Use of a functionalized introducer sheath and bioimpedance spectroscopy for real-time detection of vascular access complications

Abstract

Internal bleeding complications (IBCs) occurring at vascular access sites are associated with worsening patient outcomes and increased costs. This study assessed the IBC detection capabilities of a bioimpedance spectroscopy (BS) monitoring system that uses a novel functionalized introducer sheath. The device was tested in three large animal models of a clinical IBC. A 120-mL perivascular saline injection after sheath insertion, a slow continuous perivascular saline injection of 2.6 mL min(-1) of saline and a vessel-puncture model were tested. In each case, a significant change in normalized impedance was detected compared to the controls. This study provides evidence that a functionalized vascular access sheath using BS can detect an intraprocedural vascular access IBC. Clinical use of the device could help guide patient care by directly detecting vascular access complications early, thereby preventing unnecessary diagnostic scans to rule out the presence of IBCs.

Near‐field impedance accurately distinguishes among pericardial, intracavitary, and anterior mediastinal position

“…10 Bioimpedance is an increasingly used tool with multiple medical applications, including estimating volume status in patients with heart failure, detecting cancer, and monitoring patients for internal bleeding complications after percutaneous femoral access. [11][12][13][14] In these scenarios, bioimpedance has proved accurate in detecting small changes in tissue composition.…”

Confirming pericardial access by using impedance measurements from a micropuncture needle

“…One such strategy is bioimpedance measurement, which can be used to differentiate between various tissue types. Bioimpedance measurements are commonly used to measure body composition, 6 identify tumor cells, 7 detect bleeding complications during vascular access, 8 and prevent steam pops during cardiac ablation 9 . During pericardial access procedures, the needle tip passes through the skin, subcutaneous tissue, fat, and the pericardial sac with its serous fluid.…”