Present disclosure relates to a medical device for blood vessels compression that is applied to a limb of a patient in order to achieve local haemostasis. In particular, the device of the disclosure is used in invasive cardiology and radiology to compress a blood vessel upon removal of a vascular sheath from a patient's blood vessel after heart catheterization, coronary angiography or other intravascular procedures and interventions that require a vascular access port.
Many different blood vessel compression devices are known in the prior art. For example, WO2013060883 discloses an arterial compression band having a tube-like shaped body with bevelled endings and a holding element in a form of a strap that is attached to the outside surface of the body. This medical device is applied at a bleeding vessel site, in particular, the bleeding site of an artery (radial or ulnar) from which a catheter or cannula has been removed, by pressing manually the body against the bleeding vessel site, followed by immobilizing the body on the patient's limb by applying the holding element around the patient's limb. The device is fixed to the patient's limb by the fastening means, such as a hook and loop fastener, which can be located on the holding element. The device disclosed therein is quite simple in manufacturing and for application to a patient's limb. Most of all, it provides manual control of the blood vessel compression upon placing the device on a patient's limb, i.e. a medical personnel (for example a physician or a nurse) can apply the body to the site of the catheter or cannula entry to the blood vessel, while gripping on the inside of the hollow body, remove the catheter or cannula and, at the same time, exert the necessary compression to the blood vessel, and fix the body to the patient's limb by applying the strap around the patient's limb and over the body of the device while still holding the inside of the hollow body.
However, once applied on a patient's limb the device is prone to accidental displacement, either by tipping over or by shifting or sliding. This influences the compression force exerted on blood vessel or even the compression application site on the limb after the device was applied, making the device less effective at its primary purpose. Moreover, after the device is fixed to the patient's limb, the device does not provide a sufficient control of the compression level, especially when the compression needs to be gradually decreased after the device is placed on the patient. The compression is controlled only by strap positioning or by the means of adjusting the cross-section dimensions or shape of the body. However, in the first case the adjustment of the strap is required, which is very inconvenient and requires the medical staff to unfasten the holding means and fasten it again in a new position, risking device displacement that may result in bleeding. In the latter case, the construction of the body becomes very complex and the level of compression adjustment is also very limited.
In order to ensure sufficient compression control in compression haemostatic devices, screw-and-nut systems can be used to exert pressure onto a patient's limb. In US20100280541, a radial artery compression device is disclosed that includes a rotatable member and a compression pad adapted in such a way that rotation of the rotatable member does not affect the rotational orientation of the compression pad. The rotation of the rotatable member results in extension or retraction of the compression pad relative to the body of the radial artery compression device, thus increasing or decreasing, respectively, the compression on a patient's radial artery. Therefore, in such devices the screw-and-nut system drives the compression pad directly, thus enabling precise compression control. A similar device is described in US20120191127. However, in this case the screw-and-nut system can also be located outside the diameter of the compression pad, which is attached to the base of the device. In this case, the compression level is controlled by deflection of the entire base.
Although, the above-described devices provide more precise control of the compression level, they are not very easy to apply. They do not provide the manual control upon application as the device described in WO2013060883. Even though the rotatable member is provided with a recess that can receive a finger or a thumb of a medical personnel, who controls the pressure of the device upon placing the device of a patient's limb, this recess is not very convenient for gripping, as it can only be accessed from the top of the rotatable member. Moreover, although said recess is provided with a transparent floor, the view of the catheter or cannula entry site is still significantly blocked by the screw-and-nut system elements. Finally, in both devices of US20100280541 and US20120191127 the holding means or base is in direct contact with the radial side of the patient's forearm. Such a design not only provides discomfort to a patient when the device is applied, but also affects the blood flow in neighbouring blood vessels, in particular arm veins or the ulnar artery, because some compression is unintentionally applied through the body and the straps. Devices for the compression of a selected blood vessel, for example, a more accurate compression in which a radial artery is compressed while maintaining the blood flow in the neighbouring blood vessels would be useful but is not apparent from the prior art.
It is asserted that there remains a need for a device which can be securely fixed in position on a limb and which provides specific and accurate blood vessel compression. Moreover, it would be advantageous if the device is able to precisely control that compression without compromising on the simplicity of its construction or ergonomic design.
The invention provides a vessel compression device for a limb, which comprises:
When applied to an injured vessel, embodiments of the medical device disclosed herein provide blood vessel compression, in particular radial compression, for the purpose of establishing haemostasis. The blood vessel compression device of the invention is ergonomically designed, so that it is easily attached to the patient limb and very convenient to use by a medical personnel. When the device of the invention is applied to the patient's limb it is stable (i.e. it is not prone to sliding or tipping) and provides a sufficient compression control. The device of the invention also provides a greater comfort to a patient, as the compression on the radial side of a patient's forearm is essentially limited to the catheter or cannula blood vessel entry site. The design of the device of the invention also prevents compression of the blood vessels other than the blood vessel with the vascular access port. The device of the invention is constructed in such a way that its elements are easy to manufacture by plastic injection moulding. While designing the device, the inventors took under consideration the shape of injection moulds, to ensure that they have a simple construction and that the elements produced by injection moulding could be easily retrieved from moulds.
In a preferred embodiment, the compression control mechanism of the device of the invention is based on a screw-and-nut system. Also preferably the strap, which, in embodiments, is attached to a hollow body at the vicinity of the compression area (i.e. on the opposite side of the hollow body relative to the compression control mechanism), upon application of the device on the patient's limb is guided across and over the compression control mechanism, which regulates the compression of the device by adjusting the tension of the strap.
Also in this embodiment the hollow body has a cylindrical-like shape with bevelled endings. More preferably, the tubular space inside the hollow body is formed by a through-hole. In this embodiment, i.e. whenever the tubular space inside the hollow body can be accessed from both sides, the vessel compression device according to the invention can be used on both forearms of the patient and to compress different vessels.
In embodiments of the invention, the compression control mechanism comprises a knob and a tightener, wherein the knob is fitted over an externally-threaded element of the hollow body, which is located on the opposite side of the hollow body, relative to the compression area, and supports the tightener. When the device of the invention is attached to the patient's limb and the knob is turned, it moves along the externally-threaded element of the hollow body and changes the vertical position of the tightener. As the tightener is moved in the vertical position, it does not turn around horizontally, providing a support for the strap. As the knob and the tightener move away from the middle of the hollow body (i.e. away from the compression area), the tightener presses upon the strap and increases its tension, thus increasing the compression of the device against patient's limb. When the knob is turned in the opposite direction, it moves along the externally-threaded element of the hollow body towards the middle of the hollow body (i.e. towards the compression area). The tightener follows the movement of the knob, thus decreasing the tension of the strap and the compression of the hollow body against the patient's limb.
The compression control mechanism, which adjusts the tension of the strap, allows for precise control of the compression of the device against the patient's limb. Also, due to the fact that the strap is guided around the hollow body, it does not compress the radial side of the patients forearm, thus eliminating the compression of other blood vessels, and, at the same time it does not block the access to the tubular space of the hollow body, thus allowing a comfortable grip of the device of the invention by pressing the compression area of the hollow body with a finger or a thumb of a medical personnel received in said tubular space of the hollow body. The hollow body, the compression control mechanism and the strap, are preferably made of transparent material and do not block the view of the blood vessel compression area. This enables visual control of the catheter or cannula vessel entry site upon or after removal thereof. Therefore, it is possible to determine if the haemostasis is achieved or to detect the bleeding from the injured vessel.
In one preferred embodiment, the stabilizing support protrudes from the hollow body in the proximity of its compression area. Additionally, in the preferred embodiment, the support for stabilizing the body is in a form of a bent fin, whose edge opposite to the edge attached to the hollow body is in the same plane as the compression area of the hollow body, thus providing the support for the hollow body, whereas the remaining part of the support is raised above the plane of the compression area. Such a shape of the stabilizing support minimalizes the contact of the device of the invention with the patient's limb, thus increasing the patient's comfort and decreasing the compression of the device on the area of the patient's limb other than the site of the punctured blood vessel. That way the compression of blood vessels other than that providing the vascular access point is minimalized. The device of the invention is therefore designed to provide precise compression control onto a selected blood vessel, while maintaining the blood flow in neighbouring blood vessels unaffected.
If the device is used to compress the radial artery, the ulnar artery is not compressed as the stabilizing support is raised above the surface of the patient's forearm region, which corresponds to the position of the ulnar artery. Accordingly, if the device is used to compress the ulnar artery (i.e. it is applied to the limb in the opposite direction), the radial artery is not compressed. Most of all, due to the device design, in particular the design of the stabilizing support, whose contact with the patient's limb is limited, the device does not compress the neighbouring veins. Therefore, the venous outflow from the hand is not hindered by the compression of the device on patient's limb and venostasis is avoided. This not only increases patient comfort, but also reduces the risk of side effects associated with catheterization and compression of the limb.
Even though only the edge of the stabilizing support opposite to the edge connected to the hollow body is in contact with the patient's forearm, the desired stability to the entire device of the invention is provided. The stabilizing support prevents the displacement of the device of the invention by tipping over or sliding, while it is attached to the patient's limb. In the most preferred embodiment, the stabilizing support is in a form of a bent fin having a wave-type cross section, wherein the edge of the support opposite to the edge connected to the hollow body is provided with a supporting foot. This supporting foot increases the patient's comfort, when the device of the invention is attached to the patient's limb.
In the preferred embodiment the strap of the device of the invention is made of anti-skid material. Preferably, the strap is made of a material that requires no additional fastening means to hold the device of the invention of the patient's limb. In particular, one surface of the straps—the outer surface, adheres to the opposite surface of the strap—the inner surface, when the strap is secured around the patient's limb and the outer and inner surface of the strap come in contact. In an alternative embodiment, the strap can be provided with additional fastening means for holding the device in a desirable position on the patient's limb selected from a group comprising an adhesive (for example, in a form of a locking sticker), tightening buckles, hooks, snap fasteners (for examples, orifices and the corresponding lugs) or hook and loop fasteners, such as Velcro °. In some preferred embodiments the fastening means comprises two parts situated on the opposite surfaces of the strap, which come into contact when the device of the invention is attached to the patient's limb. In the preferred embodiment the fastening means are provided at the free end of the strap, i.e. the end of the strap opposite to the strap end connected to the base of the hollow body.
In embodiments, the device of the invention is equipped with a clicking mechanism, which indicates the turn of the knob on the externally-threaded element. That way an acoustic control of the compression adjustment is possible. The clicking mechanism according to the preferred embodiment comprises a ring spring, which is fixed within the tightener, wherein said ring spring comprises downward protrusions that engage with uniformly spaced cogs located in the vicinity of the knob rim closest to the tightener. That way, whenever the knob is turned the protrusion of the ring spring is displaced from one space between the cogs to another, wherein upon the displacement it engages with the cog and produces a clicking sound. The system consisting of the ring spring with protrusions that engage with the elements on the knob is very space efficient. Therefore, the clicking functionality of the device of the invention can be introduced without increasing the size of the entire device of the invention. Moreover, the design of the clicking mechanism renders its manufacturing method quite simple, since it does not require any complex injection moulding forms.
The present invention will be described in a greater detail herein below in reference to a drawing wherein:
The present invention relates to a vessel compression device 1.
Whenever a reference is herein made to a term “bottom” or “below” or “underneath” with respect to the device 1 or an element thereof, it means a part of the device 1 proximal to the patient and limb desired to be compressed, when the device 1 is properly attached to said limb. The term “downwards” also means in a direction towards the patient's limb.
The term “top” or “above” as used herein in reference to the device 1 or an element thereof, refers to the part of the device 1, which is located distal from the patient's limb, when the device 1 is properly attached to said limb. The term “upwards” refers to a distal direction from the patient's limb.
The device 1 of the invention has been designed to apply proper compression forces in the specific area of the limb in order to prevent bleeding from an injured blood vessel. At the same time, the device 1 does not apply forces to other major blood vessels in a patient's limb.
As presented in
On the opposite side to the strap 4 attachment site, i.e. at the top, the device 1 is provided with a tightener 30 and a knob 31, both of which are in a bolt-nut movable connection with hollow body 2, in particular with the externally-threaded element 21 of the hollow body 2. The tightener 30 is supported by the knob 31, which is located underneath of the tightener 30. After the device 1 is assembled, the tightener 30 and the knob 31 move together relative to the hollow body 2 along the externally-threaded element 21 of the hollow body 2. The movement of the tightener 30 relative the hollow body 2 provides control of the compression of the device 1 onto the patient's limb.
As shown in
The hollow body 2, in embodiments, is provided with a support 20, which may be an integral part of the hollow body 2. The support 20 extends from a side of the hollow body 2 (i.e. from the side wall 22 of the hollow body 2 near the base 26 of the hollow body 2), and away from the compression area 24.
In the preferred embodiment, the support 20 is in a form of a bent fin having a wave-type cross section. Initially, as it extends away from the hollow body 2, the bent fin of the support 20 is directed upwards to the inflection point where its direction changes towards the plane of the compression area 24. The support 20 does not extend beyond the plane of the base 26 of the hollow body 2. Moreover, at its free end (i.e. opposite to the site where the support 20 is connected to the side wall 22 of the hollow body 2), the support 20 is equipped with a supporting foot 200. When the device is applied to the patient's limb, the support 20 is in contact with a patient's limb, at a certain distance from the compression area 24. The contact of the support 20 is provided only by its free end or by the foot 200 of the support 20 as presented in this embodiment. That way, the device 1 does not compress other major blood vessels, which are in the vicinity of the blood vessel undergoing the medical procedure. Thus, the distance between the compression area 24 and the supporting foot 200 of the support 20 provides the space without compression that results in an undisturbed blood flow in other blood vessels that are not intended to be compressed in the medical procedure. Therefore, the contact of the device 1 with the surface of the palm side of the patient's forearm is limited to the minimum, i.e. to the compression area 24 and the free end of the support 20 or the foot 200 if it is present at the free end of the support 20, thus decreasing the discomfort level in a patient when device 1 is applied.
Despite its limited contact to the patient's limb, the support 20 provides an additional support to the device 1. The function of support 20 is, therefore, to stabilize the hollow body 2 on a patient's limb and consequently prevent any undesired movement of the device 1 after it is secured to the patient's limb. Without the support 20, the device would be prone to tipping sideways due to the forces that are applied by the strap 4. Preferably, the support 20 has a wave-type shape, as shown in
In the presently described embodiment, the hollow body 2, which is in a form of the tube, includes the side walls 22, which extend from base 26 circumferentially and are connected at the top by the externally-threaded element 21. Inside of the tube, between the base 26, side walls 22 and externally-threaded element 21 (i.e. within a periphery formed by the side walls 22, base 26 and externally-threaded element 21), there is a tubular space 23. The tubular space 23 is designed to receive a finger or a thumb of a medical personnel who, upon application of the device onto the patient's limb, puts initial compression onto the compression area 24 by pressing the base 26 of the hollow body 2. In order to provide a better access to the base 26 of the hollow body 2, the width of the side walls 22 decreases as they extend upwards (i.e. the walls gradually become narrower). The hollow body 2 is designed in a manner that the tubular space 23 can be accessed from both sides of the hollow body 2 (i.e. the tube forming the hollow body 2 is opened on both endings). This way the device is suitable to be used on both left and right forearms of the patient. This ensures a universal character of the device.
The side walls 22 provide support for a top part of a hollow body 2—the externally-threaded element 21, which forms an integral part of the hollow body 2. In the present embodiment, the externally-threaded element 21 has a shape of a hollow screw with the axis of rotation positioned perpendicularly to an axis of the tube of the hollow body 2. The axis of rotation of the externally-threaded element 21 is also perpendicular to the surface of the base 26 of the hollow body 2. This threaded element 21 has a plurality of grooves referred to as guiding slots 27, which extend in parallel to the rotation axis of the externally-threaded element 21. In this embodiment, there are four guiding slots 27 located symmetrically on the externally-threaded element 21. The guiding slots 27 are situated along the axis of rotation and perpendicularly to the thread of the externally-threaded element 21. When the device 1 is assembled, the guiding slots 27 receive the knob supporting elements 301 and guiding elements 302 of the tightener 30. This way the hollow body 2 and the tightener 30 are engaged with each other. Two of the guiding slots 27, which are located opposite to each other and receive the guiding elements 302 of the tightener 30, are provided at the top with blocking protrusions 270. As the tightener 30 moves upwards, these blocking protrusions 270 engage with free ends of the guiding elements 302 of the tightener 30, thus blocking their further upward movement and preventing the tightener 30 from becoming disengaged from the hollow body 2. The other pair of guiding slots 27, which are also located opposite each other, receives knob supporting elements 301 of the tightener 30.
The hollow body 2 in the assembled form of the device 1 engages with the tightener 30, which is placed above the hollow body 2.
The anti-skid inset 33 engages with the strap 4, which extends around the patient's limb and is guided over the hollow body 2 and tightener 30, between the longitudinal ribs 305 of the strap guide 304. The strap 4 extends in the direction perpendicular to the axis of the tube of the hollow body 2 and is led above and across of the hollow body 2, in a way that does not obstruct access to the tubular space 23 inside the hollow body 2. According to the preferred embodiment, as shown in
The guiding elements 302, not only guide the tightener 30 in reciprocating movement without rotation, but also limit the tightener 30 movement in the predefined range, by stopping the movement, when the bottom parts of the guiding elements 302 reach the top rim of the of the externally-threaded element 21 of the hollow body 2. The knob supporting elements 301 not only guide the tightener 30 in reciprocating movement without rotation, but also move the tightener 30 together with the knob 31 that is turned along the thread of the externally-threaded element 21, especially in the downward direction. During the upward movement, the knob 31 raises the tightener 30, as the tightener 30 is paced on the top of the knob 31.
All the elements of the tightener 30—the housing 300, supporting 301 and guiding 302 elements, and a strap guide 304—are formed as an integral element from plastic material. Preferably, the plastic material is transparent, which renders this element very aesthetic, but also is useful in the medical application of this component, as it does not obstruct the view of the patient's limb, in particular the vessel puncture site. In the most preferred embodiment the tightener 30 is made of polycarbonate by injection moulding. Thanks to its construction, the tightener 30 is easily released from the injection mould.
The movement of the tightener 30, and thus the compression control of the device 1, is possible due to a system comprising both the tightener 30 and the knob 31. The knob 31 as presented in
The knob 31 performs both rotating and reciprocating movement, wherein the reciprocating movement of the knob 31 causes the reciprocating movement of the tightener 30. This reciprocating movement is a movement of the compression control mechanism 3, which adjusts the compression force of the device 1 onto the patient's limb. The rotating movement of the knob 31 by engagement of the external thread of the externally-threaded element 21 of the hollow body 2, onto which the knob 31 is screwed with its internal thread 312, enforces reciprocating movement of the compression control mechanism 3 perpendicularly to the limb. Such movement of the compression control mechanism 3 adjusts the strap 4 compression on the device 1, thus regulating the compression of the device 1 onto patient's limb. Further, the knob 31 in its top area has a peripherally situated groove. This grove is provided with cogs 310, which preferably are formed in a way of gearwheel teeth, i.e. the cogs 310 are protrusions, which are separated by recesses. The cogs 310 interact with the ring spring 32 placed within the housing 300 of the tightener 30 and upon rotation of the knob 31 produce the clicking sound. This clicking sound is an audio confirmation that the rotation of the knob 31 takes place, which further corresponds to the information regarding the compression of the device 1.
Similarly to the other elements of the device 1 all edges of the knob 31 are rounded not only for aesthetic purposes, but also to prevent any injury to the patient. Moreover, according to preferred embodiment, the knob 31 is formed from plastic material. More preferably, it is formed by injection moulding from a transparent plastic material, such as poly(ethylene terephthalate). The transparency of this element is advantageous for the same reasons as already described for other components of the device 1.
The radial compression device 1 is provided with a compression regulation element consisting of the tightener 30 and the knob 31. In accordance with the preferred embodiment of the invention the device 1 is provided with means for indicating of the displacement of the tightener 30 and the knob 31 to facilitate the compression control. Apart from the pointers 311 and value indicators located on the knob 31, in the preferred embodiment of the invention, the device is provided with audio means for indicating the rotation of the knob 31. For that purpose a ring spring 32 is provided. The ring spring 32, as shown in
In the assembled device 1, the ring spring 32 is placed within the dome of the housing 300, so that it is adjacent to the surrounding walls of the housing 300, the blocking tongues 321 are inserted between the adjacent studs 303 of the housing 300, and the protrusions 320 extent downward towards the recesses between the cogs 310 of the knob 31. In the preferred embodiment the ring spring 32 is bent, so that its parts equipped with protrusions 320 project from the plane of the spring ring 32 in the direction of the knob 31. Moreover, the ring spring 32 is formed from plastic material. In the preferred embodiment the plastic material is elastic to ensure the desired flexibility of the ring spring 32. In the most preferred embodiment the ring spring 32 is made of polyetherimide, which provides both flexibility and durability of the ring spring 32. The use of the ring spring 32 is very advantageous because it provides the clicking mechanism and, at the same time, does not increase the dimensions of the device 1 (i.e. the clicking mechanism has been significantly miniaturized).
As described above, the movement of aforesaid compression control mechanism 3, which comprises the tightener 30 and the knob 31, is responsible for tightening or loosen the strap 4 extending around the patient's limb and the tightener 30. This way, the device 1 provides easy control of the compression force applied to blood vessels in the limb. While the knob 31 is rotated, it provides reciprocating movement of the compression control mechanism 3 in a direction perpendicular to the surface of the limb. Upon upward movement of the tightener 30, the increasing tension is applied to a strap 4, which in turns generates the increased compression of the hollow body 2 onto the patient's limb.
The strap 4 is an integral element, i.e. it is formed from a single piece of a plastic material. In the preferred embodiment the strap 4 has also anti-slip properties, i.e. the surfaces thereof when in contact do not slide against each other. This also increases the stability of the device 1, when it is applied to the patient's limb. Preferably, the strap 4 is transparent, i.e. it does not obstruct the view of the patient's limb. At the same time, the strap 4 is elastic, it can be wrapped around the patient's limb and over the top of the device 1. As shown in
The narrow strap part 41 extents, preferably gradually, into the wide strap part 42. When the device is applied into the patent's limb the wide strap part 42 is in contact with the dorsal side of patient's limb. The increased width of the strap 4 in this section increases patient's comfort and stability of the device when it is applied to the limb. The wide strap part 42 is preferably provided with two guiding edges 44, which extend in the lengthwise direction of the strap 4 and form a groove. The distance between the guiding edges 44 corresponds to the width of the narrow strap part 41, which is received in the groove formed between the guiding edges 44, when the device 1 is applied to the limb. The guiding edges 44 ensure that the narrow strap part 41 is held in place when the strap 4 is wrapped around the patient's limb.
The strap 4 is connected to the hollow body 2 by the connection strap part 43. The connection between the strap 4 and the hollow body 2 is durable, since it withstands forces associated with tension generated by upward movement of the tightener 30. In the present embodiment, the connection strap part 43 is connected to the hollow body 2 by an adhesive 5 that is placed between the connection strap part 43 and the compression area 24 of the hollow body 2. In addition, on the surface opposite to the adhesive 5, the connection strap part 43 is provided with the compression inset 45 (i.e. the compression inset 45 faces the limb of the patient). The compression inset 45 is preferably formed from an elastic material and provides additional compression in desired area of the limb.
The vessel compression device 1 according to the preferred embodiment, as shown in
Number | Date | Country | Kind |
---|---|---|---|
P-428964 | Feb 2019 | PL | national |
Filing Document | Filing Date | Country | Kind |
---|---|---|---|
PCT/EP2020/054189 | 2/18/2020 | WO | 00 |