Vascular access device advancement devices, systems, and methods

Abstract

The vascular access instrument advancement device may include a housing and an extension tube extending through the housing. The extension tube may extend through the housing. The extension tube may include a first lumen and a second lumen. The blood collection path may extend through the first lumen. The wedge may be disposed within the housing and the second lumen of the extension tube. The pair of opposing pinch members may be configured to pinch the extension tube. The pair of opposing pinch members may be disposed within the housing proximal to the wedge and configured to move along the extension tube with the housing. The instrument may extend distally from the wedge. The instrument may be disposed within the second lumen. In response to moving the housing distally along the extension tube, the pair of opposing pinch members push the wedge distally and the instrument is advanced distally.

Description

[Technical Field]

[0001] FIELD OF THE INVENTION The present invention relates to vascular access device advancement devices, systems, and methods. [Background technology]

[0002] This application claims priority to U.S. Provisional Application Serial No. 63 / 137,049, filed January 13, 2021, entitled "Vascular Access Device Advancement Device, System, and Method," the entire disclosure of which is incorporated herein by reference in its entirety.

[0003] Catheters are commonly used to infuse fluids into a patient's vascular system. For example, catheters may be used to infuse saline, various medications, or total parenteral nutrition. Catheters may also be used to withdraw blood from a patient.

[0004] The catheter may include an over-the-needle peripheral intravenous ("IV") catheter. In this case, the catheter may be mounted over an introducer needle having a sharp distal tip. The catheter and introducer needle may be assembled so that the distal tip of the introducer needle extends beyond the distal tip of the catheter and the bevel of the needle faces up, away from the patient's skin. The catheter and introducer needle are generally inserted through the skin at a shallow angle into the patient's vascular system.

[0005] To confirm proper placement of the introducer needle and / or catheter within the blood vessel, the clinician will typically check for a "flashback" of blood in a flashback chamber. After introducer needle placement is confirmed, the clinician may remove the introducer needle, leaving the catheter in place for future blood draws or infusions. Summary of the Invention [Problem to be solved by the invention]

[0006] Over time, the tip of the catheter can become blocked due to the presence of fibrin sheaths, thrombi, vein walls, and valves. Blockages can limit the catheter's ability to infuse and / or withdraw blood. The subject matter claimed herein is not limited to embodiments that solve every drawback or that operate only in environments such as those described above. Rather, this background is provided only to illustrate one example technology area in which some implementations described herein may be practiced. [Means for solving the problem]

[0007] The present disclosure generally relates to instrument advancement devices and related systems and methods. In some embodiments, the instrument advancement 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 is understood that in some embodiments, the extension tube may include one or more additional lumens relative to the first lumen and the second lumen. In some embodiments, a blood collection path may extend through the first lumen and / or the one or more additional lumens.

[0008] In some embodiments, the instrument advancement device may include a wedge disposed within the housing and the second lumen of the extension tube. In some embodiments, the instrument advancement device may include a pair of opposing pinch members configured to pinch the extension tube. In some embodiments, the pair of opposing pinch members may be disposed within the housing and configured to move along the extension tube with the housing. In some embodiments, the pair of opposing pinch members may be disposed within the housing proximal to the wedge.

[0009] In some embodiments, the instrument advancement device can include an instrument that can extend distally from the wedge. In some embodiments, the instrument can be disposed within the second lumen. In some embodiments, in response to moving the housing distally along the extension tube, a pair of opposing pinch members can push the wedge distally, and the instrument can be advanced distally. In some embodiments, the instrument can include a vascular access instrument configured to be advanced distally through the catheter assembly and into the patient's vasculature.

[0010] In some embodiments, the instrument advancement device can include another pair of opposing pinch members configured to pinch the extension tube. In some embodiments, the other pair of opposing pinch members can be disposed within the housing distal to the wedge and configured to move along the extension tube with the housing. In some embodiments, in response to moving the housing proximally along the extension tube, the other pair of opposing pinch members can push the wedge proximally, causing the instrument to be proximally retracted.

[0011] In some embodiments, the opposing pinch members may rotate relative to the housing and extension tube in response to movement of the housing along the extension tube. In some embodiments, the inner surface of the housing may include one or more bumps that contact the pair of opposing pinch members. In some embodiments, the opposing pinch members may be fixed relative to the housing.

[0012] In some embodiments, the instrument may include a guidewire. In some embodiments, the instrument 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 instrument advancement device may include a septum disposed within the distal adapter and configured to seal the second lumen but not the first lumen. In some embodiments, the instrument advancement device may include a septum disposed within the distal adapter and sealing the second lumen. In some embodiments, the instrument advancement device may include a blunt cannula extending from the first lumen through the septum.

[0013] In some embodiments, the distal adapter may include a shaft and an opposing lever lock. In some embodiments, the shaft may include a blunt cannula. 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.

[0014] In some embodiments, the first lumen can extend through the extension tube. In some embodiments, the second lumen can extend through the extension tube. In some embodiments, the extension tube can include markings on a top surface thereof. In some embodiments, in response to the housing aligning with the markings, the instrument can be advanced distally a distance beyond the catheter tip. In some embodiments, the markings can indicate a distance. In some embodiments, the top surface of the extension tube can include other markings. In some embodiments, in response to the housing aligning with the other markings, the instrument can be aligned with the catheter tip.

[0015] In some embodiments, the top surface of the extension tube or distal adapter may include markings. In some embodiments, the top surface of the instrument may include other markings. In some embodiments, in response to the other markings aligning with the markings, the instrument may be advanced a distance distally beyond the catheter tip.

[0016] In some embodiments, the top surface of the extension tube or distal adapter may include markings. In some embodiments, the top surface of the instrument may include other markings. In some embodiments, the instrument may be aligned with the catheter tip in response to the other markings being aligned with the markings.

[0017] In some embodiments, the top surface of the distal adapter may include a marking. In some embodiments, the top surface of the instrument may include another marking. In some embodiments, in response to the other marking moving from the proximal end of the marking to the distal end of the marking, the instrument may be advanced beyond the catheter tip by the length of the marking. In some embodiments, the length of the marking may be 10 mm, 20 mm, 30 mm, 40 mm, 50 mm, or another length. In some embodiments, the length of the marking may be, for example, 10 mm to 50 mm, 10 mm to 30 mm, 10 mm to 40 mm, or 20 mm to 40 mm.

[0018] In some embodiments, the instrument delivery device can include a proximal adapter coupled to the proximal end of the extension tube. In some embodiments, the proximal adapter can be configured to couple to a blood collection device. In some embodiments, the distal adapter and / or the proximal adapter can be overmolded onto the extension tube, which can prevent fluid leakage.

[0019] It is to be understood that both the foregoing general description and the following detailed description are exemplary and explanatory only and are not restrictive of the invention as claimed. It is to be understood that the various embodiments are not limited to the arrangements and instrumentality shown in the drawings. It is also to be understood that the embodiments may be combined or other embodiments may be utilized, and that structural changes may be made, unless otherwise claimed, without departing from the scope of the various embodiments of the present invention. Therefore, the following detailed description is not to be taken in a limiting sense. [Brief explanation of the drawings]

[0020] Example embodiments will be described and explained with additional specificity and detail through the use of the accompanying drawings.

[0021] [Figure 1] FIG. 1 is a top perspective view of an exemplary instrument advancement device, according to some embodiments. [Figure 2] 1 is a cross-sectional view of an exemplary distal end of an instrument advancement device, according to some embodiments. [Figure 3] 12A-12C are cross-sectional views of another example of a distal end of an instrument advancement device, according to some embodiments. [Figure 4] 1 is a cross-sectional view of an exemplary housing of an instrument advancement device showing an exemplary extension tube extending therethrough, according to some embodiments. [Figure 5A] FIG. 10 is a top perspective view of an example of a part of a housing, according to some embodiments. [Figure 5B] 5B is a top perspective view of another example of a housing component configured to couple to the housing component of FIG. 5A, according to some embodiments. [Figure 6A] FIG. 10 is a top view of an exemplary cap coupled to an advancement device of an instrument, according to some embodiments. [Figure 6B] FIG. 10 is a top perspective view of a cap, according to some embodiments. [Figure 6C]10 is another top perspective view of the cap, showing an exemplary opening, according to some embodiments. [Figure 7] 1 is a cross-sectional view of an exemplary proximal end of an instrument advancement device, according to some embodiments. [Figure 8A] FIG. 10 is a top view of an exemplary distal adapter including exemplary markings, according to some embodiments. [Figure 8B] FIG. 10 is a top perspective view of an exemplary device showing other exemplary markings, according to some embodiments. [Figure 8C] FIG. 10 is a top perspective view of a portion of an instrument advancement device showing exemplary markings, according to some embodiments. [Figure 8D] FIG. 1 is a top perspective view of an instrument advanced distally beyond the catheter tip of an exemplary catheter, according to some embodiments. DETAILED DESCRIPTION OF THE INVENTION

[0022] 1, an instrument advancement device 10 is shown according to some embodiments. In some embodiments, the instrument advancement 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 add rigidity to the extension tube 14. In some embodiments, the extension tube 14 may include a multi-lumen extension tube.

[0023] In some embodiments, the instrument advancement device 10 may include an instrument 16, which may include a guidewire, a tube, or another suitable instrument. In some embodiments, the instrument 16 may be colored to enhance visibility. In some embodiments, the guidewire may be constructed of metal or another suitable material. In these and other embodiments, the instrument 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 reduce blood contamination due to drug adsorption within the catheter assembly.

[0024] In some embodiments, the device 16 may include a guidewire that may include a spring or coil. In some embodiments, the spring or coil may include a pitch that varies along the length of the spring or coil. For example, the pitch of the spring or coil upstream or proximal to the catheter tip may be larger to promote more blood flow and increase the flow rate, while the pitch of the spring or coil near the catheter tip may be smaller to prevent blood clots from entering the catheter tip while allowing blood to flow through the catheter tip. In some embodiments, the guidewire may include a rod that may extend through a central portion of the spring or coil. In some embodiments, the guidewire may include a rod or not include a spring or coil.

[0025] Over time, catheters can become blocked at the catheter tip due to fibrin sheaths, thrombi, or the presence of venous walls or valves. In some embodiments, instrument 16 can be configured to extend into and / or through the catheter assembly to advance the catheter and / or break up catheter blockages. In some embodiments, instrument 16 can overcome thrombi and fibrin sheaths in or around the catheter assembly or within the vein that can prevent blood collection. In some embodiments, instrument advancement device 10 can reduce trauma to the vasculature while also facilitating fluid delivery, blood collection, patient or device monitoring, or other clinical needs. In some embodiments, instrument advancement device 10 can reduce hemolysis and reduce blood exposure. In some embodiments, instrument 16 can include a vascular access instrument configured to be advanced distally through the catheter assembly into the patient's vasculature.

[0026] In some embodiments, the distal end of the instrument advancement device 10 may include a distal adapter 18 or another suitable connector. In some embodiments, the distal adapter 18 may be configured to couple to a catheter assembly that may be present or already indwelling within the patient's vasculature. 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 end of the catheter adapter and the proximal end 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 intravenous catheter, a midline catheter, or a peripherally inserted central catheter. In some embodiments, the catheter assembly may include an introducer needle that extends through the catheter and may facilitate puncturing the skin and vasculature to insert the catheter into the patient. In some embodiments, the introducer needle may be detached from the catheter assembly prior to coupling the instrument advancement device 10 to the catheter assembly.

[0027] In some embodiments, the catheter assembly may be straight. In other embodiments, the catheter assembly may be integrated with the catheter adapter, having an extension tube integrated therewith. In some embodiments, the catheter assembly may include an extension set, which 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 couple to a portion of the catheter assembly, such as the proximal end of the catheter adapter and / or the needleless access connector. In some embodiments, the needleless access connector may be coupled to the proximal end, T-connector, or another portion of the extension set. In some embodiments, the needleless access connector may be permanently connected to the distal adapter 18, for example, via adhesive, to prevent intentional or unintentional removal by the user.

[0028] In some embodiments, the distal end of the extension tube 14 may be coupled to a distal adapter 18. In some embodiments, the proximal end of the extension tube 14 may be coupled 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 couple to a blood collection device. In some embodiments, the blood collection device may include a syringe capable of providing suction, a BD VACUTAINER® disposable holder (available from Becton, Dickinson and Company of Franklin Lakes, New Jersey), a BD VACUTAINER® LUER-LOK® access device (also available from Becton, Dickinson and Company of Franklin Lakes, New Jersey), or another suitable blood collection device.

[0029] In some embodiments, the instrument 16 may be advanced before or during an infusion or blood draw. In some embodiments, after the blood draw or infusion is complete and before uncoupling the instrument advancement device 10 from the catheter assembly, the user may retract the instrument by moving the housing 12 rearward or proximally. Thus, in some embodiments, the risk of user exposure to blood may be reduced.

[0030] 2, in some embodiments, extension tube 14 may include a first lumen 22 and a second lumen 24, which may be separate from first lumen 22 along the entire length of extension tube 14. In some embodiments, a blood collection path may extend through first lumen 22. In some embodiments, instrument 16 may be disposed within second lumen 24. In some embodiments, the diameter of second lumen 24 may be larger than the diameter of first lumen 22. In some embodiments, the diameter and / or length of first lumen 22 may be selected based on a desired flow rate and / or to reduce hemolysis.

[0031] In some embodiments, in response to moving the housing 12 distally along the extension tube 14, the instrument 16 may be advanced distally within the second lumen 24. In some embodiments, in response to moving the housing 12 proximally along the extension tube 14, the instrument 16 may be retracted proximally within the second lumen 24.

[0032] In some embodiments, the instrument advancement device 10 may include a septum 26 disposed within the distal adapter 18 and configured to seal the second lumen 24 or prevent blood flow into the second lumen 24. In these and other embodiments, the septum 26 may not seal the first lumen 22 such that blood may flow proximally from the distal adapter 18 through the first lumen 22 along the fluid pathway 28 for blood collection. In some embodiments, the septum 26 may be elastomeric.

[0033] In some embodiments, when the housing 12 is fully retracted proximally, the distal end of the instrument 16 may be disposed proximal to the distal end of the distal adapter 18. In some embodiments, the distal end of the instrument 16 may be disposed proximal to the septum 26 and / or the instrument 16 may be sealed within the extension tube 14 when the housing 12 is fully retracted proximally.

[0034] In some embodiments, the instrument advancement device 10 may include a cannula 30 that may connect the distal end of the first lumen 22 and the distal adapter 18. In some embodiments, the cannula 30 may be blunt. In some embodiments, the fluid pathway 28 may extend through the cannula 30, which may prevent blood leakage. In some embodiments, the cannula 30 may be constructed of steel, plastic, metal, or another suitable material. In some embodiments, the cannula 30 may be coupled to the distal adapter 18 or may be integrally formed with the distal adapter 18 as a single unit. In some embodiments, the septum 26 may be concentric with the second lumen 24 or may be slightly offset to obtain the appropriate wall thickness.

[0035] 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 with a lubricant, which may reduce insertion force into the catheter assembly. In some embodiments, the male distal adapter may include a male luer, a male luer lock, a male slip luer, a luer, or another suitable connector.

[0036] 3, in some embodiments, septum 26 may extend across the width of the lumen of distal adapter 18. In some embodiments, septum 26 may seal off second lumen 24 or prevent blood flow into second lumen 24. In some embodiments, cannula 30 may extend from first lumen 22 through septum 26 to allow fluid to flow through cannula 30.

[0037] 4, in some embodiments, the instrument advancement device 10 may include a wedge 32 disposed within the housing 12 and the second lumen 24 of the extension tube 14. In some embodiments, the instrument advancement device 10 may include a pair of opposing pinch members 34 configured to pinch the extension tube 14. In some embodiments, the pair of opposing pinch members 34a, b may be disposed within the housing 12 proximal to the wedge 32 and configured to move along the extension tube 14 with the housing 12.

[0038] In some embodiments, the instrument 16 can extend distally from the wedge 32. In some embodiments, the instrument 16 can be disposed within the second lumen 24. In some embodiments, in response to moving the housing 12 distally along the extension tube 14, a pair of opposing pinch members 34 a, b can push the wedge 32 distally, advancing the instrument 16 distally.

[0039] In some embodiments, the instrument advancement device 10 may include another pair of opposing pinch members 34c, d configured to pinch the extension tube 14. In some embodiments, the another pair of opposing pinch members 34c, d may be disposed within the housing distal to the wedge 32 and configured to move along the extension tube 14 with the housing 12. In some embodiments, in response to moving the housing 12 proximally along the extension tube 14, the pair of opposing pinch members 34c, d may push the wedge 32 proximally, causing the instrument 16 to retract proximally.

[0040] The pair of opposing pinch members 34a, b and the other pair of opposing pinch members 34c, d may be collectively referred to in this disclosure as "opposing pinch members 34." In some embodiments, in response to movement of the housing 12 along the extension tube 14, the opposing pinch members 34 may rotate relative to the housing 12 and the extension tube 14. In some embodiments, in response to movement of the housing 12 along the extension tube 14, the opposing pinch members 34 may rotate relative to the housing 12 and 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 bumps 36 in contact with the opposing pinch members 34, which may reduce friction as the opposing pinch members 34 rotate. In some embodiments, the wedges 32 and / or the opposing pinch members 34 may be lubricated with a lubricant, which may reduce friction.

[0041] In some embodiments, the opposing pinch members 34 may be constructed of plastic, metal, or another suitable material. In some embodiments, the opposing pinch members 34 may include spherical balls, ball bearings, wheels, or cylinders that may be configured to rotate relative to the housing 12. In some embodiments, the opposing pinch members 34 may include wheels that may be smooth or may include legs along the edges of the pinch members 34. In these embodiments, a lubricant may be applied to the axles of the wheels to reduce friction. In some embodiments, the opposing pinch members 34 may be fixed relative to the housing 12. For example, the opposing pinch members 34 may be molded into the housing 12.

[0042] In some embodiments, the number of opposing pinch members 34 may vary based on the shape of the wedge 32. In some embodiments, the instrument advancement device 10 may include one pair of opposing pinch members 34a, b and another pair of opposing pinch members 34c, d depending on the shape of the wedge 32, for example, being cylindrical. In some embodiments, the instrument advancement device 10 may include a single pair of opposing pinch members 34, such as a pair of opposing pinch members 34a, b, depending on the wedge 12 including a dogbone shape, where the single pair may be located in the center or recess of the dogbone shape.

[0043] 5A-5B, in some embodiments, the housing 12 may include an opening 41 extending therethrough and configured to receive the 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 multiple components 44a, b that may be coupled together via pegs 45 or any other suitable mechanism. In other embodiments, the housing 12 may be monolithically formed as a single unit.

[0044] In some embodiments, housing 12 may include multiple cutouts 46, which may include bumps 36. In these and other embodiments, opposing pinch members 34 may include spherical balls. In some embodiments, cutout 46 may be generally spherical and / or may extend outward from opening 41. In some embodiments, halves of cutout 46 shown in multiple pieces 44a,b may be joined together to form cutout 46.

[0045] In some embodiments, housing 12 may be rigid or semi-rigid to facilitate gripping and / or one-handed advancement by a user. In some embodiments, housing 12 may include one or more gripping features or shapes to facilitate gripping by a user. In some embodiments, gripping features may include one or more of ridges, indentations, and tabs on the top of housing 12 and / or on one or more sides of housing 12. In some embodiments, the shape of housing 12 may include a square, cylindrical, dogbone, or another suitable shape. In some embodiments, the shape and / or gripping features of housing 12 may facilitate advancing and / or retracting instrument 16 without the user touching the instrument, thereby reducing the risk of contamination and / or infection. In some embodiments, housing 12 may include one or more textured surfaces to facilitate gripping by a user.

[0046] 6A-6C, in some embodiments, the instrument advancement 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 to facilitate removal from a shaft 38 that may become dull. In some embodiments, for example, as shown in FIG. 6B, the cap 48 may be filled at the distal end, which may prevent an instrument from prematurely pushing too far over the tip of the shaft 38 during shipping or priming of the instrument advancement device 10.

[0047] 6C, the distal end of cap 48 may include opening 50. In some embodiments, opening 50 may reduce material, cost, and prevent damage to instrument 16 if the user neglects to remove cap 48 before advancement.

[0048] 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 slip luer, a luer, or another suitable connector. In some embodiments, the proximal adapter 20 may be configured to couple 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.

[0049] In some embodiments, the distal adapter 18 may not include a septum, such as the septum 26 described with respect to Figures 2-3. 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, as shown, for example, in Figure 7. In some embodiments, sealing may 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.

[0050] In some embodiments, the instrument advancement device 10 may include a cannula 52 that may connect the proximal end of the first lumen 22 and the proximal adapter 20 to prevent blood leakage. In some embodiments, the cannula 52 may be blunt. In some embodiments, the fluid pathway 28 may extend through the cannula 52. In some embodiments, the fluid pathway, such as the length and / or diameter through one or more of the following, may be selected or optimized to increase flow rate and reduce the risk of hemolysis: the distal adapter 18, the proximal adapter 20, the cannula 52, the cannula 30, and the extension tube 14.

[0051] 8A-8B, in some embodiments, the top surface of the distal adapter 18 may include a marking 54 that is visible to a user during use. In some embodiments, the top surface of the instrument 16 may include other markings 56. In some embodiments, the distal adapter 18 may be transparent, which may allow a user to view the other markings 56 through the distal adapter 18. In some embodiments, the marking 54 and / or the other markings 56 may instruct the user regarding the advancement of the instrument 16. In some embodiments, in response to the other markings 56 moving from the proximal end of the marking 54 to the distal end of the marking 54, the instrument 16 may advance beyond the catheter tip a distance equal to the length of the marking 54. In some embodiments, the length of the marking 54 may be 30 mm or another suitable length.

[0052] In some embodiments, the marking 54 and / or other markings 56 may be molded, etched, lasered, painted, or provided by another suitable method. In some embodiments, the marking 54 may include a line parallel to the longitudinal axis of the instrument advancement device 10. Additionally, in some embodiments, the marking 54 may include a number and / or units corresponding to the length of the marking 54. In some embodiments, the other markings 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 visibility of the instrument 16 by a user. In some embodiments, the distal adapter 18 may include a docking pocket 57 to which the distal end of the extension tube 14 may be secured and / or adhered.

[0053] Referring now to FIG. 8C , in some embodiments, the upper surface of the extension tube may include one or more markings that may be visible to a user during use. In some embodiments, the markings may be molded, etched, lasered, painted, or provided in another suitable manner. In some embodiments, the markings may instruct the user regarding the advancement of the instrument 16. In some embodiments, the upper surface of the extension tube 14 may include the marking 54 described with respect to FIG. 8A . In some embodiments, in response to the instrument's other marking 56 (see, e.g., FIG. 8B ) being moved from the proximal end of the marking 54 to the distal end of the marking 54, the instrument 16 may be advanced beyond the catheter tip a distance equal to the length of the marking 54. In some embodiments, the length of the marking 54 may be 30 mm or another suitable length.

[0054] In some embodiments, the markings on the upper 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 be advanced distally a distance beyond the catheter tip 64 of the catheter 62 (see, e.g., FIG. 8D ). In some embodiments, the marking 58 may indicate a distance, such as, for example, 30 mm. More particularly, in some embodiments, the marking 58 may include a numerical value and / or units corresponding to the distance.

[0055] In some embodiments, in response to the housing 12 or marking 56 being aligned with the marking 60, the instrument 16 may be aligned with the catheter tip 64. In some embodiments, the marking 58 and / or marking 60 may include a line that may be perpendicular to the longitudinal axis of the instrument advancement device 10, or other suitable marking. In some embodiments, the marking 60 may include a number and / or units that correspond to the position of the distal end of the instrument 16.

[0056] In some embodiments, the extension tube 14 may be transparent to facilitate visibility of the instrument 16 within the extension tube 14. In some embodiments, the markings 58 and / or markings 60 may be disposed on the distal adapter 18, which may be transparent. Now, referring to FIG. 8D , the instrument 16 may be positioned distal to the catheter tip 64. In some embodiments, the instrument 16 may be advanced distally beyond the catheter tip 64 in response to the housing 12 being advanced distally.

[0057] All examples and conditional language recited in this specification are intended for educational purposes to help the reader understand the concepts contributed by the inventor to the development of the present invention and the art, and should be construed as not being limited to such specifically recited examples and conditions. Although embodiments of the present invention have been described in detail, it should be understood that various changes, substitutions, and alterations can be made thereto without departing from the spirit and scope of the present invention.

Claims

1. 1. A vascular access device advancement device comprising: Housing and an extension tube extending through the housing, the extension tube having a first lumen and a second lumen, a blood collection path extending 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 an extension tube, the pair of opposing pinch members being disposed within the housing and configured to move along the extension tube with the housing; an instrument extending distally from the wedge, the instrument being disposed within the second lumen, and in response to moving the housing distally along the extension tube, the pair of opposing pinch members urge the wedge distally, thereby advancing the instrument distally; and a distal adapter coupled to a distal end of the extension tube, the distal adapter configured to be coupled to a catheter assembly; 1. A vascular access device advancement device comprising:

2. 2. The vascular access device advancement device of claim 1, wherein the pair of opposing pinch members further comprises another pair of opposing pinch members disposed within the housing proximal to the wedge and configured to pinch the extension tube, the other pair of opposing pinch members disposed within the housing distal to the wedge and configured to move along the extension tube with the housing, such that in response to moving the housing proximally along the extension tube, the pair of opposing pinch members push the wedge proximally and the device is retracted proximally.

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

4. The vascular access device advancement device of claim 3 , wherein the inner surface of the housing includes a plurality of bumps that contact the pair of opposing pinch members.

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

6. The vascular access device advancement device of claim 1 , wherein the device comprises a guidewire.

7. The vascular access device advancement device of claim 1 , further comprising a septum disposed within the distal adapter and configured to seal the second lumen but not the first lumen.

8. 10. The vascular access device advancement device of claim 1, further comprising a septum disposed within the distal adapter sealing the second lumen, and further comprising a blunt cannula extending from the first lumen through the septum.

9. The vascular access device advancement device of claim 1 , wherein the distal adapter comprises a shaft and opposing lever locks, and further comprises a cap disposed on the shaft.

10. The vascular access device advancement device of claim 1 , further comprising a proximal adapter coupled to a proximal end of the extension tube, wherein the distal adapter or the proximal adapter is overmolded onto the extension tube.

11. The vascular access device advancement device of claim 1 , wherein the first lumen extends through the extension tube and the second lumen extends through the extension tube.

12. 10. The vascular access device advancement device of claim 1, wherein a top surface of the extension tube comprises markings, and in response to the housing being aligned with the markings, the device is advanced distally a distance beyond the catheter tip.

13. The vascular access device advancement device of claim 12 , wherein the markings indicate a distance.

14. The vascular access device advancement device of claim 1 , wherein a top surface of the extension tube includes other markings, and the device is aligned with a catheter tip in response to the housing being aligned with the other markings.

15. 10. The vascular access device advancement device of claim 1, wherein a top surface of the extension tube or the distal adapter includes a marking, a top surface of the instrument includes another marking, and in response to the other marking being aligned with the marking, the instrument is advanced distally a distance beyond the catheter tip.

16. 10. The vascular access device advancement device of claim 1, wherein a top surface of the extension tube or the distal adapter includes a marking, a top surface of the instrument includes another marking, and the instrument is aligned with the catheter tip in response to the other marking being aligned with the marking.

17. 10. The vascular access device advancement device of claim 1, wherein a top surface of the distal adapter comprises a marking and a top surface of the instrument comprises another marking, and in response to the other marking being moved from a proximal end of the marking to a distal end of the marking, the instrument is advanced beyond the catheter tip a distance equal to the length of the marking.

18. 18. The vascular access device advancement device of claim 17, wherein the length of the marking is greater than or equal to 10 mm and less than or equal to 50 mm.

19. The vascular access device advancement device of claim 1 , further comprising a proximal adapter coupled to a proximal end of the extension tube, the proximal adapter configured to couple to a blood collection device.

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