Systems and methods for arteriotomy localization

• US 20070213616A1
• Filed: 10/19/2006
• Published: 09/13/2007
• Est. Priority Date: 10/20/2005
• Status: Abandoned Application

• Current Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Original Assignee: Otsuka Medical Devices Co., Ltd. (Otsuka Holdings Company Limited)
• Inventors: Zhang, Jimin, Emery, Charles, Pedersen, Robert, Perozek, David, Kook, John, Gisselberg, Margo, Anderson, Thomas, Sekins, K., Kulesa, Larry, Zhao, Xiao
• Application Number:
  US11/583,656
• Publication Number:
  US 20070213616A1
• Time in Patent Office: Days
• US Class Current: 600/448
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 18/02 by cooling, e.g. cryogenic techniques devices for cooling specific reflex points of the body within cell-life limits A61H39/06
• CPC Class Codes: A61B 2017/00557 inflatable A61B2017/22051 takes precedence
• CPC Class Codes: A61B 2017/00637 for sealing trocar wounds through abdominal wall
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2090/372 Details of monitor hardware
• CPC Class Codes: A61B 2090/3784 both receiver and transmitter being in the instrument or receiver being also transmitter
• CPC Class Codes: A61B 2090/3929 Active markers
• CPC Class Codes: A61B 2090/3958 emitting a signal
• CPC Class Codes: A61B 2090/397 electromagnetic other than visible, e.g. microwave
• CPC Class Codes: A61B 34/25 User interfaces for surgical systems
• CPC Class Codes: A61B 5/026 Measuring blood flow A61B3/1233, A61B3/1241 take precedence
• CPC Class Codes: A61B 50/13 Trolleys, e.g. carts
• CPC Class Codes: A61B 8/0833 involving detecting or locating foreign bodies or organic structures
• CPC Class Codes: A61B 8/0841 for locating instruments
• CPC Class Codes: A61B 8/12 in body cavities or body tracts, e.g. by using catheters catheters per se A61M25/00
• CPC Class Codes: A61B 8/4405 Device being mounted on a trolley
• CPC Class Codes: A61B 8/445 Details of catheter construction
• CPC Class Codes: A61F 2/82 Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents stent-grafts for tubular structures of the body other than blood vessels A61F2/04; stent-grafts for blood vessels A61F2/07; instruments specially adapted for placement or removal of stents or stent-grafts A61F2/95; for closing wounds, or holding wounds closed A61B17/04 - A61B17/115; dilators A61M29/00
• CPC Class Codes: A61M 25/10 Balloon catheters A61M25/0125 takes precedence; embolectomy A61B17/22032; retractors A61B17/02; inflatable balloons for placing stents or stent-grafts A61F2/958 ; stomach balloons for treatment of obesity A61F5/0003; oesophagal tubes A61J15/00
• CPC Class Codes: A61N 7/02 : Localised ultrasound hyperthermia hyperthermia in general A61F7/00

Abstract

A targeting catheter is used to locate an arteriotomy, such as is formed during a femoral artery catheterization procedure. The targeting catheter includes one or more targeting aids, such as an inflatable balloon or sensor (e.g., Doppler or temperature sensor), to locate the arteriotomy. The targeting aid may be positioned at the arteriotomy. An ultrasonic beacon on the catheter may then be located relative to a therapeutic ultrasonic applicator (e.g., by using acoustic time-of-flight) so that the focus of ultrasonic energy from the applicator can be aligned with the arteriotomy.

Claims

1. An arteriotomy targeting catheter, comprising:

an arteriotomy targeting aid coupled to the catheter and adapted to detect the location of an arteriotomy; and

one or more beacons coupled to the catheter proximal to the arteriotomy targeting aid.

2. The catheter of claim 1, wherein the arteriotomy targeting aid comprises an inflatable balloon.

3. The catheter of claim 2, wherein the balloon comprises an elastic polymeric material.

4. The catheter of claim 3, wherein the soft elastic polymeric material is selected from the group consisting of one or more of a polyamide, a polyamide blend, a polyethylene, a polyethylene terephthalate, a polyurethane, a polyamide, and a polyamide blend.

5. The catheter of claim 4, wherein the polyamide blend is PBAX.

6. The catheter of claim 2, wherein the durometer of the balloon material is between 20A and 90D.

7. The catheter of claim 6, wherein the durometer of the balloon material is between 80 A and 65 D.

8. The catheter of claim 7, wherein the durometer of the balloon material is 90 A.

9. The catheter of claim 1, wherein the arteriotomy targeting aid comprises a mechanical expansible device.

10. The catheter of claim 1, wherein the arteriotomy targeting aid comprises an arteriotomy locating sensor.

11. The catheter of claim 10, wherein the arteriotomy locating sensor comprises a temperature sensor.

12. The catheter of claim 11, wherein the temperature sensor is a thermistor.

13. The catheter of claim 10, wherein the arteriotomy locating sensor comprises a flow measurement sensor.

14. The catheter of claim 10, wherein the arteriotomy locating sensor comprises an optical sensor.

15. The catheter of claim 10, wherein the arteriotomy locating sensor comprises an impedance sensor.

16. The catheter of claim 10, wherein the arteriotomy locating sensor comprises a Doppler sensor.

17. The catheter of claim 1, wherein the beacon comprises an ultrasonic transmitter.

18. The catheter of claim 1, wherein the beacon comprises a radio frequency transmitter.

19. The catheter of claim 1, wherein the beacon comprises a magnetic field generator.

20. A method of determining the location of a therapeutic site in a body, comprising:

inserting a catheter into the body, wherein the catheter comprises a targeting aid; and

manipulating the catheter such that the targeting aid is adjacent to or at the therapeutic site.

21. The method of claim 20, wherein the therapeutic site is an arteriotomy.

22. The method of claim 20, wherein manipulating the catheter comprises moving the catheter until a Doppler signal from the targeting aid determines that the targeting aid is adjacent to or at the therapeutic site.

23. The method of claim 20, wherein the targeting aid comprises a temperature sensor and manipulating the catheter comprises moving the catheter until the temperature sensor indicates that it is adjacent to or at the therapeutic site.

24. The method of claim 20, wherein the targeting aid comprises a fluid flow detector and manipulating the catheter comprises moving the catheter until the fluid flow detector indicates that it is adjacent to or at the therapeutic site.

25. The method of claim 20, wherein the targeting aid comprises an optical sensor and manipulating the catheter comprises moving the catheter until the optical sensor indicates that it is adjacent to or at the therapeutic site.

26. The method of claim 20, wherein the targeting aid comprises a pressure sensor and manipulating the catheter comprises moving the catheter until the pressure sensor indicates that it is adjacent to or at the therapeutic site.

27. The method of claim 20, wherein the targeting aid comprises an impedance sensor and manipulating the catheter comprises moving the catheter until the impedance sensor indicates that it is adjacent to or at the therapeutic site.

28. The method of claim 20, wherein the targeting aid comprises a force detector and manipulating the catheter comprises moving the catheter until the force detector indicates that it is adjacent to or at the therapeutic site.

29. The method of claim 20, wherein the targeting aid comprises a mechanically expansive device and the method comprises expanding the mechanically expansive device and moving the catheter until the device is adjacent to or at the therapeutic site.

30. The method of claim 20, wherein the targeting aid comprises an inflatable balloon and the method comprises inflating the balloon and moving the catheter until the balloon is adjacent to or at the therapeutic site.

31. The method of claim 20, wherein:

the therapeutic site is an arteriotomy created by an introducer sheath inserted into an artery;

inserting the catheter into the body comprises inserting the catheter and targeting aid through the lumen of the introducer sheath past the arteriotomy and into the artery; and

manipulating the catheter comprises retracting the catheter such that the targeting aid approaches the arteriotomy.

32. The method of claim 31, wherein the introducer sheath is retracted simultaneously with retraction of the catheter.

33. The method of claim 31, wherein the targeting aid comprises an inflatable balloon and wherein the balloon is inflated after insertion of the catheter and prior to retracting the catheter.

34. The method of claim 31, further comprising applying compression above the arteriotomy.

35. A method of determining the location of a therapeutic site in a body relative to a therapeutic applicator, comprising:

inserting a targeting catheter into the body;

identifying the location of the therapeutic site using the targeting catheter; and

determining the position of the targeting catheter relative to the therapeutic applicator.

36. The method of claim 35, wherein the therapeutic site is an arteriotomy.

37. The method of claim 35, further comprising aligning the therapeutic applicator with the therapeutic site based on the relative position of the targeting catheter.

38. The method of claim 35, wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises using triangulation.

39. The method of claim 38, wherein the triangulation is based on magnetic fields.

40. The method of claim 38, wherein the triangulation is based on acoustic signals.

41. The method of claim 40, wherein the triangulation is based on an acoustic time-of-flight determination.

42. The method of claim 35, wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises transmitting an ultrasound signal from a transmitter located on the catheter to multiple receivers located on the therapeutic applicator.

43. The method of claim 42, wherein the transmitter comprises a piezoelectric cylinder.

44. The method of claim 42, wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises determining the acoustic time-of-flight from the transmitter to the receivers.

45. The method of claim 35, wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises transmitting ultrasound signals from multiple transmitters located on the therapeutic applicator to a receiver located on the catheter.