Systems and methods for sealing a vascular opening
Systems and methods for sealing a vascular opening such as an arteriotomy formed during a femoral artery catheterization procedure are described. The blood vessel is transiently occluded during application of therapeutic energy, such as high intensity focused ultrasound. The occlusion improves the efficiency of the therapy without causing damage to the blood vessel. Also described are methods for locating the arteriotomy, aligning the therapeutic applicator to the arteriotomy, and a station keeping procedure for maintaining alignment.
1 . A method for sealing a vascular opening in a blood vessel, comprising:
transiently substantially occluding the blood vessel;
applying energy adjacent to the vascular opening such that the opening is sealed; and
removing the blood vessel occlusion.
2 . The method of claim 1 , wherein the blood vessel is a fermoral, brachial, or radial artery.
3 . The method of claim 1 , wherein the blood vessel is transiently fully occluded.
4 . The method of claim 1 , wherein occluding the blood vessel comprises applying compressive force to the blood vessel.
5 . The method of claim 0 , wherein the compressive force is applied using an energy applicator that is used to apply the energy.
6 . The method of claim 0 , wherein the compressive force is applied to the surface of skin located over the blood vessel.
7 . The method of claim 1 , wherein applying energy adjacent to the vascular opening comprises directing energy from an energy applicator located on or near the surface of skin over the blood vessel.
8 . The method of claim 1 , wherein applying energy to the vascular opening comprises energizing an energy applicator positioned inside a patient near the vascular opening.
9 . The method of claim 1 , wherein the energy applied is acoustic energy.
10 . The method of claim 0 , wherein the energy applied is high intensity focused ultrasound energy.
11 . The method of claim 1 , wherein the energy applied is radio frequency energy.
12 . The method of claim 1 , wherein the energy applied is microwave energy.
13 . The method of claim 1 , wherein the energy applied is optical energy.
14 . The method of claim 0 , wherein the optical energy comprises one or more of ultraviolet, visible, near—infrared, or infrared energy.
15 . The method of claim 1 , wherein the energy is thermal energy.
16 . The method of claim 0 , wherein the energy is cryogenic energy.
17 . A method for sealing a vascular opening in a blood vessel in a patient, comprising:
inserting a targeting catheter into the blood vessel;
locating the vascular opening using the targeting catheter;
aligning a therapeutic energy applicator relative to the targeting catheter;
initiating a station keeping algorithm configured to detect relative motion between tissue in the vicinity of the vascular opening and the applicator; and
applying energy from the applicator to tissue adjacent to the vascular opening to seal the opening.
18 . The method of claim 0 , wherein inserting the targeting catheter comprises inserting the catheter through the vascular opening.
19 . The method of claim 0 , wherein the vascular opening is created by insertion of an introducer sheath and inserting the targeting catheter comprises inserting the catheter through the sheath.
20 . The method of claim 0 , wherein locating the vascular opening comprises manipulating the targeting catheter until a targeting aid on the catheter is adjacent to or at the vascular opening.
21 . The method of claim 0 , wherein aligning the therapeutic energy applicator comprises detecting the position of the applicator relative to a beacon located on the catheter.
22 . The method of claim 0 , wherein detecting the position of the applicator relative to the beacon comprises emitting an ultrasonic signal from the beacon to multiple receivers on the applicator.
23 . The method of claim 0 , wherein the energy is high intensity focused ultrasound.
24 . The method of claim 0 , comprising withdrawing the catheter from the blood vessel prior to applying energy from the applicator.
25 . The method of claim 0 , wherein the targeting catheter remains in the patient's body during application of the energy.
26 . The method of claim 0 , wherein the targeting catheter is removed from the patient's body prior to application of the energy.
27 . The method of claim 0 , comprising applying pressure to the blood vessel to transiently partially or fully occlude the vessel prior to initiating station keeping.