EP1981563A1 - Sas vasculaire medical avec fonction de blocage - Google Patents

Sas vasculaire medical avec fonction de blocage

Info

Publication number
EP1981563A1
EP1981563A1 EP06706701A EP06706701A EP1981563A1 EP 1981563 A1 EP1981563 A1 EP 1981563A1 EP 06706701 A EP06706701 A EP 06706701A EP 06706701 A EP06706701 A EP 06706701A EP 1981563 A1 EP1981563 A1 EP 1981563A1
Authority
EP
European Patent Office
Prior art keywords
balloon
guide tube
lumen
occlusion
lock
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Withdrawn
Application number
EP06706701A
Other languages
German (de)
English (en)
Inventor
Egon Wiest
Albertus Scheule
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Medicor GmbH
Original Assignee
Medicor GmbH
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Medicor GmbH filed Critical Medicor GmbH
Publication of EP1981563A1 publication Critical patent/EP1981563A1/fr
Withdrawn legal-status Critical Current

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
    • A61M25/10—Balloon catheters
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/295—Balloon pumps for circulatory assistance
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40—Details relating to driving
    • A61M60/497—Details relating to driving for balloon pumps for circulatory assistance
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/50—Details relating to control
    • A61M60/508—Electronic control means, e.g. for feedback regulation
    • A61M60/515—Regulation using real-time patient data
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/50—Details relating to control
    • A61M60/508—Electronic control means, e.g. for feedback regulation
    • A61M60/538—Regulation using real-time blood pump operational parameter data, e.g. motor current
    • 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
    • A61M25/0021—Catheters; Hollow probes characterised by the form of the tubing
    • A61M25/0023—Catheters; Hollow probes characterised by the form of the tubing by the form of the lumen, e.g. cross-section, variable diameter
    • A61M25/0026—Multi-lumen catheters with stationary elements
    • A61M2025/0037—Multi-lumen catheters with stationary elements characterized by lumina being arranged side-by-side
    • 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
    • A61M25/10—Balloon catheters
    • A61M2025/1043—Balloon catheters with special features or adapted for special applications
    • A61M2025/1052—Balloon catheters with special features or adapted for special applications for temporarily occluding a vessel for isolating a sector
    • 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
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/247—Positive displacement blood pumps
    • A61M60/253—Positive displacement blood pumps including a displacement member directly acting on the blood
    • A61M60/268—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders
    • A61M60/274—Positive displacement blood pumps including a displacement member directly acting on the blood the displacement member being flexible, e.g. membranes, diaphragms or bladders the inlet and outlet being the same, e.g. para-aortic counter-pulsation blood pumps
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/802—Constructional details other than related to driving of non-positive displacement blood pumps
    • A61M60/833—Occluders for preventing backflow

Definitions

  • the invention relates to a medical vascular lock, in particular for non-drug pressure and perfusion modulation in the vascular system of a patient.
  • Circulatory instability often requires medical and, if necessary, mechanical circulation support.
  • a drug therapy with catecholamines, such as norepinephrine increases the afterload, ie the resistance that the heart muscle must overcome in emptying the ventricle, with the result of reduced perfusion, especially in the arterial Endstrom which abdominal organs.
  • mechanical circulatory support may be provided by the use of an intraortic balloon pump, which is introduced into the corresponding punctured femoral artery of the patient by known methods of minimally invasive catheterization and advanced into the descending aorta.
  • the intra-aortic balloon pump (IABP) balloon is inflated and deflated by delivery of a pressure medium in the balloon via an out-going catheter in response to the heart rhythm to assist the heart. It achieves vascular resistance reduction and enhancement of coronary artery perfusion. Embodiments of such intra-aortic balloon pumps are described in US Pat. Nos. 3,692,018 and 5,910,103.
  • the invention is therefore based on the object to remedy the described needs by relatively easy to use measures effectively.
  • a medical vascular lock was created, which is the subject of claim 1.
  • the new vascular lock has a flexible guide tube having a first access lumen open into the vasculature at the distal end of the tube and designed and sized to be inserted into a patient's vasculature.
  • Valve means are provided at the proximal end of the delivery tube for temporarily closing the first access lumen and for enabling the sealed passage of a catheter or instrument through the first access lumen into the vessel.
  • the guide tube includes a second lumen, which is separate from the first access lumen and which communicates with balloon occlusion means, which are arranged in the region of the distal end of the guide tube.
  • means for connecting a pressure medium source to the second lumen are provided, from which the balloon occlusion means can be acted upon for the purpose of widening them with pressure medium.
  • the new lock is thus equipped with the additional function of temporary balloon occlusion of a vessel in which it is inserted. It can be used in vessels of both the arterial and venous circulation. In any case, in addition to the balloon occlusion function, it retains its proper function as a vascular lock for introducing catheters, instruments, guide wires and the like into the vasculature.
  • the new lock for example, be designed and dimensioned with its guide tube for insertion into the infrarenal main artery of a patient.
  • It can take over the function of the temporary balloon occlusion of the infrarenal aorta, because by widening its balloon occlusion means a temporary balloon occlusion of the infrarenal aorta can be achieved.
  • the afterload for the heart can be immediately and reversibly increased non-drug, which in the Kopf maybertigen vessels a higher blood pressure / perfusion flow can be achieved.
  • the new vascular sheath may also be used for non-drug blood pressure and perfusion modulation in a system according to another invention having a pressure medium source connected to the second lumen of the vascular sheath, controlled by a controller such that inflation and deflation of the balloon occlusion means of the present invention Vessel lock in response to control signals of the control device are controllable.
  • the balloon occlusion means can be controlled by the control device, for example, depending on the heart activity of the patient.
  • the system may include means for acquiring a patient's ECG data and controlling the balloon occlusion means in response to that data.
  • the system may also, if appropriate in addition, have means for measuring intravascular pressure at a predetermined point in the vascular system of a patient, the balloon occlusion means of the vascular lock being controlled by the control device. tion can also be controlled in dependence on the respective measured temporal pressure curve.
  • This allows the ECG or pressure curve triggering of inflation and deflation of the vaso-occlusive balloon occlusion devices to limit the blocking function to specific periods of the cardiac cycle, thus ensuring adequate perfusion of the lower extremities and increasing the effectiveness of an intra-aortic balloon pump in that the lock acts temporarily as a foot-side counter bearing (analogous to the closed aortic valve).
  • the diastolic perfusion of the head vessels can be increased in this way, while at the same time ensuring the systolic perfusion of the lower extremities.
  • the above-mentioned cardiac cycle triggering of the vaso-occlusive balloon occlusion devices may also extend the efficiency of the intra-aortic balloon pump to the perfusion of the abdominal organs.
  • the blood pressure for releasing must be briefly massively reduced in order to ensure a secure positioning.
  • the blood pressure should quickly rise again.
  • the vascular lock can be placed in a vessel on the venous side of the bloodstream, ie in a vein of the upper or lower half of the body, in particular via the jugular vein in the superior vena cava, and reduce the blood backflow to the heart by appropriate inflation of the balloon occlusion means the consequence of a reduction in the output of the heart, resulting in an arterial lowering of blood pressure.
  • the balionic occlusion agents can be abruptly deflated so that the blood pressure quickly rises again and the patient is not endangered by a long hypotonic phase.
  • the vascular lock inserted into the vein also allows access to the vessel with a catheter or a corresponding tool.
  • FIG. 1 shows a vascular lock according to the invention in axial section in a side view and in a schematic representation to illustrate the principle
  • FIG. 2 shows a vascular lock according to the invention in a practical embodiment with inserted catheters in a side view
  • Figure 3 shows the vascular lock of Figure 2, taken along the line III-III of Figure 2, in a plan view and on a different scale.
  • FIG. 5 shows a detail at A of the vascular lock according to FIG. 2 in a side view and on a different scale
  • Fig. 6 shows a detail 2 at B of the vascular sheath after Figure in perspective and on a different scale
  • FIG. 7 shows a vascular lock according to the invention inserted into the infrarenal aorta with inflated balloon occlusion means in a side view and in a schematic representation;
  • FIG. 8 shows a system for non-drug blood pressure and perfusion modulation using a vascular sluice inserted into the infrarenal aorta of a patient according to the invention in a schematic representation
  • FIG. 9 and 10 show a detail of the arrangement according to FIG. 8, illustrating the heart and the aorta with inserted intra-aortic balloon pump (IABP) in the deflated state, during systole or in the inflated state during diastole;
  • IABP intra-aortic balloon pump
  • FIG. 11 is a diagram illustrating the opening and closing rhythm of the balloon occlusion means of the vascular lock of the system of Figure 8, depending on the cardiac cycle and
  • FIG. 12 shows a vascular lock according to the invention, inserted into the upper vena cava of a patient, in a schematic representation.
  • the guide tube 1 is for insertion into a vessel, for example.
  • a pelvic vessel or the upper vena cava of a patient, determined, with its dimensions and its length are adapted to the particular application.
  • the vascular lock is used with its guide tube 1 in a conventional manner in the appropriately punctured vessel from the outside.
  • the guide tube 1 which is open at its distal end, encloses a first access lumen 5, via which a catheter or another tool can be introduced into the vessel and advanced in the vessel when the vascular lock is inserted into a vessel.
  • the valve means 4 have in the illustrated embodiment, a kugelkalottenförmige elastic sealing membrane 6, which is peripherally connected to the guide tube 1 and centrally provided with an insertion slot 7, which is closed by the inherent elasticity of the membrane 6 in the idle state.
  • the sealing membrane 6 differs elastically, wherein it bears against the catheter or the instrument under bias and thus ensures a secure seal.
  • the sealing membrane 6 is provided at the edge with an integrally formed mounting flange 8, which is connected to the guide tube 1.
  • a rohrförmi- ges, axially parallel second lumen 9 is formed, which is separated from the first lumen 5 and sealed both at the proximal and at the distal end of the guide tube.
  • the second lumen 9 opens at the proximal end sealed one flexible pressure medium supply line 10, while in the region of the distal end, the second lumen 9 is connected via a channel 11 with balloon occlusion means, which are generally designated 12.
  • the balloon occlusion means 12 comprise an inflatable balloon 13 which in the unexpanded, deflated state is in the form of a thin-walled, elastic tube externally surrounding the guide tube, which is "sealed in the region of its axially opposite ends at 14 around the guide tube outer wall
  • a pressure medium for example a pressure fluid or a compressed gas
  • the balloon 13 is widened or inflated so that it assumes the substantially spherical shape indicated at 15 in Figure 1. If the pressurization of the second lumen 9 ceases the occlusion balloon 13 returns to the rest state illustrated in FIG. 1, which is smooth on the outside of the guide tube.
  • FIGS. 2 to 6 An exemplary embodiment of the practical embodiment of the vascular lock shown only schematically in principle in FIG. 1 is illustrated in FIGS. 2 to 6. With Figure 1 the same parts are provided with the same reference numerals and not explained again.
  • a valve 16 is connected to the pressure medium supply line 10, which makes it possible to shut off or open the connection to a pressure medium source, not shown, or to vent the inflated dargestellen occlusion balloon 13.
  • a catheter 17 is inserted, which protrudes from the guide tube 1 at the distal end and a continuous lumen 18, which is connected to a valve 19 containing a line 20, taken from the vascular lock containing the vessel blood or liquid, for example. A drug can be introduced into this.
  • the catheter 17 can also be designed as a balloon catheter or belong to an intra-aortic balloon pump (IABP), as will be explained in detail later.
  • IABP intra-aortic balloon pump
  • a second catheter 21 is sealed in the illustrated case via valve means 22, which are shown in FIG. 4 and basically designed similar to FIG.
  • the catheter 21 also has a continuous lumen which can be connected by a fitting 23 to a pump or the like. However, the lumen can also be used for pressure measurement in the vessel in the region of the distal end of the catheter 21.
  • Both catheters 17, 21 can be removed from the guide tube 1 in the case of a vascular lock inserted into a vessel of the patient, wherein the valve means 4 or 22 prevent liquid leakage from the vessel.
  • Figure 7 illustrates schematically the situation when using the new vascular lock in the infrarenal main artery 24 of a patient.
  • the renal arteries indicated schematically at 25 descend sideways, while at locations upstream of the renal arteries, the lower intestinal artery 26, the upper drabrar 27 and the celiac trunk branch off to supply the liver, pancreas, stomach, etc.
  • the left armpit leaving the aorta descen- den 29 is finally at 30 indicated.
  • the vascular lock is inserted with its guide tube 1 via the left femoral artery 31 which is punctured at the corresponding suitable place, its length being dimensioned and advanced so far that the occlusion balloon 13 illustrated in the flattened state 15 flows downstream of the renal arteries 25 is placed in the infrarenal main artery 24.
  • a here illustrated as injection syringe 31 ' pressure medium source is connected, which allows by pressing its piston 32, the occlusion balloon 13, as shown at 15, expand and thus to block the infrarenal main artery 24.
  • a catheter 33 or a guide wire, etc. is inserted sealed into the aorta, in which it can be advanced to the descending aorta 29 or further.
  • the occlusion balloon 13 can be deflated from the expanded state 15, whereby the perfusion is restored to the lower extremities. Since the occlusion means 21 of the vascular lock containing the occlusion balloon 13 can be rendered very effective and ineffective by inflating and deflating the occlusion balloon 13, the new vascular lock permits rapid non-drug blood pressure and perfusion modulation.
  • FIG. 8 A system suitable for this purpose is illustrated in FIG. 8 in its basic features:
  • the vascular lock is inserted with its guide tube 1 into the right femoral artery 31a of a patient 34 and placed so that its balloon occlusion means 12 is similar to the occlusion balloon 13 shown here in the widened state 15 in the infrarenal main artery 24 as in Figure 7, lie.
  • the pressure medium supply line 10 is connected to a pressure medium source indicated at 35, which may contain, for example, an electric pressure medium pump 35a and a deaerating valve 35b, not shown further, both of which can be controlled by a control unit 36 via a signal line 37.
  • the catheter 17 of an intra-aortic balloon pump 37 is inserted into the aorta, the balloon 38 of which is placed in the aortic descendent 29 departing from the heart indicated at 39.
  • the catheter 17 is connected to the controller 36, which contains a pressure medium source acting on the lumen of the catheter 17, such as an electrically controlled pressure medium pump 40, which allows the balloon 38 to be inflated while an associated vent valve 41 controls Deflation of the balloon 38 can bring about.
  • a pressure sensor line which may be formed, for example, by the catheter 21 of the vascular lock of Figure 2 and which allows the intra-vessel pressure in the aorta descendens 29 in the area 'between the balloon 38th and to measure the heart 39.
  • a pressure sensor can also be used, which is connected via an electrical supply line to the control unit 36, to which the catheter 21 is connected in the present case.
  • the controller 36 receives pressure signals indicative of the arterial pressure on the discharge side of the heart 39 via the metering catheter 21. In addition, via line 42, it receives heart rhythm signals from appropriate known exit sites on the chest wall or the extremities of the patient 34 are derived, of which only one is indicated at 43.
  • FIGS. 9, 10 The basic function of the intra-aortic balloon pump 37 controlled by the controller 36 is illustrated in FIGS. 9, 10:
  • the balloon 38 of the IABP 37 is deflated, i. As the heart 39 pumps, the deflated balloon 38 provides minimal drag in the aortic descendent 29.
  • the balloon 38 is filled and inflated, thereby delivering blood to the cranial arteries and coronary arteries.
  • the efficiency of the described IABP 37 can be increased with the new vascular lock, while at the same time ensuring systolic perfusion of the lower limbs.
  • This can be achieved by controlling the balloon occlusion means 12 with the occlusion balloon 13 as a function of the heart rhythm. This is explained in FIG. 11 on the basis of a diagram:
  • the course of the arterial pressure 44 as a function of time over the known ECG curve 45 is recorded. Signals corresponding to both curves 44, 45 are input into the control unit 36 via the lines 21, 42 (FIG. 8), on the one hand the occlusion means 12 the vascular lock and on the other hand, the filling and emptying of the balloon 38 of the IABP 37 controls.
  • the occlusion balloon 13 of the balloon occlusion means 12 of the vascular sheath is placed in the infrarenal aorta 24, as shown in FIG Figure 8 ' can be seen.
  • the systole of the heart extends approximately from the Q wave of the QRS complex to the beginning of the P wave, as shown in FIG. It is followed in a known manner by the diastole, which extends on the ECG approximately from the time from the end of the T-wave to the end of the P-wave.
  • the controller 36 may be programmed to substantially close the occlusion balloon 13 to the pressure medium source during the duration of the systole, i. deflated holds. Since the balloon 38 of the IABP 37 is deflated (FIG. 9), systolic perfusion of the lower extremities is ensured. ⁇
  • the occlusion balloon 13 of the balloon occlusion means 12 is connected by the controller 36 to the source of pressurized medium and is inflated to block the aorta 24 below the renal arteries 25.
  • the occlusion balloon 13 acts as fuß->rti- ges anvil, the heart side corresponds to the closed aortic valve.
  • the displacement of the balloon 38 of the IABP 37, displacement of the blood in the aorta 24 on the one hand leads to an increase in the diastolic perfusion of the head vessels and on the other hand to an expansion of the perfusion on the abdominal organs via the vessels 25 to 28, the in the area between the occlusion balloon 13 and the balloon 38 of the IABP 37.
  • This time course of the inflation and deflation of the occlusion balloon is shown in FIG. 11 by a dot-dashed line 46 below the ECG curve 45.
  • the occlusion balloon 13 is deflated; in the areas above the center line 47 it is inflated.
  • the inflation and deflation of the occlusion balloon 13 may also be controlled as a function of the arterial pressure curve 44. This is illustrated in Figure 11 in solid lines for a 1 certain exemplary procedure.
  • the pressure curve 44 triggers the deflation of the occlusion balloon 13 at the beginning of the systolic pressure increase and triggers the inflation of the occlusion balloon 13 at the end of the arterial pressure rise.
  • the control of the blocking function of the occlusion balloon 13 can also be carried out in a different dependence on the time course of the cardiac cycle, the new vascular lock naturally also being independent, i. not only in connection with the IABP 37 can be used.
  • the control of the blocking function of the occlusion balloon 13 can also be carried out in a different dependence on the time course of the cardiac cycle, the new vascular lock naturally also being independent, i. not only in connection with the IABP 37 can be used.
  • the control of the blocking function of the occlusion balloon 13 can also be carried out in a different dependence on the time course of the cardiac cycle, the new vascular lock naturally also being independent, i. not only in connection with the IABP 37 can be used.
  • the blocking function of the infrarenal aorta by the occlusion balloon 13 can also be limited to certain periods of the cardiac cycle.
  • the occlusion agents do not work on their own A balloon catheter or provided as part of the IABP 37, the access to the vessel remains accessible irrespective of the currently used control method for the balloon occlusion means 12.
  • the vascular lock can also be dimensioned and sized in length so that it can be inserted into other vessels of the arterial or venous blood system.
  • An example of this is illustrated in FIG.
  • the vascular lock with its guide tube 1 is placed via the jugular vein (internal jugular vein) 50 in the upper vena cava (vena cava superior) 51 such that the occlusion balloon 13 below the branch of the anterior vena 52 and the Vena brachialis cephalic destra 53, as illustrated in FIG.
  • the remaining parts of the vascular lock are designated by the corresponding reference numerals according to FIG. 7 and are not explained again.
  • the blood backflow to the heart can be temporarily reduced, thus causing an arterial blood pressure reduction.
  • a massive reduction in blood pressure is, for example, in the short term necessary for the placement of endovascular prostheses for release in order to ensure a secure positioning.
  • the required rapid recovery of blood pressure can be achieved in a simple manner by deflating the occlusion balloon 13, which can be done, for example, by opening the valve 16.
  • the vascular lock can also be placed over veins of the lower half of the body, for example, the inferior vena cava 54, if appropriate in individual cases.
  • the invention has been explained with reference to some embodiments; but she is not limited to that.
  • the configuration of the guide tube 1 and the valve means 4 of the vascular lock may be different, as it is also conceivable to provide more than one occlusion balloon 13 on the guide tube 1, the balloons being arranged at a predetermined axial distance and each having its own (or groupwise common) lumen, which allows the occlusion balloons individually or in groups or together to inflate and deflate.
  • the blood pressure and perfusion modulation by means of the occlusion means 21 of the new vascular lock can also be carried out in a manner deviating from the described procedure.
  • the balloon occlusion means 12 are dimensioned so that the occlusion balloon 13 in the expanded state 15 has a diameter of preferably between 30 mm to 35 mm.
  • the length of the lying in the patient part of the guide tube 1 is on the order of about 25 cm.
  • the occlusion balloon 13 may also be formed on the material of the guide tube 1.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Mechanical Engineering (AREA)
  • Biophysics (AREA)
  • Medical Informatics (AREA)
  • Child & Adolescent Psychology (AREA)
  • Pulmonology (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention concerne un sas vasculaire doté d'un tube de guidage (1) et de moyens de soupape (4) prévus à son extrémité proximale et qui permettent d'insérer un cathéter ou un instrument par la lumière d'accès du tube de guidage jusque dans un vaisseau. Dans la zone de l'extrémité distale du tube de guidage, le sas vasculaire est doté de moyens (12) d'occlusion à ballon qui présentent un ballon d'occlusion (13) qui peut être relié par une lumière séparée ménagée dans le tube de guidage à une source de fluide sous pression de manière à pouvoir être sélectivement gonflé et dégonflé. Le sas vasculaire peut être utilisé pour une modulation non médicamenteuse de la pression sanguine ou d'une perfusion, par exemple en étant utilisé dans l'aorte infrarénale et en bloquant ou libérant l'aorte en fonction du cycle cardiaque. Le sas vasculaire peut faire partie d'un système non médicamenteux de modulation de la pression sanguine et d'une perfusion qui présente une source de fluide sous pression qui gonfle et dégonfle le ballon d'occlusion (13) et qui contient un dispositif de commande qui commande le gonflement et le dégonflement du moyen d'occlusion à ballon en fonction de signaux de commande reçus. Différents procédés de commande sont possibles pour cette commande.
EP06706701A 2006-02-07 2006-02-07 Sas vasculaire medical avec fonction de blocage Withdrawn EP1981563A1 (fr)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2006/001049 WO2007090416A1 (fr) 2006-02-07 2006-02-07 Sas vasculaire medical avec fonction de blocage

Publications (1)

Publication Number Publication Date
EP1981563A1 true EP1981563A1 (fr) 2008-10-22

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP06706701A Withdrawn EP1981563A1 (fr) 2006-02-07 2006-02-07 Sas vasculaire medical avec fonction de blocage

Country Status (4)

Country Link
US (1) US20100211008A1 (fr)
EP (1) EP1981563A1 (fr)
JP (1) JP2009525791A (fr)
WO (1) WO2007090416A1 (fr)

Families Citing this family (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US11337707B2 (en) 2010-05-25 2022-05-24 Miracor Medical Sa Treating heart tissue
DE102015005002A1 (de) * 2015-04-21 2016-10-27 Xenios Ag Kanüle
AU2016297622B2 (en) 2015-07-22 2020-06-18 Viaderm Llc Cardiac assist device
CN115282469B (zh) * 2022-08-23 2023-11-28 中国医学科学院阜外医院 主动脉内双气囊驱动反搏导管装置

Family Cites Families (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3477438A (en) * 1967-04-17 1969-11-11 Dwight L Allen Catheter having one-way inflations valve
US3692018A (en) * 1970-02-11 1972-09-19 Robert H Goetz Cardiac assistance device
US4934996A (en) * 1984-02-27 1990-06-19 Boston Scientific Corporation Pressure-controlled intermittent coronary sinus occlusion apparatus and method
FR2577423B1 (fr) * 1985-02-20 1989-05-05 Gilles Karcher Pompe d'assistance circulatoire et coronaire a ballonnets intra-aortiques
US5176619A (en) * 1989-05-05 1993-01-05 Jacob Segalowitz Heart-assist balloon pump with segmented ventricular balloon
JP3860868B2 (ja) * 1996-11-29 2006-12-20 株式会社ヴァーユ バルーンカテーテル
US5910103A (en) * 1997-06-23 1999-06-08 Datascope Investment Corp. Device and method for an IAB assist with multiple balloons
US6562049B1 (en) * 2000-03-01 2003-05-13 Cook Vascular Incorporated Medical introducer apparatus
US7331949B2 (en) * 2003-02-27 2008-02-19 Margaret Grahn Marisi Urinary catheter with check valve

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2007090416A1 *

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WO2007090416A1 (fr) 2007-08-16
US20100211008A1 (en) 2010-08-19

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