Systems and methods for arteriotomy localization
A targeting catheter is used to locate an arteriotomy, such as is formed during a femoral artery catheterization procedure. The targeting catheter includes one or more targeting aids, such as an inflatable balloon or sensor (e.g., Doppler or temperature sensor), to locate the arteriotomy. The targeting aid may be positioned at the arteriotomy. An ultrasonic beacon on the catheter may then be located relative to a therapeutic ultrasonic applicator (e.g., by using acoustic time-of-flight) so that the focus of ultrasonic energy from the applicator can be aligned with the arteriotomy.
1 . An arteriotomy targeting catheter, comprising:
an arteriotomy targeting aid coupled to the catheter and adapted to detect the location of an arteriotomy; and
one or more beacons coupled to the catheter proximal to the arteriotomy targeting aid.
2 . The catheter of claim 1 , wherein the arteriotomy targeting aid comprises an inflatable balloon.
3 . The catheter of claim 2 , wherein the balloon comprises an elastic polymeric material.
4 . The catheter of claim 3 , wherein the soft elastic polymeric material is selected from the group consisting of one or more of a polyamide, a polyamide blend, a polyethylene, a polyethylene terephthalate, a polyurethane, a polyamide, and a polyamide blend.
5 . The catheter of claim 4 , wherein the polyamide blend is PBAX.
6 . The catheter of claim 2 , wherein the durometer of the balloon material is between 20A and 90D.
7 . The catheter of claim 6 , wherein the durometer of the balloon material is between 80 A and 65 D.
8 . The catheter of claim 7 , wherein the durometer of the balloon material is 90 A.
9 . The catheter of claim 1 , wherein the arteriotomy targeting aid comprises a mechanical expansible device.
10 . The catheter of claim 1 , wherein the arteriotomy targeting aid comprises an arteriotomy locating sensor.
11 . The catheter of claim 10 , wherein the arteriotomy locating sensor comprises a temperature sensor.
12 . The catheter of claim 11 , wherein the temperature sensor is a thermistor.
13 . The catheter of claim 10 , wherein the arteriotomy locating sensor comprises a flow measurement sensor.
14 . The catheter of claim 10 , wherein the arteriotomy locating sensor comprises an optical sensor.
15 . The catheter of claim 10 , wherein the arteriotomy locating sensor comprises an impedance sensor.
16 . The catheter of claim 10 , wherein the arteriotomy locating sensor comprises a Doppler sensor.
17 . The catheter of claim 1 , wherein the beacon comprises an ultrasonic transmitter.
18 . The catheter of claim 1 , wherein the beacon comprises a radio frequency transmitter.
19 . The catheter of claim 1 , wherein the beacon comprises a magnetic field generator.
20 . A method of determining the location of a therapeutic site in a body, comprising:
inserting a catheter into the body, wherein the catheter comprises a targeting aid; and
manipulating the catheter such that the targeting aid is adjacent to or at the therapeutic site.
21 . The method of claim 20 , wherein the therapeutic site is an arteriotomy.
22 . The method of claim 20 , wherein manipulating the catheter comprises moving the catheter until a Doppler signal from the targeting aid determines that the targeting aid is adjacent to or at the therapeutic site.
23 . The method of claim 20 , wherein the targeting aid comprises a temperature sensor and manipulating the catheter comprises moving the catheter until the temperature sensor indicates that it is adjacent to or at the therapeutic site.
24 . The method of claim 20 , wherein the targeting aid comprises a fluid flow detector and manipulating the catheter comprises moving the catheter until the fluid flow detector indicates that it is adjacent to or at the therapeutic site.
25 . The method of claim 20 , wherein the targeting aid comprises an optical sensor and manipulating the catheter comprises moving the catheter until the optical sensor indicates that it is adjacent to or at the therapeutic site.
26 . The method of claim 20 , wherein the targeting aid comprises a pressure sensor and manipulating the catheter comprises moving the catheter until the pressure sensor indicates that it is adjacent to or at the therapeutic site.
27 . The method of claim 20 , wherein the targeting aid comprises an impedance sensor and manipulating the catheter comprises moving the catheter until the impedance sensor indicates that it is adjacent to or at the therapeutic site.
28 . The method of claim 20 , wherein the targeting aid comprises a force detector and manipulating the catheter comprises moving the catheter until the force detector indicates that it is adjacent to or at the therapeutic site.
29 . The method of claim 20 , wherein the targeting aid comprises a mechanically expansive device and the method comprises expanding the mechanically expansive device and moving the catheter until the device is adjacent to or at the therapeutic site.
30 . The method of claim 20 , wherein the targeting aid comprises an inflatable balloon and the method comprises inflating the balloon and moving the catheter until the balloon is adjacent to or at the therapeutic site.
31 . The method of claim 20 , wherein:
the therapeutic site is an arteriotomy created by an introducer sheath inserted into an artery;
inserting the catheter into the body comprises inserting the catheter and targeting aid through the lumen of the introducer sheath past the arteriotomy and into the artery; and
manipulating the catheter comprises retracting the catheter such that the targeting aid approaches the arteriotomy.
32 . The method of claim 31 , wherein the introducer sheath is retracted simultaneously with retraction of the catheter.
33 . The method of claim 31 , wherein the targeting aid comprises an inflatable balloon and wherein the balloon is inflated after insertion of the catheter and prior to retracting the catheter.
34 . The method of claim 31 , further comprising applying compression above the arteriotomy.
35 . A method of determining the location of a therapeutic site in a body relative to a therapeutic applicator, comprising:
inserting a targeting catheter into the body;
identifying the location of the therapeutic site using the targeting catheter; and
determining the position of the targeting catheter relative to the therapeutic applicator.
36 . The method of claim 35 , wherein the therapeutic site is an arteriotomy.
37 . The method of claim 35 , further comprising aligning the therapeutic applicator with the therapeutic site based on the relative position of the targeting catheter.
38 . The method of claim 35 , wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises using triangulation.
39 . The method of claim 38 , wherein the triangulation is based on magnetic fields.
40 . The method of claim 38 , wherein the triangulation is based on acoustic signals.
41 . The method of claim 40 , wherein the triangulation is based on an acoustic time-of-flight determination.
42 . The method of claim 35 , wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises transmitting an ultrasound signal from a transmitter located on the catheter to multiple receivers located on the therapeutic applicator.
43 . The method of claim 42 , wherein the transmitter comprises a piezoelectric cylinder.
44 . The method of claim 42 , wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises determining the acoustic time-of-flight from the transmitter to the receivers.
45 . The method of claim 35 , wherein determining the position of the targeting catheter relative to the therapeutic applicator comprises transmitting ultrasound signals from multiple transmitters located on the therapeutic applicator to a receiver located on the catheter.