JPH1033666A - Bypass tube - Google Patents

Abstract

PROBLEM TO BE SOLVED: To provide a bypass tube which his used with a catheter, by which a required blood flow is secured to prevent a lesion caused by ischemia. SOLUTION: A bypass tube 1 comprises two tubes 14, each one end of which is connected to both sides of a valve member 10 through a connector 12, and an insert member 16 connected to the other end of each tube 14 through a connector 12. The bypass tube 1 is used jointly with an IABP balloon catheter, for example, and in the case of inserting the catheter from one femoral artery, the tube is installed in such a manner as to communicate the femoral artery on the periphery side from the insert position with the other femoral artery. Thus, even if a catheter insert position is obstructed in the catheter insert position, ischemia of the legs can be prevented by blood flowing-in from the other femoral artery.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001]

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates to a bypass tube used to secure blood flow to a blood vessel downstream of a blood flow obstruction.

[0002]

2. Description of the Related Art In recent years, with the advance of medical technology, even in cases where surgery was required before, a catheter is percutaneously inserted from a femoral artery or the like, and the vicinity of the heart is passed through a blood vessel. By carrying out various tests, treatments, and the like, treatments with little burden on patients can be performed.

[0003]

However, there are still points to be improved in treatment using a catheter, one of which is lower limb ischemia when using a catheter. This is because when a catheter or the like is inserted into the blood vessel from the femoral artery of the lower limb, the catheter itself or a tube (sheath) used for percutaneous insertion becomes an obstacle, causing blood flow obstruction. In the worst case, if the ischemia of the lower limb occurs, there is a risk of causing necrosis in a part of human body tissue.

For this reason, in the past, efforts have been made to ensure blood flow by making the outer diameter of the catheter or sheath as small as possible. However, there is a limit in reducing the diameter of the catheter, and the blood vessel diameter is relatively small. In some cases, treatment using a catheter cannot be performed for patients with small sickness. Further, when the diameter of the catheter is increased, there is a problem that the functional aspect or the strength aspect of the catheter cannot be improved.

SUMMARY OF THE INVENTION The present invention has been made to solve the above-mentioned problems, and an object of the present invention is to provide a bypass which can be used together with a catheter to secure a necessary blood flow and prevent a failure caused by ischemia. To provide a tube.

[0006]

Means for Solving the Problems and Effects of the Invention In order to achieve the above-mentioned object, a bypass tube of the present invention comprises:
As described in claim 1, a long and flexible tube, provided at both ends of the tube, the distal end is shaped to be insertable into a blood vessel, and a through-hole penetrating from the distal end into the tube is formed. And an insertion member.

According to the bypass tube of the present invention, when the distal ends of the insertion members at both ends of the tube are inserted into the blood vessel, blood flows into the tube through the through-hole of the insertion member at one end, and the blood flows through the tube. , And flows out through the through hole of the insertion member at the other end, so that blood can be supplied from a site where a sufficient blood flow is secured to a site that is likely to be ischemic. Therefore, when a catheter or the like is inserted into a blood vessel from the femoral artery of one foot (for example, the right foot),
By inserting the insertion member at one end into the femoral artery of the other foot (for example, the left foot) and inserting the insertion member at the other end into the femoral artery downstream of the catheter insertion site in the blood flow direction, the other foot is inserted. Can flow into peripheral blood vessels from the catheter insertion site, and even if blood flow is blocked at the catheter insertion site, lower limb ischemia does not occur.

By using such a bypass tube, safety in treatment using a catheter or the like can be further enhanced, and further, for example, for patients whose blood vessels are thin and the use of a catheter has been difficult in the past. In contrast, treatment using a catheter can be performed. In addition, if blood flow can be secured by the bypass tube, it is possible to use a catheter having a larger outer diameter than before, so for example, the strength aspect of the catheter which had to be abandoned in the past in consideration of the outer diameter dimension and Functional improvements are also possible.

The tube and the insertion member may be formed of a resin material generally used for medical instruments. More specifically, for example, as for the tube, anything may be used as long as it does not bend and hinder blood flow.
It may be made of vinyl chloride, silicon, urethane, nylon, Teflon, polypropylene, polyethylene, or the like. Further, as for the insertion member, it is preferable that the insertion member and the moldability are good, and it is preferable that the insertion member is made of polypropylene, polyethylene, Teflon, nylon, urethane or the like.

[0010] Further, when a part or all of a part which comes into contact with blood is coated with an antithrombotic material, the formation of a thrombus is suppressed, so that it can be used for a longer time. There is an advantage that it becomes possible. The antithrombotic material may be coated with a known material according to a conventional method, and is not particularly limited. Examples of the antithrombotic material include a fluorine-containing segmented polyurethane and a specific example. Fluorinated acrylic styrene urethane silicon copolymer, silicon-containing polyurethane (trade name: Cardiosan), 2-hydroxyethyl methacrylate-styrene block copolymer,
By fixing a copolymer of methacrylic acid ester (for example, methacryloyloxyethyl phosphorylcholine) and n-butyl methacrylate, a block copolymer consisting of a polyamino acid block and a polybutadiene block, a water-soluble polymer substance or a derivative thereof with an appropriate binder One having a lubricating surface, one having an antithrombotic or anticoagulant such as heparin or urokinase, or one having an antiplatelet aggregating agent such as prostacyclin fixed on a substrate by an appropriate method can be considered.

According to a third aspect of the present invention, there is provided a bypass tube provided at a predetermined position between both ends of the tube and having a communication hole communicating with an inner cavity of the tube, and opening the communication hole. Alternatively, when a valve member that can be closed is provided, when blood flows through the bypass tube, air in the tube and the insertion member can be suctioned and removed through the valve member, which is convenient. . In addition, heparin or other necessary drug solution or the like may be supplied through a valve member to perform a treatment or the like for suppressing thrombus formation. Furthermore, since it becomes possible to measure the blood pressure in the bypass tube by connecting a transducer or the like, it is possible to monitor a change in the blood pressure of the patient, particularly, whether the bypass tube is functioning normally. .

If only air in the bypass tube is to be removed, only one of the insertion members is inserted into the blood vessel, and in this state, air is sucked and removed while introducing blood into the tube, and then the other is inserted. It is also possible to adopt a method of inserting the insertion member into the blood vessel.
The valve member as described may not be provided.

In the bypass tube according to the present invention, the tube and the insertion member are detachably connected to each other via a connector.
First, the insertion member is inserted into the blood vessel, and then the tube may be connected via the connector, so that the tube does not cling to the body when puncturing the human body, and the handling of the insertion member is facilitated. .

As long as the connector can be connected to the tube and the insertion member, even if the connector is formed integrally with one or both of the tube and the insertion member, the connector is separate from the tube and the insertion member. May be interposed between them. In particular, when the insertion member is configured to be detachable, the insertion member is disposed in a state of being inserted into a through hole of the insertion member as described in claim 5, and after the insertion member is inserted into a blood vessel, the insertion member is inserted. If you have a puncture needle that can be removed from the back end side, the insertion member integrated with the puncture needle can be inserted into the blood vessel, so make a hole in advance using another puncture needle etc. You don't have to worry about it. Further, at the time of insertion into a blood vessel, the puncture needle is held so that the through hole of the insertion member is not crushed.

[0015]

Next, embodiments of the present invention will be described with reference to the drawings. The bypass tube described below is merely an example of the embodiment of the present invention, and the constituent means of the present invention is not limited to a specific device or the like exemplified below.

The bypass tube 1 is, as shown in FIG.
It has a symmetrical structure around the valve member 10, two tubes 14 having one end connected to both sides of the valve member 10 via a connector 12, and the other end of each tube 14. And an insertion member 16 connected via a connector 12.

Of these, the valve member 10 is made of polypropylene resin and has a communicating path which branches into two branches to form three openings. Of these, two openings are connected to the two openings through the connector 12. The tube 14 is connected, and the other opening is provided with a cock 20 for opening or closing the opening by manual operation.

The connector 12 is made of polypropylene resin and has a valve member 10, a tube 14, or an insertion member 16.
The outer periphery of the pipe is integrally formed with a flange 22 for easy handling. The tube 14 is made of vinyl chloride resin,
The inner wall surface of the tube 14 is coated with an antithrombotic material (a fluorine-containing acrylic styrene urethane silicon copolymer in this example).

The insertion member 16 is made of a polypropylene resin, has a through hole at the center, and has a shape that becomes thinner toward the distal end as shown in the figure. The insertion member 16 is in a state before use, as shown in FIG.
4 is provided with the puncture needle 24 inserted into the through hole. As shown in FIG. 2B, the puncture needle 24 can be removed from the rear end side of the insertion member 16. FIG.
As shown in (1), the insertion member 16 and the tube 14 are connected via the connector 12.

The connecting portion between the connector 12 and each of the other components should not be displaced when the bypass tube 1 is used. Therefore, it is desirable that the connecting portion be structured so as not to be displaced as much as possible. Other than press-fitting structure,
For example, it is preferable that the connector 12 and the other components have a structure that can be securely locked, such as being screwed together with a screw groove. In particular, a portion between the valve member 10 and the connector 12 and the like may be easily dislocated to other connection points or more due to its structure. Therefore, it is preferable to adopt a locking structure that is more secure than press-fitting.

Next, a method of using the bypass tube 1 will be described by taking as an example a case where the bypass tube 1 is used in combination with an IABP balloon catheter. As shown in FIG. 3, the bypass tube 1 is attached so as to connect the femoral arteries 32L and 32R of both the left and right legs of the patient who is being treated with the IABP balloon catheter 30.

In mounting, first, as shown in FIG. 2 (a), the femoral artery 32L is inserted using the puncture needle 24 while the insertion member 16 and the puncture needle 24 are integrated.
(Or 32R). Here, the right leg femoral artery 3
The puncture position of the 2R is slightly peripheral to the insertion position of the IABP balloon catheter 30 (that is, the insertion position of the sheath 34).

When the distal end of the insertion member 16 has sufficiently entered the blood vessel, only the puncture needle 24 is withdrawn and the insertion member 1 is removed.
The tube 14 is connected to 6. At this time, the valve member 10
Is opened, and a negative pressure is applied to the inside of the tube 14 by a suction device (not shown). Thereby, excess air in the bypass tube 1 is removed.

Finally, the cock 20 of the valve member 10 is closed. As a result, if the blood flow to the peripheral side from the insertion position of the IABP balloon catheter 30 is obstructed, the pressure difference between the left and right femoral arteries 32L and 32R causes the blood to flow from the left femoral artery 32L to the right femoral artery 32R. Flows, and blood flow to the peripheral side from the insertion position of the IABP balloon catheter 30 is secured.

If the cock 20 of the valve member 10 is opened, various chemicals can be introduced into the blood vessel from here. Also, by connecting a pressure sensor, it can be monitored whether the bypass tube 1 is functioning normally. As described above, if the bypass tube 1 is used, lower limb ischemia associated with the insertion of the IABP balloon catheter 30 can be prevented beforehand.
Security in IABP can be further improved.
Further, even for a patient whose blood vessels are thin and the use of the IABP balloon catheter 30 has been difficult in the past, the I
ABP can be implemented. Furthermore, if the blood flow can be secured by the bypass tube 1, a catheter or sheath having a larger outer diameter than before can be used. For example, a catheter which had to be abandoned in consideration of the outer diameter in the past. It is also possible to improve in terms of strength and function.

Although the embodiments of the present invention have been described above, various constitutional means of the present invention can be considered in addition to the above embodiments. For example, the bypass tube 1
Although the components are connected by the connector 12 and have a structure that can be arbitrarily disassembled, it is not always necessary to have a structure that can be disassembled.

Although the bypass tube 1 is provided with the valve member 10, this is not essential. Further, a three-way cock may be provided instead of the valve member 10.

[Brief description of the drawings]

FIG. 1 is a front view showing an example of a bypass tube of the present invention.

FIG. 2 is a front view showing an insertion member and a puncture needle.

FIG. 3 is a schematic diagram showing a use state of a bypass tube.

[Explanation of symbols]

1 ... bypass tube, 10 ... valve member, 1
2 ... connector, 14 ... tube, 16 ... insertion member, 20 ... cock, 22 ... flange, 24 ...
Puncture needle.

Claims (5)

[Claims] 1. An insertion member provided with a long and flexible tube, provided at both ends of the tube, having a distal end formed into a shape capable of being inserted into a blood vessel, and having a through hole penetrating from the distal end into the tube. And a bypass tube comprising: 2. The bypass tube according to claim 1, wherein a part or all of a portion that comes into contact with blood is coated with an antithrombotic material. 3. The bypass tube according to claim 1, further comprising a communication hole provided at a predetermined position between both ends of the tube and communicating with a lumen of the tube, wherein the communication hole is opened or A bypass tube comprising a valve member that can be closed. 4. The bypass tube according to claim 1, wherein the tube and the insertion member are detachably connected via a connector. 5. The bypass tube according to claim 4, wherein the bypass tube is arranged so as to be inserted into a through hole of the insertion member, and can be withdrawn from a rear end side of the insertion member after the insertion member is inserted into a blood vessel. A bypass tube comprising a puncture needle.