ACCESS CLOSURE WITH BLEED MONITORING
A blood vessel access closure device includes an inner blood vessel wall support member and an outer blood vessel wall support member. The closure device also includes a deployment member and an electrode. The deployment member is configured to draw the inner and outer blood vessel wall support members towards each other when the inner and outer blood vessel wall members are deployed on opposite sides of a blood vessel wall during closure of a hole in the blood vessel wall. The electrode is configured to be attached to the deployment member and configured to be used to measure impedance.
This application is a continuation of U.S. Non-Provisional application Ser. No. 16/738,176 filed Jan. 9, 2020, which claims priority to U.S. Provisional Application No. 62/790,906, filed Jan. 10, 2019, both of which are hereby incorporated by reference.
BACKGROUNDSome medical procedures involve accessing a patient's blood vessel. For example, catheterizations involve inserting a catheter into a blood vessel to access other parts of the person such as the heart. To access a blood vessel, a needle is first inserted through the person's skin and into the blood vessel. A wire is then inserted through the needle and the needle is then removed. Other components, such as an introducer sheath are then inserted through the hole in the blood vessel wall. While some vessel wall holes may close themselves, not all do. At the end of the medical procedure, the hole in the blood vessel may need to be manually closed such as through use of any of a variety of blood vessel access closure devices and techniques.
SUMMARYVarious examples of blood vessel access closure devices are disclosed that include the ability for bioimpedance to be measured. The impedance of the body around the site of a blood vessel hole being closed can be used to determine if the hole has been adequately closed, or whether the hole is still leaking blood.
In one example, a blood vessel access closure device includes an inner blood vessel wall support member and an outer blood vessel wall support member. The closure device also includes a deployment member and an electrode. The deployment member is configured to draw the inner and outer blood vessel wall support members towards each other when the inner and outer blood vessel wall members are deployed on opposite sides of a blood vessel wall during closure of a hole in the blood vessel wall. The electrode is configured to be attached to the deployment member and configured to be used to measure impedance.
In another example, a blood vessel access closure device includes a suture wire and an electrode. The suture wire is configured to close a hole in a blood vessel. The electrode is coupled to the suture wire and is configured to be attached to the deployment member and configured to be used to measure impedance.
For a detailed description of various examples, reference will now be made to the accompanying drawings in which:
Blood vessel access closure systems are used to close a hole in a blood vessel. However, it is possible that blood still leaks through the hole in the blood vessel wall even after use of the access closure device. In accordance with the disclosed examples, the access closure systems described herein include the ability to measure electrical impedance in the area around the blood vessel hole. The impedance of blood is different than the impedance of other body tissues and thus an accumulation of blood on the outside of the blood vessel in the area around the hole being closed indicates that blood is still leaking through the hole despite the application of the access closure device.
In
To measure impedance, the patch's circuit may inject a predetermined current magnitude through one pair of electrodes (including the electrode 120 near the site of the blood vessel 95) and measure the resulting voltage using a different set of electrodes. One of the electrodes may be used for both the current injection and voltage measurement. The ratio of voltage to current equals impedance. Alternatively, the circuit may use one pair of electrodes (including electrode 120) to apply a voltage of a predetermined amplitude and measure the resulting current. The current or voltage applied to the electrodes may be AC or DC. Impedance measurements made at certain frequencies may provide more useful information than at other frequencies. At certain frequencies, it may be difficult to detect a bleed, whereas at other frequencies, bleed detection is easier. In one example, the frequency used for the impedance measurements are in the range of 1000 Hz to 200 KHz, although a different frequency range may be acceptable as well. Additional information regarding impedance measurements may be found in US. Pat. Pub. No. 2017/0049359 which incorporated herein by reference.
In the example of
In another example, the patch has no battery. Instead, the patch has a coil of wire or other type of antenna that can receive wireless power from an external device (e.g., a handheld wand). When the external device is brought near the patch, the patch's circuit is powered up, initiates an impedance measurement, and transfers one or more values indicative of impedance to the external device.
Another example includes an electrode 120 that is constructed of a conductive bioabsorbable polymer that is not removed. Instead, following use of the electrode during a medical procedure to detect bleeding, the electrode remains in the body and is reabsorbed. Suitable polymers for such an electrode are described in U.S. Pat. No. 6,696,575, incorporated herein by reference.
In one example, at the end of a vascular access procedure, the guidewire is left in the vessel to monitor for bleed complications until it is determined that the risk of bleeding is sufficiently low. The physician deploys an access closure device in the form of a collagen plug 920 that seals around the guidewire 910 and hole 921. After it is determined that the risk of bleeding is low, the physician may then remove the guidewire 910 by pulling the guidewire through the collagen plug 920 and leg tissue. The collagen plug 920 may remain in place maintaining a seal around the blood vessel wall.
The central control system 1110 includes a processor 1102 and storage 1104 (e.g., memory, hard drive, etc.). The storage 1104 may store the received patent-related bleed information and software to be executed by the processor 1102. In one example, the central control system 1110 is a computer. The central control system 1110 may transmit alerts for a given patient to that patient's physician who carries one of the portable devices 1130, 1132. As such, a patient's physician may be kept abreast of the status of that physician's patients (e.g., whether the patient is experiencing a bleed, the severity of the bleed, etc.).
Modifications are possible in the described embodiments, and other embodiments are possible, within the scope of the claims.
Claims
1. A blood vessel access closure device, comprising:
- an inner blood vessel wall support member;
- an outer blood vessel wall support member;
- a deployment member configured to draw the inner and outer blood vessel wall support members towards each other when the inner and outer blood vessel wall members are deployed on opposite sides of a blood vessel wall during closure of a hole in the blood vessel wall; and
- a first electrode configured to be attached to the deployment member and configured to be used to measure impedance, wherein the first electrode is bioabsorbable.
2. The blood vessel access closure device of claim 1, wherein the deployment member comprises a conductive suture wire attached to the first electrode.
3. The blood vessel access closure device of claim 1, further comprising an adhesive patch configured to be placed on a person's skin over a blood vessel access location, the adhesive patch comprising a second electrode.
4. The blood vessel access closure device of claim 3, wherein the adhesive patch includes a circuit configured to transmit a wireless signal, the wireless signal indicative of the impedance.
5. The blood vessel access closure device of claim 1, further comprising an adhesive patch configured to be placed on a person's skin over the blood vessel, the adhesive patch comprising a plurality of electrodes.
6. The blood vessel access closure device of claim 5, wherein the adhesive patch comprises a circuit configured to use the first electrode and one or more of the plurality of electrodes on the adhesive patch to measure multiple impedance values in multiple different locations.
7. The blood vessel access closure device of claim 5, wherein the adhesive patch comprises a visual indicator of one or more of the multiple impedance values, the visual indicator indicative of a location of a bleed.
8. The blood vessel access closure device of claim 5, wherein the adhesive patch has a rectangular shape, the rectangular shape having a width and a length, and the plurality of electrodes are positioned along the length.
9. The blood vessel access closure device of claim 5, wherein the adhesive patch is circular.
10. The blood vessel access closure device of claim 1, further including:
- a guide wire including multiple electrodes; and
- an adhesive patch configured to be placed on a person's skin over a blood vessel access location, the adhesive patch comprising: multiple electrodes; a circuit configured to determine an impedance between (a) any of the multiple electrodes on the adhesive patch and (b) the first electrode and any of the multiple electrodes on the guide wire to detect occurrence of a bleed; and a visual indicator indicative of a location of a detected bleed.
11. A patch adapted to be placed on a person's skin over a blood vessel, the patch comprising:
- a first electrode; and
- a circuit coupled to the first electrode and configured to measure an impedance value between the first electrode and a second electrode.
12. The patch of claim 11, further comprising a third electrode, and the circuit is configured to measure an impedance value between the third electrode and the second electrode.
13. The patch of claim 12, further comprising one or more electrodes in addition to the first and third electrodes, the circuit is configured to measure impedance values between the one or more electrodes and the second electrode.
14. The patch of claim 12, wherein the patch has a rectangular shape, the rectangular shape having a width and a length, and the first, third, and the one or more electrodes are positioned along the length.
15. The patch of claim 10, wherein the patch is circular.
16. The patch of claim 10, further comprising a visual indicator of the impedance value.
17. The patch of claim 10, wherein the patch is adhesive.
18. The patch of claim 10, wherein the circuit includes a transceiver configured to transmit a wireless signal, the wireless signal indicative of the impedance value.
19. The patch of claim 10, wherein the circuit is battery-operated.
Type: Application
Filed: Dec 10, 2021
Publication Date: Mar 31, 2022
Inventors: Philippe GENEREUX (New York, NY), Robert M. KIPPERMAN (Morristown, NJ), Kenneth M. BUECHE (Friendswood, TX), Zaffer SYED (Houston, TX)
Application Number: 17/548,052