JP2013027580A - Vascular access device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a vascular access device for reducing the risk of developing cardiovascular diseases compared to conventional devices.SOLUTION: The vascular access device 1 comprises a first tubular connecting member 10 that is configured to be connected to a vein, a second tubular connecting member 20 that is configured to be connected to a vein at a position downstream of the position of the vein where the first connecting member 10 is connected, and a body 30 including puncture members 32 and 34. An inner flow passage 40 is formed inside the first connecting member 10, the second connecting member 20, and the body 30, linking the end of the first connecting member 10 to the end of the second connecting member 20. In the flow interval from an upstream connection hole 12 to a first downstream connection hole 22 or to a second downstream connection hole 24, the inner flow passage 40 is divided into a first passage flow 42 linking the upstream connection hole 12 to the first downstream connection hole 22 and a second passage flow 44 linking the upstream connection hole 12 to the second downstream connection hole 24.

Description

  The present invention relates to a blood vessel access device that serves as an entrance and exit of blood from a blood vessel to a blood circuit or the like when performing hemodialysis or the like.

  As a conventional vascular access device, a subcutaneously implantable vascular access device that connects an artery and a vein is known (see, for example, Patent Documents 1 and 2).

  The vascular access device disclosed in Patent Document 1 includes a tube whose end is sutured to an artery, a catheter whose end is inserted into a vein, and a needle access site connected to these tube and catheter. Tubes and catheters (and needle access sites) are configured to provide continuous blood flow.

  Further, the blood vessel access device disclosed in Patent Document 2 is connected to a main body portion in which a blood passage is formed inside and a communication hole that communicates the blood passage and the outside is provided, and a blood passage in the main body portion. Two tubes, and a closing member that is disposed so as to close the communication hole, is piercable with a puncture needle, and has resealability. One of the two tubes is ligated and connected to a vein, and the other tube is ligated and connected to an artery.

JP 2002-5157998 A Japanese Patent Laid-Open No. 11-4888

  By the way, since the blood vessel access device disclosed in Patent Documents 1 and 2 is of a type in which an artery and a vein are directly connected, blood flowing through the artery may flow directly into the vein. Increasing the amount of blood flowing from an artery to a vein via a vascular access device may increase the burden on the heart, resulting in cardiovascular disease such as cardiac hypertrophy. In particular, since the vascular access device disclosed in Patent Document 1 directly connects a subclavian artery close to the heart and a subclavian vein (or superior vena cava), the burden on the heart becomes greater. .

  Therefore, the present invention has been made to solve such problems, and an object of the present invention is to provide a vascular access device capable of reducing the risk of occurrence of cardiovascular disease as compared with the prior art.

  A vascular access device (1) according to the present invention comprises a tubular first connection part (10) configured to be connectable to a vein, and a downstream side of a position of the vein to which the first connection part (10) is connected. A tubular second connection portion (20) configured to be connectable to a vein at a position of the first connection portion, and the first connection at a position between the first connection portion (10) and the second connection portion (20). A body part (30) connected to the part (10) and the second connection part (20), the first connection part (10), the second connection part (20) and the body part (30). Is provided with an internal flow path (40) communicating from the end of the first connection part (10) to the end of the second connection part (20). When a fluid is present in the internal flow path (40), the fluid can be sent to the outside, and the internal flow path from the outside 40), the first connection portion (10) is provided with an upstream communication hole (12) communicating with the internal flow path (40), and the second connection portion (20). ) Is provided with a downstream first communication hole (22) and a downstream second communication hole (24) communicating with the internal flow path (40), and the internal flow path (40) is formed with the upstream communication hole. In the section from (12) to the downstream first communication hole (22) and the downstream second communication hole (24), the upstream communication hole (12) to the downstream first communication hole (22). The first flow path (42) to be reached and the second flow path (44) from the upstream communication hole (12) to the downstream second communication hole (24) are branched.

  For this reason, according to the vascular access device of the present invention, since both the first connection portion and the second connection portion are configured to be connectable to the vein, the first connection portion and the second connection portion are respectively connected to the vein. In this case, blood flowing through the vein flows through the internal flow path to the vein as it is. That is, the vascular access device of the present invention is not of the type that directly connects an artery and a vein as in the conventional vascular access device, so that the burden on the heart can be reduced as compared with the conventional vascular access device. It becomes possible to reduce the risk of vascular disease.

  Further, according to the vascular access device of the present invention, blood flowing through the vein communicates from the upstream communication hole to the internal flow path, and directly passes through the downstream first communication hole or the downstream second communication hole to the vein. Since it is configured to flow, there is an advantage that blood does not easily stay in the blood vessel access device. As a result, it is possible to suppress the occurrence of thrombus caused by the retention of blood in the vascular access device, and if a predetermined amount of blood flow in the vascular access device is secured, an anti-heparin or the like can be used. The blood coagulant need not be injected into the vascular access device.

  In this specification, the “downstream side” refers to the downstream side of the flow when the blood flow is regarded as a river flow. On the other hand, the “upstream side” refers to the upper side of the flow when the flow of blood is regarded as a flow of a river. When the first connection part and the second connection part are respectively connected to the same vein, for example, when both the first connection part and the second connection part are connected to the right subclavian vein, the connection of the first connection part The position is an upstream position (a position far from the heart) of the right subclavian vein, and the connection position of the second connection portion is a downstream position (a position close to the heart) of the right subclavian vein. Further, when the first connection portion and the second connection portion are respectively connected to different veins and continuous veins, for example, the first connection portion and the second connection portion are connected to the right subclavian vein and the superior vena cava. When connected, the connection position of the first connection portion is the right subclavian vein upstream of the superior vena cava, and the connection position of the second connection portion is downstream of the right subclavian vein. It becomes the superior vena cava.

  In the vascular access device (1) of the present invention, it is preferable that a portion branched into the first flow path (42) and the second flow path (44) exists in the first connection portion (10). .

  With this configuration, there are always two channels (the first channel and the second channel) in the main body, so the two channels are accessed independently from the outside. It becomes possible to do. For example, when the vascular access device of the present invention is used as a vascular access device for hemodialysis, a blood removal needle is inserted into a position where the first flow path in the main body portion passes and a second flow path in the main body portion passes. By inserting a needle for returning blood, the first flow path can be used as a blood removal line and the second flow path can be used as a blood return line.

  In the vascular access device (1) of the present invention, one of the downstream side first communication hole (22) and the downstream side second communication hole (24) is configured such that the main body portion is more than the other communication hole. It is preferable to be provided at a position close to (30).

  With this configuration, the vascular access device of the present invention is suitable for use in applications where it is desirable to separate the positions of the downstream first communication hole and the downstream second communication hole. For example, when the vascular access device of the present invention is used as a vascular access device for hemodialysis, if the first flow path is used as a blood removal line and the second flow path is used as a blood return line, the downstream first communication hole is removed from the blood. The second communication hole on the downstream side serves as a blood return port. By configuring as described above, the position of the blood removal port and the blood return port can be separated. Become.

  In the vascular access device (1) of the present invention, the first connection portion (10), the main body portion (30), and the second connection portion (20) are preferably configured to be implantable subcutaneously. .

  By comprising in this way, it becomes possible to suppress generation | occurrence | production of an infectious disease. Moreover, since each member which comprises a blood-vessel access device becomes difficult to stand out in appearance, it is excellent also from a cosmetic viewpoint.

  In the vascular access device (1) of the present invention, the main body (30) is formed of a flexible artificial blood vessel, and is configured so that a needle can be punctured from the outside to the main body (30). It is preferable that

  When the vascular access device of the present invention is implanted under the skin, it becomes more inconspicuous when configured as described above, and the vascular access device is particularly excellent in cosmetics.

  In the vascular access device (2) of the present invention, the main body (70) includes a housing (80, 84) whose upper surface is opened and a septum (82a to 82c, 86a to 86) arranged so as to close the opening. 86c), and the internal flow path (92, 94) is formed by the housing (80, 84) and the septum (82a-82c, 86a-86c). The septum (82a to 82c, 86a to 86c) is also preferably configured to be able to puncture a needle from the outside.

  When the vascular access device of the present invention is implanted under the skin, it is relatively easy to confirm the position of the vascular access device by palpation.

  In addition, the reference numerals added in parentheses below the wording of each member, etc. described in the claims and in this column (column of means for solving the problems) are the contents described in the claims and this column. It is used for facilitating understanding of the present invention, and does not limit the contents described in the claims and in this section.

The figure which shows the state which left the vascular access device 1 which concerns on 1st Embodiment in the body. The figure shown in order to demonstrate the vascular access device 1 which concerns on 1st Embodiment. Schematic which shows simply the internal flow path 40 of the vascular access device 1 which concerns on 1st Embodiment. The figure which shows the state which left the vascular access device 2 which concerns on 2nd Embodiment in the body. The figure shown in order to demonstrate the vascular access device 2 which concerns on 2nd Embodiment. Schematic which shows simply the internal flow path 90 of the vascular access device 2 which concerns on 2nd Embodiment. Schematic which shows simply the internal flow path 40A of the blood vessel access device 1A which concerns on a modification.

  Hereinafter, a vascular access device of the present invention will be described based on an embodiment shown in the drawings.

[First Embodiment]
FIG. 1 is a diagram illustrating a state in which the blood vessel access device 1 according to the first embodiment is placed in the body. FIG. 2 is a view for explaining the vascular access device 1 according to the first embodiment. 2A is a partial cross-sectional view of the first connection portion 10 and the main body 30 when the vascular access device 1 is cut along the longitudinal direction, and FIG. 2B is a sectional view of the vascular access device 1 in the longitudinal direction. It is a fragmentary sectional view of the 2nd connection part 20 when it cut | disconnects along, FIG.2 (c) is an AA arrow end surface figure of FIG.2 (b). FIG. 3 is a schematic diagram simply showing the internal flow path 40 of the vascular access device 1 according to the first embodiment.
In FIG. 1 and FIG. 2, in order to facilitate understanding of the invention, the overall size of the blood vessel access device 1 and the constituent ratios and thicknesses of the members constituting the blood vessel access device 1 are exaggerated to some extent. Yes.

  As shown in FIGS. 1 and 2, the vascular access device 1 according to the first embodiment includes a first connection unit 10, a second connection unit 20, and a connection between the first connection unit 10 and the second connection unit 20. This is a subcutaneously implantable vascular access device comprising a main body portion 30 connected to the first connection portion 10 and the second connection portion 20 at the position. The vascular access device 1 according to the first embodiment is a vascular access device for hemodialysis that serves as an entrance / exit of blood from a blood vessel to a blood circuit when performing hemodialysis.

  Although the description by illustration is abbreviate | omitted, the 1st connection part 10 is a substantially Y-shaped tubular member whose outer surface shape and inner surface shape are both perfect circles. The first connection portion 10 is provided with an upstream communication hole 12 that communicates with the internal flow path 40. As shown in FIGS. 2A and 3, the internal flow path 40 is branched into two flow paths (a first flow path 42 and a second flow path 44) at a predetermined position up to the main body 30. ing. The first flow path 42 and the second flow path 44 will be described later.

  As shown in FIG. 2C, the second connecting portion 20 is a tubular member having a gourd-like cross-sectional shape on the outer surface. A first flow path 42 and a second flow path 44 having a true circular cross section are provided in parallel inside the second connection portion 20. As shown in FIG. 2B, the second connection portion 20 includes a downstream first communication hole 22 that communicates with the first flow path 42 and a downstream second communication hole 24 that communicates with the second flow path 44. Is provided. As can be seen from FIGS. 2 and 3, the downstream first communication hole 22 is provided at a position closer to the main body 30 than the downstream second communication hole 24.

  The 1st connection part 10 and the 2nd connection part 20 are tubes which consist of silicone resins, for example. In addition, as a material which comprises the 1st connection part 10 and the 2nd connection part 20, other well-known material excellent in biocompatibility (blood compatibility), such as PTFE (polytetrafluoroethylene), for example is used suitably. be able to.

  As shown in FIG. 1, the first connection portion 10 and the second connection portion 20 are suture-connected to the right subclavian vein V2. The end of the first connection portion 10 is located in the right subclavian vein V2, and the end of the second connection portion 20 is located in the superior vena cava V1. Since blood flowing through the right subclavian vein V2 flows into the heart H (right atrium) through the superior vena cava V1, the connection position of the first connection unit 10 is “upstream”, and the second connection unit 20 The connection position is “downstream”.

  The connection method between the first connecting portion 10 and the right subclavian vein V2 will be specifically described. For example, a hole for passing the first connecting portion 10 is provided at a predetermined position on the upstream side of the right subclavian vein V2, The first connecting portion 10 and the right subclavian vein V2 are sutured and connected while the first connecting portion 10 is passed through the hole. At this time, the first connecting portion 10 is sutured so that the end of the first connecting portion 10 is located inside the right subclavian vein V2. The same applies to the connection method between the second connecting portion 20 and the right subclavian vein V2.

  As shown in FIGS. 1 and 2, the main body portion 30 includes two puncture portions 32 and 34. The puncture parts 32 and 34 are flexible artificial blood vessels, and although description by illustration is abbreviate | omitted, both the outer surface shape and inner surface shape are circular tube members. The center part of each puncture part 32 and 34 is comprised so that it may become thick compared with the edge part (connection part with the 1st connection part 10 or the 2nd connection part 20) of each puncture part 32 and 34. FIG.

  The main body 30 has, for example, a two-layer structure in which an inner layer is made of a silicone resin and an outer layer is made of a PTFE shrinkable material. Thereby, a needle can be punctured from the outside with respect to the entire circumferential direction of the main body 30, and a puncture hole (a hole formed by the punctured needle) can be closed even after the needle is removed.

  The first connection portion 10, the second connection portion 20, and the main body portion 30 are formed as separate bodies, and are securely connected so as not to cause a step between members as much as possible.

  Inside the first connection unit 10, the second connection unit 20, and the main body unit 30, an internal flow path 40 that communicates from the end of the first connection unit 10 to the end of the second connection unit 20 is provided. As shown in FIG. 2 and FIG. 3, the internal flow path 40 is located downstream from the upstream communication hole 12 in the section from the upstream communication hole 12 to the downstream first communication hole 22 and the downstream second communication hole 24. A first flow path 42 reaching the first communication hole 22 and a second flow path 44 extending from the upstream communication hole 12 to the downstream second communication hole 24 are branched. The first flow path 42 passes through the inside of the puncture section 32, and the second flow path 44 passes through the inside of the puncture section 34.

  As shown in FIG. 3, the blood removal needle N1 is inserted into the puncture section 32 (position where the first flow path 42 passes through the main body section 30), and the puncture section 34 (position where the second flow path 44 passes through the main body section 30). ), The blood in the body is sent from the downstream first communication hole 22 through the first flow path 42 to the blood circuit or the like via the blood removal needle N1. On the other hand, the blood returned from the blood circuit or the like is returned to the body through the second flow passage 44 and the downstream second communication hole 24 via the blood return needle N2.

  According to the vascular access device 1 according to the first embodiment configured as described above, since the first connection unit 10 and the second connection unit 20 are both configured to be connectable to a vein, the first connection unit 10 and the second connecting portion 20 are respectively connected to the right subclavian vein V2, the blood flowing through the right subclavian vein V2 passes through the internal flow path 40 (the first flow path 42 and the second flow path 44). It will flow to the vein V1. That is, since the vascular access device 1 according to the first embodiment is not a type that directly connects an artery and a vein as in the conventional vascular access device, the burden on the heart can be reduced more than before, As a result, it becomes possible to reduce the risk of occurrence of cardiovascular disease.

  Further, according to the vascular access device 1 according to the first embodiment, the blood flowing through the right subclavian vein V2 passes through the internal flow path 40 (the first flow path 42 and the second flow path 44) from the upstream communication hole 12. Since it is configured to flow directly to the superior vena cava V1 through the downstream first communication hole 22 or the downstream second communication hole 24, it is advantageous that blood does not easily stay in the vascular access device 1. There is. As a result, it is possible to suppress the occurrence of thrombus due to the retention of blood in the vascular access device, and if a predetermined amount of blood flow in the vascular access device 1 is secured, heparin or the like can be used. It is not necessary to inject the anticoagulant into the vascular access device 1.

  In the vascular access device 1 according to the first embodiment, since the portion branched into the first flow path 42 and the second flow path 44 exists in the first connection portion 10, the main body portion 30 has two flow paths. (The first flow path 42 and the second flow path 44) always exist. Therefore, it is possible to access the two flow paths independently from the outside. As described above, the blood removal needle N1 is inserted into the puncture portion 32 and the blood return needle is inserted into the puncture portion 34. By piercing N2, the first flow path 42 can be used as a blood removal line and the second flow path 44 can be used as a blood return line.

  In the vascular access device 1 according to the first embodiment, the downstream first communication hole 22 is provided at a position closer to the main body 30 than the downstream second communication hole 24. Thereby, the position of the downstream first communication hole 22 serving as the blood removal port and the position of the downstream second communication hole 24 serving as the blood return port can be separated from each other, so that a vascular access device having a high dialysis effect is obtained.

  In the vascular access device 1 according to the first embodiment, the first connection unit 10, the main body unit 30, and the second connection unit 20 are configured to be implantable under the skin, so that the occurrence of infectious diseases can be suppressed. It becomes possible. Moreover, since each member which comprises the vascular access device 1 becomes inconspicuous in appearance, it is excellent also from a cosmetic viewpoint.

  In the vascular access device 1 according to the first embodiment, the main body portion 30 (puncture portions 32 and 34) is composed of a flexible artificial blood vessel, and a needle can be punctured from the outside to the main body portion 30. It is configured. Thereby, when the vascular access device 1 is embedded under the skin, the vascular access device becomes more inconspicuous and is particularly excellent in cosmetics. In addition, since the needle can be punctured from the entire circumferential direction of the main body 30, even if the blood vessel access device 1 is moved or rotated somewhat after subcutaneous placement, the needle is not so difficult to puncture.

  In the vascular access device 1 according to the first embodiment, the central portion of each puncture portion 32, 34 is the end portion of each puncture portion 32, 34 (connection portion with the first connection portion 10 or the second connection portion 20). It is configured to be thicker than. As a result, it is possible to ensure a relatively wide range in which the needle can be inserted, and as a result, it is relatively easy to extend the life of each puncture portion 32, 34, and consequently to increase the life of the vascular access device 1. In addition, there is an effect that it is easy to secure a blood flow volume when blood is removed.

[Second Embodiment]
FIG. 4 is a diagram illustrating a state in which the blood vessel access device 2 according to the second embodiment is placed in the body. FIG. 5 is a view for explaining the vascular access device 2 according to the second embodiment. FIG. 5A is a cross-sectional view of the access port 72 cut along the longitudinal direction, and FIG. 5B is a cross-sectional view of the access port 74 cut along the longitudinal direction. FIG. 6 is a schematic diagram simply showing the internal flow path 90 of the vascular access device 2 according to the second embodiment.
4 and 5, in order to facilitate understanding of the invention, the overall size of the blood vessel access device 2 and the constituent ratios and thicknesses of the members constituting the blood vessel access device 2 are exaggerated to some extent. Yes.

  The vascular access device 2 according to the second embodiment basically has a configuration similar to that of the vascular access device 1 according to the first embodiment, but the configuration of the main body is the vascular access device according to the first embodiment. Different from 1.

  That is, in the vascular access device 2 according to the second embodiment, the main body 70 is composed of two access ports 72 and 74 as shown in FIGS.

  As shown in FIG. 5A, the one access port 72 includes a housing 80 whose upper surface is open, and three septa 82a, 82b, and 82c that are arranged so as to close the opening.

  The housing 80 is substantially trapezoidal. The first connection portion 50 and the second connection member 60 are connected to the side surfaces of the housing 80, respectively. On the upper surface of the housing 80, there are provided two raised portions 81a and 81b that are raised higher than the surface height of the septums 82a to 82c (the height from the bottom surface of the housing 80 to the septums 82a to 82c). The positions of the septums 82a and 82b are partitioned by the raised portions 81a, and the positions of the septums 82b and 82c are partitioned by the raised portions 81b.

  The housing 80 is made of, for example, a titanium alloy. The material constituting the housing 80 is, for example, a metal such as stainless steel or titanium, a hard synthetic resin such as polyacetal, or a ceramic such as a ceramic that does not easily penetrate the septum and has excellent biocompatibility. Other known materials can be preferably used.

  The septums 82a to 82c are made of, for example, a silicone resin. In addition, as a constituent material of the septums 82a to 82c, for example, PTFE (polytetrafluoroethylene) or the like, other known materials that can puncture a needle from the outside, have a self-sealing property, and have excellent biocompatibility. It can be used suitably.

  As shown in FIG. 5B, the other access port 74 has a housing 84 whose upper surface is open, and three septa 86a, 86b, 86c arranged so as to close the opening. The structures and functions of the housing 84 and the septums 86a to 86c and the raised portions 85a and 85b are the same as those of the housing 80, the septums 82a to 82c and the raised portions 81a and 81b in the access port 72, and detailed description thereof is omitted. To do.

  Inside the first connection unit 50, the second connection unit 60, and the main body unit 70, an internal flow path 90 that communicates from the end of the first connection unit 50 to the end of the second connection unit 60 is provided ( (See FIG. 6.) As shown in FIG. 5 and FIG. 6, the internal flow path 90 is located downstream from the upstream communication hole 52 in the section from the upstream communication hole 52 to the downstream first communication hole 62 and the downstream second communication hole 64. A first flow path 92 that reaches the first communication hole 62 and a second flow path 94 that reaches from the upstream communication hole 52 to the downstream second communication hole 64 are branched. The first flow path 92 passes through the access port 72, and the second flow path 94 passes through the access port 74.

  As shown in FIG. 6, the blood removal needle N1 is inserted into any one of the septa 82a to 82c in the access port 72, and the blood is returned to any one of the septa 86a to 86c in the access port 74. By piercing the needle N2, the blood in the body is sent from the downstream first communication hole 62 to the blood circuit or the like through the first flow path 92 and the blood removal needle N1, while The blood returned from the blood circuit or the like is returned to the body through the second flow path 94 and the downstream second communication hole 64 via the blood return needle N2.

In addition, the position of the vein to which the first connection unit 50 and the second connection unit 60 are connected, the materials constituting the first connection unit 50 and the second connection unit 60, and the like described in the first embodiment. Since it is the same as that of the 1 connection part 10 and the 2nd connection part 20, detailed description is abbreviate | omitted.
In addition, the vascular access device 2 according to the second embodiment is a blood vessel dialysis access device for hemodialysis similar to the vascular access device 1 according to the first embodiment.

  As described above, the vascular access device 2 according to the second embodiment differs from the vascular access device 1 according to the first embodiment in the configuration of the main body, but is similar to the case of the vascular access device 1 according to the first embodiment. In addition, both the first connection part 50 and the second connection part 60 are configured to be connectable to a vein, and are not of a type that directly connects an artery and a vein as in a conventional vascular access device. The burden on the heart can be reduced, and as a result, the risk of occurrence of cardiovascular disease can be reduced.

  Further, according to the vascular access device 2 according to the second embodiment, the blood flowing through the right subclavian vein V2 flows from the upstream communication hole 52 into the internal flow as in the case of the vascular access device 1 according to the first embodiment. Through the passage 90 (the first flow path 92 and the second flow path 94), it flows through the downstream first communication hole 62 or the downstream second communication hole 64 and flows directly to the superior vena cava V1. Therefore, there is an advantage that blood does not easily stay in the blood vessel access device 2. As a result, it is possible to suppress the occurrence of thrombus caused by the retention of blood in the vascular access device, and if a predetermined amount of blood flow in the vascular access device 2 can be secured, heparin or the like It is not necessary to inject the anticoagulant into the vascular access device 2. By eliminating the need to inject the anticoagulant into the vascular access device 2, the volume of the internal flow path of the main body 70 can be made relatively large.

  In the vascular access device 2 according to the second embodiment, since the main body portion 70 is configured by the access ports 72 and 74, it is relatively easy to confirm the position of the vascular access device 2 by palpation after subcutaneous placement.

  In the vascular access device 2 according to the second embodiment, since the septum portion is composed of three septa 82a to 82c and 86a to 86c, puncture is performed in a patient who needs hemodialysis three times a week, for example. There is an advantage that the puncture position can be clearly distinguished, for example, the puncture position can be easily switched according to the day of the week. In addition, since the raised portions 81a, 81b, 85a, and 85b are provided, the puncture position can be more clearly distinguished.

  The vascular access device 2 according to the second embodiment has the same configuration as that of the vascular access device 1 according to the first embodiment except that the configuration of the main body is different, and thus the vascular access device 1 according to the first embodiment. Among the effects possessed, the corresponding effect is maintained as it is.

  The vascular access device of the present invention has been described based on each of the above embodiments. However, the present invention is not limited to each of the above embodiments, and can be implemented in various modes without departing from the gist thereof. For example, the following modifications are possible.

(1) In each of the above embodiments, the case where both the first connection portion and the second connection portion are connected to the right subclavian vein V2 has been described as an example, but the present invention is not limited to this. Absent. For example, both the first connection portion and the second connection portion may be connected to the left subclavian vein V3, the first connection portion is connected to the internal jugular vein V4, and the second connection portion is connected to the superior vena cava V1. It may be connected. In addition, if the blood flow necessary for dialysis can be secured, it is possible to connect to a vein in another position (for example, a femoral vein in the groin) instead of a vein around the heart.

(2) In each of the above embodiments, when connecting the first connection portion and the second connection portion to the vein, a position that is not the end of each connection member (predetermined from the connection end portion to the opposite end portion of the main body portion) Although the case where it is sutured and connected to the vein at the position) has been described as an example, the present invention is not limited to this. For example, the end of the first connection part or the second connection part may be stitched and connected (so-called side end anastomosis) to a hole provided in the vein side wall.

(3) In the first embodiment, the case where both the outer surface shape and the inner surface shape of the first connecting portion 10 and the main body portion 30 are true circles has been described as an example, but the present invention is limited to this. Instead, for example, it may be a circular tube having an elliptical cross section, or a rectangular tube having a polygonal cross section. Further, the outer surface shape and the inner surface shape when the vascular access device of the present invention is cut in a cross section perpendicular to the longitudinal direction are not necessarily the same shape. For example, the outer surface shape is an ellipse and the inner surface shape is a perfect circle. The outer surface shape may be a polygon, and the inner surface shape may be an ellipse or a true circle. The same applies to the first connection portion 50 in the second embodiment.

(4) In each of the above embodiments, the case where the cross-sectional shapes of the first flow path and the second flow path provided inside the second connection portion are true circles has been described as an example. The shape is not limited to the above, and may be another shape such as an elliptical cross section.

(5) In the first embodiment, as shown in FIGS. 2 and 3 (particularly FIG. 2C), the first flow path 42 and the second flow path 44 are provided inside the second connection portion 20. Although the case where it is provided so as to be lined up and down has been described as an example, the present invention is not limited to this.
FIG. 7 is a view for explaining a blood vessel access device 1A according to a modification. FIG. 7A is a schematic diagram simply showing the internal flow path 40A of the vascular access device 1A according to the modification, and FIG. 7B shows the second connection portion 20A in the downstream side first communication hole 22A and the downstream side. It is the perspective view seen from the side 2nd communicating hole 24A side. 7A, the same members as those in FIG. 3 are denoted by the same reference numerals, and detailed description thereof is omitted.
For example, as shown in FIG. 7, the first flow path 42 </ b> A and the second flow path 44 </ b> A may be concentrically arranged in the second connection portion 20 </ b> A. In this case, if the internal flow path is arranged so that the first flow path 42A is on the outside and the second flow path 44A is on the inside, the downstream first communication hole 22A is more main body portion than the downstream second communication hole 24A. It will be provided at a position close to 30.

(6) In the first embodiment, the case where the first flow path 42 and the second flow path 44 are arranged in parallel inside the second connection portion 20 has been described as an example. For example, the second connection portion is composed of two independent tubes, the first flow path is provided inside one tube, and the second flow path is provided inside the other tube. It may be what was made.

(7) In the first embodiment, the case where the main body has a two-layer structure (inner layer: silicone resin, outer layer: PTFE shrinkable material) has been described as an example, but the present invention is limited to this. is not. If the needle can be punctured from the outside and the puncture hole can be closed even after the needle is pulled out, it may be composed of, for example, three or more layers, or may be composed of a single layer. May be. In the case of being composed of a plurality of layers, each layer may be composed of the same material or different materials. When it is composed of a single layer, or when there are multiple layers and the materials constituting each layer are the same, for example, the inner surface side is a dense layer and the outer surface side is a porous layer, or the inner surface side is a porous layer. The layer density may be changed depending on the position in the radial direction, for example, the outer surface side may be a dense layer.

(8) In the first embodiment, the case where the first connection portion, the second connection portion, and the main body portion are formed as separate bodies has been described as an example, but the present invention is not limited to this. Alternatively, each member may be integrally formed.

(9) In the second embodiment, the case where the overall shape of the housing is substantially trapezoidal has been described as an example. However, the present invention is not limited to this, and for example, the corners are rounded with a predetermined curvature. Other shapes such as a processed substantially rectangular parallelepiped shape may be used.

(10) In the second embodiment, the case where the number of septa in each access port is three has been described as an example. However, the present invention is not limited to this, and the septum in each access port is not limited to this. The number may be one, two, four or more.

(11) In the second embodiment, the case where the two access ports 72 and 74 constituting the main body 70 are separate (the access ports are separated and independent) has been described as an example. The invention is not limited to this. If the first flow path and the second flow path are separated by a partition wall or the like, the two access ports 72 and 74 themselves may be integrated.

  The vascular access device of the present invention can be used in various blood purification therapies such as plasma exchange therapy as well as hemodialysis as a vascular access device capable of reducing the risk of occurrence of cardiovascular disease than before. It can also be used as a vascular access device for injecting drugs such as anticancer drugs.

1, 1A, 2 Blood vessel access device 10, 50 First connection portion 12, 52 Upstream communication hole 20, 20A, 60 Second connection portion 22, 22A, 62 Downstream first communication hole 24, 24A, 64 Downstream first Two communication holes 30, 70 Main body portions 32, 34 Puncture portions 40, 40A, 90 Internal flow paths 42, 42A, 92 First flow paths 44, 44A, 94 Second flow paths 72, 74 Access ports 80, 84 Housing 81a, 81b, 85a, 85b Raised portions 82a, 82b, 82c, 86a, 86b, 86c Septum H Heart N1 Blood removal needle N2 Blood return needle V1 Upper vena cava V2 Right subclavian vein V3 Left subclavian vein V4 Internal neck vein

Claims (6)

A tubular first connection (10) configured to be connectable to a vein;
A tubular second connection part (20) configured to be connectable to a vein at a position downstream of the position of the vein to which the first connection part (10) is connected;
A body portion (30) connected to the first connection portion (10) and the second connection portion (20) at a position between the first connection portion (10) and the second connection portion (20); With
The first connection part (10), the second connection part (20), and the main body part (30) are connected to the second connection part (20) from the end of the first connection part (10). An internal channel (40) communicating to the end is provided,
The main body (30) is configured to be able to send the fluid to the outside when the fluid is present in the internal channel (40) and to receive the fluid from the outside to the internal channel (40). And
The first connection portion (10) is provided with an upstream communication hole (12) communicating with the internal flow path (40),
The second connection part (20) is provided with a downstream first communication hole (22) and a downstream second communication hole (24) communicating with the internal flow path (40),
The internal flow path (40) includes the upstream communication hole (12) in a section from the upstream communication hole (12) to the downstream first communication hole (22) and the downstream second communication hole (24). 12) to the downstream first communication hole (22), and a second flow path (44) from the upstream communication hole (12) to the second downstream communication hole (24). The blood vessel access device (1) is branched to The vascular access device of claim 1.
The blood vessel access device (1) is characterized in that a portion branched into the first flow path (42) and the second flow path (44) exists in the first connection portion (10). The vascular access device according to claim 1 or 2,
One communication hole of the downstream first communication hole (22) and the second downstream communication hole (24) is provided at a position closer to the main body (30) than the other communication hole. A vascular access device (1) characterized by The vascular access device according to any one of claims 1 to 3,
The vascular access device (1), wherein the first connection portion (10), the main body portion (30), and the second connection portion (20) are configured to be implantable subcutaneously. The vascular access device according to any one of claims 1 to 4,
The main body (30) is composed of a flexible artificial blood vessel,
A vascular access device (1), wherein the main body (30) is configured to be able to puncture a needle from the outside. The vascular access device according to any one of claims 1 to 4,
The main body (70) includes an access port (72, 74) having a housing (80, 84) whose upper surface is open and a septum (82a to 82c, 86a to 86c) arranged to close the opening. Consists of
The internal flow path (92, 94) is formed by the housing (80, 84) and the septum (82a-82c, 86a-86c),
The vascular access device (2), wherein the septum (82a to 82c, 86a to 86c) is configured to be able to puncture a needle from the outside.