Conductance Guidewire Navigation for Accurate CVC Tip Placement
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Solution Overview
Problem
Existing methods for central venous catheter (CVC) placement, such as PICC lines, are time-intensive, costly, and unreliable, particularly in situations where fluoroscopic guidance is not feasible, and can lead to complications due to improper placement.
Innovation Solution
A conductance guidewire (CGW) system that uses an elongated body with detectors and electrodes to generate an electric field, allowing for real-time conductance measurements to accurately guide CVC placement without x-ray guidance, using conductance measurements to identify specific locations within the vasculature.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Measurement precision
If fluoroscopic guidance is used for CVC placement, then placement accuracy is improved, but procedural time and cost increase
Solution Approach 1:
The patent replaces fluoroscopic (radiation-based) guidance with an electrical field-based conductance measurement system. The system uses electrodes to generate electrical fields and measures conductance changes as the catheter moves through vasculature, providing real-time placement feedback without requiring time-consuming fluoroscopy scans.
Solution Approach 2:
The conductance measurement system provides continuous real-time feedback during catheter advancement, allowing the operator to self-monitor placement accuracy without needing intermittent fluoroscopic imaging. The system serves itself by providing ongoing positional information through conductance changes.
2Measurement precision
If fluoroscopic guidance is used for CVC placement, then placement accuracy is improved, but procedural cost increases
Solution Approach 1:
The patent employs a disposable conductance guidewire with integrated electrodes that can be used once and then discarded. This eliminates the need for expensive fluoroscopic equipment and reduces procedural costs while maintaining placement accuracy through electrical field-based navigation.
Solution Approach 2:
The system substitutes expensive fluoroscopic imaging equipment with a simpler, lower-cost electrical field generation and measurement system. The conductance measurement apparatus requires minimal infrastructure compared to fluoroscopy, significantly reducing procedural costs.
3Measurement precision
If x-ray guidance is used for CVC placement, then placement verification is improved, but radiation exposure increases
Solution Approach 1:
The patent replaces x-ray imaging with electrical field-based conductance measurement to verify catheter tip location. This substitution eliminates ionizing radiation exposure while providing equivalent or superior placement verification through real-time conductance changes that indicate proximity to the cavoatrial junction.
Solution Approach 2:
The system converts the electrical properties of blood and tissue into beneficial navigational information. By measuring conductance changes caused by the catheter's movement through different vascular regions, the system transforms electrical interactions into accurate placement feedback without any harmful radiation.
4Ease of operation
If traditional feel-based placement method is used, then procedural simplicity is maintained, but placement reliability decreases
Solution Approach 1:
The patent introduces real-time conductance measurement feedback during catheter advancement. The system continuously monitors electrical conductance changes and provides immediate feedback to the operator, enabling informed decision-making about catheter placement while maintaining procedural simplicity. The feedback loop allows operators to adjust advancement based on objective measurements rather than subjective feel alone.
Applied Scientific Principles
This section explains which scientific principles are used to turn an abstract innovation direction into a practical engineering solution.
Function Achieved in This Case
Provides accurate, cost-effective, and portable CVC placement with minimal training, suitable for various patient populations, reducing complications and procedural time.
Implementation Method 1
the detector comprising a first excitation electrode and configured to generate an electric field with a second excitation electrode located external to the device
Implementation Method 2
the device further configured to obtain multiple conductance measurements within the electric field as the detector is advanced through a patient's vasculature, wherein each of the multiple conductance measurements is indicative of a location of the detector within the patient's vasculature
Data Source
Figure 1~2
Figure 3~4
Figure 5A~6
AI summary
Devices and systems for navigation and positioning a central venous catheter within a patient. In an exemplary embodiment of a system of the present disclosure, the system comprises a first pole and a second pole, the first pole and the second pole configured to generate an electric field within a mammalian body sufficient to obtain a plurality of field measurements therein, and an elongated body configured for at least partial insertion into a blood vessel of the mammalian body and advancement through a vasculature, said advancement dependent upon the plurality of field measurements indicative of one or more locations of a portion of the elongated body within the vasculature. In at least one embodiment, the elongated body is configured as a stylet.