During medical procedures, catheters are often inserted into various locations of a patient, such as vessels, ducts, and body cavities. During many catheter procedures, it can be valuable to sense the pressure within the patient, for example, to determine blood pressure or intracranial pressure. However, the pressure sensing equipment on prior art pressure sensing catheters often make them unsuitable or undesirable for many diagnostic or treatment purposes.
For example, U.S. Pat. No. 4,722,348, the contents of which are hereby incorporated by reference, is directed to a catheter having a pressure transducer in its tip that connects to specialized display equipment. Generally, these catheters are relatively expensive to manufacture due to the integrated transducer and therefore do not always achieve a price point suitable for disposable use. Further, these catheters often require specialized and expensive equipment that connect to this catheter, which further increases the cost of use for such a product.
In another example, such as U.S. Pat. No. 6,447,462, a large sleeve bladder is located on a distal end of a catheter. The bladder is often composed of a material, the proximal and distal ends of which are bonded to the catheter body. This bladder, when inflated, is generally about twice the diameter of the catheter body over which it is located. When placed within a patient, it is largely collapsed after which a small amount of air is added. The bladder of the catheter, once in the body, is therefore folded or furled about the catheter. Prior art catheters effect a volume change by compressing or expanding in a manner that changes the effective circumference of the sensor. In contrast, the circumference of the present invention is constant. A variable volume chamber is formed by placing a flaccid sleeve on the outside of the catheter and passing a small diameter tube through the chamber thus formed. The volume of the chamber is the annular area formed by the larger and smaller diameter times the chamber length. A change in pressure causes the flaccid tube to become more or less elliptical. The change in shape changes the annular area and thus the volume of the chamber. The chamber volume changes as pressure changes in accordance to Boyle's law.
These pressure sensing catheters generally have several shortcomings. First, the bladder typically must have a relatively long length, which prevents much of the distal end of the catheter from being used for other purposes. For example, there is very little space for a desirable number of drainage apertures leading to a drainage lumen.
Second, these shrink bladders have a generally large diameter due to the size of the bladder and its furled configuration. Hence, these catheters are not suitable for smaller diameter uses such as in arterial lines, PICC lines and central venous catheters.
Finally, these shrink bladders are often not suitable for uses that require that the catheter be forcibly pushed through skin and tissue as is the case in a central venous catheter as the bulk of the folded bladder increases the difficulty of insertion and the trauma to the tissue through which it passes.
Therefore, there is a need for an improved pressure sensing catheter that can maintain a relatively small diameter, a relatively short length, lower manufacturing cost and does not add to the difficulty of placing a catheter through skin.
A preferred embodiment of the present invention describes a pressure sensor assembly that creates a variable volume chamber by mounting a flaccid tube on a major diameter (i.e., larger diameter) such as two mounting sleeve members that bond the tube to the body of a catheter and a minor diameter (i.e., smaller diameter) provided by a smaller diameter tube that passes within OD of the tube. The catheter includes an aperture located beneath the tube and in communication with an air passage. As the pressure outside the flaccid tube changes, the tube shape becomes more or less elliptical and thereby changes the annular area between the major and minor diameter. Thus the chamber volume changes in response to pressure change according to Boyle's law. An air passage extends from the chamber to the proximal end of the catheter where it is connected to an external transducer that can measure the pressure sensed by the bladder
In another preferred embodiment, the catheter body beneath the tube can have a “necked” or reduced diameter relative to the adjacent areas of the catheter body. This allows the pressure sensor assembly to the same outer diameter as the outer diameter of the catheter body.
In another preferred embodiment, the pressure sensor assembly can be covered by a sheath having a plurality of apertures or slits. This sheath provides physical protection to the balloon while allowing pressure from the patient's body to be communicated to the tube.
These and other aspects, features and advantages of which embodiments of the invention are capable of will be apparent and elucidated from the following description of embodiments of the present invention, reference being made to the accompanying drawings, in which
Specific embodiments of the invention will now be described with reference to the accompanying drawings. This invention may, however, be embodied in many different forms and should not be construed as limited to the embodiments set forth herein; rather, these embodiments are provided so that this disclosure will be thorough and complete, and will fully convey the scope of the invention to those skilled in the art. The terminology used in the detailed description of the embodiments illustrated in the accompanying drawings is not intended to be limiting of the invention. In the drawings, like numbers refer to like elements.
Unless otherwise defined, all terms (including technical and scientific terms) used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs. It will be further understood that terms, such as those defined in commonly used dictionaries, should be interpreted as having a meaning that is consistent with their meaning in the context of the relevant art and will not be interpreted in an idealized or overly formal sense unless expressly so defined herein.
The pressure sensing assembly is preferably composed of a catheter body 14 having an air lumen passage 16 that extends along most of the length of the catheter body 14. An aperture 18 connects to and is in communication with the air lumen passage 16 near a distal end of the passage 16. The aperture 18 is in communication with a space formed by a flexible or flaccid tube 12 (also seen in
As seen in
Preferably, the one mounting sleeve member 10 is first bonded to a desired location adjacent the aperture 18 on the distal end of the catheter body 14. Next, the other mounting sleeve member 10 is moved towards the first mounted sleeve member 10, thereby creating some slack in the flaccid tube 12. When a desired amount of slack between the proximal and distal ends of the tube 12 has been created (i.e., longitudinal slack), the second mounted sleeve member 10 is also bonded to the catheter body 14. Preferably, enough slack is introduced into the flaccid tube 12 that it can move or deflect to a generally elliptical shape, and more specifically enough to provide a V1/V2 ratio to allow measurement of pressure from 720 mm Hg to 1060 mm Hg. for a given length variable volume chamber.
As previously discussed, the air lumen passage 16 extends through the length of the catheter. Preferably, the air lumen passage 16 opens near the proximal end of the catheter in a manner connectable with additional pressure sensing equipment, such as a pressure transducer. Hence, when the pressure sensing apparatus 1 is positioned within a patient, the pressure around the catheter applies pressure on the flaccid tube 12. The flaccid tube 12 presses on the gas (e.g., air) or liquid (e.g., saline) underneath it, changing the pressure within the air lumen passage 16 which can be ultimately measured via a connected transducer or similar system.
Finally, the catheter body 14 can also be used for other functionality via a through lumen passage 19. For example, this passage can be used for a guidewire, fluid delivery or drainage (discussed further below with regard to
As with the previously described assembly 1, the assembly 21 includes a through lumen 24 and an air lumen passage 28. A distal end of the air lumen passage 28 opens to an aperture 30 at a “necked” or recessed area 22. The recessed area 22 has a smaller diameter than nearby portions of the catheter body 27.
The proximal and distal ends of the recessed area 22 are located adjacent second recessed areas 23. The second recessed areas 23 are preferably recessed to a depth to accommodate the mounting sleeve members 29 and flaccid tube 32. Preferably, when the mounting sleeve members 29 and flaccid tube 32 are mounted on the second recessed areas 23, the diameter of these areas is preferably about flush with the adjacent areas of the catheter body 27 less about twice the thickness of the flaccid tube 32.
In this respect, the pressure sensing assembly 21 transmits or communicates pressure outside the catheter body 27 (e.g., from a lumen of a patient) to the inside of the catheter body 27 (e.g., within the air lumen passage 28 and to a measuring device such as a transducer).
Finally, it should be noted that the distal end 26 of the catheter body 27 is generally rounded so as to prevent trauma to the patient during use.
In some circumstances, it may be desirable to protect the flaccid tube 32 from damage during use. For example, a central venous catheter in a blood vessel may require that the catheter be forcibly pushed through skin and tissue.
Additionally, the sheath 34 includes a plurality of apertures 26 that allow communication of pressure from the outside environment to the flaccid tube 32 and therefore to the air lumen passage 28. Preferably, the apertures 36 have a diameter that ranges between about 0.02 and 0.04. Hence, the sheath 34 protects the flaccid tube 32 from damage (e.g., such as insertion stress) while avoiding interference with the movement and pressure communicating functionality of the flaccid tube 32.
Preferably, the fingers 42 are bonded together with a water-soluble adhesive, either along portions of the gap 44 or along the entire gap 44. Since this adhesive is water-soluble, it will maintain the relative position of the fingers 42 prior to advancing the catheter into a patient and for a period of time within the patient. However, after a predetermined period of time in the patient, the adhesive will degrade, allowing the fingers 42 to move freely.
The shape of the strips or fingers 42 allow them to move independently from one another (after any adhesive has degraded) and, for example, resist the drag on the patient's skin as the catheter is advance or retracted. Since catheters that are located within a body for longer periods can build up protein and hence clog small apertures or adhere different components together, the flexibility of the fingers 42 of the sheath 40 may reduce interference of this protein build up by retaining flexibility.
By using multiple components to compose the assembly 50, the space between the catheter body 60 and the curved nose member 56 (and therefore the amount of slack in the flaccid tube 62) can be more easily adjusted during assembly. Additionally, the use of the tube 54, which has a relatively small diameter, may allow for the overall catheter diameter to be further reduced.
A variable volume sensor assembly suitable for use in a catheter is formed by placing a set of sleeves on either side of an aperture passing through a wall of the catheter and into an internal lumen that leads to an external pressure transducer. Each end of a flaccid tube is bonded to one of the sleeves, forming an annulus defined by the internal diameter of the sleeve and the outer diameter of the catheter body beneath the sleeve. The volume of the enclosed space can be determined by multiplying the area of the annulus times the distance between the sleeves.
During use, the flaccid tube changes shape in response to changes in pressure, which therefore changes the area of the annulus. This area change is analogous to the change in area that occurs when a circle is deformed to the shape of an ellipse. The circumference of the circle and the ellipse is the same, but the area is different. As the area of the tube changes, the area of the annulus that defines the volume of the sensor changes and hence the volume of the sensor thereby changes with pressure.
The reaction of the flaccid tube to pressure thereby forms a variable volume pressure sensor that operates in accordance with Boyle's law. A preferred aspect in the manufacture of the sensor is to have the flaccid tube be slightly longer than the length of the minor diameter segment. The slack that is created allows the tube to change shape without being stretched. This slack therefore allows the tube to change shape without being constrained by tensile forces.
It should be understood that while different embodiments have been discussed as using air within the catheter for communicating pressure measurement, other gasses and fluids may also be used.
Although the invention has been described in terms of particular embodiments and applications, one of ordinary skill in the art, in light of this teaching, can generate additional embodiments and modifications without departing from the spirit of or exceeding the scope of the claimed invention. Accordingly, it is to be understood that the drawings and descriptions herein are proffered by way of example to facilitate comprehension of the invention and should not be construed to limit the scope thereof.
This application claims priority to U.S. Provisional Application Ser. No. 61/197,039 filed Oct. 24, 2008 entitled A Single Lumen Catheter with Separate Tubes Therein and U.S. Provisional Application Ser. No. 61/197,041 filed Oct. 24, 2008 entitled A Catheter with an Integrated Pressure Sensor all of which are hereby incorporated herein by reference.
Number | Date | Country | |
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61197041 | Oct 2008 | US | |
61197039 | Oct 2008 | US |