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WO2007010391A1 - Appareil pour effectuer l'hemostase arterielle - Google Patents

Appareil pour effectuer l'hemostase arterielle Download PDF

Info

Publication number
WO2007010391A1
WO2007010391A1 PCT/IB2006/002127 IB2006002127W WO2007010391A1 WO 2007010391 A1 WO2007010391 A1 WO 2007010391A1 IB 2006002127 W IB2006002127 W IB 2006002127W WO 2007010391 A1 WO2007010391 A1 WO 2007010391A1
Authority
WO
WIPO (PCT)
Prior art keywords
sensor
flow
temperature
hemostasis
perforation
Prior art date
Application number
PCT/IB2006/002127
Other languages
English (en)
Inventor
Luciano Alcidi
Marzia Nardiello
Gino Grassi
Franco Papa
Original Assignee
Luciano Alcidi
Marzia Nardiello
Gino Grassi
Franco Papa
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Luciano Alcidi, Marzia Nardiello, Gino Grassi, Franco Papa filed Critical Luciano Alcidi
Publication of WO2007010391A1 publication Critical patent/WO2007010391A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1477—Needle-like probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00571—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for achieving a particular surgical effect
    • A61B2018/0063—Sealing
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00636—Sensing and controlling the application of energy
    • A61B2018/00773—Sensed parameters
    • A61B2018/00791—Temperature

Definitions

  • the present invention relates to an apparatus and instrumentation capable of detecting with accuracy the perforation of a vascular wall and performing the hemostasis thereof.
  • the object of the invention is to overcome the drawbacks of the prior art .
  • a first advantage is given by the accuracy with which it is possible to locate the region of perforation to be occluded.
  • a further advantage, related to the possibility of directing cauterizing electrodes to the exact point, is given by the rapidity and efficacy with which the cauterization operates the occlusion.
  • the cauterization procedure can be rendered automatic and, therefore, immediate, by using, as a control element of RF energy activation, the variation of temperature that occurs when the electrode 7 leaves the arterial bed.
  • the immediacy of the cauterization allows minimizing possible hematic effusions.
  • FIG. 1 shows schematically an apparatus, according to the invention applied for the hemostasis of an arterial wall
  • Fig. 2 illustrates a detail of the active electrode of the apparatus of Fig. 1.
  • - Fig. 3 is a graph showing an example of temperature detection and RF-emission performed by the apparatus of the invention.
  • an apparatus 1 comprises a hemostasis probe 6 sliding within an introducer or cannula 2 already inserted into the vessel for the test in progress.
  • the cannulla 2 allows introducing the probe 6 thereinside in such a way as to project from the distal end of the body 2, the probe being provided with a temperature sensor 7 located at its distal end and with RF-emitters electrodes 7, 8 disposed at a known distance from the temperature sensor 7.
  • the electrode 8, which represents the reference electrode of RF-energy delivery, may be replaced by a surgery plate disposed on the back of the patient.
  • the probe 6 consists of only the temperature-sensing and RF- emitting sensor electrode 7.
  • the same temperature sensor 7 is made up of a thermocouple acting also as an electrode for the local delivery of radio frequency energy able to carry out the cauterization of the perforation 5.
  • connections 9 and 10 to an external control unit including a radio frequency generator for controlling the power emitted by the electrode 7 and measuring the local temperature induced by the RF-generated heating.
  • thermocouple 7 is made up of metal connections 11, 12, preferably of copper- constantan combination, welded to the head of the distal electrode and connected to the instrumentation to function also as RF energy-emitting electrode for the local heating of the blood and the cauterizing operation.
  • the same control unit controls the emitting power of electrode 7 during the cauterization of the hole 5 in the artery 4.
  • the probe 6 is introduced into the cannula 2 so that the electrodes 7, 8 result in the arterial bed.
  • the electrodes 7, 8 emit a power of 2-3 W and, as a consequence of the thermal flush within the arterial bed, the sensor 7 measures a temperature very close to the basal one.
  • the graph in this figure shows how the apparatus position can be detected and, in particular, it shows both the temperature variation measured by the sensor 7 between a region inside the axtery and the corresponding wall region outside the artery, and the relevant delivered power as a function of time upon the positioning stage.
  • the produced temperature variation can be advantageously utilized to automatically activate the delivery of power upon the cauterization procedure, preferably but not limitatively, a radio frequency delivery, to obtain the cauterization of the artery hole. It is stressed that the energy delivery for the cauterization is automatically controlled according to the cauterization temperature programmed beforehand (for example at 80/90°) .
  • the generator would modulate the delivered power to make it fall within the preset temeperature limits.
  • the extent of the temperature' s sudden rise allows the operator to know that the distal end of probe 6 carrying the cauterizing electrode is at that moment in the region 12 around the hole to be occluded.
  • a flow sensor consisting of a temperature sensor that "reads" the temperature difference between a stagnating blood and a flowing blood.
  • the electrodes for the local heating of the blood, and the electrodes for the cauterization of the artery wall may be replaced by a variety of means, and the same thermal sensor - herein indicated as a thermocouple - could be of a different nature.
  • the chemical-phisical characteristics of the active electrode are intended to ease the hemostasis process during the delivery of RF energy.
  • a first characteristic is the choice of a rounded or ellipsoid frusto-conical shape for the distal end of the catheter, in order not to causes traumas to the inner wall of the vessel upon inserting the catheter.
  • the active electrodes it has been found important using materials the composition and working of which are able to minimizing both mechanical and chemical-phisical adhesion of the biological material to the electrode.
  • electrodes of mechanically polished stainless steel, or of more inert materials, for example ' noble metals such as platinum and others, may be used.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Molecular Biology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Plasma & Fusion (AREA)
  • Physics & Mathematics (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Otolaryngology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
  • Surgical Instruments (AREA)

Abstract

Un appareil destiné à l'hémostase artérielle comprend une canule (2) destinée à l'insertion, via une partie du derme (3), d'une sonde ou d'un cathéter (6) coulissant avec ladite canule et muni d'un moyen (7, 8) capable d'effectuer l'hémostase d'une perforation (5) dans la paroi d'une artère (4), et avec au moins un capteur d'écoulement (7) disposé à proximité dudit moyen d'hémostase.
PCT/IB2006/002127 2005-07-22 2006-07-20 Appareil pour effectuer l'hemostase arterielle WO2007010391A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITFI20050163 ITFI20050163A1 (it) 2005-07-22 2005-07-22 Dispositivo per interventi di emostasi arteriosa
ITFI2005A000163 2005-07-22

Publications (1)

Publication Number Publication Date
WO2007010391A1 true WO2007010391A1 (fr) 2007-01-25

Family

ID=37103189

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2006/002127 WO2007010391A1 (fr) 2005-07-22 2006-07-20 Appareil pour effectuer l'hemostase arterielle

Country Status (2)

Country Link
IT (1) ITFI20050163A1 (fr)
WO (1) WO2007010391A1 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8366706B2 (en) 2007-08-15 2013-02-05 Cardiodex, Ltd. Systems and methods for puncture closure
US8372072B2 (en) 2003-02-04 2013-02-12 Cardiodex Ltd. Methods and apparatus for hemostasis following arterial catheterization
US8435236B2 (en) 2004-11-22 2013-05-07 Cardiodex, Ltd. Techniques for heat-treating varicose veins
US9629560B2 (en) 2015-04-06 2017-04-25 Thomas Jefferson University Implantable vital sign sensor
US10335043B2 (en) 2015-04-06 2019-07-02 Thomas Jefferson University Implantable vital sign sensor
US11000195B2 (en) 2015-04-06 2021-05-11 Thomas Jefferson University Implantable vital sign sensor
US11330987B2 (en) 2015-04-06 2022-05-17 Thomas Jefferson University Implantable vital sign sensor

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996036282A2 (fr) * 1995-05-15 1996-11-21 Baxter International Inc. Appareil bipolaire de scellement vasculaire et procedes
WO1999013779A2 (fr) * 1997-09-18 1999-03-25 Scimed Life Systems, Inc. Dispositif et procede de fermeture
US20010014802A1 (en) * 1999-01-19 2001-08-16 Hosheng Tu Medical device having temperature sensing and ablation capabilities

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996036282A2 (fr) * 1995-05-15 1996-11-21 Baxter International Inc. Appareil bipolaire de scellement vasculaire et procedes
WO1999013779A2 (fr) * 1997-09-18 1999-03-25 Scimed Life Systems, Inc. Dispositif et procede de fermeture
US20010014802A1 (en) * 1999-01-19 2001-08-16 Hosheng Tu Medical device having temperature sensing and ablation capabilities

Cited By (10)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8372072B2 (en) 2003-02-04 2013-02-12 Cardiodex Ltd. Methods and apparatus for hemostasis following arterial catheterization
US8435236B2 (en) 2004-11-22 2013-05-07 Cardiodex, Ltd. Techniques for heat-treating varicose veins
US8366706B2 (en) 2007-08-15 2013-02-05 Cardiodex, Ltd. Systems and methods for puncture closure
US9629560B2 (en) 2015-04-06 2017-04-25 Thomas Jefferson University Implantable vital sign sensor
US10335043B2 (en) 2015-04-06 2019-07-02 Thomas Jefferson University Implantable vital sign sensor
US10413200B2 (en) 2015-04-06 2019-09-17 Thomas Jefferson University Implantable vital sign sensor
US10602936B2 (en) 2015-04-06 2020-03-31 Thomas Jefferson University Implantable vital sign sensor
US11000195B2 (en) 2015-04-06 2021-05-11 Thomas Jefferson University Implantable vital sign sensor
US11330987B2 (en) 2015-04-06 2022-05-17 Thomas Jefferson University Implantable vital sign sensor
US11445924B2 (en) 2015-04-06 2022-09-20 Thomas Jefferson University Implantable vital sign sensor

Also Published As

Publication number Publication date
ITFI20050163A1 (it) 2007-01-23

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