JP5662139B2 - Vascular access device - Google Patents

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.

  The vascular access device (1) of the present invention includes a tubular first connecting member (10), a tubular second connecting member (20), the first connecting member (10), and the second connecting member (20). The internal flow path is connected to the first connection member (10) and the second connection member (20) at a position between them and communicates with the first connection member (10) and the second connection member (20). (32), and at least a part of the main body (30) is capable of delivering the fluid to the outside when the fluid is present in the internal flow path (32), and The first connection member (10) is configured to be connectable to a vein, and the second connection member (20) is configured to receive fluid from the outside to the internal flow path (32). A vein to which the first connecting member (10) is connected It characterized in that it is connectable to at a location downstream of the location.

  For this reason, according to the vascular access device of the present invention, since both the first connection member and the second connection member are configured to be connectable to the vein, each of the first connection member and the second connection member is 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, the internal flow path of the main body portion and the first connection member and the second connection member communicate with each other, and blood flowing through the vein passes directly through the internal flow path 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 member and the second connection member are respectively connected to the same vein, for example, when both the first connection member and the second connection member are connected to the right subclavian vein, the connection of the first connection member The position is the upstream position (position far from the heart) of the right subclavian vein, and the connection position of the second connecting member is the downstream position (position close to the heart) of the right subclavian vein. Further, when the first connection member and the second connection member are respectively connected to different veins and continuous veins, for example, the first connection member and the second connection member are connected to the right subclavian vein and the superior vena cava. When connected, the connection position of the first connection member is the right subclavian vein upstream of the superior vena cava, and the connection position of the second connection member is downstream of the right subclavian vein. It becomes the superior vena cava.

  In the vascular access device (1) of the present invention, the first connection member (10) and the second connection member (20) are both circular and the inner diameter (d2) of the second connection member (20). Is preferably larger than the inner diameter (d1) of the first connecting member (10).

  When the first connecting member and the second connecting member are connected to the veins, if the inner diameter of the second connecting member located on the downstream side is larger than the inner diameter of the first connecting member located on the upstream side, the main body portion is interposed. Therefore, there is an advantage that it is easy to secure the blood flow when blood is removed.

  In the vascular access device (2) of the present invention, the first connecting member (12) and the second connecting member (22) are both tubular, and the inner diameter of the first connecting member (12) ( It is also preferable that d1) is larger than the inner diameter (d2) of the second connecting member (22).

  When the first connecting member and the second connecting member are connected to the vein, if the inner diameter of the first connecting member located on the upstream side is larger than the inner diameter of the second connecting member located on the downstream side, the first from the vein Since the amount of blood flowing into the connecting member is relatively increased, it is possible to further suppress thrombus generation in the vascular access device.

  In the vascular access device (1) of the present invention, the first connecting member (10), the main body (30), and the second connecting member (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 (1) of the present invention, the main body (30) is composed of a single artificial blood vessel, and the outer surface area per unit length of the main body (30) is the first It is preferable that the outer surface area per unit length of the connecting member (10) and the outer surface area per unit length of the second connecting member (20) are larger.

By the way, if a needle with a sharp tip is punctured many times into an artificial blood vessel, the artificial blood vessel will gradually be damaged. Therefore, as a device for using the artificial blood vessel for as long as possible, the position where the needle is inserted for each puncture is slightly It has been conventionally performed to shift each one. However, if the surface area of the main body is relatively small, the range in which the needle can be inserted becomes narrow, so even if the needle insertion position is slightly shifted for each puncture, it is possible to extend the life of the main body. It's not easy.
On the other hand, according to the vascular access device of the present invention, the outer surface area per unit length of the main body portion is the outer surface area per unit length of the first connection member and the outer surface area per unit length of the second connection member. Since it is larger than the surface area, it is possible to ensure a relatively wide range in which the needle can be inserted. As a result, it is relatively easy to extend the life of the main body and hence the life of the vascular access device.

  In the vascular access device (3) of the present invention, the main body (50) is connected to the first connection member (14) and the second connection member (24), respectively, and the first connection member (14). And a main pipe (51) communicating with the second connection member (24), and a sub pipe (53) connected to the main pipe (51) and communicating with the main pipe (51), the main pipe (51). And the internal flow path (52, 54) constituted by the sub pipe (53) is a section from a position communicating with the first connecting member (14) to a position communicating with the second connecting member (24). It is also preferable that a route passing only the main pipe (51) and a route passing through the sub pipe (53) are secured when a fluid flows through the internal flow path (52, 54).

  Also with this configuration, it is possible to ensure a relatively wide range where the needle can be inserted. As a result, it is relatively easy to extend the life of the main body and hence the life of the vascular access device.

  In the vascular access device of the present invention, it is preferable that there are a plurality of the secondary tubes.

  By configuring in this way, it is possible to secure a wider range in which the needle can be inserted, and to further extend the life of the vascular access device.

  In the vascular access device (4) of the present invention, the main body (60) includes a housing (70) whose upper surface is opened and a septum (74a, 74b, 74c) arranged so as to close the opening. The internal flow path (62) is formed by the housing (70) and the septum (74a, 74b, 74c), and the septum (74a, 74b, 74c) It is also preferable that the needle can be punctured.

  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 conceptual diagram 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. The figure shown in order to demonstrate the vascular access device 2 which concerns on 2nd Embodiment. The figure shown in order to demonstrate the vascular access device 3 which concerns on 3rd Embodiment. The conceptual diagram which shows the state which left the vascular access device 4 which concerns on 4th Embodiment in the body. The figure shown in order to demonstrate the vascular access device 4 which concerns on 4th Embodiment.

  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 conceptual diagram showing 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 cross-sectional view of the vascular access device 1 taken along the longitudinal direction, and FIG. 2B shows the first connecting member 10, the second connecting member 20, and the main body 30 in FIG. It is a figure shown as an AA arrow end face of (a), a BB arrow end face, and a CC arrow end face. A broken line shown in FIG. 2B is an auxiliary line for clarifying the comparison of the inner diameter dimension or the outer diameter dimension of the first connection member 10, the second connection member 20, and the main body 30.
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 member 10, a second connection member 20, and between the first connection member 10 and the second connection member 20. And a main body portion 30 connected to the first connecting member 10 and the second connecting member 20 at the position of (2). 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.

  As shown in FIG. 2B, the first connecting member 10 and the second connecting member 20 are circular tube members whose outer surface shape and inner surface shape are both perfectly circular. The inner diameter d2 of the second connection member 20 is larger than the inner diameter d1 of the first connection member 10.

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

  As shown in FIG. 1, the first connecting member 10 and the second connecting member 20 are connected to the right subclavian vein V2 by stitching. The end of the first connecting member 10 is located in the right subclavian vein V2, and the end of the second connecting member 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 member 10 becomes “upstream”, and the second connection member 20 The connection position is “downstream”.

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

  The main body 30 is composed of a single flexible artificial blood vessel. As shown in FIG. 2A, the main body 30 includes internal flow channels 32 that communicate with the first connection member 10 and the second connection member 20, respectively. Have. As shown in FIG. 2B, the main body 30 is a circular tube member whose outer surface shape and inner surface shape are both perfectly circular. Further, the central portion of the main body portion 30 is configured to be thicker than the end portion of the main body portion 30 (connection portion with the first connection member 10 or the second connection member 20). More specifically, the outer diameter D3 of the main body 30 is larger than the outer diameter D1 of the first connecting member 10 and the outer diameter D2 of the second connecting member 20. When compared as the outer surface area per unit length, since “D3> D1, D2” as described above, the outer surface area per unit length of the main body 30 is per unit length of the first connecting member 10. And the outer surface area per unit length of the second connecting member 20 is larger.

  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.

  When the main body 30 is punctured with a needle, blood existing in the internal flow path 32 is pumped out to the blood circuit connected to the needle when blood is removed, and blood is returned from the blood circuit or the like to the internal flow path 32 when returning blood. Will be returned.

  After the first connecting member 10, the second connecting member 20, and the main body 30 are formed as separate bodies, the first connecting member 10, the second connecting member 20, and the main body 30 are securely connected so as not to cause a step difference between the members.

  According to the vascular access device 1 according to the first embodiment configured as described above, the first connection member 10 and the second connection member 20 are both configured to be connectable to a vein. When 10 and the second connecting member 20 are respectively connected to the right subclavian vein V2, blood flowing through the right subclavian vein V2 flows through the internal flow path 32 to the superior vena cava 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 internal flow path 32 of the main body 30 is in communication with the first connecting member 10 and the second connecting member 20 and flows through the right subclavian vein V2. Since blood is configured to flow through the internal flow path 32 to the superior vena cava V1, there is an advantage that the blood does not easily stay in the blood vessel access device 1. 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 inner diameter d2 of the second connection member 20 is larger than the inner diameter d1 of the first connection member 10, the blood flow volume when blood is removed through the main body 30 is reduced. There is a benefit that it is easy to secure.

  In the vascular access device 1 according to the first embodiment, the first connection member 10, the main body 30, and the second connection member 20 are configured to be implantable under the skin, thereby suppressing the occurrence of infectious diseases. 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 blood vessel access device 1 according to the first embodiment, the main body portion 30 is configured by a flexible artificial blood vessel, and is configured to be able to puncture the main body portion 30 from the outside. 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 outer surface area per unit length of the main body 30 is the outer surface area per unit length of the first connecting member 10 and the unit length of the second connecting member 20. Since the outer surface area is larger than the outer surface area, a relatively wide range of the needle can be secured. As a result, it is relatively easy to extend the life of the main body 30 and, in turn, extend the life of the vascular access device 1.

[Second Embodiment]
FIG. 3 is a view for explaining the vascular access device 2 according to the second embodiment. 3A is a cross-sectional view when the vascular access device 2 is cut along the longitudinal direction, and FIG. 3B shows the first connecting member 12 and the second connecting member 22 in FIG. 3A, respectively. It is a figure shown as an AA arrow end surface and a BB arrow end surface. A broken line shown in FIG. 3B is an auxiliary line for clarifying the comparison of the inner diameter dimensions of the first connecting member 12 and the second connecting member 22.
In FIG. 3, in order to facilitate understanding of the invention, the constituent ratios and thicknesses of the members constituting the blood vessel access device 2 are exaggerated to some extent.

  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 inner diameters of the first connection member and the second connection member are the same. The relationship is different from the vascular access device 1 according to the first embodiment.

  That is, in the vascular access device 2 according to the second embodiment, the inner diameter d1 of the first connection member 12 is larger than the inner diameter d2 of the second connection member 22, as shown in FIG.

  In addition, about the position of the vein to which the 1st connection member 12 and the 2nd connection member 22 are connected, and the material etc. which comprise the 1st connection member 12, the 2nd connection member 22, and the main-body part 40, 1st Embodiment. Since it is the same as that of the case of the 1st connection member 10, the 2nd connection member 20, and the main-body part 30 which were demonstrated by (1), detailed description is abbreviate | omitted.

  Thus, the vascular access device 2 according to the second embodiment is different from the vascular access device 1 according to the first embodiment in that the inner diameter d1 of the first connection member 12 is larger than the inner diameter d2 of the second connection member 22. The first connection member 12 and the second connection member 22 are both configured to be connectable to a vein, as in the case of the vascular access device 1 according to the first embodiment. Because it is not a type that directly connects arteries and veins like other vascular access devices, it can reduce the burden on the heart than before, and as a result, the risk of occurrence of cardiovascular disease can be reduced It becomes.

  Further, according to the vascular access device 2 according to the second embodiment, as in the case of the vascular access device 1 according to the first embodiment, the internal flow path 42 of the main body 40, the first connection member 12, and the second connection. Since it is in communication with the member 22 and configured such that blood flowing through the vein flows to the vein through the internal flow path 42, there is an advantage that blood does not easily stay in the vascular 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.

  In the vascular access device 2 according to the second embodiment, since the inner diameter d1 of the first connection member 12 is configured to be larger than the inner diameter d2 of the second connection member 22, the vein connects the first connection member 12. As a result, the amount of blood flowing into the blood vessel is relatively increased, and as a result, thrombus generation in the blood vessel access device 2 can be further suppressed.

  The blood vessel access device 2 according to the second embodiment is the blood vessel according to the first embodiment except that the inner diameter d1 of the first connection member 12 is configured to be larger than the inner diameter d2 of the second connection member 22. Since it has the same configuration as that of the access device 1, it has the corresponding effect as it is among the effects of the vascular access device 1 according to the first embodiment.

[Third Embodiment]
FIG. 4 is a view for explaining the blood vessel access device 3 according to the third embodiment. In FIG. 4, the vascular access device 3 is illustrated as a cross section cut along the longitudinal direction.
In FIG. 4, in order to facilitate understanding of the invention, the component ratio and thickness of each member constituting the blood vessel access device 3 are exaggerated to some extent.

  The vascular access device 3 according to the third 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 3 according to the third embodiment, as shown in FIG. 4, the main body 50 is connected to the main pipe 51 connected to the first connection member 14 and the second connection member 24, respectively. And a connected secondary pipe 53.

  Both the main pipe 51 and the sub pipe 53 are constructed of artificial blood vessels. Each of the main pipe 51 and the sub pipe 53 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, the needle can be punctured from the outside in the entire circumferential direction of the main tube 51 and the sub tube 53, and the puncture hole (the hole formed by the punctured needle) can be closed even after the needle is removed. .

  The main pipe 51 has an internal flow path 52 that communicates with the first connection member 14 and the second connection member 24. The sub pipe 53 has an internal flow path 54 that communicates with the main pipe 51. Although the description by illustration is abbreviate | omitted, the main pipe 51 and the subpipe 53 are circular pipe members in which an outer surface shape and an inner surface shape are both perfect circles.

  The internal flow paths 52 and 54 constituted by the main pipe 51 and the sub pipe 53 pass through the blood vessel access device 3 in a section from a position communicating with the first connection member 14 to a position communicating with the second connection member 24. A route that passes only the main pipe 51 when flowing (that is, a route that flows through the internal flow path 52) and a route that passes through the sub pipe 53 (that is, a route that flows through the internal flow path 54) are secured.

  After the first connecting member 14, the second connecting member 24, and the main body 50 (the main pipe 51 and the sub pipe 53) are formed as separate bodies, they are securely connected so that no step is generated between the members. Has been.

  The position of the vein to which the first connection member 14 and the second connection member 24 are connected, the materials constituting the first connection member 14 and the second connection member 24, and the like described in the first embodiment. Since it is the same as that of the 1 connection member 10 and the 2nd connection member 20, detailed description is abbreviate | omitted.

  As described above, the vascular access device 3 according to the third embodiment is different 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, the first connecting member 14 and the second connecting member 24 are both configured to be connectable to a vein, and are not of the type directly connecting 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 3 according to the third embodiment, as in the case of the vascular access device 1 according to the first embodiment, the internal flow paths 52 and 54 of the main body 50, the first connection member 14, 2 The communication with the connection member 24 is such that blood flowing through the veins flows into the veins through the internal flow paths 52 and 54, so that the blood is unlikely to stay in the blood vessel access device 3. There is an advantage. As a result, it is possible to suppress the generation 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 3 is secured, heparin or the like It is not necessary to inject the anticoagulant into the vascular access device 3. By eliminating the need for injecting the anticoagulant into the vascular access device 3, the volumes of the internal channels 52 and 54 of the main body 50 can be made relatively large.

  In the blood vessel access device 3 according to the third embodiment, as described above, the main body 50 includes the main pipe 51 and the sub pipe 53, and the internal flow paths 52 and 54 configured by the main pipe 51 and the sub pipe 53 are In the section from the position communicating with the first connecting member 14 to the position communicating with the second connecting member 24, the route passes only through the main pipe 51 when blood flows into the blood vessel access device 3, and the sub pipe 53. The route to be secured. Thereby, the range which can stab a needle | hook can be ensured comparatively widely. As a result, it is relatively easy to extend the life of the main body 50 and hence the life of the blood vessel access device 3.

  Since the vascular access device 3 according to the third 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, the vascular access device 1 according to the first embodiment. Among the effects possessed, the corresponding effect is maintained as it is.

[Fourth Embodiment]
FIG. 5 is a conceptual diagram showing a state in which the blood vessel access device 4 according to the fourth embodiment is placed in the body. FIG. 6 is a view for explaining the vascular access device 4 according to the fourth embodiment. In FIG. 6, the vascular access device 4 is illustrated as a cross section cut along the longitudinal direction.
5 and 6, in order to facilitate understanding of the invention, the overall size of the vascular access device 4 and the constituent ratios of the members constituting the vascular access device 4 are exaggerated to some extent.

  The vascular access device 4 according to the fourth 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 4 according to the fourth embodiment, as shown in FIGS. 5 and 6, the main body 60 is configured by a so-called access port.

  More specifically, the main body 60 includes a housing 70 whose upper surface is open, and three septa 74a, 74b, and 74c arranged so as to close the opening.

  As shown in FIG. 5, the housing 70 has a substantially trapezoidal shape. The first connecting member 16 and the second connecting member 26 are connected to the side surfaces of the housing 70, respectively. On the upper surface of the housing 70, there are provided two raised portions 72a and 72b that are raised higher than the surface height of the septums 74a to 74c (the height from the bottom surface of the housing 70 to the septums 74a to 74c). The positions of the septums 74a and 74b are partitioned by the raised portions 72a, and the positions of the septums 74b and 74c are partitioned by the raised portions 72b.

  The housing 70 is made of, for example, a titanium alloy. The material constituting the housing 70 is, for example, a metal such as stainless steel or titanium, a hard synthetic resin such as polyacetal, or a ceramic, etc. Other known materials can be preferably used.

The septums 74a to 74c are made of, for example, a silicone resin. As the constituent material of the septum 74 a - 74 c, for example, PTFE (polytetrafluoroethylene), etc., having a puncturable possible and self-sealing needle from the outside, the other publicly known having excellent biocompatible material Can be suitably used.

  An internal flow path 62 is formed by the housing 70 and the septums 74a to 74c. The internal flow path 62 communicates with the first connection member 16 and the second connection member 26 connected to the housing 70.

The position of the vein to which the first connection member 16 and the second connection member 26 are connected, the materials constituting the first connection member 16 and the second connection member 26, and the like described in the first embodiment. Since it is the same as that of the 1 connection member 10 and the 2nd connection member 20, detailed description is abbreviate | omitted.
The vascular access device 4 according to the fourth embodiment is a vascular access device for hemodialysis and subcutaneously implanted, similar to the vascular access device 1 according to the first embodiment.

  As described above, the vascular access device 4 according to the fourth embodiment is different 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, the first connection member 16 and the second connection member 26 are both 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 4 according to the fourth embodiment, as in the case of the vascular access device 1 according to the first embodiment, the internal flow path 62 of the main body 60, the first connection member 16, and the second connection. Since it is in communication with the member 26 and the blood flowing through the vein flows into the vein through the internal flow path 62, there is an advantage that the blood is less likely to stay in the vascular access device 4. . As a result, it is possible to suppress the generation 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 4 can be secured, heparin or the like The anticoagulant does not need to be injected into the vascular access device 4. By eliminating the need to inject the anticoagulant into the vascular access device 4, the volume of the internal flow path 62 of the main body 60 can be made relatively large.

  In the vascular access device 4 according to the fourth embodiment, since the main body 60 is configured by an access port having the housing 70 and the septums 74a to 74c, the position of the vascular access device 4 can be confirmed by palpation after subcutaneous placement. Relatively easy.

  In the vascular access device 4 according to the fourth embodiment, since the septum portion is composed of three septa 74a to 74c, for example, according to the day of the week for puncture in a patient requiring hemodialysis three times a week. There is an advantage that the puncture position can be clearly distinguished, for example, it becomes easy to switch the puncture position. Further, since the raised portions 72a and 72b are provided, the puncture position can be more clearly distinguished.

  Since the vascular access device 4 according to the fourth 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, 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 connecting member and the second connecting member 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 connecting member and the second connecting member may be connected to the left subclavian vein V3, the first connecting member is connected to the internal jugular vein V4, and the second connecting member 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 connecting member and the second connecting member to the vein, a position that is not the end of each connecting member (predetermined from the connecting end portion to the main body portion to the opposite end 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 member or the second connection member may be suture-connected (so-called side end anastomosis) to a hole provided in the vein side wall.

(3) In the first embodiment and the second embodiment described above, the first connecting member, the second connecting member, and the main body portion have been described by way of example as a circular tube having a perfectly circular cross section. For example, it may be a circular tube with an elliptical cross section, or a rectangular tube with 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.

(4) In the first to third embodiments, the case where the main body (in the third embodiment, the main pipe and the sub pipe) has a two-layer structure (inner layer: silicone resin, outer layer: PTFE shrinkable material) is exemplified. However, the present invention is not limited to this. 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.

(5) In the said 1st Embodiment and 2nd Embodiment, although the case where the 1st connection member, the 2nd connection member, and the main-body part were formed as a different body was demonstrated and demonstrated, this invention is based on this. It is not limited and each member may be integrally formed.

(6) In the said 3rd Embodiment, although the case where the number of subpipes was one was illustrated and demonstrated, this invention is not limited to this, The number of subpipes is two or more, Also good. In this case, it is possible to secure a wider range in which the needle can be inserted and to further extend the life of the vascular access device.

(7) In the fourth 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.

(8) In the fourth embodiment, the case where the number of septums is three is described as an example. However, the present invention is not limited to this, and the number of septums is one, two, or There may be four or more.

  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, 2, 3, 4 Blood vessel access device 10, 12, 14, 16 First connecting member 20, 22, 24, 26 Second connecting member 30, 40, 50, 60 Main body 32, 42, 52, 54, 62 Internal flow path 70 Housings 72a, 72b Raised portions 74a, 74b, 74c Septum D1 Outer diameter D2 of first connecting member Outer diameter D2 of second connecting member Outer diameter d1 of main body d2 Inner diameter d2 of first connecting member Second connecting member Inner diameter H heart V1 superior vena cava V2 right subclavian vein V3 left subclavian vein V4 internal jugular vein

Claims (1)

A tubular first connecting member (10);
A second tubular connection member (20);
The first connecting member (10) and the second connecting member (20) are connected to the first connecting member (10) and the second connecting member (20) at a position between the first connecting member (10) and the second connecting member (20). 10) and a main body (30) having an internal flow path (32) communicating with the second connection member (20),
At least a part of the main body (20) can send the fluid to the outside when the fluid is present in the internal flow path (32), and can pass the fluid from the outside to the internal flow path (32). Configured to be acceptable,
The first connecting member (10) is configured to be connectable to a subclavian vein,
The second connection member (20) is the same subclavian vein or superior vena cava as the subclavian vein to which the first connection member (10) is connected, and the first connection member (10) is connected to the second connection member (20). It is configured to be connectable at a position downstream of the position ,
In the first connecting member (10) and the second connecting member (20), the end of the first connecting member (10) is located in the subclavian vein and the end of the second connecting member (20) Is located in the superior vena cava,
The vascular access device (1) , wherein an inner diameter (d2) of the second connection member (20) is larger than an inner diameter (d1) of the first connection member (10 ).

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