DE8134164U1 - DEVICE FOR REMOVAL OR FOR THE EXPANSION OF NARROW BOTTLES IN BODY LIQUID, IN PARTICULAR BLOOD VESSELS - Google Patents

Description

Device for removing or widening constrictions in body fluid leading vessels, especially blood vessels

Dife invention relates to a device for removal or widening of constrictions in vessels carrying body fluids, in particular blood vessels, according to the preamble of claim 1.

In known devices of this type (DE-OS 30 28 089) is used to expand constrictions in the arterial system a catheter is used, at the end of which a balloon is attached which is definitely expandable in its circumference is. This balloon is in; Placed in the area of the constriction and filled with fluid via a catheter, so that the tissue causing the constriction is pressed into the wall of the blood vessel and there remains. In this case, it is often unavoidable that tears will occur during the dilation the intima - the innermost wall of the vascular system comes from. There is also the risk that the inner vascular layers are partly detached and occupy the free interior space of the blood vessel, causing the vascular system Occlusions and / or reduced blood flow to the organs can result from the affected blood vessel are supplied. For example, it can affect the coronary arteries as a result of insufficient blood supply a heart attack develop.

«J. The object on which the present invention is based consists in creating one that is simple in construction, economical to manufacture and reliable Device with the help of which the constrictions of any body fluid-carrying vessels independently their spatial arrangement or expansion in the vascular system are reduced or eliminated in this way, that there can be no breaks or cracks in the vessel wall. When applying the compliance ^ the device in blood vessels is intended to supply of the organs subordinate to the bottleneck auo.i ensured during a long-term treatment of constrictions and thus also in such cases a The risk of a heart attack can be excluded.

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According to the invention, this object is achieved by the characterizing features of claim 1.

Because the constriction on both sides of the inflated balloons within the corresponding body vessel can be completely blocked, an isolation of the narrowing area is achieved a targeted dissolution of the constriction material by a flushing process and also in a relatively short time a discharge of the loosened parts allows, at the same time a sufficient supply of the downstream Organ can be ensured. It is particularly advantageous that with the invention within predeterminable Areas of vessels carrying body fluids in a delimitable area for treatment fluid

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opportunities, possibly also in a more concentrated manner Form, brought to action on the constriction material over largely arbitrarily selectable periods of time can be.

Advantageous embodiments of the invention are the subject of the subclaims.

The invention is illustrated below with the aid of exemplary embodiments, which are shown in greatly enlarged form in the drawing Scale are shown, explained in more detail. Show it:

Figure 1 in longitudinal section a blood vessel with an introduced guide and loading

action catheter, as well as with the constriction on both sides Barrier balloons,

Figure 2 shows a cross section according to the section line H-II of Figure 1,

FIG. 3 shows a longitudinal section of the treatment catheter with a slidable thereon classified balloon,

FIG. 4 shows a cross section according to the section line IV-IV of FIG. 3,

Figure 5 is a view of a treatment catheter

with retracted partition walls to form channels for the supply and discharge of Liquids or gases and

FIG. 6 shows a longitudinal section of a treatment catheter part with partially perforated ones Outer surfaces or predetermined breaking points, according to the section line VI-VI of Figure 5-5

The treatment catheter 1 is guided by a guide catheter 2 inserted into a blood vessel 3. It protrudes beyond the guide catheter 2 to such an extent that the balloons 4 and 5 arranged on the treatment catheter 1 are interposed with the them enclosed bottleneck 6 or stenosis in front of the end of the guide catheter 2. The bottleneck 6 is usually formed from a sponge-like, lime and fat-rich tissue 7, which is in the Drawing is indicated with cross hatching. For the Case that the tissue 7 e'en passage of the blood vessel 3 completely or almost completely closed, the treatment catheter 1 or another instrument in advance this pushed through. Otherwise, the treatment catheter 1 is so far through the still existing opening of the Constriction 6 led that the balloon 4 in the inflated state 4 'the constriction 6 on the back and the balloon 5 in the inflated state 5 'seals the constriction 6 on the front side, i.e. the blood vessel 3 on both sides the constriction 6 is tightly closed around the hex.

The balloons 4, 5 can be expanded or inflated by gas or a liquid medium. The latter can through the inlet or outlet nozzle 8 tzw. 9 and are let in or out via the channel 10 from the outside, wherein whose quantity and pressure can be regulated. So that in the treatment of constrictions in blood vessels despite the two-

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side closures of the bottleneck 6 the supply of the subordinate organs is ensured, especially in the case of longer intervention times an additional supply channel 11 is provided, the a kind of "bypass line" to the sealed narrow part area represents. This supply channel 11 is preferably coaxial with the treatment catheter 1 arranged. However, it can also deviate from this in a different position and / or in the form of a larger number can be built in or attached to ducts. Via this supply channel 11 blood and / or another can Liquid, preferably at overpressure, from the outside or with the help of an overflow channel from the bloodstream flow in before the blockage. This means that sufficiently long intervention times are available without that there is a risk of heart attack.

This means that only the lime and fat-rich tissue 7 of the constriction 6, but not dip inner skins of the blood vessel 3 are attacked, is through the inlet channel 12 with the inlet piece A a chemical Agent in the form of a solution is pumped into the space containing the constriction tissue 7, which space is capable of to dissolve the tissue 7. Digestive enzymes or similar substances are suitable for this.

For other applications, such as the treatment of biliary or kidney concretions, other substances are also used, such as dissolving acids.

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For the removal of the dissolved or crushed particles and to shorten the treatment time continuous flushing is advantageous is guaranteed via a return channel 13 with the outlet piece B, but in principle it is also possible the agent dissolving the constriction material 7 or dividing it into smaller particles via a feed a single channel and alternately via the same channel the dissolved or comminuted constriction material 7 to be discharged. It goes without saying that: 1 inlet duct 12 can also be used as a return duct and the return duct 13 can also be used as an inlet channel. Depending on requirements, the number of dT inlet and return channels also be increased.

In order to be able to adapt the size of the blockage point to the extent of the tissue 7, it is advantageous if the balloon 5 is not arranged rigidly - as indicated in FIG. Such an embodiment is shown in FIGS. The balloon is attached to a slide 14, which is preferably made with the help of a stiffer synthetic fiber, preferably Perlon wire 15 or the like. vun can be moved back and forth on the outside. The synthetic fiber wire 15 can be guided into a channel 16 which, for example, is practically inserted in its wall reinforcement in an elongated elevation 17 of the treatment catheter 1 that is also used to guide the slide 14. Through this channel 16, the inflation medium can be supplied and f-.bführi at the same time; and its pressure can be regulated externally.

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So that the gap between the slide 14 and the outer wall of the treatment catheter 1 is properly sealed a sealing sleeve 18 is provided at least on the side facing the constriction 6, thanks to the special design of the Bailorss 5 contributes to an effective seal at this sealing point. At 19 the nozzle is referred to, over which supplies or removes the gaseous or liquid medium for inflating the now displaceable balloon 5 will.

Instead of the hose-shaped which are fed and fastened to the wall parts of the treatment catheter 1 The interior of the treatment catheter 1 can also pass channels 10, 12, 13 through longitudinal partition walls 20 (FIGS 2 and 5) are subdivided accordingly, so that chambers 21 arise through which, as required, the appropriate medium can be directed.

Furthermore, it can be advantageous in some cases, especially when using longitudinal partition walls instead of attaching the nozzles 8 and 9 or the nozzles A and B to the ends of the channels 12 and 13, to these Provide the wall of the treatment catheter 1 with perforations and these, as from the Figures 5 and 6 can be seen to be provided with Scllbruchstellen 22 so that their perforation length before Intervention can be adjusted according to the bottleneck to be treated.

The catheter according to the invention for the treatment of constrictions can be used with all types of body fluid

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leading vessels, i.e. all types of blood vessels or vessels carrying other liquids, such as liquor ducts or larger lymph vessels are used.

Other areas of application - in addition to the main area of application of the treatment of long parts in blood vessels - are for example the handling of constrictions in the bile duct, in the pancreatic duct or in the spinal canal.

With the invention it is also possible to use chemical substances in a highly or highly concentrated form to bring them to vascular areas with the aim of stimulating capillary sprouting from these vascular areas. In particular, those of Dr. Josef Wissler, Max Planck Institute, Bad Nauheim substances described for the stimulation of vascular sprouting, namely angiotropins, which are made from white blood cells to be isolated.

The constriction treatment with the catheter according to the invention can be carried out in several stages, if necessary under Use of different treatment media and / or different concentrations of the treatment media be made.

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summary

Device for removing or widening constrictions in body fluid leading Vessels, especially blood vessels

To create a device for reducing or eliminating constrictions in vessels of all types “whereby Penetrations and cracks in the vessel walls and also one in the treatment of stenoses in blood vessels To avoid the risk of infarction, it is proposed that the treatment catheter (1) with two expandable Balloons (4,5) is provided which seal the constriction (6) on both sides so that the degree of expansion of both balloons (4,5) can be regulated from the outside and that in the wall of the treatment catheter (1) in the area bounded by the two balloons (4,5) there is an inlet piece (A) for the supply of the constriction material (7) dissolving or dividing it into smaller particles Means and an outlet piece (B) for the discharge of the loosened or divided constriction material (7) is provided (Figure 1).

Claims (1)

• « ■ ο · • · ···· · · «ta ti Dr. Andreas YTe ikl and
Volkmar Merkel 8520 Erlangen file number: G 01 34 164.4 New protection claims 1. Device for removing or widening constrictions in body fluid leading vessels, especially blood vessels, using a treatment catheter, at the end of the vessel-side an expandable in its circumference balloon is attached, the degree of expansion is adjustable from the outside, as characterized in that the Flexible treatment catheter (1) which can be inserted into the vessel, in particular blood vessel (3) through a guide catheter (2), is provided with two expandable balloons (4, 5), one of which extends through the constriction (6) and seals on the back and the other balloon (5) is brought to bear in front of the constriction (6) and seals the constriction on the front side so that the degree of expansion of both balloons (4, 5) can be regulated from the outside and that in the wall of the treatment catheter (1) in the area bounded by the two balloons (4, 5) an inlet piece (A) for the supply of particles which dissolve the constriction material (7) or which dissolve into smaller particles dividing means and an outlet piece (B) is provided for the discharge of the dissolved or divided constriction material (7) or that the constriction material (7) dissolving or dividing into smaller particles through a single channel ι ■ · · • · · ■ the loosened or comminuted constriction material (7) can be fed in and removed alternately via the same channel is. 2. Apparatus according to claim 1, characterized in that the treatment catheter (1) has a supply channel (11) which extends through aie constriction (6). 10
, 3- device according to claim 1 or 2, characterized ί characterized in that the supply channel (11) is coaxial i ■ * ——————— I is arranged to the treatment catheter (1). The device according to claim 1, characterized in that the degree of expansion of each individual balloon (4, 5) can be regulated independently of one another. ^{; 1} 5. Device according to one of claims 1 to 4, \ characterized in that the inlet and outlet pieces (A, B) open into flushing channels (12, 13), the 'by dividing the treatment catheter cross section 25 into sectors by longitudinal partition walls (20) or by housed or in the treatment catheter (1) on its wall parts ¹ attached hoses are formed. ft · I I 6. Device according to one of claims 1 to 5, i characterized in that the inlet and outlet pieces P (A, B) for the treatment agent through into the wall fi perforations made in the treatment catheter (1)! (23) are formed and that the treatment catheter (1) r by one or more longitudinal partition walls (20) in chambers (21) is divided. 7. Device according to one of claims 1 to 6, characterized in that the constriction (6) on the inlet cord closing balloon (5) is arranged displaceably on the outer wall of the treatment catheter (1). 8. Apparatus according to claim 7, characterized in that a slide (14) which can be moved to and fro from the outside is used as the displacement means for the movable balloon (5). 9. Apparatus according to claim 7 or 8, characterized in that the slide (14) is guided on the jacket of the treatment catheter (1). 10. Device according to one of claims 7 to 9, characterized in that the slide (14) serves as a carrier of the hose (16) for forwarding the inflation means for the balloon (5) connected to it or is itself designed as such. -4- 11. The device according to one of claims 7 to 10, characterized in that the slide (14) at least on the side facing the constriction (6) has a sealing sleeve (18) which is supported by a pressing means, in particular from the inflated balloon (5 ')> is pressed firmly onto the surface of the treatment catheter (1).