US20100191168A1 - Endovascular cerebrospinal fluid shunt - Google Patents

Endovascular cerebrospinal fluid shunt Download PDF

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Publication number
US20100191168A1
US20100191168A1 US12362152 US36215209A US2010191168A1 US 20100191168 A1 US20100191168 A1 US 20100191168A1 US 12362152 US12362152 US 12362152 US 36215209 A US36215209 A US 36215209A US 2010191168 A1 US2010191168 A1 US 2010191168A1
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Prior art keywords
shunt
helical tip
patient
cerebrospinal fluid
end
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Abandoned
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US12362152
Inventor
Carl HEILMAN
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TUFTS MEDICAL CENTER
Tufts University
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Tufts University
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another
    • A61M27/006Cerebrospinal drainage; Accessories therefor, e.g. valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A61M25/0075Valve means
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M27/00Drainage appliances for wounds or the like, i.e. wound drains, implanted drains
    • A61M27/002Implant devices for drainage of body fluids from one part of the body to another
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, E.G. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2230/00Geometry of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2230/0063Three-dimensional shapes
    • A61F2230/0091Three-dimensional shapes helically-coiled or spirally-coiled, i.e. having a 2-D spiral cross-section
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M25/00Catheters; Hollow probes
    • A61M25/0067Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0074Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
    • A61M25/0075Valve means
    • A61M2025/0076Unidirectional valves
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2202/00Special media to be introduced, removed or treated
    • A61M2202/04Liquids
    • A61M2202/0464Cerebrospinal fluid
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2205/00General characteristics of the apparatus
    • A61M2205/02General characteristics of the apparatus characterised by a particular materials
    • A61M2205/0238General characteristics of the apparatus characterised by a particular materials the material being a coating or protective layer
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2210/00Anatomical parts of the body
    • A61M2210/06Head
    • A61M2210/0687Skull, cranium
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2210/00Anatomical parts of the body
    • A61M2210/06Head
    • A61M2210/0693Brain, cerebrum
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61MDEVICES 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
    • A61M2210/00Anatomical parts of the body
    • A61M2210/12Blood circulatory system

Abstract

An implantable shunt device for draining cerebrospinal fluid from a patient's subarachnoid space. The device includes a shunt having opposed first and second ends. A one-way valve is located at the first end of the shunt. A helical tip is disposed at the second end. The helical tip is constructed to penetrate a sinus wall of the patient. Upon implantation, a hollow passageway extends between the helical tip and one-way valve such that fluid can be drained through the helical tip and out through the valve. The endovascular cerebrospinal fluid shunt of the present invention can be placed into a patient percutaneously via a catheter inserted into the venous system of the body through a needle hole, without the need for open surgery and the skin incisions required with current shunt devices. The device also allows for more physiologic drainage of cerebrospinal fluid since the device is shunting cerebrospinal fluid into the same cerebral venous system that occurs naturally in normal people.

Description

    BACKGROUND OF THE INVENTION
  • 1. Field of the Invention
  • The present invention relates to an endovascular shunt implantable into the wall of a patient's sigmoid sinus, and more particularly, to a shunt capable of draining cerebrospinal fluid from the patient's subarachnoid space to the venous system.
  • 2. Description of the Related Art
  • It is known to treat hydrocephalus by draining cerebrospinal fluid (CFS) from the brain with a drain tube, catheter or shunt. See U.S. Pat. Nos. 5,385,541 and 4,950,232. These known devices are complex and invasive. The risk for infection is also increased due to the complexity of these devices.
  • The known shunts are limited to areas of placement due to fluid flow control. Moreover, the known shunts and methods of placements do not work in conjunction with a body's natural disease control processes. Accordingly, in recent years exploration of placement of a catheter or shunt in the venous sinus of a patient has been explored. See U.S. Pat. No. 6,283,934 and Published Application No. 2005/0256510.
  • However, fluid flow still poses difficulties due to the complexity of the devices and the placement areas. Commonly, the shunts/catheters are placed through the skull of the patient requiring pressure control to facilitate CSF flow and also creating a dangerous infection site.
  • Thus, there is a need for an endovascular shunt that can be inserted into the venous system percutaneously.
  • SUMMARY OF THE INVENTION
  • The present invention relates to an endovascular CSF shunt that drains CSF from the cistern around the cerebellum into the sigmoid sinus lumen.
  • The present invention also relates to a method of draining CSF by inserting, deploying and detaching the shunt of the present invention by an endovascular route through the venous system. The venous system is accessed either through the femoral vein or the jugular vein percutaneously.
  • The endovascular cerebrospinal fluid shunt of the present invention is an improvement over the standard cerebrospinal fluid shunts because it can be placed into a patient percutaneously via a catheter inserted into the venous system of the body through a needle hole, without the need for open surgery and the skin incisions required with current shunt devices. In some patients, the device can be inserted without general anesthesia, which is not possible with current cerebrospinal fluid shunts. The device also will allow for more physiologic drainage of cerebrospinal fluid since the device is shunting cerebrospinal fluid into the same cerebral venous system that occurs naturally in normal people.
  • One aspect of the present invention is to provide an implantable shunt device for draining fluid from a patient's subarachnoid space. The device includes a shunt having opposed first and second ends. A one-way valve is located at the first end of the shunt and a helical tip is disposed at the second end. The helical tip penetrates the sigmoid sinus wall of the patient and a hollow passageway extending between the helical tip and the CSF cistern allows the CSF to be drained through the helical tip and out through the valve.
  • Another aspect of the present invention provides a method for draining cerebrospinal fluid from a patient's subarachnoid space, the method includes the steps of providing a shunt having opposed first and second ends, delivering the shunt to the sinus wall, implanting the helical tip in the sinus wall of the patient; and draining cerebrospinal fluid from the patient.
  • These and other features, aspects, and advantages of the present invention will become more apparent from the following detailed description of the preferred embodiment relative to the accompanied drawings, in which:
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • FIG. 1 is a top cross-sectional view of a human skull illustrating the placement of the shunt of the present invention.
  • FIG. 2 is a partial cross-section of an embodiment of the endovascular shunt of the present invention.
  • FIG. 3 is a partial view of delivering the endovascular shunt of the present invention to the CSF space of a patient's venous system.
  • FIG. 4 is a partial view of the implantation of the endovascular shunt of the present invention into the sigmoid sinus wall.
  • FIG. 5 is a partial view of the endovascular shunt of the present invention implanted in the sigmoid sinus wall.
  • DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
  • Referring to FIG. 1, the endovascular shunt device of the present invention can be delivered to the right or left sigmoid sinus 12A, 12B of a patient's skull 10 via either the right or left jugular vein respectively of the venous system. The sigmoid sinus lumen 12 is located between the temporal bone (FIGS. 3-5) and the cerebellum.
  • A shunt 20 is implanted into a sigmoid sinus wall 16, so that one end communicates with CSF located in the cistern or CSF space 18 around the cerebellum 19. The device of the present invention uses the body's natural disease control mechanisms by delivering the CSF from cistern 18 into sigmoid sinus lumen 12 of the venous system. The venous system of the patient can be accesses either through the femoral or jugular veins (not shown) percutaneously. It should be appreciated that the shunt device of the present invention can be delivered to the sigmoid sinus via other locations.
  • As shown in FIG. 2, one embodiment of the endovascular CSF shunt 20 of the present invention includes opposed first and second ends 22, 24. A one-way valve 26 is located at first end 22. As will be described further herein, CSF can travel through shunt 20 and out end 22, however, other fluid cannot enter the shunt from open end 22.
  • A helical tip 30 is located at second end 24. As will be described further herein, helical tip 30 has a closed sharpened end 31 that is adapted to penetrate sinus wall 16. Tip 30 includes a plurality of apertures 34 through which the CSF enters the tip. A hollow passageway 32 extends from tip 30 and open end 22, such that the CSF fluid entering through apertures 34 can pass through valve 26 and pass from an outlet 36.
  • Referring to FIGS. 3-5 and as described above, a delivery catheter 40 is delivered to the venous system via the femoral or jugular vein. Catheter 40 is inserted into sigmoid sinus lumen 12 at a proximal location 13 toward the neck and inserted toward a distal end 15, which is toward the brain.
  • Delivery catheter 40 includes a second lumen 44 and a shunt delivery port 42. Lumen 44 directs the entire catheter to the correct location with for example, a guide wire, to allow injection of intravenous contrast to visualize the venous lumen. Lumen 44 also supports balloons 46 that can be deployed to occlude venous flow during stunt implantation. Shunt 20 is positioned at an end of an internal catheter 48 that is manipulated through catheter 40 and port 42. To prevent thrombosis within the sigmoid sinus and around the endovascular shunt, shunt 20 can be provided with an antithrombic coating 38
  • As shown in FIG. 4, internal catheter 48 facilitates twisting of shunt 20 so that it penetrates through sigmoid sinus wall 12. Catheter 48 includes a hollow lumen to allow CSF withdrawal after shunt penetration of the sigmoid sinus wall to confirm that CSF is flowing through the shunt. However, it must be rigid enough to allow twisting of the shunt such that it penetrates the sigmoid sinus wall. Upon insertion, helical tip 30 extends into cistern 18 and CSF located therein. A projection 28 located on shunt 20 between the ends abuts the wall and prevents the shunt from passing therethrough. Upon placement, internal catheter 48 is detached. The CSF can also be aspirated back prior to detachment of catheter 48.
  • Thereafter, delivery catheter 40 can be removed and shunt 20 is implanted as shown in FIG. 5. CSF 50 draining from outlet 36 from CSF space 18 is delivered to the venous blood flow 17 and removed. It should be appreciated that other means of fluid removal can communicate with shunt 20 to direct the CSF as desired. It also should be appreciated that shunt 20 can incorporate different tips at end 24.
  • Thus, the endovascular cerebrospinal fluid shunt of the present invention can be placed into a patient percutaneously via a catheter inserted into the venous system of the body through a needle hole, without the need for open surgery and the skin incisions required with current shunt devices. In some patients, the device can be inserted without general anesthesia, which is not possible with current cerebrospinal fluid shunts. The device also will allow for more physiologic drainage of cerebrospinal fluid since the device is shunting cerebrospinal fluid into the same cerebral venous system that occurs naturally in normal people.
  • Although the present invention has been described in relation to particular embodiments thereof, many other variations and modifications and other uses will become apparent to those skilled in the art. It is preferred therefore, that the present invention be limited not by the specific disclosure herein, but only by the appended claims.

Claims (6)

  1. 1. An implantable shunt device for draining cerebrospinal fluid from a patient's subarachnoid space, the device comprising:
    a shunt having opposed first and second ends;
    a one-way valve located at the first end of the shunt;
    a helical tip disposed at the second end, said helical tip being constructed to penetrate a sinus wall of the patient; and
    a hollow passageway extending between the helical tip and one-way valve such that cerebrospinal fluid can be drained through the helical tip and out through the valve.
  2. 2. The shunt of claim 1, wherein the helical tip includes a plurality of apertures into which the cerebrospinal fluid enters the tip.
  3. 3. The shunt of claim 1, wherein the shunt includes an antithrombic coating.
  4. 4. An implantable system for draining cerebrospinal fluid from a patient's subarachnoid space, the system comprising:
    a shunt having opposed first and second ends, a one-way valve located at the first end of the shunt, and a helical tip disposed at the second end, said helical tip being constructed to penetrate a sinus wall of the patient, wherein the first and second ends are in fluid communication to enable the cerebrospinal fluid to be drained through the helical tip and out through the valve; and
    a catheter for delivering and implanting the shunt into the sinus wall.
  5. 5. A method for draining cerebrospinal fluid from a patient's subarachnoid space, the method comprising the steps of:
    providing a shunt having opposed first and second ends, a one-way valve located at the first end of the shunt, and a helical tip disposed at the second end, said helical tip being constructed to penetrate a sinus wall of the patient, wherein the first and second ends are in fluid communication to enable the cerebrospinal fluid to be drained through the helical tip and out through the valve;
    delivering the shunt to the sinus wall;
    implanting the helical tip in the sinus wall of the patient; and
    draining cerebrospinal fluid from the patient.
  6. 6. An implantable shunt device for draining fluid from a patient's subarachnoid space, the device comprising:
    a shunt having opposed first and second ends;
    a one-way valve located at the first end of the shunt; and
    a helical tip disposed at the second end, said helical tip being constructed to penetrate tissue of the patient; and
    a hollow passageway extending between the helical tip and one-way valve such that fluid can be drained through the helical tip and out through the valve.
US12362152 2009-01-29 2009-01-29 Endovascular cerebrospinal fluid shunt Abandoned US20100191168A1 (en)

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US12362152 US20100191168A1 (en) 2009-01-29 2009-01-29 Endovascular cerebrospinal fluid shunt
US13569212 US8672871B2 (en) 2009-01-29 2012-08-08 Endovascular cerebrospinal fluid shunt
US14179622 US9199067B2 (en) 2009-01-29 2014-02-13 Endovascular cerebrospinal fluid shunt
US14920024 US10112036B2 (en) 2015-10-22 Endovascular cerebrospinal fluid shunt
US15294000 US9737697B2 (en) 2009-01-29 2016-10-14 Endovascular cerebrospinal fluid shunt

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US13569212 Active US8672871B2 (en) 2009-01-29 2012-08-08 Endovascular cerebrospinal fluid shunt
US14179622 Active US9199067B2 (en) 2009-01-29 2014-02-13 Endovascular cerebrospinal fluid shunt
US15294000 Active US9737697B2 (en) 2009-01-29 2016-10-14 Endovascular cerebrospinal fluid shunt

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US13569212 Active US8672871B2 (en) 2009-01-29 2012-08-08 Endovascular cerebrospinal fluid shunt
US14179622 Active US9199067B2 (en) 2009-01-29 2014-02-13 Endovascular cerebrospinal fluid shunt
US15294000 Active US9737697B2 (en) 2009-01-29 2016-10-14 Endovascular cerebrospinal fluid shunt

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Cited By (6)

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US20150018764A1 (en) * 2012-02-15 2015-01-15 Kyungpook National University Industry-Academic Cooperation Foundation Brain Cooling Device for Craniotomy Patient Having Drainage Function
US20150196741A1 (en) * 2014-01-15 2015-07-16 Tufts Medical Center, Inc. Endovascular cerebrospinal fluid shunt
WO2015108917A1 (en) * 2014-01-15 2015-07-23 Tufts Medical Center, Inc. Endovascular cerebrospinal fluid shunt
US9199067B2 (en) 2009-01-29 2015-12-01 Tufts Medical Center, Inc. Endovascular cerebrospinal fluid shunt
WO2016070147A1 (en) * 2014-10-31 2016-05-06 Cerevasc, Llc Methods and systems for treating hydrocephalus
US10112036B2 (en) 2015-10-22 2018-10-30 Tufts Medical Center, Inc. Endovascular cerebrospinal fluid shunt

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