AUTOMATIC DEVICES FOR REMOTE ISCHEMIC PRECONDITIONING

• US 20120130419A1
• Filed: 01/31/2012
• Published: 05/24/2012
• Est. Priority Date: 06/23/2009
• Status: Active Grant

• Current Assignee: Infarct Reduction Technologies, Inc.
• Original Assignee: Infarct Reduction Technologies, Inc.
• Inventors: Leschinsky, Boris
• Granted Patent: US 8,753,283 B2
• Time in Patent Office: Days
• US Class Current: 606/202
• CPC Class Codes: A61B 17/12109 in a blood vessel
• CPC Class Codes: A61B 17/12136 Balloons
• CPC Class Codes: A61B 17/135 inflatable for measuring blood pressure A61B5/022; inflatable pressure pads A61F5/34
• CPC Class Codes: A61B 17/1355 Automated control means therefor
• CPC Class Codes: A61B 2017/00199 with a console, e.g. a control panel with a display
• CPC Class Codes: A61B 5/02208 using the Korotkoff method
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/02233 Occluders specially adapted therefor tourniquets A61B17/132
• CPC Class Codes: A61H 1/006 Apparatus for applying pressure or blows for compressive stressing of a part of the skeletal structure, e.g. for preventing or alleviating osteoporosis
• CPC Class Codes: A61H 2201/5035 Several programs selectable
• CPC Class Codes: A61H 2201/5038 freely programmable by the user
• CPC Class Codes: A61H 2201/5071 Pressure sensors
• CPC Class Codes: A61H 2230/30 Blood pressure A61H2230/04 takes precedence
• CPC Class Codes: A61H 9/0078 with intermittent or alternately inflated bladders or cuffs mattresses for preventing bed-sores with alternated pressurized chambers A61G7/05776
• CPC Class Codes: A61H 9/0092 Cuffs therefor

Abstract

Single- or dual-bladder devices for remote ischemic preconditioning and blood pressure monitoring are disclosed along with various oscillometry-based and other methods for detecting systolic and diastolic blood pressure while the ischemic preconditioning treatment is in progress. The devices and methods of the invention provide for delivery of ischemic preconditioning at the lowest effective cuff pressure while closely monitoring patient'"'"'s hemodynamics. Advantageously, the device of the invention allows both ischemic preconditioning and blood pressure monitoring to be done on the same limb. Disposable battery-powered version of the device of the present invention is especially useful for emergency use with patients suffering from acute myocardial infarction, acute stroke, or acute trauma. Additional device configurations are described for use in a percutaneous intervention and vascular sealing settings.

Claims

1. An automatic device for remote ischemic preconditioning treatment, the device comprising:

a disposable cuff configured to retract about a limb of a subject,

a reusable battery-operated rechargeable controller detachably retained on said cuff, said controller is configured to periodically;

inflate said cuff to a cuff pressure at or above a limb occlusion pressure of the subject,

maintain said cuff pressure at or above said limb occlusion pressure for a period of at least about one minute, and

deflate said cuff,

wherein said cuff and said controller are further configured to be retained about said limb and deliver said remote ischemic preconditioning therapy as one unit.

2. The device as in claim 1, wherein said controller is retained on an outer side of said cuff over said limb.

3. The device as in claim 2, wherein said controller is retained over an inflatable portion of said cuff and oriented to face a user.

4. The device as in claim 1, wherein said controller is sufficiently powered for at least two remote ischemic preconditioning treatments.

5. An automatic device for remote ischemic preconditioning treatment, the device comprising:

a disposable cuff configured to retract about a limb of a subject,

a reusable battery-operated rechargeable controller detachably retained on an outer side of said cuff over said limb, said controller is configured to periodically;

inflate said cuff to a cuff pressure at or above a limb occlusion pressure of the subject,

maintain said cuff pressure at or above said limb occlusion pressure for a period of at least about one minute, and

deflate said cuff,

wherein after initial activation by a user, said controller is further configured to conduct and complete said entire treatment without further user input.

6. The device as in claim 5, wherein said initial activation is a single user input.

7. The device as in claim 6, wherein said controller includes a START button configured to provide said single user input for initial activation of said device.

8. The device as in claim 5, wherein said controller is further configured for automatic hemodynamic surveillance of the subject during said remote ischemic preconditioning treatment.

9. The device as in claim 8, wherein said hemodynamic surveillance is based on measuring pressure in said cuff.

10. The device as in claim 9, wherein said controller is further configured to detect systolic blood pressure of said subject.

11. The device as in claim 10, wherein said controller is further configured to detect systolic blood pressure of said subject at least once during maintaining said cuff pressure at or above said limb occlusion pressure for said period of at least about one minute.

12. The device as in claim 5, wherein said controller is further configured to detect presence or absence of the subject'"'"'s heart beats after inflating said cuff to a predetermined cuff pressure.

13. The device as in claim 12, wherein said controller is further configured to progressively inflate said cuff to higher cuff pressures until said heart beats are no longer detected to be present.

14. The device as in claim 12, wherein said controller is further configured to inflate said cuff to a cuff pressure when said heart beats are no longer detected to be present.

15. A device for remote ischemic preconditioning, the device comprising:

a cuff sized to retract about a limb of a subject,

a controller connected to said cuff, said controller configured to inflate and deflate said cuff according to a remote ischemic preconditioning treatment protocol, said treatment protocol includes a plurality of treatment cycles, each of said treatment cycles comprising;

inflating said cuff to a cuff pressure at or above a limb occlusion pressure of the subject,

maintaining said cuff pressure at or above said limb occlusion pressure for a period of at least about one minute, and

deflating said cuff,

wherein during maintaining said cuff pressure at or above said limb occlusion pressure, said controller is further configured to vary said cuff pressure above said limb occlusion pressure at least once during at least one of said treatment cycles.

16. The device as in claim 15, wherein said controller is further configured to detect a systolic blood pressure of the subject during varying of said cuff pressure.

17. The device as in claim 16, wherein said controller is further configured to inflate said cuff pressure to a vicinity of a previously recorded systolic blood pressure during varying of said cuff pressure.

18. The device as in claim 17, wherein said controller is further configured to determine a diastolic pressure of the subject, whereby said subject is under continuous hemodynamic surveillance throughout said ischemic preconditioning treatment.