Surgery – Means for introducing or removing material from body for... – Treating material introduced into or removed from body...
Patent
1996-02-05
1998-04-07
Yasko, John D.
Surgery
Means for introducing or removing material from body for...
Treating material introduced into or removed from body...
604 20, A61M 500
Patent
active
057358281
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE INVENTION
The present invention refers to a process for catheterization of the vascular system and a device for carrying out this process.
BACKGROUND OF THE INVENTION
A previously known device for guiding a catheter into its position in a blood vessel is disclosed in SE-A-404 491. The device consists of a head part and a sheath with a slit along the entire length of the device, both tubular and head member included. The sheath is made of a flexible material with the slit extending along its entire extension. Similar devices are known from U.S. Pat. No. 3,853,130, EP-A-00911434, U.S. Pat. No. 3,472,232, U.S. Pat. No. 4,619,644 and EP-A-0067260.
These prior art devices have the following disadvantages:
U.S. Pat. No. 3,472,232 consists of several movable parts and has no wide slot, making a deformation of the catheter unavoidable. EP-A-0067260 requires a deformation to create or enlarge a slit (with a resulting increase in the outer diameter of the device). U.S. Pat. No. 4,619,644 is not designed for flexible long catheters without stiffening guide-wires that must subsequently be extracted. Neither U.S. Pat. No. 3,472,232 nor U.S. Pat. No. 4,619,644 are designed for use with the Seldinger technique, the most atraumatic and safe method.
Catheters are introduced into the vascular system to create a link to the outside world. If great and fast dilution exists, the administration of highly irritating solutions will be possible. For this reason central vessels close to the heart are catheterized when delivering cytotoxics, certain antibiotics and amino acids.
A centrally positioned catheter can be connected to a port, subcutaneously placed by surgery, and a system concealed from the outside world will be obtained. When necessary, this system can be connected to the outside world by penetrating the silicone top of the port (and the skin) with a special cannula, which in turn is connected to an infusion system.
Catheters inserted in "central" veins are soft and highly flexible, in size and consistency like boiled spaghetti. In order to penetrate the skin and underlying tissues as well as the wall of a vessel, a tube or sheath through which the catheter will be introduced or, alternatively, a guide-wire over which the catheter will be advanced into the vascular lumen, is required. The intravascularly positioned catheter is connected to infusion systems via standardized attachments or connected to a subcutaneously placed port. Catheters are often tunnelled in order to minimize the risk of infection or simply for practical reasons, giving the port or catheter a convenient position.
The direct method implies introduction of the catheter through a sufficiently large cannula after positioning of the latter in the vascular lumen. This method postulates a large cannula (inner-diameter=catheter diameter), and a "stripped" catheter without mounts, attachments or port.
A cannula with an enveloping plastic sheath on the outside is introduced into the vascular lumen, the sheath is passed over the cannula into a vessel and the cannula is thereafter extracted. The catheter is inserted through the sheath. This method requires a "stripped" catheter and a rather large cannula.
Method A:
A guide-wire is inserted through a small bore cannula into the lumen. A catheter is threaded over the guide-wire reaching an intraluminar position.
Disadvantage: The guide-wire may not make sharp turns as the friction between catheter and guide-wire at the insertion of the catheter, or extraction of the guide-wire, will be too great and the catheter will get caught. The guide-wire is extracted through the distal end of the catheter, making a port impracticable.
Method B:
A guide-wire is introduced into the vascular lumen via a small bore cannula. A plastic sheath with a tapered proximal end and a plastic tubular sleeve on the outside is pushed or forced into the vessel, and the tubular sleeve pushed in, whereupon the sheath (dilator) and guide-wire is extracted. The catheter is inserted through the remaining tubular sleeve into the tu
REFERENCES:
patent: 3472232 (1969-10-01), Earl
patent: 3827434 (1974-08-01), Thompson et al.
patent: 3853130 (1974-12-01), Sheridan
patent: 4354491 (1982-10-01), Marbry
patent: 4619644 (1986-10-01), Scott
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