Systems and methods for sealing a vascular opening

• US 20070233185A1
• Filed: 10/19/2006
• Published: 10/04/2007
• 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, Anderson, Thomas, Perozek, David, Silverstein, Fred, Sekins, K.
• Application Number:
  US11/583,256
• Publication Number:
  US 20070233185A1
• Time in Patent Office: Days
• US Class Current: 606/213
• 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

Systems and methods for sealing a vascular opening such as an arteriotomy formed during a femoral artery catheterization procedure are described. The blood vessel is transiently occluded during application of therapeutic energy, such as high intensity focused ultrasound. The occlusion improves the efficiency of the therapy without causing damage to the blood vessel. Also described are methods for locating the arteriotomy, aligning the therapeutic applicator to the arteriotomy, and a station keeping procedure for maintaining alignment.

Claims

1. A method for sealing a vascular opening in a blood vessel, comprising:

transiently substantially occluding the blood vessel;

applying energy adjacent to the vascular opening such that the opening is sealed; and

removing the blood vessel occlusion.

2. The method of claim 1, wherein the blood vessel is a fermoral, brachial, or radial artery.

3. The method of claim 1, wherein the blood vessel is transiently fully occluded.

4. The method of claim 1, wherein occluding the blood vessel comprises applying compressive force to the blood vessel.

7. The method of claim 1, wherein applying energy adjacent to the vascular opening comprises directing energy from an energy applicator located on or near the surface of skin over the blood vessel.

8. The method of claim 1, wherein applying energy to the vascular opening comprises energizing an energy applicator positioned inside a patient near the vascular opening.

9. The method of claim 1, wherein the energy applied is acoustic energy.

11. The method of claim 1, wherein the energy applied is radio frequency energy.

12. The method of claim 1, wherein the energy applied is microwave energy.

13. The method of claim 1, wherein the energy applied is optical energy.

15. The method of claim 1, wherein the energy is thermal energy.

5. The method of claim 0, wherein the compressive force is applied using an energy applicator that is used to apply the energy.

6. The method of claim 0, wherein the compressive force is applied to the surface of skin located over the blood vessel.

10. The method of claim 0, wherein the energy applied is high intensity focused ultrasound energy.

14. The method of claim 0, wherein the optical energy comprises one or more of ultraviolet, visible, near—

infrared, or infrared energy.

16. The method of claim 0, wherein the energy is cryogenic energy.

17. A method for sealing a vascular opening in a blood vessel in a patient, comprising:

inserting a targeting catheter into the blood vessel;

locating the vascular opening using the targeting catheter;

aligning a therapeutic energy applicator relative to the targeting catheter;

initiating a station keeping algorithm configured to detect relative motion between tissue in the vicinity of the vascular opening and the applicator; and

applying energy from the applicator to tissue adjacent to the vascular opening to seal the opening.

18. The method of claim 0, wherein inserting the targeting catheter comprises inserting the catheter through the vascular opening.

19. The method of claim 0, wherein the vascular opening is created by insertion of an introducer sheath and inserting the targeting catheter comprises inserting the catheter through the sheath.

20. The method of claim 0, wherein locating the vascular opening comprises manipulating the targeting catheter until a targeting aid on the catheter is adjacent to or at the vascular opening.

21. The method of claim 0, wherein aligning the therapeutic energy applicator comprises detecting the position of the applicator relative to a beacon located on the catheter.

22. The method of claim 0, wherein detecting the position of the applicator relative to the beacon comprises emitting an ultrasonic signal from the beacon to multiple receivers on the applicator.

23. The method of claim 0, wherein the energy is high intensity focused ultrasound.

24. The method of claim 0, comprising withdrawing the catheter from the blood vessel prior to applying energy from the applicator.

25. The method of claim 0, wherein the targeting catheter remains in the patient'"'"'s body during application of the energy.

26. The method of claim 0, wherein the targeting catheter is removed from the patient'"'"'s body prior to application of the energy.

27. The method of claim 0, comprising applying pressure to the blood vessel to transiently partially or fully occlude the vessel prior to initiating station keeping.