The present disclosure relates to medical instruments and systems for providing hemostasis at a vascular puncture site. The features relating to the methods and devices described herein can be applied to any hemostasis device utilizing a syringe to deflate the hemostasis device by stages.
The embodiments disclosed herein will become more fully apparent from the following description and appended claims, taken in conjunction with the accompanying drawings. The drawings depict only typical embodiments, which embodiments will be described with additional specificity and detail in connection with the drawings in which:
Medical procedures which include access to a patient's cardiovascular system are commonly performed in hospitals and outpatient clinics. Such procedures may be performed to diagnose or provide therapeutic treatment for a medical issue. Access to the cardiovascular system may entail the use of needles, guidewires, and long catheters. Upon removal of these devices, a puncture hole remains open in a wall of a vessel. Blood may leak from the puncture hole resulting in a hematoma or blood loss. Due to a higher pressure within arteries, the risk of hematoma or blood loss is higher when an artery is accessed for a procedure. In some procedures, the puncture hole is occluded with a device to plug the hole or pressure is applied over the puncture hole following removal of an access device until the hole is occluded by a blood clot. Pressure may be applied in a variety of ways, including by hand, a sandbag, a pressure dressing, or by an inflatable hemostasis device.
Some inflatable hemostasis devices may be deflated in stages over time. A syringe may be utilized to deflate the inflatable hemostasis device. Achievement of timely hemostasis may avoid complications, facilitate patient discharge, and quick turnover of the procedure room.
Embodiments of the disclosure may be understood by reference to the drawings, wherein like parts are designated by like numerals throughout. It will be readily understood by one of ordinary skill in the art having the benefit of this disclosure that the components of the embodiments, as generally described and illustrated in the figures herein, could be arranged and designed in a wide variety of different configurations. Thus, the following more detailed description of various embodiments, as represented in the figures, is not intended to limit the scope of the disclosure, but is merely representative of various embodiments. While the various aspects of the embodiments are presented in drawings, the drawings are not necessarily drawn to scale unless specifically indicated.
Various features are sometimes grouped together in a single embodiment, figure, or description thereof for the purpose of streamlining the disclosure. Many of these features may be used alone and/or in combination with one another.
The phrases “coupled to” and “in communication with” refer to any form of interaction between two or more entities, including mechanical, electrical, magnetic, electromagnetic, fluid, and thermal interaction. Two components may be coupled to, or in communication with, each other even though they are not in direct contact with each other. For example, two components may be coupled to, or in communication with, each other through an intermediate component.
The directional terms “distal” and “proximal” are given their ordinary meaning in the art. That is, the distal end of a medical device means the end of the device furthest from the practitioner during use. The proximal end refers to the opposite end, or the end nearest the practitioner during use. As specifically applied to a deflation syringe, the proximal end of the syringe refers to the end nearest the flange and the distal end refers to the opposite end, the end nearest the inlet/outlet port of the syringe.
The barrel member 110 further comprises a retention ring 114 disposed adjacent the proximal end portion 117 of the barrel 111. The retention ring 114 extends radially inwardly from a wall of the bore 115. The retention ring 114 may be configured to extend circumferentially without breaks, or it may be segmented into two or more portions. The retention ring 114 may have a height of 0.01 inch to 0.10 inch, including 0.04 inch to 0.06 inch. The retention ring 114 may be shaped in any suitable shape, such as the shape of a semi-circle, the shape of a right triangle where the vertical leg is oriented distally and the inclined leg is oriented proximally, etc. Functions of the retention ring 114 are further detailed below.
The flange 112 of the barrel member 110 is disposed adjacent the proximal end portion 117. The flange 112 is configured to provide finger gripping surfaces. The flange 112, in the depicted embodiment, comprises two portions which extend radially outward from a central axis of the barrel 111. In some embodiments, the flange 112 may comprise a circular shape such that the flange 112 extends circumferentially radially outward from the central axis of the barrel 111. The flange 112 may further comprise any suitable grip enhancing feature, such as ribs, dimples, detents, grooves, etc.
The port 113 is disposed adjacent a distal end portion 116 of the barrel 111. In the illustrated embodiment, the port 113 is configured as a male Luer fitting having a Luer taper outer surface and a lumen that is in fluid communication with the bore 115 of the barrel 111. In other embodiments, the port 113 may be configured as a male Luer lock fitting having an internally threaded collar configured to couple with external threads of a female Luer lock connector. Still further various port 113 shapes, fittings, and connectors are within the scope of this disclosure.
Referring to
With continued reference to
The insert 124 may be coupled to the body 126 and disposed adjacent the proximal end portion 128 of the body 126. In some embodiments, the insert 124 may be integrally formed with the body 126, including embodiments wherein the insert 124, or any portion thereof (such as the insert flange 125 discussed below) is a molded feature of the plunger body 126. In the embodiment of
In the illustrated embodiment, the insert 124 comprises an insert flange 125 and an extension portion 131. The insert 124 may be formed from any suitable rigid polymeric or semi-rigid material, such as polycarbonate, polypropylene, polyethylene, ABS, etc. The insert 124 may be coupled to the body 126 using any suitable technique, such as overmolding, heat welding, sonic welding, adhesive, etc.
The insert flange 125 extends radially outward from the longitudinal axis of the body 126. The insert flange 125 may be disposed between the ribs 122 of the body 126. In some embodiments, the insert 124 is disposed between at least two ribs 122 such that the insert flange 125 forms an arc between the two ribs 122. In other embodiments, the insert 124 is disposed between more than two ribs 122 such that the insert flange 125 forms a circumferential arc around the body 126.
In the illustrated embodiment, the outside diameter D1 of the insert flange 125 is configured to be greater than inside diameter D2 (
In some embodiments, the insert flange 125 and/or the retention ring 114 may be deformed when the insert flange 125 engages the retention ring 114 with adequate force such that the insert flange 125 may be retracted proximally to the retention ring 114. In other embodiments, the retention ring 114 may form a hard stop such that the insert flange 125 cannot be retracted proximally to the retention ring 114.
In still other embodiments, the retention ring 114 may be formed in an incomplete ring such that a gap is formed between ends of the retention ring 114. A diameter of the bore 115 between the ends of the retention ring 114 may be equivalent to the inside diameter D3 of the bore 115. The insert flange 125 may be configured as with arc segments configured to align with the gaps of the retention ring 114 such that the insert flange may be retracted proximally to the retention ring when the arc segments are aligned with the gaps.
In certain embodiments, the insert flange 125 may be positioned along the longitudinal axis of the barrel 111 such that the stroke distance L1 of the plunger member 120 is restricted to provide a desired volume of air or liquid within a portion of the bore 115. For example, the insert flange 125 may be positioned along the body 126 such that 1 milliliter, 2 milliliter, 3 milliliter, 4 milliliter, or any other desired volume of air or liquid may be drawn into the portion of the bore 115 distal to the plunger tip 123. In some embodiments, the insert flange 125 may be fixedly coupled to the body 126 at the desired position to provide the desired volume of air or liquid. In other embodiments, the insert 124 may be longitudinally adjustable such that the insert flange 125 can be positioned at a variety of desired locations along the body 126 by the healthcare worker at the time of use. The insert 124 and the body 126 may comprise a ratchet mechanism to facilitate adjustability of the position of the insert flange 125. Further, embodiments wherein the retention ring 114 and/or insert flange 125 are disposed other portions of the barrel 111 are within the scope of this disclosure.
In the illustrated embodiment, the extension portion 131 of the insert 124 is shown to extend longitudinally toward the proximal end portion 128 of the body 126. The extension portion 131 may be disposed between at least two ribs 122. In other embodiments, the extension portion 131 may be disposed between 3, 4, 5, or any number of ribs 122. The extension portion 131 may comprise an indicia to indicate the volume of air or liquid the staged deflation syringe 100 is configured to withdraw from an inflatable hemostasis device.
The port 113 of the barrel 111 may be sealingly coupled to a connector 130 of the inflatable hemostasis device. The connector 130 may comprise a valve configured to retain the air or fluid within the inflatable hemostasis device under pressure until the connector is coupled to a device, such as the staged deflation syringe 100. Upon coupling, pressure within the inflatable hemostasis device may be adequate to cause the air or liquid within the inflatable hemostasis device to flow from the inflatable hemostasis device through the connector 130, through the port 113, and into the bore 115 as the plunger member 120 is driven proximally to the retracted configuration. The plunger member 120 is driven proximally until the insert flange 125 couples with the retention ring 114. An excess of air or fluid cannot flow into a distal portion 119 of the bore 115 due to restriction of distal axial movement of the plunger member 120 such that the inflatable hemostasis device is deflated a desired volume. Excess deflation of the inflatable hemostasis device may result in bleeding from or hematoma formation at the vascular puncture site due to a reduced applied pressure at the puncture site. The deflation process may be repeated over time until the inflatable hemostasis device is fully deflated and hemostasis of the puncture site is achieved. For example, the staged deflation syringe 100 may be decoupled from the connector 130 for a period of time, such as 15 minutes. The staged deflation syringe 100 may then be recoupled to the connector 130 with the plunger member 120 distally positioned.
In some embodiments, the pressure within the inflatable hemostasis device is not high enough to drive the plunger member 120 distally even when the valve of the connector 130 is opened by the staged deflation syringe 100. In such instances, the healthcare worker may grasp the plunger flange 121 with fingers and manually displace the plunger member 120 axially distally until the insert flange 125 engages with the retention ring 114. As the plunger member 120 is axially displaced, air or fluid is drawn into the distal portion 119 of the bore 115 by negative pressure created within the distal portion 119.
Without further elaboration, it is believed that one skilled in the art may use the preceding description to utilize the present disclosure to its fullest extent. The examples and embodiments disclosed herein are to be construed as merely illustrative and exemplary and not a limitation of the scope of the present disclosure in any way. It will be apparent to those having skill in the art, and having the benefit of this disclosure, that changes may be made to the details of the above-described embodiments without departing from the underlying principles of the disclosure herein.
This application claims priority to U.S. Provisional Application No. 62/585,234, filed on Nov. 13, 2017 and titled, “Staged Deflation Syringe Systems and Associated Methods,” which is hereby incorporated by reference in its entirety.
Number | Name | Date | Kind |
---|---|---|---|
1393720 | Lomas et al. | Oct 1921 | A |
3831603 | Armenti | Aug 1974 | A |
3901413 | Harris, Sr. | Aug 1975 | A |
3938505 | Jamshidi | Feb 1976 | A |
4275729 | Silver et al. | Jun 1981 | A |
4386606 | Tretinyak et al. | Jun 1983 | A |
4476866 | Chin | Oct 1984 | A |
4562844 | Carpenter et al. | Jan 1986 | A |
4592746 | Burkholder | Jun 1986 | A |
4635792 | Yamada et al. | Jan 1987 | A |
4711637 | Leigh et al. | Dec 1987 | A |
4747484 | Ackeret | May 1988 | A |
4758232 | Chak | Nov 1988 | A |
4807749 | Ackeret | Feb 1989 | A |
4810249 | Haber et al. | Mar 1989 | A |
4875578 | Nehl | Oct 1989 | A |
4929238 | Baum | May 1990 | A |
4966581 | Landau | Oct 1990 | A |
5000735 | Whelan | Mar 1991 | A |
5009646 | Sudo | Apr 1991 | A |
5011010 | Francis et al. | Apr 1991 | A |
5049135 | David | Sep 1991 | A |
5135111 | Stoger | Aug 1992 | A |
5205823 | Zdeb | Apr 1993 | A |
5213209 | Son | May 1993 | A |
5306248 | Barrington | Apr 1994 | A |
5306258 | De La Fuente | Apr 1994 | A |
5314416 | Lewis | May 1994 | A |
5358497 | Dorsey | Oct 1994 | A |
5397313 | Gross | Mar 1995 | A |
5411488 | Pagay et al. | May 1995 | A |
5413115 | Baldwin | May 1995 | A |
5685864 | Shanley et al. | Nov 1997 | A |
5735825 | Stevens et al. | Apr 1998 | A |
5814917 | Isobe et al. | Sep 1998 | A |
6203521 | Menne | Mar 2001 | B1 |
6234996 | Bagaoisan et al. | May 2001 | B1 |
6579269 | Kleyman | Jun 2003 | B1 |
7022112 | Pokorney | Apr 2006 | B2 |
7604618 | Dixon | Oct 2009 | B2 |
7927315 | Sudo et al. | Apr 2011 | B2 |
8475415 | Schiller | Jul 2013 | B2 |
9332972 | Boutaghou | May 2016 | B2 |
20020198500 | Leung | Dec 2002 | A1 |
20040138612 | Shermer et al. | Jul 2004 | A1 |
20040236283 | Tang | Nov 2004 | A1 |
20050137533 | Sudo et al. | Jun 2005 | A1 |
20060178643 | Sudo et al. | Aug 2006 | A1 |
20060195063 | Lim et al. | Aug 2006 | A1 |
20060264837 | Bloom et al. | Nov 2006 | A1 |
20070219508 | Bisegna | Sep 2007 | A1 |
20090247961 | Carlyon | Oct 2009 | A1 |
20090326479 | Janish | Dec 2009 | A1 |
20100168662 | Bingham | Jul 2010 | A1 |
20100211000 | Killion et al. | Aug 2010 | A1 |
20110009829 | Kosinski et al. | Jan 2011 | A1 |
20110178475 | Tanaka et al. | Jul 2011 | A1 |
20110319864 | Beller et al. | Dec 2011 | A1 |
20120136298 | Bendix et al. | May 2012 | A1 |
20130123693 | Lampropoulos et al. | May 2013 | A1 |
20140031764 | Kabushiki | Jan 2014 | A1 |
20140052078 | Heinz | Feb 2014 | A1 |
20140062036 | Maeda et al. | Mar 2014 | A1 |
20140100509 | Defonzo | Apr 2014 | A1 |
20140124542 | Kojima et al. | May 2014 | A1 |
20140288408 | Deutsch | Sep 2014 | A1 |
20150018800 | Reb et al. | Jan 2015 | A1 |
20150314074 | Howlett | Nov 2015 | A1 |
20150320937 | Kosinski et al. | Nov 2015 | A1 |
20160058988 | Kesten et al. | Mar 2016 | A1 |
20160101269 | Benz | Apr 2016 | A1 |
20160243305 | Nakamura | Aug 2016 | A1 |
20160279395 | Lampropoulos et al. | Sep 2016 | A1 |
20170000988 | Stevens et al. | Jan 2017 | A1 |
20170007807 | Weerakoon et al. | Jan 2017 | A1 |
20170312177 | Bhargava et al. | Nov 2017 | A1 |
Number | Date | Country |
---|---|---|
102013104018 | Oct 2014 | DE |
0208975 | May 1987 | EP |
0338671 | Oct 1989 | EP |
0375778 | Jul 1990 | EP |
0420126 | Sep 1990 | EP |
1602389 | Dec 2005 | EP |
02152463 | Jun 1990 | JP |
0698921 | Apr 1994 | JP |
199409838 | May 1994 | WO |
199530444 | Nov 1995 | WO |
199744077 | Nov 1997 | WO |
200041494 | Jul 2000 | WO |
2004044464 | May 2004 | WO |
2007006030 | Jan 2007 | WO |
2011006086 | Jan 2011 | WO |
2011006103 | Jan 2011 | WO |
2014077670 | May 2014 | WO |
Entry |
---|
European Search Report dated Sep. 19, 2016 for EP14771008.1. |
International Preliminary Report dated Sep. 24, 2015 for PCT/US2014/027649. |
International Search Report and Written Opinion dated May 22, 2017 for PCT/US2017/014043. |
International Search Report and Written Opinion dated Oct. 20, 2016 for PCT/US2016/041047. |
Office Action dated Mar. 14, 2018 for U.S. Appl. No. 15/202,785. |
Office Action dated May 22, 2015 for U.S. Appl. No. 14/212,096. |
Office Action dated Jun. 2, 2016 for U.S. Appl. No. 14/212,096. |
Office Action dated Jun. 29, 2018 for U.S. Appl. No. 15/202,785. |
Office Action dated Jul. 11, 2018 for U.S. Appl. No. 15/410,364. |
Office Action dated Sep. 4, 2018 for U.S. Appl. No. 15/410,305. |
Office Action dated Nov. 27, 2015 for U.S. Appl. No. 14/212,096. |
European Search Report dated Mar. 6, 2019 for EP16821894.9. |
Notice of Allowance dated Jun. 10, 2019 for U.S. Appl. No. 15/202,785. |
Office Action dated Jan. 25, 2019 for U.S. Appl. No. 15/202,785. |
Office Action dated Feb. 8, 2019 for U.S. Appl. No. 15/410,305. |
European Search Report dated Aug. 26, 2019 for EP17741885.2. |
Office Action dated Jul. 9, 2019 for U.S. Appl. No. 15/410,305. |
International Search Report and Written Opinion dated Apr. 2, 2019 for PCT/US2018/060089. |
Notice of Allowance dated Feb. 14, 2020 for U.S. Appl. No. 15/410,305. |
European Search Report dated Jul. 9, 2021 for EP18876110.0. |
Number | Date | Country | |
---|---|---|---|
20190142433 A1 | May 2019 | US |
Number | Date | Country | |
---|---|---|---|
62585234 | Nov 2017 | US |