Vascular Access Declotting Catheter Bypass Stenosis
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Solution Overview
Problem
Patients undergoing hemodialysis often face challenges with vascular access due to central venous stenosis, where existing methods fail to provide reliable and long-term access, especially when peripheral venous sites are exhausted.
Innovation Solution
A vascular access device system comprising a first tubular conduit and a second tubular conduit, both potentially self-sealing, with radiopaque markers and nitinol reinforcement for resistance to kinking, coupled via connectors to establish a fluid-tight artificial blood flow path that can bypass stenosis, and a declotting catheter for clearing occlusions.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If peripheral venous sites are used for vascular access, then initial access is easier to obtain, but long-term reliability deteriorates when central venous stenosis develops
Solution Approach 1:
The vascular access system is divided into multiple segments: a peripheral venous catheter for initial access and a central venous graft for long-term reliability. The graft can be selectively deployed when stenosis develops in the peripheral site, allowing the system to transition from short-term to long-term access mode.
Solution Approach 2:
The invention transitions from two-dimensional peripheral venous access to three-dimensional central venous access by deploying a graft that extends from the peripheral vein into the right atrium, creating a new spatial pathway that bypasses stenotic segments.
2Reliability
If central venous grafts are deployed to bypass stenosis, then long-term access reliability is improved, but device complexity increases
Solution Approach 1:
The central venous graft is designed to be nested within or alongside the peripheral venous catheter, allowing both components to coexist in a compact configuration. The graft can be collapsed within the catheter during insertion and then expanded at the target site, reducing the overall system footprint and simplifying deployment.
3Reliability
If self-sealing conduits are used to prevent clotting, then access reliability is improved, but the risk of clot formation and occlusion increases over time
Solution Approach 1:
The harmful clot is extracted from the vascular access system using a dedicated extraction catheter that can be introduced through the existing access points. The catheter includes mechanisms for capturing, fragmenting, and removing clots, allowing the self-sealing property to be maintained while periodically clearing accumulated thrombi.
Solution Approach 2:
Anticoagulant therapy is applied preliminarily to prevent clot formation in the first place, and the system is designed with clot-resistant surface treatments. Regular flushing protocols are implemented to prevent stasis-induced clotting before clots can form and cause occlusion.
4Adaptability or versatility
If multiple conduits and connectors are used to create artificial blood flow paths, then bypass capability is improved, but fluid-tight connection reliability deteriorates
Solution Approach 1:
The peripheral venous catheter and central venous graft are merged into a single integrated access system, eliminating the need for separate connections. The graft is directly anastomosed to the catheter tip, creating a continuous fluid pathway without external connectors that could leak or disconnect.
Data Source
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AI summary
Methods of declotting vascular access technologies, such as vascular access assemblies that facilitate hemodialysis, are provided. The methods can include disposing a catheter within a patient to access a vascular access assembly within the heart of the patient. The catheter can be coupled to the vascular access assembly such that a clot can be evacuated from within the vascular access assembly via the catheter.