DE3941949A1 - Method of removal of blood clots - uses catheter into which saline solution is pumped at pressure - Google Patents
Method of removal of blood clots - uses catheter into which saline solution is pumped at pressureInfo
- Publication number
- DE3941949A1 DE3941949A1 DE19893941949 DE3941949A DE3941949A1 DE 3941949 A1 DE3941949 A1 DE 3941949A1 DE 19893941949 DE19893941949 DE 19893941949 DE 3941949 A DE3941949 A DE 3941949A DE 3941949 A1 DE3941949 A1 DE 3941949A1
- Authority
- DE
- Germany
- Prior art keywords
- catheter
- saline solution
- pressure
- removal
- hole nozzle
- 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.)
- Withdrawn
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
- A61M25/00—Catheters; Hollow probes
- A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
- A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
- A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22047—Means for immobilising the guide wire in the patient
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22038—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for with a guide wire
- A61B2017/22047—Means for immobilising the guide wire in the patient
- A61B2017/22048—Balloons
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/22—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for
- A61B2017/22082—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance
- A61B2017/22084—Implements for squeezing-off ulcers or the like on the inside of inner organs of the body; Implements for scraping-out cavities of body organs, e.g. bones; Calculus removers; Calculus smashing apparatus; Apparatus for removing obstructions in blood vessels, not otherwise provided for after introduction of a substance stone- or thrombus-dissolving
Landscapes
- Health & Medical Sciences (AREA)
- Life Sciences & Earth Sciences (AREA)
- General Health & Medical Sciences (AREA)
- Surgery (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Public Health (AREA)
- Animal Behavior & Ethology (AREA)
- Anesthesiology (AREA)
- Hematology (AREA)
- Pulmonology (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Vascular Medicine (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Biophysics (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Surgical Instruments (AREA)
- Media Introduction/Drainage Providing Device (AREA)
Abstract
Description
Die Erfindung betrifft einen Katheter zur Behebung einer Blutgefäßverstopfung (Thrombose) oder Embolie.The invention relates to a catheter for eliminating a Blockage of blood vessels (thrombosis) or embolism.
Bei der Thrombose handelt es sich um eine abnorme lokalisier te Gerinnung von Blutbestandteilen in einem Blutgefäß (Vene oder Arterie), die zur Bildung eines Gerinnsels (Thrombus) führt.Thrombosis is an abnormal localization coagulation of blood components in a blood vessel (vein or artery) that form a clot (thrombus) leads.
Durch Verlegung des Gefäßes kommt es zu einer örtlichen Stö rung des vor- und/oder nachgeschalteten Kreislaufabschnitts.A local disruption occurs when the vessel is moved tion of the upstream and / or downstream circuit section.
Löst der Thrombus sich von der Gefäßwand am Ort der Entstehung, so kann er mit dem Blutstrom in einen anderen Kreislaufabschnitt fortgeschleppt werden und dort erneut zur Verstopfung lebens wichtiger Blutgefäße führen. Dieser Vorgang wird als Embolie bezeichnet.If the thrombus detaches from the vessel wall at the point of origin, so he can move the bloodstream to another section of the circulation be dragged away and live there again for constipation important blood vessels. This process is called an embolism designated.
Für die Behebung von Blutgefäßverstopfungen (Thrombosen) stehen im wesentlichen die nachfolgend geschilderten drei Verfahren zur Verfügung:For the removal of blood vessel blockages (thrombosis) are essentially the three described below Procedures available:
-
1) Chemisch-medikamentöse Verfahren.
Durch sogenannte thrombolytische Substanzen, z. B. Strepto kinase, Urokinase, rt-PA und andere Plasmogenaktivatoren wird das in einem Thrombus gebundene Fibrin in Bruchstücke zerlegt und dadurch der Thrombus zur Auflösung gebracht. Dieser Prozeß schreitet zeitabhängig nur langsam fort. Die Auflösung eines Thrombus in Coronar-Arterien (Herzkranz- Arterien) nimmt in der Regel etwa eine Stunde, in anderen Gefäßen oft mehrere Stunden bis Tage in Anspruch. Die Ischämietolerenz der meisten Organe ist jedoch wesentlich kürzer, d. h. häufig tritt eine irreversible Schädigung des Organs ein, bevor das Gerinnsel durch Thrombolyse zur Auf lösung gebracht werden kann. 1) Chemical-drug procedures.
Through so-called thrombolytic substances, e.g. B. Streptokinase, urokinase, rt-PA and other plasmogen activators, the fibrin bound in a thrombus is broken down into fragments and the thrombus is thereby dissolved. This process only proceeds slowly depending on the time. The dissolution of a thrombus in coronary arteries (coronary arteries) usually takes about an hour, in other vessels it often takes several hours to days. However, the ischemia tolerance of most organs is much shorter, ie irreversible damage to the organ often occurs before the clot can be resolved by thrombolysis. -
2) Operative Verfahren.
Bei einer massiven Lungen-Embolie, bei der die Haupt stämme der Pulmonalarterien verlegt werden, mußte bisher Brustkorb und Pulmonalarterie (Lungen-Arterie) eröffnet werden, um das Gerinnsel direkt entfernen zu können (Tren delenburg-Operation). Dieser Eingriff wird nur von etwa 50% der Patienten überlebt. Viele Patienten versterben darüberhinaus,bevor sie eine Klinik erreichen, in der eine solche Operation durchgeführt werden kann. Selbst in günstig gelagerten Fällen, in denen der Patient sich bereits in einer entsprechend ausgerüsteten Klinik befindet, ist die Zeitspanne vom Eintritt des Ereignisses (z. B. Lungenembolie) bis zur definitiven Entfernung des Gerinnsels zu lang, um den Patienten vor einer irreversiblen Organschädigung zu bewahren.2) Operative procedures.
In the case of a massive pulmonary embolism, in which the main strains of the pulmonary arteries are relocated, the chest and pulmonary artery (pulmonary artery) had to be opened in order to be able to remove the clot directly (Tren delenburg operation). Only 50% of patients survive this procedure. Many patients also die before reaching a clinic where such an operation can be performed. Even in favorable cases, where the patient is already in a suitably equipped clinic, the time from the occurrence of the event (e.g. pulmonary embolism) to the definitive removal of the clot is too long to prevent the patient from irreversible organ damage preserve. -
3) Katheter-Verfahren.
- a) Pulmonalarterien-Saug-Katheter:
Bei Einsatz eines Katheters ist es in der Regel nicht möglich, ein größeres Gerinnsel durch einen englumigen Katheter unter Sog aus dem Körper zu entfernen. - b) Fogarty-Katheter:
Dieser Katheter wird durch das Gerinnsel hindurchgeführt.
- a) Pulmonary artery suction catheter:
When using a catheter, it is usually not possible to remove a larger clot from the body with suction through a narrow-bore catheter. - b) Fogarty catheter:
This catheter is passed through the clot.
- a) Pulmonalarterien-Saug-Katheter:
Dann wird ein am Katheterende befindlicher Ballon aufge blasen und der Katheter zurückgezogen. Nach operativer Eröffnung des Gefäßes (z. B. Beckenvene) kann so das Gerinnsel in toto entfernt werden. Der wesentlichste Nachteil dieser Methode ist ihre begrenzte Anwendbarkeit.Then a balloon located at the end of the catheter is opened blow and the catheter is withdrawn. After operative Opening the vessel (e.g. pelvic vein) can do this Clots can be removed in toto. The most essential The disadvantage of this method is its limited applicability.
Bei Lungenembolien oder Coronarthrombosen ist diese Methode z. B. nicht anwendbar.This method is used for pulmonary embolism or coronary thrombosis e.g. B. not applicable.
Der Erfindung liegt die Aufgabe zugrunde, einen Katheter vorzuschlagen, welcher die dargelegten Nachteile der be kannten Verfahren vermeidet und das Gerinnsel schnellst möglich zur Auflösung bringt.The invention has for its object a catheter to propose which the disadvantages of the be known procedures avoided and the clot as quickly as possible possible resolution.
Die Erfindung geht von der Erkenntnis aus, daß es zweck mäßiger ist, nicht den gesamten Thrombus als Einheit zu entfernen, sondern in fraktionierten Einzelteilen, so daß die Gefäßverlegung so rasch wie möglich beseitigt wird.The invention is based on the knowledge that it is useful is more moderate, not the entire thrombus as a unit remove, but in fractional parts, so that vascular removal is eliminated as soon as possible.
Gelöst wird diese Aufgabe nach der Erfindung durch einen Katheter, bei dem im Innenraum des Katheters ein flüssiges Medium -beispielsweise Wasser oder physiologische Kochsalz lösung- untergebracht ist, das mittels einer am freien, hinteren Ende des Katheters angeschlossenen Vorrichtung wie Pumpe oder Drucktank auf Überdruck gebracht werden kann und das durch eine Mehrloch-Düse am vorderen Ende des Katheters aus diesem austritt.This object is achieved according to the invention by a Catheter with a liquid inside the catheter Medium - for example water or physiological table salt solution- is housed, which by means of an outdoor, rear end of the catheter connected device like Pump or pressure tank can be brought to positive pressure and through a multi-hole nozzle at the front end of the catheter exits from this.
Zweckmäßig sind die Austrittskanäle in der Mehrloch-Düse auf einer um die Katheter-Längsachse umlaufenden Spirale verteilt angeordnet.The outlet channels in the multi-hole nozzle are expedient on a spiral running around the longitudinal axis of the catheter distributed.
Vorteilhaft schließen die Längsachsen der Austrittskanäle der Mehrloch-Düse unterschiedliche Winkel mit der Katheter- Längsachse ein.The longitudinal axes of the outlet channels advantageously close the multi-hole nozzle different angles with the catheter Longitudinal axis.
In einem solchen Katheter kann auch ein längsverschieblicher Führungsdraht untergebracht sein,der an seinem vorderen Ende als Widerlager für den Thrombus einen Bürstenkopf oder einen aufblasbaren Ballon tragen kann. In such a catheter can also be a longitudinally displaceable Guide wire housed at its front end as an abutment for the thrombus a brush head or can carry inflatable balloon.
Das flüssige Druckmedium kann ganz oder teilweise aus thrombolytischen Substanzen bestehen, so daß die hydrau lisch fraktionierten Thromboseteile mit ihren vergrößer ten Oberflächen durch diese thrombolytischen Substanzen schneller angegriffen und aufgelöst werden können.The liquid pressure medium can be made up entirely or partially thrombolytic substances exist, so that the hydrau lisch fractionated thrombosis parts with their enlarger th surfaces by these thrombolytic substances can be attacked and resolved more quickly.
Claims (5)
- - im Innenraum des Katheters ein flüssiges Medium -beispielsweise Wasser oder physiologische Kochsalz lösung- untergebracht ist,
- - das mittels einer am freien, hinteren Ende des Katheters angeschlossenen Vorrichtung wie Pumpe oder Drucktank auf Überdruck gebracht werden kann, und das
- - durch eine Mehrloch-Düse am vorderen Ende des Katheters aus diesem austritt.
- a liquid medium — for example water or physiological saline solution — is accommodated in the interior of the catheter,
- - That can be brought to positive pressure by means of a device connected to the free, rear end of the catheter, such as a pump or pressure tank, and that
- - Leaves the catheter through a multi-hole nozzle at the front end.
- - in dem Katheter ein längsverschieblicher Führungs draht untergebracht ist,
- - der an seinem vorderen Ende als Widerlager für den Thrombus einen Bürstenkopf oder einen aufblasbaren Ballon tragen kann.
- - In the catheter a longitudinally movable guide wire is housed,
- - Who can wear a brush head or an inflatable balloon at its front end as an abutment for the thrombus.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19893941949 DE3941949A1 (en) | 1989-12-20 | 1989-12-20 | Method of removal of blood clots - uses catheter into which saline solution is pumped at pressure |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE19893941949 DE3941949A1 (en) | 1989-12-20 | 1989-12-20 | Method of removal of blood clots - uses catheter into which saline solution is pumped at pressure |
Publications (1)
Publication Number | Publication Date |
---|---|
DE3941949A1 true DE3941949A1 (en) | 1991-06-27 |
Family
ID=6395814
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE19893941949 Withdrawn DE3941949A1 (en) | 1989-12-20 | 1989-12-20 | Method of removal of blood clots - uses catheter into which saline solution is pumped at pressure |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE3941949A1 (en) |
Cited By (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0879578A1 (en) * | 1997-05-19 | 1998-11-25 | Micro Therapeutics, Inc. | Apparatus for power lysis of a thrombus |
US6635027B1 (en) | 1997-05-19 | 2003-10-21 | Micro Therepeutics, Inc. | Method and apparatus for intramural delivery of a substance |
-
1989
- 1989-12-20 DE DE19893941949 patent/DE3941949A1/en not_active Withdrawn
Cited By (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0879578A1 (en) * | 1997-05-19 | 1998-11-25 | Micro Therapeutics, Inc. | Apparatus for power lysis of a thrombus |
US6063069A (en) * | 1997-05-19 | 2000-05-16 | Micro Therapeutics Inc. | Method and apparatus for power lysis of a thrombus |
US6635027B1 (en) | 1997-05-19 | 2003-10-21 | Micro Therepeutics, Inc. | Method and apparatus for intramural delivery of a substance |
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Legal Events
Date | Code | Title | Description |
---|---|---|---|
8139 | Disposal/non-payment of the annual fee |