Vascular access instrument advancing device

Abstract

This disclosure relates to a vascular access device advancement device, which may include a housing and an extension tube extending through the housing. The extension tube may include a first lumen and a second lumen. A blood collection path may extend through the first lumen. A wedge may be disposed within the housing and the second lumen of the extension tube. A pair of opposing clamping members may be configured to clamp the extension tube. The pair of opposing clamping members may be disposed proximally to the wedge within the housing and configured to move along the extension tube with the housing. A device may extend distally from the wedge. The device may be disposed within the second lumen. In response to distal movement of the housing along the extension tube, the pair of opposing clamping members distally push the wedge, and the device is advanced distally.

Description

Technical Field

[0001] This disclosure relates to medical devices. In particular, this disclosure relates to a vascular access device propulsion device. Background Technology

[0002] Catheters are commonly used to infuse fluids into a patient's vascular system. For example, catheters can be used to infuse saline solutions, various medications, or total parenteral nutrition. Catheters can also be used to draw blood from a patient.

[0003] The catheter may include a needle-type peripheral venous (“IV”) catheter. In this case, the catheter may be mounted on a guide needle with a sharp distal end. The catheter and guide needle may be assembled such that the distal end of the guide needle extends beyond the distal end of the catheter, wherein the bevel of the needle faces upward away from the patient’s skin. The catheter and guide needle are typically inserted into the patient’s vascular system through the skin at a small angle.

[0004] To verify proper placement of the guide needle and / or catheter in the blood vessel, clinicians typically confirm the presence of blood "backflow" in the reflux chamber. Once guide needle placement has been confirmed, the clinician can remove the guide needle, leaving the catheter in place for future blood draws or fluid infusions.

[0005] Over time, catheters may become occluded at their distal ends due to the presence of fibrin sheaths, thrombi, or the vein wall or valves. Occlusion limits the catheter's ability to be used for infusion and / or blood draw. The subject matter claimed herein is not limited to addressing any drawbacks or to embodiments that operate only in environments such as those described above. Rather, this background is provided merely to illustrate an exemplary technical field in which some of the embodiments described herein can be practiced. Summary of the Invention

[0006] This disclosure generally relates to device propulsion devices, and related systems and methods. In some embodiments, the device propulsion device may include a housing and an extension tube extending through the housing. In some embodiments, the extension tube may include a first lumen and a second lumen. It will be understood that in some embodiments, the extension tube may include one or more additional lumens in addition to the first and second lumens. In some embodiments, a blood collection path may extend through the first lumen and / or one or more additional lumens.

[0007] In some embodiments, the instrument propulsion device may include a wedge-shaped member disposed within a second lumen of the housing and the extension tube. In some embodiments, the instrument propulsion device may include a pair of opposing clamping members configured to clamp the extension tube. In some embodiments, the pair of opposing clamping members may be disposed within the housing and configured to move along the extension tube together with the housing. In some embodiments, the pair of opposing clamping members may be disposed within the housing proximal to the wedge-shaped member.

[0008] In some embodiments, the device advancement device may include a device that extends distally from the wedge. In some embodiments, the device may be disposed within the second lumen. In some embodiments, in response to distal movement of the housing along the extension tube, the pair of opposing clamping members may push the wedge distally, and the device may be advanced distally. In some embodiments, the device may include a vascular access device configured to be advanced distally through the catheter assembly and into the patient's vascular system.

[0009] In some embodiments, the instrument propulsion device may include another pair of opposing clamping members configured to clamp the extension tube. In some embodiments, the other pair of opposing clamping members may be disposed distal to the wedge within the housing and configured to move along the extension tube together with the housing. In some embodiments, in response to proximal movement of the housing along the extension tube, the other pair of opposing clamping members may push the wedge proximally, and the instrument may retract proximally.

[0010] In some embodiments, in response to movement of the housing along the extension tube, the opposing clamping members may rotate relative to the housing and the extension tube. In some embodiments, the inner surface of the housing may include one or more protrusions that contact the pair of opposing clamping members. In some embodiments, the pair of opposing clamping members may be fixed relative to the housing.

[0011] In some embodiments, the device may include a guidewire. In some embodiments, the device advancement device may include a distal adapter. In some embodiments, the distal end of the extension tube may be coupled to the distal adapter. In some embodiments, the device advancement device may include a diaphragm disposed within the distal adapter and configured to seal a second lumen but not a first lumen. In some embodiments, the device advancement device may include a diaphragm disposed within the distal adapter and sealing a second lumen. In some embodiments, the device advancement device may include a blunt sleeve extending from the first lumen through the diaphragm.

[0012] In some embodiments, the distal adapter may include a shaft and an opposing rod lock. In some embodiments, the shaft may include a blunt sleeve. In some embodiments, the instrument advancement device may include a cap disposed on the shaft. In some embodiments, the distal end of the cap may include an opening.

[0013] In some embodiments, a first lumen may extend through the extension tube. In some embodiments, a second lumen may extend through the extension tube. In some embodiments, the top surface of the extension tube may include a marking. In some embodiments, in response to alignment of the housing with the marking, the instrument may be advanced distally beyond the catheter tip by a distance. In some embodiments, the marking may indicate the distance. In some embodiments, the top surface of the extension tube may include another marking. In some embodiments, in response to alignment of the housing with the other marking, the instrument may be aligned with the catheter tip.

[0014] In some embodiments, the top surface of the distal adapter or extension tube may include markings.

[0015] In some embodiments, the top surface of the device may include another mark. In some embodiments, in response to alignment of the other mark with the first mark, the device may be advanced distally beyond the catheter tip.

[0016] In some embodiments, the top surface of the distal adapter or extension tube may include markings.

[0017] In some embodiments, the top surface of the device may include another mark. In some embodiments, in response to the alignment of the other mark with the first mark, the device may be aligned with the catheter tip.

[0018] In some embodiments, the top surface of the distal adapter may include a mark. In some embodiments, the top surface of the device may include another mark. In some embodiments, in response to the other mark moving from the proximal end of the mark to the distal end of the mark, the device may be advanced a distance beyond the catheter tip equal to the length of the mark. In some embodiments, the length of the mark may be 10 mm, 20 mm, 30 mm, 40 mm, 50 mm, or another length. In some embodiments, the length of the mark may be between 10 mm and 50 mm, including the end value; between 10 mm and 30 mm, including the end value; between 10 mm and 40 mm, including the end value; or between 20 mm and 40 mm, including the end value.

[0019] In some embodiments, the device advancement device may include a proximal adapter coupled to the proximal end of the extension tube. In some embodiments, the proximal adapter may be configured to be coupled to a blood collection device. In some embodiments, the distal adapter and / or the proximal adapter may be overmolded onto the extension tube, which may prevent fluid leakage.

[0020] It should be understood that the foregoing general description and the following detailed description are exemplary and illustrative, and not intended to limit the claimed invention. It should be understood that the various embodiments are not limited to the arrangements and arrangements shown in the drawings. It should also be understood that embodiments may be combined, or other embodiments may be utilized, and structural changes may be made without departing from the scope of the various embodiments of the invention unless stated otherwise. Therefore, the following detailed description should not be construed as limiting. Attached Figure Description

[0021] Example embodiments will be described and explained with additional features and details using the accompanying drawings, in which:

[0022] Figure 1 This is a top perspective view of an example machine propulsion device according to some embodiments;

[0023] Figure 2 This is a cross-sectional view of an exemplary distal end of a device propulsion device according to some embodiments;

[0024] Figure 3 This is a cross-sectional view of another exemplary distal end of a device propulsion device according to some embodiments;

[0025] Figure 4 This is a cross-sectional view of an example housing of a device propulsion device according to some embodiments, showing an example extension tube extending through it;

[0026] Figure 5A This is a top perspective view of an exemplary part of a housing according to some embodiments;

[0027] Figure 5B The housing, according to some embodiments, is configured to be connected to Figure 5A Another example of a housing component is the upper perspective view of the component;

[0028] Figure 6A This is a top view of an exemplary cap attached to a machine propulsion device according to some embodiments;

[0029] Figure 6B This is a top perspective view of a cap according to some embodiments;

[0030] Figure 6C This is another upper perspective view of a cap according to some embodiments, which shows an exemplary opening;

[0031] Figure 7 This is a cross-sectional view of an exemplary proximal end of a device propulsion device according to some embodiments;

[0032] Figure 8AThis is a top view of an exemplary distal adapter including exemplary markings according to some embodiments;

[0033] Figure 8B This is a top perspective view of an exemplary device according to some embodiments, which shows another exemplary label;

[0034] Figure 8C This is a top perspective view of a portion of a device propulsion apparatus according to some embodiments, showing exemplary markings; and

[0035] Figure 8D This is a top perspective view of an instrument that is advanced distally beyond the distal end of an exemplary catheter, according to some embodiments. Detailed Implementation

[0036] This application claims priority to U.S. Provisional Application 63 / 137,049, filed January 13, 2021, entitled “Vascular Access Device Propulsion Device, System, and Method,” the entire disclosure of which is incorporated herein by reference.

[0037] Now for reference Figure 1 According to some embodiments, an instrument propulsion device 10 is shown. In some embodiments, the instrument propulsion device 10 may include a housing 12 and an extension tube 14 extending through the housing 12. In some embodiments, the extension tube 14 may be rigid, semi-rigid, or flexible. In some embodiments, the extension tube 14 may include a co-extruded guidewire to increase the stiffness of the extension tube 14. In some embodiments, the extension tube 14 may include a multi-lumen extension tube.

[0038] In some embodiments, the device advancement device 10 may include a device 16, which may include a guidewire, a tube, or other suitable device. In some embodiments, the device 16 may be colored to increase visibility. In some embodiments, the guidewire may be made of metal or other suitable material. In these and other embodiments, the device 16 may be lubricated or coated to facilitate advancement. In some embodiments, the tube may be flexible or rigid. In some embodiments, the tube may form a closed path for blood flow and / or to reduce blood contamination due to drug adsorption in the catheter assembly.

[0039] In some embodiments, device 16 may include a guidewire, which may include a spring or coil. In some embodiments, the spring or coil may include a pitch that varies along its length. For example, the pitch of the spring or coil upstream or proximal to the catheter tip may be larger to allow more blood flow and increase flow rate, and the pitch of the spring or coil near the catheter tip may be smaller to prevent blood clots from entering the catheter tip while still allowing blood to flow through the catheter tip. In some embodiments, the guidewire may include a rod that extends through the central portion of the spring or coil. In some embodiments, the guidewire may include a rod and may not include a spring or coil.

[0040] Over time, the catheter may become occluded at its tip due to the presence of fibrin sheaths, thrombi, or the vein wall or valves. In some embodiments, the device 16 may be configured to extend into and / or through the catheter assembly to push through the catheter and / or disrupt the occlusion. In some embodiments, the device 16 may overcome thrombi and fibrin sheaths in or around the catheter assembly or in the vein that may prevent blood aspiration. In some embodiments, the device advancement device 10 may reduce trauma to the vascular system while also facilitating fluid delivery, blood collection, patient or device monitoring, or other clinical needs. In some embodiments, the device advancement device 10 may reduce hemolysis and blood exposure. In some embodiments, the device 16 may include a vascular access device configured to be advanced distally through the catheter assembly and into the patient's vascular system.

[0041] In some embodiments, the distal end of the device advancement device 10 may include a distal adapter 18 or another suitable connector. In some embodiments, the distal adapter 18 may be configured to connect to a catheter assembly that may be present or already residing within a patient's vascular system. In some embodiments, the catheter assembly may include a catheter adapter that may include a distal end, a proximal end, and a lumen extending through the distal and proximal ends of the catheter adapter. In some embodiments, the catheter may extend from the distal end of the catheter adapter. In some embodiments, the catheter may include a peripheral venous catheter, a midline catheter, or a peripherally inserted central catheter. In some embodiments, the catheter assembly may include a guide needle that extends through the catheter and facilitates puncture of the skin and vascular system to insert the catheter into the patient. In some embodiments, the guide needle may be removed from the catheter assembly before the device advancement device 10 is coupled to the catheter assembly.

[0042] In some embodiments, the catheter assembly may be straight. In other embodiments, the catheter assembly may be integrated, having an extension tube integrated with the catheter adapter. In some embodiments, the catheter assembly may include an extension kit that may include an extension tube extending from and integrated with a side port of the catheter adapter. In some embodiments, the distal adapter 18 may be configured to be coupled to a portion of the catheter assembly, such as the proximal end of the catheter adapter and / or a needleless access connector. In some embodiments, the needleless access connector may be coupled to the proximal end of the extension kit, a T-connector, or another portion. In some embodiments, the needleless access connector may be permanently attached to the distal adapter 18 (e.g., by adhesive) to prevent intentional or unintentional removal by the user.

[0043] In some embodiments, the distal end of the extension tube 14 may be connected to a distal adapter 18. In some embodiments, the proximal end of the extension tube 14 may be connected to a proximal adapter 20, which may include another distal adapter or another suitable connector. In some embodiments, the proximal adapter 20 may be configured to be coupled to a blood collection device. In some embodiments, the blood collection device may include a syringe, a BD VACUTAINER disposable retainer (available from BD VACUTAINER, Franklin Lake, New Jersey), or a BD VACUTAINER LUER-LOK. TM Access devices (which are also available from BD Company in Franklin Lake, New Jersey), or another suitable blood collection device that can provide aspiration.

[0044] In some embodiments, the device 16 may be advanced before or during infusion or blood draw. In some embodiments, after blood draw or infusion is completed and before disengaging the device advancement device 10 from the catheter assembly, the user can retract the device by moving the housing 12 backward or proximally. Thus, in some embodiments, the risk of user exposure to blood can be reduced.

[0045] Now for reference Figure 2 In some embodiments, the extension tube 14 may include a first lumen 22 and a second lumen 24, the second lumen being separate from the first lumen 22 along its entire length. In some embodiments, a blood collection path may extend through the first lumen 22. In some embodiments, the device 16 may be disposed within the second lumen 24. In some embodiments, the diameter of the second lumen 24 may be larger than the diameter of the first lumen 22. In some embodiments, the diameter and / or length of the first lumen 22 may be selected based on a desired flow rate and / or reduction of hemolysis.

[0046] In some embodiments, in response to distal movement of the housing 12 along the extension tube 14, the device 16 may advance distally within the second lumen 24. In some embodiments, in response to proximal movement of the housing 12 along the extension tube 14, the device 16 may retract proximally within the second lumen 24.

[0047] In some embodiments, the device propulsion device 10 may include a diaphragm 26 disposed within the distal adapter 18 and configured to seal the second lumen 24 or prevent blood from flowing into the second lumen 24. In these and other embodiments, the diaphragm 26 may not seal the first lumen 22, allowing blood to flow along fluid path 28 from the distal adapter 18 to the proximal side through the first lumen 22 for blood collection. In some embodiments, the diaphragm 26 may be an elastomer.

[0048] In some embodiments, when the housing 12 is fully retracted in the proximal direction, the distal end of the device 16 may be positioned proximal to the distal end of the distal adapter 18. In some embodiments, when the housing 12 is fully retracted in the proximal end direction, the distal end of the device 16 may be positioned proximal to the diaphragm 26, and / or the device 16 may be sealed within the extension tube 14.

[0049] In some embodiments, the device propulsion device 10 may include a cannula 30 that connects the distal end of the first lumen 22 to the distal adapter 18. In some embodiments, the cannula 30 may be blunt. In some embodiments, a fluid path 28 may extend through the cannula 30 to prevent blood leakage. In some embodiments, the cannula 30 may be made of steel, plastic, metal, or other suitable materials. In some embodiments, the cannula 30 may be coupled to the distal adapter 18 or integrally formed as a single unit with the distal adapter 18. In some embodiments, the diaphragm 26 may be concentric or slightly offset with the second lumen 24 to achieve sufficient wall thickness.

[0050] In some embodiments, the distal adapter 18 may include a shaft 38 and an opposing lever lock 40. In some embodiments, the lever lock 40 may facilitate coupling to a needleless access connector. In some embodiments, the shaft 38 may be lubricated, which may reduce the force required to insert into the catheter assembly. In some embodiments, the male distal adapter may include a male Luer, a male Luer lock, a male sliding Luer, a Luer, or another suitable connector.

[0051] Now refer to Figure 3 In some embodiments, the diaphragm 26 may extend across the width of the inner lumen of the distal adapter 18. In some embodiments, the diaphragm 26 may seal the second lumen 24 or prevent blood from flowing into the second lumen 24. In some embodiments, the cannula 30 may extend from the first lumen 22 through the diaphragm 26 to allow fluid to flow through it.

[0052] Now for reference Figure 4 In some embodiments, the instrument propulsion device 10 may include a wedge 32 disposed within a second cavity 24 of the housing 12 and the extension tube 14. In some embodiments, the instrument propulsion device 10 may include a pair of opposing clamping members 34 configured to clamp the extension tube 14. In some embodiments, the pair of opposing clamping members 34a, b may be disposed proximal to the wedge 32 within the housing 12 and configured to move along the extension tube 14 together with the housing 12.

[0053] In some embodiments, the device 16 may extend distally from the wedge 32. In some embodiments, the device 16 may be disposed within the second lumen 24. In some embodiments, in response to movement of the housing 12 distally along the extension tube 14, the pair of opposing clamping members 34a, b may push the wedge 32 distally, and the device 16 may be advanced distally.

[0054] In some embodiments, the instrument propulsion device 10 may include another pair of opposing clamping members 34c, d configured to clamp the extension tube 14. In some embodiments, the other pair of opposing clamping members 34c, d may be disposed distal to the wedge 32 within the housing and configured to move along the extension tube 14 together with the housing 12. In some embodiments, in response to proximal movement of the housing 12 along the extension tube 14, the other pair of opposing clamping members 34c, d may push the wedge 32 proximally, and the instrument 16 may retract proximally.

[0055] In this disclosure, the pair of opposing clamping members 34a, b and the other pair of opposing clamping members 34c, d may be collectively referred to as "opposing clamping members 34". In some embodiments, the opposing clamping members 34 may rotate relative to the housing 12 and the extension tube 14 in response to movement of the housing 12 along the extension tube 14. In some embodiments, the opposing clamping members 34 may rotate relative to the housing 12 and the extension tube 14 in response to movement of the housing 12 along the extension tube 14, which may rotate the instrument 16. In some embodiments, the inner surface of the housing 12 may include one or more protrusions 36 that contact the opposing clamping members 34, which may reduce friction during rotation of the opposing clamping members 34. In some embodiments, the wedge 32 and / or the opposing clamping members 34 may be lubricated with a lubricant, which may reduce friction.

[0056] In some embodiments, the opposing clamping member 34 may be made of plastic, metal, or other suitable material. In some embodiments, the opposing clamping member 34 may include a spherical ball, ball bearing, wheel, or cylinder configured to rotate relative to the housing 12. In some embodiments, the opposing clamping member 34 may include a wheel, which may be smooth or include feet along its edges. In these embodiments, lubricant may be applied to the wheel axle to reduce friction. In some embodiments, the opposing clamping member 34 may be fixed relative to the housing 12. For example, the opposing clamping member 34 may be molded into the housing 12.

[0057] In some embodiments, the number of opposing pinching members 34 may vary based on the shape of the wedge 32. In some embodiments, the instrument propulsion device 10 may include the pair of opposing pinching members 34a, b and the other pair of opposing pinching members 34c, d in response to the shape of, for example, a cylindrical wedge 32. In some embodiments, the instrument propulsion device 10 may include a single pair of opposing pinching members 34, such as the pair of opposing pinching members 34a, b, in response to a wedge 12 comprising a dog bone shape, and the single pair of opposing pinching members may be disposed in the middle or recess of the dog bone shape.

[0058] Now for reference Figures 5A-5B In some embodiments, the housing 12 may include a hole 41 extending therethrough, the hole 41 being configured to receive an extension tube 14. In some embodiments, the inner surface of the housing 12 may include one or more protrusions 42 that may contact the extension tube 14 to reduce friction between the extension tube 14 and the housing 12 as the housing 12 moves along the extension tube 14. In some embodiments, the housing 12 may include a plurality of components 44a,b that may be connected together by a stake 45 or any other suitable mechanism. In other embodiments, the housing 12 may be integrally formed as a single unit.

[0059] In some embodiments, the housing 12 may include a plurality of cuts 46, each cut 46 including a protrusion 36. In these and other embodiments, the opposing clamping member 34 may include a spherical ball. In some embodiments, the cuts 46 may be generally spherical and / or may extend outward from the hole 41. In some embodiments, halves of the cuts 46 shown in the plurality of components 44a, b may be joined together to form the cuts 46.

[0060] In some embodiments, the housing 12 may be rigid or semi-rigid to facilitate user gripping and / or one-handed propulsion. In some embodiments, the housing 12 may include one or more gripping features or shapes to facilitate user gripping. In some embodiments, gripping features may include one or more ridges, notches, and tabs on the top and / or one or more sides of the housing 12. In some embodiments, the shape of the housing 12 may include a square, cylindrical, dog-bone shaped, or other suitable shape. In some embodiments, the shape of the housing 12 and / or gripping features may facilitate user propulsion and / or retraction of the device 16 without contact with the device, thereby reducing the risk of contamination and / or infection. In some embodiments, the housing 12 may include one or more textured surfaces to facilitate user gripping.

[0061] Now for reference Figures 6A-6C In some embodiments, the instrument propulsion device 10 may include a cap 48 disposed on the shaft 38. In some embodiments, the cap 48 may include one or more gripping features along the edge of the cap 48 for easy removal from the shaft 38, and the gripping features may be blunt. In some embodiments, the cap 48 may be padded at the distal end, for example as... Figure 6B As shown, this prevents the instrument from being prematurely pushed past the end of the shaft 38 during transport or loading of the instrument propulsion device 10.

[0062] In some embodiments, the distal end of the cap 48 may include an opening 50, such as... Figure 6C As shown. In some embodiments, the opening 50 can reduce material and cost, and prevent damage to the device 16 if the user forgets to remove the cap 48 before advancing.

[0063] See now Figure 7 In some embodiments, the proximal end of the extension tube 14 may be coupled to a proximal adapter 20, which may include a female Luer, a female Luer lock, a female sliding Luer, a Luer, or other suitable connector. In some embodiments, the proximal adapter 20 may be configured to be coupled to a blood collection device. In some embodiments, a first lumen 22 may extend through the extension tube 14. In some embodiments, a second lumen 24 may extend through the extension tube 14.

[0064] In some embodiments, the distal adapter 18 may not include a diaphragm (e.g., see reference 18). Figure 2-3 (Diaphragm 26 as described herein). In these and other embodiments, the proximal adapter 20 may block the proximal end of the extension tube 14 to prevent blood leakage through the proximal adapter 20, for example... Figure 7As shown. In some embodiments, a seal can be achieved by overmolding the proximal adapter 20 and / or the distal adapter 18 onto either end of the extension tube 14 to form a seal around the instrument 16.

[0065] In some embodiments, the device propulsion device 10 may include a cannula 52 that connects the proximal end of the first lumen 22 to the proximal adapter 20 to prevent blood leakage. In some embodiments, the cannula 52 may be blunt. In some embodiments, a fluid path 28 may extend through the cannula 52. In some embodiments, the fluid path (e.g., length and / or diameter) is selected or optimized by one or more of the following to increase flow rate and reduce the risk of hemolysis: distal adapter 18, proximal adapter 20, cannula 52, cannula 30, and extension tube 14.

[0066] Now refer to Figures 8A-8B In some embodiments, the top surface of the distal adapter 18 may include a mark 54 that is visible to the user during use. In some embodiments, the top surface of the device 16 may include another mark 56. In some embodiments, the distal adapter 18 may be transparent, which may allow the user to see the other mark 56 through the distal adapter 18. In some embodiments, mark 54 and / or the other mark 56 may indicate to the user the advancement of the device 16. In some embodiments, in response to the other mark 56 moving from the proximal end of mark 54 to the distal end of mark 54, the device 16 may advance a distance beyond the catheter tip equal to the length of mark 54. In some embodiments, the length of mark 54 may be 30 mm or another suitable length.

[0067] In some embodiments, marking 54 and / or another marking 56 may be provided by molding, etching, laser processing, coloring, or other suitable means. In some embodiments, marking 54 may include a line parallel to the longitudinal axis of the instrument advancement device 10. Additionally, in some embodiments, marking 54 may include a number and / or units corresponding to the length of marking 54. In some embodiments, another marking 56 may include a line that may be perpendicular to the longitudinal axis of the instrument advancement device 10, or other suitable markings. In some embodiments, the instrument 16 may be shaded or frosted, which may facilitate the user's visibility of the instrument 16. In some embodiments, the distal adapter 18 may include a coupling cavity 57 in which the distal end of the extension tube 14 may be fixed and / or adhered.

[0068] Now refer to Figure 8CIn some embodiments, the top surface of the extension tube may include one or more markings that are visible to the user during use. In some embodiments, the markings may be molded, etched, laser-processed, colored, or otherwise provided in a suitable manner. In some embodiments, the markings may indicate the advance of the user device 16. In some embodiments, the top surface of the extension tube 14 may include reference retrieval systems. Figure 8A The described mark 54. In some embodiments, in response to another mark 56 of the device (e.g., see...) Figure 8B From the proximal end of marker 54 to the distal end of marker 54, instrument 16 may advance beyond the catheter tip by a distance equal to the length of marker 54. In some embodiments, the length of marker 54 may be 30 mm or another suitable length.

[0069] In some embodiments, the markings on the top surface of the extension tube 14 may include marking 58 and / or marking 60. In some embodiments, in response to the housing 12 or marking 56 aligning with marking 58, the instrument 16 may advance distally beyond the catheter tip 64 of the catheter 62 by a distance (e.g., see...). Figure 8D In some embodiments, mark 58 may indicate a distance, such as 30 mm. More specifically, in some embodiments, mark 58 may include a number and / or unit corresponding to the distance.

[0070] In some embodiments, in response to the alignment of housing 12 or mark 56 with mark 60, instrument 16 may be aligned with catheter tip 64. In some embodiments, mark 58 and / or mark 60 may include a line that may be perpendicular to the longitudinal axis of instrument advance device 10, or other suitable markings. In some embodiments, mark 60 may include a number and / or units corresponding to the position of the distal end of instrument 16.

[0071] In some embodiments, the extension tube 14 may be transparent to allow visualization of the device 16 therein. In some embodiments, markings 58 and / or 60 may be provided on the distal adapter 18, which may be transparent. Referring now... Figure 8D The device 16 may be positioned distal to the catheter tip 64, and in some embodiments, the device 16 may advance distally beyond the catheter tip 64 in response to the housing 12 advancing in the distal direction.

[0072] All examples and conditional language described herein are for educational purposes and are intended to help the reader understand the concepts contributed by the inventors to advance the art, and should be construed as not being limited to such specifically described examples and conditions. Although embodiments of the invention have been described in detail, it should be understood that various changes, substitutions, and modifications can be made thereto without departing from the spirit and scope of the invention.

Claims

1. A vascular access instrument advancing device, characterized by, The vascular access instrument advancement device comprises: a housing; an extension tube extending through the housing, wherein the extension tube comprises a first lumen and a second lumen, the first lumen and the second lumen each extending from a proximal end of the extension tube to a distal end of the extension tube, wherein a blood collection path extends through the first lumen; a wedge disposed within the housing and the second lumen of the extension tube; a pair of opposing pinch members configured to pinch the extension tube, wherein the pair of opposing pinch members are disposed within the housing and are configured to move along the extension tube with the housing; an instrument extending distally from the wedge, wherein the distally extending instrument is disposed within the second lumen such that a proximal end of the distally extending instrument is contained within the wedge, wherein in response to moving the housing distally along the extension tube, the pair of opposing pinch members distally push the wedge and the distally extending instrument is distally advanced through the second lumen.

2. The vascular access instrument advancing device of claim 1, wherein, The pair of opposing pinch members are disposed within the housing proximally of the wedge, the vascular access instrument advancement device further comprising a second pair of opposing pinch members configured to pinch the extension tube, wherein the second pair of opposing pinch members are disposed within the housing distally of the wedge and are configured to move along the extension tube with the housing, wherein in response to moving the housing proximally along the extension tube, the second pair of opposing pinch members proximally push the wedge and the distally extending instrument proximally retracts.

3. The vascular access instrument advancing device of claim 1, wherein, The pair of opposing pinch members rotate relative to the housing and the extension tube in response to the housing moving along the extension tube.

4. The vascular access instrument advancing device of claim 3, wherein, An inner surface of the housing comprises a plurality of bumps in contact with the pair of opposing pinch members.

5. The vascular access instrument advancing device of claim 1, wherein, The pair of opposing pinch members are fixed relative to the housing.

6. The vascular access instrument advancing device of claim 1, wherein, The distally extending instrument comprises a guidewire.

7. The vascular access instrument advancing device of claim 1, wherein, The vascular access instrument advancement device further comprises a distal adapter, wherein the distal end of the extension tube is coupled to the distal adapter.

8. The vascular access instrument advancing device of claim 7, wherein, The vascular access instrument advancement device further comprises a septum disposed within the distal adapter and configured to seal the second lumen without sealing the first lumen.

9. The vascular access instrument advancing device of claim 7, wherein, The vascular access instrument advancement device further comprises a septum disposed within the distal adapter and sealing the second lumen, the vascular access instrument advancement device further comprising a blunt cannula extending through the septum from the first lumen.

10. The vascular access instrument advancing device of claim 7, wherein, The distal adapter comprises a shaft and opposing lever locks, the vascular access instrument advancement device further comprising a cap disposed on the shaft.

11. The vascular access instrument advancing device of claim 7, wherein, The vascular access instrument advancement device further comprises a proximal adapter coupled to the proximal end of the extension tube, wherein the distal adapter or the proximal adapter is overmolded onto the extension tube.

12. The vascular access instrument advancing device of claim 1, wherein, A top surface of the extension tube comprises a marker, wherein in response to the housing being aligned with the marker, the distally extending instrument is distally advanced a distance beyond a catheter tip.

13. The vascular access instrument advancing device of claim 12, wherein, The marker indicates the distance.

14. The vascular access instrument advancing device of claim 12, wherein, A top surface of the extension tube includes a second marker, wherein, in response to the housing being aligned with the second marker, the distally extending instrument is aligned with the catheter tip.

15. The vascular access instrument advancing device of claim 7, wherein, A top surface of the distal adapter or the extension tube includes a first marker, wherein a top surface of the distally extending instrument includes a second marker, wherein, in response to the second marker being aligned with the first marker, the distally extending instrument is advanced distally a distance beyond a catheter tip.

16. The vascular access instrument advancing device of claim 7, wherein, A top surface of the distal adapter or the extension tube includes a first marker, wherein a top surface of the distally extending instrument includes a second marker, wherein, in response to the second marker being aligned with the first marker, the distally extending instrument is aligned with a catheter tip.

17. The vascular access instrument advancing device of claim 7, wherein, A top surface of the distal adapter includes a first marker, wherein a top surface of the distally extending instrument includes a second marker, wherein, in response to the second marker moving from a proximal end of the first marker to a distal end of the first marker, the distally extending instrument is advanced a distance beyond a catheter tip equal to a length of the first marker.

18. The vascular access instrument advancing device of claim 17, wherein, The length of the first marker is between and including 10 mm and 50 mm.

19. The vascular access instrument advancing device of claim 1, wherein, The vascular access instrument advancement device further includes a proximal adapter coupled to the proximal end of the extension tube, wherein the proximal adapter is configured to be coupled to a blood collection device.

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