JPS6139063B2 - - Google Patents

Info

Publication number
JPS6139063B2
JPS6139063B2 JP51081101A JP8110176A JPS6139063B2 JP S6139063 B2 JPS6139063 B2 JP S6139063B2 JP 51081101 A JP51081101 A JP 51081101A JP 8110176 A JP8110176 A JP 8110176A JP S6139063 B2 JPS6139063 B2 JP S6139063B2
Authority
JP
Japan
Prior art keywords
catheter
passageway
cannula
gasket
blood
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired
Application number
JP51081101A
Other languages
English (en)
Other versions
JPS5231591A (en
Inventor
Shii Suteiibunzu Robaato
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cordis Corp
Original Assignee
Cordis Corp
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cordis Corp filed Critical Cordis Corp
Publication of JPS5231591A publication Critical patent/JPS5231591A/ja
Publication of JPS6139063B2 publication Critical patent/JPS6139063B2/ja
Granted legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/06—Body-piercing guide needles or the like
    • A61M25/0662—Guide tubes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M39/0606—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof without means for adjusting the seal opening or pressure
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/062—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof used with a catheter
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
    • A61M2039/064—Slit-valve
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0633—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof the seal being a passive seal made of a resilient material with or without an opening
    • A61M2039/0653—Perforated disc
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
    • A61M39/02—Access sites
    • A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
    • A61M2039/0686—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof comprising more than one seal
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
    • A61M25/00—Catheters; Hollow probes
    • A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
    • A61M25/0105—Steering means as part of the catheter or advancing means; Markers for positioning
    • A61M25/0108—Steering means as part of the catheter or advancing means; Markers for positioning using radio-opaque or ultrasound markers

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Pulmonology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Biophysics (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Infusion, Injection, And Reservoir Apparatuses (AREA)
  • Surgical Instruments (AREA)

Description

【発明の詳細な説明】 本発明は套管に関するものであり、特に血管造
影レントゲン撮影用カテーテルとして知られてい
る血管内カテーテルを配設しそして操作するため
に使用される套管に関するものである。
血管造影レントゲン撮影法は導管及び器官の病
気を診断するのに使用される周知の極めて有益な
方法である。該方法は、中空の管状のカテーテル
を例えば股動脈又は上腕動脈のような、大動脈や
大静脈の一つに導入し、そして検査すべき小さな
分岐脈管へと前記カテーテルを押し進めそして操
作することから成つている。カテーテルが適所に
配置されると、放射線を通さない流体がカテーテ
ルを通し検査される脈管系統に注入されそしてＸ
線を通さなくなつた脈管構造のＸ線写真が取られ
る。
前記のようなカテーテルを導入するための従来
の技術は「カツトダウン（cut down）」方法とし
て知られているもの及び「セルデインガ
（Seldiger）」技術の種々の変更態様として知られ
ているものを包含している。前記「カツトダウ
ン」技術は外科的に静脈又は動脈を切開しそして
該切開部を通し直接脈管撮影用カテーテルを導入
するものである。この方法は静脈の結紮及び動脈
の治療と同様に該切開部を通しての血液の損失が
避けることのできないものであつた。この方法の
使用は、特に多くの検査が必要とされる場合に同
じ導管を使用するということを困難ならしめた。
1972年９月発行のザ・アメリカン・ジヤーナ
ル・オブ・カーデオロギ（The American
Journal of Cardiology）Vol.3Dの第378頁には、
セルデインガ技術の変更態様である。別法の必臓
カテーテル挿入方法が記載されており、この方法
では経皮的鞘が血管の内腔に導入される。中空針
が皮膚を貫通して前記血管内腔へと挿入される；
ガイドワイヤが前記針を貫通し動脈又は静脈へと
進められ検査される器官へと進められる；針は除
去され、ガイドワイヤが脈管中に残る；鞘及び拡
張器ユニツトがワイヤを覆つて脈管へと進められ
る；そして拡張器がガイドワイヤと共に除去され
る。次で同様の直径の所望のタイプのカテーテル
が鞘を通して脈管中に挿入される。過剰の流血を
回避し且つ空気塞栓が起らないようにするため
に、この技術は医者がカテーテルの交換中に鞘の
オリフイスを閉じることを必要とする。この処置
は、血の固まりが必臓、肝臓又は手足に移動する
可能性を有している。鞘及びカテーテルの間の環
状空間を通つての血液損失は避けるのが困難であ
る。
これら両方法は、特に多数の検査が必要とされ
た時に、静脈血栓症及び皮下血腫を生ぜしめたり
患者に他の極めて不快な事態を与える点にも特徴
を有している。明らかに、これら両方法は全体と
して満足すべきものではない。
従つて、本発明の目的は脈管撮影又は他のカテ
ーテル挿入時に脈管内に残され、カテーテルが套
管及び脈管内で操作され得るようにした套管を提
供することである。カテーテルが適所に配置され
た時、血液の損失はなくしかもカテーテルの操作
の制約は最少限とされる。カテーテルが除去され
た時、最小300mmの血圧に耐えることのできるシ
ールが提供され、従つて套管を閉じる必要性をな
くし又常に著しく血液の損失を防止する。本発明
の他の目的は本体部分の内部に流体が停滞する面
積を最小とした套管を提供することである。本発
明の更に他の目的は套管の内部又は套管及びカテ
ーテルの境界に凝血が起らないように常に套管本
体及び管を洗浄するようにした手段を提供するこ
とである。カテーテルの挿入は使い捨ての案内及
び拡張器ユニツトを使用して簡単に行なわれる。
可撓性の管が動脈壁との連通を行ない、従つて壁
を必要なく穿孔する危険性を減少させる。又これ
は鋭い中空の針が套管として使用される場合に存
在するような、カテーテル回収時に該カテーテル
を細片に切裂するといつた可能性も除去する。
一般に、本発明は、カテーテルを受容する通路
と、該通路にて互いに接触し並置して設けられた
一対のガスケツトとを有した本体を具備する止血
套管により特徴付けられる。ガスケツトの一方は
丸い孔を有し、他方はＹ形状のスリツトを有す
る。第１のガスケツトはカテーテルと密封関係を
保持し、又両ガスケツトは、カテーテルを通路か
ら回収するときスリツトを持つたガスケツトが第
１のガスケツトの方に当接して押し付けられるの
で、協働して通路を閉鎖する。好ましい実施態様
において、套管は更に本体と流体密に係合した或
る長さの可撓性管を具備する。患者の動脈に流体
を導入するために套管の本体と連通する口が又設
けられる。
本発明の他の利益及び特徴は当業者には以下の
説明から明らかとなるであろう。
第１図に図示されるように、套管は大体円筒状
をしたハブ又は本体部分１０を具備し、該本体部
分１０は弾発的に嵌着されるキヤツプ１２と先細
形状部分１３とを有し、該先細部分１３は可撓性
の管１８に至つている。概括して矢印１４で示さ
れる通路が本体１０の内部に設けられる。本体部
分１０及び入口管１８は周知の適当なプラスチツ
ク材料で作ることができ、例えば高密度ポリエチ
レンが掲げられる。一対のガスケツト２２，２４
がキヤツプ１２内に囲繞される。環状ガスケツト
２２は中央に孔２６が設けられ又該ガスケツトは
ラテツクス、シリコンゴム又は他の適当なシール
材料で作られる。孔２６は套管と一緒に使用され
るカテーテル４６の直径よりやや小さくされ、そ
のためカテーテル４６が通路１４を貫通して挿入
された時、第２図に図示されるようにガスケツト
２２は通路２２と密封係合するであろう。自己密
封ガスケツト２４にはＹ形状スリツト２８が中央
部に設けられる。該スリツトはカテーテル４６が
そこを貫通される時は比較的円滑な通路を提供す
るが、カテーテル４６が套管内に配置されていな
い時は該スリツトは閉鎖し、ガスケツト２２に当
接しそして最低300mmの血圧に耐え、それによつ
て血液が通路１４を通つて逆流するのを防止す
る。キヤツプ１２にはガスケツト２２，２４と軸
線を同じくして中央部に孔１６が設けられ、又該
キヤツプにはガスケツト２２をキヤツプ１２に対
して密封する環状突起部３２が設けられる。本体
１０に配設される第２の環状突起部３０も同様に
ガスケツト２４を密封するために作用する。
本体１０から横方向外方向にのび、通路１４へ
と至る通路２０を有したボス３４が本体１０と一
体に形成される。ボス３４はプラスチツク管３６
に連結するための手段を提供するためにその外部
が段状にされる。套管ハブ部分及び套管の内部を
洗浄するために管３６を通して液体を導入するこ
とができ、従つて該液体は套管の内部又は患者の
血管内のカテーテルと套管の境界にて凝血が起る
のを防止する作用をなす。
医者は、血液が洗浄口２０を通つて流れないよ
うに、手術中には洗浄流体の圧力を正に保つであ
ろう。
第３図に図示されるように、カテーテル４６の
直径と大略等しい直径の中空プラスチツク拡張器
４２が通路１４に配設され得て、その先細とされ
た端部４５は管１８の末端を越えてのびている。
套管が案内４３を覆つた血管内に挿入された後、
拡張器及び案内は除去されそして捨てられてもよ
い。
手術に当り、切開部４１が使用される血管の近
くの患者の皮膚に設けられ、止血器具が該切開部
に導入されそして血管が露出するまで組織を貫通
して操作される。次で中実の鋭くされた套管針が
挿入された中空の針が血管へと導入される。血管
の内腔４０が貫通されると、套管針に除去されそ
して案内４３と取り替えられ、次で前記中空針が
除去される。次で、第３図に図示されるように、
中空プラスチツク拡張器４２が套管の通路１４を
貫通して螺入されそして案内４３を覆つて嵌装さ
れる。医者は次で拡張器４２の先細形状端４５を
血管壁に挿入し該管壁を貫通する孔を拡張しそし
て入口管１８を血管内腔４０に導入する。次で套
管は患者の身体の適所にテープで固定され、供給
管３６は連結部３４に取付けられる。又医者はヘ
パリン食塩水をゆつくりと流しながら、拡張器４
２と案内４３を回収する。この点にて、ガスケツ
ト２４のスリツト２８は閉じ、隣接したガスケツ
ト２２の支持によつて患者の血圧によつて付勢さ
れた力に対抗し、血液の損失を防止する。次でカ
テーテルが孔１６を通して導入され、ガスケツト
２２及び２４を貫通する。カテーテルはハブ１０
を貫通し先細形状部分１３によつて管１８へと案
内される。最後にカテーテルは血管の拡張器４０
へと挿入される（第４図）。第２図に図示される
ように、ガスケツト２４のスリツト２８はカテー
テルを通すために開口する。環状のガスケツト２
２がカテーテル４６の外部周囲のシールを形成
し、それによつて入口孔１６を通しての血液の損
失を防止する。ガスケツト２４はカテーテルに対
し容易に屈撓し、カテーテルの操作を制止するこ
とはない。カテーテル４６と入口管１８との間の
環状空間４８（第２図）は凝血を防止するため口
２０及び管３６を介して導入されたヘパリン食塩
水の流れによつて常時洗浄される。カテーテル４
６が適所へと操作されると、該カテーテルを通し
て放射線を通さない流体が注入されそして検査さ
れる器官の放射線を通さない導管系統のＸ線写真
がとられる。
多数の調査が必要とされる場合又はカテーテル
が正確に配置されていない場合に、カテーテルを
除去したり、他のものを導入したりすることは簡
単なことである。もし適当とされるのであれば、
ガイドワイヤを用いることもできる。カテーテル
４６を除去する際に、ガスケツト２２及び２４は
一緒に閉じ入口孔１６を再度密封するので、患者
から血が流出するということはない。所望なら
ば、カテーテルが除去されると共に、例えば麻酔
剤又は静脈栄養溶液のような他の流体を管３６を
介して血管へと導入することもできる。端部が閉
鎖しているカテーテルであろうと端部が開放して
いるカテーテルであろうと本発明に係る套管を介
して都合よく挿入することができる。
発本明は本発明の範囲内で他の実施態様で考え
られる。従つて本発明の上記実施態様は説明のた
めであり、本発明を限定するものではない。
【図面の簡単な説明】
第１図は本発明に係る一実施態様の一部断面分
解図である。第２図はカテーテルが套管に囲繞さ
れている第１図の実施態様の断面図である。第３
図は拡張器ユニツト及び案内を囲繞した套管の側
面図である。第４図はカテーテルが挿入された血
管の内腔に配置された第１図の実施態様を表わ
す。 図の主要な部分は次の通りである。１０：本体
部分、１２：キヤツプ、１３：先細形状、１４：
通路、１６：入口孔、１８：可撓性の入口管、２
０：洗浄口、２２，２４：一対のガスケツト、３
４：ボス、４２：拡張器、４３：案内、４６：カ
テーテル。

Claims (1)

    【特許請求の範囲】
  1. １ カテーテルを受容するようにした通路が貫通
    して設けられた本体と、前記通路に密着して重ね
    合せて取付けられた弾力性の第１及び第２ガスケ
    ツトと、前記本体の一端と流体密に係合し且つ前
    記通路と連通する或る長さの可撓性管と、液体を
    患者の血管へと導入するために前記本体の他端に
    設けられ前記通路に連通する口とより成る止血套
    管において、前記第１ガスケツトは前記カテーテ
    ルの挿入時にカテーテルを密封する孔を有し、前
    記第２ガスケツトはＹ形スリツトを有し、前記第
    １ガスケツトは前記通路に受容されるカテーテル
    に対して密封を行い、前記カテーテルを受容して
    いないときは前記第１及び第２ガスケツトが密着
    することにより前記Ｙ形スリツトを閉じて前記通
    路を封止するものである、止血套管。
JP51081101A 1975-07-09 1976-07-09 Hemostatic trocar Granted JPS5231591A (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
US05/594,521 US4000739A (en) 1975-07-09 1975-07-09 Hemostasis cannula

Publications (2)

Publication Number Publication Date
JPS5231591A JPS5231591A (en) 1977-03-10
JPS6139063B2 true JPS6139063B2 (ja) 1986-09-02

Family

ID=24379230

Family Applications (1)

Application Number Title Priority Date Filing Date
JP51081101A Granted JPS5231591A (en) 1975-07-09 1976-07-09 Hemostatic trocar

Country Status (10)

Country Link
US (1) US4000739A (ja)
JP (1) JPS5231591A (ja)
CA (1) CA1070205A (ja)
CH (1) CH600895A5 (ja)
DE (1) DE2623511A1 (ja)
FR (1) FR2316972A1 (ja)
GB (1) GB1503429A (ja)
IT (1) IT1063138B (ja)
NL (1) NL180277C (ja)
SE (1) SE7607793L (ja)

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DE2623511A1 (de) 1977-02-24
IT1063138B (it) 1985-02-11
FR2316972B1 (ja) 1983-01-14
JPS5231591A (en) 1977-03-10
CA1070205A (en) 1980-01-22
SE7607793L (sv) 1977-02-09
FR2316972A1 (fr) 1977-02-04
DE2623511C2 (ja) 1988-08-04
NL180277C (nl) 1987-02-02
GB1503429A (en) 1978-03-08
CH600895A5 (ja) 1978-06-30
NL7606805A (nl) 1977-01-11
US4000739A (en) 1977-01-04

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