Catheter insertion system and catheter placement system

Abstract

This application discloses a catheter insertion system and a catheter placement system. The catheter insertion system includes: a catheter defining a catheter lumen and extending along a longitudinal axis; a needle defining a needle lumen and disposed within a portion of the catheter lumen; a housing supporting one of the catheter or the needle; and a blood return indicator in fluid communication with the needle lumen, the blood return indicator including a plunger fixedly attached to the housing and including a syringe barrel slidably engaged with the plunger along the longitudinal axis.

Description

[0001] priority

[0002] This application claims the benefit of priority to U.S. Provisional Application No. 63 / 128,677, filed December 21, 2020, which is incorporated herein by reference in its entirety. Technical Field

[0003] This application relates to the field of medical devices, and more specifically to catheter insertion systems and catheter placement systems. Background Technology

[0004] An extended blood flow path can be detrimental to the operation of a catheter placement system by delaying indication time, reducing the effectiveness of vacuum, or increasing the chance of coagulation. Summary of the Invention

[0005] In summary, the embodiments disclosed herein relate to fluid path optimization in catheter insertion systems and related methods. Advanced insertion systems are required when placing slender catheters such as central venous catheters (CVCs) and rapid-insertion central catheters (RICCs). These insertion systems may include a housing, needle, guidewire, dilator, or blood flash indicator, configured to enter the vascular system, confirm correct vascular access, dilate the insertion site, and place the catheter. Advantageously, the insertion system can contain these structures within a closed environment to reduce repeated insertion and removal of multiple devices and mitigate the introduction of pathogens.

[0006] The sequential nature of the tools within these insertion systems can result in long and complex pathways for blood flow before reaching the blood return indicator. For example, a needle positioned within the lumen of a catheter requires blood to flow to at least the proximal end of the catheter before it leaves and is observed. Furthermore, the blood return indicator may be positioned distal to the insertion device, close to the insertion site for easy observation. Therefore, blood flow will have to travel twice the length of the catheter before it is observed.

[0007] This elongated flow path can lead to various problems. For example, a longer flow path requires an increased volume of blood to flow through the system before reaching the return indicator and being observed. This elongated flow path may mask the nature of pulsatile flow, obscuring the difference between arterial and venous flow. The delay caused by the increased travel time may cause the user to continue insertion even after entering the vascular system, resulting in vascular "backflush," i.e., inserting the needle through the distal wall of the blood vessel. In cases where the return system contains a vacuum to aspirate blood flow, a swirling flow path may reduce or impair the force of the vacuum. Finally, the extended blood flow path may have an increased risk of blood clotting before reaching the return indicator. The embodiments disclosed herein aim to address these problems.

[0008] This document discloses a catheter insertion system comprising: a catheter defining a catheter lumen and extending along a longitudinal axis; a needle defining a needle lumen and disposed within a portion of the catheter lumen; a housing supporting either the catheter or the needle; and a blood return indicator in fluid communication with the needle lumen, the blood return indicator including a plunger fixedly attached to the housing and including a syringe barrel slidably engaged with the plunger along the longitudinal axis.

[0009] In some embodiments, the syringe barrel is configured to slide proximally relative to one of the plunger or housing to create a vacuum and aspirate blood through the needle lumen and into the syringe barrel. The syringe barrel is formed of a transparent material to allow observation of blood color or pulsating flow. The syringe barrel is supported by a cradle that includes a clamping feature and is configured to facilitate sliding of the syringe barrel along a longitudinal axis. The housing includes a needle interface defining a needle channel and a blood return channel, the needle channel being configured to receive an extension of the needle through a portion of the needle channel, and the blood return channel providing fluid communication between the needle channel and the syringe barrel.

[0010] In some embodiments, the needle includes a notch extending through the needle wall to provide fluid communication between the needle lumen and the needle channel. The needle channel includes a first O-ring and a second O-ring, the first O-ring being arranged circumferentially around the needle and distal to the needle notch, and the second O-ring being arranged circumferentially around the needle and proximal to the needle notch. Each of the first and second O-rings extends between an outer surface of the needle and an inner surface of the needle channel to provide a fluid-impermeable seal between the outer surface of the needle and the inner surface of the needle channel. The needle and needle channel are slidably engaged. In some embodiments, a portion of the blood return channel is formed by a flexible tube. The catheter is a central venous catheter or a rapid insertion central catheter.

[0011] A method for placing a catheter is also disclosed, comprising: inserting a needle into a vascular system, the needle defining a needle lumen and being supported by a housing; sliding a syringe barrel proximally relative to the housing along a longitudinal axis; creating a vacuum within the syringe barrel; and drawing blood through the needle lumen and into the syringe barrel.

[0012] In some embodiments, the method further includes a plunger slidably engaged with a syringe barrel, the plunger being fixedly attached to a housing to prevent any relative longitudinal movement between the plunger and the housing. In some embodiments, the method further includes a bracket coupled to the syringe barrel and including clamping features. In some embodiments, the method further includes observing the color or pulsating flow of blood within the syringe barrel, the syringe barrel being formed of a transparent material. In some embodiments, the housing includes a needle interface defining a needle channel and a return blood channel, the needle channel being configured to receive an extension of the needle through a portion of the needle channel, and the return blood channel providing fluid communication between the needle channel and the syringe barrel. The needle includes a notch extending through the wall of the needle to provide fluid communication between the needle lumen and the needle channel.

[0013] In some embodiments, the needle channel includes a first O-ring and a second O-ring, the first O-ring being arranged circumferentially around the needle and distal to the needle notch, and the second O-ring being arranged circumferentially around the needle and proximal to the needle notch. Each of the first and second O-rings extends between the outer surface of the needle and the inner surface of the needle channel to provide a fluid-impermeable seal between the outer surface of the needle and the inner surface of the needle channel. The needle and needle channel are slidably engaged. In some embodiments, a portion of the blood return channel is formed by a flexible tube. The catheter is a central venous catheter or a rapid insertion central catheter.

[0014] Also disclosed is a catheter placement system comprising: a catheter defining a catheter lumen and extending along a longitudinal axis; a needle defining a needle lumen and extending through a portion of the catheter lumen; a housing supporting one or both of the catheter and the needle, and including a needle interface to provide fluid communication between the needle lumen and a blood return channel; and a blood return indicator in fluid communication with the blood return channel at a point distal to the proximal end of the needle, the blood return indicator including a syringe barrel fixedly attached to the housing and a plunger slidably engaged with the syringe barrel between a proximal and a distal position.

[0015] In some embodiments, the plunger is configured to slide from a proximal position to a distal position to create a vacuum within the syringe barrel. A needle interface defines a needle channel communicating with a return blood channel, the needle channel being configured to receive an extension of the needle through a portion of the needle channel. The needle includes a notch extending through the needle wall to provide fluid communication between the needle lumen and the needle channel. The needle channel includes a first O-ring and a second O-ring, the first O-ring being arranged annularly around the needle and distal to the needle notch, and the second O-ring being arranged annularly around the needle and proximal to the needle notch, each extending between an outer surface of the needle and an inner surface of the needle channel to provide a fluid-impermeable seal between the outer surface of the needle and the inner surface of the needle channel. The needle and needle channel are slidably engaged. In some embodiments, a portion of the return blood channel is formed of a flexible tube. The catheter is a central venous catheter or a rapid insertion central catheter. Attached Figure Description

[0016] A more specific description of the disclosure will be presented with reference to specific embodiments illustrated in the accompanying drawings. It should be understood that these drawings depict only typical embodiments of the invention and should not be considered as limiting its scope. Exemplary embodiments of the invention will be described and explained using additional features and details, in which:

[0017] Figure 1A A perspective view of an exemplary catheter insertion system according to an embodiment disclosed herein is shown.

[0018] Figure 1B A side view of an exemplary catheter insertion system according to an embodiment disclosed herein is shown.

[0019] Figure 1C A plan view of an exemplary catheter insertion system according to an embodiment disclosed herein is shown.

[0020] Figure 2 An exploded view of an exemplary catheter insertion system according to an embodiment disclosed herein is shown.

[0021] Figure 3A A side sectional view of an exemplary catheter insertion system according to an embodiment disclosed herein is shown.

[0022] Figure 3B The embodiments disclosed herein are shown. Figure 3A A cross-sectional view of the needle interface of the catheter insertion system.

[0023] Figures 4A to 4C A schematic diagram of a blood return system for an exemplary catheter insertion system according to an embodiment disclosed herein is shown.

[0024] Figure 5 A perspective view of an exemplary catheter insertion system according to an embodiment disclosed herein is shown. Detailed Implementation

[0025] Before disclosing some specific embodiments in more detail, it should be understood that the specific embodiments disclosed herein do not limit the scope of the concepts provided herein. It should also be understood that the specific embodiments disclosed herein may have features that allow them to be readily separable from the specific embodiments and optionally combined with or substituted for features of any of the many other embodiments disclosed herein.

[0026] Regarding the terminology used herein, it should also be understood that these terms are for the purpose of describing certain specific embodiments, and that these terms do not limit the scope of the concepts presented herein. Ordinal numbers (e.g., first, second, third, etc.) are generally used to distinguish or identify different features or steps in a set of features or steps, and do not provide for any order or numerical limitation. For example, the features or steps “first,” “second,” and “third” do not necessarily have to appear in that order, and a particular embodiment including such features or steps does not necessarily have to be limited to three features or steps. For convenience, labels such as “left,” “right,” “top,” “bottom,” “front,” “back,” etc., are used, and these labels are not intended to imply, for example, any particular fixed position, orientation, or direction. Rather, such labels are used to reflect, for example, relative position, orientation, or direction. The singular forms “a,” “an,” and “the” include plural references unless the context clearly indicates otherwise.

[0027] The terms "proximal," "proximal portion," or "proximal portion" of a catheter, as disclosed herein, include the portion of the catheter intended to be close to the clinician when used with a patient. Similarly, the term "proximal length" of a catheter includes the length of the catheter intended to be close to the clinician when used with a patient. For example, the term "proximal end" of a catheter includes the tip of the catheter intended to be close to the clinician when used with a patient. A proximal portion, proximal portion, or proximal length of a catheter may include the proximal end of the catheter; however, a proximal portion, proximal portion, or proximal length of a catheter does not necessarily include the proximal end of the catheter. That is, unless the context otherwise suggests, a proximal portion, proximal portion, or proximal length of a catheter is not the distal portion or distal length of the catheter.

[0028] The terms "distal," "distal portion," or "distal part" of a catheter, as disclosed herein, include the portion of the catheter intended to be close to or within the patient when used in a patient. Similarly, the term "distal length" of a catheter includes the length of the catheter intended to be close to or within the patient when used in a patient. For example, the term "distal end" of a catheter includes the tip of the catheter intended to be close to or within the patient when used in a patient. A distal portion, distal part, or distal length of a catheter may include the distal end of the catheter; however, a distal portion, distal part, or distal length of a catheter does not necessarily include the distal end of the catheter. That is, unless the context otherwise suggests, a distal portion, distal part, or distal length of a catheter is not the distal portion or distal length of the catheter.

[0029] To help describe the implementation scheme described in this article, such as Figure 1AAs shown, the longitudinal axis extends substantially parallel to the axial length of the catheter. The lateral axis extends perpendicular to the longitudinal axis, and the transverse axis extends perpendicular to both the longitudinal and lateral axes. Unless otherwise defined, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art.

[0030] Figures 1A to 2 An exemplary catheter insertion system (“system”) 100 is illustrated, which generally includes a needle 110, a catheter 120, a housing 130, and a blood return indicator 150. Optionally, the insertion system 100 may include one or more guidewires (not shown). The needle 110 may define a needle lumen 114 and may be supported by a needle bushing 112 disposed at the proximal end of the needle. The needle 110 may be configured to extend through at least a portion of the lumen of the catheter 120. A distal tip 116 of the needle 110 may extend distal to the distal tip of the catheter 120 and may define a sharp end configured for skin puncture and vascular access.

[0031] Catheter 120 can be a central venous catheter (CVC), rapid-injection central catheter (RICC), or a similar thin catheter configured to provide access to the patient's vascular system. For example... Figure 2 As shown, catheter 120 may be an RICC catheter 120, which includes an entry section 162 defining a first diameter, an expansion section 164, and a catheter body section 166 defining a second diameter greater than the first diameter.

[0032] The entry segment 162 may define a single lumen and may be formed of a material that is harder than the catheter body segment 166. The catheter body segment 166 may define one or more lumens and may be formed of a material that is softer and more compliant than the entry segment 162. The dilation segment 164 may be formed of the same material as the entry segment 162 or of a third material. The third material may have a harder consistency than the material of the catheter body segment 166. The dilation segment 164 may provide a tapered transition between a first diameter of the entry segment 162 and a second diameter of the catheter body segment 166. The entry segment 162 and the dilation segment 164 may provide relatively more rigid mechanical properties and may be relatively more resistant to kinking or folding than the catheter body segment 166 when axial forces are applied. The catheter body segment 166 may be relatively more compliant to facilitate access through tortuous blood vessels. In one embodiment, the catheter 120 may also include a bushing 168, a bifurcation 170, and / or one or more extension legs 172, each extension leg communicating with the lumen of the catheter 120. In one embodiment, the needle 110 may extend through the extension leg 172, through the lumen of the catheter body segment 166, and through the lumen of the access segment 162 to extend distally to the distal tip of the catheter 120.

[0033] In use, clinicians can use the RICC catheter 120 to access the vascular system by inserting the needle tip 116 and the distal portion of the entry segment 162 into the vascular system. Blood flow can flow proximally through the needle lumen 114 to the blood return indicator 150. Color and pulsating flow can be observed to confirm correct vessel entry. In the event of incorrect vessel entry, the entry segment 162 can be withdrawn due to its relatively small diameter, and the insertion site can be closed by applying pressure. With correct vessel entry confirmed, the catheter 120 can optionally be advanced over the guidewire until the dilator segment 164 enters the insertion site and dilates the insertion site to a second diameter of the catheter body segment 166. The catheter body segment 166 can then be advanced until the distal portion of the catheter 120 is at the target location within the vascular system. Further details of RICC catheters, related insertion systems, and related methods can be found in U.S. Patent No. 10,376,675; U.S. Patent Publications US2019 / 0255294, US2021 / 0069471, US2021 / 0085927, US2021 / 0113809, US2021 / 0113810, US2021 / 0121661, US2021 / 0121667, US2021 / 0228843, US2021 / 0322729, US2021 / 0330941, US2021 / 0330942, and US2021 / 0361915, each of which is incorporated herein by reference in its entirety.

[0034] As will be understood, according to the construction of the catheter insertion system, before exiting the catheter 120 and flowing distally to the return blood indicator, the return blood flow must travel from the needle tip 116 through the needle lumen 114, essentially reaching the proximal end of the catheter 120. The embodiments disclosed herein relate to reducing the travel distance between the needle tip 116 and the return blood indicator 150.

[0035] In an embodiment where the blood return indicator is arranged toward the distal end of the device, the fluid path can be reduced by positioning the blood return indicator 150 proximally. More specifically, by positioning the blood return indicator 150 proximally to the centroid of the catheter 120, the length of the blood return fluid path can be reduced by 20%-30%.

[0036] In one implementation scheme, such as Figures 3A to 3B As shown, the catheter insertion system 100 may include a needle interface 140 configured to provide fluid communication between the needle lumen 114 and the blood return indicator 150 via a notch 118 disposed in the wall of the needle 110. The needle notch 118 can be positioned distal to the proximal end of the needle bushing 112 by a distance (x). Therefore, the fluid path distance between the needle tip 116 and the blood return indicator 150 can be further reduced by a distance (2x).

[0037] The needle interface 140 may define a needle channel 142 extending along a longitudinal axis and configured to receive a portion of a needle 110 therethrough. The needle 110 may slidably engage with the needle channel 142. The needle interface 140 may also include one or more O-rings 144 extending circumferentially around the needle 110 and disposed between the outer surface of the needle 110 and the inner surface of the channel 142 to provide a fluid-impermeable seal between the needle and the needle channel.

[0038] The needle interface 140 may also include a return channel 152 communicating between the needle channel 142 and the return indicator 150. The return channel 152 may extend substantially perpendicularly from the needle channel 142 before extending toward the return indicator 150. Before use, a needle notch 118 may be arranged within the needle channel 142, between a first O-ring 144A and a second O-ring 144B, and aligned with the return channel 152. When the needle tip 116 is advanced into the vascular system, blood flow may flow proximally through the needle lumen 114, through the notch 118, and into the return channel 152, reaching the return indicator 150. The first O-ring 144A and the second O-ring 144B prevent fluid leakage between the outer surface of the needle 110 and the inner surface of the needle channel 142. Blood flow color or pulsation can be observed to confirm correct vessel entry. The needle 110 can then be withdrawn proximally through the needle channel 142 and optionally removed. In one embodiment, the portion of the needle 110 distal to the needle notch 118 may be blocked by the needle channel 142 to seal the fluid therein.

[0039] In one embodiment, the blood return indicator 150 may include a container configured to receive blood flow therein. This container may be formed of a transparent material to allow a user to observe the color and pulsating flow disposed therein. In one embodiment, the blood return indicator 150 may include a vacuum container configured to maintain a vacuum therein to facilitate proximal aspiration of blood through the needle lumen 114, through the needle notch 118, and into the vacuum container. In one embodiment, a portion of the needle 110 that blocks the blood return channel 152 may maintain a vacuum within the vacuum container. When the user is ready to examine the blood vessel entry, the needle 110 may be advanced relative to the housing 130 until the needle bushing 112 abuts against the housing 130 and the needle notch 118 is aligned with the blood return channel 152. Thus, the vacuum in the vacuum container is then placed in fluid communication with the needle lumen 114 and facilitates proximal aspiration of blood through the needle lumen 114.

[0040] In one embodiment, the blood return indicator 150 may include a syringe barrel 154 and a plunger 156, the plunger being slidably engaged with the syringe barrel and configured to generate a vacuum to draw blood proximally through the needle lumen 114 and into the syringe barrel 154. In one embodiment, the operation of the syringe barrel 154 and the plunger 156 may be reversed. For example, the plunger 156 may be fixedly engaged with the housing 130 to prevent any longitudinal movement relative to the housing. The plunger 156 may be engaged with the housing 130 using interference fit, snap fit, press fit, adhesive, welding, bonding, etc. The syringe barrel 154 may be supported by a barrel holder 158. The barrel 154 and barrel holder 158 assembly may slide relative to the plunger 156 and housing 130 assembly and are configured such that sliding the barrel 154 and holder 158 assembly proximally can generate a vacuum within the barrel 154. In one embodiment, the barrel holder 158 may be made of a transparent material to facilitate observation of the blood flow therein.

[0041] Advantageously, the operation of the syringe barrel 154 and plunger 156 that reverses the blood return indicator can further reduce the fluid path between the needle tip and the blood return indicator 150. For example, as Figures 4A to 4C As shown, from Figure 4A Starting from the indicated initial position, the blood return fluid path can be defined by a first distance (d1) extending from the needle tip 116 to the syringe barrel 154. As shown... Figure 4B As shown, the blood return indicator 150 includes a syringe barrel 154 and a plunger 156 constructed in a "conventional" manner, the plunger 156 being withdrawn distally from the syringe barrel 154 to create a vacuum. However, in doing so, the fluid path extends from a first distance (d1) to a second distance (d2), which is greater than the first distance (d1).

[0042] On the contrary, such as Figure 4C As shown, the disclosed embodiment fixes the plunger 156 to prevent any movement along the longitudinal axis, and the syringe barrel 154 slides proximally to create a vacuum. Therefore, the length of the fluid path decreases from a first distance (d1) to a third distance (d3) less than the first distance (d1). By reversing the operation of the syringe return indicator 150, the syringe barrel 154 can slide proximally toward the needle notch 118 to create a vacuum, thereby reducing the length of the fluid path between the return indicator 150 and the needle tip 116.

[0043] Advantageously, the movement of the syringe barrel 154 and plunger 156 still allows clinicians to utilize tactile and visual feedback provided via the syringe-based blood flashback system. Furthermore, moving the syringe barrel 154 proximally away from the distal end of the insertion device 100 provides a clearer view at the insertion site and allows for additional operations such as manipulation of the guidewire advancement assembly, catheter advancement assembly, articulated housing portion, etc.

[0044] In one embodiment, the syringe barrel support 158 ​​may include one or more clamping features to grip and proximally push the syringe barrel 154. The clamping features may include one or more supports, finger rings, finger pads, ridges, ribs, or comprise a material with an increased coefficient of friction, such as rubber or silicone. In one embodiment, a portion of the fluid communication between the needle notch 118 of the return channel 152 and the syringe barrel 154 may include a flexible tube, etc. Advantageously, the flexible tube may allow the syringe barrel 154 to slide proximally relative to the needle interface 140.

[0045] In one implementation scheme, such as Figure 5 As shown, the insertion system 200 may include a blood return indicator system 250, which includes a syringe used in a "conventional" manner. The insertion system 200 typically includes a housing 230, a catheter 220 (e.g., a CVC catheter or RICC catheter), and a needle 210. Optionally, the insertion system 200 may include one or more guidewires (not shown). The blood return indicator system 250 may include a syringe barrel 254 coupled to the housing 230 to prevent relative longitudinal movement between them. A plunger 256 is slidably engaged with the syringe barrel 254 and can be advanced distally to create a vacuum within the syringe barrel 254. As shown, the plunger 256 may include finger pads for gripping the plunger. The proximal end of the syringe barrel may be aligned adjacent to a needle notch (not shown) and a needle interface 240, as described herein.

[0046] In use, the insertion system 200 can be advanced until the needle tip 216 enters the patient's vascular system. The plunger 256 can extend distally to allow the user to manipulate it while grasping the distal portion of the housing 230. Distal advancement of the plunger 256 creates a vacuum within the syringe barrel 254, drawing blood through the needle lumen to the needle notch, through the needle interface 240, through the return channel, and into the syringe barrel 254. As shown, the syringe barrel 254 can be formed of a transparent material to facilitate observation of blood color and pulsating flow. Advantageously, longitudinally aligning the proximal end of the syringe barrel 254 adjacent to the needle interface 240 reduces the length of the return channel, thereby further reducing the overall length of the return fluid path.

[0047] While certain specific embodiments have been disclosed herein, and while these specific embodiments have been disclosed in considerable detail, they are not intended to limit the scope of the concepts provided herein. Other adaptations and / or modifications will be apparent to those skilled in the art, and these adaptations and / or modifications are also covered in a broader sense. Therefore, changes can be made to the specific embodiments disclosed herein without departing from the scope of the concepts provided herein.

Claims

1. A catheter insertion system, characterized in that, include: A catheter that defines the lumen of a catheter and extends along a longitudinal axis; A needle that defines a needle lumen and is disposed within a portion of the lumen of the catheter; A housing that supports one of the catheters or the needle; and A blood return indicator, which is in fluid communication with the inner lumen of the needle, the blood return indicator includes a plunger fixedly attached to the housing and a syringe barrel slidably engaged with the plunger along the longitudinal axis. The housing includes a needle interface defining a needle channel and a blood return channel, the needle channel being configured to receive an extension of the needle through a portion of the needle channel, and the blood return channel providing fluid communication between the needle channel and the syringe barrel.

2. The catheter insertion system according to claim 1, characterized in that, The syringe barrel is configured to slide proximally relative to one of the plunger or the housing to create a vacuum and draw blood flow through the needle lumen and into the syringe barrel.

3. The catheter insertion system according to claim 1, characterized in that, The syringe barrel is made of a transparent material to allow observation of blood color or pulsating flow.

4. The catheter insertion system according to claim 1, characterized in that, The syringe barrel is supported by a bracket that includes clamping features and is configured to facilitate sliding of the syringe barrel along the longitudinal axis.

5. The catheter insertion system according to claim 1, characterized in that, The needle includes a notch extending through the wall of the needle to provide fluid communication between the needle lumen and the needle channel.

6. The catheter insertion system according to claim 5, characterized in that, The needle channel includes a first O-ring and a second O-ring, the first O-ring being arranged annularly around the needle and disposed distally to the notch, and the second O-ring being arranged annularly around the needle and disposed proximally to the notch. The first O-ring and the second O-ring each extend between the outer surface of the needle and the inner surface of the needle channel to provide a fluid-impermeable seal between the outer surface of the needle and the inner surface of the needle channel.

7. The catheter insertion system according to claim 1, characterized in that, The needle is slidably engaged with the needle channel.

8. The catheter insertion system according to claim 1, characterized in that, A portion of the blood return channel is formed by a flexible tube.

9. The catheter insertion system according to claim 1, characterized in that, The catheter is a central venous catheter or a rapid insertion central catheter.

10. A catheter placement system, characterized in that, include: A catheter that defines the lumen of a catheter and extends along a longitudinal axis; A needle that defines a needle lumen and extends through a portion of the lumen of the catheter; A housing that supports one or both of the catheter and the needle, and the housing includes a needle interface to provide fluid communication between the needle lumen and the blood return channel at a point distal to the proximal end of the needle. and A blood return indicator, which is in fluid communication with the blood return channel, the blood return indicator includes a syringe barrel fixedly attached to the housing and includes a plunger slidably engaged with the syringe barrel between a proximal position and a distal position. The needle interface defines a needle channel in communication with the blood return channel, the needle channel being configured to receive an extension of the needle through a portion of the needle channel. The needle includes a notch extending through the wall of the needle to provide fluid communication between the needle lumen and the needle channel, and The needle channel includes a first O-ring and a second O-ring, the first O-ring being arranged annularly around the needle and disposed distally to the notch, and the second O-ring being arranged annularly around the needle and disposed proximally to the notch. The first O-ring and the second O-ring each extend between the outer surface of the needle and the inner surface of the needle channel to provide a fluid-impermeable seal between the outer surface of the needle and the inner surface of the needle channel.

11. The catheter placement system according to claim 10, characterized in that, The plunger is configured to slide from the proximal position to the distal position to create a vacuum within the syringe barrel.

12. The catheter placement system according to claim 10, characterized in that, The needle is slidably engaged with the needle channel.

13. The catheter placement system according to claim 10, characterized in that, A portion of the blood return channel is formed by a flexible tube.

14. The catheter placement system according to claim 10, characterized in that, The catheter is a central venous catheter or a rapid insertion central catheter.

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