US20230321421A1

US20230321421A1 - Hemostasis valve device

Info

Publication number: US20230321421A1
Application number: US18/333,337
Authority: US
Inventors: Joseph Borrello; Jacob Wolf; Alexis Bruhat; Thomas Oxley; Anthony Costa
Original assignee: Merit Medical Systems Inc
Current assignee: Merit Medical Systems Inc
Priority date: 2020-12-14
Filing date: 2023-06-12
Publication date: 2023-10-12
Also published as: WO2022132639A1; EP4259263A1; US20220184367A1; WO2022133438A1; EP4259262A1

Abstract

A hemostasis valve device includes a valve body having an open first end and an open second end with a main lumen extending from the open first end to the open second end. The valve includes a valve member disposed within the main lumen of the valve body at or proximate to the open first end, the valve member having an open position and a closed position. An actuator is disposed between the valve member and the open second end. The actuator is configured to move the valve member between the open position and the closed position.

Description

CROSS REFERENCE TO RELATED APPLICATION

The present application claims priority to and the benefit of US patent application Ser. No. 63/124,996, filed Dec. 14, 2020, which is hereby expressly incorporated by reference in its entirety.

TECHNICAL FIELD

The present disclosure relates to medical devices and instruments and more particularly, the present disclosure relates to hemostasis valve devices with improved actuators and hemostasis cannula units containing hemostasis valves.

BACKGROUND

Current surgical procedures often require temporary and at times repeated introduction of catheters (cannulas device) and/or guidewires and/or other instruments into the neuroendovascular and/or cardiovascular system of a patient. For example, a catheter can be introduced into the body of a patient and be used to deliver fluid, such as a medicament, directly to a predetermined location within the patient's neuroendovascular and/or cardiovascular system. Catheters can also be used for exploratory surgery and for removing tissue samples within a body.
A common catheter design used in performing many procedures includes an elongated, flexible, cylindrical catheter body that has a fluid flow passageway or a lumen extending along the interior of the catheter body. In one exemplary procedure, an end of the catheter is inserted into a vessel within the vasculature of the patient. The catheter is advanced along the internal passageway of the vessel until the end of the catheter is located at a predetermined location within the patient's body. This location is often associated with a point at which a medicament is to be delivered or a therapeutic procedure is to be performed.
In order to position the catheter, a long, cylindrical, and rigid but manipulable guidewire is often used to direct the catheter to a desired location within the body. In other words, the rigid configuration and small diameter of such guidewires are specially configured for directing and advancing the guidewire to a desired location within the cardiovascular system. The end of the guidewire, positioned outside the body of the patient, is then received within the lumen of the catheter. Using the guidewire as a guide, the catheter is advanced along the length of the guidewire so as to properly position the catheter within the body of the patient. The guidewire can then be removed from within the catheter to open the lumen of the catheter.
It will be appreciated that medical procedures which utilize catheters often require the insertion and removal of several different types of catheters and guidewires. One of the issues that is encountered with the insertion and removal of catheters and guidewires is controlling bleeding at the point where the catheters and guidewires are first introduced into the cardiovascular system. One approach which has been utilized to control the bleeding at the catheter insertion point while also facilitating insertion and removal of the catheter and/or guidewire within the cardiovascular system is to utilize an introducer during the insertion procedure. An introducer is a relatively large gauge tube which is inserted into the patient. One end of the introducer is positioned outside the body of the patient and is attached to an adapter. The adapter typically comprises a short, rigid tube having a passageway extending therethrough. The adapter tube includes a valve commonly referred to as a hemostasis valve.
The hemostasis valve, which either closes independently or is compressed around the catheter and/or guidewire, restricts blood from spilling out of the adapter through the lumen of the valve.
A hemostasis valve is routinely used in neuroendovascular procedures to decrease the risk of thromboembolism and more specifically, a hemostasis valve is commonly used for continuous irrigation of guide and microcatheters to decrease the risk of thromboembolism. A conventional hemostasis valve has a rotating seal at the end, which is turned open or closed each time a wire or microcatheter/guidewire is introduced or extracted. Often this results in significant back bleeding. When a rotating seal is adjusted suboptimally during a wire or microcatheter manipulation, leakage of pressurized saline from the end of a hemostasis valve results in stagnation of blood within a guiding catheter, which becomes a potential source of emboli during a procedure.
There are a wide variety of hemostasis valve devices that are commercially available; however, these valves suffer from the main disadvantage that these hemostasis valve devices require two hands to operate in that the surgeon holds the valve body in one end and in the case of a rotatable actuator, the surgeon uses his or her other hand to manipulate the rotatable actuator to effectuate opening and closing of the hemostasis valve. In addition, many hemostasis valve devices have lengths that are too great to permit access into the brain to perform neuroendovascular procedures.
The present disclosure sets forth hemostasis valves that are configured so that the surgeon can use one hand to both hold and manipulate the actuator to cause opening and closing of the valve.

SUMMARY

A hemostasis valve device, according to one embodiment, includes a valve body having an open first end and an open second end with a main lumen extending from the open first end to the open second end. The valve includes a valve member disposed within the main lumen of the valve body at or proximate to the open first end, the valve member having an open position and a closed position. An actuator is disposed between the valve member and the open second end. The actuator is configured to move the valve member between the open position and the closed position. The actuator is located along a side of the valve body and is configured to translate a force applied to the actuator into opening of the valve member. For example, the actuator is configured to translate an applied force that is perpendicular (normal) to a longitudinal axis of the main lumen into a longitudinal force that causes the valve member to open.
The actuator can include a first portion that is accessible along one or more sides of the valve body and a second portion that is disposed completely within the main lumen, the first portion being configured to translate the applied force into axial translation of the second portion within the main lumen resulting in the valve member being breached and opened by the second portion.
In another embodiment, the actuator comprises a pair of two-bar linkages that are pivotally coupled to the valve body and move between a relaxed position in which the valve member is closed and a compressed position in which the valve member is open.
In yet another embodiment, an actuator is configured to translate axial, longitudinal motion along the exterior of the device into axial movement of another part of the actuator to cause opening and closing of the valve member.

BRIEF DESCRIPTION OF THE DRAWING FIGURES

FIG. 1 is a perspective view of a hemostasis valve device according to a first embodiment;

FIG. 2 is a cross-sectional view of the hemostasis valve device with an actuator being shown in a first at rest position;

FIG. 3 is another cross-sectional view of the hemostasis valve device in the first, at rest, position;

FIG. 4 is another cross-sectional view of the hemostasis valve device in the first, at rest, position;

FIG. 5 is another perspective view of the hemo stasis valve device;

FIG. 6 is a cross-sectional view of the hemostasis valve device with an actuator being shown in a second actuated position;

FIG. 7 is a cross-sectional view of a hemostasis valve device that includes a different actuator;

FIG. 8 is another cross-sectional view thereof;

FIG. 9 is an exploded perspective view of a hemostasis valve device according to another embodiment;

FIG. 10 is a top plan view thereof showing the device in a first at rest position;

FIG. 11 is a cross-sectional view taken along the line A-A of FIG. 10 ;

FIG. 12 is a top plan view thereof showing the device in a second actuated position; and

FIG. 13 is a cross-sectional view taken along the line A-A of FIG. 12 .

DETAILED DESCRIPTION OF CERTAIN EMBODIMENTS

FIGS. 1-6 illustrate a hemostasis valve device 100 that is configured to mate with a cannula device (not shown), such as a catheter or the like, as well as other external devices, such as medical instruments, etc. that are intended to be fed through the hemostasis valve device 100. The device 100 includes a hollow main body (manifold) 110 that has an open first end 112 and an opposing open second end 114 with a main lumen 120 extending completely from the first end 112 to the second end 114. The main body 110 thus can be thought of as being a central tubular body. As shown in the figures, the main lumen 120 can have a non-uniform shape in that one end of the main lumen 120 can have a diameter (width) that is different than the other end and/or other portions of the main lumen 120. In some areas within the body 110, the main lumen 120 can be defined by a tubular structure 129.
The main body 110 can be formed of any number of suitable materials including but not limited to plastics.
A catheter access section 130 is defined at the second end 114 of the main body 110 and is configured to mate with an external device, such as the cannula device, (not shown). As shown, the catheter access section 130 has an inner surface or face 132 that can be a threaded section and an external surface of face 134. The external surface 134 can be a ribbed surface as shown. The threaded inner surface 132 is thus configured to mate with external threads that are part of the cannula device to couple the cannula device to the catheter access section 130. For example, the cannula device can be screwed onto the threaded inner surface 132 of the catheter access section 130 to couple the cannula device to the device 100. The lumen of the cannula device is thus placed in fluid communication with the main lumen 120 when the cannula device is coupled to the device 100.
As shown in FIG. 3 , the main lumen 120, defined by the tubular structure 129, extends beyond the end of the access section 130.
Connection Branch 140
The main body 110 also includes a connection branch 140 that extends radially outward from a first side 111 of the main body 110 between the first end 112 and the second end 114. In the industry, this type of arrangement is known as a hemostasis valve Y connector and as mentioned, traditionally, such Y connectors can include a rotating male luer lock and a female luer lock sideport or other types of actuators/locks.
The first side 111 of the main body 110 can be considered to be a top side/top surface of the main body 110. The connection branch 140 is a tubular structure that has an exposed, free end 142 to which an external device (not shown) is attached. A lumen 141 is formed in the connection branch 140. For example, the external device can be a syringe that permits a fluid, such as medication, to be dispensed into the main lumen 120 since the connection branch 140 is in fluid communication with the main lumen 120. The free end 142 is configured to permit the external device to be coupled in a sealed manner to the free end 142. For example, the free end 142 can be in the form of a threaded end or it can be in the form of a luer fitting (luer lock sideport).
Finger Supports 145, 147
One feature of the device 100 is that the connection branch 140 also serves as a first finger rest in that an inner surface 143 can be a sloped surface and more particularly, the lower portion of the inner surface 143 adjacent the main body 110 can be a sloped surface (concave shaped) to permit resting of a finger thereagainst. In addition, along the connection branch 140 there is a first finger support 145. The first finger support 145 can be in the form of a curved protrusion (finger) that protrudes outwardly from the first side 111 in the direction toward the second end 114 of the main body 110. The first finger support 145 defines the upper end of the curved, sloped inner surface 143 that receives the finger.
A second side 113 of the main body 110, which can be considered to be a bottom side/bottom surface, includes a second finger support 147. The second finger support 147 comprises a curved protrusion (finger) that protrudes outwardly from the second side 113 in the direction toward the second end 114 of the main body 110. The second finger support 147 can be located slightly closer to the first end 112 of the main body 110 compared to the first finger support 145. As shown, both of the first finger support 145 and second finger support 147 have a concave shape in the direction of the of the second end 114.
Based on the foregoing construction, each of the first side 111 and the second side 113 is a swept surface that provides an ergonomic design to the main body 110 that can be grasped and held by the user.
Valve Member 200
The device 100 includes a valve member 200 that moves between an open position and a closed position. In the open position, an external device, such as a surgical instrument and/or guide wire, can be fed through the valve member 200. In the closed position, the valve member 200 is sealed shut. The valve member 200 is disposed at or proximate to the first end 112. The valve member 200 can take many different forms and in the illustrated embodiment, the valve member 200 can take the form of an elastic gasket that moves between the open and closed positions when a force is applied.
The valve member 200 is thus located within main body 110 and more particularly, the valve member 200 is located within (along) the main lumen 120 and thus, in the open position of the valve member 200, the main lumen 120 is open. Conversely, when the valve member 200 is closed, the main lumen 120 is occluded.
The valve member 200 can have a cylindrical shape that has a first end 202 that is located at or proximate the first end 112 of the device 100 and an opposing second end 204. The valve member 200 also includes an inner wall 210 that extends across a side wall of the valve member 200 within the hollow interior of the valve member 200. The inner wall 210 has an openable/sealable slit or opening 215 formed therein (e.g., a single slit or cross-hair shaped slit). The opening of the valve member 200 is marked by the opening of the opening 215 and conversely, the closing of the valve member 200 is marked by the closing/sealing of the opening 215. As shown in FIG. 2 , the inner wall 210 is at or proximate to the first end 202 and does not extend completely to the second end 204 resulting in an open space 205 being formed in the valve member 200 at the first end 202. In the illustrated embodiment, the open space 205 has a cylindrical shape.
As shown, the valve member 200 can be contained in an enlarged interior space within the main body 110 with the side wall of the valve member 200 being in contact with the inner wall of the main body 110 that defines this enlarged interior space. The opening of the main body 110 at the first end 112 can have an enlarged size relative to the opening at the first end 114. The opening at the first end 112 serves as an entrance into which an external device (e.g., a surgical instrument and/or guide wire, etc.) can be inserted, while the opening at the second end 114 serves as an exit through which the external device exits.
Actuator 300
The device 100 also includes an actuator 300 that is configured to open and close the valve member 200. More specifically, the actuator 300 is accessible to the user (surgeon) and when manipulated by the user, the actuator 300 opens and closes the valve member 200. The present disclosure describes and illustrates several different types of actuators that are configured to perform the intended function described herein, namely, the opening and closing of the valve member 200.
Actuator #1
FIGS. 1-6 illustrate actuator 300 according to one embodiment. The actuator 300 is designed to translate a user squeezing or pinching action (compressive force) of the actuator 300 into opening and closing of the valve member 200. Within the main body 110 there is an actuator inner space 305.
The actuator 300 is accessible along at least one of the first side 111 and the second side 113 of the main body 110. In the illustrated embodiment, the actuator 300 is accessible along both the first side 111 and the second side 113. For example, the first side 111 and the second side 113 can include an opening that is in fluid communication with actuator inner space 305 and the main lumen 120. FIG. 5 shows the opening in the first side 111, with the opening in the second side 113 being a mirror image thereof. In other words, the openings lead into the actuator inner space 305. The openings can be formed to have any number of different shapes including circular or oval. These openings are axially aligned along an axis that passes through the actuator inner space 305 and the main body 110 and can define a single through hole that passes from and is open along the first side 111 and the second side 113.
The actuator 300 can include a first part 310 that is disposed within the main body 110, namely, within the main lumen 120, and a second part 320 that is disposed within the main body 110, namely, within the main lumen 120. The first part 310 is a tubular structure and therefore its placement in the main lumen 120 does not restrict the flow of fluid within the main lumen 120 and similarly, the second part 320 is a tubular structure and therefore its placement in the main lumen 120 does not restrict the flow of fluid within the main lumen 120. The first part 310 and the second part 320 are spaced apart from one another and more particularly, the first part 310 is positioned between the actuator 300 and the first end 112 and the second part 320 is positioned between the actuator 300 and the second end 114.
The first part 310 and the second part 320 can thus be in the form of a hollow pin. As shown, the first part 310 can have a stepped construction with a distal section 312 being configured to be sealingly fitted within the main lumen 120, while a proximal section 314 is received within the actuator inner space 305. The proximal section 314 can thus be in the form of an annular flange.
The second part 320 preferably comprises a frustoconical shaped hollow pin that has an inward taper in the direction of the distal end of the second part 320. As shown, the second part 320 can have a stepped construction with a distal section 322 and a proximal section 324 is received within the actuator inner space 305. The proximal section 324 can thus be in the form of an annular flange. The frustoconical shaped second part 320 is sized such that the proximal section 324 has a greater width (diameter) than the distal section 322. When the proximal section 324 is thus inserted into the main lumen 120, the proximal section 324 is sealingly fitted to the main lumen 120.
As discussed herein, the first part 310 can be fixedly attached to the main body 110 within the main lumen 120, while the second part 320 is movable within main body 110 and more particularly, the second part 320 moves axially (along a longitudinal axis) within the main lumen 120 to contact the valve member 200 and move it from the closed (sealed) position to the open position.
The actuator 300 includes a biasing mechanism that is configured to move the second part 320 between an extended position in which the second part 320 is driven into contact with and through the valve member 200 to cause opening of the valve member 200 and a retracted position in which the second part 320 is spaced from the valve member 200 which remains closed. The biasing mechanism is configured such that when a force is applied to the actuator 300, the second part 320 is driven in the direction toward the first end 112 of the main body 110. The driving of the second part 320 causes the second part 320 to contact and pierce the inner wall 210 by passing through the opening 215 to cause opening of the valve member 200 as shown in FIG. 6 . Since the second part 320 is a tubular structure, when the second part 320 opens and passes through the valve member 200, the main lumen 120 is open from the first end 112 to the second end 114, thereby allowing the external device to enter the first end 112 and exit the second end 114 and enter into the other external device (e.g., catheter) attached to the second end 114. As shown in FIG. 6 , in the fully extended position, the second part 320 passes completely through the valve member 200 (through the opening formed therein) and the distal end of the second part 320 is open to the enlarged opening of the main body 110 at the first end 112.
The biasing mechanism is also configured such that when the applied force is removed, the biasing mechanism reverts back to its at rest position which is a position in which the second part 320 is retracted and is withdrawn from the opening 215 of the valve member 200 resulting in the closing (sealing) of the valve member 200.
In the illustrated embodiment, the biasing mechanism can be in the form of first and second leaf springs 330, 340. The first leaf spring 330 is disposed along the first side 111 and the second leaf spring 340 is disposed along the second side 113. The first leaf spring 330 at least partially extends through the opening formed in the first side 111 and is coupled to both the first part 310 and the second part 320. A first end of the first leaf spring 330 is attached to the first part 310 and an opposite second end is attached to the movable second part 320. Similarly, the second leaf spring 340 at least partially extends through the opening formed in the second side 113 and is coupled to both the first part 310 and the second part 320. A first end of the second leaf spring 340 is attached to the first part 310 and an opposite second end is attached to the movable second part 320. As shown, each of the first leaf spring 330 and the second leaf spring 340 can have a U-shape.
In the at rest position, the distal end of the second part 320 is received within the open space 205 but does not pierce the inner wall of the valve member 200.
When the first and second leaf springs 330, 340 are compressed by applied forces against the respective leaf springs 330, 340 in the direction that is perpendicular to the main body 110 (i.e., perpendicular to the longitudinal axis of the device 100), the actuator operates on the valve member 200. The actuator 300 is thus configured to translate an applied force in a first direction (direction perpendicular to the main body 110) into movement of the actuator 300 in a second different direction (an axial direction along the longitudinal axis of the device). In other words, the compression of the leaf springs 330, 340 is translated into axial movement of the second part 320 in a direction toward the first end 112 resulting in the second part 320 being driven into contact with and through the valve member 200 as described herein for the opening thereof. FIG. 6 shows this position in which the valve member 200 is in the open position. It will be seen that in this position, the first part 310 has not moved and remains stationary as it is fixed to the main body 110; however, the second part 320 has moved axially toward the first end 112.
The actuator 300 also includes an actuator cover that is sealingly coupled to the main body 110 and covers the actuator 300. More specifically, the actuator cover can be in the form of a first actuator cover 350 that is disposed over the first leaf spring 330 and is disposed over the opening in the first side 111. The first actuator cover 350 thus seals the opening in the first side 111 and prevents any fluid within the main lumen from existing the first side 111. At the same time, the first actuator cover 350 permits contact with and compression of the first leaf spring 330.
The actuator cover can be in the form of a second actuator cover 360 that is disposed over the second leaf spring 340 and is disposed over the opening in the second side 113. The second actuator cover 360 thus seals the opening in the second side 113 and prevents any fluid within the main lumen from existing the second side 113. At the same time, the second actuator cover 360 permits contact with and compression of the second leaf spring 340.
The first and second actuator covers 350, 360 are thus formed of a flexible material (e.g., polymeric material (e.g., silicone)) that can easily compress under application of a force. As illustrated, the first and second actuator covers 350, 360 can be flexible dome shaped structures.
By placing two biasing mechanisms along the two opposing sides 111, 113, the device 100 can be considered to be a dual sided actuator that allows the user (surgeon) to hold the main body 110 and operate the actuator 300 along both sides 111, 113 of the main body 110. However, it will be appreciated that while two biasing mechanisms are shown in the figures, the device 100 can include a single actuator in that the device 100 can include only one biasing mechanism located along one of the sides 111, 113.
Actuator #2
FIGS. 7-8 illustrate an actuator according to a second embodiment. This second embodiment is similar to the first embodiment in that it includes an actuator that is configured to translate a squeezing action (compressive force) into axial movement for purposes of opening and closing the valve member 200.
The second embodiment includes an actuator 301 that is very similar to the actuator 300 and therefore, like parts are numbered alike. The main difference between the actuator 301 and the actuator 300 is that the first and second biasing mechanisms are different. More particularly, each of the first biasing mechanism and the second biasing mechanism comprises a two- bar linkage 311, 321, respectively, and therefore, the actuator 301 can be characterized as being a four-bar linkage. The first two-bar linkage 311 is located along the side 111 and the second two-bar linkage 321 is located along the side 113.
One end of the first two-bar linkage 311 is attached to the first part 310, while the other end of the first two-bar linkage 321 is attached to the second part 320 and similarly, the second two-bar linkage 321 is attached to the first part 310, while the other end of the second two-bar linkage 321 is attached to the second part 320. Much like the leaf springs 330, 340, the first and second two- bar linkages 311, 321 are configured to compress (collapse) when a force (e.g., squeezing action) is applied in a direction normal to the longitudinal axis of the main body 110. This compression drives the second part 320 through the valve member 200 for opening thereof as described herein with respect to actuator 300. When the applied force is removed, the first and second two- bar linkages 311, 321 return to their fully retracted at rest positions.
The actuators 300, 301 thus operate in a similar manner.
As with the first embodiment, it will be appreciated that the actuator of the second embodiment can include only a single two-bar linkage as opposed to using two two-bar linkages as shown in the figure.
Location of Actuator 300 to the Valve Member 200
In accordance with one feature of the present device 100 and in direct contrast to conventional hemostasis valve constructions, the actuator 300 is spatially separated from the valve member 200. More specifically, the actuator 300 is located between the valve member 200 and the second end 114 and more particularly, the actuator 300 is between the connection branch 140 and the second end 114. As shown, the actuator 300 is located on one side of a center axis that passes through the connection branch 140, while the valve member 200 is located on an opposite side of the center axis. In other words, the actuator 300 is located on one side of the connection branch 140, while the valve member 200 is located on the other side of the connection branch 140.
As mentioned previously, conventional hemostasis valve constructions are such that the actuator (such as a knob) is an integral part of the valve member. By spatially separating the actuator and moving the actuator 300 to an intermediate location along the main body 110, the user can hold the device 100 with one hand along this intermediate location and at the same time operate the actuator 300 with the same time. To hold the device 100, the user places his or her finger against the first finger support 145, while the thumb is placed against the second finger support 147. From this holding position, the user can then press down (squeeze or pinch) the first biasing mechanism and the second biasing mechanism. When these two biasing mechanisms are compressed, the second part 320 is driven toward and through the valve member 200, thereby opening the valve member 200. Once the valve member 200 is open, the external device can be fed through the opening 215 in the valve member 200 and pass through the main lumen 120. Once use of the external device is completed, the user removes the external device and then releases the actuator causing the automatic retraction of the second part 320 and the return of the first and second biasing mechanisms to the at rest position.
The frustoconical shape of the second part also promotes opening of the valve member 200 as the second part 320 is progressively driven into and through the second part 320.
Use of Connection Branch 140
In addition, the construction of the actuator 300 is such that fluid that flows through the connection branch 140 is not obstructed by the actuator 300 and instead flows directly into the main lumen 120. The fluid thus flows around and/or through the actuator 300 and into the main lumen 120. As shown, the lower end of the connection branch 140 can have a curved shape to channel and direct fluid into the main lumen 120 and toward the second end 114. In the fully retracted (at rest) position of the actuator 300, the connection branch 140 is located above the second part 320. However, as mentioned, the second part 320 does not obstruct the flow of fluid through the connection branch 140 into the main lumen 120. Thus, fluid can flow around the second part 320 into the main lumen 120. The second part 320 can also include one or more holes (not shown) that are formed in the side wall of the second part 320 to allow for flow from a location outside the second part 320 to a location inside the second part 310. The one or more holes can be in the form of a series of pin holes that are arranged in sets that are formed circumferentially about the second part 320. For example, each set can include three pin holes that are formed in a line. The sets are spaced apart from one another in the circumferential direction.
Axial Sleeve Embodiment (FIGS. 9-13 )
FIGS. 9-13 illustrate another hemostasis valve device 500 that is similar to the hemostasis valve device 100 and therefore like parts are numbered alike.
The hemostasis valve device 500 include a main body 510 that includes the catheter access section 130 defined at the distal end of the main body 510. The main body 510, like main body 110, is a hollow structure that includes main lumen 120. As shown in FIGS. 9 and 11 , inside of the main body 510 there is an actuator tube 520. Unlike the device 100, the actuator tube 520 is fixedly attached to the main body 510 and thus there is no relative movement between the actuator tube 520 and the main body 510. The inside of the actuator tube 520 at one end is in fluid communication with the catheter access section 130. The actuator tube 520 terminates in a free end 522. As shown in FIG. 11 , the actuator tube 520 can include a set of openings formed therein and circumferentially thereabout similar to the openings described above with respect to the actuator 300.
The main body 510 also includes the connection branch 140 which is in fluid communication with the main lumen 120 and as described herein, allows for injection of fluid into the main lumen 120.
The main body 510 also includes a first finger support 530 formed along the top of the main body 510 and a second finger support 540 formed along the bottom of the main body 510. These two finger supports can thus be oriented 180 degrees apart as illustrated. Each finger support 530, 540 has a curved surface against a thumb or finger can rest to hold the main body 510 similar to the use of the finger supports 145, 147. The finger supports 530, 540 are curved towards the catheter access section 130.
Unlike the device 100, the device 500 includes a slider part 550 that moves axially relative to the main body 510 and more particularly, the slider part 550 is sealingly coupled to the main body 510 and slides thereover. The slider part 550 has a pair of arcuate shaped side walls 552, 554 that are complementary to the main body 510 to allow the side walls 552, 554 to seat against the outer surface of the main body 510 and slide thereover. The slider part 550 has a third finger support 560 that extends downwardly form the slider part 550 and has a curved finger support surface. This curved surface faces away from the main body 510. Between the side walls 552, 554, there is a top slot 557 and an opposite bottom slot 559.
The slider part 550 is thus slidingly coupled to the main body 510 such that when a compressive force is applied to either of these parts causing these two parts to be drawn together, the side walls 552, 554 slide over the outer surface of the main body 510. The slider part 550 is biased relative to the main body 510 in that a spring 565 is provided and seats between an inner surface of the main body 510 and an inner surface of the slider part 550, thereby causing the two parts to be biased relative to one another. FIGS. 10 and 11 show an at rest position prior to actuation and in this state, the spring 565 is in an at rest, extended position and is not storing energy. This results in the slider part 550 being in a fully extended position relative to the main body 510.
As shown in FIG. 11 , the valve 200 is disposed and contained within the slider part 550. The valve 200 is thus carried by the slider part 550 and therefore, when the slider part 550 slides relative to the main body 510, the position of the valve 200 relative to the main body 510 likewise changes. Much like the device 100, the slider part 550 is open at both of its ends and therefore, the valve 200 is positioned adjacent an end opening of the slider part 550 (similar to end 112 of device 100). The valve 200 in device 500 can have the same characteristics as the valve 200 in device 100 and thus moves between an open and closed position. In the at rest position prior to actuation, the valve 200 is closed as shown in FIG. 11 with the distal free end 522 of the actuator tube 520 being adjacent but not breaching the valve 200.
To actuate the device 500, as shown in FIGS. 12 and 13 , the user pulls the slider part 550 toward the main body 510 and this causes the compression of the spring (not shown for ease of illustration) (resulting in the spring storing energy) and the sliding of the slider part 550 over the main body 510 causes the actuator tube 520 to be driven through the valve 200 (similar to the opening of the valve 200 of device 100). The actuator tube 520 thus opens the valve 200 and is placed in fluid communication with the end opening of the slider part 550 to allow insertion of a tool through the slider part 550 into and through the actuator tube 520 to and through the catheter access section 130. The slot 557 accommodates the connector branch 140 and the first finger support 530, while the slot 559 accommodates the second finger support 540 when the slider part 550 slides over the main body 510.
To return the valve 200 to the closed position, the user simply releases the slider part 550 and the spring 565 releases its stored energy causing the extension of the slider part 550 relative to the main body 510. This action in effect causes the actuator tube 520 to slide out of engagement with the valve 200 and the valve 200 automatically closes.
Unlike conventional hemostasis valve devices, the actuator is designed to operate from the inside out in that an external element that is outside the valve devices is moved from the outside to the inside of the device to open the valve. The devices 100, 500 disclosed herein have the direct opposite constructions and functionality in that the valve is opened by moving an internal part from the inside out.
Exemplary Method of Use
One exemplary method of use of the device 100 includes the performance of the following steps. The distal end 114 of the device 100 is connected to the proximal end of a primary guiding catheter (not shown). The valve (gasket) 200 is opened by the actuator 300 with the application of external perpendicular (pressing) force upon the external (exposed) arc shaped sections (leaf springs 330, 340) of the actuator 300. The internal lumen of the device 100 is flushed with normal saline to remove air bubbles by connecting the top wall end of the bifurcated proximal component device (identified at 140) to a syringe full of saline. The entire device 100 can be filled with saline.
The valve 200 closes when the perpendicular pressing force upon the leaf springs 330, 340 of the actuator 300 is released.
Perpendicular force upon the arch mechanism (leaf springs 330, 340) is used to open the valve 200 and a secondary (internal) guiding catheter is introduced through the proximal end 112 of the device 100. While maintaining perpendicular force, the entire secondary guiding catheter is fed through the device 100 until reaching the area of therapeutic benefit. Perpendicular force is removed, closing the valve 200 around the secondary guiding catheter as needed.
At the end of the procedure, the hemostatic valve 200 is opened by including perpendicular force upon the leaf springs 330, 340, and all guiding catheters are removed.
It will be appreciated that when pushing in the arch mechanism (leaf springs 330, 340) completely, blood and other fluids leak from the patient. Minimizing blood loss during endovascular procedures is important. With multiple insertions, extractions, and exchanges of catheters and wires, small blood loss in each step can be significant. The present system and device 100 are designed to minimize blood loss by reducing valve opening/closing time while providing a continuous flush system.
The quick access system also reduces the possibility of blood stagnation within the guide catheter, reducing the risk of thromboembolism. One of the problems with some conventional hemostasis valve is that they are cumbersome to operate, taking a long time to open and close due to hand position during the compression of the mechanism. The present device 100 allows a natural perpendicular (to the device 100) pushing in and out of a mechanism (actuator 300) instead of an inadequate parallel (to the device 100) pushing move. The present disclosure thus describes an ergonomic method for hemostasis valve actuation and catheter manipulation which requires a singular hand grip and no changes to hand position during the entirety of a procedure.
The physician holds the device 100 with one hand between the thumb and index finger at the main body 110. The required holding position facilitates two functions. A first function is the actuation of the luminal valve 200 via a squeezing force at 350 orthogonal to the longitudinal axis of the device 100. The second function is to advance or rotate the catheter. Previous technologies require frequent shifts in hand position in order to perform each of these tasks. The present method and device 100 facilitate each task without any hand shift or movement between them.
Actuation opens the lumen which allows either fluid or a catheter to freely move along the axis of the device 100. The present system (device 100) provides a novel method of use that reduces the amount of time the device 100 remains in the open actuated position during a procedure, thereby minimizing blood loss. With multiple insertions, extractions, and exchanges of catheters and wires, small blood loss in each step can be significant. The quick access system also reduces the possibility of blood stagnation within the guide catheter, reducing the risk of thromboembolism.
The terminology used herein is for the purpose of describing particular embodiments only and is not intended to be limiting of the invention. As used herein, the singular forms “a”, “an” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising”, when used in this specification, specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not precludes the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof.
Also, the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting. The use of “including,” “comprising,” or “having,” “containing,” “involving,” and variations thereof herein, is meant to encompass the items listed thereafter and equivalents thereof as well as additional items.
The subject matter described above is provided by way of illustration only and should not be construed as limiting. Various modifications and changes can be made to the subject matter described herein without following the example embodiments and applications illustrated and described, and without departing from the true spirit and scope of the present invention, which is set forth in the following claims.

Claims

1. A hemostasis valve device comprising:

a valve body having an open first end and an open second end with a main lumen extending from the open first end to the open second end;

a valve member disposed within the main lumen of the valve body at or proximate to the open first end, the valve member having an open position and a closed position; and

an actuator disposed between the valve member and the open second end, the actuator being configured to move the valve member between the open position and the closed position.

2. The hemostasis valve device of claim 1, wherein the valve body further includes a hollow side port that extends radially outward from the valve body so as to define a Y-shaped structure, the hollow side port having a center axis that intersects a longitudinal axis of the main lumen of the valve body at a location between the actuator and the valve member.

3. (canceled)

4. The hemostasis valve device of claim 2, wherein a portion of the actuator that is accessible by a user is located between the hollow side port and the open second end of the valve body.

5. The hemostasis valve device of claim 1, wherein the actuator is located along a side of the valve body and is configured to translate a force applied to the actuator into opening of the valve member, and

wherein the force that is applied is perpendicular a longitudinal axis of the valve body.

6. (canceled)

7. The hemostasis valve device of claim 5, wherein the actuator includes a first portion that is exposed along the side of the valve body and a second portion that contacts the valve member to open the valve member, and

wherein the first portion of the actuator comprises a biased part that moves between an extended position and a collapsed position and the second portion comprises an elongated hollow driven pin that upon actuation of the actuator is driven into contact with the valve member to cause an opening thereof, thereby fluidly connecting the open first end and the open second end of the valve body and upon retraction of the elongated hollow driven pin, the valve member seals and returns to the closed position.

8. (canceled)

9. The hemostasis valve device of claim 7, wherein the first portion includes a first spring and a second spring, the first and second springs being radially positioned around and symmetric about the longitudinal axis of the valve body.

10. The hemostasis valve device of claim 9, wherein the first spring and the second spring comprise leaf springs.

11. The hemostasis valve device of claim 1, wherein the valve body has one or more side openings through which at least a first portion of the actuator extends to allow the actuator to be accessible and contactable along a side of the valve body, the one or more side openings being in fluid communication with the main lumen and therefore the actuator is fluidly sealed relative to the valve body and about the one or more side openings,

wherein the one or more side openings comprises a pair of opposing side openings and the first portion of the actuator comprises a first biased element and a second biased element that are operatively coupled to the valve member such that when the first biased element and the second biased element are relaxed to a relaxed position, the valve member is closed and when the first biased element and the second biased element are compressed to a compressed position and store energy, the valve member is in the open position,

wherein the first biased element and the second biased element are coupled to an elongated hollow driven pin that is driven into contact with the valve member to cause an opening thereof when the first biased element and the second biased element move from the relaxed position to the compressed position and conversely, when the first biased element and the second biased element return to the relaxed position, the elongated hollow driven pin retracts relative to the valve member for closing thereof.

12-14. (canceled)

15. The hemostasis valve device of claim 11, wherein a first end of each of the first biased element and the second biased element is fixedly coupled to the valve body and an opposite second end of each of the first biased element and the second biased element is fixedly coupled to the elongated hollow driven pin.

16. The hemostasis valve device of claim 1, wherein the actuator comprises a dual sided actuator that is accessible along opposite sides of the valve body.

17. The hemostasis valve device of claim 1, wherein the actuator comprises a first portion that moves in a first direction and a second portion that moves in a second direction, the second direction being a direction that is different than the first direction and is along a longitudinal direction along the main lumen.

18. The hemostasis valve device of claim 17, wherein the first direction is perpendicular to the second direction.

19. (canceled)

20. The hemostasis valve device of claim 1, wherein the valve member comprises an elastomeric gasket,

wherein the elastomeric gasket has a side wall and a membrane extending between the side wall, the membrane having a slit formed therein, wherein in the open position, the slit is open and in the closed position, the slit is closed, and

wherein the side wall of the gasket is sealingly fixed to an inner surface of the valve body.

21-22. (canceled)

23. The hemostasis valve device of claim 1, further including an elastomeric cover that surrounds the actuator and is fluidly sealed to the valve body.

24. The hemostasis valve device of claim 1, wherein the actuator comprises a pair of two-bar linkages that are pivotally coupled to the valve body and move between a relaxed position in which the valve member is closed and a compressed position in which the valve member is open.

25. The hemostasis valve device of claim 1, wherein the valve body includes a first finger support along a side of the valve body and a second finger support along an opposite side of the valve body,

wherein the actuator is disposed between: (1) the first finger support and second finger support and (2) the open second end of the valve body, and

wherein the valve body further includes a hollow side port that extends radially outward from the valve body, the hollow side port having a center axis that intersects a longitudinal axis of the main lumen of the valve body at a location between the actuator and the valve member, wherein the first finger support is integrally formed as part of the hollow side port.

26-27. (canceled)

28. A hemostasis valve device comprising:

a valve member disposed within the main lumen of the valve body at or proximate to the open first end, the valve member having an open position and a closed position;

an actuator disposed between the valve member and the open second end, the actuator being movable between a first position in which the valve member is in the closed position and a second position in which the valve member is in the open position; and a cover that surrounds the actuator and is fluidly sealed to the valve body.

29. The hemostasis valve device of claim 28, wherein the valve body has one or more side openings through which at least a first portion of the actuator extends to allow the actuator to be accessible along a side of the valve body, the one or more side openings being in fluid communication with the main lumen, the cover being fluidly sealed to the valve body such that the one or more side openings lie within the cover, and

wherein the one or more side openings comprises a pair of opposing side openings and the first portion of the actuator comprises a first biased element and a second biased element that are operatively coupled to the valve member such that when the first biased element and the second biased element are relaxed in the first position of the actuator, the valve member is closed and when the first biased element and the second biased element are compressed in the second position of the actuator, the valve member is in the open position.

30. (canceled)

31. A hemostasis valve device comprising:

a valve member disposed within the main lumen of the valve body at or proximate to the open first end, the valve member having an open position and a closed position; an actuator disposed between the valve member and the open second end, the actuator being movable between a first position in which the valve member is in the closed position and a second position in which the valve member is in the open position, the actuator being configured to translate an applied force that is perpendicular to a longitudinal axis of the main lumen into a longitudinal force that causes the valve member to open.

32. The hemostasis valve device of claim 31, wherein the actuator includes a first portion that is accessible along one or more sides of the valve body and a second portion that is disposed completely within the main lumen, the first portion being configured to translate the applied force into axial translation of the second portion within the main lumen resulting in the valve member being breached and opened by the second portion.

33-34. (canceled)