Ulnar Artery Compression for Radial Hemostasis
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Solution Overview
Problem
Radial artery occlusion is a common complication following transradial catheterization, which can be attributed to the blockage of the radial artery lumen due to cannulation, leading to reduced blood flow and potential future access issues.
Innovation Solution
The method involves inserting a sheath into the radial artery, followed by applying pressure to the un-instrumented ulnar artery to increase radial artery flow while simultaneously applying pressure to the radial artery access site to achieve hemostasis. This is facilitated by a device that applies compressing force to the ulnar artery, such as an inflatable bladder or impinger, to manage blood flow effectively.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If blunt pressure is applied to the radial artery at the access site to achieve hemostasis, then bleeding at the cannulation wound is stopped, but blood flow through the radial artery is blocked causing radial artery occlusion
Solution Approach 1:
The compression is segmented into two separate targets: the radial artery at the access site for hemostasis, and the ulnar artery for flow redirection. By applying compression to the ulnar artery specifically, the patent creates a pressure gradient that redirects blood flow through the radial artery while maintaining hemostasis at the access site, thus preventing radial artery occlusion
Solution Approach 2:
The ulnar artery compression acts as an intermediary mechanism to achieve the dual goal of hemostasis and flow maintenance. By compressing the ulnar artery, the patent creates a pressure differential that serves as a mediator to redirect flow through the radial artery, preventing occlusion while maintaining effective hemostasis
2Reliability
If conventional dose of anticoagulant is administered to prevent radial artery occlusion, then occlusion risk is reduced, but hemostasis duration is prolonged
Solution Approach 1:
The patent changes the dosage parameter of anticoagulant from conventional high doses to reduced doses, combined with the ulnar artery compression technique. This parameter change allows adequate prevention of radial artery occlusion while minimizing the prolonged anticoagulant effect that would extend hemostasis duration, thus resolving the contradiction between patency protection and hemostasis timing
3Reliability
If prolonged hemostatic compression is applied to the radial artery, then hemostasis is maintained, but patient comfort is reduced and radial artery occlusion risk increases
Solution Approach 1:
The patent applies preliminary compression to the ulnar artery before and during the hemostasis process. This preliminary action redirects blood flow through the radial artery in advance, creating a protective pressure gradient that maintains radial artery patency during the hemostasis period, thereby reducing both the duration and intensity of compression needed and improving patient comfort
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
This approach minimizes the risk of radial artery occlusion by maintaining blood flow through the radial artery during hemostasis, reducing the duration of hemostatic compression, and potentially lowering the dose of anticoagulants required, thereby enhancing patient comfort and procedural outcomes.
Implementation Method 1
The device includes a trunk having an inflatable bladder... The bladder is inflated with a tube connected to an inflator to cause the bladder to impinge upon the ulnar artery
Data Source
AI summary
Disclosed are methods and devices for obtaining patent hemostasis of the radial artery by compressing the uninstrumented ulnar artery to increase radial artery flow. The device comprises a band having an inflatable bladder for applying blunt pressure to the ulnar artery. The method comprises applying a pressure to the homolateral ulnar artery and applying a pressure to the radial artery at the access site to obtain hemostasis at the access site. The method further comprises administering an anticoagulant to a patient at a dose ranging from about 20 units per kg of body weight to about 30 units per kg of body weight.