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WO2010063676A1 - Percutaneous catheter and method for measuring pressure in blood vessels - Google Patents

Percutaneous catheter and method for measuring pressure in blood vessels Download PDF

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Publication number
WO2010063676A1
WO2010063676A1 PCT/EP2009/066056 EP2009066056W WO2010063676A1 WO 2010063676 A1 WO2010063676 A1 WO 2010063676A1 EP 2009066056 W EP2009066056 W EP 2009066056W WO 2010063676 A1 WO2010063676 A1 WO 2010063676A1
Authority
WO
WIPO (PCT)
Prior art keywords
pressure
catheter
blood vessels
measuring
hepatic vein
Prior art date
Application number
PCT/EP2009/066056
Other languages
French (fr)
Inventor
Jaime Bosch Genover
Andrea De Gottardi
Original Assignee
Fundacio Clinic Per A La Recerca Biomedica
Hospital Clinic I Provincial De Barcelona
Universitat De Barcelona
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Fundacio Clinic Per A La Recerca Biomedica, Hospital Clinic I Provincial De Barcelona, Universitat De Barcelona filed Critical Fundacio Clinic Per A La Recerca Biomedica
Publication of WO2010063676A1 publication Critical patent/WO2010063676A1/en

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/02—Detecting, measuring or recording pulse, heart rate, blood pressure or blood flow; Combined pulse/heart-rate/blood pressure determination; Evaluating a cardiovascular condition not otherwise provided for, e.g. using combinations of techniques provided for in this group with electrocardiography or electroauscultation; Heart catheters for measuring blood pressure
    • A61B5/021—Measuring pressure in heart or blood vessels
    • A61B5/0215—Measuring pressure in heart or blood vessels by means inserted into the body
    • A61B5/02152—Measuring pressure in heart or blood vessels by means inserted into the body specially adapted for venous pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B5/00—Measuring for diagnostic purposes; Identification of persons
    • A61B5/68—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient
    • A61B5/6846—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive
    • A61B5/6847—Arrangements of detecting, measuring or recording means, e.g. sensors, in relation to patient specially adapted to be brought in contact with an internal body part, i.e. invasive mounted on an invasive device
    • A61B5/6852—Catheters
    • A61B5/6853—Catheters with a balloon
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0017—Catheters; Hollow probes specially adapted for long-term hygiene care, e.g. urethral or indwelling catheters to prevent infections
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0208—Subcutaneous access sites for injecting or removing fluids
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M2025/0001—Catheters; Hollow probes for pressure measurement
    • A61M2025/0003—Catheters; Hollow probes for pressure measurement having an additional lumen transmitting fluid pressure to the outside for measurement
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/0208—Subcutaneous access sites for injecting or removing fluids
    • A61M2039/0211—Subcutaneous access sites for injecting or removing fluids with multiple chambers in a single site
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M2230/00—Measuring parameters of the user
    • A61M2230/30—Blood pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • A61M25/0026—Multi-lumen catheters with stationary elements
    • A61M25/0032—Multi-lumen catheters with stationary elements characterized by at least one unconventionally shaped lumen, e.g. polygons, ellipsoids, wedges or shapes comprising concave and convex parts

Definitions

  • a first aspect of the present invention relates to a percutaneous catheter and a second aspect relates to a method for measuring pressure in blood vessels, which have an application in the field of medicine, and more specifically in the diagnosis of chronic liver diseases, allowing a prolonged use access to the hepatic vein as well as the continuous and long-term measurement of the hepatoportal venous pressure gradient, without needing to repeat invasive procedures in the patient.
  • portal vein pressure There is a series of features conferring great importance to the measurement of portal vein pressure, derived from the significant complications arising in the cases of portal hypertension (PHT), in which there is an abnormal increase of the blood pressure in said portal vein.
  • PHT portal hypertension
  • a sustained increase of the pressure in the portal vein has as a consequence the onset of esophageal and gastric varices, which increase the risk of bleeding episodes occurring. Said bleeding episodes usually occur in up to 35% of the patients who have cirrhosis and esophagogastric varices.
  • the portal hypertension determines the onset of ascites, circulatory disorders and renal function disorders, and facilitates the onset of serious complications such as spontaneous bacterial peritonitis and the hepatic encephalopathy, among others.
  • Portal hypertension is developed when there is an increase of the resistance to blood flow through the liver and an increase of the inflow in the portal vein.
  • WHVP wedged hepatic venous pressure
  • HVPG hepatic venous pressure gradient
  • the hepatic venous pressure gradient i.e., the gradient between the wedged and free pressure
  • the gradient between the wedged and free pressure is small (less than 5 mmHg)
  • said gradient increases.
  • it indicates the risk of onset of portal hypertension complications (Clinically significant portal hypertension), and when the latter are present, they allow discriminating patients having a low risk of suffering from bleeding episodes, and therefore with a lower risk of mortality, as well as guiding the treatment of portal hypertension.
  • HVPG hepatic venous pressure gradient
  • a first aspect of the present invention relates to a percutaneous catheter for measuring pressure in blood vessels, which allows a prolonged use access to the hepatic vein for a simple and repeated measurement of the hepatic venous pressure gradient (HVPG), overcoming the need to repeat invasive diagnostic procedures in the patient.
  • HVPG hepatic venous pressure gradient
  • the catheter proposed by the invention allows its use by the transjugular route or by the subclavian route to measure pressure in any blood vessel, i.e., in any vein or artery, such as the hepatic vein.
  • the catheter comprises a pressure catheter, configured to measure and record pressure in a blood vessel and, furthermore, said catheter comprises close to its distal end an inflatable element, like a balloon or sac, which is configured to occlude said blood vessel when it is inflated or inserted in the blood vessel, as well as to allow free blood flow through said blood vessel when it is deflated.
  • an inflatable element like a balloon or sac
  • HVPG hepatic venous pressure gradient
  • said pressure catheter is operatively connected to a prolonged use device called Port-a-cath, comprising a double cavity.
  • the Port-a-cath system comprises a catheter connected to a venous access system called totally implantable venous access system.
  • This system consists of a small medical device which is installed beneath the skin and allows being connected to a vein.
  • the device has membranes, which are commonly called septum, through which the medication is injected or blood samples are extracted, as many times as necessary and with much less discomfort for a patient compared to the means used up until now, consisting of the repeated catheterization of the jugular or femoral vein.
  • Port-a-cath catheters are mainly used in hematological treatments and in oncology patients.
  • a Port-a-cath comprises a reservoir or deposit compartment, also called "port”, which is encapsulated in silicone to allow the insertion of a needle, precisely in the septum.
  • the septum is preferably made of a special self-sealing silicone, allowing being pricked by a needle up to thousands of times before it has to be replaced.
  • a small surgical intervention is required to place it in a patient.
  • the Port-a-cath beneath the skin, and the catheter connected thereto is introduced through the jugular or subclavian vein until reaching the hepatic vein.
  • the invention therefore allows the access to the hepatic vein and the long-term and continuous measurement of the hepatoportal venous pressure gradient, i.e., the measurement of the difference between the wedged and free hepatic venous pressure.
  • the catheter of the invention incorporates a double lumen, one for measuring the pressure inside the vein in which it is placed, the other one to allow inflating a balloon (occlusion balloon) in its end to measure the free and wedged hepatic vein pressure.
  • a balloon occlusion balloon
  • the catheter is configured to access the hepatic vein and measure, as well as record, pressure in the hepatic vein and detect portal hypertension by means of the difference between a value of wedged hepatic venous pressure and a value of free hepatic vein pressure.
  • the percutaneous catheter for measuring pressure in blood vessels comprises continuous monitoring means for the pressure measured in said blood vessel.
  • a second aspect of the present invention relates to a diagnostic method for measuring pressure in blood vessels, which comprises using a percutaneous catheter such as the one defined above, without needing to perform repetitive invasive procedures in the patient.
  • the catheter can be inserted by the transjugular route.
  • the method is configured to determine clinical cases of portal hypertension by means of the continuous and/or repeated measurement of the pressure in the hepatic vein and of the HVPG, comprising the following steps:
  • the catheter comprises continuous monitoring means for the pressure measured in the hepatic vein, comprising continuously monitoring said pressure, without needing to perform successive invasive procedures.
  • Figure 1 shows a schematic view of the percutaneous catheter proposed by the invention located in a hepatic vein.
  • Figure 2 shows a detail of the inflatable element comprised by the pressure catheter, having been depicted in the inflated position.
  • Figure 3 shows a schematic perspective view of the catheter of the invention in which a cross-section has been made, for a better appreciation of the inner double cavity.
  • the pressure catheter (1 ) is operatively connected to an prolonged use intravenous catheter (4) comprising a double cavity.
  • the invention allows the access to the hepatic vein and the long-term and continuous measurement of the hepatoportal venous pressure gradient, i.e., the measurement of the difference of wedged and free hepatic venous pressure.
  • the catheter of the invention incorporates a dual lumen Port-a-cath with a pressure catheter (1 ), i.e., a Berenstein type catheter with an occlusion balloon to measure the free and wedged hepatic vein pressure.
  • a pressure catheter (1 ) i.e., a Berenstein type catheter with an occlusion balloon to measure the free and wedged hepatic vein pressure.
  • the percutaneous catheter comprises continuous or repeated monitoring means for the pressure measured in said blood vessel.
  • the catheter is configured to access the hepatic vein and measure, as well as record, pressure in the hepatic vein and detect portal hypertension by means of the difference between a value of wedged hepatic venous pressure and a value of free hepatic vein pressure.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Animal Behavior & Ethology (AREA)
  • Public Health (AREA)
  • Biomedical Technology (AREA)
  • Veterinary Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • General Health & Medical Sciences (AREA)
  • Biophysics (AREA)
  • Anesthesiology (AREA)
  • Hematology (AREA)
  • Pulmonology (AREA)
  • Cardiology (AREA)
  • Physics & Mathematics (AREA)
  • Surgery (AREA)
  • Molecular Biology (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Child & Adolescent Psychology (AREA)
  • Physiology (AREA)
  • Vascular Medicine (AREA)
  • Urology & Nephrology (AREA)
  • Epidemiology (AREA)
  • Measuring Pulse, Heart Rate, Blood Pressure Or Blood Flow (AREA)
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Abstract

The application relates to a percutaneous catheter and method for measuring pressure in blood vessels, allowing a continuous measurement of the hepatic venous pressure gradient, comprising a pressure catheter (1), configured to measure and record pressure in a blood vessel (2), which comprises an inflatable element (3) configured to occlude said blood vessel (2) when it is inflated and allow free blood flow through said blood vessel (2) when it is deflated, in which said pressure catheter (1) is operatively connected to a prolonged use intravenous catheter (4) comprising a double cavity.

Description

PERCUTANEOUS CATHETER AND METHOD FOR MEASURING PRESSURE IN BLOOD VESSELS
Object of the Invention
A first aspect of the present invention relates to a percutaneous catheter and a second aspect relates to a method for measuring pressure in blood vessels, which have an application in the field of medicine, and more specifically in the diagnosis of chronic liver diseases, allowing a prolonged use access to the hepatic vein as well as the continuous and long-term measurement of the hepatoportal venous pressure gradient, without needing to repeat invasive procedures in the patient.
Background of the Invention
There is a series of features conferring great importance to the measurement of portal vein pressure, derived from the significant complications arising in the cases of portal hypertension (PHT), in which there is an abnormal increase of the blood pressure in said portal vein. It should be emphasized that in contrast to other blood vessels, the portal vein is difficult to access to perform diagnostic procedures, therefore all of them are invasive and require being performed in hospital.
Portal hypertension is a very common complication in chronic liver diseases such as cirrhosis, being the main cause of mortality and of liver transplant in those patients.
In such cases, a sustained increase of the pressure in the portal vein has as a consequence the onset of esophageal and gastric varices, which increase the risk of bleeding episodes occurring. Said bleeding episodes usually occur in up to 35% of the patients who have cirrhosis and esophagogastric varices. Likewise, the portal hypertension determines the onset of ascites, circulatory disorders and renal function disorders, and facilitates the onset of serious complications such as spontaneous bacterial peritonitis and the hepatic encephalopathy, among others. Portal hypertension is developed when there is an increase of the resistance to blood flow through the liver and an increase of the inflow in the portal vein.
The measurement of wedged hepatic venous pressure (WHVP) is currently the most common diagnostic procedure for the indirect determination of portal pressure. To that end, one of the hepatic veins is percutaneously catheterized under fluoroscopic control by the transjugular route (or after the puncture of another peripheral vein, such as the femoral or antecubital vein) by means of using a catheter comprising an occlusion balloon, such as for example the one described in "Berenstein occlusion balloon catheter M001173010, 17-301, Boston Scientific". The balloon is then inflated until completely occluding a branch of the hepatic vein, at which time the value of wedged hepatic venous pressure (WHVP) is measured and recorded. Afterwards, the balloon is deflated and the free hepatic venous pressure (FHVP) is recorded. The difference between both pressures is the so-called hepatic venous pressure gradient (HVPG), which is an indication of portal pressure in cirrhosis.
In the absence of portal hypertension, the hepatic venous pressure gradient, i.e., the gradient between the wedged and free pressure, is small (less than 5 mmHg), whereas in the presence of portal hypertension, said gradient increases. When it reaches values greater than 10 mmHg, it indicates the risk of onset of portal hypertension complications (Clinically significant portal hypertension), and when the latter are present, they allow discriminating patients having a low risk of suffering from bleeding episodes, and therefore with a lower risk of mortality, as well as guiding the treatment of portal hypertension.
However, the main drawback of the procedure set forth above is that the determination of the hepatic venous pressure gradient (HVPG) is a diagnostic procedure which frequently must be performed several times in the same patient, and therefore every time its performance is required a very specialized infrastructure is needed, in addition to the cost and the discomfort involved for the actual patient by the fact of having to undergo periodic invasive procedures for the measurement of HVPG. Description of the Invention
A first aspect of the present invention relates to a percutaneous catheter for measuring pressure in blood vessels, which allows a prolonged use access to the hepatic vein for a simple and repeated measurement of the hepatic venous pressure gradient (HVPG), overcoming the need to repeat invasive diagnostic procedures in the patient.
The catheter proposed by the invention allows its use by the transjugular route or by the subclavian route to measure pressure in any blood vessel, i.e., in any vein or artery, such as the hepatic vein.
According to the invention the catheter comprises a pressure catheter, configured to measure and record pressure in a blood vessel and, furthermore, said catheter comprises close to its distal end an inflatable element, like a balloon or sac, which is configured to occlude said blood vessel when it is inflated or inserted in the blood vessel, as well as to allow free blood flow through said blood vessel when it is deflated. When it is positioned in the hepatic vein, it allows measuring the wedged pressure when it is inflated, and the free pressure when deflated, and therefore the hepatic venous pressure gradient (HVPG).
Additionally, said pressure catheter is operatively connected to a prolonged use device called Port-a-cath, comprising a double cavity.
The Port-a-cath system comprises a catheter connected to a venous access system called totally implantable venous access system. This system consists of a small medical device which is installed beneath the skin and allows being connected to a vein. The device has membranes, which are commonly called septum, through which the medication is injected or blood samples are extracted, as many times as necessary and with much less discomfort for a patient compared to the means used up until now, consisting of the repeated catheterization of the jugular or femoral vein. Port-a-cath catheters are mainly used in hematological treatments and in oncology patients. A Port-a-cath comprises a reservoir or deposit compartment, also called "port", which is encapsulated in silicone to allow the insertion of a needle, precisely in the septum. The septum is preferably made of a special self-sealing silicone, allowing being pricked by a needle up to thousands of times before it has to be replaced.
A small surgical intervention is required to place it in a patient. In such intervention, the Port-a-cath beneath the skin, and the catheter connected thereto is introduced through the jugular or subclavian vein until reaching the hepatic vein.
The invention therefore allows the access to the hepatic vein and the long-term and continuous measurement of the hepatoportal venous pressure gradient, i.e., the measurement of the difference between the wedged and free hepatic venous pressure.
The catheter of the invention incorporates a double lumen, one for measuring the pressure inside the vein in which it is placed, the other one to allow inflating a balloon (occlusion balloon) in its end to measure the free and wedged hepatic vein pressure.
The possibility is contemplated that the catheter is configured to access the hepatic vein and measure, as well as record, pressure in the hepatic vein and detect portal hypertension by means of the difference between a value of wedged hepatic venous pressure and a value of free hepatic vein pressure.
The possibility is contemplated that the percutaneous catheter for measuring pressure in blood vessels comprises continuous monitoring means for the pressure measured in said blood vessel.
A second aspect of the present invention relates to a diagnostic method for measuring pressure in blood vessels, which comprises using a percutaneous catheter such as the one defined above, without needing to perform repetitive invasive procedures in the patient. For the purpose of the invention, the catheter can be inserted by the transjugular route.
The method is configured to determine clinical cases of portal hypertension by means of the continuous and/or repeated measurement of the pressure in the hepatic vein and of the HVPG, comprising the following steps:
- implanting an intravenous catheter in the hepatic vein, and a subcutaneous venous route system for prolonged use,
- connecting said intravenous catheter to a pressure catheter,
- occluding the hepatic vein by means of inflating an inflatable element and measuring, as well as recording, pressure, and
- deflating the inflatable element and measuring pressure.
Likewise, it is contemplated that the catheter comprises continuous monitoring means for the pressure measured in the hepatic vein, comprising continuously monitoring said pressure, without needing to perform successive invasive procedures.
Description of the Drawings
To complement the description which is being made and for the purpose of aiding to better understand the features of the invention according to a preferred practical embodiment thereof, a set of drawings is attached as an integral part of said description, in which the following has been depicted with an illustrative and non-limiting character:
Figure 1 shows a schematic view of the percutaneous catheter proposed by the invention located in a hepatic vein.
Figure 2 shows a detail of the inflatable element comprised by the pressure catheter, having been depicted in the inflated position.
Figure 3 shows a schematic perspective view of the catheter of the invention in which a cross-section has been made, for a better appreciation of the inner double cavity. Preferred Embodiment of the Invention
In view of the described figures, it can be observed how in one of the possible embodiment of the invention the percutaneous catheter for measuring pressure in blood vessels proposed by the invention comprises a pressure catheter (1 ), configured to measure and record pressure in a blood vessel (2), in which said pressure catheter (1 ) comprises an inflatable element (3) which is configured to occlude said blood vessel (2) when it is inflated and inserted in the blood vessel (2), as well as to allow free blood flow through said blood vessel (2) when it is deflated.
Additionally, the pressure catheter (1 ) is operatively connected to an prolonged use intravenous catheter (4) comprising a double cavity.
The invention allows the access to the hepatic vein and the long-term and continuous measurement of the hepatoportal venous pressure gradient, i.e., the measurement of the difference of wedged and free hepatic venous pressure.
The catheter of the invention incorporates a dual lumen Port-a-cath with a pressure catheter (1 ), i.e., a Berenstein type catheter with an occlusion balloon to measure the free and wedged hepatic vein pressure.
According to a preferred embodiment of the invention, the percutaneous catheter comprises continuous or repeated monitoring means for the pressure measured in said blood vessel.
Likewise, the catheter is configured to access the hepatic vein and measure, as well as record, pressure in the hepatic vein and detect portal hypertension by means of the difference between a value of wedged hepatic venous pressure and a value of free hepatic vein pressure.
In view of this description and set of figures, the person skilled in the art can understand that the embodiments of the invention which have been described can be combined in multiple ways within the object of the invention. The invention has been described according to several preferred embodiments thereof, but it will be evident for the person skilled in the art that multiple variations can be introduced in said preferred embodiments without exceeding the scope of the claimed invention.

Claims

1.- Percutaneous catheter for measuring pressure in blood vessels, comprising a pressure catheter (1 ), configured to measure and record pressure in a blood vessel (2), which comprises an inflatable element (3) configured to occlude said blood vessel (2) when it is inflated and allow free blood flow through said blood vessel (2) when it is deflated, characterized in that said pressure catheter (1 ) is operatively connected to a prolonged use intravenous catheter (4) comprising a double cavity or reservoir which is accessed by puncture, one of which is connected to the lumen of the catheter which allows inflating and deflating the occlusion balloon and the other one of which is connected to the lumen which allows measuring the pressure or obtaining blood samples.
2.- Percutaneous catheter for measuring pressure in blood vessels according to claim 1 , characterized in that it comprises continuous monitoring means for the pressure measured in said blood vessel (2).
3.- Percutaneous catheter for measuring pressure in blood vessels according to any of claims 1 and 2, characterized in that it is configured to access the hepatic vein, measure pressure in said hepatic vein and detect portal hypertension by means of the difference between a value of wedged hepatic venous pressure and a value of free hepatic vein pressure.
4.- Method for measuring pressure in blood vessels, characterized in that it comprises using a percutaneous catheter according to any of claims 1 to 3.
5.- Method for measuring pressure in blood vessels according to claim 4, characterized in that it is configured to determine clinical cases of portal hypertension by means of the continuous or repeated measurement of pressure in the hepatic vein, comprising the following steps:
- implanting an intravenous catheter (4) in the hepatic vein, and a subcutaneous venous route system for prolonged use, - connecting said intravenous catheter (4) to a pressure catheter (1 ),
- occluding the hepatic vein by means of inflating an inflatable element (3) and measuring pressure, and
- deflating the inflatable element (3) and measuring pressure.
6.- Method for measuring pressure in blood vessels according to claim 5, characterized in that the catheter comprises continuous monitoring means for the pressure measured in the hepatic vein, comprising continuously monitoring said pressure.
PCT/EP2009/066056 2008-12-01 2009-11-30 Percutaneous catheter and method for measuring pressure in blood vessels WO2010063676A1 (en)

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ESP200803416 2008-12-01
ES200803416A ES2368404B1 (en) 2008-12-01 2008-12-01 PERCUTANEOUS CATHETER AND METHOD FOR MEASURING PRESSURE IN BLOOD VESSELS.

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Cited By (4)

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WO2017173834A1 (en) * 2016-04-06 2017-10-12 祁小龙 Method of determining virtual hepatic venous pressure gradient
US10293118B2 (en) 2011-07-15 2019-05-21 Vanderbilt University Apparatus and methods for measuring peripheral venous pressure and applications of same
CN110270004A (en) * 2019-07-25 2019-09-24 苏州恒瑞宏远医疗科技有限公司 HVPG foley's tube and preparation method thereof
US20200367867A1 (en) * 2017-11-24 2020-11-26 National University Hospital (Singapore) Pte Ltd Balloon-anchored biopsy device

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US10293118B2 (en) 2011-07-15 2019-05-21 Vanderbilt University Apparatus and methods for measuring peripheral venous pressure and applications of same
WO2017173834A1 (en) * 2016-04-06 2017-10-12 祁小龙 Method of determining virtual hepatic venous pressure gradient
US10827935B2 (en) 2016-04-06 2020-11-10 Xiaolong Qi Method of determining virtual hepatic venous pressure gradient
US20200367867A1 (en) * 2017-11-24 2020-11-26 National University Hospital (Singapore) Pte Ltd Balloon-anchored biopsy device
CN110270004A (en) * 2019-07-25 2019-09-24 苏州恒瑞宏远医疗科技有限公司 HVPG foley's tube and preparation method thereof

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