WO2016008521A1 - Système d'assistance au cœur droit - Google Patents

Système d'assistance au cœur droit Download PDF

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Publication number
WO2016008521A1
WO2016008521A1 PCT/EP2014/065268 EP2014065268W WO2016008521A1 WO 2016008521 A1 WO2016008521 A1 WO 2016008521A1 EP 2014065268 W EP2014065268 W EP 2014065268W WO 2016008521 A1 WO2016008521 A1 WO 2016008521A1
Authority
WO
WIPO (PCT)
Prior art keywords
stent
graft
support system
right heart
rch
Prior art date
Application number
PCT/EP2014/065268
Other languages
German (de)
English (en)
Inventor
Hans Reiner Figulla
Alexander Lauten
Original Assignee
Universitätsklinikum Jena
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 Universitätsklinikum Jena filed Critical Universitätsklinikum Jena
Priority to EP14741270.4A priority Critical patent/EP3169383A1/fr
Priority to PCT/EP2014/065268 priority patent/WO2016008521A1/fr
Publication of WO2016008521A1 publication Critical patent/WO2016008521A1/fr

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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/89—Valves
    • A61M60/894—Passive valves, i.e. valves actuated by the blood
    • A61M60/896—Passive valves, i.e. valves actuated by the blood having flexible or resilient parts, e.g. flap valves
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/40—Details relating to driving
    • A61M60/497—Details relating to driving for balloon pumps for circulatory assistance
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/20—Type thereof
    • A61M60/295—Balloon pumps for circulatory assistance
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/841—Constructional details other than related to driving of balloon pumps for circulatory assistance
    • A61M60/843—Balloon aspects, e.g. shapes or materials
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/861—Connections or anchorings for connecting or anchoring pumps or pumping devices to parts of the patient's body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS 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
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/04—Hollow or tubular parts of organs, e.g. bladders, tracheae, bronchi or bile ducts
    • A61F2/06—Blood vessels
    • A61F2/07—Stent-grafts
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/10—Location thereof with respect to the patient's body
    • A61M60/122—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body
    • A61M60/126—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel
    • A61M60/148—Implantable pumps or pumping devices, i.e. the blood being pumped inside the patient's body implantable via, into, inside, in line, branching on, or around a blood vessel in line with a blood vessel using resection or like techniques, e.g. permanent endovascular heart assist devices
    • 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
    • A61M60/00—Blood pumps; Devices for mechanical circulatory actuation; Balloon pumps for circulatory assistance
    • A61M60/80—Constructional details other than related to driving
    • A61M60/855—Constructional details other than related to driving of implantable pumps or pumping devices
    • A61M60/89—Valves
    • A61M60/894—Passive valves, i.e. valves actuated by the blood

Definitions

  • the invention relates to a right heart support system and a surgical implantation set with such a right heart support system.
  • heart failure One of the most common diseases in industrialized countries is so-called heart failure.
  • the pumping power of the heart is reduced, which can lead to a shortage of other organs with oxygen and nutrients, at least under stress.
  • the medical treatment of heart failure is limited, so that in severe cases mechanical heart support systems are used. From the practice of such cardiac assist systems are known, in particular microaxial pumps are used.
  • micro-axial pumps The principle of micro-axial pumps is to promote blood within blood vessels by high rotation of turbine-like paddle wheels.
  • micro-axial pumps operate at high speeds of several thousand revolutions per minute to allow a sufficient pumping power despite the small diameter.
  • micro-axial pumps operate on a completely different principle of operation than the natural pumping action in the circulatory system dictates.
  • the heart as a natural pump causes a pulsating blood flow, which ultimately leads to a comparatively laminar flow as a result of the aorta's vesicular function.
  • a microaxial pump delivers continuously and can not replicate such a pulsating blood flow.
  • the object of the invention is to provide a right heart support system that allows efficient relief of the heart, in particular the right heart, has a simple structure and adapts well to the physiology of the human cardiovascular system. It is a further object of the invention to provide a surgical implant set having such a right heart assist system.
  • this object is achieved with regard to the right heart support system by the subject of claim 1 and with regard to the Implantationsset by the subject of claim 14.
  • the invention is based on the idea of specifying an implantable right heart support system with at least one stent-graft, which has a first longitudinal end for fixation in the inferior vena cava and a second longitudinal end for fixation in the pulmonary artery.
  • a stent-graft which has a first longitudinal end for fixation in the inferior vena cava and a second longitudinal end for fixation in the pulmonary artery.
  • at least two inflatable and deflatable balloons are arranged, which are positioned coaxially behind one another and are controlled such that a pulsatile blood flow is generated by the stent-graft.
  • An outlet valve is located at the first length of the stent-graft and an outlet valve at the second longitudinal end of the stent-graft.
  • the invention makes use of the principle of displacement of liquids by means of balloon inflation.
  • suitable control of the individual balloons they can be inflated with a time delay to each other, resulting in a wave-shaped displacement of liquids, in particular blood here.
  • the pulsatile blood flow which occurs naturally in the cardiovascular system, can be replicated.
  • those within the stent-graft serve this purpose arranged inflatable balloons, which are inflatable or expandable against the inner wall of the stent-graft and thus lead to a Verdrlindu ng of blood within the stent-graft.
  • the valves arranged at the longitudinal ends each act as check valves in a flow direction and as sluices in the other flow direction. In this way, the flow direction of the blood displaced by the balloons can be influenced.
  • inlet valve and the outlet valve are each formed by heart valve prostheses.
  • heart valve prostheses have already been tried and tested for a long time and therefore have a high level of reliability. In addition, they meet the corresponding requirements for biocompatibility.
  • the first longitudinal end has a cross-sectional diameter which substantially corresponds to the inner diameter of the lower vena cava.
  • the right heart assist system is preferably implanted between the inferior vena cava and the pulmonary artery, thus traversing the right ventricle of the heart. In this way, the heart should be relieved. In other words, it is provided to direct a portion of the blood to be pumped through the stent-graft, so that the natural heart only has to apply part of the pumping power. It is particularly advantageous if the stent-graft is fully implanted with its first longitudinal end in the inferior vena cava and completely absorbs the blood volume originating from the inferior vena cava.
  • the inferior vena cava is pumped into the pulmonary artery via the right ventricular assist system.
  • the stent graft may include a vena cava section, a ventricular section, and a pulmonary artery section in each of which a balloon is disposed.
  • the stent-graft may have different structural characteristics.
  • the stent-graft can For example, be formed of a lattice structure, wherein in the vena cava and the pulmonary artery section, the lattice structure has a relatively large mesh size. This can lead to an improved anchoring of the stent graft in the inferior vena cava or in the pulmonary artery.
  • the mesh size of the stent-graft may be comparatively small in order to provide good stability of the ventricular segment.
  • a balloon may be arranged in each case.
  • the vena cava section, the ventricular section and the pulmonary artery section have different cross-sectional diameters.
  • at least one of the aforementioned sections may have a different cross-sectional diameter than one or more further sections.
  • the ventricular section has a larger cross-sectional diameter than the vena cava section and / or the pulmonary artery section.
  • the cross-sectional diameters of the vena cava section and the pulmonary artery section may be limited by the internal diameters of the respective blood vessels, in this case the inferior vena cava and the pulmonary artery.
  • the ventricle portion may have a larger cross-sectional diameter, which is advantageous for increasing the pumping capacity.
  • the balloons may have different cross-sectional diameters in different sections of the stent-graft.
  • a balloon which is arranged in the ventricle section may have a different, in particular larger, cross-sectional diameter than edge-side balloons which are arranged in the vena cava section or in the pulmonary artery section.
  • the cross-sectional diameters and other dimensions of the balloons refer to the maximum inflated state, respectively. The maximum inflated state thus arises when the balloons are arranged outside the stent-graft and completely inflated.
  • the cross-sectional diameter of the balloons is limited by the contact with the stent graft.
  • at least one of the balloons, in particular all balloons each individually have a sectionally varying cross-sectional diameter.
  • individual or all balloons may each have an outer contour, which is adapted to the anatomical conditions at the implantation site.
  • the cross-sectional diameter can vary along a single balloon.
  • the outer dimension of the individual balloons is adapted so that the largest possible displacement volume is provided.
  • the greatest possible displacement of blood volume can be achieved, which enables an increase in the time volume of the right heart support system.
  • the stent-graft comprises a liquid-impermeable wall. This ensures that the blood volume displaced by the individual balloons is directed completely towards the pulmonary artery. Overall, this increases the pumping power of the right heart support system.
  • the stent-graft in particular the liquid-impermeable wall, may also have at least one lateral inlet valve. This allows the influx of blood in all sections of the stent-graft and increases the support effect or improves the relief of the natural heart muscle.
  • the lateral intake valve or the plurality of lateral intake valves may be arranged in particular in the ventricle section. It can thus be achieved that blood which flows via the upper vena cava into the ventricle, ie the right ventricle, is pumped through the right heart support system into the pulmonary artery. By also detecting blood volume from the superior vena cava by the right ventricular assist system in addition to the blood volume from the inferior vena cava, the burden on the natural cardiac muscle is further reduced. Overall, this increases the relief effect.
  • the lateral inlet valves it may also be provided that they are aligned in a line parallel to a longitudinal axis of the stent-graft.
  • the side inlet valves may be distributed over a circumference of the stent graft. Aligning the lateral inlet valves in a line parallel to the longitudinal axis of the stent-graft makes it possible to align all lateral inlet valves with, for example, the outlet opening of the superior vena cava. so that a uniform inflow of blood from the superior vena cava into the right heart support system, in particular in the ventricular portion of the stent-graft, is made possible. However, this requires precise alignment of the stent-graft during implantation.
  • a simpler placement of the stent-graft is therefore achieved with the alternative design, according to which the lateral inlet valves are distributed over a circumference of the stent-graft. In this way it is achieved that, regardless of the implantation position of the stent-graft, at least one inlet valve points in the direction of the right atrium or the superior vena cava and thus a direct inflow of blood from the upper vena cava is ensured.
  • the balloons each have a plurality of chambers which can be inflated individually, in particular sequentially. With suitable activation, this results in a peristaltic pumping movement, which leads to an improved delivery of blood and thus allows a high time volume.
  • a controller which controls deflation and inflation of the balloons in a time-shifted manner such that a peristaltic pumping movement is set along the balloons which propagate from the first longitudinal end of the stent graft to the second longitudinal end.
  • a peristaltic pumping movement forms well the pulsatile blood flow, which naturally occurs in the circulatory system, and, in contrast to known microaxial pumps, considerably reduces the shear forces acting on the blood.
  • a side-by-side aspect of the invention is to provide a surgical implant set having a right heart assist system and a catheter as described above, wherein the catheter is adapted for insertion of the right ventricular assist system via a femoral vein. Access via a femoral vein is preferred for direct access to the inferior vena cava.
  • the catheter used for this purpose should have a length sufficient to be guided from the access point at the femoral vein to the right ventricle, ie to the right ventricle.
  • FIG. 1 shows the single figure is a schematic cross-sectional view of the inventive right heart support system according to a preferred embodiment in the implanted state.
  • a section through a heart is shown, which has two chambers 30, 34, wherein the chambers 30, 34 are separated by a heart septum 35 from each other.
  • a right ventricle 30 is separated from a left ventricle 34.
  • a mitral valve 36 and an aortic valve 37 can also be seen, with the aortic valve 37 separating the left ventricle 34 from an aorta 38.
  • a section through the right ventricle 30 and the right atrium 39 is shown.
  • the right atrium 39 opens an upper vena cava 32 (superior vena cava) and a lower vena cava 31 (vena cava inferior).
  • a pulmonary artery also branches off from the right ventricle 30, which crosses over with the aorta 38.
  • the right heart assist system 10 is shown in the illustrated embodiment in the implanted state.
  • the right heart assist system 10 includes a stent graft 11 that is substantially tubular.
  • the stent-graft 11 comprises two longitudinal ends 12, 13, wherein a first longitudinal end 12 in the inferior vena cava 31 and a second longitudinal end 13 in the upper vena cava 32 is arranged.
  • the stent-graft 11 can be subdivided into three different sections.
  • the stent-graft 11 has a vena cava section 16, which is positioned in the inferior vena cava 31 in the implanted state.
  • the stent graft 11 comprises a pulmonary artery section 18, which comes to rest in the implanted state in the pulmonary artery 33.
  • a ventricular section 17 extends between the vena cava section 16 and the pulmonary artery section 18.
  • the ventricular section 17 is arranged in the right ventricle 30 in the implanted state.
  • the stent-graft 11 at the longitudinal ends 12, 13 each have a valve.
  • an inlet valve 14 is provided at the first longitudinal end 12.
  • the stent-graft 11 comprises an outlet valve 15.
  • the inlet valve 14 and the outlet valve 15 are preferably designed such that a blood flow in only one direction through the inlet valve 14 and outlet valve 15 is possible.
  • the inlet valve 14 and the outlet valve 15 allow complete closure of the lumen of the stent-graft 11 to prevent backflow of blood.
  • a vena cava balloon 20 Within the stent-graft 11 three balloons 20, 21, 22 are arranged.
  • a vena cava balloon 20 In the vena cava section 16, a vena cava balloon 20, a ventricular balloon 21 in the ventricular section 17, and a pulmonary artery bile ion 22 in the pulmonary artery section 18 are arranged.
  • the balloons 20, 21, 22 are preferably interconnected with each other, wherein each individual balloon 20, 21, 22 is separately inflatable.
  • the balloons 20, 21, 22 have different outer contours.
  • the vena cava balloon 20 has a length which is greater than the length of the pulmonary artery balloon 22. It is also conceivable that the vena cava balloon 20 and the pulmonary artery balloon 22 comprise the same length. It is preferably provided that the ventricular balloon 21 has a larger cross-sectional diameter in the inflated state than the vena cava balloon 20 and / or pulmonary artery balloon 22. Thus, the available volume in the right ventricle 30 can be exploited to allow greater blood displacement in the ventricular segment 17.
  • lateral inlet valves 23 are provided in the ventricle section 17 and are aligned essentially with respect to the right atrium 39. The lateral ones
  • Inlet valves 23 operate in substantially the same manner as the inlet valve 14 at the first longitudinal end 12 of the stent-graft 11. Specifically, the side inlet valves 23 allow the flow of blood from the right atrium 39 into the stent-graft 11, but block backflow of blood the stent-graft 11 in the right atrium 39.
  • the lateral inlet valves 23 are formed in particular in a wall 19 of the stent-graft 11.
  • the wall 19 of the stent-graft is preferably formed fluid-impermeable to ensure a safe and reliable delivery of blood through the stent-graft 11.
  • the right heart assist system 10 provides support for the right ventricle 30 in patients with acute or chronic right heart failure.
  • the delivery of the implantable right heart support system 10 is preferably via a catheter which is advanced via the femoral vein into the inferior vena cava 31 and the right heart support system 10 at the implantation site in the region of the right ventricle 30 releases.
  • the pumping assistance of the right ventricle 30 is performed in the right heart support system 10 by a peristaltic pumping movement, which is made possible by sequentially inflating and deflating the individual balloons 20, 21, 22.
  • the balloons 20, 21, 22 are formed so short in their length that a deleterious extension via the femoral vein inserted catheter is avoided.
  • the inflation and deflation of the individual balloons 20, 21, 22 is preferably cyclic during ventricular systole and diastole.
  • the activation of the individual balloons 20, 21, 22 preferably takes place in such a way that the natural pulse wave frequency is imaged.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Cardiology (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Anesthesiology (AREA)
  • Biomedical Technology (AREA)
  • Hematology (AREA)
  • Mechanical Engineering (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physics & Mathematics (AREA)
  • Geometry (AREA)
  • Prostheses (AREA)

Abstract

La présente invention concerne un système d'assistance (10) au cœur droit, implantable, présentant au moins une endoprothèse (11), qui présente une première extrémité longitudinale (12) pour la fixation dans la veine cave inférieure (31) et une deuxième extrémité longitudinale (13) pour la fixation dans l'artère pulmonaire (33), au moins deux ballonnets (20, 21, 22) pouvant être gonflés et dégonflés étant disposés dans l'endoprothèse (11), qui sont positionnées coaxialement l'une derrière l'autre et actionnées de manière telle qu'une circulation sanguine pulsatile est générée par l'endoprothèse (11), et un clapet d'entrée (14) étant disposé au niveau de la première extrémité longitudinale (12) de l'endoprothèse (11) et un clapet de sortie (15) étant disposé au niveau de la deuxième extrémité longitudinale (13) de l'endoprothèse (11). L'invention concerne en outre une trousse chirurgicale d'implantation présentant un tel système d'assistance au cœur droit.
PCT/EP2014/065268 2014-07-16 2014-07-16 Système d'assistance au cœur droit WO2016008521A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
EP14741270.4A EP3169383A1 (fr) 2014-07-16 2014-07-16 Système d'assistance au coeur droit
PCT/EP2014/065268 WO2016008521A1 (fr) 2014-07-16 2014-07-16 Système d'assistance au cœur droit

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2014/065268 WO2016008521A1 (fr) 2014-07-16 2014-07-16 Système d'assistance au cœur droit

Publications (1)

Publication Number Publication Date
WO2016008521A1 true WO2016008521A1 (fr) 2016-01-21

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Application Number Title Priority Date Filing Date
PCT/EP2014/065268 WO2016008521A1 (fr) 2014-07-16 2014-07-16 Système d'assistance au cœur droit

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EP (1) EP3169383A1 (fr)
WO (1) WO2016008521A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3267950A4 (fr) * 2015-03-11 2018-03-21 Board of Regents of the University of Nebraska Système de commande d'hémorragie automatisé et récupérable
WO2019071148A1 (fr) 2017-10-06 2019-04-11 Troy Thornton Dispositif de décongestion rénale

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000035515A1 (fr) * 1998-12-15 2000-06-22 Corvascular, Inc. Dispositif intravasculaire d"assistance cardiaque et procede associe
US6210318B1 (en) * 1999-03-09 2001-04-03 Abiomed, Inc. Stented balloon pump system and method for using same

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2000035515A1 (fr) * 1998-12-15 2000-06-22 Corvascular, Inc. Dispositif intravasculaire d"assistance cardiaque et procede associe
US6210318B1 (en) * 1999-03-09 2001-04-03 Abiomed, Inc. Stented balloon pump system and method for using same

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP3267950A4 (fr) * 2015-03-11 2018-03-21 Board of Regents of the University of Nebraska Système de commande d'hémorragie automatisé et récupérable
US10758386B2 (en) 2015-03-11 2020-09-01 Board Of Regents Of The University Of Nebraska Automated retrievable hemorrhage control system
US11857443B2 (en) 2015-03-11 2024-01-02 Board Of Regents Of The University Of Nebraska Automated retrievable hemorrhage control system
WO2019071148A1 (fr) 2017-10-06 2019-04-11 Troy Thornton Dispositif de décongestion rénale
EP3691710A4 (fr) * 2017-10-06 2021-07-21 Troy Thornton Dispositif de décongestion rénale
US11534304B2 (en) 2017-10-06 2022-12-27 Troy Thornton Device for renal decongestion

Also Published As

Publication number Publication date
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