Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1991-03-04
1993-05-04
Yasko, John D.
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604175, A61M 1100
Patent
active
052076440
DESCRIPTION:
BRIEF SUMMARY
The invention relates to a device comprising an infusion chamber which is implantable into the subcutaneous fatty tissue of a patient and which has a region of elastic material, which can be pierced by means of an injection needle, and comprising a catheter which extends away from the infusion chamber and which can be introduced into a blood vessel, for example an artery, or another body cavity.
German patent specification No 3 102 993 already discloses a subcutaneously implantable device for the supply of liquid medications which comprises an infusion chamber with a piercable membrane as a puncture window and a hose connected to the chamber for transmission of the medicament. Disposed in opposite relationship to the puncture window is a reinforcement which prevents the rear wall of the chamber from suffering from perforations.
German patent specification No 3 309 788 describes an entirely similar device comprising an infusion chamber having a piercable puncture window, and a catheter which can be connected to the infusion chamber. The infusion chamber which is referred to as a `injection member` has an annular bead which surrounds the puncture window and which projects beyond same and in opposite relationship to the annular bead at the underside a plate which projects peripherally beyond the chamber, with holes arranged in a distributed array around the periphery, for fixing by means of threads in the implanted condition.
Devices of that kind permit permanent access to a venous or arterial vessel. Devices intended for arterial vessel accesses differ from venous systems by virtue of a valve at the tip of the catheter in order to preclude occlusion due to a reverse flow of blood in the arterial high-pressure system due to thrombosis formation.
Devices of that kind which serve for the selective feed of medicaments into vessels can be subcutaneously implanted, which presupposes surgical intervention at any event with the use of local anaesthetic.
In a known implantation method, after an incision in the skin has been made, the vessel into which a catheter is to be introduced is opened for example by means of a puncture cannula or in another suitable manner and then the catheter is inserted into the vessel. Thereupon an epifascial pocket is to be prepared for the infusion chamber and the infusion chamber is to be placed in the pocket in such a way that a puncture window in the form of a diaphragm lies outside the cut location under the skin. After the implantation operation and after the operation which is possibly carried out beforehand of fitting a suction drainage, the wound is to be closed with subcutaneous or skin sutures.
If for anatomical reasons access to the vessel is possible only at a further distance from the intended position of the infusion chamber, a skin incision must be made in the region of that access and the cathether must be laid from a subcutaneous pocket for receiving the infusion chamber through a subcutaneous tunnel to the skin incision before the catheter can be introduced into the vessel.
Subcutaneously implantable devices are suitable in particular for intra-arterial chemotherapy which permits regional tumourtherapy of primary tumours and metastases. For the purposes of pre-implantation planning, an arteriograph must be produced in order to give precise information about the anatomical vessel supply to a tumour-bearing organ and thus determine the location of the catheter tip in the vessel system for the purposes of medicament delivery.
The advantage of the intra-arterial method is that higher levels of concentration of the chemotherapy agents to be used can be introduced into the tumour tissue, which thus permit specific and directed treatment with lower general side-effects. The medicament which is to be delivered intra-arterially can be delivered only through a puncture in the skin and the diaphragm of the puncture window into the infusion chamber and from there selectively into the tumour-supplying artery by way of the hose or tube system which is introduced into the latter.
Howe
REFERENCES:
patent: 3971376 (1976-07-01), Wichterle
patent: 4710167 (1987-12-01), Lazorthes
patent: 4718894 (1988-01-01), Lazorthes
patent: 4778452 (1988-10-01), Moden et al.
patent: 4802479 (1989-02-01), Haber et al.
Fogiel Max
Godlewski Richard J.
Yasko John D.
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