing the images with respect to the given phase of the cyclic activity; and   displaying the stabilized image stream.   
     
     
         10 . A method for use with a blood vessel of a subject that moves as a result of cyclic activity of a body system of the subject, the blood vessel defining a blood vessel lumen, the method comprising:
 inserting a bypass tool into the lumen; and   bypassing an occlusion within the blood vessel lumen, with the bypass tool, by:
 acquiring a plurality of image frames of the bypass tool disposed within the blood vessel; 
 sensing a phase of the cyclic activity; 
 generating a stabilized image stream of the bypass tool within the blood vessel by stabilizing the images with respect to a given phase of the cyclic activity; 
 in a first cycle of the cyclic activity, penetrating a wall of the blood vessel on a first side of the occlusion with the bypass tool by allowing movement of a distal portion of the bypass tool to outside the lumen, in response to sensing that the cyclic activity is at the given phase thereof; 
 following the given phase in the first cycle, and prior to an occurrence of the given phase in a subsequent cycle of the cyclic activity, inhibiting movement of the distal portion of the bypass tool; and 
 in a second cycle of the cyclic activity, subsequent to the first cycle of the cyclic activity, allowing movement of the distal portion of the bypass tool to inside the lumen on a second side of the occlusion, in response to sensing that the cyclic activity is at the given phase thereof. 
   
     
     
         11 . The method according to  claim 10 , wherein allowing movement of the distal portion of the bypass tool comprises allowing movement of the distal portion of the bypass tool in response to a user moving a control mechanism, the method further comprising providing force feedback to the user that is smoothened with respect to the cyclic activity. 
     
     
         12 . The method according to  claim 10 , wherein allowing movement of the distal portion of the bypass tool comprises allowing movement of the distal portion of the bypass tool in response to a user moving a control mechanism, the method further comprising providing force feedback to the user that does not vary with respect to cyclic activity. 
     
     
         13 . The method according to  claim 10 , wherein inhibiting the movement of the distal portion of the bypass tool comprises inhibiting the movement of the distal portion of the bypass tool using a self-locking clamp of a tool modulator.