FR2555432A1 - Method for puncturing blood vessels combining a needle propeller with a Doppler ultrasonograph which guides it - Google Patents

Method for puncturing blood vessels combining a needle propeller with a Doppler ultrasonograph which guides it Download PDF

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Publication number
FR2555432A1
FR2555432A1 FR8318794A FR8318794A FR2555432A1 FR 2555432 A1 FR2555432 A1 FR 2555432A1 FR 8318794 A FR8318794 A FR 8318794A FR 8318794 A FR8318794 A FR 8318794A FR 2555432 A1 FR2555432 A1 FR 2555432A1
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France
Prior art keywords
method
needle
doppler
puncture
vessel
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Pending
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FR8318794A
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French (fr)
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Franceschi Claude
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Priority to FR8318794A priority Critical patent/FR2555432A1/en
Publication of FR2555432A1 publication Critical patent/FR2555432A1/en
Application status is Pending legal-status Critical

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/06Measuring blood flow
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/150007Details
    • A61B5/150015Source of blood
    • A61B5/15003Source of blood for venous or arterial blood
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/150007Details
    • A61B5/150053Details for enhanced collection of blood or interstitial fluid at the sample site, e.g. by applying compression, heat, vibration, ultrasound, suction or vacuum to tissue; for reduction of pain or discomfort; Skin piercing elements, e.g. blades, needles, lancets or canulas, with adjustable piercing speed
    • A61B5/150106Means for reducing pain or discomfort applied before puncturing; desensitising the skin at the location where body is to be pierced
    • A61B5/15016Means for reducing pain or discomfort applied before puncturing; desensitising the skin at the location where body is to be pierced by accessories for bringing the piercing element into the body, e.g. through rotation of the piercing element
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/150007Details
    • A61B5/150175Adjustment of penetration depth
    • A61B5/15019Depth adjustment mechanism using movable stops located inside the piercing device housing and limiting the travel of the drive mechanism
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/150007Details
    • A61B5/150748Having means for aiding positioning of the piercing device at a location where the body is to be pierced
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/153Devices specially adapted for taking samples of venous or arterial blood, e.g. with syringes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/48Other medical applications
    • A61B5/4887Locating particular structures in or on the body
    • A61B5/489Blood vessels
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/08Detecting organic movements or changes, e.g. tumours, cysts, swellings
    • A61B8/0833Detecting organic movements or changes, e.g. tumours, cysts, swellings involving detecting or locating foreign bodies or organic structures
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B8/00Diagnosis using ultrasonic, sonic or infrasonic waves
    • A61B8/12Diagnosis using ultrasonic, sonic or infrasonic waves in body cavities or body tracts, e.g. by using catheters
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M5/00Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests
    • A61M5/42Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests having means for desensitising skin, for protruding skin to facilitate piercing, or for locating point where body is to be pierced
    • A61M5/427Locating point where body is to be pierced, e.g. vein location means using ultrasonic waves, injection site templates
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/150007Details
    • A61B5/150374Details of piercing elements or protective means for preventing accidental injuries by such piercing elements
    • A61B5/150381Design of piercing elements
    • A61B5/150389Hollow piercing elements, e.g. canulas, needles, for piercing the skin
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00Detecting, measuring or recording for diagnostic purposes; Identification of persons
    • A61B5/15Devices for taking samples of blood
    • A61B5/150007Details
    • A61B5/150374Details of piercing elements or protective means for preventing accidental injuries by such piercing elements
    • A61B5/150381Design of piercing elements
    • A61B5/150503Single-ended needles

Abstract

The invention relates to a method for puncturing blood vessels characterised by the coupling of a rapid needle propeller 1, 2, 6 with a Doppler-effect ultrasonograph which guides it 5, 8. The effect of this method is to reduce the trauma due to puncture, by the speed of propulsion of the needle. The effect of this method is to make the puncture easy and precise to perform by guiding of the needle, by means of a Doppler-effect ultrasonograph. The applications of this method essentially relate to human and veterinary medicine for the intra-vascular injection of therapeutic or diagnostic substances as well as for blood sampling. <IMAGE>

Description

PROCEDE DE PONCTION DES VAISSEAUX SANGUINS ASSOCIANT UN PUNCTURE PROCESS COMBINING A BLOOD VESSEL
PROPULSEUR D AIGUILLE A UN ULTRASONOGRAPHE DOPPLER QUI BOW OF A NEEDLE WITH DOPPLER ultrasonograph
LE GUIDE. GUIDE.

La présente invention a trait à un procédé de ponction des vaisseaux sanguins associant un propulseur d aiguille à un vélocimètre Doppler ultrasonore qui le guide. The present invention relates to a puncture process of blood vessels involving a thruster needle to an ultrasound Doppler velocimetry which the guide. Les appareils à effet Doppler ainsi que le-système de propulsion ne font donc pas en soi l'objet de cette invention. The Doppler devices and the propulsion-system are therefore not in itself the object of this invention.

La ponction des vaisseaux, artères et veines, est indispensable en médecine humaine et vétérinaire à l'administration des nombreuses thérapeutiques ainsi qu'à l'injection de produits de contraste ou d'isotopes, destinés au diagnostic. The puncture of the vessels, arteries and veins, is essential in human and veterinary medicine for the administration of many therapeutic as well as the injection of contrast agents or isotopes for diagnosis.

La ponction se fait actuellement à la main, ce qui a pour effet de provoquer un traumatisme des parois des vaisseaux et de tissus environnants, en raison de la lenteur de pénétration des aiguilles. The puncture is currently done by hand, which has the effect of causing trauma to the vessel wall and surrounding tissues, due to the slow penetration of the needles.

La ponction est actuellement guidée par la vue pour les veines très superficielles, par la palpation manuelle pour les artères et par des repères anatomiques pour les veines profondes. The puncture is currently guided by the view for very superficial veins by manual palpation for the arteries and anatomical landmarks for the deep veins. Dans ces deux dernières circonstances la précision de la ponction est sujette à erreur dans un nombre important de cas, en raison des variations anatomiques, de la difficulté de palper les pouls, ce qui nécessite de la répéter plusieurs fois, ce qui aggrave son caractère traumatisant, pour parfois ne pas aboutir à la pénétration souhaitée dans le vaisseau. In the latter two circumstances the accuracy of the puncture is prone to error in a significant number of cases, due to anatomical variations, difficulty to feel the pulse, which requires repeat several times, adding to its traumatic nature to sometimes not lead to the desired penetration into the vessel. De plus, aucune information ne permet d'éviter une ponction dans une zone dangereuse du fait de la pathologie du vaisseau : thrombus dans une veine, thrombus ou rétrécissement focale dans une artère. Moreover, there is no information to avoid a puncture in a dangerous area because of the condition of the vessel: thrombus in a vein thrombus or focal narrowing in an artery.

La présente invention se propose de remédier à ces inconvénients en permettant une ponction moins traumatisante grâce à une grande vitesse de pénétration de l'aiguille (qui de plus peut être bien plus fine que celles qui sont nécessaires à la ponction manuelle), en guidant précisemment la The present invention proposes to overcome these disadvantages by providing a less traumatic puncture through high rate of penetration of the needle (which again can be much finer than those required for manual puncture), guiding precisely the
Ponction sur le vaisseau choisi (et en reconnaissant de plus les zones dangereuses : rétrécissements, thrombus) grâce au guidage de l'aiguille par la sonde d'un vélo- cimètre Doppler â ultrasons simplement posée sur la peau, le signal Doppler détectant le vaisseau circulant et ses éventuelles anomalies. Puncture the selected vessel (and recognizing more hazardous areas: strictures, thrombosis) due to guidance of the needle by the probe of an ultrasonic Doppler bike-cimètre simply placed on the skin, the Doppler signal detecting vessel flowing and any anomalies.

Enfin, cette ponction est moins douloureuse pour le patient en raison de la pénétration rapide de l'aiguille, mais aussi du fait que par sa précision, elle n'a pas besoin d'être repetée. Finally, the puncture is less painful for the patient due to the rapid penetration of the needle, but also because of its precision, it need not be repeated.

La présente invention se caractérise donc par le couplage d'une sonde d'ultrasonographe a effet Doppler un dispositif de ponction rapide des vaisseaux sanguins, tel qu'il est schématisé sur les figures I et Il. The present invention is thus characterized by coupling a probe ultrasonograph has Doppler effect a rapid puncture device for blood vessels, as shown schematically in Figures I and II.

La figure I représente le dispositif en position avant le tir, la figure Il représente le dispositif en fin de tir. Figure I shows the device in position prior to firing, Figure It represents the end shooter device.

Le dispositif de ponction rapide est constitué d'un porte aiguille (1) monté sur un propulseur (2) constitué soit d'un ressort a détente dont on peut régler la tension et la longueur de détente par des gâchettes sur crémaillère (3), afin d'obtenir la force et la longueur de pénétration désirée, soit d'un électro aimant piloté dans sa course par le temps de passage du courant dans la bobine (4). The rapid puncture device is constituted by a needle holder (1) mounted on a bow (2) consists either of a spring detent which can adjust the tension and the length of relaxation by the tumblers on rack (3), in order to obtain strength and desired length of penetration, either an electromagnet controlled in its stroke by the current passing time in the coil (4).

Le dispositif Doppler est constitué d'une sonde (5) solidaire du dispositif de~ponction au moyen d'un porte-sonde (6) avec lequilelle entretient des rapports réglables de direction, de décalage et d'angulation, au moyen de molettes et rotules (7). The Doppler device comprises a probe (5) integral with the ~ puncturing device by means of a probe holder (6) with adjustable lequilelle maintains reports direction, offset and angulation, by means of wheels and ball joints (7).

Le système Doppler (8) est soit un vélocirnètre ultrasonore a émission continue, focalisée et directionnelle, qui donne précisément la direction, la vitesse et éventuellement les anomalies de 1'hémodynamique du vaisseau à ponctionner, soit un vélocimètre ultrasonore à émission pulsée qui a pour avantage de reconnaître, en plus des données fournies par le Doppler à émission continue, la profondeur exacte du vaisseau (9) par rapport au plan cutané (10) permettant de définir de surcroit la profondeur de pénétration optimale de l'aiguille (11). The Doppler system (8) is either an ultrasonic vélocirnètre a continuous emission, focused and directional, which specifically gives the direction, the speed and optionally the 1'hémodynamique abnormalities of the vessel to be punctured or an ultrasound velocimeter pulsed emission which has advantage to recognize, in addition to data supplied by the Doppler continuous wave, the exact depth of the ship (9) relative to the skin surface (10) to define addition that optimal penetration depth of the needle (11). Le réglage de la profondeur de pénétration de l'aiguille pouvant être soit manuel(3) (4), soit automatique par l'appareil Doppler pulsé réglant la course de l'électro aimant en fonction de la mesure automatique par Doppler pulsé de la profondeur du vaisseau, au moyen d'un aéclencheur électronique (12). Adjusting the penetration depth of the needle may be either manual (3) (4) or automatically by the pulsed Doppler device controlling the electro magnet race according to the automatic measurement by pulsed Doppler depth vessel by means of an electronic aéclencheur (12).

Le dispositif de ponction rapide est donc solidaire du dispositif du recueil du signal Doppler en un ensemble léger et maniable, dans lequel sont réglables à volonté la direction du tir de l'aiguille dans les 3 dimensions de l'espace par rapport à la direction du signal Doppler recueilli. The rapid puncture device is integral with the collection device of the Doppler signal into a light and handy assembly wherein are adjustable at will the direction of fire of the needle into the three dimensional space relative to the direction of collected Doppler signal.

De plus, l'utilisation d'un Doppler pulsé permet de régler la profondeur de pénétration de l'aiguille selon la distance mesurée du vaisseau par rapport à la peau. In addition, the use of a pulsed Doppler adjusts the penetration depth of the needle according to the measured distance of the vessel relative to the skin.

Ces caractéristiques rendent, par rapport aux méthodes manuelles habituelles, la ponction des vaisseaux à la fois plus simple, plus rapide, plus précise et plus sure d'exécution pour le praticien, moins traumatisante et moins douloureuse dans ses effets pour le patient. These characteristics make, compared to the usual manual methods, the puncture of the vessels at once simpler, faster, more accurate and safer execution for the practitioner, less traumatic and less painful in its effects for the patient.

Claims (5)

REVENDICATIONS
1. Procédé de ponction des vaisseaux caractérisé par le fait qu'il associe un système de ponction (1, 2, 6) avec un système de repérage de vaisseau par ultrasonographie Doppler bi-directionnel ou non à émission continue ou pulsée. 1. A method of puncturing the vessel characterized in that it associates a puncture system (1, 2, 6) with a Doppler ultrasound by vessel tracking system bi-directional or non-continuous or pulsed emission. (5~)~ (5 ~) ~
2. Procédé selon la revendication 1 caractérisé par le fait que la ponction est rapide (1) et réglable (3) (4) (12) dans sa course. 2. A method according to claim 1 characterized in that the puncture is fast (1) and adjustable (3) (4) (12) in its stroke.
3. Procédé selon les revendications 1 et 2 caractérisé par le fait que le repérage du vaisseau par la sonde a ultrasonographie Doppler guide la direction de tir du système de ponction rapide, au moyen d'une articulation entre le système propulseur de l'aiguille et le système de repérage du vaisseau permettant de régler leurs rapports de direction, de décalage et d'angulation (3). 3. Process according to claims 1 and 2 characterized in that the identification of the vessel by the Doppler ultrasound probe guide the shooting direction of the quick puncture system by means of a hinge between the propellant system of the needle and the vessel tracking system for adjusting their management reports, shift and angulation (3).
4. Procédé selon les revendications 1, 2 et 3 caractérisé par le fait qu'il permet de régler la profondeur de pénétration souhaitée de l'aiguille par rapport au plan cutané. 4. Process according to Claims 1, 2 and 3 characterized by the fact that to adjust the desired depth of penetration of the needle relative to the skin surface.
5. Procédé -selon les revendications 1, 2, 3 et 4 caractérisé par le fait que la profondeur de pénétration de l'aiguille utile pour atteindre le vaisseau par rapport au plan cutané peut être repérée par llultra- sonographie Doppler à émission pulsé et commandée automatiquement (4) (5) 5. A method -according to Claim 1, 2, 3 and 4 characterized in that the penetration depth of the needle useful to reach the vessel relative to the skin surface can be identified by llultra- Doppler sonography pulsed emission and controlled automatically (4) (5)
FR8318794A 1983-11-25 1983-11-25 Method for puncturing blood vessels combining a needle propeller with a Doppler ultrasonograph which guides it Pending FR2555432A1 (en)

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FR8318794A FR2555432A1 (en) 1983-11-25 1983-11-25 Method for puncturing blood vessels combining a needle propeller with a Doppler ultrasonograph which guides it

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