Methods for assessing a vessel with sequential physiological measurements

Abstract

A method, device, and system for evaluating a vessel of a patient, and in particular the hemodynamic impact of a stenosis within the vessel of a patient. Proximal and distal pressure measurements are made using first and second instrument while the first instrument is moved longitudinally through the vessel from a first position to a second position and the second instrument remains in a fixed longitudinal position within the vessel. A series of pressure ratio values are calculated, and a pressure ratio curve is generated. One or more stepped change in the pressure ratio curve are then identified and/or located using an Automatic Step Detection (ASD) process and/or algorithm. The ASD includes identifying a general position of a starting point of the stepped change by identifying a change in the pressure ratio values within a first window along the pressure ratio curve that is at or above a first threshold change value, and identifying an optimized position of the starting point by identifying a change in the pressure ratio values within a second window along the pressure ratio curve that is at or above a second threshold change value, wherein the second window is smaller than the first window, and the second threshold change value is smaller than the first threshold change value.