WO1989002290A1 - Catheter ventriculaire a trous inclines - Google Patents

Catheter ventriculaire a trous inclines Download PDF

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Publication number
WO1989002290A1
WO1989002290A1 PCT/US1988/003063 US8803063W WO8902290A1 WO 1989002290 A1 WO1989002290 A1 WO 1989002290A1 US 8803063 W US8803063 W US 8803063W WO 8902290 A1 WO8902290 A1 WO 8902290A1
Authority
WO
WIPO (PCT)
Prior art keywords
catheter
apertures
hollow
elongated member
insert
Prior art date
Application number
PCT/US1988/003063
Other languages
English (en)
Inventor
Jamshid B. G. Ghajar
Robert J. Hariri
Fathali Ghahremani-Ghadjar
Original Assignee
Neurodynamics, Inc.
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
Priority claimed from US07/098,097 external-priority patent/US4784638A/en
Priority claimed from US07/227,397 external-priority patent/US4970926A/en
Application filed by Neurodynamics, Inc. filed Critical Neurodynamics, Inc.
Publication of WO1989002290A1 publication Critical patent/WO1989002290A1/fr

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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
    • A61M25/0009—Making of catheters or other medical or surgical tubes
    • A61M25/0015—Making lateral openings in a catheter tube, e.g. holes, slits, ports, piercings of guidewire ports; Methods for processing the holes, e.g. smoothing the edges
    • 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
    • A61M25/0067—Catheters; Hollow probes characterised by the distal end, e.g. tips
    • A61M25/0068—Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
    • A61M25/007—Side holes, e.g. their profiles or arrangements; Provisions to keep side holes unblocked

Definitions

  • the present invention relates to a ventricular catheter having specifically angled apertures which facilitate access to or drainage of cerebral spinal fluid and certain methods of making and using same.
  • ventricles of the human brain are interconnected cavities that produce and circulate cerebral spinal fluid (CSF) .
  • CSF cerebral spinal fluid
  • Procedures involving ventriculostomy i.e., placement of a catheter into the ventricular system of the brain, form a major part of a neurosurgeon's clinical practice.
  • General areas of application of ventricular catheter placement include intracranial pressure monitoring (ICP) , draining or shunting of CSF and the instillation of pharmacological therapeutic agents.
  • ICP intracranial pressure monitoring
  • CSF drainage is essential for patients with congen ⁇ ital or acquired hydrocephalus.
  • CSF drainage which can only be performed with, an intraventricular catheter, is a life- preserving procedure, because it can immediately reduce intracranial pressure.
  • the ventricular catheter, used to drain CSF is connected to a peripheral subcutaneous drainage system, i.e., to the peritoneal cavity or systemic circulation via the heart or in the case of ICP to an external drainage collection system.
  • Standard procedures for ventricular catherization are disclosed in the textbook literature. See, for example, Neurosurgery, edited by Robert H. ilkins and Setti S. Rengachary, Section A, Chapter 13, Techniques of Ventricular Puncture (McGraw Hill 1984) .
  • the most frequently chosen site for ventricular catheterization is coronal.
  • a catheter is inserted in the anterior horn of the lateral ventricle through an orifice or burr hole drilled just anterior to the coronal suture in the midpupillary line of the cranium, i.e., in the frontal bone over the ventricle.
  • the burr hole only slightly larger than the diameter of the selected catheter to insure a snug fit and provide a seal against CSF leakage, is placed approximately 1 cm anterior to the coronal suture, approximately 10 to 12 cm above the nasion, and approximately 2 to 3 cm from the midline over the nondominant hemisphere.
  • the dura and underlying pia- arachnoid are opened and coagulated, for example, with a fine-tipped blade after cauterizing the dural surface.
  • the lateral ventricles of the human brain form an arc parallel to the arc of the cranium, i.e., the contour of the lateral ventricles parallels the arc of the surface of the skull.
  • a catheter guided perpendicular to the cranial surface at the point of entry into the cranium will enter the ventricular system.
  • any line pene ⁇ trating a burr hole in the surface of the skull at a 90° angle also bisects the lateral ventricle.
  • a more recently developed procedure to ensure cor ⁇ rect catheter placement is disclosed in U.S. Patent No. 4,613,324.
  • the apparatus comprises a guide assembly which, when positioned over an orifice drilled in the cranium above the anterior horn of the lateral ventricle, guides a catheter and obturator through the orifice and into the lateral ven ⁇ tricle at an angle normal to an imaginary plane formed by a tangent to the cranium at the orifice, while the correspon ⁇ ding method comprises providing an orifice in the cranium just anterior to a coronal suture in a midpupillary line of the cranium and inserting a ventricular catheter containing an obturator through the orifice towards a lateral ventricle, wherein the catheter containing the obturator is guided through the orifice, by means of a novel guide assembly, at an angle normal to an imaginary plane formed by a tangent to the cranium at the orifice.
  • catheters are known in the prior art for the purpose of penetrating the ventricular cavity.
  • Such catheters are typically in the form of a hollow tube which is provided with a plurality of apertures at the ventricular or inflow end to permit the passage of CSF from the brain into the catheter and thence to the bloodstream or peritoneal cavity of the patient or to an external drainage system.
  • malfunctions frequently occur with such a catheter due to the blockage of the apertures in the inflow end of the catheter.
  • Such blockage is usually caused by the growth of choroid plexus or ependymal tissue within the ventricle into the apertures in the inflow end of the catheter.
  • This tissue may block the apertures in the inflow end of the catheter in a relatively short period of time after the catheter has been inserted into the ventricle thereby rendering the cathether inoperative in relieving excess pressure due to the build-up of CSF within the ventricle.
  • prior art catheter apertures are cut ⁇ perpendicular to the length of the catheter, thus causing abrasion of brain tissue when the catheter is inserted.
  • the likelihood of ventricular catheter malfunction by aperture plugging with brain tissue can be lessened by angling the aperture holes in the wall of the catheter such that there is "no see through” flow from the outside to the inside of the lumen. Also, by positioning the rows of apertures 120° apart there is essentially no chance for direct ingrowth of ventricular tissue therethrough. In addition, the apertures are angled away from the direction of the insertion of the catheter into the brain thus lessening the chance of brain abrasion. Further, by slightly stretching the catheter by means of the stylet (which is integral to the catheter and used for placement of it into the brain) the holes will close so that no opening will be visible during the placement thereof, with the holes re ⁇ opening after the tension on the catheter is relieved by removal of the stylet.
  • a catheter which overcomes the problems of previously devised ventricular catheters which are emplaceable within a ventricle of a human brain to control the flow of excess fluids to or from the brain.
  • the present invention provides a simple solution which resolves the problems of prior art catheters in a novel and unexpected manner.
  • the present invention relates to a catheter for placement into the ventricular system of the brain of a subject comprising a flexible elongated body having a wall ,thickness sufficient to contain and-transport fluid therein.
  • the body has a forward end and tip for insertion into the ventricular system and a plurality of spaced apertures located in the forward end of the body spaced from the tip.
  • Each of the apertures extends through the wall thickness at an angle such that a portion of the wall thickness is visible when viewing the aperture perpendicular to the axis of the body.
  • This arrangement facilitates closure of the apertures by slightly stretching the body with a placement stylet to minimize abrasion of brain tissue upon insertion of the catheter.
  • This arrangement also helps prevent choroid plexus tissue from growing into the catheter apertures, thereby providing improved flow of fluid into or from the ventricular s stem.
  • each of the apertures extends through the wall thickness at an angle of about 35° with respect to the longitudinal axis of the body, and a plurality of apertures are aligned in a number of rows. Also, rows of these apertures are spaced 120° apart around the circumference of the body for maximizing the structural integrity of the catheter forward end.
  • the forward end of the body can be made of a radioopaque material at least in the area surrounding the apertures to facilitate monitoring of catheter placement.
  • the body may include means to indicate the depth of penetration of the catheter forward end to assist in proper placement thereof.
  • These depth penetration indication means may be markings of a radioopaque material to facilitate
  • the invention also relates to method of accessing CSF in a ventricle within a human cranium which comprises drilling an orifice in the cranium just anterior to a coronal suture in a midpupillary line of the cranium, and guiding a catheter through the orifice by means of a guide assembly in a direction perpendicular to an imaginary plane defined by a tangent to the cranium at the orifice.
  • the catheter thus accurately penetrates the ventricle on the first insertion with minimal abrasion of brain tissue.
  • the catheter described above, i.e., one having the appropriate positioning and configuration of apertures to minimize ventricular tissue growth thereinto, is preferred so that increased flow of fluid to or from the ventricle is obtained.
  • the catheter of this method utilizes a guide assembly comprising tubular means and support means for the tubular means". Therefore, the method further comprises placing the support means so as to rest unsecured on the human cranium in surrounding spaced relation to the orifice, and guiding the catheter through the tubular means, into the orifice and into the ventricle.
  • the support means and tubular means are related to each other such that the catheter is guided through the orifice by the tubular means in a direction perpendicular to an imaginary plane defined by a tangent to the cranium of the orifice, independent of the orifice.
  • the tubular means is supported through a support means comprising a plurality of legs of equal length.
  • this method further comprises inserting a removable insert within the tubular means to reduce the diameter thereof for receiving the catheter.
  • a stylet may be utilized to assist in the insertion of the catheter in a manner such that the catheter is stretched so as to flatten the apertures to further reduce abrasion of brain tissue upon insertion therein.
  • the catheter body includes means for indicating the depth of penetration of the catheter forward end so that the method further comprises inserting the catheter to a predetermined depth into the ventricle.
  • the indicating means may be radioopaque markings so that the placement of the catheter in the ventricle can be monitored.
  • the present invention also relates to an apparatus for making catheters having a plurality of angled holes in a flexible, elongated body.
  • catheters are hollow elongated members having a plurality of apertures nea one end.
  • One embodiment of this apparatus comprises an insert and a molding assembly.
  • the insert includes rod mean for forming the plurality of apertures of a predetermined size and shape and means for forming and supporting the bore of the elongated member: the rod means being positioned at predetermined orientation with respect to the bore forming means so that the hollow elongated member receives a plurality of apertures at a predetermined position, orientation and dimension.
  • the molding assembly includes means for forming an supporting the hollow elongated member, a plurality of guide holes in the forming means for at least partially receiving the rod means to properly orient the insert therein, and means for allowing a polymerizable liquid to be introduced into the space between the insert and the molding assembly t form the catheter by polymerization therein.
  • th rod means and bore forming means of the insert are integral and made of a material which is capable of withstanding temperatures caused by polymerization of the polymerizable liquid.
  • the forming and supporting means is constructed in the form of a hollow elongated cylinder havin an open end and a closed end wherein the insert is introduce into the open end in a manner such that the rod means extend into a respective guide hole in the cylinder.
  • These rod means and corresponding cylinder holes can be oriented in a spiral configuration around the circumferenfce of the bore forming means or at predetermined stepped intervals along th length of the bore forming means.
  • the invention also contemplates an apparatus for cutting apertures in a hollow elongated member which comprises a cutting assembly having means for cutting a plurality of apertures of a predetermined size, and a holdin assembly.
  • the holding assembly includes means for supportin and substantially completely surrounding a portion of a hollow elongated member in the vicinity where apertures are to be made; means adjacent the supporting means for guidably directing the cutting assembly through the supporting means for cutting contact with the hollow elongated member at a predetermined angle thereto; and means operatively associated with the directing and supporting means for positioning the portion of the hollow elongated member at a predetermined orientation with respect to the cutting assembly so that the hollow ' elongated member can be placed into the holding assembly in a manner to receive a plurality of apertures therein .at a predetermined position, orientation and dimension.
  • the holding assembly preferably comprises a holding block containing an elongated aperture of a size and dimension slightly larger than that of the hollow elongated member so that the member can'be easily and removably inserted into the elongated aperture, while the cutting assembly comprises a plurality of elongated rods.
  • the directing means correspondingly comprises a plurality of elongated guide apertures corresponding to the rods of the cutting apparatus but being of slightly greater size and dimension so as to allow the rods to easily and removably pass therethrough for cutting the apertures in the hollow elongated member.
  • the positioning means includes a stop member for prevention of insertion- of an end of the hollow elongated member beyond a predetermined point in the elongated aperture of the holding block, which is advantageously in the shape of a cube with the elongated aperture extending along a diagonal line passing through the center of the cube.
  • the directing means comprises three sets of elongated apertures, each set being spaced from the others so that the hollow elongated member is provided with rows of apertures spaced 120° apart along its outer periphery.
  • each of the sets of elongated apertures of the directing means would extend alon a diagonal line across a face of the holding block cube to achieve this result.
  • FIG. 1 is a perspective view of a catheter according to the invention
  • FIG. 2 is a cross-sectional view taken along line 2—2 of FIG. 1;
  • FIG. 3 is a cross-sectional view taken along line 3—3 of FIG. 1;
  • FIG. 4 is a perspective view of an apparatus for holding the catheter during the cutting of apertures therein;
  • FIG. 5 is a top view of the apparatus of FIG. 4;
  • FIG. 6 is a section taken along lines 6—6 of FIG. 5 over which is shown an apparatus for cutting apertures in the catheter;
  • FIG. 7 is an enlarged view of the cutting apparatus piercing the catheter sidewall when the catheter is placed in the holding apparatus of FIG. 4;
  • FIG. 8 is a perspective view of a symmetric molding insert according to the invention.
  • FIG. 9 is a perspective view of a spiral molding insert according to the invention.
  • FIG. 10 is a cross sectional view of a mold housing for use with the insert of FIG. 8;
  • FIG. 11 is a cross sectional view of a mold housing for use with the insert of FIG. 9;
  • FIG. 12 is a cross sectional view of the mold of FIG. 10 taken along lines 12—12 thereof;
  • FIG. 13 is a cross sectional view of the mold of FIG. 11 taken along lines 13—13 thereof.
  • FIG. 1 there is illustrated
  • catheter 10 which is intended for insertion into a ventricle of the human brain for access to or drainage of CSF such as; for example, would be necessary to drain excess CSF during treatment of hydrocephalus. Since the present invention is primarily concerned with the forward or insertion end of the 0 catheter, a detailed description of the opposite or out flow end of the catheter is not provided as such details are well known in the relevant surgical art.
  • This catheter 10 is a flexible, hollow, elongated member having a sufficient wall thickness for the containment 5 and or transport of fluids therein and therethrough.
  • the forward end 12 of the catheter includes a plurality of apparatus 14 for access -to CSF in the ventricle of the brain.
  • access By “access” what is meant is contact of CSF for removal or drainage from the brain or, conversely, to enable medicaments 0 or other fluids to be directed or delivered into the brain from the catheter through the apertures 14.
  • the catheter 10 is designed with 3 sets of holes set 120° apart. These holes are cut at an angle into the wall of the catheter such that the angle of the cut.is measured along the longitudinal axis of the catheter in the direction of movement of the catheter
  • each hole in the catheter is proportional to the thickness of the catheter wall so that, as best illustrated 5 in FIG. 3, there is no direct linear visual access to the interior of the catheter when the holes are viewed perpendicular to the longitudinal axis of the catheter.
  • the ventricle so less brain tissue is destroyed as a direct result of such decreased abrasion. Further, by stretching the catheter slightly, the holes in the catheter are closed thus preventing such tissue as may come in contact with the catheter from entering the lumen upon insertion.
  • 25 plexus or brain cell growth will extend across the inner diameter of the catheter even if such growth does penetrate into one or more of the holes.
  • holes are advantageously shown as being cut at an angle of 35° with respect to the longitudinal
  • the catheter of the invention can be inserted into the ventricle of the brain in any manner currently known, including "freehand" or with the use of a guide. To assist in the proper location and placement of the catheter, a plurality of markings 16 are provided along the length of the catheter body.
  • markings correspond to predetermined insertion lengths of the catheter and enables the surgeon to know precisely how far the tip of catheter is inserted into the ventricle
  • a radioopaque material such as barium
  • the depth of placement of the catheter can easily be monitored by conventional techniques.
  • the forward section of the catheter in the area around the apertures can also be made of a radioopaque material for viewing on various scanning equipment the precise placement of the forward end and tip of the catheter.
  • the improvements provided by the catheter of this invention are significant in that the physician does ' not require any guess work to determine the precise placement of the catheter in the patient's brain. Furthermore, when so placed, the catheter provides improved fluid delivery and/or removal with minimal disturbance of the surrounding brain cells while also discouraging brain tissue growth into the catheter apertures.” As mentioned above, the catheter can be inserted in the brain in any manner commonly utilized. Rather than a "free hand" technique, it is advantageous to utilize a guide assembly to insure correct catheter placement.
  • a preferred guide apparatus and method of insertion of a catheter into the ventricle is disclosed in U.S. Patent No. 4,613,324, the disclosure of which is expressly incor ⁇ porated herein by reference thereto.
  • a stylet is used to assist in the insertion of the catheter.
  • the stylet can be used to stretch the present catheters so that the angled apertures can be flattened to minimize the abrasion of brain tissue during insertion.
  • this flattening operation slightly reduces the overall diameter of the catheter which further reduces such abrasion.
  • the present invention significantly reduces and minimizes this problem since.the angled holes are more receptive to the introduction of the second stylet in a compact orientation (i.e., in a "V" shape, rather than an "L”' shape) which greatly enhances the manipulation of the catheter and stylets during placement in the ventricle.
  • FIG. 5 shows a holding apparatus 20 in the form of a machined metal block or cube 22.
  • a longitudinal extending aperture 24 extends diagonally from one corner of the cube through the center to the opposite corner.
  • the diameter of the aperture 24 is only slightly greater than the diameter of the catheter 10 so that the catheter is fully supported in the aperture when the angled holes are made in the catheter wall.
  • FIG. 6 illustrates a cutting apparatus 30 consisting of a handle 32 and a plurality of hollow tube like cutting elements 34 each of which have a sharpened tip 36.
  • the tube elements 34 extend through guide apertures 28 on on face of the cube 22 until contact is made with the catheter 10.
  • the cutting tubes 34 penetrate the catheter wall, thus. forming the appropriately sized holes therein at the predetermined angle, position and configuration.
  • Prior art catheters as noted above, have four set of holes oriented 90° apart along the circumference of the catheter.
  • holes on opposite sides of the catheter i.e., those 180° apart
  • a punching tool This results in holes on one side being larger in diameter than those on the opposite side. Therefore, two sets of holes are large and two are small.
  • This non-uniformity Effects CSF flow and the smaller holes can easily become blocked by brain tissue growth, thus causing reduced operation of those catheters.
  • the present invention resolves these problems by accurately and precisely placing three sets of uniform holes cut at the desired angle to the catheter body and spaced apart exactly by 120°-. This results in increased flow through the holes, higher strength and integrity of the catheter body, and greater ease of insertion and placement of the catheter in the ventricle.
  • FIGS. 4 through 6 illustrate the placement of guide apertures 28 on the various faces of the cube.
  • these guides are positioned in a diagonal line along the top and two side faces of the cube 22, so that each set of holes is placed 120° apart around the periphery or circumference of the catheter body.
  • This apparatus guarantees the accuracy of the hole cutting at the appropriate angle as well as the precise spacing of the holes relative to each other around the periphery or circumference of the catheter.
  • the user merely inserts the tubes 34 of cutting apparatus 30 into the guides 28 when a catheter is placed in the holding block 20.
  • the cutting apparatus 30 after piercing the catheter wall 10 is then removed, resulting in placement of the holes at the 'precise orientation and configuration in a simple manner which allows for repeatable and rapid production of such angled hole catheters Further, the precision obtained in utilizing this apparatus is very high and reproducible to facilitate mass production.
  • FIGS. 8 and 9 illustrate two preferred disposable inserts 50, 55.
  • Each of these inserts has an elongated body portion 52, 57 and a plurality of rod like extensions 52, 54 extending from the body at a predetermined angle.
  • the rod - like extensions 52, 59, of these inserts are positioned at an angle preferably of 35 degrees with respect to the axis of the body member 52, 57.
  • Fig. 8 illustrates an insert for forming three rows of apertures in the catheter
  • FIG. 9 illustrates a spiral orientation of such apertures about the circumference of the catheter body.
  • FIGS. 10 through 13 illustrate the molding cylinders 60, 80 for use with the previously described inserts 50, 55.
  • Each mold includes an open end 62, 82 which enables insertion of the corresponding inserts 50, 55, and a closed end 64, 84 which is used to form the insertion tip of the catheter.
  • These molds 60, 80 include a plurality of guide apertures 66, 86 for at least partially receiving the rod like members 52, 59 of the respective inserts 50, 55.
  • the guide holes 66, 86 extend through the wall 68, 88 of the molding cylinders 60, 80 at an angle which corresponds to the desired angle of the catheter holes.
  • a plurality of molds 60, 80 and a much greater number of inserts 50, 55 are prepared. Since the molds 60, 80 are reusable,, basically any material can be used which would provide a useful service life. This would include, for example, steel, stainless steel, aluminum, etc. and certain engineering thermoplastics may also be suitable. These materials must be sufficiently strong to retain the insert and withstand the temperatures anticipated for the polymerization of the material used to form the catheter. Such mold material must also be dimensionally stable over the entire curing temperature range.
  • the insert 50, 55 should be made of a self- lubricating material that does not bind or stick to the polymerizable liquid used to form the catheter. Also, the self-lubricating material must be sufficiently flexible so that it can be easily inserted and drawn out of the mold without damaging the catheter: At this time, the most preferred material for the insert is an injection molded polyamide material.
  • a preferred material for the catheter itself is a polymerizable silicon liquid which has a very low injection and curing temperature, i.e., about 100 F. While this requires a relatively long curing time, high production rates can be achieved through the use of multiple molding cavities.
  • the inserts are disposable so that each insert can only be used to make one catheter. As noted above, the mold itself can be reused an infinite number of times.
  • the polymerizable liquid is introduced into the space between the insert and the mold.
  • the liquid is then allowed to polymerize and cure to form the catheter.
  • the insert and catheter are removed from the mold and the insert is then destroyed to form the final catheter product.
  • the catheter holes can be configured in any shape or size relative to the axis of the catheter. For example, spiral, off-set 90 degree or off-set 120 degree holes can easily be obtained.
  • the angle of the hole relative to the axis of the catheter can be easily changed by providing different mold inserts and mold cavities. This allows optimization of the hole angle compared to the hole diameter as a function of cell growth. This relationship is governed by the formula given above. 3) this apparatus assures that no "flashing" will occur on the internal bores of the catheter. Any excess material due to "flashing", will be visible on the -exterior surf ce of the catheter and can be easily trimmed therefrom. 4) this apparatus assures that each catheter can be manufactured to very close tolerances with little or no variation in the construction of each device: hence, a high degree of reproducibility in mass production is achieved.

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  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Biomedical Technology (AREA)
  • Pulmonology (AREA)
  • Engineering & Computer Science (AREA)
  • Anesthesiology (AREA)
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  • Heart & Thoracic Surgery (AREA)
  • Hematology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
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Abstract

Un cathéter (10) destiné à être placé dans le système ventriculaire du cerveau d'un patient comprend un corps allongé flexible, dont la paroi présente une épaisseur suffisante pour contenir et transporter un fluide, comportant une extrémité avant (12) et une pointe d'introduction dans le système ventriculaire du cerveau du patient. Une pluralité d'ouvertures (14) écartées entre elles sont situées sur l'extrémité avant (12) du corps à une certaine distance de la pointe, et chacune des ouvertures (14) s'étend à travers toute l'épaisseur de la paroi en formant un angle tel qu'une partie de l'épaisseur de la paroi soit visible lorsqu'on regarde l'ouverture (14) perpendiculairement à l'axe longitudinal du corps, afin de réduire au minimum l'abrasion des tissus du cerveau lors de l'introduction du cathéter et pour empêcher toute croissance du plexus choroïde et du tissu épendymaire dans les ouvertures du cathéter (14), de manière à assurer un meilleur écoulement de fluide en direction et en provenance du système ventriculaire. Sont également décrits des procédés et un dispositif de fabrication de ce type de cathéter.
PCT/US1988/003063 1987-09-17 1988-09-07 Catheter ventriculaire a trous inclines WO1989002290A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
US07/098,097 US4784638A (en) 1987-09-17 1987-09-17 Angled hole ventricular catheter and method of making same
US098,097 1987-09-17
US227,397 1988-08-02
US07/227,397 US4970926A (en) 1987-09-17 1988-08-02 Apparatus for making angled hole ventricular catheter

Publications (1)

Publication Number Publication Date
WO1989002290A1 true WO1989002290A1 (fr) 1989-03-23

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PCT/US1988/003063 WO1989002290A1 (fr) 1987-09-17 1988-09-07 Catheter ventriculaire a trous inclines

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EP (1) EP0382753A4 (fr)
JP (1) JPH03501219A (fr)
AU (1) AU2425088A (fr)
CA (1) CA1323537C (fr)
CH (1) CH678017A5 (fr)
WO (1) WO1989002290A1 (fr)

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EP0546646A1 (fr) * 1991-12-10 1993-06-16 The Kendall Company Cathéter à microbille avec optiques latéraux
US5383890A (en) * 1993-10-27 1995-01-24 Baxter International Inc. Low-profile single-lumen perfusion balloon catheter
GB2295092A (en) * 1994-11-17 1996-05-22 Simpla Plastics Body fluid drainage apparatus
WO1997013543A1 (fr) * 1995-10-10 1997-04-17 Gambro Ab Catheter specialement conçu pour les dialyses peritoneales
NL1005846C2 (nl) * 1996-04-26 1998-03-17 Nippon Ozone Co Werkwijze voor het behandelen van huisdieren, zoals koeien, tegen mastitis, en inrichting voor het in uiers injecteren van ozon.
EP0829241A1 (fr) * 1996-09-12 1998-03-18 Nippon Ozone Co., Ltd. Méthode de traitement de la mastite chez les animaux domestiques tels que les vaches, et dispositif d'injection d'ozone les truies
EP0846012A1 (fr) * 1995-11-13 1998-06-10 Uresil Corporation Sonde amelioree
FR2785815A1 (fr) * 1998-11-17 2000-05-19 Henri Mehier Dispositif destine a assurer la delivrance d'une substance active directement au sein d'un organe cible, moyen d'implantation du dispositif et appareil destine a l'injection de substance active dans ledit dispositif
WO2000029055A1 (fr) * 1998-11-17 2000-05-25 Henri Mehier Dispositif destine a assurer la delivrance d'une substance active directement au sein d'un tissu cellulaire, moyen d'implantation du dispositif et appareils destines a l'injection de substance active dans ledit dispositif
US6913589B2 (en) 2002-01-14 2005-07-05 Codman & Shurtleff, Inc. Multi-catheter insertion device and method
US7037288B2 (en) 2002-01-14 2006-05-02 Codman & Shurtleff, Inc. Anti-block catheter
KR20160100598A (ko) * 2015-02-16 2016-08-24 신준식 약물주입용 니들 및 이를 포함하는 약물주입장치

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FR2880542A1 (fr) * 2005-01-10 2006-07-14 Peters Surgical Soc Par Action Sonde de drainage pourvue d'oeils
US8496629B2 (en) 2008-04-22 2013-07-30 Becton, Dickinson And Company Catheter hole having a flow breaking feature
US8403911B2 (en) 2008-04-22 2013-03-26 Becton, Dickinson And Company Systems and methods for improving catheter hole array efficiency
US9399112B2 (en) 2008-04-22 2016-07-26 Becton, Dickinson And Company Catheter hole having an inclined trailing edge
US9364634B2 (en) 2008-04-22 2016-06-14 Becton, Dickinson And Company Systems and methods for improving catheter hole array efficiency
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JP7312556B2 (ja) * 2019-01-25 2023-07-21 テルモ株式会社 カテーテル

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US1544856A (en) * 1924-09-09 1925-07-07 John F Murray Removing cores
US2393003A (en) * 1944-05-03 1946-01-15 Smith Minton Larkin Kidney catheter
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US3739461A (en) * 1971-08-03 1973-06-19 J Cupler Method of producing clean walled bores in laminates workpieces
US3885561A (en) * 1971-12-15 1975-05-27 Charles N Mazal Cami Catheter
US3996832A (en) * 1975-04-10 1976-12-14 Standard Oil Company (Indiana) Punch for producing holes in foamed thermoplastic containers
US4149695A (en) * 1976-06-01 1979-04-17 International Paper Company Apparatus and process for molding of hollow articles
US4391276A (en) * 1980-12-16 1983-07-05 Harrison Lazarus Peritoneal catheter
US4750877A (en) * 1983-05-23 1988-06-14 Taut, Inc. Injection molding of a thin-walled elongated tubular product such as a catheter
US4613324A (en) * 1985-06-17 1986-09-23 Ghajar Jamshid B G Method and apparatus for guiding catheter into ventricular system of human brain
US4647419A (en) * 1985-10-10 1987-03-03 Eastman Kodak Company Method and apparatus for producing a flash free pipette
US4737152A (en) * 1986-07-02 1988-04-12 Becton, Dickinson And Company Catheter assembly
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Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0546646A1 (fr) * 1991-12-10 1993-06-16 The Kendall Company Cathéter à microbille avec optiques latéraux
US5383890A (en) * 1993-10-27 1995-01-24 Baxter International Inc. Low-profile single-lumen perfusion balloon catheter
GB2295092B (en) * 1994-11-17 1999-03-03 Simpla Plastics Fluid drainage apparatus
GB2295092A (en) * 1994-11-17 1996-05-22 Simpla Plastics Body fluid drainage apparatus
WO1997013543A1 (fr) * 1995-10-10 1997-04-17 Gambro Ab Catheter specialement conçu pour les dialyses peritoneales
US6132405A (en) * 1995-10-10 2000-10-17 Gambro Ab Catheter for peritoneal dialysis
AU712309B2 (en) * 1995-10-10 1999-11-04 Gambro Lundia Ab Catheter, in particular for peritoneal dialysis
EP0846012A4 (fr) * 1995-11-13 1999-09-29 Uresil Corp Sonde amelioree
EP0846012A1 (fr) * 1995-11-13 1998-06-10 Uresil Corporation Sonde amelioree
NL1005846C2 (nl) * 1996-04-26 1998-03-17 Nippon Ozone Co Werkwijze voor het behandelen van huisdieren, zoals koeien, tegen mastitis, en inrichting voor het in uiers injecteren van ozon.
EP0829241A1 (fr) * 1996-09-12 1998-03-18 Nippon Ozone Co., Ltd. Méthode de traitement de la mastite chez les animaux domestiques tels que les vaches, et dispositif d'injection d'ozone les truies
FR2785815A1 (fr) * 1998-11-17 2000-05-19 Henri Mehier Dispositif destine a assurer la delivrance d'une substance active directement au sein d'un organe cible, moyen d'implantation du dispositif et appareil destine a l'injection de substance active dans ledit dispositif
WO2000029055A1 (fr) * 1998-11-17 2000-05-25 Henri Mehier Dispositif destine a assurer la delivrance d'une substance active directement au sein d'un tissu cellulaire, moyen d'implantation du dispositif et appareils destines a l'injection de substance active dans ledit dispositif
US6719738B2 (en) 1998-11-17 2004-04-13 Henri Mehier Device for directly delivering an active substance within a cell tissue, means for implanting said device and appliances for injecting active substance into said device
US6913589B2 (en) 2002-01-14 2005-07-05 Codman & Shurtleff, Inc. Multi-catheter insertion device and method
US7037288B2 (en) 2002-01-14 2006-05-02 Codman & Shurtleff, Inc. Anti-block catheter
US7699800B2 (en) 2002-01-14 2010-04-20 Codman & Shurtleff, Inc. Multi-catheter insertion device and method
KR20160100598A (ko) * 2015-02-16 2016-08-24 신준식 약물주입용 니들 및 이를 포함하는 약물주입장치
KR101657514B1 (ko) * 2015-02-16 2016-09-19 신준식 약물주입용 니들 및 이를 포함하는 약물주입장치

Also Published As

Publication number Publication date
EP0382753A4 (en) 1991-01-30
JPH03501219A (ja) 1991-03-22
CA1323537C (fr) 1993-10-26
CH678017A5 (fr) 1991-07-31
AU2425088A (en) 1989-04-17
EP0382753A1 (fr) 1990-08-22

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