CA1197603A - Hemostat with blood flow sensor - Google Patents
Hemostat with blood flow sensorInfo
- Publication number
- CA1197603A CA1197603A CA000417720A CA417720A CA1197603A CA 1197603 A CA1197603 A CA 1197603A CA 000417720 A CA000417720 A CA 000417720A CA 417720 A CA417720 A CA 417720A CA 1197603 A CA1197603 A CA 1197603A
- Authority
- CA
- Canada
- Prior art keywords
- hemostat
- blood
- blood flow
- pressure
- pressure pad
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B5/00—Measuring for diagnostic purposes; Identification of persons
- A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
- A61B5/6801—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be attached to or worn on the body surface
- A61B5/6843—Monitoring or controlling sensor contact pressure
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B17/132—Tourniquets
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/06—Measuring blood flow
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B8/00—Diagnosis using ultrasonic, sonic or infrasonic waves
- A61B8/42—Details of probe positioning or probe attachment to the patient
- A61B8/4209—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames
- A61B8/4218—Details of probe positioning or probe attachment to the patient by using holders, e.g. positioning frames characterised by articulated arms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/12—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord
- A61B2017/12004—Surgical instruments, devices or methods, e.g. tourniquets for ligaturing or otherwise compressing tubular parts of the body, e.g. blood vessels, umbilical cord for haemostasis, for prevention of bleeding
Abstract
HEMOSTAT WITH BLOOD FLOW SENSOR
Abstract A hemostat for restricting blood flow through a blood vessel for assisting hemostasis. An ultrasonic sensor is mounted with a pressure pad to sense rate of blood flow through the vessel when pressure is applied to obtain minimum bleeding with maximum flow through the vessel, without need for continual observation. The output signal of the sensor may be connected to an auditory signal unit or a visual display to free personnel from the site to perform other necessary tasks.
Abstract A hemostat for restricting blood flow through a blood vessel for assisting hemostasis. An ultrasonic sensor is mounted with a pressure pad to sense rate of blood flow through the vessel when pressure is applied to obtain minimum bleeding with maximum flow through the vessel, without need for continual observation. The output signal of the sensor may be connected to an auditory signal unit or a visual display to free personnel from the site to perform other necessary tasks.
Description
7~
; HEMOSTAT WITH BLOOD FLOW SENSOR
Backaround of the Invention Many medical tests require the insertion of a catheter ,into an artery. The catheter is normally inserted throut3h a percutaneous puncture made through the wall ox, the artery and pushed into the artery to a desired position.
Catheterization techniques 7nay be employed or such various procedures as heart hlood pressure anaJysis, dialysis, arterial blood was assays, and visualization of vascular location for X-rays.
Upon removing the catheter from the artery, the puncture in the arterial waJl rnu~t be closed Jo top blceding. Since the puncture site is ~3mall, as is the size of the artery itself, the use of sutures iFs cumbersome and possibly dangerous. Most often, blood ilow through the artery is restricted to reduce bleeding throutJh the puncture so a clot may Eorm at the puncture site and close the opening. 'this technique requires application of pr~sFiure to the artery up~3tream of the puncture site to reduce t,)'100d Elow foc a ~uf~icLently lon~3 time for a clot Jo e~rm ancl ~eco1ne atkactled to the will 0~ the artery.
I're~3~ur~ ~u~t hc appL1~1 to the artery from ten to twenty minutecs on the avera(~3, anc'l at ti,meF; foc lon(3e~r period.
`Ln the pat in~3e~r pre~3l1re WclS applLe~1 to the ~5 ~rkt3ry, whlch frequently reviled the u~t,,~ oE bokh hands an ~Ee~ctLvt3 colllpres~sitn and al~;o re~luirec'l a reasonab1,e degree of skill in order to apply the proper amount oE
pressure re~uirecl without collapsirlg the artery. It was neceC;sary for a trained person to remain at the puncture site until a clot wa~3 for~ned and hleedin~ c3topped.
Many problerns were inhercnt in this procedure.
~3eC'clllse it is tediouc; to af)ply pressure to the wound site for Ch a lonq perlod ox ki~ne, the fin~Jer pry ure '"',' applied was unsteady and there was a danger of collapsinq the artery completely by the application of too much pressure. Collapsing the artery could result in the formation of thrombosis in the collapsed region, which could completely and permanently block the artery, requiring subsequent surgical procedures to relieve the blockage In certain procedures, such as heart catheterizati.Qn, which require insertion of a catheter into the femoral artery, which feeds blood to the leg, serious damage including gangrene and resultant amputation is possible by cessation of blood flow for too long a period. At best thrombosis may form; or muscular spasms may re-~ult, causing complications.
Secondarily, haviny a trained person rernain at the puncture site or the prolonged period required for clot formation is unproductive. The person should be performing other necessary tasks. Also, the trained person may be hindered fron renderinc3 emergency care to the patient should an emerc3ency situation arise.
To ~olv~ these problem mechanical devices have been d~velop~c1 for applyinc3 pressure to an artery to obtain hcmosta~i5, allowing trained personnel to attcnd to other dutie5. U.5. Patcnt No. 3,779,2~ show a C-clamp device having a lary~ dL5c shc~lpe~ pad attached Jo the end Oe a 25 cantil~v~rt~ arm which extends over a patient lying below. The arm end pad are lowered so that the pad will cover the puncture site upon withdrawal oE the catheter until a clot in the puncture is obtained. Duriny use, the C-clamp device exerts a non-calibrated and uneven pressure directly on the area Oe the puncture site to restrict ble~dinc3. the pad GOVe~S the punctllre, preventirlg doctor frorn vi~witlg the puncture it to determine whether bleedirlc3 has teen ~t~pped end to wcltch thy prog L'e";S~ ion ox clot formation in tne puncture This clamp device provides only vertical movement of the arm and pac3, which makes adju5tment to the location of the puncture difficult. The large area of the pad covering the puncture site applies pressure to a substantially larger area tnan to the artery alone. This large pad, in combination with the crude sliding adjustment, makes S accurate pressure application to the artery difficult and provides poor control to restrict blood flow. Use of this device still requires the constant attention of a physician, or other trained person, to control bleeding.
This device provides little advantage over the application of Ginger pressure to an artery and, in fact, can cause a false tense of security in personnel which use it.
Other devices have been constructed which use a large inflated and 1exible pad to cover the catheter entry site. One example, shown in U.S. Patent No. 3,625,219 has a perpendicular rod assembly which is universally adiustahle. Once positioned, the pad assembly i5 held in position by screw clamps. A pad positioned at a distal end of a horl~on~al rod or arrn has a transparent rubber membrane cl~mp~d beneath a transparent plastic base. Air, or other fluid, if injected into the chamber between the bate and m~mb~ane to expand the membcane outwardly to apply prei~ure over the arterial opening. Once the pad is infl3ted to apply pre~ure to the puncture area, the applled pr~5u~e may ye determined by ob~rvation ox a g~uye conrlecte~ to the ch~nber inlet. Pulsing indication of the blood pressure within the artery i-s also indicated on the pressure gauge. However, such pressure indications are not very accurate The inflatable pad of thl~ device overlies a large area surrounding the artery, so that, 3G even though the pad elements are transparent, observation o thy amount of bleeding and clot formation art ohs~cur~d. The c;læe ox the pod makes it difficult to apply pin-point and accurAte pces~;ure to the artery. Pressure can be applied unevenly to the artery, possibly loading to a hemato~a of the arterial wall. Further, this device also requires a physician or technician to remain with the device to control the amount of air introduced into the chamber and to observe the pressure gauge. The clamp for maintaining adjustment o pressure applied to the artery by the pad i5 undependable and may by disturbed, thereby changing the pressure applied and allowing increased bleeding.
A second inflated pad device, shown in U.S. Patent No.
4,~33,890, also comprising a universally adjustable arm mechanism, has a pillow-like pressure pad similar to that disclosed in U~5. Patent No. 3,625,219 mounted to a distal end of an extending arm. This device suffers from the tame inadequacies of the device mentioned above and is of little advantaye over the first C-clamp device described. There is no accurate way to control the pressure applied to the artery by this device or to accurately control the restriction of blood flow through the artery. There is no way to assure uniform distribution ox pressure to the artery. Nor is there any wry to clearly visualixe the area surrounding the artery to d~t~rmin~ the amount of bleeding or the adveancement of clot for~nation. This clevice alto require constant ; c~pervi~ion~
It can be seen that none of the prior devices provlde for con accurate and dependeable control ox blood slow ~hrou~h an artery to reduce b.].eedin~ ox a puncture in order for a clot to be Eormed; nor do any teach a means for sensing blood low in the artery. These devices all require continual visual attention of a person for the duration of time required Eor clot formation, thereby 30 preventing their attention to other ta~ks~
Summary of the Inventisrl -This :invention p~ovic.les a he~nostatic:-d~vice to ontrol bleedlncJ of any percutal1~su~ vascl.llelr entry which can accurately apply a dec;ired prey re loc(llLy to a blood vessel, without need of pecicll assistance from or supervision of attendiny personnel. The capability of r _ ,, this device arises from a blood flow sensing means which determines the flow rate of blood through the vessel, and which produces an output signal which can be used to signal supervising personnel. The flow sensing means provides an accurate indication of blood flow and restriction of the blood vessel to all personnel present, without requiring their constant attention. The device further comprises an accurate means of adjusting pressure applied to a blood vessel, including an indicator for determining the clamping pressure. The hemostat may include a mean for indicating systolic and diasytolic blood pressure supplied Jo the artery at the site of restriction.
A small changeable pressure pad is provided ko apply firm and uniform pressure across the width of the artery upstream ox a puncture, within a locali2ed area. The pressure pad is removable for ease of selection to adapt a proper size relative to the size ox the artery, and for e~s~ oE ~terilizat~on. rhe pressure pad is provided with a or which i3 connected with the slow tensing means or at and accur~tc tensing of changes in thy blood slow i through an artary against which lt i,q po~itioned~
Xn preferred Norm, the flow ~n~in~ man provides an auditory signal which chan~cs in pitch or volume in
; HEMOSTAT WITH BLOOD FLOW SENSOR
Backaround of the Invention Many medical tests require the insertion of a catheter ,into an artery. The catheter is normally inserted throut3h a percutaneous puncture made through the wall ox, the artery and pushed into the artery to a desired position.
Catheterization techniques 7nay be employed or such various procedures as heart hlood pressure anaJysis, dialysis, arterial blood was assays, and visualization of vascular location for X-rays.
Upon removing the catheter from the artery, the puncture in the arterial waJl rnu~t be closed Jo top blceding. Since the puncture site is ~3mall, as is the size of the artery itself, the use of sutures iFs cumbersome and possibly dangerous. Most often, blood ilow through the artery is restricted to reduce bleeding throutJh the puncture so a clot may Eorm at the puncture site and close the opening. 'this technique requires application of pr~sFiure to the artery up~3tream of the puncture site to reduce t,)'100d Elow foc a ~uf~icLently lon~3 time for a clot Jo e~rm ancl ~eco1ne atkactled to the will 0~ the artery.
I're~3~ur~ ~u~t hc appL1~1 to the artery from ten to twenty minutecs on the avera(~3, anc'l at ti,meF; foc lon(3e~r period.
`Ln the pat in~3e~r pre~3l1re WclS applLe~1 to the ~5 ~rkt3ry, whlch frequently reviled the u~t,,~ oE bokh hands an ~Ee~ctLvt3 colllpres~sitn and al~;o re~luirec'l a reasonab1,e degree of skill in order to apply the proper amount oE
pressure re~uirecl without collapsirlg the artery. It was neceC;sary for a trained person to remain at the puncture site until a clot wa~3 for~ned and hleedin~ c3topped.
Many problerns were inhercnt in this procedure.
~3eC'clllse it is tediouc; to af)ply pressure to the wound site for Ch a lonq perlod ox ki~ne, the fin~Jer pry ure '"',' applied was unsteady and there was a danger of collapsinq the artery completely by the application of too much pressure. Collapsing the artery could result in the formation of thrombosis in the collapsed region, which could completely and permanently block the artery, requiring subsequent surgical procedures to relieve the blockage In certain procedures, such as heart catheterizati.Qn, which require insertion of a catheter into the femoral artery, which feeds blood to the leg, serious damage including gangrene and resultant amputation is possible by cessation of blood flow for too long a period. At best thrombosis may form; or muscular spasms may re-~ult, causing complications.
Secondarily, haviny a trained person rernain at the puncture site or the prolonged period required for clot formation is unproductive. The person should be performing other necessary tasks. Also, the trained person may be hindered fron renderinc3 emergency care to the patient should an emerc3ency situation arise.
To ~olv~ these problem mechanical devices have been d~velop~c1 for applyinc3 pressure to an artery to obtain hcmosta~i5, allowing trained personnel to attcnd to other dutie5. U.5. Patcnt No. 3,779,2~ show a C-clamp device having a lary~ dL5c shc~lpe~ pad attached Jo the end Oe a 25 cantil~v~rt~ arm which extends over a patient lying below. The arm end pad are lowered so that the pad will cover the puncture site upon withdrawal oE the catheter until a clot in the puncture is obtained. Duriny use, the C-clamp device exerts a non-calibrated and uneven pressure directly on the area Oe the puncture site to restrict ble~dinc3. the pad GOVe~S the punctllre, preventirlg doctor frorn vi~witlg the puncture it to determine whether bleedirlc3 has teen ~t~pped end to wcltch thy prog L'e";S~ ion ox clot formation in tne puncture This clamp device provides only vertical movement of the arm and pac3, which makes adju5tment to the location of the puncture difficult. The large area of the pad covering the puncture site applies pressure to a substantially larger area tnan to the artery alone. This large pad, in combination with the crude sliding adjustment, makes S accurate pressure application to the artery difficult and provides poor control to restrict blood flow. Use of this device still requires the constant attention of a physician, or other trained person, to control bleeding.
This device provides little advantage over the application of Ginger pressure to an artery and, in fact, can cause a false tense of security in personnel which use it.
Other devices have been constructed which use a large inflated and 1exible pad to cover the catheter entry site. One example, shown in U.S. Patent No. 3,625,219 has a perpendicular rod assembly which is universally adiustahle. Once positioned, the pad assembly i5 held in position by screw clamps. A pad positioned at a distal end of a horl~on~al rod or arrn has a transparent rubber membrane cl~mp~d beneath a transparent plastic base. Air, or other fluid, if injected into the chamber between the bate and m~mb~ane to expand the membcane outwardly to apply prei~ure over the arterial opening. Once the pad is infl3ted to apply pre~ure to the puncture area, the applled pr~5u~e may ye determined by ob~rvation ox a g~uye conrlecte~ to the ch~nber inlet. Pulsing indication of the blood pressure within the artery i-s also indicated on the pressure gauge. However, such pressure indications are not very accurate The inflatable pad of thl~ device overlies a large area surrounding the artery, so that, 3G even though the pad elements are transparent, observation o thy amount of bleeding and clot formation art ohs~cur~d. The c;læe ox the pod makes it difficult to apply pin-point and accurAte pces~;ure to the artery. Pressure can be applied unevenly to the artery, possibly loading to a hemato~a of the arterial wall. Further, this device also requires a physician or technician to remain with the device to control the amount of air introduced into the chamber and to observe the pressure gauge. The clamp for maintaining adjustment o pressure applied to the artery by the pad i5 undependable and may by disturbed, thereby changing the pressure applied and allowing increased bleeding.
A second inflated pad device, shown in U.S. Patent No.
4,~33,890, also comprising a universally adjustable arm mechanism, has a pillow-like pressure pad similar to that disclosed in U~5. Patent No. 3,625,219 mounted to a distal end of an extending arm. This device suffers from the tame inadequacies of the device mentioned above and is of little advantaye over the first C-clamp device described. There is no accurate way to control the pressure applied to the artery by this device or to accurately control the restriction of blood flow through the artery. There is no way to assure uniform distribution ox pressure to the artery. Nor is there any wry to clearly visualixe the area surrounding the artery to d~t~rmin~ the amount of bleeding or the adveancement of clot for~nation. This clevice alto require constant ; c~pervi~ion~
It can be seen that none of the prior devices provlde for con accurate and dependeable control ox blood slow ~hrou~h an artery to reduce b.].eedin~ ox a puncture in order for a clot to be Eormed; nor do any teach a means for sensing blood low in the artery. These devices all require continual visual attention of a person for the duration of time required Eor clot formation, thereby 30 preventing their attention to other ta~ks~
Summary of the Inventisrl -This :invention p~ovic.les a he~nostatic:-d~vice to ontrol bleedlncJ of any percutal1~su~ vascl.llelr entry which can accurately apply a dec;ired prey re loc(llLy to a blood vessel, without need of pecicll assistance from or supervision of attendiny personnel. The capability of r _ ,, this device arises from a blood flow sensing means which determines the flow rate of blood through the vessel, and which produces an output signal which can be used to signal supervising personnel. The flow sensing means provides an accurate indication of blood flow and restriction of the blood vessel to all personnel present, without requiring their constant attention. The device further comprises an accurate means of adjusting pressure applied to a blood vessel, including an indicator for determining the clamping pressure. The hemostat may include a mean for indicating systolic and diasytolic blood pressure supplied Jo the artery at the site of restriction.
A small changeable pressure pad is provided ko apply firm and uniform pressure across the width of the artery upstream ox a puncture, within a locali2ed area. The pressure pad is removable for ease of selection to adapt a proper size relative to the size ox the artery, and for e~s~ oE ~terilizat~on. rhe pressure pad is provided with a or which i3 connected with the slow tensing means or at and accur~tc tensing of changes in thy blood slow i through an artary against which lt i,q po~itioned~
Xn preferred Norm, the flow ~n~in~ man provides an auditory signal which chan~cs in pitch or volume in
2$ re5pon5~ to chan4es in blood flow through the artery The auditory signal allows all personnel it the area to hear a change in blood flow through the artery, thereby obviating need of constant supervision ox the hemostat, though immediately indicating a problem to those present. The flow ~,~n~ing meanfi can al50 be connected to a vic3eo canner to vl~ually di~pla~ ehanqes in blooc3 flow through thy artery, or 'co a ehart reeo~d~r to obtain a p~rm7nént reeord of artecial flow.
This hemostatie deviee allows or aeeurate eontrol of 35 bleeding through a puneture site and ean be effectively us2d Jo speed clot Formation in closure oE the puneture.
r _ . . .
1~97~
I_ The accurate control of pressure applied locally to the artery provides means for minimizing bleeding thrvugh the puncture while maintaining maximum flaw of blood through-the artery to the dependant extremity. The sensor in the 5 pressure pad and the flow sensing means provide an accurate indication of flow throuyh the artery, thereby signaling when a problem should occur. An attending physician or technician will immed~a~ely be made aware so that emergency action can be taken Further, an accurate 10 means for obtaining a measurement of pre.ssure applied on the artery is provided to assist a user in setting the device to re5trict arterial flow, and as.sure that the artery will not be collapsed.
Brief Description oE the Drawings FIGURE 1 is a forward perspective view of a hemostat having a brood flow sensing means, including a c-lt-away ox a pressure pad holding member;
FIGURE 2 is a rearward perspective view of a hemostat having a blood flow arising means;
FIGURE 3 is a view illustrating a lever and linkage or pivotlncJ cankil~vered arms;
F~GU~ is a wide view oE a h~mo tat ~howlng a ; pressure pod end ~upport1ng arm in raised position;
FICIU~. 5 it a rear perspective view ox a second embodiment of a hemostat according to the invention;
FIG~E 6 is a forward perspective of the apparatus oE
FIGURES;
FIGURE 7 is a cross sectional view taken along line 7-7 of PIGURE 6; and FIGURE 8 is an elevation view of a pr2ssure pad and indicatc)r ïight~ -D~cri~tion ox the Preferred Embodiment -Referring to F;gures 1 end 2, hemostat 10 for.
restricting hlood flow in blood vessel to control bleediny through a percutaneous puncture is generally illustrated. A mounting fixture, generally indicated as :;
11, mounts hori%ontally extending arms 12 and canti.levers the arms 12 from a first end 14 outwardly from the mounting fixture 11~ A pressure pad holding member 18 is mounted to a distal opposing end 16 o the arms 12. The holding pressure pad member 18 holds a pressure pad 20 at a lower portion and positions the pressure pad 20 in a generally downward position to engage a blood vessel o a patient lying thereunder. The pressure pad 20 of the hemostat it positioned upstream ox the puncture to apply a pressure force against the wall ox the blood vessel to constrict blood flow through the vessel and limit bleeding through the puncture.
The pressure pad 20 includes a sensor 21, as shown in Figure 1, for detecting the flow of blood throuyh a blood vessel. In preferred form, the sensor 21 comprises an ultrasonic signal generator and a doppler transducer which measure the velocity of a patient's blood flow by transmitting an ultrasonic signal through the blood and d~t~ting thy re1ected signal, or echo. the frequency of thy echo ~lgnal will by di~erent from that of the original 3ignal due to the doppler efEect produced by the movlng blood. The difference in frequencies between the original and reflected c;ic3nals can be used to calctllate thy v~loc.lty ox the blood flow and to provlde an output 2$ 3igna.l corresponding to blood flow and changes in blood low. The signal yenerator and transducer are encapsulated in an epoxy material to form the sensor 21.
The sensor 21 is fastened within a small recess in the pressure pad 20, formed centrally in a face 22 of the 30 pressure pad 20 applied against the artery. The sensor 21 may by ~lther flush with thy face ~2 of l:ho pressure pad 20 or reed approxlrnat~ly orle to 'cwo milllm~ter~; in i order to produe the highest signal output in response to pulsating blood slow. The angular orientation of the 35 setl~or 21 r~latlve to the face 22 is selected to maximize the tensor output signal.
.
The sensor 21 may, however, comprise an optical doppler apparatus, a transducer for photoplethysmography~
a transducer for impedance plethysmographyr a magneto- _ .
I dynamic blood flow probe for magnetic flow measurement technigues, or other non-occlusive slow sensing means.
All of above-mentioned sensor devices are well known in the art and are extremely accurate on determining the rate flow of blood through a blood Bessel.
The output signal provided by the sensor is directed through connectors 23 to a signal processor generally shown as 24, which analyzes the output signal produced by the sensor 21 and produces a second output signal, preferably a sound which varies in pitch or volume in response to changes in blood flow thraugh the blood 15 vessel. The ultrasonic sensor 21 and signal processor 24 herein described or determining a doppler effect responsive to blood flow are well known in the art of medical instrumentation. Such devices which function ~3tisaatorily in the hemostat 10 are model numbers 812 i 20 and B41 marXet~d by Pork Electronic Laboratories of vq~t~n, Oregon.
The second output ~lynal mayt however, by dir~ct0d to video display to visually depict the blood Elow rat and chant@ ox blood slow Nate in the vessel, or to a chart ~cord~r whlch providcs a permanent record ox blood slow rate through the blood vessel.
he pres$ure pad ~0 is a generally disc-fihaped plate havlng a substantially hard surface or applying pressure to the Ycssel. The pressure pad 20 is provided in a selection of s;zes so that a proper width Jay be selected to closely approximate the width of the blood vesscl to whiz it will apply pressure. Proper sizing of the . r pre.~ure pad 20 applies pr~sure only locally to the ve3sel ln which.~lood flow i5 to be re5tricted, and not to thy surrounding tissue ar2as. Proper sizing oE the pressure pad 20 provides for accurate control of blood ~;~
g flow restrictions and accurate positioning of the pressure pad 20 over the vessel to prevent the occurrence of problems, such as hematoma caused by uneven pressure. The pFessure pad 20 is removable from the holding member 18 for each of replacement and for sterilization, and may be made disposable.
Referring to Figure 2, the pressure exerted on the blood vessel by the pressure pad 20 is accurately controlled by adjustments provided in the hemostat 10 to accurately limit flood flow. The pressure pad holding member l is incrementally adjustable by a detent pin 28 positioned through the arm 12, which i5 adapted to engat3e one of a number of detent holes 29 in the holding mernber 18. The ir~t incremental adjustment permits lartge segmented adjustments of the pressure pad holding member 18 relative to the distal end of the arm 12 to which it is mounted to allow large adjustments in the position of the pressure pad 20 relative to the artery which it will compress .
~0 A ~ub~tant~ally infinitely fin screw adjustment, generally shown at 30, i5 u3ed after the incremental ~dju~tment to maXe ~tmall precise movements ox thy pressure pad 20 Jo doter~ino the exact pressure desired applied to the artery, ~n~ to accurately restrict blood flow through the artery by the d~ir~d mount Thy in screw adju~tm~nt 30 is preEerably provided by a fine-threaded sr~w 32 which moves the arm 12, pressure pad 20 and holding member 18 relative to the blood ve~-~el which is compressed.
An indicating instrument 39 indicates pressure exerted by the pressure pad 20 on the blood ve5sel. The instrument compri~et~ a p~e;sure g~ut3e 40 mounted to tha h~mo~3t~t 10 which re~;pont3s to pre~ure~ exerted by the pressure pad 2d against the artery. he indicclting instrurnent .39 may, however, comprise electrorlic pressure sensiny apparatus to give an accurate indication of the pressure exerted against the artery, and a means of indicating blood pressure in the artery (not shown), as depicted by a second indicator gauge 41.
In a preferred embodiment, the hemostat mounting fixture 11 comprises a substantlally flat base 44 to which a pair of elongate cylindrical support members 46 aye attached and are extended upwardly The upper ends ~8 of the support members 46 are engaged and rigidly held by a cap 50 to maintain dimensional rigidity. A body member 52 slidably engages the support members and is slidable therewith in a lengthwise direction by means of bearing elements, such as ball slides 54, shown in phantom view in Figure t.
The fine-threaded screw 32 is rotatakly attached to the cap 50 to allow turning movement of the screw while restricting longitudinal movement relative to the cap 50 and support memhers 46. The screw 32 is threaded into the body member 52 to provide a fine, substantially infinite adjustment of the body member 52 relative to the support Z0 member ~6 and base 44. A handle 56 is provided at thy upper end of the screw 32 above the`cap 50, for convenient turning of the cow 32 by a physician or technician.
Thc pressure pad holding member 18 it attached between the distal ends 16 of the extending arms 12 and is vertically movablc therewith The holding member 18 may by vertically moved to selected positions provided by the d~ten~ pin 28 enc3aglng one of the number oE detent holes Z9 formed in the holding me~lber 18. The holding member 18 is prohibited any movement other than a vertical movement relative to the supporting arms 12. A pedestal 70 is provided in the lower end oE the holding member 18 to which the pressure pad 20 i5 connected. The pedestal 70 protrude ~rorn a central opening 7~ forrned through the holding member l a5 i9 shown in Figure 1. The pedestal 70 acts as a piston to move fluid or air contained within the ~r~ntral opéning relative to the opening 72 at the upper end of the holding member 18. The pressure gauge 40 is attached at the upper opening to provide an indicat.ion of movement of the pressure pad 20 relative go the end of the holding member 18, which movement corresponds to a pressure or contact force applied agàinst the blood vessel. A biasing means snot shownl may be positioned within the central opening 72 to urge the pedestal 70 and pressure pad 20 prom the holding member 18.
A pair of pivotal plates 58 are mounted to the body member 52 by a hinge pin 60 with one plate 58 being on each side of the body parallel to a plane through support the member 46. The hinge pin 60 is positioned through the Cody member 52 and pivot plates 58 at a forward position, allowing the mass of the plates 58 rearwardly o the hinge pin 60 to act as a counterweight for pivotal movement of the plates 58 about the hinge pill 60. A slot 62 i5 formed generally horizontally and longitudinally through each plate 58 to recieve an arm t2 which is cantilevered outwardly therefrom. Each arm 12 ls slidable relatlve to the pivot plate S8 through the slot 62 to provide for horizontal adjustment of their distal ends 16 dative to the mountiny fixture I0. The arts 12 are held in a dined potion by a set screw 64 on Mach plate. A
bract 66 i5 provlded betwesn the distal ends 16 of the arms 12 to pea and support them Pi lever 74 and ad^j~cent linkage 76, shown in Figure 3, are coupled betwe0n the body member 52 and the rearward ends af the pivot plates 5~ to direct pivotal movement ox : the extending arms 12 and the pressure pad 20 in the : 30 holding member 18, about the hinge pin 60 through the pivot plates 58~ The lever 74 is pivotally mounted to the body 52 by pin 53~ ~Jinkage 76 i5 connected to lever 7~ by pin 55 and connected to pivot plates 58 by pin 57. The lover 7~ ~urthor provide for on emergency release of pressure exerted by the pressure pad 20 on the blood ves5el, and allows the hemostat 10 to be quickly and easily removed should occasion arise, by simply moving the lever 74 to pivot the arns t2 and the pressure pad 20 upwardly and out of the way, as shown in Fiyure 4.
When used, the hemostat 10 is positioned adjacent to a patient, with the arms 18 and pressure pad 20 pivoted upwaraly~ The base 44 is positioned beneath the portion of the body in which the artery to be catheterized extends with the arms 18 and pressure pad 20 extending over the proposed entry site. Prior to initiation of the surgical procedure, the hernostat 10 is adjusted into position to apply pressure to he artery. The pressure pad 20 is preferably located at a position upstream of the entry site of the catheter so that the puncture which is made to insert the catheter may be clearly visible to the attending physician for observance of clot formation and hemostasis.
The adjustment process is accomplished by pivotally lowering the arms 18 and pressure pad 20 until the lever 74 directing the rearward end of the pivotal moverment is in locking position, shown if Figure 4. Horizontal adjustment Oe the pressure pad 20 to properly place the pr~~æure pad 20 above the blood vessel is accomplished by sliding the armC 18 relative to the pivot plates 58 and locking the 5e~. 5crew 6~ to rel:ain the position o the arms. 'the pres~urc pad holdincJ mernber 18 is then vertically ad~ust~d to the des:ired detent po~,ition 29 so as to place the pressure pad 20 in proxirnity to the blood vessel whose flow it must restrict The fine screw adjustment 30 is then to be used by turning the handle 56 above the cap 50 at the top of the support members ~6 to lower the pressure pad 20 into engagement it with the blood vessel Advant~c3eou~ly, the handle 56 i turned whit the physicidn or technici.ltl obc;rve~ bokh the indic~ltion of pc-~sure Oll the ensure g~u~3e 40 end listens to the flow indication Oe blood flow provided by the audible output s.iyllcll, unt.il desired restriction of ~97~
-12a-The blood vessel is obtained, without collapsing the vessel.
Once adjustment is perfected, the release lever 74 may be moved to pivot the arms 18 and pressure pad 20 upwardly and outwardly away from the site of the surgical procedure, so that the catherterization may be performed.
~9~ 3 Upon completion of the catheterization pro-edure and as the catheter is withdrawn, the pressure pad 20 may be quickly and accurately applied to control blood flow through the blood vessel, and thus bleeding at the puncture site; by moving the lever 74 into locking position to pivot the pressure pad ~0 into contact with : the blood vessel in the pre-adjusted pos;tion. gain, fine adjustments my be made to provide a calibrated pressure to control the blood flow through the artery by using the fine thread adjustment 30. Once accurate adjustment is accomplished, the physician or technician may then proceed with other needed tasks while listening to the blood slow pulses as detected by the blood flow sensor 21 and audibly produced by the signal processor 24.
tSA signif icant iEeature of this investion i5 that adequate blood flow through the blood vessel to lower extremities is always assured. If any change in blood flow through the artery should occur, it will become immediately apparent to the personnel in the area by a ~0 change in the sound provided hy the signal processor 24.
Emergency action can then he immediately taken.
P~rsonn~l, h~ev~r, may normally continue about their duties without maintaining supervision ox thy herno~tate oth~ thin li5tening to the signal provided ln response to ~5 blood flow through th0 artery4 hould an erner~ency ocur, the herno~tat 10 tnay by quickly removed by a 5imple unlocking ox the lever 74 to upwardly pi.vot the pressure pad 20 and arts 12 out of the way to remove the hemostat tO from the patient.
~0Figures 5 through 7 illustrate a second preferred embodiment of a hemostat 98 includinq blood flow sensor 21. Referring first to Figure 5, the hemostat 98 compri~e~ a support plate 100 having a slightly curved portlon 102 or placement below a pat$ent's body to position the hemostat ~8 in relation to the body of a patient during post-op~rative period when the hemv~t~t 98 is used to assist hemostasis. One end of the Bupport plate 100 is provided with a slat portion ~04 to which a bracket 10~ is fastened by any suitable means such as t0 welding or common threaded fasteners. An upri9ht support - member 108 is pivotally attached to the bracket 106 by a bolt or a hinge pin 112 and is allowed pivotal movement both toward and away from the support plate 100. A flat lower end 110 of the support member 108 is pivotally attached to the bracket 106 by the hinge pin 112 to provide pivotal movement between the upright support member 108 and the support plate 100. The flat end 110 of the support member 108 includes an arcuate slot 114 therein through which a wing bolt 116 extends to connect the support member 108 to the support plate 100. The wing bolt 116 passes through the slot 114 and is threaded into the bracket 106 so that when tightened, the wing jolt 116 will apply a compressive force between a flat portion 110 of the support member 108 and the bracket 106 to provide frictional engagement between the bracket 106 and support member 108 to hold the support member 108 in the desired pivotal position An upwardly extending por.ion 120 of the support member 108 is generally cylindrical in shape. preferably, the support member 108 is comprised of a hollow cylindrical tube which has its lower end flattened and machined to provide the described features. A mounting block 122 is slidably positioned over the upper portion 120 of the upright support member 108. The mounting block 122 includes bore 124 of a size slightly larger than the diame er of the cylindrical upper portion 12D of the .. . .... . . .
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support member 108, which extends through the bore 12~ of the mounting block 122 for a loose sliding fit7 while providing sufficient rigidity ox the mounting block 122 on the upright member for substantially inflexible support.
lAdjustment of the position of the mounting block 122 on the support member 108 provides a coarse adjustment ox a pair of arms 126, which extend over the wound site.
The pair of arms 126 are connected to and extend in spaced relation from the mounting blsck 122 in cantilever fashion. The arms 126 engage matinq recesses 129 wormed in the sides of the mounting bloc 122, as shown in Figure 6. The arms 126 are attached wi}hin the recesses 128 by threaded fasteners 130. A wing scrQw 131 it threaded through an opposing end 132 of the mounting block 1~2 for lS engagement with the upright support member 103 to control movement of the mounting block 122 relative to the support member 108 and to hold the mounting block 122 in adjusted position on the upright support member 108. Loosening wing screw 131 permits adjustment of the position of the mounting block 122 along the length oE the support member 108 and permits rotation of the mounting block 122 about the axis of the support member 108 to facilitate movement of the arms 126 adjacent to or away from an artery.
A pressure pad holding member 134 is slidably mounted between the arms 126. With reference to Figure 7, the holding member 134 comprises a block 136 which has a generally rectangular cross section The block 136 is sized to have a width slightly meter than the spacing between the arms l26 for easy sliding engagement there~etween. The block 136 is positioned between the arms 126 with a lip 138 protruding from a lower portion ox each side of the block 136 to engage a lower edge 140 of the arms 126. The height of the block 136 above the upper face 141 of the protruding lips 138 is slightly less than the height of the arms 126. A plate 142 of rectangular shape having the same length of the block 136, though 76~;3 slightly wider, is fastened by threaded fasteners 144 to the upper portion of the block 136 when the block 136 is inserted between the arms 12~ to capture the block 136 bet~ee~n the arms t26 for sliding movement along the length 5 ` theredf. The plate 142 is attached at one end by threaded fasteners 144 end spaced by spacers 146 prom the upper surface of the block 136 so that the distance between the upper surface 141 of the protruding lip 1~8 and the lower surface of the plate 142 is slightly larger than the height of the protruding arms 125 to provide for easy sliding movement. A thumb screw 148 extends through the plate 12 at an opposing end and is threaded into the block 136 so that when the thumb screw 14~ is tightened the plate 142 is deflected toward the block 136, decreasing the distance between the upper surface 141 of the protruding lip 138 and the loser ~urfac~ of the plate 142 to apply force to the arms 126 between the lip t38 and the plate 142. The frictional engagement between the aFms 126 and the plate 142 and block 136 holds the pressure pad holding member 134 in adjusted position. Adjustment of the position of the pressure pad holding-member 134 thus provides accurate placement of a pressure pad 125 over a selected artery of the patient. The pressure pad 1~5 includes a sensor 21 of the type described with reference to Figure 1.
Continuing reference to Figure, 7, a pressure regulating assembly 150 includes a cylindrical pedcstal 152 for mounting the pressure pad 125 to the block 136.
The pressure regulating assembly 150 comprises a tubular member 154 which is press fitted into a counter bore 156 in the block 136, to position the tubular member 154 in perpendicular relation to the arms 126. The pedestal~152 is inserted into an interior passage 158 of the tubular T~ember 154, and through a sized bore 160 formed through the block 136 concentrically with the counter bore 156 to positron the pedestal 152 to support the press-lre pad ;~
~976~33 125. The pedestal 152 and the bore 160 formed through the block 136 have a sliding fit to allow sliding movement of the pedestal 152 within the block 13~.
The uppermost portion of the pedestal 152 has an enlarged cylindrical port;on 161 slightly smaller in diameter than the interior passage 158 in the tubular member 154 to maintain guided sliding engagement of the upper portion 161 oE the pedestal t52 within the passage ` 158. A spring 164 is positioned above the pedestal ~52 to tO apply force through the pedestal 152 to- the pressure pad - 125 to apply pressurP to an artery on which the pressure pad 125 is placed.
. An upper spring seat 168 is positioned over the spring 164 to position the upper face of the spring 164 in a desired vertical position within the tubular member 154.
An end cap 166 is threaded into the uppermost end of the tubular member 154. A screw 170 is threaded through the end cap 166 with a lower end of the screw 170 engaging the upper spring seat 108 to pOSitiQn the upper spring seat 108 in a desired position within the tubular member t5~.
The screw 170 compresses the spring 164l so that the spring 964 will apply force to the pedestal 152 and the pressure pad 125. Therefore, as the screw 170 is turned and screwed into the end cap 66, the upper spring seat 168 is lowered within the tubular member 154 to compress the spring 164 to provide increased .vressure-~o the pedestal 152 and the pressure pad 125. Adjustment of the screw 170 to control the compression of spring 164 provides an infinitely variable fine adjustment of the pressure applied to an artery positioned below the pressure pad 125.
The tubular member 154 includes a window 172 intermediately positioned between the upper and lower ends thereof, through which the enlarged portion t61 of the pedestal 152 may be viewed. A scale calibration 174 is posi~loned immediately adjacent the window 172 so that the '7~
pressure aplied by the pedestal 152 may be ascertained by viewing the position of the enlarged portion 161 relative to the calibration scale through the window 172.
the pressure pad t25 is mounted to the lowermost portion of the pedestal 152 and may be provided in a number of varied siæes for adaptation to the size of artery in which blood flow restriction is desîred.
referring to Figure 8, the lowPr portion of the pressure pad 125 is generally cylindrical, but the edge 184 between 10the face 186 ana the side 188 of the pressure pad 125 may be slightly curved to avoid having a sharp edge pressing against the patient's body.
Referring to Figures 5, 6, and 8, the hemostat 98 may conveniently include a light indicator 182, which is connected to the sensor 21 in the presure pad 1~5. The light indicator 1~2 flickers in response to pulsating blood flow to provide a visual indication of whether the pressure pad 125 is on an artery and to indicate the blood flow rate through the artery. The light indicator 18~
20 begins to flicker to indicate proper placement of the pressure pad 125 over an artery and continues to flicker when the pressure pad t25 is pressing on the artery in response to pulsating blood E1QW. The light indicator 1~2 ceases to flicker to indicate that the pressure pad 125 is removed from the artery or that blood flow through the artery has stopped, which may indicate excessive pressure between the pressure pad 125 and the artery.
- The blood slow sensor 21 is connected to an audible control unit 179 by a pair of wires 180. The audible control unit 179 includes a signal processor (not sh3wn in Figure 8), as described with reference to Figures 1 and 2. The audible control unit 179 produces a sound output which varies in pitch or volume in response to changes in blood flow through an artery adjacent the pressure pad 125.
Referring to Figures 5 and 6, the hemostat 98 may 6~3 , V
include a low-power radio frequency transmitter t90 connected to the output oE the sensor 21. The transmitter 190 may be conveniently mounted to the audible control unit 179. Transmitter t90 outputs a low power radio frequency signal which is capable of being received by a portable receiver (not shown several feet away prom transmitter 1~0, such as in a hospital room adiacent the room in which the hemostat 98 us in use. The receiver preferably converts the radio frequency signal into an audible signal. Thus, the t~ansmitteF 190 enables hospital personnel to monitor the progress of hemostasis without being in the same room as the patient.
Table I indicates the height, weight, and hemostasis time for 21 patients upon whom the invention was tested Ordinary catheters were inserted in patients 1 through 9, and 1 t-l 4 who had normal blood clotting rates. The blood of patient 10 clotted at a rate which was only 2~% of the normal blood clotting rate; therefore, the hemostasis time for this patient was much longer than the typical ten minute hemostasis time for a patient whose blood clots at the normal rate. Achieving hemostasis in patient tO`would have been extremely dificult using ordinary methods and would have required the constant attention of trained personnel. Patients 15-21 received an angiopla~ty which requires the insertion of a catheter which is much larger than the catheters used on patients 1-14.- of the group of patients who received an angioplasty, only patient 2~ had an unusually long hemostasis time Patient ~0 had received lO,000 units of Heparin, which prolonged the hemostasis time.
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Patient Height _' -is Tlmo 5'8" 14~ 1/2 lb 10 minus 2 ' 5'0" 1~9 l
This hemostatie deviee allows or aeeurate eontrol of 35 bleeding through a puneture site and ean be effectively us2d Jo speed clot Formation in closure oE the puneture.
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I_ The accurate control of pressure applied locally to the artery provides means for minimizing bleeding thrvugh the puncture while maintaining maximum flaw of blood through-the artery to the dependant extremity. The sensor in the 5 pressure pad and the flow sensing means provide an accurate indication of flow throuyh the artery, thereby signaling when a problem should occur. An attending physician or technician will immed~a~ely be made aware so that emergency action can be taken Further, an accurate 10 means for obtaining a measurement of pre.ssure applied on the artery is provided to assist a user in setting the device to re5trict arterial flow, and as.sure that the artery will not be collapsed.
Brief Description oE the Drawings FIGURE 1 is a forward perspective view of a hemostat having a brood flow sensing means, including a c-lt-away ox a pressure pad holding member;
FIGURE 2 is a rearward perspective view of a hemostat having a blood flow arising means;
FIGURE 3 is a view illustrating a lever and linkage or pivotlncJ cankil~vered arms;
F~GU~ is a wide view oE a h~mo tat ~howlng a ; pressure pod end ~upport1ng arm in raised position;
FICIU~. 5 it a rear perspective view ox a second embodiment of a hemostat according to the invention;
FIG~E 6 is a forward perspective of the apparatus oE
FIGURES;
FIGURE 7 is a cross sectional view taken along line 7-7 of PIGURE 6; and FIGURE 8 is an elevation view of a pr2ssure pad and indicatc)r ïight~ -D~cri~tion ox the Preferred Embodiment -Referring to F;gures 1 end 2, hemostat 10 for.
restricting hlood flow in blood vessel to control bleediny through a percutaneous puncture is generally illustrated. A mounting fixture, generally indicated as :;
11, mounts hori%ontally extending arms 12 and canti.levers the arms 12 from a first end 14 outwardly from the mounting fixture 11~ A pressure pad holding member 18 is mounted to a distal opposing end 16 o the arms 12. The holding pressure pad member 18 holds a pressure pad 20 at a lower portion and positions the pressure pad 20 in a generally downward position to engage a blood vessel o a patient lying thereunder. The pressure pad 20 of the hemostat it positioned upstream ox the puncture to apply a pressure force against the wall ox the blood vessel to constrict blood flow through the vessel and limit bleeding through the puncture.
The pressure pad 20 includes a sensor 21, as shown in Figure 1, for detecting the flow of blood throuyh a blood vessel. In preferred form, the sensor 21 comprises an ultrasonic signal generator and a doppler transducer which measure the velocity of a patient's blood flow by transmitting an ultrasonic signal through the blood and d~t~ting thy re1ected signal, or echo. the frequency of thy echo ~lgnal will by di~erent from that of the original 3ignal due to the doppler efEect produced by the movlng blood. The difference in frequencies between the original and reflected c;ic3nals can be used to calctllate thy v~loc.lty ox the blood flow and to provlde an output 2$ 3igna.l corresponding to blood flow and changes in blood low. The signal yenerator and transducer are encapsulated in an epoxy material to form the sensor 21.
The sensor 21 is fastened within a small recess in the pressure pad 20, formed centrally in a face 22 of the 30 pressure pad 20 applied against the artery. The sensor 21 may by ~lther flush with thy face ~2 of l:ho pressure pad 20 or reed approxlrnat~ly orle to 'cwo milllm~ter~; in i order to produe the highest signal output in response to pulsating blood slow. The angular orientation of the 35 setl~or 21 r~latlve to the face 22 is selected to maximize the tensor output signal.
.
The sensor 21 may, however, comprise an optical doppler apparatus, a transducer for photoplethysmography~
a transducer for impedance plethysmographyr a magneto- _ .
I dynamic blood flow probe for magnetic flow measurement technigues, or other non-occlusive slow sensing means.
All of above-mentioned sensor devices are well known in the art and are extremely accurate on determining the rate flow of blood through a blood Bessel.
The output signal provided by the sensor is directed through connectors 23 to a signal processor generally shown as 24, which analyzes the output signal produced by the sensor 21 and produces a second output signal, preferably a sound which varies in pitch or volume in response to changes in blood flow thraugh the blood 15 vessel. The ultrasonic sensor 21 and signal processor 24 herein described or determining a doppler effect responsive to blood flow are well known in the art of medical instrumentation. Such devices which function ~3tisaatorily in the hemostat 10 are model numbers 812 i 20 and B41 marXet~d by Pork Electronic Laboratories of vq~t~n, Oregon.
The second output ~lynal mayt however, by dir~ct0d to video display to visually depict the blood Elow rat and chant@ ox blood slow Nate in the vessel, or to a chart ~cord~r whlch providcs a permanent record ox blood slow rate through the blood vessel.
he pres$ure pad ~0 is a generally disc-fihaped plate havlng a substantially hard surface or applying pressure to the Ycssel. The pressure pad 20 is provided in a selection of s;zes so that a proper width Jay be selected to closely approximate the width of the blood vesscl to whiz it will apply pressure. Proper sizing of the . r pre.~ure pad 20 applies pr~sure only locally to the ve3sel ln which.~lood flow i5 to be re5tricted, and not to thy surrounding tissue ar2as. Proper sizing oE the pressure pad 20 provides for accurate control of blood ~;~
g flow restrictions and accurate positioning of the pressure pad 20 over the vessel to prevent the occurrence of problems, such as hematoma caused by uneven pressure. The pFessure pad 20 is removable from the holding member 18 for each of replacement and for sterilization, and may be made disposable.
Referring to Figure 2, the pressure exerted on the blood vessel by the pressure pad 20 is accurately controlled by adjustments provided in the hemostat 10 to accurately limit flood flow. The pressure pad holding member l is incrementally adjustable by a detent pin 28 positioned through the arm 12, which i5 adapted to engat3e one of a number of detent holes 29 in the holding mernber 18. The ir~t incremental adjustment permits lartge segmented adjustments of the pressure pad holding member 18 relative to the distal end of the arm 12 to which it is mounted to allow large adjustments in the position of the pressure pad 20 relative to the artery which it will compress .
~0 A ~ub~tant~ally infinitely fin screw adjustment, generally shown at 30, i5 u3ed after the incremental ~dju~tment to maXe ~tmall precise movements ox thy pressure pad 20 Jo doter~ino the exact pressure desired applied to the artery, ~n~ to accurately restrict blood flow through the artery by the d~ir~d mount Thy in screw adju~tm~nt 30 is preEerably provided by a fine-threaded sr~w 32 which moves the arm 12, pressure pad 20 and holding member 18 relative to the blood ve~-~el which is compressed.
An indicating instrument 39 indicates pressure exerted by the pressure pad 20 on the blood ve5sel. The instrument compri~et~ a p~e;sure g~ut3e 40 mounted to tha h~mo~3t~t 10 which re~;pont3s to pre~ure~ exerted by the pressure pad 2d against the artery. he indicclting instrurnent .39 may, however, comprise electrorlic pressure sensiny apparatus to give an accurate indication of the pressure exerted against the artery, and a means of indicating blood pressure in the artery (not shown), as depicted by a second indicator gauge 41.
In a preferred embodiment, the hemostat mounting fixture 11 comprises a substantlally flat base 44 to which a pair of elongate cylindrical support members 46 aye attached and are extended upwardly The upper ends ~8 of the support members 46 are engaged and rigidly held by a cap 50 to maintain dimensional rigidity. A body member 52 slidably engages the support members and is slidable therewith in a lengthwise direction by means of bearing elements, such as ball slides 54, shown in phantom view in Figure t.
The fine-threaded screw 32 is rotatakly attached to the cap 50 to allow turning movement of the screw while restricting longitudinal movement relative to the cap 50 and support memhers 46. The screw 32 is threaded into the body member 52 to provide a fine, substantially infinite adjustment of the body member 52 relative to the support Z0 member ~6 and base 44. A handle 56 is provided at thy upper end of the screw 32 above the`cap 50, for convenient turning of the cow 32 by a physician or technician.
Thc pressure pad holding member 18 it attached between the distal ends 16 of the extending arms 12 and is vertically movablc therewith The holding member 18 may by vertically moved to selected positions provided by the d~ten~ pin 28 enc3aglng one of the number oE detent holes Z9 formed in the holding me~lber 18. The holding member 18 is prohibited any movement other than a vertical movement relative to the supporting arms 12. A pedestal 70 is provided in the lower end oE the holding member 18 to which the pressure pad 20 i5 connected. The pedestal 70 protrude ~rorn a central opening 7~ forrned through the holding member l a5 i9 shown in Figure 1. The pedestal 70 acts as a piston to move fluid or air contained within the ~r~ntral opéning relative to the opening 72 at the upper end of the holding member 18. The pressure gauge 40 is attached at the upper opening to provide an indicat.ion of movement of the pressure pad 20 relative go the end of the holding member 18, which movement corresponds to a pressure or contact force applied agàinst the blood vessel. A biasing means snot shownl may be positioned within the central opening 72 to urge the pedestal 70 and pressure pad 20 prom the holding member 18.
A pair of pivotal plates 58 are mounted to the body member 52 by a hinge pin 60 with one plate 58 being on each side of the body parallel to a plane through support the member 46. The hinge pin 60 is positioned through the Cody member 52 and pivot plates 58 at a forward position, allowing the mass of the plates 58 rearwardly o the hinge pin 60 to act as a counterweight for pivotal movement of the plates 58 about the hinge pill 60. A slot 62 i5 formed generally horizontally and longitudinally through each plate 58 to recieve an arm t2 which is cantilevered outwardly therefrom. Each arm 12 ls slidable relatlve to the pivot plate S8 through the slot 62 to provide for horizontal adjustment of their distal ends 16 dative to the mountiny fixture I0. The arts 12 are held in a dined potion by a set screw 64 on Mach plate. A
bract 66 i5 provlded betwesn the distal ends 16 of the arms 12 to pea and support them Pi lever 74 and ad^j~cent linkage 76, shown in Figure 3, are coupled betwe0n the body member 52 and the rearward ends af the pivot plates 5~ to direct pivotal movement ox : the extending arms 12 and the pressure pad 20 in the : 30 holding member 18, about the hinge pin 60 through the pivot plates 58~ The lever 74 is pivotally mounted to the body 52 by pin 53~ ~Jinkage 76 i5 connected to lever 7~ by pin 55 and connected to pivot plates 58 by pin 57. The lover 7~ ~urthor provide for on emergency release of pressure exerted by the pressure pad 20 on the blood ves5el, and allows the hemostat 10 to be quickly and easily removed should occasion arise, by simply moving the lever 74 to pivot the arns t2 and the pressure pad 20 upwardly and out of the way, as shown in Fiyure 4.
When used, the hemostat 10 is positioned adjacent to a patient, with the arms 18 and pressure pad 20 pivoted upwaraly~ The base 44 is positioned beneath the portion of the body in which the artery to be catheterized extends with the arms 18 and pressure pad 20 extending over the proposed entry site. Prior to initiation of the surgical procedure, the hernostat 10 is adjusted into position to apply pressure to he artery. The pressure pad 20 is preferably located at a position upstream of the entry site of the catheter so that the puncture which is made to insert the catheter may be clearly visible to the attending physician for observance of clot formation and hemostasis.
The adjustment process is accomplished by pivotally lowering the arms 18 and pressure pad 20 until the lever 74 directing the rearward end of the pivotal moverment is in locking position, shown if Figure 4. Horizontal adjustment Oe the pressure pad 20 to properly place the pr~~æure pad 20 above the blood vessel is accomplished by sliding the armC 18 relative to the pivot plates 58 and locking the 5e~. 5crew 6~ to rel:ain the position o the arms. 'the pres~urc pad holdincJ mernber 18 is then vertically ad~ust~d to the des:ired detent po~,ition 29 so as to place the pressure pad 20 in proxirnity to the blood vessel whose flow it must restrict The fine screw adjustment 30 is then to be used by turning the handle 56 above the cap 50 at the top of the support members ~6 to lower the pressure pad 20 into engagement it with the blood vessel Advant~c3eou~ly, the handle 56 i turned whit the physicidn or technici.ltl obc;rve~ bokh the indic~ltion of pc-~sure Oll the ensure g~u~3e 40 end listens to the flow indication Oe blood flow provided by the audible output s.iyllcll, unt.il desired restriction of ~97~
-12a-The blood vessel is obtained, without collapsing the vessel.
Once adjustment is perfected, the release lever 74 may be moved to pivot the arms 18 and pressure pad 20 upwardly and outwardly away from the site of the surgical procedure, so that the catherterization may be performed.
~9~ 3 Upon completion of the catheterization pro-edure and as the catheter is withdrawn, the pressure pad 20 may be quickly and accurately applied to control blood flow through the blood vessel, and thus bleeding at the puncture site; by moving the lever 74 into locking position to pivot the pressure pad ~0 into contact with : the blood vessel in the pre-adjusted pos;tion. gain, fine adjustments my be made to provide a calibrated pressure to control the blood flow through the artery by using the fine thread adjustment 30. Once accurate adjustment is accomplished, the physician or technician may then proceed with other needed tasks while listening to the blood slow pulses as detected by the blood flow sensor 21 and audibly produced by the signal processor 24.
tSA signif icant iEeature of this investion i5 that adequate blood flow through the blood vessel to lower extremities is always assured. If any change in blood flow through the artery should occur, it will become immediately apparent to the personnel in the area by a ~0 change in the sound provided hy the signal processor 24.
Emergency action can then he immediately taken.
P~rsonn~l, h~ev~r, may normally continue about their duties without maintaining supervision ox thy herno~tate oth~ thin li5tening to the signal provided ln response to ~5 blood flow through th0 artery4 hould an erner~ency ocur, the herno~tat 10 tnay by quickly removed by a 5imple unlocking ox the lever 74 to upwardly pi.vot the pressure pad 20 and arts 12 out of the way to remove the hemostat tO from the patient.
~0Figures 5 through 7 illustrate a second preferred embodiment of a hemostat 98 includinq blood flow sensor 21. Referring first to Figure 5, the hemostat 98 compri~e~ a support plate 100 having a slightly curved portlon 102 or placement below a pat$ent's body to position the hemostat ~8 in relation to the body of a patient during post-op~rative period when the hemv~t~t 98 is used to assist hemostasis. One end of the Bupport plate 100 is provided with a slat portion ~04 to which a bracket 10~ is fastened by any suitable means such as t0 welding or common threaded fasteners. An upri9ht support - member 108 is pivotally attached to the bracket 106 by a bolt or a hinge pin 112 and is allowed pivotal movement both toward and away from the support plate 100. A flat lower end 110 of the support member 108 is pivotally attached to the bracket 106 by the hinge pin 112 to provide pivotal movement between the upright support member 108 and the support plate 100. The flat end 110 of the support member 108 includes an arcuate slot 114 therein through which a wing bolt 116 extends to connect the support member 108 to the support plate 100. The wing bolt 116 passes through the slot 114 and is threaded into the bracket 106 so that when tightened, the wing jolt 116 will apply a compressive force between a flat portion 110 of the support member 108 and the bracket 106 to provide frictional engagement between the bracket 106 and support member 108 to hold the support member 108 in the desired pivotal position An upwardly extending por.ion 120 of the support member 108 is generally cylindrical in shape. preferably, the support member 108 is comprised of a hollow cylindrical tube which has its lower end flattened and machined to provide the described features. A mounting block 122 is slidably positioned over the upper portion 120 of the upright support member 108. The mounting block 122 includes bore 124 of a size slightly larger than the diame er of the cylindrical upper portion 12D of the .. . .... . . .
~97~
-15- . .
support member 108, which extends through the bore 12~ of the mounting block 122 for a loose sliding fit7 while providing sufficient rigidity ox the mounting block 122 on the upright member for substantially inflexible support.
lAdjustment of the position of the mounting block 122 on the support member 108 provides a coarse adjustment ox a pair of arms 126, which extend over the wound site.
The pair of arms 126 are connected to and extend in spaced relation from the mounting blsck 122 in cantilever fashion. The arms 126 engage matinq recesses 129 wormed in the sides of the mounting bloc 122, as shown in Figure 6. The arms 126 are attached wi}hin the recesses 128 by threaded fasteners 130. A wing scrQw 131 it threaded through an opposing end 132 of the mounting block 1~2 for lS engagement with the upright support member 103 to control movement of the mounting block 122 relative to the support member 108 and to hold the mounting block 122 in adjusted position on the upright support member 108. Loosening wing screw 131 permits adjustment of the position of the mounting block 122 along the length oE the support member 108 and permits rotation of the mounting block 122 about the axis of the support member 108 to facilitate movement of the arms 126 adjacent to or away from an artery.
A pressure pad holding member 134 is slidably mounted between the arms 126. With reference to Figure 7, the holding member 134 comprises a block 136 which has a generally rectangular cross section The block 136 is sized to have a width slightly meter than the spacing between the arms l26 for easy sliding engagement there~etween. The block 136 is positioned between the arms 126 with a lip 138 protruding from a lower portion ox each side of the block 136 to engage a lower edge 140 of the arms 126. The height of the block 136 above the upper face 141 of the protruding lips 138 is slightly less than the height of the arms 126. A plate 142 of rectangular shape having the same length of the block 136, though 76~;3 slightly wider, is fastened by threaded fasteners 144 to the upper portion of the block 136 when the block 136 is inserted between the arms 12~ to capture the block 136 bet~ee~n the arms t26 for sliding movement along the length 5 ` theredf. The plate 142 is attached at one end by threaded fasteners 144 end spaced by spacers 146 prom the upper surface of the block 136 so that the distance between the upper surface 141 of the protruding lip 1~8 and the lower surface of the plate 142 is slightly larger than the height of the protruding arms 125 to provide for easy sliding movement. A thumb screw 148 extends through the plate 12 at an opposing end and is threaded into the block 136 so that when the thumb screw 14~ is tightened the plate 142 is deflected toward the block 136, decreasing the distance between the upper surface 141 of the protruding lip 138 and the loser ~urfac~ of the plate 142 to apply force to the arms 126 between the lip t38 and the plate 142. The frictional engagement between the aFms 126 and the plate 142 and block 136 holds the pressure pad holding member 134 in adjusted position. Adjustment of the position of the pressure pad holding-member 134 thus provides accurate placement of a pressure pad 125 over a selected artery of the patient. The pressure pad 1~5 includes a sensor 21 of the type described with reference to Figure 1.
Continuing reference to Figure, 7, a pressure regulating assembly 150 includes a cylindrical pedcstal 152 for mounting the pressure pad 125 to the block 136.
The pressure regulating assembly 150 comprises a tubular member 154 which is press fitted into a counter bore 156 in the block 136, to position the tubular member 154 in perpendicular relation to the arms 126. The pedestal~152 is inserted into an interior passage 158 of the tubular T~ember 154, and through a sized bore 160 formed through the block 136 concentrically with the counter bore 156 to positron the pedestal 152 to support the press-lre pad ;~
~976~33 125. The pedestal 152 and the bore 160 formed through the block 136 have a sliding fit to allow sliding movement of the pedestal 152 within the block 13~.
The uppermost portion of the pedestal 152 has an enlarged cylindrical port;on 161 slightly smaller in diameter than the interior passage 158 in the tubular member 154 to maintain guided sliding engagement of the upper portion 161 oE the pedestal t52 within the passage ` 158. A spring 164 is positioned above the pedestal ~52 to tO apply force through the pedestal 152 to- the pressure pad - 125 to apply pressurP to an artery on which the pressure pad 125 is placed.
. An upper spring seat 168 is positioned over the spring 164 to position the upper face of the spring 164 in a desired vertical position within the tubular member 154.
An end cap 166 is threaded into the uppermost end of the tubular member 154. A screw 170 is threaded through the end cap 166 with a lower end of the screw 170 engaging the upper spring seat 108 to pOSitiQn the upper spring seat 108 in a desired position within the tubular member t5~.
The screw 170 compresses the spring 164l so that the spring 964 will apply force to the pedestal 152 and the pressure pad 125. Therefore, as the screw 170 is turned and screwed into the end cap 66, the upper spring seat 168 is lowered within the tubular member 154 to compress the spring 164 to provide increased .vressure-~o the pedestal 152 and the pressure pad 125. Adjustment of the screw 170 to control the compression of spring 164 provides an infinitely variable fine adjustment of the pressure applied to an artery positioned below the pressure pad 125.
The tubular member 154 includes a window 172 intermediately positioned between the upper and lower ends thereof, through which the enlarged portion t61 of the pedestal 152 may be viewed. A scale calibration 174 is posi~loned immediately adjacent the window 172 so that the '7~
pressure aplied by the pedestal 152 may be ascertained by viewing the position of the enlarged portion 161 relative to the calibration scale through the window 172.
the pressure pad t25 is mounted to the lowermost portion of the pedestal 152 and may be provided in a number of varied siæes for adaptation to the size of artery in which blood flow restriction is desîred.
referring to Figure 8, the lowPr portion of the pressure pad 125 is generally cylindrical, but the edge 184 between 10the face 186 ana the side 188 of the pressure pad 125 may be slightly curved to avoid having a sharp edge pressing against the patient's body.
Referring to Figures 5, 6, and 8, the hemostat 98 may conveniently include a light indicator 182, which is connected to the sensor 21 in the presure pad 1~5. The light indicator 1~2 flickers in response to pulsating blood flow to provide a visual indication of whether the pressure pad 125 is on an artery and to indicate the blood flow rate through the artery. The light indicator 18~
20 begins to flicker to indicate proper placement of the pressure pad 125 over an artery and continues to flicker when the pressure pad t25 is pressing on the artery in response to pulsating blood E1QW. The light indicator 1~2 ceases to flicker to indicate that the pressure pad 125 is removed from the artery or that blood flow through the artery has stopped, which may indicate excessive pressure between the pressure pad 125 and the artery.
- The blood slow sensor 21 is connected to an audible control unit 179 by a pair of wires 180. The audible control unit 179 includes a signal processor (not sh3wn in Figure 8), as described with reference to Figures 1 and 2. The audible control unit 179 produces a sound output which varies in pitch or volume in response to changes in blood flow through an artery adjacent the pressure pad 125.
Referring to Figures 5 and 6, the hemostat 98 may 6~3 , V
include a low-power radio frequency transmitter t90 connected to the output oE the sensor 21. The transmitter 190 may be conveniently mounted to the audible control unit 179. Transmitter t90 outputs a low power radio frequency signal which is capable of being received by a portable receiver (not shown several feet away prom transmitter 1~0, such as in a hospital room adiacent the room in which the hemostat 98 us in use. The receiver preferably converts the radio frequency signal into an audible signal. Thus, the t~ansmitteF 190 enables hospital personnel to monitor the progress of hemostasis without being in the same room as the patient.
Table I indicates the height, weight, and hemostasis time for 21 patients upon whom the invention was tested Ordinary catheters were inserted in patients 1 through 9, and 1 t-l 4 who had normal blood clotting rates. The blood of patient 10 clotted at a rate which was only 2~% of the normal blood clotting rate; therefore, the hemostasis time for this patient was much longer than the typical ten minute hemostasis time for a patient whose blood clots at the normal rate. Achieving hemostasis in patient tO`would have been extremely dificult using ordinary methods and would have required the constant attention of trained personnel. Patients 15-21 received an angiopla~ty which requires the insertion of a catheter which is much larger than the catheters used on patients 1-14.- of the group of patients who received an angioplasty, only patient 2~ had an unusually long hemostasis time Patient ~0 had received lO,000 units of Heparin, which prolonged the hemostasis time.
---20~
Patient Height _' -is Tlmo 5'8" 14~ 1/2 lb 10 minus 2 ' 5'0" 1~9 l
3 5-5" 151 10 5'7~ 194 l 5'10" 153 10 6 6'1/2" 212 10 7 51911 146 lQ
8 5'7" 103 10 9 6'3 ~34 1/2 10 11 5'6" 161 10 12 5'8" 162 15 13 5'2" 144 1û
14 5 ' 3 10 4 7 5'8" 138 10 16 5'7" 160 10 17 ' 4" ~68 20 18 6'6 192 10 19 5'3" 1 13 10 5' 1" 128 35 21 5 ' 7" 168 Jo 3~
~L~976~)~
Although the invention is described in detail with reference to speciic embodiments, modifications may be made which are within the scope and spirit of the invention. Accordingly thy scope of the invention is limited only b; the appended claims.
:
3û
.
,~5
8 5'7" 103 10 9 6'3 ~34 1/2 10 11 5'6" 161 10 12 5'8" 162 15 13 5'2" 144 1û
14 5 ' 3 10 4 7 5'8" 138 10 16 5'7" 160 10 17 ' 4" ~68 20 18 6'6 192 10 19 5'3" 1 13 10 5' 1" 128 35 21 5 ' 7" 168 Jo 3~
~L~976~)~
Although the invention is described in detail with reference to speciic embodiments, modifications may be made which are within the scope and spirit of the invention. Accordingly thy scope of the invention is limited only b; the appended claims.
:
3û
.
,~5
Claims (12)
1. A hemostat for restricting flow of blood in a blood vessel characterized by:
a mounting fixture;
an arm adjustabley mounted to the mounting fixture;
a pressure pad mounted to said arm for applying pressure to said blood vessel; and a sensor mounted with said pressure pad for detecting blood flow through the vessel, the sensor being responsive to the rate of blood flow through the vessel and providing an output signal in response thereto.
a mounting fixture;
an arm adjustabley mounted to the mounting fixture;
a pressure pad mounted to said arm for applying pressure to said blood vessel; and a sensor mounted with said pressure pad for detecting blood flow through the vessel, the sensor being responsive to the rate of blood flow through the vessel and providing an output signal in response thereto.
2. The hemostat of Claim 1 wherein the blood flow sensor generates an ultrasonic signal and uses a doppler effect caused by blood flow to produce the output signal.
3. The hemostat of Claim 1 or 2 further comprising an audio signal generator coupled to the output signal of the sensor for producing an audible signal which changes in frequency and volume in response to changes in blood flow rate through the blood vessel.
4. A hemostat according to Claim 1 further comprising a signal processor for providing a second output signal in response to said output signal of the sensor, the second output signal being indicative of changes in the rate of blood flow.
5. A hemostat according to Claim 1 further comprising apparatus for adjusting the force applied by the pressure pad to the blood vessel so that blood flow through the blood vessel may be accurately controlled.
6. The hemostat of Claim 5 further comprising a pressure indicator for indicating the force applied by the pressure pad to the blood vessel.
7. A hemostat according to Claim 1 wherein the arm is cantilever mounted to the mounting fixture.
8. A hemostat according to Claim 7 wherein the arm is pivotally mounted to the mounting fixture.
9. A hemostat according to Claim 8 wherein a lever and a linkage control pivotal movement of the arm relative to the mounting fixture.
10. A hemostat according to Claim 1 further including a visual indicator for indicating changes in blood flow through the blood vessel.
11. A hemostat according to Claim 1 further including a support plate; and a support member pivotally mounted to the support plate.
12. A hemostat according to Claim 11 wherein an arm is mounted to the support member with the arm being slidable along the support member and pivotal about the support member.
Applications Claiming Priority (4)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US33123681A | 1981-12-16 | 1981-12-16 | |
| US331,236 | 1981-12-16 | ||
| US06/398,621 US4509528A (en) | 1981-12-16 | 1982-07-15 | Hemostat with blood flow sensor |
| US398,621 | 1989-08-25 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA1197603A true CA1197603A (en) | 1985-12-03 |
Family
ID=26987650
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA000417720A Expired CA1197603A (en) | 1981-12-16 | 1982-12-15 | Hemostat with blood flow sensor |
Country Status (4)
| Country | Link |
|---|---|
| US (1) | US4509528A (en) |
| EP (1) | EP0082009A1 (en) |
| BR (1) | BR8207276A (en) |
| CA (1) | CA1197603A (en) |
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| US4742825A (en) * | 1986-09-05 | 1988-05-10 | Freund Medical Products, Inc. | Adjustable compress apparatus |
| DE3717045A1 (en) * | 1987-05-21 | 1988-12-15 | Bosch Gmbh Robert | DEVICE FOR VASOMETRY |
| DE3879266D1 (en) * | 1987-05-21 | 1993-04-22 | Optische Ind De Oude Delft Nv | DEVICE FOR VASOMETRY. |
| DE3720665A1 (en) * | 1987-06-23 | 1989-01-05 | Schael Wilfried | DEVICE FOR HAEMODIALYSIS AND HAEMOFILTRATION |
| GB8723621D0 (en) * | 1987-10-08 | 1987-11-11 | Eidawn Biosensors Ltd | Monitoring of cardiac output |
| DE69114369T2 (en) * | 1990-06-11 | 1996-06-20 | Radi Medical Systems | Thigh compression device. |
| US5197972A (en) * | 1991-03-25 | 1993-03-30 | Hakki A Hamid | Arterial manometric dressing |
| DK105591A (en) * | 1991-06-03 | 1992-12-04 | L L Medico V Helle Leth Kjelds | DEVICE FOR CLOSING THE OPERATION WARE AFTER INSERT IN AORTA |
| FR2697988A1 (en) * | 1992-11-16 | 1994-05-20 | Godillon Jean Francois | Compression apparatus for punctured femoral artery - comprises panel with adjustable side straps and cross-piece with inflatable cushion through which pressure is applied |
| US5997564A (en) * | 1995-11-17 | 1999-12-07 | I.B.S. International Biomedical Systems, S.R.L. | Femoral compression device for post-catheterization |
| US6254601B1 (en) * | 1998-12-08 | 2001-07-03 | Hysterx, Inc. | Methods for occlusion of the uterine arteries |
| US6699199B2 (en) * | 2000-04-18 | 2004-03-02 | Massachusetts Institute Of Technology | Photoplethysmograph signal-to-noise line enhancement |
| US6550482B1 (en) | 2000-04-21 | 2003-04-22 | Vascular Control Systems, Inc. | Methods for non-permanent occlusion of a uterine artery |
| US7223279B2 (en) * | 2000-04-21 | 2007-05-29 | Vascular Control Systems, Inc. | Methods for minimally-invasive, non-permanent occlusion of a uterine artery |
| US20030120306A1 (en) * | 2000-04-21 | 2003-06-26 | Vascular Control System | Method and apparatus for the detection and occlusion of blood vessels |
| US6638286B1 (en) | 2000-11-16 | 2003-10-28 | Vascular Control Systems, Inc. | Doppler directed suture ligation device and method |
| US6635065B2 (en) | 2000-11-16 | 2003-10-21 | Vascular Control Systems, Inc. | Doppler directed suture ligation device and method |
| US20030120286A1 (en) * | 2001-03-28 | 2003-06-26 | Vascular Control System | Luminal clip applicator with sensor |
| US7354444B2 (en) * | 2001-03-28 | 2008-04-08 | Vascular Control Systems, Inc. | Occlusion device with deployable paddles for detection and occlusion of blood vessels |
| WO2002078549A2 (en) | 2001-03-28 | 2002-10-10 | Vascular Control Systems, Inc. | Method and apparatus for the detection and ligation of uterine arteries |
| KR20030034439A (en) * | 2001-10-23 | 2003-05-09 | (주) 태웅메디칼 | A compression-style stanching device |
| US7207996B2 (en) * | 2002-04-04 | 2007-04-24 | Vascular Control Systems, Inc. | Doppler directed suturing and compression device and method |
| US7172603B2 (en) * | 2002-11-19 | 2007-02-06 | Vascular Control Systems, Inc. | Deployable constrictor for uterine artery occlusion |
| US20040097961A1 (en) | 2002-11-19 | 2004-05-20 | Vascular Control System | Tenaculum for use with occlusion devices |
| US7404821B2 (en) * | 2003-01-30 | 2008-07-29 | Vascular Control Systems, Inc. | Treatment for post partum hemorrhage |
| US7651511B2 (en) * | 2003-02-05 | 2010-01-26 | Vascular Control Systems, Inc. | Vascular clamp for caesarian section |
| US7333844B2 (en) * | 2003-03-28 | 2008-02-19 | Vascular Control Systems, Inc. | Uterine tissue monitoring device and method |
| US20040202694A1 (en) * | 2003-04-11 | 2004-10-14 | Vascular Control Systems, Inc. | Embolic occlusion of uterine arteries |
| US7325546B2 (en) * | 2003-11-20 | 2008-02-05 | Vascular Control Systems, Inc. | Uterine artery occlusion device with cervical receptacle |
| US7686817B2 (en) * | 2003-11-25 | 2010-03-30 | Vascular Control Systems, Inc. | Occlusion device for asymmetrical uterine artery anatomy |
| AU2004203059A1 (en) * | 2004-06-08 | 2005-12-22 | The Government Of The United States Of America As Represented By The Secretary Of The Department Of Health And Human Services, Centers For Disease Control And Prevention | Apparatus and method for assessing peripheral circulation to evaluate a physiological condition |
| US7875036B2 (en) * | 2004-10-27 | 2011-01-25 | Vascular Control Systems, Inc. | Short term treatment for uterine disorder |
| US20070049973A1 (en) * | 2005-08-29 | 2007-03-01 | Vascular Control Systems, Inc. | Method and device for treating adenomyosis and endometriosis |
| DE102011014304A1 (en) * | 2011-03-17 | 2012-09-20 | GS-Elektromedizinische Geräte, G. Stemple GmbH | Device for resuscitating a patient |
| US11701127B2 (en) * | 2012-03-06 | 2023-07-18 | Accumed Radial Systems, Llc | Hemostasis apparatus and method |
| CN104703552B (en) | 2012-08-13 | 2018-03-30 | 莫尔研究应用有限公司 | Radial artery equipment |
| WO2014036531A1 (en) * | 2012-08-30 | 2014-03-06 | Accumed Radial Systems, Llc. | Hemostasis sensor and method thereof |
| US9463026B2 (en) | 2012-11-21 | 2016-10-11 | Medical Ingenuities, LLC | Radial compression hemostasis band with Doppler confirming vascular patency |
| CN104758024B (en) * | 2015-04-19 | 2017-01-25 | 庄严 | Pressing bleeding stop device for department of cardiology |
| EP3302304A4 (en) | 2015-06-08 | 2019-02-27 | Richard F. Corrigan Jr. | Radial compression hemostasis band with doppler confirming vascular patency |
| CN105534557B (en) * | 2016-01-29 | 2018-12-04 | 甘起伟 | Light source positions compression hemostasis device |
| US10335045B2 (en) | 2016-06-24 | 2019-07-02 | Universita Degli Studi Di Trento | Self-adaptive matrix completion for heart rate estimation from face videos under realistic conditions |
| CN110786906A (en) * | 2018-08-03 | 2020-02-14 | 连新龙 | Tap type compression hemostat |
| CN109223089B (en) * | 2018-11-19 | 2020-12-11 | 卜凡莉 | Hemostasis compressor for cardiology |
| US11730487B2 (en) * | 2019-08-29 | 2023-08-22 | Mohammad Reza Rajebi | Vascular hemostasis system |
| CN112690864B (en) * | 2019-10-23 | 2022-03-22 | 苏州英途康医疗科技有限公司 | Medical instrument and automatic clamp feeding method |
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| CN112957091A (en) * | 2021-01-25 | 2021-06-15 | 贾士岭 | Intracardiac nurse is with pressing hemostasis device |
| CN216876486U (en) * | 2021-11-02 | 2022-07-05 | 深圳市人民医院 | Bracelet type anterior wall artery puncture postoperative wrapping device with blood flow monitoring function |
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| US3625219A (en) * | 1969-01-03 | 1971-12-07 | Raymond M Abrams | Apparatus to facilitate sealing of arterial punctures |
| US3825008A (en) * | 1971-06-19 | 1974-07-23 | R Shook | Apparatus for controlling flow of blood |
| US3777740A (en) * | 1971-10-21 | 1973-12-11 | Administrator For Veterans Aff | Method and apparatus for non-invasively visualizing blood vessels |
| US3779249A (en) * | 1972-04-19 | 1973-12-18 | H Semler | Artery clamp |
| US3884240A (en) * | 1973-08-03 | 1975-05-20 | C Malcolm B Gilman | Tourniquet |
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| US4154231A (en) * | 1977-11-23 | 1979-05-15 | Russell Robert B | System for non-invasive cardiac diagnosis |
| US4239047A (en) * | 1978-05-22 | 1980-12-16 | William L. Griggs, III | Method and apparatus for aurally determining presence or absence of pathological stenosis |
| US4256094A (en) * | 1979-06-18 | 1981-03-17 | Kapp John P | Arterial pressure control system |
| US4321929A (en) * | 1979-10-12 | 1982-03-30 | Lemelson Jerome H | Tourniquet |
-
1982
- 1982-07-15 US US06/398,621 patent/US4509528A/en not_active Expired - Lifetime
- 1982-12-13 EP EP82306651A patent/EP0082009A1/en not_active Withdrawn
- 1982-12-14 BR BR8207276A patent/BR8207276A/en unknown
- 1982-12-15 CA CA000417720A patent/CA1197603A/en not_active Expired
Also Published As
| Publication number | Publication date |
|---|---|
| BR8207276A (en) | 1983-10-18 |
| EP0082009A1 (en) | 1983-06-22 |
| US4509528A (en) | 1985-04-09 |
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