CA2048513A1 - Dilator - Google Patents
DilatorInfo
- Publication number
- CA2048513A1 CA2048513A1 CA 2048513 CA2048513A CA2048513A1 CA 2048513 A1 CA2048513 A1 CA 2048513A1 CA 2048513 CA2048513 CA 2048513 CA 2048513 A CA2048513 A CA 2048513A CA 2048513 A1 CA2048513 A1 CA 2048513A1
- Authority
- CA
- Canada
- Prior art keywords
- cross
- dilator
- section
- vein
- guide wire
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M29/00—Dilators with or without means for introducing media, e.g. remedies
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/06—Body-piercing guide needles or the like
- A61M25/0662—Guide tubes
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Anesthesiology (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Hematology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Pulmonology (AREA)
- Biophysics (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
ABSTRACT
A dilator is provided for use with a guide wire to create a subcutaneous tunnel into a vein for subsequent insertion of a catheter over the wire and into the vein. The dilator has an elongate main body with a first cross-section extending about a longitudinal axis and a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator. The main body extends from the tip portion to a proximal end of the dilator, and the tip portion has a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section. A tailing taper extends smoothly from the main body and converges from the first cross-section to the second cross-section, and an opening extends between the proximal and distal ends of the dilator for receiving the guide wire.
A method creating a subcutaneous tunnel is also provided.
A dilator is provided for use with a guide wire to create a subcutaneous tunnel into a vein for subsequent insertion of a catheter over the wire and into the vein. The dilator has an elongate main body with a first cross-section extending about a longitudinal axis and a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator. The main body extends from the tip portion to a proximal end of the dilator, and the tip portion has a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section. A tailing taper extends smoothly from the main body and converges from the first cross-section to the second cross-section, and an opening extends between the proximal and distal ends of the dilator for receiving the guide wire.
A method creating a subcutaneous tunnel is also provided.
Description
~ 3~
This invention relates to subcutaneous insertion of catheters into veins such as the femoral or subclavian veins, and more particularly to a dilator for following a guide wire to form a tunnel for receiving the catheter.
The invention will be described with reference to the procedure of inserting a catheter for use in hemodialysis by the Seldinger technique, but it will be recognised that this description is exemplary of procedures for other purposes and that the dilator described here can be used in such other procedures.
Since Dr. Seldinger introduced his technique in 1953, it has become common practice to use guide wires when inserting catheters into veins. In hemodialysis procedures, a hollow needle is first used to create a small incision in a vein, typically 4 French. This hollow needle allows blood flow to show that the needle has been positioned in the vein. Next a very flexible wire is pushed through the needle, into the vein, and then moved for some distance down the vein to act as a guide for subsequent engagement of a dilator and then a catheter.
With the wire in place, the needle is withdrawn leaving behind tissue expanded to about 4 French and an opening in the vein of about the same size. The eventual catheter to be placed is typically 11 French so that dilation to 11 French (or close to this size) must take place. As the dilator is pushed along the wire, blood will flow through the dilator so there is further blood loss as this takes place.
At this point it is worthwhile noting that this is a subcutaneous procedure which means that the leading end of the 2~a~ 3 dilator must first stretch the quite strong skin which requires a significant force and then dilate the underlying tissue, before stretching the vein. The forces required and the fact that the surgeon is dealing with very flexible and resilient material makes it difficult for the surgeon to sense the dilator following the wire, especially if larger forces are required due to the enlargement being done by a single dilator. The procedure can be very traumatic for the patient if not done properly.
10One approach to creating a tunnel is to slide a dilator over the wire. However the difference between 4 French and 11 French makes it difficult to insert an 11 French dilator over the wire for two reasons. Firstly the enlargement demands significant force, and secondly this force reduces the surgeon's tactile sensitivity so that when the catheter is inserted over the wire it can be driven off track taking the wire with the catheter into adjacent tissue. This can result in serious ~ trauma. This problem is emphasized by the fact that the tissue tends to return to its original form after the needle is removed so that the dilation required can possibly be from the wire size to 11 French.
The tactile sensitivity can be improved by the use of a series of dilators of increasing diameter. Such a procedure is slow because each of the dilators must be engaged over the wire, removed, and a new dilator put in place. Because the dilators are forming a tunnel of increasing size, there will be a significant loss of blood. Also, each of the dilators must be handled very carefully because the leading ends enter the vein 2 ~ ,7, '`,!
and if the dilator is pushed too far, it could damage the side of the vein opposite the entry opening.
A second approach to dilation which has been used is to insert the ultimate catheter directly over the wire. This is 5 not a desirable procedure because the design requirements of a catheter used in this way for dilation are contrary to the design requirements of a catheter which make it suitable to be placed in a vein for the time needed for treatment. On the one hand, the tip of the catheter designed for dilation must be quite firm so that when it is pushed along the wire, the tip will dilate the tissue without collapsing the tip. By contrast a catheter designed for prolonged use in a vein should have a very flexible tip so that any movement which causes contact between the tip of the catheter and the vein will result in the tip flexing to minimize the risk of deforming the vein.
A further approach to dilation has been to provide a set of dilators which fit one over another. A first and smaller dilator is entered over the wire and then this is followed by one or more dilators which are slipped over one another and lead forwardly to a predetermined location so that the resulting combination of dilators represents generally the size OL the catheter to be placed. While this combination of dilators has some advantages, it must be remembered that the sizes are very small. The dilator is expanding tissue generally from the size of the needle which is typically 4 French up to about 10 or 11 French. There is very little room for wall thickness in these sizes and consequently the dilators are not simple to hand]e and the procedure of sliding one over another can be quite dangerous 2~ ;3 due to the fact that the first dilator is in place ln the vein and can cause damage if oscillated sideways or pushed forwardly.
As a result of these difflculties t:here is a need for a single dilator which will follow a wire and form a tunnel of a shape and size which will permit insertion of a catheter directly regardless of the fact that the catheter may have a very flexible tip.
Accordingly, a dilator is provided, in accordance with one aspect of the invention, for use with a guide wire to create a subcutaneous tunnel into a vein for subsequent insertion of a calheter over the wire and into the vein. The dilator has an elongate main body with a first cross-section extending about a longitudi.nal axis and a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator.
The main body extends from the tip portion to a proximal end of the dilator, and the tip portion has a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section. ~ tailing taper extends smoothly from the main body and converges from the first cross-section to the second cross-section, and an opening extends between the proximal and distal ends of the dilator for receiving the guide wire.
In accordance w;th another aspect of the invention, a method of creating a subcutaneous tunnel for catherisation procedures involving inserting a catheter into a vein is provided.
The invention will be better understood with reference to the drawings,in which:
Fig.l is a somewhat schematic isometric view of a preferred embodiment of a dilator according to the invention shown partly entered ;nto a subcut:aneous tunnel and following a wire which has been engaged ;n a vein.
The accepted procedure for subcutaneous insertion of a catheter involves engaging a needle into a vein 20 underlying body tlssue 22 beneath t:he skin 24. Typically the needle creates a tunnel 26 of about 4 French and of course once the needle is removed this tunnel tends to collapse around a Seldinger guide wire 28 left behind when the needle is withdrawn. For the purposes of the illustration the tunnel 26 is shown as it would appear with the needle engaged.
A dilator 30 according to the invention consists of an elongate main body 32 extending about a longitudinal axis from a proximal end fitting 34 to a tip portion 36 at the distal end of the dilator. This tip portion has a leading taper 38 spaced from a trailing taper 40 which together combine to dilate the tunnel. The tapers 38 and 40 are separated in this preferred embodiment by a leading portion 42 which is of reduced cross section compared with the main body 32. Typically the main body is of 12 French and the portion 41 of 10 French and an opening extends longitudinally through the dilator to contain the wire 28 as shown in broken outline.
The leading taper 38 fits snugly about the wire 28 and when the dilator is fed along the wire, it initially makes contact with the skin 24 and the taper dilates the skin and then commences dilation of the tissue 22. This continues until the trailing taper 40 meets the skin whereupon dilation of the skin to the full size of the body 32 takes place as the taper 38 continues to dilate the tissue. As the dilator progesses, the taper 40 dilates tissue until the taper 38 has dilated the vein and entered the vein, to dilate the vein to the size of the leading portion 42. At this point the skin and some of the tissue has been dilated to the full size of the dilator and a portion of the tissue controlled by the length of the leading portion 42, and the access opening in the vein has been dilated to the size of the portion 42.
The result is that a subcutaneous tunnel is formed capable of receiviny a catheter guided by the wire 28 and which is itself used to dilate only a portion of the tissue and the vein from about 10 French to 11 French. This permits the use of a relatively soft tip catheter and yet permits the catheter to complete the dilation to the size and shape of the catheter.
Consequently, if the catheter is not entirely round or the exact shape of the dilator, the stretching will enable the catheter to form an opening in the vein which tends to be self sealing. At the same time the catheter is not required to dilate all of the tunnel but only the very last part where it engages the vein.
The tissue also stretches around the catheter and this combined with the veln helps to ensure sealing.
It should also be noted that the catheter insertion is done using a single dilator which minimizes time, ensures a good seal, and at the same time makes engagement simple because the lead part is of a small cross section and this gets buried in the tunnel and then leads the larger taper 40.
Variations can of course be made to the dilator. In ~ L~;3 particular the leading portion 42 can have any length consistent with meeting the requirements of having the portion 40 engage through the skin and into the tissue at the time the leading taper 38 engages the vein. Also, portion 42 could itself be S slightly tapered resulting in a gradual dilation from the leading end of the dilator through to the main body 32.
Procedurally, the dilator helps to ensure a smooth entry of the catheter with minimal trauma. The dilation can be considered to be in three stages: firstly dilation of the complete tunnel to the size of portion 42; secondly, and contemparaneously with the latter part of the dilation to the size of portion 42, dilation of skin and adjacent tissue to the size of body 32; and lastly, dilation of the vein and adjacent tissue to the size of the catheter by the catheter.
~11 of these variations are within the scope of the invention as claimed.
This invention relates to subcutaneous insertion of catheters into veins such as the femoral or subclavian veins, and more particularly to a dilator for following a guide wire to form a tunnel for receiving the catheter.
The invention will be described with reference to the procedure of inserting a catheter for use in hemodialysis by the Seldinger technique, but it will be recognised that this description is exemplary of procedures for other purposes and that the dilator described here can be used in such other procedures.
Since Dr. Seldinger introduced his technique in 1953, it has become common practice to use guide wires when inserting catheters into veins. In hemodialysis procedures, a hollow needle is first used to create a small incision in a vein, typically 4 French. This hollow needle allows blood flow to show that the needle has been positioned in the vein. Next a very flexible wire is pushed through the needle, into the vein, and then moved for some distance down the vein to act as a guide for subsequent engagement of a dilator and then a catheter.
With the wire in place, the needle is withdrawn leaving behind tissue expanded to about 4 French and an opening in the vein of about the same size. The eventual catheter to be placed is typically 11 French so that dilation to 11 French (or close to this size) must take place. As the dilator is pushed along the wire, blood will flow through the dilator so there is further blood loss as this takes place.
At this point it is worthwhile noting that this is a subcutaneous procedure which means that the leading end of the 2~a~ 3 dilator must first stretch the quite strong skin which requires a significant force and then dilate the underlying tissue, before stretching the vein. The forces required and the fact that the surgeon is dealing with very flexible and resilient material makes it difficult for the surgeon to sense the dilator following the wire, especially if larger forces are required due to the enlargement being done by a single dilator. The procedure can be very traumatic for the patient if not done properly.
10One approach to creating a tunnel is to slide a dilator over the wire. However the difference between 4 French and 11 French makes it difficult to insert an 11 French dilator over the wire for two reasons. Firstly the enlargement demands significant force, and secondly this force reduces the surgeon's tactile sensitivity so that when the catheter is inserted over the wire it can be driven off track taking the wire with the catheter into adjacent tissue. This can result in serious ~ trauma. This problem is emphasized by the fact that the tissue tends to return to its original form after the needle is removed so that the dilation required can possibly be from the wire size to 11 French.
The tactile sensitivity can be improved by the use of a series of dilators of increasing diameter. Such a procedure is slow because each of the dilators must be engaged over the wire, removed, and a new dilator put in place. Because the dilators are forming a tunnel of increasing size, there will be a significant loss of blood. Also, each of the dilators must be handled very carefully because the leading ends enter the vein 2 ~ ,7, '`,!
and if the dilator is pushed too far, it could damage the side of the vein opposite the entry opening.
A second approach to dilation which has been used is to insert the ultimate catheter directly over the wire. This is 5 not a desirable procedure because the design requirements of a catheter used in this way for dilation are contrary to the design requirements of a catheter which make it suitable to be placed in a vein for the time needed for treatment. On the one hand, the tip of the catheter designed for dilation must be quite firm so that when it is pushed along the wire, the tip will dilate the tissue without collapsing the tip. By contrast a catheter designed for prolonged use in a vein should have a very flexible tip so that any movement which causes contact between the tip of the catheter and the vein will result in the tip flexing to minimize the risk of deforming the vein.
A further approach to dilation has been to provide a set of dilators which fit one over another. A first and smaller dilator is entered over the wire and then this is followed by one or more dilators which are slipped over one another and lead forwardly to a predetermined location so that the resulting combination of dilators represents generally the size OL the catheter to be placed. While this combination of dilators has some advantages, it must be remembered that the sizes are very small. The dilator is expanding tissue generally from the size of the needle which is typically 4 French up to about 10 or 11 French. There is very little room for wall thickness in these sizes and consequently the dilators are not simple to hand]e and the procedure of sliding one over another can be quite dangerous 2~ ;3 due to the fact that the first dilator is in place ln the vein and can cause damage if oscillated sideways or pushed forwardly.
As a result of these difflculties t:here is a need for a single dilator which will follow a wire and form a tunnel of a shape and size which will permit insertion of a catheter directly regardless of the fact that the catheter may have a very flexible tip.
Accordingly, a dilator is provided, in accordance with one aspect of the invention, for use with a guide wire to create a subcutaneous tunnel into a vein for subsequent insertion of a calheter over the wire and into the vein. The dilator has an elongate main body with a first cross-section extending about a longitudi.nal axis and a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator.
The main body extends from the tip portion to a proximal end of the dilator, and the tip portion has a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section. ~ tailing taper extends smoothly from the main body and converges from the first cross-section to the second cross-section, and an opening extends between the proximal and distal ends of the dilator for receiving the guide wire.
In accordance w;th another aspect of the invention, a method of creating a subcutaneous tunnel for catherisation procedures involving inserting a catheter into a vein is provided.
The invention will be better understood with reference to the drawings,in which:
Fig.l is a somewhat schematic isometric view of a preferred embodiment of a dilator according to the invention shown partly entered ;nto a subcut:aneous tunnel and following a wire which has been engaged ;n a vein.
The accepted procedure for subcutaneous insertion of a catheter involves engaging a needle into a vein 20 underlying body tlssue 22 beneath t:he skin 24. Typically the needle creates a tunnel 26 of about 4 French and of course once the needle is removed this tunnel tends to collapse around a Seldinger guide wire 28 left behind when the needle is withdrawn. For the purposes of the illustration the tunnel 26 is shown as it would appear with the needle engaged.
A dilator 30 according to the invention consists of an elongate main body 32 extending about a longitudinal axis from a proximal end fitting 34 to a tip portion 36 at the distal end of the dilator. This tip portion has a leading taper 38 spaced from a trailing taper 40 which together combine to dilate the tunnel. The tapers 38 and 40 are separated in this preferred embodiment by a leading portion 42 which is of reduced cross section compared with the main body 32. Typically the main body is of 12 French and the portion 41 of 10 French and an opening extends longitudinally through the dilator to contain the wire 28 as shown in broken outline.
The leading taper 38 fits snugly about the wire 28 and when the dilator is fed along the wire, it initially makes contact with the skin 24 and the taper dilates the skin and then commences dilation of the tissue 22. This continues until the trailing taper 40 meets the skin whereupon dilation of the skin to the full size of the body 32 takes place as the taper 38 continues to dilate the tissue. As the dilator progesses, the taper 40 dilates tissue until the taper 38 has dilated the vein and entered the vein, to dilate the vein to the size of the leading portion 42. At this point the skin and some of the tissue has been dilated to the full size of the dilator and a portion of the tissue controlled by the length of the leading portion 42, and the access opening in the vein has been dilated to the size of the portion 42.
The result is that a subcutaneous tunnel is formed capable of receiviny a catheter guided by the wire 28 and which is itself used to dilate only a portion of the tissue and the vein from about 10 French to 11 French. This permits the use of a relatively soft tip catheter and yet permits the catheter to complete the dilation to the size and shape of the catheter.
Consequently, if the catheter is not entirely round or the exact shape of the dilator, the stretching will enable the catheter to form an opening in the vein which tends to be self sealing. At the same time the catheter is not required to dilate all of the tunnel but only the very last part where it engages the vein.
The tissue also stretches around the catheter and this combined with the veln helps to ensure sealing.
It should also be noted that the catheter insertion is done using a single dilator which minimizes time, ensures a good seal, and at the same time makes engagement simple because the lead part is of a small cross section and this gets buried in the tunnel and then leads the larger taper 40.
Variations can of course be made to the dilator. In ~ L~;3 particular the leading portion 42 can have any length consistent with meeting the requirements of having the portion 40 engage through the skin and into the tissue at the time the leading taper 38 engages the vein. Also, portion 42 could itself be S slightly tapered resulting in a gradual dilation from the leading end of the dilator through to the main body 32.
Procedurally, the dilator helps to ensure a smooth entry of the catheter with minimal trauma. The dilation can be considered to be in three stages: firstly dilation of the complete tunnel to the size of portion 42; secondly, and contemparaneously with the latter part of the dilation to the size of portion 42, dilation of skin and adjacent tissue to the size of body 32; and lastly, dilation of the vein and adjacent tissue to the size of the catheter by the catheter.
~11 of these variations are within the scope of the invention as claimed.
Claims (5)
1. A dilator for use with a guide wire to create a subcutaneous tunnel into a vein for subsequent insertion of a catheter over the wire and into the vein, the dilator comprising:
an elongate main body with a first cross-section extending about a longitudinal axis;
a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator; and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, and a tailing taper extending smoothly from the main body and converging from the first cross-section to the second cross-section, and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire.
an elongate main body with a first cross-section extending about a longitudinal axis;
a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator; and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, and a tailing taper extending smoothly from the main body and converging from the first cross-section to the second cross-section, and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire.
2. A method of catheterisation for procedures involving inserting a catheter into a vein, the method comprising the steps:
providing a hollow elongate needle and engaging the needle through the skin, underlying tissue, and into the vein;
providing a flexible guide wire and pushing the guide wire through the needle and into the vein until the guide wire has progressed down the vein sufficient to guide a catheter into position in the vein;
withdrawing the needle over the guide wire leaving the guide wire in place;
providing a dilator having an elongate main body with a first cross-section extending about a longitudinal axis, a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator, and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, and a tailing taper extending smoothly fron the main body and converging from the first cross-section to the second cross-section, and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire;
engaging the dilator over the guide wire and moving the dilator along the wire to dilate the skin and adjacent tissue to a first cross-section and the vein and adjacent tissue to the second cross-section so that a tunnel is created about the guide wire;
removing the dilator leaving the guide wire in place;
providing a catheter having a cross-section larger than said second cross-section and similar to said first cross-section;
engaging the catheter over the wire and moving the catheter through the tunnel and into the vein so that the vein and adjacent tissue are dilated to the cross-section of the catheter and the catheter is positioned in the vein;
removing the guide wire; and connecting the catheter for conducting the procedure.
providing a hollow elongate needle and engaging the needle through the skin, underlying tissue, and into the vein;
providing a flexible guide wire and pushing the guide wire through the needle and into the vein until the guide wire has progressed down the vein sufficient to guide a catheter into position in the vein;
withdrawing the needle over the guide wire leaving the guide wire in place;
providing a dilator having an elongate main body with a first cross-section extending about a longitudinal axis, a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator, and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, and a tailing taper extending smoothly fron the main body and converging from the first cross-section to the second cross-section, and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire;
engaging the dilator over the guide wire and moving the dilator along the wire to dilate the skin and adjacent tissue to a first cross-section and the vein and adjacent tissue to the second cross-section so that a tunnel is created about the guide wire;
removing the dilator leaving the guide wire in place;
providing a catheter having a cross-section larger than said second cross-section and similar to said first cross-section;
engaging the catheter over the wire and moving the catheter through the tunnel and into the vein so that the vein and adjacent tissue are dilated to the cross-section of the catheter and the catheter is positioned in the vein;
removing the guide wire; and connecting the catheter for conducting the procedure.
3. A method of creating a subcutaneous tunnel for entering a catheter of predetermined cross-section into a vein, the method comprising:
providing a hollow elongate needle and engaging the needle through the skin, underlying tissue, and into the vein;
providing a flexible guide wire and pushing the guide wire through the needle and into the vein until the guide wire has progressed down the vein sufficient to guide a catheter into position in the vein;
withdrawing the needle over the guide wire leaving the guide wire in place;
providing a dilator having an elongate main body with a first cross-section extending about a longitudinal axis, a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator, and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, and a tailing taper extending smoothly fron the main body and converging from the first cross-section to the second cross-section; and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire;
engaging the dilator over the guide wire and moving the dilator along the wire to dilate the skin and adjacent tissue to a first cross-section and the vein and adjacent tissue to the second cross-section so that a tunnel is created about the guide wire; and removing the dilator leaving the guide wire in place;
providing a hollow elongate needle and engaging the needle through the skin, underlying tissue, and into the vein;
providing a flexible guide wire and pushing the guide wire through the needle and into the vein until the guide wire has progressed down the vein sufficient to guide a catheter into position in the vein;
withdrawing the needle over the guide wire leaving the guide wire in place;
providing a dilator having an elongate main body with a first cross-section extending about a longitudinal axis, a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator, and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, and a tailing taper extending smoothly fron the main body and converging from the first cross-section to the second cross-section; and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire;
engaging the dilator over the guide wire and moving the dilator along the wire to dilate the skin and adjacent tissue to a first cross-section and the vein and adjacent tissue to the second cross-section so that a tunnel is created about the guide wire; and removing the dilator leaving the guide wire in place;
4. A dilator for use with a guide wire to create a subcutaneous tunnel into a vein for subsequent insertion of a catheter over the wire and into the vein, the dilator comprising:
an elongate main body with a first cross-section extending about a longitudinal axis;
a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator; and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, a leading portion blending into the leading taper and extending towards the proximal end, the leading portion having said second cross-section, and a tailing taper extending smoothly from the main body and converging from the first cross-section to the leading portion; and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire.
an elongate main body with a first cross-section extending about a longitudinal axis;
a tip portion extending from the main body longitudinally and terminating at a distal end of the dilator, and the main body extending from the tip portion to a proximal end of the dilator; and the tip portion having a leading taper enlarging from the distal end towards a second cross-section smaller than the first cross-section, a leading portion blending into the leading taper and extending towards the proximal end, the leading portion having said second cross-section, and a tailing taper extending smoothly from the main body and converging from the first cross-section to the leading portion; and the dilator defining an opening extending between the proximal and distal ends for receiving the guide wire.
5. A dilator as claimed in claims 1 or 4 in which the first cross-section and second cross-section differ by 2 French.
Priority Applications (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2048513 CA2048513A1 (en) | 1991-08-07 | 1991-08-07 | Dilator |
| AU24188/92A AU2418892A (en) | 1991-08-07 | 1992-08-07 | Dilator |
| PCT/CA1992/000345 WO1993002735A1 (en) | 1991-08-07 | 1992-08-07 | Dilator |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA 2048513 CA2048513A1 (en) | 1991-08-07 | 1991-08-07 | Dilator |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2048513A1 true CA2048513A1 (en) | 1993-02-08 |
Family
ID=4148138
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA 2048513 Abandoned CA2048513A1 (en) | 1991-08-07 | 1991-08-07 | Dilator |
Country Status (3)
| Country | Link |
|---|---|
| AU (1) | AU2418892A (en) |
| CA (1) | CA2048513A1 (en) |
| WO (1) | WO1993002735A1 (en) |
Families Citing this family (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AUPN766296A0 (en) * | 1996-01-22 | 1996-02-15 | Endogad Research Pty Limited | Trocar and introducing kit |
| US6056762A (en) * | 1997-05-22 | 2000-05-02 | Kensey Nash Corporation | Anastomosis system and method of use |
| US8152767B2 (en) * | 2005-05-27 | 2012-04-10 | Cook Medical Technologies Llc | Low profile introducer apparatus |
| US7682337B2 (en) | 2007-02-07 | 2010-03-23 | Cook Incorporated | Method and apparatus for gaining percutaneous access to a body |
| CN102671287B (en) * | 2012-05-07 | 2014-04-02 | 先健科技(深圳)有限公司 | Puncture dilator |
Family Cites Families (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4405314A (en) * | 1982-04-19 | 1983-09-20 | Cook Incorporated | Apparatus and method for catheterization permitting use of a smaller gage needle |
| JPS60234671A (en) * | 1984-05-09 | 1985-11-21 | テルモ株式会社 | Catheter inserter |
| US4840622A (en) * | 1987-10-06 | 1989-06-20 | Menlo Care, Inc. | Kink resistant catheter |
| US5011478A (en) * | 1989-01-31 | 1991-04-30 | Cook Incorporation | Recessed dilator-sheath assembly and method |
-
1991
- 1991-08-07 CA CA 2048513 patent/CA2048513A1/en not_active Abandoned
-
1992
- 1992-08-07 AU AU24188/92A patent/AU2418892A/en not_active Abandoned
- 1992-08-07 WO PCT/CA1992/000345 patent/WO1993002735A1/en active Application Filing
Also Published As
| Publication number | Publication date |
|---|---|
| AU2418892A (en) | 1993-03-02 |
| WO1993002735A1 (en) | 1993-02-18 |
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Legal Events
| Date | Code | Title | Description |
|---|---|---|---|
| FZDE | Dead |