EP2841146A1 - Cathéter à lumières multiples - Google Patents

Cathéter à lumières multiples

Info

Publication number
EP2841146A1
EP2841146A1 EP13781070.1A EP13781070A EP2841146A1 EP 2841146 A1 EP2841146 A1 EP 2841146A1 EP 13781070 A EP13781070 A EP 13781070A EP 2841146 A1 EP2841146 A1 EP 2841146A1
Authority
EP
European Patent Office
Prior art keywords
catheter
lumen
distal end
blood
fluid
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Withdrawn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
EP13781070.1A
Other languages
German (de)
English (en)
Other versions
EP2841146A4 (fr
Inventor
Timothy W. I. CLARK
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.)
Aegis Medical Technologies LLC
Original Assignee
Aegis Medical Technologies LLC
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
Priority claimed from US13/453,663 external-priority patent/US9333321B2/en
Application filed by Aegis Medical Technologies LLC filed Critical Aegis Medical Technologies LLC
Priority to EP19208800.3A priority Critical patent/EP3626301A1/fr
Publication of EP2841146A1 publication Critical patent/EP2841146A1/fr
Publication of EP2841146A4 publication Critical patent/EP2841146A4/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Withdrawn legal-status Critical Current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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3659—Cannulae pertaining to extracorporeal circulation
    • 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
    • A61M1/00—Suction or pumping devices for medical purposes; Devices for carrying-off, for treatment of, or for carrying-over, body-liquids; Drainage systems
    • A61M1/36—Other treatment of blood in a by-pass of the natural circulatory system, e.g. temperature adaptation, irradiation ; Extra-corporeal blood circuits
    • A61M1/3621—Extra-corporeal blood circuits
    • A61M1/3653—Interfaces between patient blood circulation and extra-corporal blood circuit
    • A61M1/3659—Cannulae pertaining to extracorporeal circulation
    • A61M1/3661—Cannulae pertaining to extracorporeal circulation for haemodialysis
    • 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
    • A61M25/003—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves
    • 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
    • A61M25/0041—Catheters; Hollow probes characterised by the form of the tubing pre-formed, e.g. specially adapted to fit with the anatomy of body channels
    • 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
    • A61M25/003—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves
    • A61M2025/0031—Multi-lumen catheters with stationary elements characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves characterized by lumina for withdrawing or delivering, i.e. used for extracorporeal circuit treatment
    • 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
    • A61M2025/0073—Tip designed for influencing the flow or the flow velocity of the fluid, e.g. inserts for twisted or vortex flow

Definitions

  • the present invention relates to a multi-lumen catheter and, more specifically, to a dual-lumen catheter with entry and exit ports having curved or angled walls to direct the flow of fluids therethrough.
  • Dual-lumen catheters have been available for many years for a variety of medical purposes. It is only in recent years, however, that such catheters have been developed for use in hemodialysis and other treatments which involve the removal and replacement of blood.
  • the general form of dual-lumen catheters goes back to as early as 1882 when Brunswicke patented such a catheter in the United States under Ser. No. 256,590.
  • This patent teaches a flexible dual-lumen catheter which is used primarily for cleaning and drainage of, for example, the bladder, rectum, stomach and ear. In this type of catherization, the catheter is introduced into an existing body orifice without the use of any puncturing needle or guide wire.
  • Hemodialysis can be defined as the temporary removal of blood from a patient for the purpose of extracting or separating toxins therefrom and the return of the cleansed blood to the same patient. Hemodialysis is indicated in patients where renal impairment or failure exists, that is, in cases where the blood is not being properly or sufficiently cleansed, particularly to remove waste materials and water, by the kidneys.
  • hemodialysis In the case of chronic renal impairment or failure, hemodialysis has to be carried out on a repetitive basis. For example, in end-stage kidney disease where transplantation of kidneys is not possible or for medical reasons is contra- indicated, the patient may have to be dialyzed about 100 to 150 times per year. This can result in several thousand accesses to the blood stream to enable hemodialysis to be performed over the remaining life of the patient.
  • Dr. Stanley Shaldon and colleagues developed, in the Royal Free Hospital in London, England, a technique for hemodialysis by percutaneous catheterization of deep blood vessels, specifically the femoral artery and vein. The technique was described in an article published by Dr. Shaldon and his associates in the Oct. 14, 1961 edition of The Lancet at Pages 857 to 859. Dr. Shaldon and his associates developed single lumen catheters having tapered tips for entry over a Seldinger wire to be used in
  • Dr. Shaldon and his colleagues began to insert single lumen inlet and outlet catheters in the femoral vein and this was reported in the British Medical Journal of Jun. 19, 1963.
  • the purpose of providing both inlet and outlet catheters in the femoral vein was to explore the possibility of a "self-service" approach to dialysis. Dr. Shaldon was subsequently successful in doing this and patients were able to operate reasonably normally while carrying implanted catheters which could be connected to hemodialysis equipment periodically.
  • An advantage of dual-lumen catheters in hemodialysis is that only one vein access need be affected to establish continued dialysis of the blood.
  • One lumen serves as the conduit for blood flowing from the patient to the dialysis unit and the other lumen serves as a conduit for treated blood returning from the dialysis unit to the patient.
  • Dr. Shaldon used the femoral vein, and in about 1977 Dr. P. R. Uldall, in Toronto Western Hospital, Canada, began clinical testing of a subclavian catheter that would remain in place between dialysis treatments. An article describing this was published by Dr. Uldall and others in
  • the tip of the catheter In order to insert a catheter over a guide wire using the Seldinger technique, or indeed any similar technique, the tip of the catheter must possess sufficient rigidity so that it does not concertina as it contacts the skin because this would enlarge the skin puncture as the catheter is being entered over the wire. To some extent this is at odds with the desirable material qualities of the main body of catheter which should be soft and flexible for patient comfort.
  • a variety of tips have been formed within the limitations of using a single extrusion from which the body and tip are formed. The result is that the tips have in general been made by using some of the excess material found in the shorter intake lumen.
  • Hemodialysis as practiced today, normally employs one of two types of catheters to remove blood from the patient for processing and return processed blood to the patient. Most commonly, a dual-lumen catheter is used, each lumen having either a generally cylindrical or semi-cylindrical configuration. Alternatively, two separate tubes, each usually having a full cylindrical configuration, are used separately to remove blood for dialysis and return the processed blood.
  • Hemodialysis membranes are now able to process blood at over 500 ml of flow per minute. Even higher processing rates are foreseeable. However, problems occur with both the line introducing purified blood back into the vein and the line removing blood for purification at flow rates above 300 ml per minute. A high flow rate from the venous line may cause whipping or "firehosing" of the tip in the vein with consequent damage to the vein lining. A corresponding high flow rate into the arterial line may cause the port to be sucked into the vein wall, resulting in occlusion.
  • the rate of flow through a catheter lumen is controlled by a number of factors including the smoothness of the wall surface, the internal diameter or cross-sectional area of the tube lumen, and the length of the tube lumen. The most important factor is the cross-sectional area of the tube lumen.
  • the force or speed of the fluid flow in a tube lumen for a given cross-sectional area is controlled by the external pumping force. This is a positive pressure pushing processed blood through the venous lumen and a negative (suction) pressure pulling unprocessed blood through the arterial lumen.
  • dual-lumen catheters are, to a great extent, catheters with a main port which opens at the end of a lumen substantially on the axis of the lumen.
  • Firehosing frequently results. Firehosing may damage the vein wall, triggering the build-up of fibrin on the catheter tip. Fibrin build-up may further result in port occlusion.
  • catheters have not been entirely successful in solving problems related to hemodialysis with dual lumen catheters, e.g., high incidences of catheter port occlusion as well as some degree of fire-hosing. Further, the abrupt change in direction of the flow of blood from the vein into the catheter can result in trauma and damage to red blood cells, especially at higher flow rates.
  • An object of the present invention is to provide an improved multi-lumen catheter for use in hemodialysis, plasmapheresis, and other therapies which require removal of blood from one lumen of the catheter and return of treated blood through the other lumen.
  • Another object is to provide a multi-lumen catheter which is capable of accommodating high flow rates.
  • Yet another object is to provide a more efficient multi-lumen catheter for use in hemodialysis, plasmapheresis, and other therapies which require removal of blood from one lumen of the catheter and return of treated blood through the other lumen.
  • Still another object is to provide a multi-lumen catheter which permits high flow rates while reducing trauma to vessel walls and red cell damage.
  • Yet another object of the present invention is a multi-lumen catheter having a tip configuration which minimizes recirculation by maximizing the control and direction of blood flow into and out from the lumen ports.
  • an apparatus which comprises an elongated catheter body for placement within a vessel, a septum that runs longitudinally through the interior of the catheter body so as to divide the interior of the catheter body into a first lumen and a second lumen each having a distal end having curved or angled internal walls that terminate at ports located on opposing sides of the catheter body.
  • the curved or angled internal walls at the distal end of the lumina provide for a transition zone in which the flow of blood into and out from the catheter travels a path that gradually changes the direction of the flow of fluids between the direction of flow in the lumen and the direction of flow in the vessel.
  • the change in direction of the flow pattern into and out of the catheter body is substantially helical.
  • the direction of the flow pattern into and out of the catheter body is curved, and in still other embodiments the direction of the flow pattern into and out of the catheter body is angled. In this manner, the flow patterns of these embodiments provide for more efficient exchange of blood by creating an alternate pattern of blood dynamics through the catheter lumina and the vessel.
  • the ports of the lumina are longitudinally spaced. In this manner the withdrawal of blood to be treated and the return of treated blood are further separated so as to advantageously minimize the recirculation of treated blood with untreated blood.
  • the length of separation may vary according with specific application, and is preferably from about 2 to about 3 centimeters.
  • the lumen port associated with the withdrawal of blood from the patient is "upstream" of the lumen port associated with the return of treated blood.
  • FIG. 1 illustrates a perspective view of a dual-lumen catheter of the present invention attached to inflow and outflow tubing.
  • FIG. 2 illustrates a cross-sectional view of a dual lumen catheter of FIG. 1.
  • FIG. 3 illustrates a perspective view of a dual-lumen catheter of the present invention shown apart from inflow and outflow tubing.
  • FIG. 4 illustrates another perspective view of the dual- lumen catheter of FIG.
  • FIG. 5 illustrates a third perspective view of the dual-lumen catheter of FIG.
  • FIGS. 6A-6D illustrate an alternative embodiment of a split tip multi-lumen catheter.
  • FIGS. 7A-7E illustrate an alternative embodiment of a step tip multi-lumen catheter.
  • FIGS. 8A-8E illustrate an alternative embodiment of a symmetrical tip multi- lumen catheter.
  • FIGS. 9A-9D illustrate an alternative embodiment of a symmetrical tip multi-lumen catheter having a spiral twisting septum.
  • a catheter body that is adapted for insertion into a vessel of a patient such as, for example, a vein.
  • the catheter body comprises an external wall and a septum extending longitudinally along the internal length of the catheter body to define two substantially parallel lumina each having an internal wall and a port located at the side of the distal end thereof.
  • each lumen At the distal end of each lumen, at least a portion of the internal walls of the lumina are curved or angled to define a transition zone terminating at the port. So configured, the transition zone permits the flow of fluids traveling the length of the lumen to be gradually deflected from the longitudinal direction of the lumen to the transverse direction of the side-facing port at the distal end thereof. [0043] For fluids entering the side- facing port of the lumen, the transition zone permits the flow to be gradually deflected from the direction of travel through the vessel through the lateral direction of entry to the longitudinal direction of travel in the lumen. In this fashion, the transition zone provides a gradual change in the direction of flow into and out of the lumina.
  • This smoother and more physiologic change of direction of the fluids traveling through the lumina decreases firehosing of the catheter tip during high rates of fluid exchange, reduces stresses experienced by the fluid, and permits a more efficient and higher rate of flow into and out from the catheter.
  • This more gradual change in direction of blood flow also results in less prolongation of blood residence time within the catheter tips which can decrease the likelihood of thrombus formation within the catheter.
  • decrease in stress provided by the transition zones at the distal end of the lumina decreases the incidence of platelet activation, hemolysis and trauma to the vessel lining.
  • a first lumen of the catheter terminates in a first bolus cavity, which is formed into one side of a bolus tip at a position between the interfacing section of the lumen and a nose section of the bolus tip.
  • the nose section of the terminal portion of the first lumen may be formed through an injection molding process to create a helical shape of the nose section and first bolus cavity so that fluids such as blood traveling through the lumen have a smooth transition of its direction of flow as it enters the first lumen.
  • the second lumen of the catheter terminates in a second bolus cavity oriented 180 degrees from the first bolus cavity, and possesses a nose section which has a similar injection molded- configuration as the nose tip of the first lumen.
  • the nose sections of the first and second lumina direct blood flow in directions opposite to each other thereby reducing the admixture of treated blood with non-treated blood.
  • the second lumen in this embodiment extends beyond the first lumen by about 2 to about 3 centimeters so that the nose section of the terminal portion of the second lumen is longitudinally spaced from the nose section of the terminal portion of the first lumen.
  • the terminations of the first and second lumina within the nose section are partly recessed, to enable the overhanging aspect of the nose section to serve as a barrier with the vessel wall. This design is intended to reduce the phenomenon of partial or total occlusion of the lumina of the catheter.
  • an additional lumen is provided within the catheter body to allow introduction of a guide wire.
  • the guide wire inserted into this additional lumen and used to assist in the introduction and proper placement of the catheter tip into a vessel of a patient.
  • the additional lumen for the guide wire may terminate at the same position as the first and/or second lumina, or may terminate distally beyond the distal ends of the lumina to provide additional stability to the catheter body. In such a
  • the substantially helical transition zones of the first and second lumina may be created through mechanically or thermally (e.g., with a laser) skiving the apertures within the terminal shafts of the catheter.
  • first and second lumina may be split apart along the distal portion of the septum by, for example, a splittable membrane in the septum. In this manner, the lumina may be partially longitudinally separated from each other.
  • reference to curvature or angularity with regard to the internal walls of the lumina includes a wide range of configurations in which at least a portion of the internal walls of the lumen at the distal ends thereof undergoes a transition in direction from the longitudinal direction of the lumen to a direction angled from such longitudinal direction. In this fashion, fluids traveling in either direction through the lumen will bear against the curved or angled wall in the transition zone in changing direction from or to a longitudinal orientation.
  • This change in the direction of the internal wall of the lumen in the transition zone may be constant or may vary along some or all of the transition zone, and may extend along two dimensions in which the flow path changes direction substantially within a single plane, or through three dimensions.
  • the curvature or angularity of the internal walls of the lumina extends in three dimensions and is substantially helical.
  • helical patterns includes patterns that are regular and irregular and with constant or varying diameters along their length. So configured, the movement of fluids through the transition zone imparts a helical flow pattern to such fluids. This helical flow pattern reduces the incidence of in-plane recirculation. In the context of hemodialysis, plasmapheresis, and other therapies which require the transport of blood, this helical flow pattern reduces the incidence of treated blood that is delivered to the patient through the catheter to re-enter the catheter at the intake port. The reduction of this type of recirculation allows for more efficient blood exchange and, consequently, reduced treatment time.
  • the cross-sectional area and geometry of the lumina may be similar to or different from each other.
  • the cross-sectional area of each lumen is similarly sized in order to accommodate similar flow volumes and rates into and out from the catheter.
  • the cross-sectional area of each lumen is from about 3.5mm to about 5mm, and more preferably from about 4.5mm to about 5mm.
  • the cross-section geometry of the lumina may assume a variety of shapes including circular, semi -circular (D-shaped), elliptical, semi-elliptical, teardrop-shaped, or curved teardrop-shaped resembling a yin-yang symbol.
  • the ports provided in the side walls of the distal ends of the lumina may accommodate a range of sizes and shapes including circular, semi-circular (D-shaped), elliptical, semi-elliptical, teardrop-shaped.
  • the ports are semi-elliptical and are from about 3 to about 6 mm in maximal diameter.
  • the terminating cavities of the first and second channels have a greater surface area than prior designs, such us that shown in U.S. Pat. No. 4,808, 155 by Mahurkar. This results in more efficient exchange of fluids and blood.
  • the catheter of the present invention may be constructed from materials that are commonly used for multi-lumen catheters such as silicone or polyurethanes including polyurethanes sold under the trademark Carbothane® by Carboline Company of St. Louis, Mo.
  • a method for exchanging fluids in a patient comprising the step of positioning a catheter of the present invention in communication with a fluid-containing vessel of a patient.
  • the exchanged fluid comprises blood and the fluid-containing vessel of the patient is a vein.
  • the method of the present invention is particularly well-suited to the performance of hemodialysis, plasmapheresis, and other therapies which require removal and return of blood from a patient.
  • the method of the present invention may further comprise the steps of ultrafiltration and/or venous sampling.
  • FIGS. 1-5 there is shown a catheter 10 having a septum 12 bisecting the interior of catheter 10 to form two lumina 14 and 16.
  • the lumina 14 and 16 At the distal end of catheter 10, the lumina 14 and 16 have with curved walls 18 and 20 which terminate at ports 22 and 24 disposed on opposite sides of catheter 10.
  • the cross-section shape of lumina 14 and 16 are semicircular.
  • lumen 16 extends beyond the end of lumen 14 so as to further separate the intake port 24 from outflow port 22.
  • fluid such as blood
  • intake port 24 changes direction as the flow of fluid passes curved wall 20 through lumen 14 to tube 32 which conveys the fluid for treatment to a device such as a dialysis machine (not shown).
  • a device such as a dialysis machine (not shown).
  • the treated fluid is returned to a patient through tube 30 to lumen 16.
  • the fluid is deflected by curved wall 18 and out port 22 into the vessel of the patient.
  • FIGS. 6A-6D illustrate an alternative embodiment of a multi-lumen catheter.
  • the catheter 60 includes a split tip to form two lumina 61 and 62.
  • the split design eliminates the shared septum used to bisect the interior of the catheter.
  • Each lumen 61 and 62 has a unique wall that defines their shape.
  • the lumina 61 and 62 may have with curved walls 63 and 64 which terminate at ports 65 and 66 disposed on opposite sides of catheter 60.
  • the lumen 61 extends beyond the end of lumen 62 so as to further separate the intake port 65 from outflow port 66.
  • fluid such as blood
  • intake port 65 changes direction as the flow of fluid passes curved wall 63 through lumen 61 to tube 67 which conveys the fluid for treatment to a device such as a dialysis machine (not shown).
  • a device such as a dialysis machine (not shown).
  • the treated fluid is returned to a patient through tube 68 to lumen 62.
  • the fluid is deflected by curved wall 64 and out port 66 into the vessel of the patient.
  • the lumina 61 and 62 of the catheter 60 may be attached with a weak adhesive to maintain structural integrity of the catheter during operation.
  • the adhesive may be water-soluble such that blood flow around the catheter 60 causes the adhesive to dissolve, thereby causing at least a portion of the lumina 61 and 62 to split.
  • the catheter 60 may be manufactured such that the last 5cm of the catheter have the water-soluble adhesive and thus split when the adhesive dissolves.
  • one or more side holes 69 may be included in the catheter 60.
  • the side holes 69 may assist in providing additional means of blood or other fluid exchange as well as serve as a mounting point for attaching the catheter 60 on a guide wire during insertion/removal/exchange from a patient.
  • the side holes 69 may be sized and positioned such that fluid flow is optimized about the lumen tips.
  • the side holes 69 may be approximately 1mm in diameter, and be positioned approximately 1cm from the ports 65 and 66.
  • the side holes may be smaller (e.g., .5mm), larger (e.g., 1.5mm), or positioned in another location (e.g., 1.5cm from the ports).
  • the size and location of the side holes 69 may produce changes in shear stress and blood cell residence time at the catheter tips, and thus the optimal balance may incorporate side holes being approximately .75mm to 1.2mm in diameter.
  • Using properly spaced and sized side holes, such as side holes 69, may result in a highly optimized catheter.
  • side holes 69 may result in a highly optimized catheter.
  • fluid flow through the catheter may be optimized while recirculation is greatly reduced.
  • side holes 69 as shown in FIGS. 6A-6D are shown by way of example only. Additional or alternative apertures such as slits, flaps, semicircular cuts, and other similar shapes may be used. Additionally, the side holes may have a helical contour to produce additional deflection to any fluid flowing therethrough.
  • the curved walls 63 and 64 define an area of deflection such that fluid flowing through the catheter 60 is deflected.
  • an angle of the curved walls 63 and 64 may vary accordingly.
  • the curved walls 63 and 64 may be approximately 54°.
  • the curved walls 63 and 64 may be between the range of 0° and 90°.
  • 0° and 90° may not be used as they both have inherent drawbacks.
  • 0° would cause no deflection to the fluid.
  • 90° would result in the port being perpendicular to the axial flow path of the catheter. On the input port, this could cause a vacuum force which attaches the associated lumina to the side of a blood vessel. While a side hole would help to alleviate any potential vacuum pressure, overall performance of the catheter would still decrease.
  • FIGS. 7A-7E illustrate an alternative embodiment of a multi-lumen catheter.
  • the catheter 70 includes a stepped tip to form two lumina 71 and 72. Like the split design, this design results in one lumen being longer than the other.
  • the stepped tip design also eliminates a septum at the tip to bisect the interior of the catheter to form two ports where the septum extends beyond the ports. Rather, each lumina 71 and 72 has a unique curved wall that defines their shape and the flow of fluid therethrough such that no extended septum is required to maintain fluid separation.
  • the lumina 71 and 72 may have with curved walls 73 and 74 which terminate at ports 75 and 76 disposed on opposite sides of catheter 70.
  • the lumen 71 extends beyond the end of lumen 72, thereby forming a stepped tip design and further separating the intake port 75 from outflow port 76.
  • fluid such as blood
  • enters intake port 75 changes direction as the flow of fluid passes curved wall 73 through lumen 71 to tube 77 which conveys the fluid for treatment to a device such as a dialysis machine (not shown).
  • the treated fluid is returned to a patient through tube 78 to lumen 72.
  • the fluid is deflected by curved wall 74 and out port 76 into the vessel of the patient.
  • one or more side holes may be included in the catheter 70.
  • the side holes 79 may assist in providing additional means of blood or other fluid exchange as well as serve as a mounting point for attaching the catheter 70 on a guide wire during catheter insertion and/or removal and/or exchange from a patient.
  • the curved walls 73 and 74 define an area of deflection such that fluid flowing through the catheter 70 is deflected. Depending on the application of the catheter 70, and the amount of desired deflection, an angle of the curved walls 73 and 74 may vary accordingly.
  • the curved walls 73 and 74 may be approximately 54°.
  • the curved walls 73 and 74 may be between the range of 0° and 90°.
  • 0° and 90° may not be used as they both have inherent drawbacks. 0° would cause no deflection to the fluid. 90° would result in the port being perpendicular to the axial flow path of the catheter. On the input port, this could cause a vacuum force which attaches the associated lumina to the side of a blood vessel. While a side hole would help to alleviate any potential vacuum pressure, overall performance of the catheter would still decrease.
  • FIGS. 8A-8E illustrate an alternative embodiment of a multi-lumen catheter.
  • the catheter 80 includes a symmetrical tip where two lumina 81 and 82 terminate at the same point such that the ports are adjacent. Additionally, unlike common prior art, the
  • each lumen 81 and 82 has a unique curved wall that defines their shape and the flow of fluid therethrough such that no extended septum is required to maintain fluid separation. As shown in FIG. 8D, the cross- section shape of lumina 81 and 82 are semicircular.
  • the lumina 81 and 82 may have with curved walls 83 and 84 which terminate at ports 85 and 86 disposed on opposite sides of catheter 80.
  • the lumen 81 extends to same point as the lumen 82, thereby forming a symmetrical tip design.
  • fluid such as blood
  • enters intake port 85 changes direction as the flow of fluid passes curved wall 83 through lumen 81 to tube 87 which conveys the fluid for treatment to a device such as a dialysis machine (not shown).
  • the treated fluid is returned to a patient through tube 88 to lumen 82.
  • the fluid is deflected by curved wall 84 and out port 86 into the vessel of the patient.
  • the design eliminates the septum extending beyond the ports while still maintaining a low level of fluid from the out port 86 mixing with fluid entering the intake port 85.
  • one or more side holes 89 may be included in the catheter 80.
  • the side holes 89 may assist in providing additional means of blood or other fluid exchange as well as serve as a mounting point for attaching the catheter 80 on a guide wire during insertion and/or removal and/or exchange from a patient.
  • the side holes 89 may be sized and positioned such that fluid flow is optimized about the lumen tips.
  • the side holes 89 may be approximately 1mm in diameter, and be positioned approximately 1cm from the ports 85 and 86.
  • the side holes may be smaller (e.g., .5mm), larger (e.g., 1.5mm), or positioned in another location (e.g., 1.5cm from the ports).
  • the size and location of the side holes 89 may produce changes in shear stress and blood cell residence time at the catheter tips, and thus the optimal balance may incorporate side holes being approximately .75mm to 1.2mm in diameter.
  • Using properly spaced and sized side holes, such as side holes 89, may result in a highly optimized catheter.
  • a similar catheter to the catheter 80 as shown in FIGS. 8A-8E fluid flow through the catheter may be optimized while recirculation is greatly reduced.
  • side holes 89 as shown in FIGS. 8A-8E are shown by way of example only. Additional or alternative apertures such as slits, flaps, semicircular cuts, and other similar shapes may be used. Additionally, the side holes themselves may have a helical contour to produce additional deflection to any fluid flowing therethrough.
  • the curved walls 83 and 84 define an area of deflection such that fluid flowing through the catheter 80 is deflected.
  • an angle of the curved walls 83 and 84 may vary accordingly.
  • the curved walls 83 and 84 may be approximately 54°.
  • the curved walls 83 and 84 may be between the range of 0° and 90°.
  • 0° and 90° may not be used as they both have inherent drawbacks. 0° would cause no deflection to the fluid. 90° would result in the port being perpendicular to the axial flow path of the catheter. On the input port, this could cause a vacuum force which attaches the associated lumina to the side of a blood vessel. While a side hole would help to alleviate any potential vacuum pressure, overall performance of the catheter would still decrease.
  • FIGS. 9A-9D illustrate an alternative embodiment of a multi-lumen catheter.
  • the catheter 90 includes a symmetrical tip where two lumina 91 and 92 terminate at the same point such that the ports are adjacent. Additionally, unlike common prior art, the
  • each lumen 91 and 92 has a unique curved wall that defines their shape and the flow of fluid therethrough such that no extended septum is required to maintain fluid separation. As shown in FIG. 9D, the cross- section shape of lumina 91 and 92 are semicircular.
  • the catheter 90 includes a spiral twist at the distal end.
  • the twisted portion 100 of the catheter 90 with the spiral twist may be rotated between 1° and 359°, however, an optimum value would be somewhere in the middle of this range, depending on the viscosity and volume of fluid being moved through the catheter.
  • a rotation of about 135° within about 4 cm extending from the distal end of the catheter may be optimal.
  • a range of about 120° to about 150° within an approximate 1cm to 5cm extending from the distal end of the catheter may be optimal.
  • the lumina 91 and 92 may have with curved walls 93 and 94 which terminate at ports 95 and 96 disposed on opposite sides of catheter 90.
  • the lumen 91 extends to same point as the lumen 92, thereby forming a symmetrical tip design.
  • fluid such as blood
  • intake port 95 changes direction as the flow of fluid passes curved wall 93 and through the twisted portion 100 of lumen 91 to tube 97 which conveys the fluid for treatment to a device such as a dialysis machine (not shown).
  • the treated fluid is returned to a patient through tube 98 to lumen 92.
  • the fluid is deflected by the twisted portion 100 and the curved wall 94, and passes through out port 96 into the vessel of the patient.
  • this design eliminates the septum extending beyond the ports while still maintaining a low level of fluid from the out port 96 mixing with fluid entering the intake port 95.
  • one or more side holes 99 may be included in the catheter 90.
  • the side holes 99 may assist in providing additional means of blood or other fluid exchange as well as serve as a mounting point for attaching the catheter 90 on a guide wire during insertion and/or removal and/or exchange from a patient.
  • the side holes 99 may be sized and positioned such that fluid flow is increased about the lumen tips.
  • the side holes 99 may be approximately 1mm in diameter, and be positioned approximately 1cm from the ports 95 and 96.
  • the side holes may be smaller (e.g., .5mm), larger (e.g., 1.5mm), or positioned in another location (e.g., 1.5cm from the ports).
  • the size and location of the side holes 99 may produce changes in shear stress and blood cell residence time at the catheter tips, and thus the optimal balance may incorporate side holes being approximately .75mm to 1.2mm in diameter.
  • Using properly spaced and sized side holes, such as side holes 99, may result in a highly optimized catheter.
  • a similar catheter to the catheter 90 as shown in FIGS. 9A-9D fluid flow through the catheter may be optimized while recirculation is greatly reduced.
  • side holes 99 as shown in FIGS. 8A-8E are shown by way of example only. Additional or alternative apertures such as slits, flaps, semicircular cuts, and other similar shapes may be used. Additionally, the side holes themselves may have a helical contour to produce additional deflection to any fluid flowing therethrough.
  • the curved walls 93 and 94 define an area of deflection such that fluid flowing through the catheter 90 is deflected.
  • an angle of the curved walls 93 and 94 may vary accordingly.
  • the curved walls 93 and 94 may be approximately 54°.
  • the curved walls 93 and 94 may be between the range of 0° and 90°.
  • 0° and 90° may not be used as they both have inherent drawbacks. 0° would cause no deflection to the fluid. 90° would result in the port being perpendicular to the axial flow path of the catheter.

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  • Health & Medical Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Vascular Medicine (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Cardiology (AREA)
  • Biophysics (AREA)
  • Pulmonology (AREA)
  • Urology & Nephrology (AREA)
  • External Artificial Organs (AREA)

Abstract

L'invention concerne un cathéter à placer dans un vaisseau d'un patient. Le cathéter comprend un corps de cathéter allongé, un septum s'étendant dans le sens longitudinal à travers l'intérieur du corps de cathéter, qui divise l'intérieur du corps de cathéter en une première lumière et une seconde lumière. Chaque lumière présente des parois internes incurvées ou coudées au niveau de l'extrémité distale du cathéter, qui se terminent en des orifices situés sur des côtés opposés du corps de cathéter. L'invention concerne également un procédé d'échange de fluides dans un patient, qui comprend l'étape de positionnement du cathéter de la présente invention en communication avec un vaisseau contenant un fluide du patient. Le procédé est particulièrement bien adapté pour l'hémodialyse, la plasmaphérèse et d'autres traitements qui nécessitent le retrait et la restitution de sang chez un patient.
EP13781070.1A 2012-04-23 2013-04-23 Cathéter à lumières multiples Withdrawn EP2841146A4 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP19208800.3A EP3626301A1 (fr) 2012-04-23 2013-04-23 Cathéter à lumières multiples

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US13/453,663 US9333321B2 (en) 2004-04-12 2012-04-23 Multi-lumen catheter
PCT/US2013/037783 WO2013163172A1 (fr) 2012-04-23 2013-04-23 Cathéter à lumières multiples

Related Child Applications (1)

Application Number Title Priority Date Filing Date
EP19208800.3A Division EP3626301A1 (fr) 2012-04-23 2013-04-23 Cathéter à lumières multiples

Publications (2)

Publication Number Publication Date
EP2841146A1 true EP2841146A1 (fr) 2015-03-04
EP2841146A4 EP2841146A4 (fr) 2016-08-31

Family

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EP13781070.1A Withdrawn EP2841146A4 (fr) 2012-04-23 2013-04-23 Cathéter à lumières multiples
EP19208800.3A Pending EP3626301A1 (fr) 2012-04-23 2013-04-23 Cathéter à lumières multiples

Family Applications After (1)

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EP19208800.3A Pending EP3626301A1 (fr) 2012-04-23 2013-04-23 Cathéter à lumières multiples

Country Status (6)

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EP (2) EP2841146A4 (fr)
JP (1) JP6529905B2 (fr)
CN (2) CN108310505B (fr)
AU (2) AU2013251786A1 (fr)
CA (1) CA2871329C (fr)
WO (1) WO2013163172A1 (fr)

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* Cited by examiner, † Cited by third party
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EP3558424A4 (fr) * 2016-12-21 2020-07-01 Alcyone Lifesciences, Inc. Systèmes et procédés d'administration de médicaments
DE102017118819B3 (de) * 2017-08-17 2019-02-14 Joline Gmbh & Co. Kg Dialysekatheter, insbesondere zur Langzeitanwendung
CN107583176A (zh) * 2017-09-25 2018-01-16 温州医科大学附属第医院 介入用双腔螺旋导管
CN109847175A (zh) * 2019-01-30 2019-06-07 沈阳泰伦药业有限公司 一次性五腔双囊全可视超滑前列腺扩裂导管
KR102341692B1 (ko) * 2019-05-21 2021-12-21 성균관대학교산학협력단 카테터

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Also Published As

Publication number Publication date
JP6529905B2 (ja) 2019-06-12
AU2013251786A1 (en) 2014-11-20
CA2871329A1 (fr) 2013-10-31
EP2841146A4 (fr) 2016-08-31
CN108310505A (zh) 2018-07-24
WO2013163172A1 (fr) 2013-10-31
AU2017251692A1 (en) 2017-11-09
AU2017251692B2 (en) 2019-03-21
JP2015518404A (ja) 2015-07-02
CN104379208B (zh) 2018-04-24
CN104379208A (zh) 2015-02-25
CA2871329C (fr) 2019-05-28
EP3626301A1 (fr) 2020-03-25
CN108310505B (zh) 2021-07-30

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