WO2019088360A1

WO2019088360A1 - Vascular access device for hemodialysis

Info

Publication number: WO2019088360A1
Application number: PCT/KR2017/015351
Authority: WO
Inventors: 진동찬
Original assignee: 가톨릭대학교 산학협력단
Priority date: 2017-11-03
Filing date: 2017-12-22
Publication date: 2019-05-09
Also published as: KR20190050486A; KR102004615B1

Abstract

The present invention relates to a vascular access device for hemodialysis. The vascular access device for hemodialysis according to the present invention comprises: a main conduit in which a pair of blood flow paths partitioned from each other are formed; an arterial access conduit having one side connected to any one of the blood flow paths and the other side connected to an artery; a venous access conduit having one side connected to the other of the blood flow paths and the other side connected to a vein; and connection units located on the opposite side of the arterial access conduit and the venous access conduit with respect to the main conduit and each having a pair of connection conduit sections connected to the blood flow paths and connected to a hemodialyzer.

Description

Vascular access device for hemodialysis

The present invention relates to a blood vessel connection apparatus for hemodialysis, and more particularly, it is possible to simultaneously connect a vein and an artery, so that a separate arteriovenous fistula is not required for hemodialysis, The present invention relates to a blood vessel connection apparatus for hemodialysis,

In order to maintain hemodialysis in patients with end - stage renal failure, it is essential to have a blood vessel connection or access device capable of maintaining a rapid blood flow of 250-500 cc per minute.

Although the arteriovenous fistula has been used as an aneurysm, it has been used with a thick needle. However, in elderly patients and diabetic patients, the arteriovenous fistula is difficult to be thickened after surgery. The risk of hemodynamic burden in the cardiovascular system as well as the shape of the fistula due to too much blood flow of the arteriovenous fistula.

In addition, the arteriovenous fistula is difficult to treat due to the difficulty of needle puncture and pain, inconvenience of hemostasis, arteriovenous fistula lumen stenosis, infectious disease, and the like during each dialysis. In the case of a plastic catheter for hemodialysis which is temporarily used, complications such as infectious diseases and thrombosis occur and there is a problem that can not be used for a long time.

It is an object of the present invention to provide a blood vessel connection apparatus for hemodialysis which enables simultaneous connection to an artery and a vein to perform hemodialysis smoothly without an arteriovenous fistula procedure. .

It is another object of the present invention to provide a blood vessel connection apparatus for hemodialysis which minimizes the intravascular structure to prevent complications.

It is still another object of the present invention to provide a blood vessel connection apparatus for hemodialysis which can stably maintain the connection holding force when a blood vessel is connected.

According to an aspect of the present invention, there is provided a blood vessel connection apparatus for hemodialysis comprising: a main conduit in which a pair of blood flow paths partitioned from each other are formed; An arterial connection conduit having one side connected to one of the blood flow paths and the other side connected to an artery; A vein connection conduit having one side connected to the other of the blood flow paths and the other side connected to the vein; And a connection unit located on the opposite side of the arterial connection conduit and the vein connection conduit with respect to the main conduit and each having a pair of connection conduit sections connected to the blood flow paths and connected to the dialyzer .

Wherein at least one of the arterial connection conduit and the vein connection conduit has a sharp-tipped end portion for drilling the blood vessel; An engaging portion provided at a position adjacent to the tip end portion and hooked to the inner wall of the blood vessel through the blood vessel together with the tip end portion; And a locking part disposed to surround the one of the conduits and installed to be movable relative to the conduit and being engaged with the locking part in the process of approaching the locking part.

Preferably, the locking part is a plurality of locking hooks provided on an outer surface of the one of the conduits at intervals along the circumferential direction, and the locking part is a ring member having a locking protrusion that is engaged with the locking hook.

It is preferable that the present invention further comprises a position fixing wire arranged so as to surround the collarbone so as to support the main catheter on the collarbone and having both ends connected to the main catheter.

It is preferable that the main conduit includes a pair of hooks to which both ends of the position fixing wire are hooked.

The connection unit is detachably connected to the main conduit so that the connection unit is selectively connected to the main conduit and when the connection unit is not connected to the main conduit, Wherein the cap member includes a pair of insertion portions to be inserted into the respective transfer paths and a pair of insertion portions formed integrally with the insertion portions, And a flange portion surrounding the outer circumferential surface of the flange portion.

The blood vessel connection apparatus for hemodialysis according to the present invention having the above-described configuration is characterized in that a pair of blood flow paths are formed in the main conduit (allowing the veins and the arteries to flow in a partitioned state) The arterial blood flow and the venous blood flow are separately connected to the dialyzer through the connecting unit and thus the operation of the arteriovenous fistula operation is performed It is possible to promptly perform hemodialysis for reasons such as not being required, and since there is no blood flow other than dialysis, there is almost no cardiovascular burden, and thus it is possible to provide a high quality medical service.

According to the embodiment in which the distal end portion, the engaging portion and the locking portion are included in the conduit connected to the blood vessel, only the tip portion is located in the blood vessel, and the connecting and holding force of the conduit to the blood vessel is stabilized It is possible to minimize the intra-vascular structure to prevent complications, and it is expected that the present embodiment can stably support the blood vessel.

1 is an exploded perspective view of a blood vessel connection apparatus for hemodialysis according to an embodiment of the present invention;

2 is a plan view showing a configuration of an embodiment of the present invention.

3 is a use state diagram of one embodiment of the present invention.

4 is a sectional view taken along the line IV-IV in Fig. 3;

5 is a diagram for explaining a stable connection state of an embodiment of the present invention.

FIG. 6 is a use state diagram different from FIG. 3 of the embodiment of the present invention. FIG.

7 is a view for explaining the principle of hemodialysis in one embodiment of the present invention.

8 is a view for explaining an installation process of an embodiment of the present invention.

Hereinafter, a blood vessel connection apparatus for hemodialysis according to an embodiment of the present invention will be described in detail with reference to the accompanying drawings.

FIG. 1 is a perspective view of an apparatus for connecting a blood vessel for hemodialysis according to an embodiment of the present invention. FIG. 2 is a plan view of a blood vessel connection apparatus according to an embodiment of the present invention. FIG. FIG. 4 is a cross-sectional view taken along the line IV-IV in FIG. 3, FIG. 5 is a view for explaining a stable connection state of the embodiment of the present invention,

1 and 2, the blood vessel connection apparatus for hemodialysis according to an embodiment of the present invention includes a main conduit 1, an artery connection conduit 2, a vein connection conduit 3, And a connection unit (4).

The main conduit 1 is formed in a hollow tube shape. The main conduit 1 may be formed of various materials without being limited to any one material as long as it can provide the

blood transfer passages

11 and 12 , And a flexible and elastic synthetic resin material such as polyurethane.

Although the main conduit 1 is formed in a tubular shape similar to a conduit used in conventional hemodialysis, a pair of

blood transfer passages

11 and 12 are formed instead of one transfer path, There is a structural difference from the conventional one. Herein, the blood flow of the vein (R) flows to one of the pair of moving paths, and the blood flow of the artery (A) flows to the other.

The artery connecting conduit 2 has one side connected to one of the

blood transfer passages

11 and 12 and the other side connected to the artery A. [ Here, 'connection' means not only a physical connection but also a line through which the vein R and the artery A can flow.

That is, the artery connecting conduit 2 and the main conduit 1 are separately manufactured, and then the artery A is provided with a moving line by mutual physical connection, It is also possible to connect the

moving passages

11 and 12 and the artery A with each other.

One side of the vein connection conduit 3 is connected to the other of the

blood transfer passages

11 and 12 and the other side is connected to the vein R. [

The connection unit 4 is located on the opposite side of the arterial connection conduit 2 and the vein connection conduit 3 with respect to the main conduit 1 and the blood transfer passages 11, And a pair of connecting

conduits

41 and 42 connected to the dialyzer, respectively.

One of the connecting

conduits

41 and 42 is connected to one of the

blood flow paths

11 and 12 and the other is connected to the other of the

blood flow paths

11 and 12 Lt; / RTI > These connecting

conduits

41 and 42 are connected to the dialyzer 8 so as to form a closed loop together with the dialyzer 8 to enable hemodialysis.

A blood connecting apparatus for hemodialysis according to an embodiment of the present invention having such a configuration is provided with a pair of

blood transfer passages

11 and 12 formed in the main conduit 1 (a vein R and an artery A) And the

blood flow paths

11 and 12 are connected to the artery A and the vein R through the artery connecting conduit 2 and the vein connecting conduit 3 respectively The arterial blood flow and the venous blood flow can be flowed into the dialyzer 8 through the connecting unit 4 at the same time in a state in which the arterial blood flow and the venous blood flow are separately distinguished from each other, Therefore, it is possible to provide a high-quality medical service, since there is no blood flow other than dialysis, and there is almost no cardiovascular burden.

Hereinafter, the configuration for preventing complications and the configuration for enhancing the connection maintaining ability to blood vessels according to the present embodiment will be described.

The present embodiment is structured such that it can securely maintain a connection holding force with respect to a blood vessel because it should not be separated from the blood vessel arbitrarily while the dialysis operation is performed as shown in Fig.

That is, the artery connecting conduit 2 and the vein connecting conduit 3 adopted in the present embodiment are provided with the leading

ends

21 and 31, the

engaging portions

22 and 32, and the locking portion 23, (33).

4 (a), it is preferable that the

tip portions

21 and 31 are formed to have sharp ends so that they can easily pass through the blood vessel, and the fastening

portions

22 and 32 4 (b), it is provided at a position adjacent to the

tip ends

21 and 31 and is provided with the

tip ends

21 and 31 and penetrates the blood vessels, Hang on the side wall.

The

locking portions

23 and 33 are disposed in a manner to surround the

respective conduits

2 and 3 and are provided so as to be movable relative to the conduits. In FIGS. 4A and 4B, And is engaged with the

engaging portions

22 and 32 in the process of approaching the

engaging portions

22 and 32 as shown in FIG.

The present embodiment having such a configuration allows the blood vessels to be easily pierced by the

tip portions

21 and 31 of the

respective conduits

2 and 3 and prevents the tip It is possible to secure the primary connection maintaining force between the conduit and the blood vessel by the

portions

22 and 32. When the

locking portions

23 and 33 are caught while the

locking portions

22 and 32 are caught by the inner wall of the blood vessel The

conduits

2 and 3 can be clamped to the blood vessels by the second and

third portions

22 and 32 so that the conduits can be separated from the blood vessels due to strong blood flow or pressure generated during hemodialysis And the like.

According to the present embodiment, only the

tip portions

21 and 31 are positioned in the blood vessel and the

conduits

2 and 3 are fixed by using the

locking portions

22 and 32 and the

locking portions

23 and 33, It is expected that the intravenous structure can be minimized and the complication can be prevented.

Although the

latching portions

22 and 32 can be variously constructed as long as they can be hooked on the inner side wall of the blood vessel, the

latching portions

22 and 32 may be formed on the outer surface of any one of the above- The hooking hooks being formed by a plurality of hooks.

The

locking portions

23 and 33 are for forming a connection with the

locking portions

22 and 32 so as to secure a greater connection holding force. In this embodiment, the

locking portions

23 and 33, Member.

3 and 5, the present invention is characterized in that the main conduit 1 is arranged to surround the collarbone C so that the main conduit 1 can be supported on the collarbone C, And a position fixing wire (5) connected to the main conduit (1).

The vein R and the artery A to which the

respective conduits

2 and 3 are connected in the present embodiment are the subclavian vein and subclavian artery formed at positions adjacent to the collarbone C respectively.

The position fixing wire 5 passes through the tissue in the body so as to cover the collarbone C and is connected to the main conduit 1 after passing through it so that the blood vessel connection holding force of the present embodiment is further secured I will.

3, the main conduit 1 is connected to the position fixing wire 5 so that both ends of the position fixing wire 5 are engaged with each other so that the connection operation with the position fixing wire 5 can be performed smoothly. And preferably includes a pair of rings 13.

6 is a use state diagram different from FIG. 3 of the embodiment of the present invention.

As shown in this figure, the connection unit 4 employed in the present embodiment is detachably connected to the main conduit 1, thereby being selectively connected or disconnected to the main conduit 1.

This embodiment is characterized in that when the connecting unit 4 is not connected to the main conduit 1 a cap member for closing the pair of

blood transfer passages

11 and 12 of the main conduit 1 6). The cap member 6 includes a pair of

insertion portions

61 and 62 and a flange portion 63.

The flange portion 63 is formed integrally with the inserting

portions

61 and 62, and the flange portion 63 is formed integrally with the inserting

portions

61 and 62, The outer circumferential surface of the main conduit 1 is wrapped with each of the inserting

portions

61 and 62 being inserted into the moving path.

In this embodiment having such a configuration, the flange 63 seals the outer circumferential surface of the main conduit 1 in a state in which the pair of inserting

portions

61 and 62 are in close contact with the respective passageways, There is an advantage that contamination of each traveling path can be prevented when the use of the conduit 1 is not required.

As shown in this figure, the present embodiment allows the connector 7, which is a connection medium between the connecting unit 4 and the dialyzer 8, to be connected to the dialyzer 8 through the connecting unit 4, The connector 7 and the connecting unit 4 can be rapidly and reliably connected to each other in the case where hemodialysis is not required by making detachable coupling (screwing) It has an advantage that it can be separated.

8 is a view for explaining the installation process of the embodiment of the present invention.

The installation process of this embodiment will be described with reference to this drawing.

That is, before connecting the present embodiment to the blood vessel, first, the lower skin of the left collarbone (C) is disinfected and cut about 3-4 cm laterally (not shown). Thereafter, the subclavian vein (V) and the artery (A) are exposed to about 1 cm (not shown), and then the artery (A) and the vein (V) 91).

This embodiment with the expander 92 is then accessed through the safety wire 91 and then the venous connection conduit 3 is connected to the vein V and then the expander 92 is closed, The safety wire 91 is removed after the locking part 33 is moved toward the locking part 32 side to form a mold.

The artery connecting conduit 2 is connected to the portion of the artery A in the same manner and then the expander 92 is removed and then the locking portion 23 is made to approach the engaging portion 22 side , The safety wire 91 is removed.

As described above, in the present embodiment, in a state where the blood vessel is clamped, the position fixing wire 5 surrounds the collarbone C using a curved mosquito hemostat or the like, thereby firmly securing the present embodiment to the underment.

Then, the exposed part of the skin is exposed to the outside of the skin by connecting the trocar, and then the incised skin is sutured. The connected trocar needle is removed and the hemodialysis is performed by connecting the present embodiment to the dialyzer 8 through the connector 7. [

While the present invention has been particularly shown and described with reference to exemplary embodiments thereof, it is clearly understood that the same is by way of illustration and example only and is not to be taken by way of limitation in the scope of the present invention It will be apparent that those skilled in the art can easily devise modifications and specific embodiments within the scope of the present invention.

Claims

A main conduit in which a pair of blood flow paths partitioned from each other are formed;

An arterial connection conduit having one side connected to one of the blood flow paths and the other side connected to an artery;

A vein connection conduit having one side connected to the other of the blood flow paths and the other side connected to the vein; And

And a connection unit located on the opposite side of the arterial connection conduit and the vein connection conduit with respect to the main conduit and each having a pair of connection conduit sections connected to the blood flow paths and connected to the dialyzer, And the blood vessel is connected to the blood vessel.
The method according to claim 1,

Wherein at least one of the arterial connection conduit and the vein connection conduit is formed by:

A tip portion having a sharp end so as to penetrate the blood vessel;

An engaging portion provided at a position adjacent to the tip end portion and hooked to the inner wall of the blood vessel through the blood vessel together with the tip end portion; And

And a locking part which is disposed in a manner to surround any one of the conduits and which is installed to be movable relative to the conduit and which is engaged with the locking part in a process of approaching the side of the locking part. A blood vessel connection device for dialysis.
3. The method of claim 2,

Wherein the engaging portion is a plurality of engaging hooks provided on an outer surface of the one of the conduits at intervals along the circumferential direction,

Wherein the locking portion is a ring member having a locking protrusion that is engaged with the locking hook.
The method according to claim 1,

Further comprising: a position fixing wire arranged to surround the collarbone so as to support the main catheter on the collarbone, and both ends of the wire being connected to the main catheter.
5. The method of claim 4,

Wherein the main conduit includes a pair of hooks to which both ends of the position fixing wire are hooked.
The method according to claim 1,

Wherein the connection unit is detachably coupled to the main conduit so as to be selectively connected to the main conduit,

And a cap member for closing the pair of blood flow paths of the main conduit when the connection unit is not connected to the main conduit,

The cap member includes a pair of insertion portions to be inserted into each moving path and a flange portion which is formed integrally with the insertion portions and surrounds the outer circumferential surface of the main conduit in a state where the insertion portions are inserted in the moving path And the blood vessel is connected to the blood vessel.