The present invention generally relates to a hemostatic device and method of performing hemostasis.
As a catheter procedure, a procedure is known in which a blood vessel (for example, radial artery) in an arm of a patient is punctured, and various medical elongated bodies are introduced into the blood vessel via a puncture site formed in the blood vessel in the arm of the patient so as to perform treatment or therapy on a lesion area. An example of this is disclosed in Japanese Patent Application Publication No. 2008-119517. The catheter procedure utilizing the radial artery is referred to as transradial artery approach and is considered a useful technique for, for example, coronary artery access and lower limb artery access.
A radial artery located in an arm of a human body is connected to a palmar artery which bypasses a hand side. Therefore, currently, as a new method of transradial artery approach, a catheter procedure using distal transradial approach (dTRA) has been attempted to access the palmar artery (including a distal radial artery) from an anatomical snuffbox located on a dorsal side of the hand or from a position around the snuffbox, and perform treatment through the vascular access site.
Blood vessels such as palmar arteries located in the hand are located in places where there are many movable parts such as fingers. For this reason, a shape around the puncture site in the hand changes with movement of the hand. Therefore, when hemostasis is performed on the puncture site, a pressing member placed on the hand is preferably an inflatable member that follows the movement of the hand and can easily adjust a compressive force on the puncture site.
However, when the pressing member is the inflatable member, the inflatable member exerts a force to inflate from the inside to the outside of the inflatable member in an inflated state. For this reason, in a hemostatic device having the inflatable member, a shape around a hemostatic site changes due to the movement of the hand, the inflatable member is shifted from the puncture site, and it may not be possible to properly maintain the compressive force of the inflatable member on the puncture site in some cases. Therefore, when hemostasis is performed on the puncture site of the hand, the hemostatic device having the inflatable member needs to suppress position shift of the inflatable member by force acting in a direction away from the puncture site, thereby appropriately securing the inflatable member to the puncture site. In this way, it is considered that the hemostatic device having the inflatable member can appropriately maintain the compressive force of the inflatable member on the puncture site even when the shape around the puncture site is changed by the movement of the hand.
The hemostatic device disclosed here is capable of suppressing position shift of an inflatable member with respect to a site where bleeding is to be stopped on a hand and appropriately maintaining a compressive force of the inflatable member on the site where bleeding is to be stopped on the hand even when a patient moves the hand while the inflatable member is inflated.
A hemostatic device according to one aspect includes a covering member configured to cover a site on a hand of a patient where bleeding is to be stopped, a securing member connected to the covering member and configured to secure the covering member on the hand of the patient while the covering member is covering the site on the patient's hand where bleeding is to be stopped, and an inflatable member connected to the covering member and configured to be inflated by injection of a fluid. The covering member includes a main body to which the inflatable member is connected, a first arm portion extending away from the main body in a longitudinal direction of extent, and a second arm portion extending away from the main body in a direction forming an obtuse angle with the longitudinal direction of extent of the first arm portion. The first arm portion includes one end portion closest to the main body and an opposite end portion remote from the main body, with the first arm portion including an enlarged portion that protrudes in a width direction of the first arm portion at the opposite end portion of the first arm portion. The second arm portion is longer than the first arm portion, wherein the second arm portion includes a first part configured to be secured to the enlarged portion by way of a first part of the securing member. The second arm portion is configured to pass between fingers of the hand of the patient while the second arm portion is wrapped around a limb of the patient and includes a second part configured to be secured to a third part of the second arm portion by way of a second part of the securing member.
A hemostatic device according to another aspect includes a covering member configured to cover a site on a hand of a patient where bleeding is to be stopped, a securing member connected to the covering member and configured to secure the covering member on the hand of the patient while the covering member is covering the site on the patient's hand where bleeding is to be stopped, and an inflatable member connected to the covering member and configured to be inflated by injection of a fluid. The covering member includes a main body to which the inflatable member is connected, a first arm portion extending away from the main body in a longitudinal direction of extent, and a second arm portion extending away from the main body in a direction forming an obtuse angle with the longitudinal direction of extent of the first arm portion. The inflatable member includes a first inflatable portion and a deformable auxiliary member which has a smaller outer shape than an outer shape of the first inflatable portion and is offset toward one end side of the first inflatable portion. The first arm portion and the second arm portion of the covering member are configured to be connectable to one another by the securing member in a state in which the covering member is wrapped around a limb of the patient. The auxiliary member is disposed between the first arm portion and the second arm portion.
The hemostatic device is configured so that the main body in which the inflatable member is disposed can be secured to the limb by disposing a part of the second arm portion between adjacent fingers of the patient and connecting the enlarged portion and the second arm portion while wrapping the first arm portion and the second arm portion around the limb of the patient. The first arm portion and the second arm portion are fastened to the limb by connecting the enlarged portion and the second arm portion, and the main body is secured to the limb. Further, by disposing the second arm portion between the adjacent fingers of the patient, it is possible to suppress position shift of the inflatable member disposed in the main body with respect to the site where bleeding is to be stopped. Further, the hemostatic device has a simple securing structure capable of tightening the inflatable member to the hand of the patient by connecting the two arm portions protruding from the main body. For this reason, the hemostatic device can reduce the number of arm portions installed for securing the inflatable member. In this way, the hemostatic device can suppress an increase in arm portions that may interfere with a medical device such as an introducer in a state where the hemostatic device is attached to the hand of the patient, and thus it is possible to easily remove the medical device from the site where bleeding is to be stopped even after the hemostatic device is attached. In addition, a movable range of the hand increases from a wrist side to a fingertip side of the hand. In the hemostatic device, the first arm portion and the second arm portion extend from the fingertip side to the wrist side of the hand while forming an obtuse angle, so that the first arm portion and the second arm portion can be connected on the wrist side of the hand of the patient. Therefore, in the hemostatic device, the first arm portion and the second arm portion can be secured on the wrist side where the movable range is small, and thus the main body can be secured to the limb while maintaining the movable range on the fingertip side of the hand. An outer circumference of the hand becomes larger from the wrist side to the fingertip side of the hand in a state where the hand is spread. Therefore, since the first arm portion and the second arm portion extend in a direction opposite to a direction in which the outer circumference of the hand becomes larger, the first arm portion and the second arm portion can be reliably connected on the wrist side of the hand in the state where the hemostatic device is attached. Furthermore, in the hemostatic device, even in the case where the patient moves the hand with the inflatable member inflated, when the first arm portion and the second arm portion are secured in a state of being tightened to the limb of the patient, it is possible to prevent rising of the distal side (fingertip side) of the main body to which the inflatable member is connected, and to appropriately maintain the compressive force of the inflatable member on the site where bleeding is to be stopped formed on the dorsal side of the hand of the patient.
In addition, since the first arm portion and the second arm portion extend from the main body so as to form an obtuse angle, when the hemostatic device is attached to the limb of the patient, the respective arm portions can be connected so that the entire finger of the patient is not covered by the covering member. For this reason, the patient is less likely to be restricted in movement of the hand even when the hemostatic device is attached, and thus a degree of freedom on the fingertip side can be increased. Further, since the hemostatic device has the deformable auxiliary member located on the distal side of the first inflatable portion, when the first inflatable portion is inflated, the auxiliary member presses the first inflatable portion against the limb of the patient to inhibit the first inflatable portion from rising in a direction away from the puncture site on the hand of the patient. As a result, the hemostatic device can maintain an appropriate compressive force on the site where bleeding is to be stopped while increasing the degree of freedom on the fingertip side. Furthermore, in the hemostatic device, since the first arm portion and the second arm portion extend from the fingertip side to the wrist side of the hand while forming an obtuse angle, the first arm portion and the second arm portion can be secured on the wrist side where the movable range is small. Therefore, the main body can be appropriately secured to the limb while maintaining the movable range on the fingertip side of the hand. Further, in the hemostatic device, since the first inflatable portion can be secured to the site where bleeding is to be stopped by the two arm portions including the first arm portion and the second arm portion and the auxiliary member, it is unnecessary to add different arm portions between the first arm portion and the second arm portion. Therefore, the operator, etc. can easily remove the medical device such as an introducer sheath after attaching the hemostatic device. Further, since the first arm portion and the second arm portion are connected in a state of being wrapped around the limb of the patient, the first arm portion and the second arm portion are pressed against the hand of the patient while pulling the main body located therebetween toward the both side portion sides of the main body. Since the auxiliary member is located between the first arm portion and the second arm portion, the inflatable member can be reliably pressed against the body surface of the hand of the patient by connection of the first arm portion and the second arm portion. Therefore, the hemostatic device can press the first inflatable portion against the limb of the patient by the auxiliary member, and reliably inhibit the first inflatable portion from rising in the direction away from the site where bleeding is to be stopped on the hand of the patient. In this way, the hemostatic device can reliably press the first inflatable portion against the hand of the patient and maintain an appropriate compressive force on the puncture site while increasing the degree of freedom on the fingertip side during attachment of the hemostatic device.
Another aspect involves a method of producing hemostasis at a puncture site on a hand of a patient where bleeding is to be stopped. The method involves positioning a main body of a covering member in overlying relation to the puncture site on the hand of the patient where bleeding is to be stopped so that an inflatable member underlying the main body portion is positioned relative to the puncture site. The covering member also includes a first arm portion extending away from the main body in a longitudinal direction of extent, and a second arm portion extending away from the main body in a direction forming an obtuse angle with the longitudinal direction of extent of the first arm portion. The first arm portion includes one end portion closest to the main body and an opposite end portion remote from the main body, with the opposite end portion of the first arm portion including an enlarged portion that protrudes in a width direction of the first arm portion, and the second arm portion being longer than the first arm portion. The method additionally involves wrapping the first arm portion and the second arm portion around a limb of the patient while the main body is in overlying relation to the puncture site on the hand of the patient, securing a first part of the second arm portion and the enlarged portion of the first arm to one another while the first part of the second arm portion is in contact with the enlarged portion of the first arm, passing the second arm portion between two fingers of the hand of the patient, securing a second part of the second arm portion and a third part of the second arm portion to one another while the second part of the second arm portion and the third part of the second arm portion are in contact with one another, and introducing a fluid into the inflatable member to inflate the inflatable member and apply a compressive force from the inflatable member to the puncture site to perform hemostasis.
Set forth below with reference to the accompanying drawings is a detailed description of embodiments of a hemostatic device and method of performing hemostasis representing examples of the inventive hemostatic device and method disclosed here. The dimensions or scales on the drawings may be exaggerated or different from actuality/reality for convenience of description and illustration. The following description does not limit the technical scope or the meaning of terms in the appended claims.
As illustrated in
In brief, as illustrated in
<Covering Member>
As illustrated in
The first arm portion 130 has an inclined portion 131 located on an end portion side connected to a first region 121a of the main body 120, and an enlarged portion 133a protruding in a width direction of the first arm portion 130 at an end portion 133 opposite to a side where the inclined portion 131 is disposed. In the illustrated embodiment, the enlarged portion 133a is positioned at the free end of the first arm portion 130 disposed remote from the main body 120 as shown in
As illustrated in
The inclined portion 131 and the enlarged portion 133a of the first arm portion 130 are formed of a flexible band-shaped member that allows the first arm portion 130 to be wrapped around the right hand H1 of the patient.
As illustrated in
As illustrated in
The second arm portion 140 is formed of a flexible band-shaped member that can be wrapped around the limb of the patient. The limb around which the second arm portion 140 is wrapped includes, for example, a part of the right hand H1 of the patient, a part of the forearm A, and a part of a wrist. Further, a space between the fingers (inter-finger portion) through which the second arm portion 140 passes is, for example, a space between the thumb f1 and the index finger f2 of the right hand H1 of the patient. However, a position of the limb around which the second arm portion 140 is wrapped or a position of the inter-finger portion through which the second arm portion 140 is passed is not particularly limited. The hemostatic device 100 according to the present embodiment can be attached to the left hand H2 in the same manner as each part of the right hand H1 described above (see
As illustrated in
In the present embodiment, as illustrated in
As described above, in the hemostatic device 100, the first arm portion 130 and the second arm portion 140 form an obtuse angle on the plan views illustrated in
An angle formed by a straight line d3 (vertical line in
As illustrated in
The inclined portion 141 of the second arm portion 140 includes the first inclined portion 141a connected to the first region 121a of the main body 120 and a second inclined portion 141b extending between the first inclined portion 141a and the second arm end portion 143.
The first inclined portion 141a is inclined in a direction away from the distal side of the main body 120. Similarly to the first inclined portion 141a, the second inclined portion 141b is inclined in a direction away from the distal side of the main body 120. As shown in
A width of the first inclined portion 141a gradually decreases from the first region 121b side of the main body 120 toward the second inclined portion 141b side. A width of the second inclined portion 141b gradually decreases from the first inclined portion 141a side to the second arm end portion 143 side.
The second arm end portion 143 extends linearly along an extending direction of the second arm portion 140 with a substantially constant width. The second arm end portion 143 is a portion including a predetermined range in the extending direction of the second arm portion 140 from an end portion (terminal) of the second arm portion 140.
As illustrated in
By way of example, the width W1 of the inclined portion 141 may be 15 mm to 45 mm. Further, for example, the width W2 of the second arm end portion 143 may be 10 mm to 20 mm. A maximum value of the width W1 of the inclined portion 141 illustrated above is a maximum value of the first inclined portion 141a, and a minimum value of the width W1 of the inclined portion 141 is a minimum value of the second inclined portion 141b. The inclined portion 141 can be formed by one inclined portion extending from the first region 121b side of the main body 120 to the second arm end portion 143. Even in such a configuration, the width W1 of the inclined portion 141 discussed above may still apply.
In the first arm portion 130 and the second arm portion 140, for example, it is possible to provide an entry portion (information entry portion) that allows the operator, etc. to enter information such as the amount of air injected into the inflatable member 160, a hemostatic time, etc. in a procedure using the hemostatic device 100. The entry portion can be made of a material allowing the information, etc. to be written using ink, etc. provided in a known pen.
As illustrated in
The first region 121a is disposed between the second region 122 and the first arm portion 130. The first region 121b is disposed between the second region 122 and the second arm portion 140.
As illustrated in
As illustrated in
The insertion portion 128a is a space formed between the cover member 128 disposed to cover a part of the outer surface of the main body 120 and the main body 120.
An insertion port 128b communicating with the insertion portion 128a is formed on the proximal side (lower side of
The cover member 128 can be connected to the covering member 110 by, for example, adhesion or welding. In the present embodiment, the cover member 128 is connected to the covering member 110 at three sides, namely the three sides other than a part where the insertion port 128b is formed.
As illustrated in
When the inflatable member 160 is inflated, the curved portion 125a of the support member 125 wraps or extends around (encircles) the vicinity of the end portion of the inflatable member 160 on the distal side (an end portion 173 of the first inflatable portion 170 and an end portion 183 of the second inflatable portion 180), so that the compressive force of the inflatable member 160 is directed toward the central portion of the support member 125 (center portion in the left-right direction of
An apex 125c of the curved portion 125a of the support member 125 (a part of the curved portion 125a most distant from the inflatable member 160) can be disposed, for example, on the distal side of the main body 120 with respect to the center position of the inflatable member 160. That is, the apex may be displaced away from the center of the inflatable member 160 and toward the distal side of the inflatable member 160. By disposing the apex 125c of the curved portion 125a at the position described above, the support member 125 can reliably wrap or encircle the vicinity of the end portion of the inflatable member 160 on the distal side when the inflatable member 160 inflates, and thus it is possible to effectively inhibit the compressive force of the inflatable member 160 from escaping to the outside of the support member 125.
As illustrated in
A width direction dimension (vertical direction dimension of
The support member 125 may be disposed, for example, on the inner surface side of the main body 120 of the covering member 110 (surface on a side where each of the inflatable portions 170 and 180 is disposed, which is a surface on a lower side of
In the present embodiment, the first regions 121a and 121b and the second region 122 of the main body 120 are integrally formed of one member to form a unitary, one-piece member as shown. However, the first region 121a and 121b and the second region 122 may be configured by connecting different or separate members.
In the second region 122 of the main body 120, the cover member 128, the support member 125, the first inflatable portion 170, and the second inflatable portion 180, a portion overlapping the marker portion 105 in the plan view illustrated in
It is preferable that the first regions 121a and 121b of the main body 120 are made of a material having higher elasticity than that of the first arm portion 130 and the second arm portion 140. In this way, when the hemostatic device 100 is attached to the right hand H1 of the patient, by wrapping each of the arm portions 130 and 140 around the limb of the patient, the first region 121a is pulled toward the first arm portion 130 side and extended, and the first region 121b is pulled toward the second arm portion 140 side and extended. As a result, a physical property of the main body 120 changes at each boundary between the first arm portion 130 and the second arm portion 140 to allow the main body to be deformed relatively easily, and thus the first arm portion 130 and the second arm portion 140 can be easily disposed on the right hand H1 of the patient in a state where the main body 120 is disposed on the puncture site t1 formed on the right hand H1 of the patient.
Further, a material of the support member 125 is preferably more rigid than a material of each of the first arm portion 130 and the second arm portion 140. As a result, when the inflatable member 160 inflates, the support member 125 can suppress rising of the main body 120 by the inflatable member 160 due to the rigidity of the support member 125. Further, since the first arm portion 130 and the second arm portion 140 are configured to be more flexible than the support member 125, the hemostatic device 100 can be easily attached to the patient along the limb of the patient when being attached to the patient.
In the present embodiment, in the covering member 110, each of the main body 120, the first arm portion 130, and the second arm portion 140 is formed as a separate member. When each portion of the covering member 110 is configured as a separate member in this way, each of the main body 120, the first arm portion 130, and the second arm portion 140 can be connected by, for example, adhesion, welding, etc. However, in the covering member 110, any of the main body 120, the first arm portion 130, and the second arm portion 140 may be integrally formed as one member.
The material used to fabricate the main body 120 of the covering member 110 is not particularly limited. Examples of such material include polyvinyl chloride, polyolefin such as polyethylene, polypropylene, polybutadiene, or ethylene-vinyl acetate copolymer (EVA), polyester such as polyethylene terephthalate (PET) or polybutylene terephthalate (PBT), polyvinylidene chloride, silicone, polyurethane, various thermoplastic elastomers such polyamide elastomer, polyurethane elastomer, and polyester elastomer, nylon, nylon elastomer, or any combination thereof (blended resin, polymer alloy, laminate, etc.).
The material used to fabricate the cover member 128 is not particularly limited, and examples of such material include the same materials as those exemplified as the material of the covering member 110.
The material used to fabricate the support member 125 preferably has a higher rigidity than that of the material used for the first regions 121a and 121b of the main body 120 of the covering member 110. Examples of such a material may include acrylic resin, polyvinyl chloride (especially hard polyvinyl chloride), polyolefin such as polyethylene, polypropylene, or polybutadiene, polystyrene, poly-(4-methylpentene-1), polycarbonate, ABS resin, polymethylmethacrylate (PMMA), polyacetal, polyacrylate, polyacrylonitrile, polyvinylidene fluoride, ionomer, acrylonitrile-butadiene-styrene copolymer, polyester such as polyethylene terephthalate (PET) or polybutylene terephthalate (PBT), butadiene-styrene copolymer, aromatic or aliphatic polyamide, fluorine-based resin such as polytetrafluoroethylene, etc.
The material used to produce the first arm portion 130 and the second arm portion 140 of the covering member 110 is not particularly limited. Examples of such material may include the same materials as the materials described above to produce the main body 120 of the covering member 110, woven fabric, nonwoven fabric, felt, cloth, knitted fabric, and paper.
<Securing Member>
As illustrated in
As illustrated in
As illustrated in
As illustrated in
As illustrated in
The first securing member 151 and the second securing member 152 are formed on a male side of a surface fastener. The third securing member 153, the fourth securing member 154, the fifth securing member 155, and the sixth securing member 156 are formed on a female side of the surface fastener. The surface fastener is a fastener that is removable in terms of surface, and is, for example, MAGIC TAPE (registered trademark) or VELCRO (registered trademark).
A specific configuration of each of the securing members 151, 152, 153, 154, 155, and 156 is not limited as long as the second arm portion 140 wrapped around the limb of the patient can be secured to the enlarged portion 133a, and a part of the second arm portion 140 passed between the thumb f1 and the index finger f2 can be secured to the second arm portion 140. For example, some of the securing members 151, 152, 153, 154, 155, and 156 can be omitted, and positions where the securing members are disposed on the respective arm portions 130 and 140 can be changed as appropriate. Further, when each of the securing members 151, 152, 153, 154, 155, and 156 includes a surface fastener, a male side and a female side of the surface fastener may be interchanged. Further, for example, each of the securing members 151, 152, 153, 154, 155, and 156 may be a snap, a button, a clip, a frame member in which a hole is formed, etc.
<Inflatable Member>
As illustrated in
The auxiliary member 180 overlaps the first inflatable portion 170 on the distal side of the main body 120.
The first inflatable portion 170 includes a lumen 171 into which a fluid can be injected, and a communication hole 172 formed at a position facing the auxiliary member 180.
In the present embodiment, the auxiliary member 180 is a second inflatable portion configured to be inflated by injection of a fluid. Hereinafter, the auxiliary member 180 will be referred to as a second inflatable portion.
The second inflatable portion 180 includes a lumen 181 into which a fluid can be injected, and a communication hole 182 disposed at a position facing the communication hole 172 of the first inflatable portion 170.
The lumen 181 of the second inflatable portion 180 communicates with the lumen 171 of the first inflatable portion 170 through the communication hole 182 of the second inflatable portion 180 and the communication hole 172 of the first inflatable portion 170.
As illustrated in
In the present embodiment, the second inflatable portion 180 has a substantially square shape. Therefore, in the second inflatable portion 180, a center position of the square in the left-right direction is disposed at the center position of the main body 120. Further, the marker portion 105, which will be described later, is disposed at the center of the second inflatable portion 180.
The second inflatable portion 180 is fixed to the inner surface of the covering member 110 (the inner surface of the main body 120 of the covering member 110). Specifically, the end portion 183 of the second inflatable portion 180 located on the distal side of the second inflatable portion 180 is fixed to the inner surface of the covering member 110.
In the first inflatable portion 170, the periphery of the communication hole 172 of the first inflatable portion 170 is fixed to the periphery of the communication hole 182 of the second inflatable portion 180. Specifically, in the first inflatable portion 170, only a certain range around each of the communication holes 172 and 182 located near the central portion of the second inflatable portion 180 is fixed to the second inflatable portion 180. As described above, the first inflatable portion 170 is not directly connected to the covering member 110, and is indirectly connected to the covering member 110 via the second inflatable portion 180. As a result, in the second inflatable portion 180, the peripheral edge of the second inflatable portion 180 is not fixed to the first inflatable portion 170, and thus the outer shape of the second inflatable portion 180 is freely deformed. For this reason, even when the patient bends the finger (for example, the thumb f1) or the wrist upward (to the dorsal side Hb of the hand), the hemostatic device 100 can maintain a large area in which the second inflatable portion 180 compresses the first inflatable portion 170. Therefore, the hemostatic device 100 can effectively apply a compressive force to the puncture site t1 from the inflatable member 160. In the first inflatable portion 170 and the second inflatable portion 180, for example, the first inflatable portion 170 and the second inflatable portion 180 may be integrally connected to the covering member 110 by fixing the end portion 183 of the second inflatable portion 180 to the covering member 110 in a state where the first inflatable portion 170 and the second inflatable portion 180 are connected.
The inflatable member 160 may be fixed to the inner surface of the covering member 110 at a position different from that shown in
Further, it is preferable that the second inflatable portion 180 is located inside the curved portion 125a of the support member 125 and overlaps the first inflatable portion 170. As a result, since the second inflatable portion 180 is located inside the curved portion 125a of the support member 125, the compressive force of the second inflatable portion 180 is directed toward the center portion of the support member 125 by the curved portion 125a, and inhibited from escaping to the outside of the support member 125. Further, when the second inflatable portion 180 overlaps the first inflatable portion 170 on the curved portion 125a side of the support member 125, the second inflatable portion 180 can prevent the first inflatable portion 170 from rising on the distal side of the right hand H1 or the left hand H2 while preventing position shift of the first inflatable portion 170. Therefore, the hemostatic device 100 can more reliably prevent the inflatable member 160 from rising, and can suppress a decrease in the compressive force applied to the puncture site t1 by the inflatable member 160.
The first inflatable portion 170 has a substantially square shape on the plan view illustrated in
The lumen 171 of the first inflatable portion 170 communicates with a lumen of a tube 193 for supplying a fluid such as air to the first inflatable portion 170. As illustrated in
The tube 193 may be connected to the second inflatable portion 180. Further, a position at which the tube 193 extends to the outside of the main body 120 can be appropriately changed.
As illustrated in
The marker portion 105 is disposed at a position corresponding to a substantially center position (center position with respect to the plan view illustrated in
As illustrated in
The marker portion 105 preferably includes a transparent central portion and a colored linear frame portion surrounding the central portion. In this way, the operator can dispose or position the marker portion 105 at the puncture site t1 while confirming the puncture site t1 through the transparent central portion of the marker portion 105. For this reason, the operator can easily dispose the center position of the first inflatable portion 170 at the puncture site t1 using the marker portion 105. The marker portion 105 may be, for example, formed only by the colored central portion without having the frame portion. Further, a specific shape and color of the marker portion 105, a formation method on each portion of the hemostatic device 100, etc. are not particularly limited.
In the present embodiment, the first inflatable portion 170 is formed of two sheet-shaped members. For example, the first inflatable portion 170 can be formed by forming the lumen 171 between two sheet-shaped members each possessing a substantially rectangular shape and bonding outer peripheral edges of the two sheet-shaped members in this state. Similarly to the first inflatable portion 170, the second inflatable portion 180 can be formed of two substantially rectangular sheet-shaped members bonded together.
A method of bonding the sheet-shaped members forming the first inflatable portion 170, and a method of bonding the sheet-shaped members forming the second inflatable portion 180 are not particularly limited. For example, it is possible to use adhesion or welding. Further, a method of connecting the second inflatable portion 180 and the main body 120 of the covering member 110 is not particularly limited. For example, adhesion or welding can be used. Further, a method of fixing the first inflatable portion 170 and the second inflatable portion 180 is not particularly limited. For example, adhesion or welding can be adopted.
The first inflatable portion 170 and the second inflatable portion 180 may not have a structure in which plural sheet-shaped members are bonded together. The first inflatable portion 170 and the second inflatable portion 180 may be formed of, for example, one bag-shaped member in which a space into which a fluid can flow is formed.
A material used for producing the first inflatable portion 170 and the second inflatable portion 180 is not particularly limited, and examples of such material may include the same materials as those described above as the material of the main body 120 of the covering member 110.
<Injection Portion>
As illustrated in
The injection portion 191 includes a connector having an incorporated check valve. A syringe can be connected to the injection portion 191.
A cushioning member 192 having an inflatable space is disposed between the injection portion 191 and the inflatable member 160. The cushioning member 192 includes a flexible bag-shaped member having a space formed inside. The cushioning member 192 may be provided with an arrow-shaped marker indicating a direction in which the syringe is inserted into the injection portion 191.
The injection portion 191 is connected to one end side of the cushioning member 192. A lumen of the injection portion 191 communicates with a space in the cushioning member 192. However, while the check valve incorporated in the injection portion 191 is closed, communication between the lumen of the injection portion 191 and the space in the cushioning member 192 is cut off.
A flexible tube 193 is connected to the other end of the cushioning member 192. A lumen of the tube 193 communicates with the space in the cushioning member 192. Further, in the tube 193, the other end portion opposite to one end portion connected to the cushioning member 192 is connected to the first inflatable portion 170. The lumen of the tube 193 communicates with the lumen 171 of the first inflatable portion 170.
The other end portion of the tube 193 can be connected to the first inflatable portion 170 using, for example, an adhesive, etc. while being interposed between the two sheet-shaped members forming the first inflatable portion 170. In the sheet-shaped members forming the first inflatable portion 170, for example, convex portions partially protruding outward from the sheet-shaped members may be formed at parts interposing the tube 193 therebetween.
To inflate the first inflatable portion 170 and the second inflatable portion 180, the operator inserts a distal tubular portion of a syringe into the injection portion 191 to open the check valve. The operator injects air in the syringe into the lumen 171 of the first inflatable portion 170 by pushing a plunger of the syringe with the check valve of the injection portion 191 open.
When air is injected into the lumen 171 of the first inflatable portion 170, the first inflatable portion 170 inflates. Further, the air injected into the lumen 171 of the first inflatable portion 170 flows into the lumen 181 of the second inflatable portion 180 via the communication hole 172 of the first inflatable portion 170 and the communication hole 182 of the second inflatable portion 180. When air flows into the lumen 181 of the second inflatable portion 180, the second inflatable portion 180 inflates. When the first inflatable portion 170 and the second inflatable portion 180 inflate, the cushioning member 192 communicating with the lumen 171 of the first inflatable portion 170 via the tube 193 inflates.
The space in cushioning member 192 and the lumen 171 of the first inflatable portion 170 are in communication with each other via the tube 193 at all times. The injection portion 191 maintains the check valve incorporated in the injection portion 191 in a closed state when the syringe is not inserted into the injection portion 191 to prevent air from leaking from the injection portion 191. For this reason, when the internal pressure of the inflatable member 160 increases due to movement of the right hand H of the patient, etc., the air in the lumen 171 of the first inflatable portion 170 and the lumen 181 of the second inflatable portion 180 moves to the cushioning member 192 side which is not pressed against the puncture site t1 by the covering member 110. In this way, the compressive force applied to the puncture site t1 by the inflatable member 160 is adjusted, and thus the compressive force to the puncture site t1 by the inflatable member 160 can be appropriately maintained.
When the operator contracts the first inflatable portion 170 and the second inflatable portion 180, the operator inserts the distal tubular portion of the syringe into the injection portion 191 and pulls the plunger of the syringe. By performing the above operation, the operator can discharge the air in the first inflatable portion 170 and the air in the second inflatable portion 180 to the syringe.
When the operator, etc. inflates the inflatable member 160, the operator, etc. can visually confirm that the first inflatable portion 170 and the second inflatable portion 180 can be pressurized without leakage of air by confirming expansion of the cushioning member 192.
Next, a usage example of the hemostatic device 100 will be described with reference to
At the start of hemostasis, as illustrated in
Subsequently, as illustrated in
When the second arm portion 140 is secured to the enlarged portion 133a, the operator, etc. can confirm the position of the enlarged portion 133a and the shape of the enlarged portion 133a by the feel of the fingers. Therefore, the operator, etc. can guide the second arm portion 140 to the enlarged portion 133a disposed on the palm Hp side of the right hand H1 of the patient and recognize a direction in which the second arm portion 140 is disposed on the enlarged portion 133a, and thus the second arm portion 140 can be easily secured to the enlarged portion 133a.
Subsequently, as illustrated in
Subsequently, the operator, etc. wraps a portion (surplus portion) of the second arm end portion 143 not secured to the first inclined portion 141a along a circumferential direction of the right hand H1 of the patient, thereby further securing the second arm end portion 143 to the enlarged portion 133a. In this way, the hemostatic device 100 can prevent the second arm end portion 143 from being caught in a surrounding article, etc. while the hemostatic device 100 is attached to the operator, etc.
The operator, etc. can secure the hemostatic device 100 to the right hand H1 of the patient by the above procedure.
Next, the operator, etc. connects the syringe to the injection portion 191 and injects air into the first inflatable portion 170 to inflate the first inflatable portion 170 and the second inflatable portion 180. In the hemostatic device 100, when the first inflatable portion 170 and the second inflatable portion 180 are inflated, the first inflatable portion 170 applies a compressive force to the puncture site t1. After inflating the respective inflatable portions 170 and 180, as illustrated in
The operator, etc. confirms that there is no bleeding from the puncture site t1 during hemostasis using the hemostatic device 100. When there is bleeding from the puncture site t1, the operator, etc. adjusts the amount of air injected into each of the inflatable portions 170 and 180.
After a certain period of time from the start of hemostasis, the operator, etc. gradually depressurizes each of the inflatable portions 170 and 180 to confirm that hemostasis is properly performed on the puncture site t1. After the hemostasis on the puncture site t1 is completed, the operator, etc. sufficiently depressurizes each of the inflatable portions 170 and 180. Then, the operator, etc. releases securing of the hemostatic device 100 by the first arm portion 130 and the second arm portion 140, and removes the hemostatic device 100 from the hand H of the patient.
As illustrated in
By proceeding with an attaching operation according to a procedure described with reference to
Further, since the hemostatic device 100 includes the first inflatable portion 170 as a member that applies a compressive force to the puncture site t1, the compressive force can be easily adjusted by adjusting the internal pressure of the first inflatable portion 170. Further, in the hemostatic device 100, even when the first inflatable portion 170 is deformed to change the internal pressure following movement of the right hand H1 when the patient moves the right hand H1, the deformable second inflatable portion 180 mitigates the change in the internal pressure of the first inflatable portion 170. Therefore, the first inflatable portion 170 has a high following property (conformability) to movement of the right hand H1 of the patient, and compression on the puncture site t1 by the first inflatable portion 170 can be appropriately maintained.
Further, the hemostatic device 100 is configured to cover only a part of the right hand H1 of the patient by the covering member 110, and is not configured to cover the entire right hand H1. For this reason, when the patient moves the right hand H1 in a state where the hemostatic device 100 is attached to the right hand H1 of the patient, it is possible to prevent movement of the right hand H1 of the patient from being transmitted to the entire hemostatic device 100. Therefore, the hemostatic device 100 can suppress position shift from the right hand H1 of the patient when the patient moves the right hand H1 in the state where the hemostatic device 100 is attached to the right hand H1 of the patient.
The hemostatic device 100 can be attached to the left hand H2 of the patient, for example, without changing the configuration of the hemostatic device 100. Hereinafter, a description will be given of an example of a procedure for attaching the hemostatic device 100 to the left hand H2 of the patient on which the puncture site t1 is formed. A detailed description of content overlapping with the above-described example of the procedure for attaching the hemostatic device 100 to the right hand H1 is not repeated.
As illustrated in
Subsequently, as illustrated in
Subsequently, as illustrated in
Subsequently, as illustrated in
The operator, etc. can secure the hemostatic device 100 to the left hand H2 of the patient by the above procedure.
Hereinafter, effects of the present embodiment will be described.
The hemostatic device 100 according to the present embodiment includes the covering member 110 disposed to cover the puncture site t1 on the right hand H1 (or left hand H2) of the patient, the plurality of securing members 151, 152, 153, 154, 155, and 156 configured to secure the covering member 110 in a state where the covering member 110 covers the puncture site t1, and the inflatable member 160 connected to the covering member 110 and configured to be inflated by injection of a fluid. The covering member 110 has the main body 120 to which the inflatable member 160 is connected, the first arm portion 130 protruding from the main body 120, and the second arm portion 140 protruding from the main body 120 while forming an obtuse angle with the longitudinal direction of the first arm portion 130. Further, the first arm portion 130 has the enlarged portion 133a protruding in the width direction of the first arm portion 130 at the end portion 133 of the first arm portion 130. Furthermore, the second arm portion 140 is longer than the first arm portion 130 and is configured to be secured to the enlarged portion 133a and secured to the second arm portion 140 by passing between the fingers f1 and f2 of the patient in a state where the second arm portion 140 is wrapped around the limb of the patient.
In the hemostatic device 100 configured as described above, it is possible to secure the main body 120 in which the inflatable member 160 is disposed to the limb by disposing a part of the second arm portion 140 between the adjacent fingers f1 and f2 of the patient and connecting the enlarged portion 133a and the second arm portion 140 while wrapping the first arm portion 130 and the second arm portion 140 around the limb of the patient. The first arm portion 130 and the second arm portion 140 are fastened to the limb by connecting the enlarged portion 133a and the second arm portion 140, and the main body 120 is secured to the limb. Further, by disposing the second arm portion 140 between the adjacent fingers f1 and f2 of the patient, it is possible to suppress position shift of the inflatable member 160 disposed in the main body 120 with respect to the puncture site t1. Further, the hemostatic device 100 has a simple securing structure capable of tightening the inflatable member 160 to the hand H1 of the patient by connecting the two arm portions 130 and 140 protruding from the main body 120. For this reason, the hemostatic device 100 can reduce the number of arm portions installed for securing the inflatable member 160. Therefore, the hemostatic device 100 can suppress an increase in arm portions that may interfere with a medical device such as the introducer 200 when the hemostatic device 100 is attached to the hand H1 of the patient, and it is possible to easily remove the medical device from the puncture site t1 even after the hemostatic device 100 is attached. Further, a movable range of the right hand H1 (or the left hand H2) increases from the wrist side to the fingertip side of the right hand H1. In the hemostatic device 100, the first arm portion 130 and the second arm portion 140 extend from the fingertip side to the wrist side of the right hand H1 while forming an obtuse angle, so that the first arm portion 130 and the second arm portion 140 can be connected on the wrist side of the right hand H1 of the patient. Therefore, in the hemostatic device 100, the first arm portion 130 and the second arm portion 140 can be secured on the wrist side where the movable range is small, and thus the main body 120 can be secured to the limb while maintaining the movable range on the fingertip side of the right hand H1. An outer circumference of the right hand H1 becomes larger from the wrist side to the fingertip side of the right hand H1 in a state where the right hand H1 is spread. Therefore, since the first arm portion 130 and the second arm portion 140 extend in a direction opposite to a direction in which the outer circumference of the right hand H1 becomes larger, the first arm portion 130 and the second arm portion 140 can be reliably connected on the wrist side of the right hand H1 in the state where the hemostatic device 100 is attached. Furthermore, in the hemostatic device 100, even in the case where the patient moves the hand H with the inflatable member 160 inflated, when the first arm portion 130 and the second arm portion 140 are secured in a state of being tightened to the limb of the patient, it is possible to prevent rising of the distal side (fingertip side) of the main body 120 to which the inflatable member 160 is connected, and to appropriately maintain the compressive force of the inflatable member 160 on the puncture site t1 formed on the dorsal side Hb of the hand H1 of the patient.
Further, the main body 120 has first regions 121a and 121b and the second region 122 in which the inflatable member 160 is disposed at a location different from the first regions 121a and 121b. The first region 121a is disposed between the second region 122 and the first arm portion 130, and the first region 121b is disposed between the second region 122 and the second arm portion 140. Further, the second region 122 includes the support member 125 having a higher rigidity than that of the first regions 121a and 121b. Therefore, the hemostatic device 100 can prevent the inflatable member 160 from rising or lifting from the dorsal side Hb of the hand H of the patient by the support member 125 while hemostasis is performed. As a result, the hemostatic device 100 can suitably apply a compressive force from the inflatable member 160 to the puncture site t1 while being attached to the right hand H1 of the patient.
Further, the support member 125 has the curved portion 125a formed on the distal side of the main body 120. For this reason, in the support member 125, when the inflatable member 160 is inflated, a direction in which the inflatable member 160 applies a compressive force to the right hand H1 of the patient is directed in an oblique direction toward the puncture site t1. For this reason, the hemostatic device 100 can more effectively apply a compressive force to the puncture site t1. Further, the curved portion 125a of the support member 125 directs the compressive force of the inflatable member 160 toward the center portion of the support member 125 by wrapping the end portion of the inflatable member 160 on the distal side when the inflatable member 160 inflates, and thus the compressive force of the inflatable member 160 is inhibited from escaping to the outside of the support member 125. For this reason, the hemostatic device 100 can suppress a decrease in the compressive force to the puncture site t1 by the inflatable member 160, and thus can appropriately maintain the compressive force of the inflatable member 160 to the puncture site t1.
Further, the inflatable member 160 has the first inflatable portion 170 and the deformable auxiliary member 180 having a smaller outer shape than that of the first inflatable portion 170, and the auxiliary member 180 overlaps the first inflatable portion 170 on the distal side of the main body 120. In the hemostatic device 100 configured as described above, when the first inflatable portion 170 inflates, the second inflatable portion 180 inhibits the first inflatable portion 170 from rising or lifting away from the body surface of the patient. Therefore, when the first inflatable portion 170 inflates, the first inflatable portion 170 can effectively apply the compressive force to the puncture site t1. Further, when the patient bends a finger (for example, the thumb f1) or the wrist downward (to the palm Hp side of the hand H), the hemostatic device 100 maintains a state in which the auxiliary member 180 is deformed by following movement of the finger or the wrist and the auxiliary member 180 applies the compressive force to the puncture site t1.
Further, the auxiliary member is the second inflatable portion 180 configured to be inflated by injection of a fluid, and the lumen 181 of the second inflatable portion 180 communicates with the lumen 171 of the first inflatable portion 170. Since the auxiliary member 180 includes the second inflatable portion 180 which is inflatable, it is possible to improve the following property (conformability) of the second inflatable portion 180 to movement of the right hand H1. Further, since the lumen 171 of the first inflatable portion 170 and the lumen 181 of the second inflatable portion 180 communicate with each other, the first inflatable portion 170 and the second inflatable portion 180 can be easily inflated.
In addition, the second inflatable portion 180 is disposed to have bilateral symmetry with respect to the center line d3 of the first inflatable portion 170, and the securing members 151 and 152 for securing the second arm portion 140 are disposed on the outer surface of the first arm portion 130 and the outer surface of the second arm portion 140 opposing each other with the main body 120 interposed therebetween. For this reason, when the hemostatic device 100 is attached to the right hand H1 of the patient, the operator, etc. can secure the second arm portion 140 to the enlarged portion 133a through the respective securing members 151 and 152 while disposing the first inflatable portion 170 on the puncture site t1 so that the puncture site t1 is located on the center line d3 of the auxiliary member 180. Similarly, when the hemostatic device 100 is attached to the left hand H2 of the patient, the operator, etc. can secure the second arm portion 140 to the enlarged portion 133a through the respective securing members 151 and 152 while disposing the first inflatable portion 170 on the puncture site t1 so that the puncture site t1 is located on the center line d3 of the auxiliary member 180. Therefore, the operator, etc. can attach the hemostatic device 100 to both the right hand H1 and the left hand H2 of the patient.
Further, the enlarged portion 133a protrudes or extends toward the distal side of the main body 120 in a direction intersecting the extending direction of the first arm portion 130. Therefore, when the second arm portion 140 is secured to the enlarged portion 133a, the operator, etc. can confirm the position of the enlarged portion 133a disposed on the palm Hp side of the hand H and the shape of the enlarged portion 133a by the hand feel, etc., and thus the second arm portion 140 can be easily secured to the enlarged portion 133a.
Further, the second arm portion 140 has the inclined portion 141 and the second arm end portion 143 which is continuously formed with the inclined portion 141 and forms an end portion of the second arm portion 140, and the width of the inclined portion 141 is larger than the width of the second arm end portion 143. Therefore, when the second arm portion 140 is secured to the enlarged portion 133a, by wrapping the inclined portion 141 around the hand H of the patient, the operator, etc. can more reliably dispose the inclined portion 141 with respect to the enlarged portion 133a, and easily secure the second arm portion 140.
Further, the hemostatic device 100 has the injection portion 191 for injecting a fluid into the inflatable member 160. The cushioning member 192 having an inflatable space is disposed between the injection portion 191 and the inflatable member 160. In the hemostatic device 100, when the patient moves the right hand H1 while the hemostatic device 100 is attached to the patient, the inflatable member 160 (the first inflatable portion 170 and the second inflatable portion 180) that compresses the puncture site t1 on the right hand H1 is deformed. When the inflatable member 160 is deformed, if there is no escape place for air in the lumen of the inflatable member 160 (the lumen 171 of the first inflatable portion 170 and the lumen 181 of the second inflatable portion 180), deformation of the inflatable member 160 is hindered. For this reason, the patient has a limited movable range for the right hand H1. The cushioning member 192 included in the hemostatic device 100 allows air to move from the lumen of the inflatable member 160 to the cushioning member 192 when the patient moves the right hand H1. For this reason, the patient can prevent the movable range from being restricted by the inflatable member 160 when the right hand H1 is moved. When the patient returns the right hand H1 from the deformed state to the original state, air moves from the cushioning member 192 to the inflatable member 160, and thus the compressive force can be effectively applied to the puncture site t1 from the inflatable member 160.
(Modification)
Next, a description will be set forth of a modification of the hemostatic device according to the first embodiment described above. In the description of the modification, features that are the same or similar to those described above are identified by the same reference numerals and a detailed description of such features is not repeated. Thus, content not particularly described in the description of the modification can be regarded as the same as that in the first embodiment.
In the hemostatic device 100A according to the modification, the inflatable member 160 includes only the first inflatable portion 170. That is, the inflatable member 160 does not include the second inflatable portion 180. Further, in the hemostatic device 100A, as illustrated in
In the hemostatic device 100A according to the modification, similarly to the hemostatic device 100 described above, position shift of the inflatable member 160 disposed on the main body 120 with respect to the puncture site t1 can be suppressed by connecting the enlarged portion 133a wrapped around the limb of the patient and the second arm portion 140, and securing a part of the second arm portion 140 passed between the fingers f1 and f2 of the patient to the second arm portion 140. Further, since the hemostatic device 100A has a simple securing structure capable of tightening the inflatable member 160 to the right hand H1 of the patient by connecting the two arm portions 130 and 140 protruding from the main body 120, the hemostatic device 100A can reduce the number of arm portions installed for securing the inflatable member 160. Therefore, the hemostatic device 100A can suppress an increase in arm portions that may interfere with a medical device such as the introducer 200 when the hemostatic device 100A is attached to the hand H1 of the patient, and it is possible to easily remove the medical device from the puncture site t1 even after the hemostatic device 100A is attached. Further, a movable range of the right hand H1 (or the left hand H2) of the patient increases from the wrist side to the fingertip side of the right hand H1. In the hemostatic device 100A, the first arm portion 130 and the second arm portion 140 extend from the fingertip side to the wrist side of the right hand H1 while forming an obtuse angle, so that the first arm portion 130 and the second arm portion 140 can be connected on the wrist side of the right hand H1 of the patient. Therefore, in the hemostatic device 100A, the first arm portion 130 and the second arm portion 140 can be secured on the wrist side where the movable range is small, and thus the main body 120 can be secured to the limb while maintaining the movable range on the fingertip side of the right hand H1. The outer circumference of the right hand H1 becomes larger from the wrist side to the fingertip side of the right hand H1 in a state where the right hand H1 is spread. Therefore, since the first arm portion 130 and the second arm portion 140 extend in a direction opposite to a direction in which the outer circumference of the right hand H1 becomes larger, the first arm portion 130 and the second arm portion 140 can be reliably connected on the wrist side of the right hand H1 in the state where the hemostatic device 100A is attached. Furthermore, in the hemostatic device 100A, even in the case where the patient moves the right hand H1 with the inflatable member 160 inflated, when the first arm portion 130 and the second arm portion 140 are secured in a state of being tightened to the limb of the patient, it is possible to prevent rising of the distal side (fingertip side) of the main body 120 to which the inflatable member 160 is connected, and to appropriately maintain the compressive force of the inflatable member 160 on the puncture site t1 formed on the dorsal side Hb of the right hand H1 of the patient.
Next, a description will be given of a hemostatic device according to a second embodiment. In description of the second embodiment, features that are the same or similar to those described above are identified by the same reference numerals and a detailed description of such features is not repeated. In addition, content not particularly described in the description of the second embodiment can be regarded as the same as that in the first embodiment.
As illustrated in
The end portion 133 of the first arm portion 130 of the hemostatic device 100B is continuously connected to the inclined portion 131, and extends linearly along a direction substantially the same as the extending direction of the inclined portion 131.
As illustrated in
As illustrated in
Subsequently, the operator, etc. passes the second arm portion 140 between the thumb f1 and the index finger f2 of the right hand H1 of the patient, and disposes the second arm end portion 143 on the side of the dorsal side Hb of the right hand H1 of the patient. In this instance, the operator, etc. secures the first inclined portion 141a and the second arm end portion 143 via the respective securing members 152 and 156 by bringing the sixth securing member 156 (female side of the surface fastener) disposed on the inner surface of the second arm end portion 143 into contact with the second securing member 152 (male side of the surface fastener) disposed on the outer surface of the inclined portion 141 on the side of the dorsal side Hb of the right hand H1 of the patient.
By the above procedure, as illustrated in
As described above, the hemostatic device 100B according to the second embodiment includes the covering member 110 disposed to cover the puncture site t1 on the right hand H1 (or left hand H2) of the patient, the plurality of securing members 151, 152, 153, 154, 155, and 156 that is configured to secure the covering member 110 in a state where the covering member 110 covers the puncture site t1, and the inflatable member 160 connected to the covering member 110 and configured to be inflated by injection of a fluid. Further, the covering member 110 has the main body 120 to which the inflatable member 160 is connected, the first arm portion 130 protruding from the main body 120, and the second arm portion 140 protruding from the main body 120 while forming an obtuse angle with the longitudinal direction of the first arm portion 130. Further, the inflatable member 160 has the first inflatable portion 170 and the deformable auxiliary member 180 which has a smaller outer shape than that of the first inflatable portion 170 and is biased or offset toward the distal side (one end side) of the first inflatable portion 170. In the covering member 110, the first arm portion 130 and the second arm portion 140 can be connected by the securing members 151 and 155 in a state where the covering member 110 is wrapped around the limb of the patient, and the auxiliary member 180 is disposed between the first arm portion 130 and the second arm portion 140.
In the hemostatic device 100B configured as described above, since the first arm portion 130 and the second arm portion 140 protrude from the main body 120 so as to form an obtuse angle, when the hemostatic device 1006 is attached to the right hand H1 of the patient, the arm portions 130 and 140 can be connected so that the entire finger of the patient is not covered by the covering member 110. For this reason, the patient is less likely to be restricted in movement of the right hand H1 even when the hemostatic device 1006 is attached, and thus a degree of freedom on the fingertip side can be increased. Further, since the hemostatic device 1006 has the deformable auxiliary member 180 located on the distal side of the first inflatable portion 170, when the first inflatable portion 170 is inflated, the auxiliary member 180 presses the first inflatable portion 170 against the limb of the patient to inhibit the first inflatable portion 170 from rising in a direction away from the puncture site t1 on the right hand H1 of the patient. As a result, the hemostatic device 1006 can maintain an appropriate compressive force on the puncture site t1 while increasing the degree of freedom on the fingertip side. Furthermore, in the hemostatic device 1006, since the first arm portion 130 and the second arm portion 140 extend from the fingertip side to the wrist side of the right hand H1 while forming an obtuse angle, the first arm portion 130 and the second arm portion 140 can be secured on the wrist side where the movable range is small. Therefore, the main body 120 can be appropriately secured to the limb while maintaining the movable range on the fingertip side of the right hand H1. Further, in the hemostatic device 1006, since the first inflatable portion 170 can be secured to the puncture site t1 by the two arm portions including the first arm portion 130 and the second arm portion 140 and the auxiliary member 180, it is unnecessary to add different arm portions between the first arm portion 130 and the second arm portion 140. Therefore, the operator, etc. can easily remove the medical device such as the introducer 200 after attaching the hemostatic device 1006. Further, since the first arm portion 130 and the second arm portion 140 are connected in a state of being wrapped around the right hand H1 of the patient, the first arm portion 130 and the second arm portion 140 are pressed against the right hand H1 of the patient while pulling the main body 120 located therebetween toward the both side portion sides (vertical direction in
Further, the main body 120 has the first regions 121a and 121b and the second region 122 in which the inflatable member 160 is disposed unlike the first regions 121a and 121b. The first region 121a is disposed between the second region 122 and the first arm portion 130, and the first region 121b is disposed between the second region 122 and the second arm portion 140. Further, the second region 122 includes the support member 125 having a higher rigidity than that of the first regions 121a and 121b. Therefore, the hemostatic device 1006 can prevent the inflatable member 160 from rising from the dorsal side Hb of the hand H of the patient by the support member 125 while hemostasis is performed. As a result, the hemostatic device 100 can suitably apply a compressive force from the inflatable member 160 to the puncture site t1 while being attached to the hand H of the patient.
Further, the support member 125 has the curved portion 125a formed on the distal side of the main body 120. For this reason, in the support member 125, when the inflatable member 160 is inflated, a direction in which the inflatable member 160 applies a compressive force to the right hand H1 of the patient is directed in an oblique direction toward the puncture site t1. For this reason, the hemostatic device 100 can more effectively apply a compressive force to the puncture site t1. Further, when the curved portion 125a of the support member 125 wraps or encircles the end portion of the inflatable member 160 on the distal side, the inflatable member 160 directs the compressive force toward the central portion of the support member 125, and thus the compressive force of the second inflatable portion 180 is inhibited from escaping to the outside of the support member 125. In this way, even in the case where a gap is generated between the first arm portion 130 and the right hand H1 of the patient, when the curved portion 125a presses the second inflatable portion 180 against the skin of the right hand H1 of the patient, it is possible to prevent the first inflatable portion 170 from rising or lifting away from the skin, and it is possible to prevent a decrease in the compressive force applied to the puncture site t1 by the inflatable member 160.
Further, the auxiliary member is the second inflatable portion 180 configured to be inflated by injection of a fluid, and the lumen 181 of the second inflatable portion 180 communicates with the lumen 171 of the first inflatable portion 170. Since the auxiliary member 180 includes the second inflatable portion 180 which is inflatable, it is possible to improve the following property of the second inflatable portion 180 to movement of the right hand H1. Further, since the lumen 171 of the first inflatable portion 170 and the lumen 181 of the second inflatable portion 180 communicate with each other, the first inflatable portion 170 and the second inflatable portion 180 can be easily inflated.
Further, the second arm portion 140 is longer than the first arm portion 130, and is configured to be secured to the second arm portion 140 by passing between the fingers f1 and f2 of the patient in a state where the second arm portion 140 is wrapped around the limb of the patient. For this reason, the hemostatic device 100B can secure the main body 120 in which the inflatable member 160 is disposed to the limb by disposing a part of the second arm portion 140 between the adjacent fingers f1 and f2 of the patient and connecting parts of the second arm portion 140 to each other while wrapping the first arm portion 130 and the second arm portion 140 around the limb of the patient. The first arm portion 130 and the second arm portion 140 are fastened to the limb by connecting the parts of the second arm portions 140 to each other, and the main body 120 is secured to the limb. By disposing the second arm portion 140 between the adjacent fingers f1 and f2 of the patient, it is possible to effectively suppress position shift of the inflatable member 160 disposed on the main body 120 with respect to the puncture site t1.
In addition, the second inflatable portion 180 is disposed to have bilateral symmetry with respect to the center line d3 of the first inflatable portion 170, and the securing members 151 and 152 for securing the second arm portion 140 are disposed on the outer surfaces of the first arm portion 130 and the second arm portion 140 opposing to each other with the main body 120 interposed therebetween. For this reason, when the hemostatic device 100 is attached to the right hand H1 of the patient, the operator, etc. can secure the respective arm portions 130 and 140 through the respective securing members 151 and 152 while disposing the first inflatable portion 170 on the puncture site t1 so that the puncture site t1 is located on the center line d3 of the auxiliary member 180. Similarly, when the hemostatic device 100 is attached to the left hand H2 of the patient, the operator, etc. can secure the respective arm portions 130 and 140 through the respective securing members 151 and 152 while disposing the first inflatable portion 170 on the puncture site t1 so that the puncture site t1 is located on the center line d3 of the auxiliary member 180. Therefore, the operator, etc. can attach the hemostatic device 100 to both the right hand H1 and the left hand H2 of the patient.
Further, the second arm portion 140 has the inclined portion 141 and the second arm end portion 143 which is continuously formed with the inclined portion 141 and forms an end portion of the second arm portion 140, and the width of the inclined portion 141 is larger than the width of the second arm end portion 143. Therefore, when the inclined portion 141 is wrapped around the hand H of the patient, the operator, etc. can more reliably dispose the inclined portion 141 on the second arm end portion 143, and easily secure the second arm portion 140.
Further, the hemostatic device 100B has the injection portion 191 for injecting a fluid into the inflatable member 160. The cushioning member 192 having an inflatable space is disposed between the injection portion 191 and the inflatable member 160. In the hemostatic device 1006, when the patient moves the right hand H1 while the hemostatic device 100B is attached to the patient, the inflatable member 160 (the first inflatable portion 170 and the second inflatable portion 180) that compresses the puncture site t1 on the right hand H1 is deformed. When the inflatable member 160 is deformed, if there is no escape place for air in the lumen of the inflatable member 160 (the lumen 171 of the first inflatable portion 170 and the lumen 181 of the second inflatable portion 180), deformation of the inflatable member 160 is hindered. For this reason, the patient has a limited movable range for the right hand H1. The cushioning member 192 included in the hemostatic device 1006 allows air to move from the lumen of the inflatable member 160 to the cushioning member 192 when the patient moves the right hand H1. For this reason, the patient can prevent the movable range from being restricted by the inflatable member 160 when the right hand H1 is moved. When the patient returns the right hand H1 from the deformed state to the original state, air moves from the cushioning member 192 to the inflatable member 160, and thus the compressive force can be effectively applied to the puncture site t1 from the inflatable member 160.
Even though the hemostatic device and usage method disclosed here have been described above through several embodiments representing examples of the inventive hemostatic device and method disclosed here, the invention is not limited to the specific content described in this specification, and can be appropriately modified within the claim scope.
The auxiliary member is not limited to the inflatable member described in each embodiment. For example, the auxiliary member may include a member made of a resin material such as plastic, gel, etc., a member containing gel whose moisture content decreases over time to gradually reduce a compressive force, an elastic material such as a sponge-like substance, an aggregate of fibers such as cotton, metal, a member having a predetermined three-dimensional shape (sphere, ellipsoid, triangular pyramid, etc.), an appropriate combination thereof, etc.
In addition, the shape and dimensions of each portion of the hemostatic device are not particularly limited as long as the inflatable member can be disposed at the puncture site while wrapping the first arm portion and the second arm portion around the limb, and changes can be made as appropriate.
The detailed description above describes embodiments of a hemostatic device and method of performing hemostasis representing examples of the inventive hemostatic device and method disclosed here. The invention is not limited, however, to the precise embodiments, modifications and variations described. Various changes, modifications and equivalents can be effected by one skilled in the art without departing from the spirit and scope of the invention as defined in the accompanying claims. It is expressly intended that all such changes, modifications and equivalents which fall within the scope of the claims are embraced by the claims.
Number | Date | Country | Kind |
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2018-145366 | Aug 2018 | JP | national |
This application is a continuation of International Application No. PCT/JP2019/029820 filed on Jul. 30, 2019, which claims priority to Japanese Patent Application No. 2018-145366 filed on Aug. 1, 2018, the entire content of both of which is incorporated herein by reference.
Number | Date | Country | |
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Parent | PCT/JP2019/029820 | Jul 2019 | US |
Child | 17160865 | US |