US20140188062A1 - Collection catheter and kit - Google Patents
Collection catheter and kit Download PDFInfo
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- US20140188062A1 US20140188062A1 US14/199,195 US201414199195A US2014188062A1 US 20140188062 A1 US20140188062 A1 US 20140188062A1 US 201414199195 A US201414199195 A US 201414199195A US 2014188062 A1 US2014188062 A1 US 2014188062A1
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- Prior art keywords
- collection
- suction
- lumen
- blood vessel
- sealing member
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- A61M1/0035—
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
- A61M1/3659—Cannulae pertaining to extracorporeal circulation
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/74—Suction control
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/71—Suction drainage systems
- A61M1/74—Suction control
- A61M1/743—Suction control by changing the cross-section of the line, e.g. flow regulating valves
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/1002—Balloon catheters characterised by balloon shape
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
- A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
- A61M1/3621—Extra-corporeal blood circuits
- A61M1/3627—Degassing devices; Buffer reservoirs; Drip chambers; Blood filters
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
- A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
- A61M25/0026—Multi-lumen catheters with stationary elements
- A61M25/003—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves
- A61M2025/0031—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves characterized by lumina for withdrawing or delivering, i.e. used for extracorporeal circuit treatment
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1093—Balloon catheters with special features or adapted for special applications having particular tip characteristics
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1095—Balloon catheters with special features or adapted for special applications with perfusion means for enabling blood circulation while the balloon is in an inflated state or in a deflated state, e.g. permanent by-pass within catheter shaft
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
Definitions
- This invention pertains to catheters for collecting fluid from a blood vessel of a patient.
- Collection catheters are well known for collecting blood or other fluids from blood vessels of a patient.
- International Publication No. WO 2005/082440 A1 describes collection catheters for collecting blood from a coronary sinus or other coronary vein in a perfusion system.
- blood may be collected from a coronary vein in an angiography procedure.
- Such procedures are used for assessing patency of coronary arteries. These procedures may also be used for other purposes—for example, in stent placement or other procedures.
- a contrast medium is injected into a coronary artery proximal to a suspected site of a coronary obstruction.
- Contrast media may have significant health risks if permitted to flow systemically to the patient's organs. For example, renal dysfunction or failure may occur from such systemic delivery of a contrast media. Such failure is referred to as “contrast-induced nephropathy” or CIN. Schrader, “Contrast Media-Induced Renal Failure: And Overview”, Journal of Interventional Cardiology, Vol. 18, No. 6, pages 417-423 (2005).
- Blood collected in a contrast removal or other blood collection system may be processed to be re-admitted to the patient. However, it is more common for collected blood to be discarded. It is generally recognized that a limited amount (e.g., 100 milliliters to 200 milliliters) of blood may be safely removed from a patient and discarded.
- Blood collection techniques include methods and apparatus for isolating blood flow in a vessel. This insures that substantially all antegrade flow (i.e., the normal direction of blood flow in a vessel) is collected for a period of time to substantial collect all contrast media or perfusate which is the object of collection.
- substantially all antegrade flow i.e., the normal direction of blood flow in a vessel
- Retrograde flow in a direction opposite normal blood flow in a vessel
- the suction may be such that blood in the right atrium flows retrograde and is drawn through the catheter.
- blood not laden with contrast media or perfusate is collected and possibly discarded. Since there are limits on how much blood may be discarded, it is desirable to avoid collecting and discarding blood not laden with contrast media or perfusate.
- Isolation is commonly achieved through use of balloon catheters.
- a balloon is inflated during periods of blood collection to seal against the wall of the blood vessel. Otherwise, the balloon is deflated to be spaced from the blood vessel wall.
- contrast media may be injected at multiple times during a procedure.
- a balloon is repeated inflated and deflated in a manner timed with the injection.
- a method and apparatus for collecting fluid from a blood vessel (such as a coronary sinus) of a patient.
- the method includes use of a catheter in the form of a collection member having an elongated, flexible tubular portion terminating at a distal end.
- An annular sealing member e.g., an inflatable balloon in a preferred embodiment
- a collection lumen of the tubular portion has a fluid inlet distal to the sealing member.
- a proximal end of the tubular member is adapted to be connected to a source of suction for applying a suction to the collection lumen.
- the method includes placing the distal end in a blood vessel with antegrade flow within the vessel flowing in a direction from the distal end toward the sealing member.
- the sealing member is spaced from opposing surface of the vessel in an absence of a suction applied to the collection lumen.
- a suction is applied to the collection lumen in an amount sufficient to draw blood from the vessel through the fluid inlet and into the collection lumen and further sufficient to urge the opposing surface of the blood vessel to migrate into sealing engagement with the sealing member.
- FIG. 1 illustrates a system including a collection catheter according to the present invention for collection of blood from a patient's blood vessel and also showing an optional vessel support apparatus;
- FIG. 1A is a schematic representation of the system of FIG. 1 ;
- FIG. 2 is a side longitudinal view of a collection catheter of FIG. 1 shown in a coronary sinus of a patient and illustrating spacing between a sealing member and a blood vessel wall when a suction is not applied to a lumen of the catheter;
- FIG. 3 is the view of FIG. 2 following application of a suction to the lumen of the catheter and illustrating migration of the blood vessel wall into sealing engagement with the sealing member of the catheter;
- FIG. 3A is the view of FIG. 3 illustrating potential collapse of the blood vessel if not supported distal to the collection catheter;
- FIG. 4 is a longitudinal side sectional view of the collection catheter and vessel support of FIG. 1 ;
- FIG. 5 shows, in cross-section, a sealing member within a coronary sinus and spaced from the walls of the coronary sinus;
- FIG. 6 is the view of FIG. 5 following application of suction to the catheter and showing migration of the wall of the blood vessel against the sealing member;
- FIG. 7 is the view FIG. 5 and showing an alternative geometry sealing member within a blood vessel prior to application of a suction;
- FIG. 8 is the view of FIG. 7 following application of suction
- FIG. 9 shows an alternative embodiment of a collection catheter in a blood vessel prior to application of suction
- FIG. 10 is the view of FIG. 9 following application of suction
- FIG. 11 is the view of the catheter of FIG. 9 shown urged to an uncoiled configuration for advancement through the patient's vascular system;
- FIG. 12 is an exploded perspective view of a kit according to the present invention.
- FIG. 1 shows a system 100 including a collection catheter 10 according to the present invention.
- the collection catheter 10 is used to collect blood flow laden with a perfusate or a contrast media which had been injected into a coronary artery for angiography or similar procedures.
- the collection catheter 10 is to collect blood flow from the coronary sinus before such blood flow can pass systemically to the remainder of the patient's body.
- the apparatus of the present invention can be used in any blood collection technique including that described in the aforementioned International Publication No. WO 2005/082440 A1 (incorporated herein by reference) as well as any dialysis or similar blood collection system. Accordingly, the reference to coronary sinus is illustrative only and can include any other blood vessel.
- the system 100 includes a collection canister 102 and a vacuum regulator 104 .
- the collection canister 102 is sealed from atmospheric pressure.
- the system of FIG. 1 is schematically shown in FIG. 1A which also illustrates a level of collected blood within the canister 102 and indicated by 120 . Further FIG. 1A shows a trap 109 and a pinch valve 105 as will be described.
- Tubing 106 is connects to a port 119 of the collection catheter to communicate with a central lumen 26 (as will be described with reference to FIG. 4 ) of the collection catheter 10 .
- the tubing 106 connects the collection lumen 26 to the interior of the canister 102 .
- Tubing 108 connects the interior of the canister 102 to the pressure regulator 104 .
- the pressure regulator 104 has a supply tubing 110 to be connected to a source 111 of a vacuum ( FIG. 1A ). Such a source is commonly provided in a hospital or other similar setting.
- FIG. 1A shows a trap 109 for collecting blood which might inadvertently flow toward regulator 104 .
- the system 100 further includes a pressure monitor 112 connected by a tubing 114 to tubing 106 .
- the pressure monitor 112 monitors and displays the pressure within the tubing 106 thereby corresponding to the pressure within the lumen 26 of the collection catheter 10 .
- a proximal end 17 ( FIG. 1 ) of the collection catheter 10 also includes a port 118 for connection to the source of pressurized fluid (such as air or saline) for pressurizing a sealing balloon 18 on a distal end 16 of the catheter 10 as will be described.
- the proximal end 17 also includes a port 121 for passing the support device 30 or a guide wire or the like into the catheter lumen 26 .
- the catheter 10 includes a catheter body 12 in the form of an elongated, flexible tubular portion having a proximal end 17 (shown only in FIGS. 1 and 12 ) and a distal tip 16 ( FIG. 2 ).
- a catheter body 12 in the form of an elongated, flexible tubular portion having a proximal end 17 (shown only in FIGS. 1 and 12 ) and a distal tip 16 ( FIG. 2 ).
- the drawing of FIG. 1 is not to scale and that the length of the catheter body 12 is substantially longer than that shown in FIG. 1 so that the distal tip 16 may be advanced through the vasculature of a patient into a coronary sinus CS while the proximal end 17 remains external to the patient.
- annular sealing member 18 is provided in close spacing to the distal end 16 .
- the annular sealing member 18 is a compliant balloon formed of material which can both conform and stretch as it is inflated. It will be appreciated that compliant balloons are well-known in the art and form no part of this invention per se.
- the sealing member need not be a balloon. For example, it can be a mechanically actuated sealing surface moved into close spacing from the vessel wall.
- the balloon has a radial distal end 20 of smaller diameter than a radial proximal end 22 .
- an annular surface 24 between the ends 20 , 22 is inclined relative to a longitudinal axis X-X of the tubular member 12 .
- ends 20 and 22 can have a common diameter such that the annular surface 24 is parallel to the axis X-X.
- Surface 24 can also be curved (convex or concave) relative to axis X-X.
- the end 16 is open and communicates with a collection lumen 26 running the length of the catheter body 12 .
- the collection lumen 26 communicates with port 119 .
- An inflation lumen 28 is provided in the wall thickness of body 12 for admitting an inflation fluid into the balloon 18 .
- Inflation lumen 28 communicates with port 118 .
- the catheter 10 is shown used in combination with an optional vessel support device 30 .
- the vessel support device 30 forms no part of this invention per se and may be as more thoroughly described in International Publication No. WO 2005/082440 A1.
- the vessel support 30 includes a long flexible distal end 32 with a curved tip 34 .
- the distal end 32 and 34 may be formed in accordance with conventional techniques for forming well-known guide wires to atraumatically advance through a patient's vasculature.
- a support cage 36 connects a distal wire portion 32 to a proximal wire portion 38 ( FIG. 4 ).
- the cage 36 is made up of a generally circular array (around axis X-X) of flexible elastic struts 37 (such as nitinol or other elastic material suitable for use in a blood vessel).
- the cage 36 prevents the collapse of the coronary sinus CS.
- the positioning of the cage 36 within the coronary sinus provides positioning stability to resist axial movement of the cage 36 relative to the coronary sinus.
- the cage 36 is a convenient tool for maintaining a positioning of the catheter 10 within a coronary sinus CS.
- a guide wire (not shown) is positioned with a guide wire distal end in the coronary sinus CS at the desired location for collecting blood. Procedures for advancing such guide wires are well known.
- the catheter 10 is advanced over the guide wire until the distal tip 16 is at the desired location for collecting blood.
- the distal tip 16 may be radiopaque to assess proper placement under fluoroscopy.
- the sealing balloon 18 is fully deflated.
- a physician may inflate the balloon 18 .
- normal (or antegrade) blood flow is illustrated by the arrow A indicating a direction of normal blood flow through the coronary sinus CS towards the right atrium (not shown).
- the guide wire is then withdrawn and the vessel support 30 is advanced through the catheter 10 into the coronary sinus CS.
- the cage 36 expands to the configuration shown in FIG. 2 . With such expansion, the cage 36 abuts opposing surfaces of the coronary sinus CS.
- the balloon 18 is not inflated to such an extent that it abuts against the opposing wall of the coronary sinus CS. Instead, as illustrated in FIG. 2 , the balloon 18 is only inflated partially such that an annular flow path is defined between the opposing surfaces of the sealing surface 24 and the coronary sinus CS. This flow path is illustrated by the arrows B in FIG. 2 .
- the spacing between the sealing surface 24 and the vessel wall may be about 1-2 millimeters.
- catheter lumen 26 In the absence of suction applied to the catheter lumen 26 , blood flow within the coronary sinus CS flows around the balloon 18 to the right atrium.
- the catheter lumen 26 may be primed with saline or the like to avoid loss of suction blood flow from the coronary sinus CS into the collection lumen 26 .
- a physician can determine if the balloon 18 is over inflated such that it is sealing the coronary sinus CS when no suction is applied to collection lumen 26 . If such over inflation is monitored, the balloon 18 may be slightly deflated until the physician is assured that the balloon 18 is residing in the coronary sinus CS in a non-occluding manner.
- pressure sensors 40 , 41 may optionally be provided on catheter body 12 on opposite sides of balloon 18 . A pressure differential between sensors 40 , 41 indicates occlusion of the coronary sinus CS. Further, either of sensors 40 , 41 may be a flow transducer to sensing blood flow over the sensor. Absence of such sensed flow indicates occlusion due to over-inflation of the balloon 18 .
- the physician may operate the vacuum regulator 104 to generate a suction within the canister 102 and tube 106 .
- the physician selectively applies suction to the catheter lumen 26 by operation of a pinch valve 105 ( FIG. 1A ) on tube 106 .
- the pinch valve 105 may be a clip or the like which, when opened, permits the vacuum to be applied to the catheter lumen 26 . Closure of the pinch valve 105 , pinches the tube 106 shut to block the vacuum application to the catheter lumen 26 . Accordingly, the application of vacuum to the catheter lumen 26 can be rapidly turned off or on.
- suction to the catheter lumen 26 causes the coronary sinus CS to at least partially collapse such that the surfaces of the coronary sinus CS opposing the surface 24 migrate against the surface 24 in sealing engagement. This causes blood flow within the coronary sinus CS to flow completely into the lumen 26 . Further, such sealing engagement avoids retrograde flow from the right atrium past the balloon 18 to the distal end 16 . Such sealing engagement is illustrated in FIG. 3 .
- the timing of the application of suction to the lumen 26 is preferably timed to result in collection of a contrast media injected into a coronary artery. For example after a set time (about three seconds) after injection of a contrast media into a coronary artery, the suction can be applied to the lumen 26 . Alternatively, the patient's electrocardiogram may be monitored and suction may be applied a fixed number (e.g., three) of heart beats following such injection. If desired, a detecting element can be provided at the tip 16 to detect a contrast media resulting in activating application of suction to the lumen 26 . For example, pressure sensor 40 in FIG. 2 could alternatively be a contrast media sensor.
- Blood drawn into the catheter lumen 26 is collected in canister 102 . After collection, the blood may be discarded. Alternatively, the blood may be passed to any suitable treatment apparatus (not shown) for removal of undesired constituents within the collected blood. The treated blood is then returned to the patient.
- the amount of suction provided to the lumen 26 is great enough (e.g., a negative 100 millimeters of Hg) to ensure removal of blood from the coronary sinus.
- the coronary sinus CS is a very fragile and compliant vessel. In response to such suction, the vessel is inclined to collapse. Collapse of the vessel is avoided by the vessel support cage 36 .
- FIG. 3 illustrates the cage 36 distal to the tip 16 preventing complete collapse of the coronary sinus. Instead, cage 36 narrows in diameter (resulting in axial lengthening) but resists complete collapse of the coronary sinus CS.
- FIG. 3A illustrates potential complete collapse of the coronary sinus CS in the absence of such support.
- the tendency of the coronary sinus CS to collapse is utilized as an advantage to result in sealing of the coronary sinus CS against the sealing member 18 . As a result, sealing naturally occurs when suction is applied. No additional inflation or deflation of the balloon 18 is required.
- the present invention can achieve better occlusion at lower balloon pressures. This is illustrated in reference to FIGS. 5 and 6 .
- FIG. 5 the coronary sinus is shown in a rest state (i.e., without application of a suction to the catheter).
- the sealing member 18 is shown residing within the coronary sinus CS.
- the size of a coronary sinus CS may vary significantly from patient to patient. However, in the patient with congestive heart failure the coronary sinus CS may be one to two centimeters in diameter when measured within one to two centimeters of the right atrium.
- the reference to the diameter of the coronary sinus CS suggests that the coronary sinus CS is circular in cross section. In fact, the coronary sinus CS is closer to an oval cross section. A portion of the coronary sinus CS is supported by the myocardium (the muscle tissue of the heart). The remainder of the coronary sinus CS is less supported.
- the sealing balloon 18 is shown as baying a circular cross section. However other geometries can be provided. This is illustrated in FIG. 7 where the sealing balloon 18 a is shown as having a generally square cross section. In FIG. 7 , the coronary sinus CS is shown circular in cross section for ease of illustration. By reason of the square cross section, a greater cross sectional area is defined between opposing surfaces of the sealing member 18 a and the coronary sinus CS. Hence, there is less resistance to blood flow past the balloon 18 a when the catheter lumen is not under suction. However, a complete seal is provided following application of suction as illustrated in FIG. 8 .
- the catheter 10 is packaged as a kit 200 shown in FIG. 12 .
- the catheter 10 is sized is be advanced through the vasculature with the tip 16 residing in a vein such as a coronary sinus CS.
- the catheter body 12 is sufficiently flexible and the tip 16 is sufficiently atraumatic to permit such advancement as is known in the art.
- the materials of the catheter must be appropriate to withstand the rigors of sterilization and meet all biocompatibility requirements as is known in the art.
- the catheter 10 is shown in FIG. 12 as contained in a coiled configuration in a clear plastic pouch 212 which is sealed with its contents sterilized for human clinical use.
- the pouch 212 is contained is a suitable container such as a cardboard box 202 with closure lid 204 .
- a printed sheet 206 containing instructions for use. These instructions 206 include, in at least summary format, the method of the invention described above. Namely, a user is instructed to place the catheter tip 16 in a blood vessel (e.g., coronary sinus CS) with the balloon 18 inflated to be spaced from the vessel wall to permit blood flow past the balloon 18 . When desired to collect blood with the catheter 10 , suction is applied to the lumen 26 of the catheter 10 to draw the wall of the blood vessel into sealing engagement with the balloon 18 .
- a blood vessel e.g., coronary sinus CS
- suction is applied to the lumen 26 of the catheter 10 to draw the wall of the blood vessel into sealing engagement with the balloon 18 .
- the sterile pouch 212 is shown only containing the collection catheter 10 .
- the kit 200 may contain other system components such as a vessel support 30 and any of tubing 106 , 108 , 114 or 110 .
- FIGS. 9-11 illustrate an alternative embodiment of catheter 10 ′.
- the distal end 16 ′ is shown as an elastomeric material which is biased to a coiled shape ( FIGS. 9 and 10 ).
- the distal end 16 ′ has a plurality of fluid inlets 17 ′ formed as holes on interior surfaces of the coil.
- the fluid inlets 17 ′ communicate with the catheter collection lumen.
- FIG. 10 shows the apparatus following application of such suction.
- the coronary sinus CS has migrated into sealing engagement with the balloon 18 .
- the coronary sinus CS has migrated against the external diameter of the coiled portion 16 .
- the coiled portion 16 ′ acts to support and prevent collapse of the coronary sinus CS distal to the balloon 18 ′. This structure avoids the need for the separate vessel support 30 illustrated in use in the embodiments of FIGS. 24 .
- FIG. 11 illustrates that the catheter 10 may be maintained in an elongated state by a guide wire 30 ′.
- the guide wire 30 ′ may first be placed within the coronary vasculature and the catheter 10 ′ advanced over the guide wire. Following removal of the guide wire, the bias of the distal end 16 ′ urges the distal end 16 ′ to resume the coil configuration.
- the balloon 18 ′ is shown in a fully deflated state.
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Abstract
A catheter for collecting fluid such as blood from a vessel such as a coronary sinus of a patient has an elongated, flexible tubular portion and an annular sealing member spaced from a distal end of the tubular member. A proximal end of the tubular member is adapted to be connected to a source of suction for applying suction to a collection lumen of the tubular member. The distal end is placed in a blood vessel with the sealing member spaced from opposing surface of the vessel in an absence of a suction applied to the collection lumen. Suction is applied to the collection lumen in an amount sufficient to draw blood from the vessel through the fluid inlet and into the collection lumen and further sufficient to urge the opposing surface of the vessel to migrate into sealing engagement with the sealing member.
Description
- This application is a divisional application of U.S. application Ser. No. 11/557,312, filed Nov. 7, 2006; which application is incorporated herein by reference.
- 1. Field of the Invention
- This invention pertains to catheters for collecting fluid from a blood vessel of a patient.
- 2. Description of the Prior Art
- Collection catheters are well known for collecting blood or other fluids from blood vessels of a patient. For example, International Publication No. WO 2005/082440 A1 describes collection catheters for collecting blood from a coronary sinus or other coronary vein in a perfusion system.
- In addition to collecting blood in a perfusion process, blood may be collected from a coronary vein in an angiography procedure. Such procedures are used for assessing patency of coronary arteries. These procedures may also be used for other purposes—for example, in stent placement or other procedures. In such a procedure, a contrast medium is injected into a coronary artery proximal to a suspected site of a coronary obstruction.
- Contrast media may have significant health risks if permitted to flow systemically to the patient's organs. For example, renal dysfunction or failure may occur from such systemic delivery of a contrast media. Such failure is referred to as “contrast-induced nephropathy” or CIN. Schrader, “Contrast Media-Induced Renal Failure: And Overview”, Journal of Interventional Cardiology, Vol. 18, No. 6, pages 417-423 (2005).
- A number of different techniques in catheter designs have been suggested for collecting contrast media, Examples of such are shown in U.S. Pat. No. 6,554,819 to Reich issued Apr. 29, 2003; U.S. Patent Application Publication No. US 2002/0099254 A1 to Movahed published Jul. 25, 2002; U.S. Patent Application Publication No. US 2005/0256441 A1 to Lotan et al., published Nov. 17, 2005, U.S. Patent Application Publication No. 2005/0124969 to Fitzgerald et al. published Jun. 9, 2005 and U.S. Patent Application Publication No. US 2006/0013772 A1 to LeWinter et al., published Jan. 19, 2006. A contrast removal system is also described in Michishita, et al. “A Novel Contrast Removal System From The Coronary Sinus Using An Absorbing Column During Coronary Angiography In A Porcine Model”, Journal of the American Colic of Cardiology, Vol. 47, No. 9 (2006).
- Blood collected in a contrast removal or other blood collection system may be processed to be re-admitted to the patient. However, it is more common for collected blood to be discarded. It is generally recognized that a limited amount (e.g., 100 milliliters to 200 milliliters) of blood may be safely removed from a patient and discarded.
- Blood collection techniques include methods and apparatus for isolating blood flow in a vessel. This insures that substantially all antegrade flow (i.e., the normal direction of blood flow in a vessel) is collected for a period of time to substantial collect all contrast media or perfusate which is the object of collection.
- Importantly, such isolation is employed to avoid collection of retrograde blood flow. Retrograde flow (in a direction opposite normal blood flow in a vessel) may occur, for example, where a catheter draws blood from a coronary sinus under suction. The suction may be such that blood in the right atrium flows retrograde and is drawn through the catheter. As a result, blood not laden with contrast media or perfusate is collected and possibly discarded. Since there are limits on how much blood may be discarded, it is desirable to avoid collecting and discarding blood not laden with contrast media or perfusate.
- Isolation is commonly achieved through use of balloon catheters. A balloon is inflated during periods of blood collection to seal against the wall of the blood vessel. Otherwise, the balloon is deflated to be spaced from the blood vessel wall.
- During an angiography, contrast media may be injected at multiple times during a procedure. To collect such contrast media, a balloon is repeated inflated and deflated in a manner timed with the injection. However, it is difficult to precisely coordinate the timing of the inflation and deflation with the withdrawal of blood from the catheter. Maintaining occlusion constantly is undesirable since this may lead to venous congestion and shunting of contrast-laden blood from a coronary sinus to the right atrium through collateral veins.
- It is an object of the present invention to provide a method and apparatus for collection of a fluid from a blood vessel.
- According to a preferred embodiment of the present invention, a method and apparatus are disclosed for collecting fluid from a blood vessel (such as a coronary sinus) of a patient. The method includes use of a catheter in the form of a collection member having an elongated, flexible tubular portion terminating at a distal end. An annular sealing member (e.g., an inflatable balloon in a preferred embodiment) is secured to the tubular member spaced from the distal end. A collection lumen of the tubular portion has a fluid inlet distal to the sealing member. A proximal end of the tubular member is adapted to be connected to a source of suction for applying a suction to the collection lumen. The method includes placing the distal end in a blood vessel with antegrade flow within the vessel flowing in a direction from the distal end toward the sealing member. The sealing member is spaced from opposing surface of the vessel in an absence of a suction applied to the collection lumen. A suction is applied to the collection lumen in an amount sufficient to draw blood from the vessel through the fluid inlet and into the collection lumen and further sufficient to urge the opposing surface of the blood vessel to migrate into sealing engagement with the sealing member.
-
FIG. 1 illustrates a system including a collection catheter according to the present invention for collection of blood from a patient's blood vessel and also showing an optional vessel support apparatus; -
FIG. 1A is a schematic representation of the system ofFIG. 1 ; -
FIG. 2 is a side longitudinal view of a collection catheter ofFIG. 1 shown in a coronary sinus of a patient and illustrating spacing between a sealing member and a blood vessel wall when a suction is not applied to a lumen of the catheter; -
FIG. 3 is the view ofFIG. 2 following application of a suction to the lumen of the catheter and illustrating migration of the blood vessel wall into sealing engagement with the sealing member of the catheter; -
FIG. 3A is the view ofFIG. 3 illustrating potential collapse of the blood vessel if not supported distal to the collection catheter; -
FIG. 4 is a longitudinal side sectional view of the collection catheter and vessel support ofFIG. 1 ; -
FIG. 5 shows, in cross-section, a sealing member within a coronary sinus and spaced from the walls of the coronary sinus; -
FIG. 6 is the view ofFIG. 5 following application of suction to the catheter and showing migration of the wall of the blood vessel against the sealing member; -
FIG. 7 is the viewFIG. 5 and showing an alternative geometry sealing member within a blood vessel prior to application of a suction; -
FIG. 8 is the view ofFIG. 7 following application of suction; -
FIG. 9 shows an alternative embodiment of a collection catheter in a blood vessel prior to application of suction; -
FIG. 10 is the view ofFIG. 9 following application of suction; -
FIG. 11 is the view of the catheter ofFIG. 9 shown urged to an uncoiled configuration for advancement through the patient's vascular system; and -
FIG. 12 is an exploded perspective view of a kit according to the present invention. - Referring now to the several drawing figures in which identical elements are numbered identically throughout, a description of a preferred embodiment of the present invention will now be provided.
-
FIG. 1 shows asystem 100 including acollection catheter 10 according to the present invention. In a preferred embodiment, thecollection catheter 10 is used to collect blood flow laden with a perfusate or a contrast media which had been injected into a coronary artery for angiography or similar procedures. Thecollection catheter 10 is to collect blood flow from the coronary sinus before such blood flow can pass systemically to the remainder of the patient's body. While such is a preferred embodiment, the apparatus of the present invention can be used in any blood collection technique including that described in the aforementioned International Publication No. WO 2005/082440 A1 (incorporated herein by reference) as well as any dialysis or similar blood collection system. Accordingly, the reference to coronary sinus is illustrative only and can include any other blood vessel. - In addition to the
collection catheter 10, thesystem 100 includes acollection canister 102 and avacuum regulator 104. Thecollection canister 102 is sealed from atmospheric pressure. The system ofFIG. 1 is schematically shown inFIG. 1A which also illustrates a level of collected blood within thecanister 102 and indicated by 120. FurtherFIG. 1A shows atrap 109 and apinch valve 105 as will be described. -
Tubing 106 is connects to aport 119 of the collection catheter to communicate with a central lumen 26 (as will be described with reference toFIG. 4 ) of thecollection catheter 10. Thetubing 106 connects thecollection lumen 26 to the interior of thecanister 102. -
Tubing 108 connects the interior of thecanister 102 to thepressure regulator 104. Thepressure regulator 104 has asupply tubing 110 to be connected to asource 111 of a vacuum (FIG. 1A ). Such a source is commonly provided in a hospital or other similar setting.FIG. 1A shows atrap 109 for collecting blood which might inadvertently flow towardregulator 104. - The
system 100 further includes apressure monitor 112 connected by atubing 114 totubing 106. The pressure monitor 112 monitors and displays the pressure within thetubing 106 thereby corresponding to the pressure within thelumen 26 of thecollection catheter 10. - A proximal end 17 (
FIG. 1 ) of thecollection catheter 10 also includes aport 118 for connection to the source of pressurized fluid (such as air or saline) for pressurizing a sealingballoon 18 on adistal end 16 of thecatheter 10 as will be described. Theproximal end 17 also includes aport 121 for passing thesupport device 30 or a guide wire or the like into thecatheter lumen 26. - With best reference to both of
FIGS. 1 and 2 , thecatheter 10 includes acatheter body 12 in the form of an elongated, flexible tubular portion having a proximal end 17 (shown only inFIGS. 1 and 12 ) and a distal tip 16 (FIG. 2 ). It will be appreciated that the drawing ofFIG. 1 is not to scale and that the length of thecatheter body 12 is substantially longer than that shown inFIG. 1 so that thedistal tip 16 may be advanced through the vasculature of a patient into a coronary sinus CS while theproximal end 17 remains external to the patient. - As shown in
FIG. 2 , anannular sealing member 18 is provided in close spacing to thedistal end 16. In a preferred embodiment, the annular sealingmember 18 is a compliant balloon formed of material which can both conform and stretch as it is inflated. It will be appreciated that compliant balloons are well-known in the art and form no part of this invention per se. Also, the sealing member need not be a balloon. For example, it can be a mechanically actuated sealing surface moved into close spacing from the vessel wall. - In the embodiment of
FIG. 2 , the balloon has a radialdistal end 20 of smaller diameter than a radialproximal end 22. As a result, anannular surface 24 between theends tubular member 12. It will be appreciated that this geometry is illustrative only. If desired, ends 20 and 22 can have a common diameter such that theannular surface 24 is parallel to the axis X-X.Surface 24 can also be curved (convex or concave) relative to axis X-X. - The
end 16 is open and communicates with acollection lumen 26 running the length of thecatheter body 12. Thecollection lumen 26 communicates withport 119. Aninflation lumen 28 is provided in the wall thickness ofbody 12 for admitting an inflation fluid into theballoon 18.Inflation lumen 28 communicates withport 118. - In the figures, the
catheter 10 is shown used in combination with an optionalvessel support device 30. Thevessel support device 30 forms no part of this invention per se and may be as more thoroughly described in International Publication No. WO 2005/082440 A1. - The
vessel support 30 includes a long flexibledistal end 32 with acurved tip 34. Thedistal end - A
support cage 36 connects adistal wire portion 32 to a proximal wire portion 38 (FIG. 4 ). Thecage 36 is made up of a generally circular array (around axis X-X) of flexible elastic struts 37 (such as nitinol or other elastic material suitable for use in a blood vessel). As will become apparent, thecage 36 prevents the collapse of the coronary sinus CS. Further, the positioning of thecage 36 within the coronary sinus provides positioning stability to resist axial movement of thecage 36 relative to the coronary sinus. As a result, thecage 36 is a convenient tool for maintaining a positioning of thecatheter 10 within a coronary sinus CS. - In use, a guide wire (not shown) is positioned with a guide wire distal end in the coronary sinus CS at the desired location for collecting blood. Procedures for advancing such guide wires are well known.
- Following such guide wire placement, the
catheter 10 is advanced over the guide wire until thedistal tip 16 is at the desired location for collecting blood. Thedistal tip 16 may be radiopaque to assess proper placement under fluoroscopy. During advancement, the sealingballoon 18 is fully deflated. Following such advancement, a physician may inflate theballoon 18. InFIG. 2 , normal (or antegrade) blood flow is illustrated by the arrow A indicating a direction of normal blood flow through the coronary sinus CS towards the right atrium (not shown). - The guide wire is then withdrawn and the
vessel support 30 is advanced through thecatheter 10 into the coronary sinus CS. As soon as thecage 36 passes through thedistal end 16, thecage 36 expands to the configuration shown inFIG. 2 . With such expansion, thecage 36 abuts opposing surfaces of the coronary sinus CS. - Unlike prior art devices and methods, the
balloon 18 is not inflated to such an extent that it abuts against the opposing wall of the coronary sinus CS. Instead, as illustrated inFIG. 2 , theballoon 18 is only inflated partially such that an annular flow path is defined between the opposing surfaces of the sealingsurface 24 and the coronary sinus CS. This flow path is illustrated by the arrows B inFIG. 2 . By way of non-limiting example, the spacing between the sealingsurface 24 and the vessel wall may be about 1-2 millimeters. - In the absence of suction applied to the
catheter lumen 26, blood flow within the coronary sinus CS flows around theballoon 18 to the right atrium. Thecatheter lumen 26 may be primed with saline or the like to avoid loss of suction blood flow from the coronary sinus CS into thecollection lumen 26. - By monitoring pressure on the pressure monitor 112, a physician can determine if the
balloon 18 is over inflated such that it is sealing the coronary sinus CS when no suction is applied tocollection lumen 26. If such over inflation is monitored, theballoon 18 may be slightly deflated until the physician is assured that theballoon 18 is residing in the coronary sinus CS in a non-occluding manner. Alternatively,pressure sensors 40, 41 (shown only inFIG. 2 ) may optionally be provided oncatheter body 12 on opposite sides ofballoon 18. A pressure differential betweensensors sensors balloon 18. - Following such placement, the physician may operate the
vacuum regulator 104 to generate a suction within thecanister 102 andtube 106. The physician selectively applies suction to thecatheter lumen 26 by operation of a pinch valve 105 (FIG. 1A ) ontube 106. Thepinch valve 105 may be a clip or the like which, when opened, permits the vacuum to be applied to thecatheter lumen 26. Closure of thepinch valve 105, pinches thetube 106 shut to block the vacuum application to thecatheter lumen 26. Accordingly, the application of vacuum to thecatheter lumen 26 can be rapidly turned off or on. - Application of suction to the
catheter lumen 26 causes the coronary sinus CS to at least partially collapse such that the surfaces of the coronary sinus CS opposing thesurface 24 migrate against thesurface 24 in sealing engagement. This causes blood flow within the coronary sinus CS to flow completely into thelumen 26. Further, such sealing engagement avoids retrograde flow from the right atrium past theballoon 18 to thedistal end 16. Such sealing engagement is illustrated inFIG. 3 . - The timing of the application of suction to the
lumen 26 is preferably timed to result in collection of a contrast media injected into a coronary artery. For example after a set time (about three seconds) after injection of a contrast media into a coronary artery, the suction can be applied to thelumen 26. Alternatively, the patient's electrocardiogram may be monitored and suction may be applied a fixed number (e.g., three) of heart beats following such injection. If desired, a detecting element can be provided at thetip 16 to detect a contrast media resulting in activating application of suction to thelumen 26. For example,pressure sensor 40 inFIG. 2 could alternatively be a contrast media sensor. - Blood drawn into the
catheter lumen 26 is collected incanister 102. After collection, the blood may be discarded. Alternatively, the blood may be passed to any suitable treatment apparatus (not shown) for removal of undesired constituents within the collected blood. The treated blood is then returned to the patient. - The amount of suction provided to the
lumen 26 is great enough (e.g., a negative 100 millimeters of Hg) to ensure removal of blood from the coronary sinus. The coronary sinus CS is a very fragile and compliant vessel. In response to such suction, the vessel is inclined to collapse. Collapse of the vessel is avoided by thevessel support cage 36.FIG. 3 illustrates thecage 36 distal to thetip 16 preventing complete collapse of the coronary sinus. Instead,cage 36 narrows in diameter (resulting in axial lengthening) but resists complete collapse of the coronary sinus CS.FIG. 3A illustrates potential complete collapse of the coronary sinus CS in the absence of such support. - The tendency of the coronary sinus CS to collapse is utilized as an advantage to result in sealing of the coronary sinus CS against the sealing
member 18. As a result, sealing naturally occurs when suction is applied. No additional inflation or deflation of theballoon 18 is required. - In addition to avoiding the need for selective inflation and deflation of the
balloon 18, the present invention can achieve better occlusion at lower balloon pressures. This is illustrated in reference toFIGS. 5 and 6 . InFIG. 5 , the coronary sinus is shown in a rest state (i.e., without application of a suction to the catheter). The sealingmember 18 is shown residing within the coronary sinus CS. - The size of a coronary sinus CS may vary significantly from patient to patient. However, in the patient with congestive heart failure the coronary sinus CS may be one to two centimeters in diameter when measured within one to two centimeters of the right atrium.
- The reference to the diameter of the coronary sinus CS suggests that the coronary sinus CS is circular in cross section. In fact, the coronary sinus CS is closer to an oval cross section. A portion of the coronary sinus CS is supported by the myocardium (the muscle tissue of the heart). The remainder of the coronary sinus CS is less supported.
- As a result of differential support of the coronary sinus CS, when a balloon is inflated within a coronary sinus CS, the balloon (which is frequently circular in cross section) is attempting to inflate within and seal against an oval lumen which, due to the variability of surrounding tissue, has variable compliance. By using suction to draw the wall of the coronary sinus CS against the sealing
member 18, a more uniform seal is acquired at lower pressure. This is illustrated inFIG. 6 , where the rest position of the coronary sinus CS is shown in phantom lines. Solid lines show the coronary sinus CS fully collapsed against the sealingballoon 18. - In
FIGS. 5 and 6 , the sealingballoon 18 is shown as baying a circular cross section. However other geometries can be provided. This is illustrated inFIG. 7 where the sealingballoon 18 a is shown as having a generally square cross section. InFIG. 7 , the coronary sinus CS is shown circular in cross section for ease of illustration. By reason of the square cross section, a greater cross sectional area is defined between opposing surfaces of the sealingmember 18 a and the coronary sinus CS. Hence, there is less resistance to blood flow past theballoon 18 a when the catheter lumen is not under suction. However, a complete seal is provided following application of suction as illustrated inFIG. 8 . - In a preferred embodiment, the
catheter 10 is packaged as akit 200 shown inFIG. 12 . Thecatheter 10 and its component parts of formed of plastic or other suitable material for placement in human vasculature. Thecatheter 10 is sized is be advanced through the vasculature with thetip 16 residing in a vein such as a coronary sinus CS. Thecatheter body 12 is sufficiently flexible and thetip 16 is sufficiently atraumatic to permit such advancement as is known in the art. The materials of the catheter must be appropriate to withstand the rigors of sterilization and meet all biocompatibility requirements as is known in the art. - The
catheter 10 is shown inFIG. 12 as contained in a coiled configuration in a clearplastic pouch 212 which is sealed with its contents sterilized for human clinical use. Thepouch 212 is contained is a suitable container such as acardboard box 202 withclosure lid 204. - Also contained within the
box 202 is a printedsheet 206 containing instructions for use. Theseinstructions 206 include, in at least summary format, the method of the invention described above. Namely, a user is instructed to place thecatheter tip 16 in a blood vessel (e.g., coronary sinus CS) with theballoon 18 inflated to be spaced from the vessel wall to permit blood flow past theballoon 18. When desired to collect blood with thecatheter 10, suction is applied to thelumen 26 of thecatheter 10 to draw the wall of the blood vessel into sealing engagement with theballoon 18. - In
FIG. 12 , thesterile pouch 212 is shown only containing thecollection catheter 10. Thekit 200 may contain other system components such as avessel support 30 and any oftubing -
FIGS. 9-11 illustrate an alternative embodiment ofcatheter 10′. In thecatheter 10′, thedistal end 16′ is shown as an elastomeric material which is biased to a coiled shape (FIGS. 9 and 10 ). Thedistal end 16′ has a plurality offluid inlets 17′ formed as holes on interior surfaces of the coil. Thefluid inlets 17′ communicate with the catheter collection lumen. - The
balloon 18 is shown spaced from the coronary sinus wall inFIG. 9 indicating that no suction is implied to an interior lumen of thecatheter 10′.FIG. 10 shows the apparatus following application of such suction. InFIG. 10 , the coronary sinus CS has migrated into sealing engagement with theballoon 18. Further, the coronary sinus CS has migrated against the external diameter of the coiledportion 16. As a result, the coiledportion 16′ acts to support and prevent collapse of the coronary sinus CS distal to theballoon 18′. This structure avoids the need for theseparate vessel support 30 illustrated in use in the embodiments ofFIGS. 24 . -
FIG. 11 illustrates that thecatheter 10 may be maintained in an elongated state by aguide wire 30′. Theguide wire 30′ may first be placed within the coronary vasculature and thecatheter 10′ advanced over the guide wire. Following removal of the guide wire, the bias of thedistal end 16′ urges thedistal end 16′ to resume the coil configuration. InFIG. 11 , theballoon 18′ is shown in a fully deflated state. - Having described the present invention of the preferred embodiment, modifications and equivalents will become apparent to one of ordinary skill in the art. It is intended that such modifications and equivalents be included within the scope of the claims which are appended hereto.
Claims (14)
1. A system for collecting flow from a blood vessel comprising:
a. a collection member having:
i. an elongated, flexible tubular portion terminating at a distal end;
ii. an annular sealing member secured to the tubular member spaced from the distal end;
iii. a collection lumen with a fluid inlet distal to the sealing member;
iv. a proximal end adapted to be connected to a source of suction for applying a suction to the collection lumen;
v. the sealing member sized to be spaced from opposing surface of the vessel in an absence of a suction applied to the collection lumen upon insertion of the distal end into the blood vessel;
b. a sealed collection container connected to the proximal end for collecting blood from the lumen;
c. a regulator adapted to be connected to a source of a vacuum and having an output end connected to the lumen to applied a regulated vacuum to the lumen with the regulator adjustable to adjust the regulated vacuum to apply a suction to the collection lumen in an amount sufficient to draw blood from the vessel through the fluid inlet and into the collection lumen and further sufficient to urge the opposing surface of the vessel to migrate into sealing engagement with the sealing member.
2. A kit for collecting flow from a blood vessel comprising:
a. a collection member having:
i. an elongated, flexible tubular portion terminating at a distal end;
ii. an annular sealing member secured to the tubular member spaced from the distal end;
iii. a collection lumen with a fluid inlet distal to the sealing member;
iv. a proximal end adapted to be connected to a source of suction for applying a suction to the collection lumen;
b. printed instructions for use instructing a user to:
i. place the distal end in a blood vessel with antegrade flow within the vessel flowing in a direction from the distal end toward the sealing member and with the sealing member spaced from opposing surface of the vessel in an absence of a suction applied to the collection lumen;
ii. apply a suction to the collection lumen in an amount sufficient to draw blood from the vessel through the fluid inlet and into the collection lumen and further sufficient to urge the opposing surface of the vessel to migrate into sealing engagement with the sealing member.
3. A system for collecting flow from a blood vessel, the system comprising:
a. a collection member including:
i. an flexible tubular portion defining a collection lumen, the tubular portion having a distal end and a proximal end, the distal end defining a fluid inlet to the collection lumen, the proximal end being constructed to connect to a source of suction that applies suction to the collection lumen; and
ii. an annular sealing member located adjacent to the distal end of the tubular portion; and
b. a pressure sensor that senses pressure in the blood vessel at a location distal to the annular sealing member.
4. The system of claim 3 , wherein the annular sealing member is an inflatable annular sealing member, and wherein the pressure sensor senses pressure within the blood vessel to determine an inflated size of the annular sealing member in relation to the blood vessel.
5. The system of claim 3 , wherein the pressure sensor is carried by the collection member to a location within the blood vessel.
6. The system of claim 3 , wherein the pressure sensor is located outside the blood vessel during use, the pressure sensor being constructed to sense pressure within the collection lumen of the collection member to determine the pressure in the blood vessel at the location distal to the annular sealing member.
7. The system of claim 3 , wherein the pressure sensor detects the rate of flow through the blood vessel.
8. A system for collecting flow from a blood vessel, the system comprising:
a. a collection member including:
i. an flexible tubular portion defining a collection lumen, the tubular portion having a first end and an opposite second end, the first end defining a fluid inlet to the collection lumen, the second end being constructed to connect to a source of suction that applies suction to the collection lumen; and
ii. an annular sealing member located adjacent to the first end of the tubular portion; and
b. a support device positionable at a location distal to the first end of the tubular portion, the support device being constructed to:
i. maintain blood vessel patency under application of suction through the collection lumen;
ii. maintain a position of the first end of the tubular portion of the collection member in relation to the blood vessel; and
iii. center the fluid inlet of the tubular portion of the collection member within a central area of the blood vessel.
9. A system for collecting flow from a blood vessel, the system comprising:
a. a collection member including:
i. an flexible tubular portion defining a collection lumen, the tubular portion having a distal end and a proximal end, the distal end defining a fluid inlet to the collection lumen, the proximal end being constructed to connect to a source of suction that applies suction to the collection lumen; and
ii. an annular sealing member located adjacent to the distal end of the tubular portion; and
b. a valve that controls suction applied to the collection lumen, wherein the valve is selectively opened and closed based upon a timing interval following a specific event.
10. The system of claim 9 , wherein the specific event is an injection of contrast into the blood vessel.
11. The system of claim 9 , wherein the specific event is a fixed number of heart beats following an injection of contrast into the blood vessel.
12. The system of claim 9 , wherein the valve is manually opened and closed.
13. The system of claim 9 , wherein the valve is a pinch valve.
14. A system for collecting flow from a blood vessel at a collection site, the system comprising:
a. a collection member including:
i. an flexible tubular portion defining a collection lumen, the tubular portion having a distal end and a proximal end, the distal end defining a fluid inlet to the collection lumen, the proximal end being constructed to connect to a source of suction that applies suction to the collection lumen;
ii. an annular sealing member located adjacent to the distal end of the tubular portion;
b. a sensor device positionable at the collection site, the sensor device including a sensor constructed to detect contrast, wherein upon detection of a contrast, the sensor device activates collection of flow from the blood vessel.
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Also Published As
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US20080108960A1 (en) | 2008-05-08 |
WO2008057917A2 (en) | 2008-05-15 |
JP2010508984A (en) | 2010-03-25 |
US20100082004A1 (en) | 2010-04-01 |
EP2091431A2 (en) | 2009-08-26 |
JP5443165B2 (en) | 2014-03-19 |
WO2008057917A3 (en) | 2008-07-31 |
AU2007317503B2 (en) | 2014-02-20 |
US8708986B2 (en) | 2014-04-29 |
EP2091431B1 (en) | 2019-04-10 |
AU2007317503A1 (en) | 2008-05-15 |
US8152786B2 (en) | 2012-04-10 |
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