Hemostasis valve

Details Hemostasis valve Hemostasis valve

2000-12-11

2003-10-14

Casler, Brian L. (Department: 3763)

Surgery

Means for introducing or removing material from body for...

Treating material introduced into or removed from body...

C604S167040, C604S256000

Reexamination Certificate

active

06632200

ABSTRACT:

BACKGROUND OF INVENTION
1. Field of Invention
This invention relates to medical devices and instruments. More particularly, this invention relates to hemostasis valves and hemostasis cannula units containing a hemostasis valve, wherein the hemostasis valve is comprised of two separate valve gaskets, each with the same shape, which are reversed in position, but joined together within the valve housing of the hemostasis cannula.
2. Prior Art
The introduction of catheters into blood vessels for a variety of purposes such as coronary angiography has been known for many years. Several techniques for introducing these catheters into the vasculature of the human body are available. One such technique is the cut-down method, while another is the Seldinger technique. The Seldinger technique includes surgically opening a vein or artery with a needle, inserting a guidewire into the vessel through the lumen of the needle, withdrawing the needle, inserting over the guidewire a dilator which has passed through an associated sheath containing a hemostasis valve, removing the dilator and inserting a catheter through the hemostasis valve and sheath into the blood vessel.
A wide variety of hemostasis valves are known in the prior art. However, when a guidewire is inserted through most hemostasis valves, because most guidewires are so small relative to the catheters which may also be employed, it is often difficult for the valve to seal adequately against the backward pressure of blood, while at the same time permitting easy insertion of much larger diameter catheters into the vasculature. This problem is particularly acute with catheterization procedures involving arterial introduction where there is a high reverse pressure of blood. In these arterial procedures, blood can squirt out when the guidewire is introduced through the hemostasis valve. Excessive blood leakage may be extremely dangerous to patients and a contaminant to the operating room and medical personnel. Accordingly, most prior art hemostasis valves are designed for use with only one size of catheter. It has often been difficult to employ a single type of hemostasis valve with catheters of widely varying diameters because adequate sealing around the catheter walls cannot be achieved by these hemostasis valves.
Cardiac catheter introducers used during coronary procedures often contain a hemostasis valve that is mounted in the valve housing or hub, which is secured on the proximal end of the introducer. Such an introducer is conventionally used to facilitate the insertion of catheters and guidewires into the vascular system of a patient, while minimizing injury to the patient at the access site and improving the patient's comfort during the cardiac catheterization procedure. An introducer is particularly necessary where one or more treating catheters of varying diameters are inserted into and removed from the patient's vessel repeatedly as often occurs during angiographic procedures and angioplasty. The mere presence of the catheter introducer and the insertion of different size catheters through the introducer often causes bleeding during cardiac catheterization procedures. A high performance hemostasis valve is therefore needed to seal against the leakage of blood out of or around catheters and guidewires having varying diameters as they enter an artery or other blood vessel. The hemostasis valve must also prevent the introduction of air into the artery or blood vessel of the patient when one or more than one of the elongated catheters or guidewires are withdrawn from the introducer. In addition, the valve must remain sealed when there is no medical device passing through the valve. Accordingly, the requirements for a useful hemostasis valve include at least the following: (a) the valve is always sealed when no elongated cylindrical medical device is introduced through it; (b) the insertion and retraction forces must be minimal when larger diameter catheters (such as those larger than about 9 F (3 mm)) are introduced into the valve; (3) in contrast, the valve must maintain good sealability when small diameter guidewires (such as those down to 0.014 in. (0.35 mm)) pass through its passageway; and (4) to the greatest extent possible, the deformation of the valve should be in a radial direction instead of an axial direction to prevent the transmission of air into the blood stream.
Numerous hemostasis valves are known which can be classified in three major groups. Type I, as disclosed, for example, in U.S. Pat. Nos. 5,041,095 and 5,176,652, contain a pair of disc-like gaskets of approximately equal thickness. Each gasket has a Y-shaped opening cut into the gasket radially extending from its center forming three (3) slits, each located at an angle of about 120 degrees from the other slits. Each slit penetrates the gasket from one end face to the other end face. To form a self-sealing hemostasis valve, the two Y-shaped slits of the respective gaskets are mounted in a position opposite to one another in the valve housing.
Other types of hemostasis valves containing multiple disks which are approximately the same size and thickness are disclosed, for example, in U.S. Pat. Nos. 2,023,267; 4,000,739; 4,430,081; 4,655,752; 4,673,393; 4,895,346; 5,000,745; and 5,643,227. Each of these patents discloses a different combination of valve disks that are used to form the hemostasis valve. In some embodiments, one of the disks contains Y-shaped slits and the other disk contains a circular opening in the center of that disk.
Type II hemostasis valves as disclosed, for example, in U.S. Pat. Nos. 4,626,245; 4,629,450; 5,114,408; 5,149,327 and 5,167,637 and utilize a single sealing disk. This disk generally has a first slit that opens at only one end face and a second slit that opens at only the other end face. The two slits, which form a crisscross, intersect each other inside the disk. Other types of single disk hemostasis valves with different shapes for the opening through that disk are disclosed, for example, in U.S. Pat. No. 4,705,511 (see FIG.
4
); U.S. Pat. No. 4,798,594 and 4,895,565.
Type III hemostasis valves, as disclosed, for example, in U.S. Pat. Nos. 5,149,327; 5,207,656 and 5,520,655, are similar to Type II hemostasis valves, but differ in that only one slit (Y-shaped or
-shaped) penetrates from one end face to the other end face of the gasket. The slit may be perpendicular to the body of the valve or it may be spiral cut to form a downwardly spiraling cut, as disclosed in U.S. Pat. Nos. 5,520,655, 4,789,594, and 4,895,565. Note particularly U.S. Pat. No. 4,705,511, which discloses a hemostasis valve with an angled cut extending from its proximal to its distal face.
Other types of hemostasis valves are disclosed in various patents such as in U.S. Pat. Nos. 4,610,655; 4,909,798 and 5,125,903. However, these hemostasis valves are generally designed for use with a particular size of medical device.
Because adequate sealing around the elongated cylindrical medical devices using conventional hemostasis valves cannot be assured for a wide variety of devices, each having a different diameter, it has not been possible to utilize a single hemostasis valve with devices of widely varying diameters. Also, many of the prior art hemostasis valves exhibit various performance defects due to various structural features. For example, it may be difficult to manipulate an elongated cylindrical medical device through the passageway formed by automatically closed slits because no pre-guiding centering channel is provided. In addition, for Type I hemostasis valves, the deformation arising from the insertion of the elongated cylindrical medical device into the valve is generally in an axial direction rather than radially away from the opening. In these hemostasis valves, the introduction of a medical device creates an axial gap between the gaskets that may result in leakage of blood under high blood pressure situations. For Type II hemostasis valves, such axial gaps are sometimes reduced by integrating the sealing function of two gaskets into a s

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