Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1991-02-25
1993-08-03
Yasko, John D.
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604 53, A61M 2900
Patent
active
052324443
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND OF THE INVENTION
The invention relates to a catheter having a ballon.
In the medical field, especially in radiology and cardiology, the expansion (dilatation) of constrictions (stenoses) along the arteries is currently a frequently used and highly satisfactory method of increasing the blood flow, and thus the supply of oxygen and energy, to the peripheral vascular system.
Here, a so-called dilatation catheter is pushed to the appropriate, stenosed blood vessel segment where the balloon at the leading end is expanded.
A frequent complication of the expansion of blood vessel constrictions is the formation of thrombi in the blood vessels. This often has severe consequences for the patient, especially in the region of the heart, and the difficulties will be described below with particular reference to the coronary situation.
To mitigate the above complication, various medications including, among others, dissolving agents which are to redissolve the thrombi, are dispensed via an intracoronary route (proximal and distal to the balloon) during, before and after the expansion. However, at the time of the actual expansion and the intracoronary thrombus formation induced by the same under certain circumstances, the expanded balloon prevents these medications from penetrating to the desired location. The medications can actually arrive at the dilatation area only after the balloon has been contracted or withdrawn from the expanded region of the stenosis. Under certain circumstances, however, this can be too late for effective action.
Thrombi which have formed in the area of dissections, for example, can readily cause an embolism in the peripheral system or be the starting point for a spontaneous thrombotic blockage. Also, lesions can increase the susceptibility of the inner blood vessel layer to coagulum formation.
The German Offenlegungsschrift 32 35 974 discloses a catheter which can deliver medications to the region of a stenosis during the dwell time of the catheter. Here, expandable balloons are disposed on either side of a stenosis and bound the area of the stenosis from the front and the back. A medication is then delivered to the region between the balloons via openings in the catheter wall. A disadvantage is that the medication can act only while the catheter is in the blood vessel which requires long dwell times with associated drawbacks. Penetration of the medication into the wall itself is very unsatisfactory because, as a rule, the blood vessel wall is undamaged. Hence, active metabolic and diffusion processes, which require relatively long times, have been contemplated. This is disadvantageous particularly since a catheter can quasi-block the blood vessel for only a relatively short period, e.g., seconds to at most a few minutes. However, it is questionable whether the catheter of the German Offenlegungsschrift 32 35 974 can provide an effective treatment within this short interval.
U.S. Pat. No. 4,423,725 also shows an arrangement having a plurality of balloons. Two of the balloons can be expanded on either side of a location to be treated and then seal the zone between the balloons. In addition, a third balloon is provided intermediate the sealing balloons and contains a medicinal active substance which can be dispensed in the zone between the sealing balloons.
To this end, flow apertures are distributed over the surface of the middle balloon, and the active substance can exit through the flow apertures to arrive, for the most part, in the intermediate zone between the two outer balloons. Here, also, penetration of the medication directly into the blood vessel wall during delivery of the active substance is inadequate and an extended dwell time of the catheter is therefore required to achieve penetration by diffusion and the like. Moreover, the structure of this balloon catheter, which contains three individual balloons, is complicated.
Finally, an implantable medication carrier, which is designed to deliver an active substance over an extended period of time, is known from U.S. Pat. No.
REFERENCES:
patent: 3981299 (1976-09-01), Murray
patent: 4417576 (1983-11-01), Baron
Just Hansjorg
Solzbach Ulrich
Kontler Peter K.
Yasko John D.
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