Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1983-08-16
1985-04-09
Pellegrino, Stephen C.
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604170, 128657, A61M 2500
Patent
active
045099456
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The invention relates to a catheter for catheterizing central veins via peripheral vein approaches.
PRIOR ART
Catheterization of central veins (hollow vein, Vena cava) plays an important role in the treatment of shocks, in the determination of the central venous blood pressure or in the monitoring of the latter during surgical interventions, and in parenteral feeding. Depending on the entry point of the catheter into the human body a distinction is made between the central approach routes and the peripheral approach routes. In the first case, approach is via the Vena jugularis, the vena anonyma or the Vena subclavia, whilst in the second case approach is via leg veins or brachial veins. Catheterization via a central approach route has the advantage that the catheter can be laid in a vessel which has a relatively large lumen and no venous valves, and that the distance up to the hollow vein is short. It is a disadvantage of the central approach routes, however, that it is difficult to find the veins which can be used for venipuncture, and that this requires special care because large arteries are located closeby. Thus, the puncture cannula reaches the Vena anonyma only at a depth of about 5 cm. For a puncture of the Vena jugularis, the puncture cannula must be guided through the Musculus sternocleidomastoideus under a certain angle to the skin surface, before it encounters the vein, running directly next to the Arteria carotis, at a depth of 3-4 cm. The catheterization of central veins via a central approach can therefore be carried out, largely without risk, only by particularly experienced and skilled physicians, such as in particular specialist anesthetists. In the case of less experienced practitioners or under unfavorable external circumstances, such as, for example, when treating accident victims at the scene of an accident or in the rescue vehicle or aircraft, approach to the central veins via a peripheral vein, that is to say a leg vein or a brachial vein, is to be preferred, because these veins are in most cases clearly visible through the skin or can be made readily detectable by briefly applying a ligature to the leg or to the upper arm. In the case of approach via a peripheral vein, however, advancing the catheter is more difficult, on the one hand because the distance up to the hollow vein is considerably longer, and on the other hand because the peripheral veins have a smaller internal diameter and, in addition, venous valves must be overcome.
For this reason, difficulties arise in a considerable percentage of catheterizations via a peripheral approach, when advancing the catheter tube: for example, the tip of the tube can take a wrong direction (Via falsa), can catch on venous valves or vessel branches and can cause complications, which are a danger to life, such as embolisms or hemorrhages in the thorax. There is therefore a demand for an improvement in the methods, hitherto practised, of central vein catheterization via peripheral approach, and for an appropriate catheter being made available. It was the object of the invention to provide a new catheter for the catheterization of central veins via peripheral approach, which catheter enables central vein catheterizations to be carried out safely and rapidly, in particular also in emergency situations under the frequently unfavorable environmental conditions of the scene of an accident or in rescue vehicles and aircraft.
DESCRIPTION OF THE INVENTION
It has now been found that the catheterization of the Vena cava superior via peripheral vein approach can be carried out in a substantially better way and without complications, when a catheter is used which is provided with a guide wire, the elastic front end of which is curved in the manner of a walking stick. This result is very surprising since it was assumed hitherto that mandrins curved in this way like a walking stick would be unsuitable for advancing in veins, since they would cause injuries therein, for example to the venous valves.
The subject of the inventio
REFERENCES:
patent: 2118631 (1938-05-01), Wappler
patent: 3539034 (1970-11-01), Tafeen
patent: 3547103 (1970-12-01), Cook
patent: 3612038 (1971-10-01), Halligan
patent: 3757768 (1973-09-01), Kline
patent: 4349023 (1982-09-01), Gross
patent: 4417886 (1983-11-01), Frankhouser et al.
Blitt et al., Central Veneous Catheterization via the External Jugular Vein, JAMA, Aug. 12, 1974, vol. 229, No. 7, pp. 817-818.
Kramann Bernhard
Rust Meinhard
Pellegrino Stephen C.
Sterimed Gesellschaft fur medizinischen Bedarf mbH
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