The present invention relates to a radial artery compression unit and to a radial artery compression system including a radial artery compression unit, with which a compression force is applied on the radial artery such that haemostasis can be obtained.
To access a patient's vascular system for an invasive medical procedure such as catheterization or similar procedures, a puncture is made in e.g. the femoral artery or the radial artery. The present invention is related to radial artery procedures. Following an invasive medical procedure, such as catheterisation or similar in medical procedure, the flow of blood through the puncture wound has to be stopped, so that haemostasis can begin as soon and fast as possible after the completion of the invasive medical procedure. Several devices have been suggested that facilitate and accelerate this haemostasis by providing a compression pressure that compresses blood vessels in various parts of the body to stop the flow of blood therethrough.
In the case of radial artery catheterisation, several radial artery occluders have been developed that stop the flow of blood through the puncture wound in the wrist by applying a compression force that occludes the radial artery.
One example of such a pressure-applying device is known from U.S. Pat. No. 5,601,597. This known artery occluder comprises a wrist splint, an adjustable securing strap attached to one end of the splint, and an adjustable pressure strap attached to the other end of the splint and provided with a pressure pad.
U.S. Pat. No. 6,647,986 shows a hand/wrist positioning splint to keep the hand positioned for radial artery access and to permit application of a haemostasis band. Two straps are used to secure the patient's hand to the splint and the haemostasis band comprises buckles to apply sufficient pressure to the puncture site.
Another example of a pressure-applying device is known from U.S. Pat. No. 7,498,477, disclosing a haemostatic device with an inflatable balloon. A main balloon is pressed against a puncture site of a patient and filled with a first fluid to inflate the balloon. A pressing member is further provided on the main balloon, and when filled with a second fluid, it presses against the main balloon to apply a compressive force to the puncture site that acts ht an inclined direction with respect to the surface of the limb of the patient. The main balloon and die pressing member are held in place against the puncture site with a flexible band and a curved plate.
From WO 96/25110 a further device for compression of an artery is known. The device comprises an elongated compression element, a pressure distribution and support plate and strap means for holding the compressing element and the pressure distribution plate in place.
It is an object of the invention to provide an improved device that enables an accurately applied pressurization against a puncture site, and in particular enables a following adjustment of the applied pressure to the puncture site.
It is a further object of the invention to provide an improved device which is more hygienic than prior art devices, and that is economical to manufacture and ship to the end user.
The above-mentioned objects are achieved by means of a compression unit adapted to be arranged around a patient's forearm to provide pressure to a radial artery puncture site, and a radial artery compression system comprising a dorsal forearm plate and a compression unit, according to the independent claims.
According to one aspect the present invention relates to a compression unit adapted to be arranged around a patient's forearm to provide pressure to a radial artery puncture site, wherein the compression unit comprises a unit attachment band provided with a frame, and a compression element in the shape of an inflatable bladder, the compression element is further arranged within the frame, such that when the compression unit is arranged around a patient's forearm, the compression element provides pressure to the puncture wound when the inflatable bladder is inflated. The inventive compression unit provides for a continuous adjustment of the pressure to the puncture site by inflating the bladder when the compression unit is arranged around a patient's forearm, and thereby an accurately applied pressure against the puncture site where a following adjustment of the applied pressure is possible.
According to another aspect, the invention relates to a radial artery compression system, comprising a compression unit and a dorsal forearm plate provided with a distal and a proximal attachment band adapted to attach the dorsal forearm plate at the dorsal forearm of a patient, wherein the compression unit s adapted to be arranged around a patient's forearm where the dorsal forearm plate is attached and fixated, such that the compression element provides pressure to a radial artery site.
The dorsal forearm plate fixates the wrist in a controlled position minimizing bleeding complications and is comfortable for the patient and slimmer than previously used plates. In addition, the plate prevents the patient from flexing, the wrist and causing late bleedings as well as reduces the risk of venous stasis.
The primary use for a radial artery compression system according to the present invention is to achieve hemostasis after a transradial procedure. However, with the dorsal forearm plate, the cardiologist may also use the plate pre-, during and post procedure to fixate the wrist in a flexed position which allows easier access to the radial artery. The dorsal forearm plate further distributes reaction force over the dorsal side of the forearm to avoid building up a local maximum pressure on the forearm which might give venous stasis.
The unit attachment band provides for a compression unit which is more hygienic than prior art devices, as the compression unit is in one part that can be separated from the system by means of the unit attachment band and exchanged or separately sterilized. The band is advantageously adjustable to it different sizes of forearms.
Preferred embodiments are set forth in the dependent claims and in the detailed description.
Below the invention will be described in detail with reference to the appended figures, of which:
As background information,
In the figures the compression element 2 is shown in an inflated state, but it is understood that the compression element 2 may have different shapes dependent on which material the compression is made of and how much the compression element 2 is inflated.
The frame 4 may be of any shape enabling the compression element 2 to be arranged within and attached to the frame 4. In the figures, the frame 4 has an essentially rectangular shape to be able to apply pressure longitudinally along an artery, but could instead be e.g. essentially quadratics. Regarding the thickness of the frame 4, the frame 4 preferably has a thickness withstanding the pressure that is built up when the compression element 2 is inflated, thus, the frame 4 should preferably not bend when the compression element 2 is inflated. The width of the frame 4 is according to one embodiment approximately 2-4 mm.
The frame 4 is further a stabilizing unit which provides support for the compression element 2 when the compression element 2 is attached to the frame 4 and inflated, such that the pressure can be focused against a puncture wound.
The compression element 2 is advantageously adapted to be attached to the frame 4 by means of at least one mechanical joint. From the
According to another embodiment, the compression element 2 is attached to the frame 4 by means of gluing or welding.
In the figures, the compression element 2 has an elongated extension, defining a longitudinal axis of the element, in the direction of an artery to which it is to be applied. According to one embodiment, the compression element 2 comprises a first pan 9 adapted to face a puncture wound, and an opposite second part 10. The parts 9, 10 are according to one embodiment made of two equally sized films and are attached to each other along their edges, e.g. by welding, to form an inflatable bladder. The bladder attachment means 6 are advantageously made from the same films by providing appropriate sized loops in the films, and the bladder attachment means 6 and the first and second parts 9, 10 may thus be made of the same material. The bladder is preferably attached to the frame 4 by means of the attachment means when it is substantially not inflated, and when the bladder thereafter is inflated, the bladder attachment means 6 here in the shape of loops are tightened to the frame 4 against the bladder, advantageously against a middle line of the bladder, such that the bladder is securely and firmly attached to the frame 4. Each of the parts preferably has a concave inner side and a convex outer side forming an inflatable bladder when attached to each other and inflated. The compression element 2 may thus be formed in other ways, e.g. by moulding. When the bladder is not inflated, the first part 9 and the second part 10 are according to one embodiment, of the same size. According to one embodiment, the first part 9 and the second part 10 are made of non-elastic material, i.e. rigid material. The bladder will then provide for a focused pressure over the puncture wound when the bladder is in use and inflated and also when the pressure in the bladder is increased, as the first par 9 becomes rounded against the wrist and presses in a longitudinal line following the artery in which a puncture wound has been made.
According to another embodiment, the first part 9 and the second part 10 are made of elastic material. If elastic material is used and the compression unit 1 is attached to a patient with a certain tension in the unit attachment band 3, inflation of the bladder will mainly result in an increased pressure area of the compression element 2 against the puncture wound, instead of an increased pressure locally over the artery. This is thus an advantage if an increased pressure area is desired e.g. it the puncture wound is large in size, or if it is desired to improve the distribution of the pressure. If the parts are made of materials with different elasticity, the parts may expand differently when the inflatable bladder is inflated. As can be seen from the
According to one embodiment, the first part 9 and the second part 10 are injection-moulded. The first part 9 may be injection-moulded of a thermoplastic elastomer, preferably transparent, and the second part 10 may be injection-moulded of a rigid plastic material, preferably also transparent. The first part 9 of the thermoplastic elastomer is then adapted to face a puncture wound of a patient. According to one embodiment, the compression element 2 is injection-moulded of a thermoplastic elastomer in one piece. The thermoplastic elastomer may be transparent, thus, the compression element 2 is then transparent.
If the inflatable bladder comprises pets made of materials with the same elasticity and the same thickness, they will expand essentially symmetrically when inflated.
The first part 9 may be of a material which gives certain desired properties against the skin of a patient, such as a gentle feeling or friction.
The inflatable bladder is according to one embodiment made of polyethylene terephthalate film, ethylene vinyl acetate film, polyurethane film or any other kind of weldable plastic. The compression element 2 i.e. the inflatable bladder is preferably made from a transparent material, thereby providing the possibility of direct visual observation of the puncture wound, which facilitates the positioning of the compression element 2.
To be able to inflate the compression element 2 it comprises a fluid connection 12 adapted to be connected to a tube 7 for inflation of the compression element 2. Two different embodiments are illustrated in
The unit attachment band 3 is according to one embodiment fixated to one side of the frame 4. According to another embodiment, the hand is fixated to the frame 4 by means of an inner frame 8 adapted to fit inside the frame 4 wherein the compression element 2 is arranged as can be seen in
The unit attachment band 3 is preferably flexible. The compression unit 1 may be rigidly attached to the arm of the patient by the unit attachment bands 3 provided with Velcro tape. The unit attachment band 3 may instead be provided with holes and the frame 4 provided with a mating attachment knob 11 therefore. Regarding material, the band may be made from e.g. a thermoplastic elastomer.
The invention also relates to a radial artery compression system as illustrated in inter alia
In the figure can be seen that the shape of the side of the plate is adapted to face the forearm during use and it is also adapted to the anatomy of the forearm in that it comprises two elongated depressions 18 running in the longitudinal direction of the plate. These two depressions 18 are intended to, during use of the plate, accommodate the tartar bone and radius bone of the patient, in particular the distal parts of these bones, the so called styloid processes of each bone, in the respective depression 18. Furthermore, an elongated ridge 19, formed between the depressions 18, is adapted to extend into the softer tissue between the bones in order to orient and stabilize the forearm when attached to the plate.
In order for the patient to comfortably rest and orient the forearm on the dorsal forearm plate 14 the height of the elongated ridge 19 at a cross-section A-A, essentially at a midpoint of the plate in the longitudinal direction, is at a level being in the interval of 10-50% of the total height of the plate at said cross-section A-A. The cross-section A-A is depicted e.g. in
The dorsal forearm plate 14 may be rigidly attached to the arm of the patient by the attachment hands 13 provided with Velcro tape. The attachment bands 13 may also be provided with holes and the plate provided with mating attachment knobs 11 therefore. In the latter case, the bands are preferably made at least partly of an elastic material to ensure a comfortable fit.
The dorsal forearm plate 14 is essentially arc-shaped in the longitudinal direction such that it only rests on its short sides 16, 17 when arranged on a plane surface. Each of the short sides 16, 17 has an essentially straight supporting edge along a major part of its length and the supporting edges of said short sides 16, 17 are arranged in the same virtual plane. Thereby the plate has a stable support when used on a flat surface, e.g. a table. When the plate lays on a flat surface the midpoint of the plate is about 1 cm above the surface.
In order to e.g. gain access to blood vessels at the dorsal side of the hand the dorsal forearm plate 14 is provided with a recess 20 extending from the distal short side 16 extending in the proximal direction such that an opening, having an essentially rectangular shape, is provided in the plate. This recess 20 is shown in
The surface not intended to face the forearm of the plate is provided with a texture such that the friction is high and that said high friction surface extends at least along the mid third part of the plate.
Regarding the material of the dorsal forearm plate 14 it may be made from pressure moulded plastic or any other suitable material that stabilizes the forearm. Preferred materials are polypropylene or polycarbonate. The attachment bands 13 are preferably made from a thermoplastic elastomer.
When the forearm of the patient is readily fixed in the dorsal forearm plate 14 by the attachment bands 13 the puncture can be made for e.g. an interventional procedure of choice. When the desired procedure(s) are completed, the flow of blood from the puncture wound is stopped by applying the compression element 2 to the puncture wound. Thereby, the blood flow is stopped directly and efficiently.
The present invention is not limited to the above-described preferred embodiments. Various alternatives, modifications and equivalents may be used. Therefore, the above embodiments should not be taken as limiting the scope of the invention, which is defined by the appending claims.
1 Compression unit
2 Compression element
3 Unit attachment band
4 Frame
5 Frame attachment means
6 Bladder attachment means
7 Tube
8 inner frame
9 First part
10 Second part
11 Knob
12 Tube/fluid connection
13 Attachment band
14 Dorsal forearm plate
15 Pressurizing unit
16 Distal short side
17 Proximal short side
18 Depression
19 Ridge
20 Recess
Number | Date | Country | Kind |
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1050059 | Jan 2010 | SE | national |
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/SE2011/050059 | 1/19/2011 | WO | 00 | 7/17/2012 |
Publishing Document | Publishing Date | Country | Kind |
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WO2011/090429 | 7/28/2011 | WO | A |
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