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    Methods and systems for vein harvesting and fistula creation
    2.
    发明授权
    Methods and systems for vein harvesting and fistula creation 有权

    公开(公告)号：US07074220B2

    公开(公告)日：2006-07-11

    申请号：US10366535

    申请日：2003-02-12

    申请人： Bradley Hill ,  Neil Holmgren ,  Bruce Modesitt

    发明人： Bradley Hill ,  Neil Holmgren ,  Bruce Modesitt

    IPC分类号： A61B18/18

    CPC分类号： A61B17/00008 ,  A61B18/1492 ,  A61B2017/00013 ,  A61B2090/3614

    摘要： Veins are removed using a pull catheter introduced over a guidewire which extends between first and second percutaneous access points. Optionally, a side branch management tool including an excision device and/or a viewing scope can be advanced over the same guidewire in the direction opposite to that of the pull catheter. In that way, as the pull catheter inverts the vein being removed, side branches can be selectively viewed and/or severed using the side branch management tool. Arteriovenous fistulas are formed by inverting a length of a vein, mobilizing the inverted length relocating the mobilized end of the vein, and connecting the mobilized end to an artery.

    Methods and systems for vein harvesting
    3.
    发明授权
    Methods and systems for vein harvesting 失效
    静脉采集方法和系统

    公开(公告)号：US06551314B1

    公开(公告)日：2003-04-22

    申请号：US10116730

    申请日：2002-04-03

    申请人： Bradley Hill ,  Neil Holmbren ,  Bruce Modesitt

    发明人： Bradley Hill ,  Neil Holmbren ,  Bruce Modesitt

    IPC分类号： A61B1818

    CPC分类号： A61B17/00008 ,  A61B18/1492 ,  A61B2017/00013 ,  A61B2090/3614

    摘要： Veins are removed using a pull catheter introduced over a guidewire which extends between first and second percutaneous access points. Optionally, a side branch management tool including an excision device and/or a viewing scope can be advanced over the same guidewire in the direction opposite to that of the pull catheter. In that way, as the pull catheter inverts the vein being removed, side branches can be selectively viewed and/or severed using the side branch management tool.

    摘要翻译： 使用在第一和第二经皮接入点之间延伸的导丝引入的拉动导管除去静脉。 可选地，包括切除装置和/或观察范围的侧支管理工具可以在与拉动导管相反的方向上在相同的导丝上前进。 以这种方式，当拉动导管反转被去除的静脉时，侧分支可以使用侧支管理工具被选择性地观察和/或切断。

    Apparatus and Method for Endovascular Device Guiding and Positioning Using Physiological Parameters
    4.
    发明申请
    Apparatus and Method for Endovascular Device Guiding and Positioning Using Physiological Parameters 有权
    血管内装置指导和使用生理参数定位的装置和方法

    公开(公告)号：US20090005675A1

    公开(公告)日：2009-01-01

    申请号：US12147401

    申请日：2008-06-26

    申请人： Sorin Grunwald ,  Fiona Maria Sander ,  Wilfred J. Samson ,  Bradley Hill ,  E. Tina Cheng

    发明人： Sorin Grunwald ,  Fiona Maria Sander ,  Wilfred J. Samson ,  Bradley Hill ,  E. Tina Cheng

    IPC分类号： A61B8/12

    CPC分类号： A61B8/463 ,  A61B5/0205 ,  A61B5/0215 ,  A61B5/026 ,  A61B5/029 ,  A61B5/042 ,  A61B5/0452 ,  A61B5/0456 ,  A61B5/0472 ,  A61B5/0476 ,  A61B5/0488 ,  A61B5/06 ,  A61B5/061 ,  A61B5/065 ,  A61B5/1459 ,  A61B5/6853 ,  A61B5/7405 ,  A61B5/742 ,  A61B7/04 ,  A61B8/02 ,  A61B8/06 ,  A61B8/08 ,  A61B8/0841 ,  A61B8/12 ,  A61B8/42 ,  A61B8/445 ,  A61B8/461 ,  A61B8/465 ,  A61B8/488 ,  A61B8/565 ,  A61B34/20 ,  A61B34/25 ,  A61B2017/00044 ,  A61B2017/00106 ,  A61B2017/00115 ,  A61B2017/22067 ,  A61B2034/2051 ,  A61B2034/2055 ,  A61B2034/252 ,  A61B2090/062 ,  A61B2090/064 ,  A61B2090/378 ,  G06F19/00 ,  G09B23/288

    摘要： An endovascular access and guidance system has an elongate body with a proximal end and a distal end; a non-imaging ultrasound transducer on the elongate body configured to provide in vivo non-image based ultrasound information of the vasculature of the patient; an endovascular electrogram lead on the elongate body in a position that, when the elongate body is in the vasculature, the endovascular electrogram lead electrical sensing segment provides an in vivo electrogram signal of the patient; a processor configured to receive and process a signal from the non-imaging ultrasound transducer and a signal from the endovascular electrogram lead; and an output device configured to display a result of information processed by the processor. An endovascular device has an elongate body with a proximal end and a distal end; a non-imaging ultrasound transducer on the elongate body; and an endovascular electrogram lead on the elongate body in a position that, when the endovascular device is in the vasculature, the endovascular electrogram lead is in contact with blood. The method of positioning an endovascular device in the vasculature of a body is performed by advancing the endovascular device into the vasculature; transmitting a non-imaging ultrasound signal into the vasculature using a non-imaging ultrasound transducer on the endovascular device; receiving a reflected ultrasound signal with the non-imaging ultrasound transducer; detecting an endovascular electrogram signal with a sensor on the endovascular device; processing the reflected ultrasound signal received by the non-imaging ultrasound transducer and the endovascular electrogram signal detected by the sensor; and positioning the endovascular device based on the processing step.

    摘要翻译： 血管内通路和引导系统具有带近端和远端的细长体; 所述细长主体上的非成像超声换能器被配置成提供患者的脉管系统的体内基于非图像的超声信息; 血管内电描记片在细长体上引导，当细长体处于脉管系统中时，血管内电描记图导线电传感段提供患者的体内电描记图信号; 处理器，被配置为接收和处理来自所述非成像超声换能器的信号和来自所述血管内电针引线的信号; 以及输出装置，被配置为显示由处理器处理的信息的结果。 血管内装置具有细长体，其具有近端和远端; 细长体上的非成像超声换能器; 以及在细长体上的血管内电描记线，该位置使得当血管内装置处于脉管系统中时，血管内电描记线与血液接触。 通过使血管内装置进入脉管系统来执行将血管内装置定位在身体脉管系统中的方法; 使用血管内装置上的非成像超声换能器将非成像超声信号传输到脉管系统中; 用非成像超声换能器接收反射超声信号; 用血管内装置上的传感器检测血管内电图信号; 处理由非成像超声波换能器接收到的反射超声信号和由传感器检测的血管内电描记信号; 以及基于所述处理步骤来定位所述血管内装置。

    Ultrasound methods of positioning guided vascular access devices in the venous system
    5.
    发明授权
    Ultrasound methods of positioning guided vascular access devices in the venous system 有权
    引导血管通路装置在静脉系统中的超声方法

    公开(公告)号：US08409103B2

    公开(公告)日：2013-04-02

    申请号：US11430511

    申请日：2006-05-08

    申请人： Sorin Grunwald ,  Bradley Hill

    发明人： Sorin Grunwald ,  Bradley Hill

    IPC分类号： A61B8/14

    CPC分类号： A61B34/20 ,  A61B5/02 ,  A61B5/02152 ,  A61B5/06 ,  A61B5/1459 ,  A61B5/7246 ,  A61B5/7271 ,  A61B5/742 ,  A61B8/04 ,  A61B8/06 ,  A61B8/0841 ,  A61B8/12 ,  A61B8/42 ,  A61B8/445 ,  A61B8/4472 ,  A61B8/461 ,  A61B8/488 ,  A61B8/5207 ,  A61B2017/00106 ,  A61B2034/2063 ,  A61B2090/378 ,  G06F19/00

    摘要： The invention relates to the guidance, positioning and placement confirmation of intravascular devices, such as catheters, stylets, guidewires and other flexible elongate bodies that are typically inserted percutaneously into the venous or arterial vasculature. An aspect of the invention includes, for example, an endovenous access and guidance system. The system comprises: an elongate flexible member adapted and configured to access the venous vasculature of a patient; a sensor disposed at a distal end of the elongate flexible member and configured to provide in vivo non-image based ultrasound information of the venous vasculature of the patient; a processor configured to receive and process in vivo non-image based ultrasound information of the venous vasculature of the patient provided by the sensor and to provide position information regarding the position of the distal end of the elongate flexible member within the venous vasculature of the patient; and an output device adapted to output the position information from the processor.

    摘要翻译： 本发明涉及通常经皮插入静脉或动脉脉管系统中的血管内装置（例如导管，样式，导丝和其它柔性细长体）的指导，定位和放置确认。 本发明的一个方面包括例如静脉内进入和引导系统。 该系统包括：细长的柔性构件，其适于和构造成接近病人的静脉血管; 传感器，其设置在所述细长柔性构件的远端处并且被配置为提供所述患者的静脉血管的体内基于非图像的超声信息; 处理器，被配置为接收和处理由传感器提供的患者的静脉血管的体内基于非图像的超声信息，并且提供关于细长柔性构件的远端在患者的静脉血管内的位置的位置信息 ; 以及适于从处理器输出位置信息的输出装置。

    Ultrasound methods of positioning guided vascular access devices in the venous system
    6.
    发明申请
    Ultrasound methods of positioning guided vascular access devices in the venous system 有权
    引导血管通路装置在静脉系统中的超声方法

    公开(公告)号：US20070016068A1

    公开(公告)日：2007-01-18

    申请号：US11430511

    申请日：2006-05-08

    申请人： Sorin Grunwald ,  Bradley Hill

    发明人： Sorin Grunwald ,  Bradley Hill

    IPC分类号： A61B8/14

    CPC分类号： A61B34/20 ,  A61B5/02 ,  A61B5/02152 ,  A61B5/06 ,  A61B5/1459 ,  A61B5/7246 ,  A61B5/7271 ,  A61B5/742 ,  A61B8/04 ,  A61B8/06 ,  A61B8/0841 ,  A61B8/12 ,  A61B8/42 ,  A61B8/445 ,  A61B8/4472 ,  A61B8/461 ,  A61B8/488 ,  A61B8/5207 ,  A61B2017/00106 ,  A61B2034/2063 ,  A61B2090/378 ,  G06F19/00

    摘要： The invention relates to the guidance, positioning and placement confirmation of intravascular devices, such as catheters, stylets, guidewires and other flexible elongate bodies that are typically inserted percutaneously into the venous or arterial vasculature. Currently these goals are achieved using x-ray imaging and in some cases ultrasound imaging. This invention provides a method to substantially reduce the need for imaging related to placing an intravascular catheter or other device. Reduced imaging needs also reduce the amount of radiation that patients are subjected to, reduce the time required for the procedure, and decrease the cost of the procedure by reducing the time needed in the radiology department. An aspect of the invention includes, for example, an endovenous access and guidance system. The system comprises: an elongate flexible member adapted and configured to access the venous vasculature of a patient; a sensor disposed at a distal end of the elongate flexible member and configured to provide in vivo non-image based ultrasound information of the venous vasculature of the patient; a processor configured to receive and process in vivo non-image based ultrasound information of the venous vasculature of the patient provided by the sensor and to provide position information regarding the position of the distal end of the elongate flexible member within the venous vasculature of the patient; and an output device adapted to output the position information from the processor.

    摘要翻译： 本发明涉及通常经皮插入静脉或动脉脉管系统中的血管内装置（例如导管，样式，导丝和其它柔性细长体）的指导，定位和放置确认。 目前，这些目标是使用X射线成像和某些情况下的超声成像实现的。 本发明提供了一种基本上减少与放置血管内导管或其他装置有关的成像的需要的方法。 降低成像需求还可减少患者所遭受的辐射量，减少手术所需的时间，并减少放射科所需时间，从而降低手术成本。 本发明的一个方面包括例如静脉内进入和引导系统。 该系统包括：细长的柔性构件，其适于和构造成接近病人的静脉血管; 传感器，其设置在所述细长柔性构件的远端处并且被配置为提供所述患者的静脉血管的体内非图像基超声信息; 处理器，被配置为接收和处理由传感器提供的患者的静脉血管的体内基于非图像的超声信息，并且提供关于细长柔性构件的远端在患者的静脉脉管系统内的位置的位置信息 ; 以及适于从处理器输出位置信息的输出装置。

    Apparatus and Method for Vascular Access
    9.
    发明申请
    Apparatus and Method for Vascular Access 审中-公开
    血管通路的装置和方法

    公开(公告)号：US20090118612A1

    公开(公告)日：2009-05-07

    申请号：US12147413

    申请日：2008-06-26

    申请人： Sorin Grunwald ,  Fiona Maria Sander ,  Wilfred J. Samson ,  Bradley Hill

    发明人： Sorin Grunwald ,  Fiona Maria Sander ,  Wilfred J. Samson ,  Bradley Hill

    IPC分类号： A61B8/00 ,  A61B7/00 ,  G06Q50/00

    CPC分类号： A61B8/12 ,  A61B5/0402 ,  A61B5/06 ,  A61B5/1459 ,  A61B5/411 ,  A61B7/00 ,  A61B8/06 ,  A61B8/0841 ,  A61B8/42 ,  A61B8/445 ,  A61B8/461 ,  A61B34/20 ,  A61B90/11 ,  A61B2017/00106 ,  A61B2017/003 ,  A61B2090/378 ,  A61B2090/3782 ,  A61B2090/3929 ,  G06Q50/22

    摘要： In an aspect, embodiments of the invention relate to the effective and accurate placement of intravascular devices such as central venous catheters, in particular such as peripherally inserted central catheters or PICC. One aspect of the present invention relates to vascular access. It describes devices and methods for imaging guided vascular access and more effective sterile packaging and handling of such devices. A second aspect of the present invention relates to the guidance, positioning and placement confirmation of intravascular devices without the help of X-ray imaging. A third aspect of the present invention relates to devices and methods for the skin securement of intravascular devices and post-placement verification of location of such devices. A forth aspect of the present invention relates to improvement of the workflow required for the placement of intravascular devices.

    摘要翻译： 在一方面，本发明的实施例涉及血管内装置如中心静脉导管，特别是例如外周插入的中心导管或PICC的有效和准确的放置。 本发明的一个方面涉及血管通路。 它描述用于成像引导血管通路的装置和方法以及更有效的无菌包装和处理这些装置。 本发明的第二方面涉及在没有X射线成像的帮助下血管内装置的引导，定位和放置确认。 本发明的第三方面涉及用于皮肤固定血管内装置的装置和方法以及这种装置的位置的放置后验证。 本发明的第四方面涉及改进放置血管内装置所需的工作流程。

    Endovenous access and guidance system utilizing non-image based ultrasound
    10.
    发明申请
    Endovenous access and guidance system utilizing non-image based ultrasound 有权
    使用非图像超声的无障碍访问和指导系统

    公开(公告)号：US20070016072A1

    公开(公告)日：2007-01-18

    申请号：US11431140

    申请日：2006-05-08

    申请人： Sorin Grunwald ,  Bradley Hill

    发明人： Sorin Grunwald ,  Bradley Hill

    IPC分类号： A61B8/14

    CPC分类号： A61B34/20 ,  A61B5/02 ,  A61B5/02152 ,  A61B5/06 ,  A61B5/1459 ,  A61B5/7246 ,  A61B5/7271 ,  A61B5/742 ,  A61B8/04 ,  A61B8/06 ,  A61B8/0841 ,  A61B8/12 ,  A61B8/42 ,  A61B8/445 ,  A61B8/4472 ,  A61B8/461 ,  A61B8/488 ,  A61B8/5207 ,  A61B2017/00106 ,  A61B2034/2063 ,  A61B2090/378 ,  G06F19/00

    摘要： The invention relates to the guidance, positioning and placement confirmation of intravascular devices, such as catheters, stylets, guidewires and other flexible elongate bodies that are typically inserted percutaneously into the venous or arterial vasculature. Currently these goals are achieved using x-ray imaging and in some cases ultrasound imaging. This invention provides a method to substantially reduce the need for imaging related to placing an intravascular catheter or other device. Reduced imaging needs also reduce the amount of radiation that patients are subjected to, reduce the time required for the procedure, and decrease the cost of the procedure by reducing the time needed in the radiology department. An aspect of the invention includes, for example, an endovenous access and guidance system. The system comprises: an elongate flexible member adapted and configured to access the venous vasculature of a patient; a sensor disposed at a distal end of the elongate flexible member and configured to provide in vivo non-image based ultrasound information of the venous vasculature of the patient; a processor configured to receive and process in vivo non-image based ultrasound information of the venous vasculature of the patient provided by the sensor and to provide position information regarding the position of the distal end of the elongate flexible member within the venous vasculature of the patient; and an output device adapted to output the position information from the processor.

    摘要翻译： 本发明涉及通常经皮插入静脉或动脉脉管系统中的血管内装置（例如导管，样式，导丝和其它柔性细长体）的指导，定位和放置确认。 目前，这些目标是使用X射线成像和某些情况下的超声成像实现的。 本发明提供了一种基本上减少与放置血管内导管或其他装置有关的成像的需要的方法。 降低成像需求还可减少患者所遭受的辐射量，减少手术所需的时间，并减少放射科所需时间，从而降低手术成本。 本发明的一个方面包括例如静脉内进入和引导系统。 该系统包括：细长的柔性构件，其适于和构造成接近病人的静脉血管; 传感器，其设置在所述细长柔性构件的远端处并且被配置为提供所述患者的静脉血管的体内非图像基超声信息; 处理器，被配置为接收和处理由传感器提供的患者的静脉血管的体内基于非图像的超声信息，并且提供关于细长柔性构件的远端在患者的静脉脉管系统内的位置的位置信息 ; 以及适于从处理器输出位置信息的输出装置。