DE3326648A1 - Catheter with adjustable front nozzle and balloon - Google Patents
Catheter with adjustable front nozzle and balloonInfo
- Publication number
- DE3326648A1 DE3326648A1 DE19833326648 DE3326648A DE3326648A1 DE 3326648 A1 DE3326648 A1 DE 3326648A1 DE 19833326648 DE19833326648 DE 19833326648 DE 3326648 A DE3326648 A DE 3326648A DE 3326648 A1 DE3326648 A1 DE 3326648A1
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- catheter
- nozzle
- balloon
- wire
- catheter according
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Classifications
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- 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
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/32—Surgical cutting instruments
- A61B17/3205—Excision instruments
- A61B17/3207—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions
- A61B17/320725—Atherectomy devices working by cutting or abrading; Similar devices specially adapted for non-vascular obstructions with radially expandable cutting or abrading elements
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
-
- 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
- A61M25/10—Balloon catheters
- A61M25/1018—Balloon inflating or inflation-control devices
- A61M25/10184—Means for controlling or monitoring inflation or deflation
-
- 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
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
-
- 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
- A61M2025/0018—Catheters; Hollow probes having a plug, e.g. an inflatable plug for closing catheter lumens
-
- 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
- A61M25/0074—Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
- A61M2025/0079—Separate user-activated means, e.g. guidewires, guide tubes, balloon catheters or sheaths, for sealing off an orifice, e.g. a lumen or side holes, of a catheter
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/01—Introducing, guiding, advancing, emplacing or holding catheters
- A61M25/09—Guide wires
- A61M2025/09175—Guide wires having specific characteristics at the distal tip
- A61M2025/09183—Guide wires having specific characteristics at the distal tip having tools at the distal tip
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- 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
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1063—Balloon catheters with special features or adapted for special applications having only one lumen used for guide wire and inflation, e.g. to minimise the diameter
-
- 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
- A61M25/10—Balloon catheters
- A61M2025/1043—Balloon catheters with special features or adapted for special applications
- A61M2025/1093—Balloon catheters with special features or adapted for special applications having particular tip characteristics
-
- 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
- A61M25/0082—Catheter tip comprising a tool
Abstract
Description
Katheter mit verstellbarer Frontdüse und BallonCatheter with adjustable front nozzle and balloon
Ballonkatheter sind während der letzten Jahre vor allem als Herz-Koronarkatheter bekannt geworden, un bei klinisch bedeutsamen Gefäßverengungen insbesondere von mittelstärken Herzkranzschlagsdorn Dilatationen in Aufdehnung der meist zugleich sklerotisch veränderten Gefäßwand angioplastisch durchzuführen zu können, wie das auch in anderer Körperregion mit ebenfalls verangten oder thrombozierten Becken-oder Beinarterien vorgenommen werden kann. Das hat vor allem den großen Vorteil, daß den Patienten größere operative hgriffe wie auch Brustraumeröffnung bei Bypass-Operation am Harzen erspart bleibt.During the last few years, balloon catheters have been used primarily as cardiac coronary catheters become known, un in clinically significant vasoconstriction, in particular from medium-strength coronary whiplash dilatations in expansion of the mostly at the same time To be able to perform angioplasty with sclerotically altered vessel wall, like that also in another region of the body with pelvic or thrombozoned or thrombozoned pelvis Leg arteries can be made. Above all, this has the great advantage that the patient larger surgical handles as well as opening the chest cavity during bypass surgery is spared resin.
Die zur angioplastischen Gefäßdilatation eingesetzten Katheter haben vorn einen aus Plastik bestehenden Ballon, der bei Doppelläufigkeit des Katheters mit mindestens 5 atü beaufschlagt wird.The catheters used for angioplasty vascular dilation have in front a balloon made of plastic, which when the catheter is double-ended at least 5 atmospheres are applied.
Das Stenosemuster der Harzkranzschhlagdorn ist verschieden.The stenosis pattern of the Harz wreath hammer is different.
Häufiger als fleckförmige einzelne Stenosen am Gefäß ist, daß zahlreiche Gefäße der Coronarverzweigungen durch Lipid- und Fibroseplaques bei auch weiteren Verfettungsprozessen der Gefäßinnenhaut eingeengt sind, was zehr dreidimensionale Aufdehnung von solchen Gefäßen auch an anderen Stellen des Körpers wie Bein wünschenswert macht. More common than patchy single stenoses on the vessel is, that numerous vessels of the coronary branches are caused by lipid and fibrosis plaques also further fatty processes of the vascular lining are narrowed, which is very three-dimensional Expansion of such vessels in other parts of the body such as the leg is also desirable power.
Diesbezüglich gibt es derzeit Bestrobungen, auch über den Katheter zur Dilatation von Gefäßen in Anwendung zugleich von mehreren Druckeinwirkungen, Druckimpulsgebungen ausreichend Dilatation an solchen lichtungsverengten Gefäßen vor ischämischen Herden zu bewirken.There are currently tests in this regard, also via the catheter for dilation of vessels when applying several pressure effects at the same time, Pressure pulses provide sufficient dilation in such narrowed vessels in front of ischemic herds.
Für die mehr räumliche Eingabe von Druken, Druckschwankungen in Bevorzugung der Leitungsbahn des G efäßsystems, insbesondere auch wenn solche Gefäße bezüglich Lichtung stenosiert, eingeangt sind und na@geschaltet ischämische Herde bewirken wie am Herzmuskel, dürfte somit der Einsatz eines leistungsfähigeren Katheters ebenfalls als Ballonkatheter wünschenswert sein.For the more spatial input of pressures, pressure fluctuations in preference the conduction path of the vascular system, especially when such vessels are related The clearing is stenosed, contracted, and causes ischemic foci As with the heart muscle, the use of a more powerful catheter should also be used be desirable as a balloon catheter.
Der von mir dargetane Ballonkatheter hat eine verstellbare Frontdüse : Das erbringt mehrere Vorzüge.The balloon catheter I presented has an adjustable front nozzle : This has several advantages.
a) Da nur einlumig, besitzt er eine relativ weite Lichtung.a) Since it has only one lumen, it has a relatively wide clearing.
b) Die auch außen am Monometer ablesbaren Drucke sind signifikant für die auch in der Wichtung d.s Katheters vorhandenen Drucke wie auch sehr wahrscheinlich im Ballon.b) The prints that can also be read on the outside of the monometer are significant for the pressure present in the weighting of the catheter as well as very likely in the balloon.
c) Die Durchbrechungen 21 der Katheterwand vorn zur Aufblähung des Ballons 11 können relativ breit und zahlreich sein.c) The perforations 21 in the front of the catheter wall to inflate the Balloons 11 can be relatively wide and numerous.
d) Die von außen eingebrachten Drucke und Druckschwankungen werden sich sozusagen trägheitsols bis zum vorderen Teil des Katheters fortpflanzen einschlteßlich der Drucke, die sich im Ballon 4/11 ergeben.d) The pressures and pressure fluctuations brought in from the outside Inertia, so to speak, to the front part of the catheter, including of the prints that result in balloon 4/11.
e) Es können bei einer einzigen relativ weiten Lichtung dieses neuen Katheters besser Armaturen bis in die Gefäßlichtung, Leitungsbahnen des Körpers vorgebracht wer@@n; Injektionen sind leicht durchzuführen wie auch massivere Absaugung.e) This new clearing can be found in a single, relatively wide clearing Catheters better fittings up to the vascular clearing, ducts of the body put forward who @@ n; Injections are easy to perform, as are more massive suction.
f) Druch die relativ weite Katheterlichtung können von hinten bis vorn weitere technische Elemente wie Welle 13, ggf.f) Through the relatively wide catheter opening from the back to front further technical elements like shaft 13, possibly
in Zwischenschaltung auch von Kardangelenken, eingesetzt werden Es wird dann die Frontdüse 1 des Katheters zur Achse dieser Welle 13. in the interposition of cardan joints, it can also be used then the front nozzle 1 of the catheter becomes the axis of this shaft 13.
niete Welle 13 kann vorn sam Katheter dann Armaturen betreiben, wie Fräse 14, so daß nun auch innen im Gefäß Lipid-oder Fibroseherde, Intimasporne, die die Blutströmung sehr behindern, auch ohne sonstigen größeren operativen Eingriff abradiert werden können, zugleich unter Absaugung ebenfalls über die Lichtung des Katheters. rivet shaft 13 can then operate the front sam catheter fittings, such as Milling machine 14, so that lipid or fibrosis foci, intimal spurs, which hinder the blood flow very much, even without any other major surgical intervention can be abraded, at the same time with suction also through the clearing of the Catheter.
Außerhalb des Gefäßsystems können solche Vorrichtungen am Ballonkatheter auch fflr andere Zwecke wie etwa zur Beseitigung von Steinen in anderenLeitungsbahnen des Körpers eingesetzt werden. Such devices can be attached to the balloon catheter outside the vascular system also for other purposes such as removing stones in other ducts of the body.
g) Bi Einsatz von Armaturen vorn am Katheter sind die Frontdüsen 1 mehr seitlich zu setzen, um dann Körpersäfte, Detritus, abgeschabtes Gefäßinnenhautmaterial maschinell durch Pumpe über zwischengeschaltete Wulff'ache Flasche abzusaugen, Das in der Wulff'schen Flasche autgefangene Gwebsmaterial kann dann auch der histologischen Untersuchung zugeführt werden.g) If fittings are used at the front of the catheter, the front nozzles 1 to sit more laterally, to then body fluids, detritus, scraped-off inner skin material to be sucked off mechanically by a pump through an interposed Wulff'ache bottle, Das The tissue material caught in the Wulff bottle can then also be histological Examination to be supplied.
Diese nter a bis g genannten Vorteile machen eine stets wirksame Drosselung bzw. Verschlußvorrichtung vorn am Katheter erforderlich, die nur durch Einsatz einer Düse 1 vorn am Katherter bewerkstelligt werden kans. Wir nehmen an, daß in Anwendung dieses neuen Katheters doch die Drucke zur effizienten Aufdehnung von auch arteriosklerotisch veränderten stenosierten Gefäßen wesentlich verringert werden können, wobei es ja auch nicht besonders nachteilig wäre, wenn die Dilatation über längere Zeit im Gefäß vorgenommen würde.These advantages mentioned nter a to g make a throttling that is always effective or closure device at the front of the catheter required, which can only be achieved by using a Nozzle 1 at the front of the catheter can be accomplished. We assume that in use this new catheter but the prints for efficient dilation of arteriosclerotic altered stenosed vessels can be significantly reduced, although yes nor would it be particularly disadvantageous if the dilation was in the vessel for a long time would be made.
Prinzipiell kann die axial in Längarichtung gestellte und nicht unterdimensionierte Frontdüse 1 von inflen 9 oder auch von außen 10 verschlossen werden. Der knosch geforzte Einsatzkörper für die Düse wird von uns als Verschlußkörper 9 bezeichnet, was zudem natürlich auch beinhaltet, daß dieser Verschlußkörper 9 so auf die Düse 1 einwirkt, daß Fluid zeitweilig und steuerbar durchtritt.In principle, it can be placed axially in the longitudinal direction and not undersized Front nozzle 1 of inflen 9 or also be closed from the outside 10. The knosch grooved insert for the nozzle is used by us as a closure body 9 denotes, which of course also includes that this closure body 9 acts on the nozzle 1 so that fluid passes through temporarily and controllably.
Für diesen Verschlußkörper 9 wird nun aber auch eine geeignete Haltevorrichtung benötigt: Diese glauban wir mit einem gar nicht so dünnen Haltedraht 8 garfunden zu haben, der vorn mit dem Verschlußkörper 9 fest verbunden bis zum hinteren Tail des Katheters innerhalb der Lichtung des Katheters durchläöuft, und hinten mit der Verschlußschraube 5 des Katheters, auch zur Kurbel 12 zum besseren Betreiben umgewandelt, in Verbindung steht. Hier scheint es zweckmäßig, den Draht 8 hinten konzentrisch mit einer Scheibe zu verbinden, die bei entsprechand weiterer übergreifender Vorrichtung der Schraube 5 zur Gleitfläche 2 hinten am Katheter wird, so daß sich der Draht 8 bei Drchung der Schraube 5 nicht immer mitdrehen muß.A suitable holding device is now also required for this closure body 9 Required: This is believed to have been found with a holding wire 8 that is not so thin to have the front with the closure body 9 firmly connected to the rear tail of the catheter passes through the clearing of the catheter, and behind with the Locking screw 5 of the catheter, also converted to crank 12 for better operation, communicates. Here it seems expedient to have the wire 8 concentrically at the rear to be connected to a disk, which in the case of a corresponding further overarching device the screw 5 to the sliding surface 2 at the back of the catheter, so that the wire 8 does not always have to turn when turning screw 5.
Prospektiv ist nun aber bezüglich der Verschlußvorrichtung mit auch Haltedraht 8 jetzt schon zu berücksichtigen, daß sehr wahrscheinlich bei einer Länge des Katheters von über 1 m bei Beaufschlagung mit Fluid über ein oder zwei atü zeitweilig, vieileicht auch noch mehr, sich Verlängerung des.However, it is also prospective with regard to the locking device Retaining wire 8 already take into account that very likely at a length of the catheter of more than 1 m when exposed to fluid over one or two atmospheres temporarily, perhaps even more so, extending the.
selben um einige Millimeter ergeben kann in Abhängigkeit natürlich auch von dem Material, aus dem der Katheter (Katheterkörper) besteht.the same can result by a few millimeters depending on Naturally also of the material from which the catheter (catheter body) is made.
Um nun eine sozusagen automatische Steuerung de Verschlusses in stetiger Absicherung dieses Verschlusses an der Frontdüse 1 zu bewirken, dürfte noch eine Zusatzvorrichtung dieses Haltedrahtes für den Verschlußkörper 9 erforderlich sein, die wir als Elongationsvorrichtung bezeichnet haben Fig. 2).To now a so to speak automatic control of the lock in steady Safeguarding this closure on the front nozzle 1 is likely to be another Additional device of this retaining wire may be required for the closure body 9, which we have referred to as the elongation device (Fig. 2).
Wir bringen hier verständlicherweise nur eine relativ einfache Ausführung.Understandably, we are only giving a relatively simple implementation here.
Diese Elongationsvorrichtung, die doch sehr wahrscheinlich im eigentlichen Sinne zur Verlängerung des Haltedrahtes 8 automatisch dienen kann, besteht aus einer blechartn Verbreiterung 18 des an dieser Stelle unterbrochenen Haltedrahtes 8, mit in Längsrichtung eingegebenem Schlitz 15.This elongation device, which is very likely in the actual Meaning can automatically serve to extend the retaining wire 8 consists of a blechartn widening 18 of the holding wire 8, which is interrupted at this point, with slot 15 entered in the longitudinal direction.
während der andere Drahtteil in einer Gabel 19 von der anderen noch offenen Seite herübergreift und beide Formelemente nun veden werden über quergestellte 3olzen 16 innerhalb des Schltzes 15 und die Gabel 19 zweimal verschließen@, wobei für die Elongation von weiterer Bedeutung ist, daß der eine Bolzen in der Mitte des Schlitzes 15 angeordnet zu sein hat, was dann um mehrere Millimeter Spielraum für Elongation bzw.while the other wire part is still in one fork 19 from the other open side reaches over and both form elements are now vedas across 3bolt 16 within the slot 15 and the fork 19 close twice @, whereby for elongation it is of further importance that one bolt is in the middle of the slot 15 has to be arranged, which then has a margin of several millimeters for elongation or
Verlängerung des Drahtes 8 im Imeren des Katheters, unabhängig von Druck und Fluideinwirkung gibt, und das automatisch, wenn durch Fluid- und Druckeinwirkung sich der in Zukunft gebaute Ballonkatheter mit Frontdüse verlängen sollte.Extension of the wire 8 in the interior of the catheter, regardless of There are pressure and fluid action, and automatically if by fluid and pressure action the balloon catheter with a front nozzle built in the future should lengthen.
Der Anschlag das Bolzens 16 bei Elongation an oberen Rand des Schlitzes 15 sorgt dafür, daß die beiden Drähte immer in Kontakt bleiben. Nullstellung mit gegeneinandergezogenen Drahtenden wird über Federn 17 und weitere kleine Bolzen 20 erreicht, an denen die Federn befestigt @@zusagen beide Drähte überbrücken.The stop of the bolt 16 when elongated at the upper edge of the slot 15 ensures that the two wires always stay in contact. Zero setting with wire ends pulled against each other is held by springs 17 and other small bolts 20 reached, to which the springs attached @@ promise to bridge both wires.
Es liegt auf der Hand, daß man natürlich die Frontdüse 1 auch von vom ebenfalls über konisch gefersten, vom mehr flachen Verschlußkörper 10 verschließen kann. Dann müßte aber der ganze Gegendruck zum Fluid allein von dem Haltedraht 8 kompenziert werden, was für Routineunter@@hung nicht dienlich ist, Aber wenn man einen solchen Verschlußkörper 10 vom etwa aus hinteren Teil eines eigentlichen Frontballons 11 des Katheters macht, könnte dieser doch gelegentlich nützlich eingesetzt werden. Mediale innerer Teil einem solchen Verschlußkörpers 10 vom in der Frontdüse 1 kann zur Aufnahme von weiteren kleineren Büsen 21 benutzt werden, die mit vorher zusammengefalteten Frontballon 11 in Verbindung stehen, so daß man dann durch Fluid zugleich zwei Ballone 4/11 in mehr oder weniger stenozierten Gefäßen ebenfalls synchron aufdehnen könnte.It is obvious that you can of course also use the front nozzle 1 from from the also conically strengthened, from the more flat closure body 10 close can. Then, however, the entire counterpressure to the fluid would have to come from the holding wire 8 alone be compensated, which is not useful for routine under @@ hung, but if you such a closure body 10 from approximately the rear part of an actual front balloon 11 of the catheter, it could be used occasionally. Medial inner part of such a closure body 10 from in the front nozzle 1 can can be used to accommodate further smaller bushes 21, which were previously folded up Front balloon 11 are connected so that two balloons are then at the same time by fluid 4/11 could also expand synchronously in more or less stenosed vessels.
Das Einbringen von solchen Katheten allgemein wie auch des Coronerkathetes bedeutet ja doch innerhin einen scharfen Eingriff am arteriellen gefäß wie der A. femoralis, und wenn nun schon der Coronarkatheter gelegt ist, so sollte man diese Situation sehr und ggf. auch über längere Zeit zuuen des stenokardischen Patienten nutzen. Vorteile sehe ich in wiederholten, auch längerwährenden Druckimpulsgebungen im coronargefäßsystem aben auch in Dilatation von mehreren insbesondere arteriosklerotisch veränderten Gefäßen, möglichst ohne stärkere oder später Komplikationen machende Gefäßwandzerreißung, was ja auch nachfolgend zur örtlichen Gefäßthrombose dasselbst führen kann. The introduction of such catheters in general as well as the coronary catheter does mean a sharp intervention on the arterial vessel like the artery. femoralis, and if the coronary catheter is already in place, so one should treat this situation very much and possibly also over a longer period of time of the stenocardial Use patients. I see advantages in repeated, even longer-lasting pressure impulses in the coronary vascular system there are also dilation of several, especially arteriosclerotic Altered vessels, if possible without major or later complications Rupture of the vascular wall, which is also the result of the local vascular thrombosis itself can lead.
Noch besser scheint mir möglichst rärmlich, dreidimensional allmählich ganze dem ischämischen Herd vorgeschaltete Gefäßsysteme durch Einsatz des Ballons / Ballone synchron mit zugleich Fluidaustritt mit auch Pumpwirkung ins Gefäßsystem günstig Einfluß zu nehmen insbesondere auch zur Erweiterung eingeengter Gefäßteile wie auch möglichst von A@astomosen bzw. Gefäßquerverbindungen, die es auch aufzudehnen gilt, um dem ischämischen Herd nach Einsatz des Ballonkatheters mehr Blut als bisher zuführen zu können.It seems even better to be as poor as possible, three-dimensional gradually entire vascular systems upstream of the ischemic focus through the use of the balloon / Balloons synchronous with fluid discharge at the same time with also pumping action into the vascular system to exert favorable influence, in particular also for the expansion of constricted vessel parts as well as, if possible, from a @ astomoses or vascular cross-connections, which also expand it applies to the ischemic focus after use of the balloon catheter more blood than before to be able to supply.
Wenig verständlich ist mir, daß von zusätzliche Sauerstoffzufuhr mit Fluid über den Katheter in das Blut des Herzens biaher noch nicht oder wenig Gebrauch gemacht sein soll.I can hardly understand that with additional oxygen supply Fluid through the catheter into the blood of the heart has not yet been used or has little use should be made.
Hyperbarer Sauerstoffgehalt im Fluid ist außerhalb des Körpers im abgeschlossenen Raum unter mäßig erhöhtem Druck leicht erreichbar, und die mögliche autochthone Gasentbindung in Gefäßen des Herzens in Vorschaltung zum ischämischen Herd wird sich wahrscheinlich sehr in Grenzen halten. Feine dort entstehende Sauerstoffbläschen, die chnehin schneller als Stickstoff im Blut resorbiert werden, werden kaum mehr das Lungencapillarnetz erreichen, sich dort aber auch festfahren und durch baldige Resorption unschädlich werden. Hunderte von Kubikzentimeter Luft habe ich machem Hund intravenös zugefiihrt und diesem keinen gröberen Schaden zufügen können.Hyperbaric oxygen content in the fluid is outside the body in the closed space under moderately increased pressure easily accessible, and the possible autochthonous gas release in vessels of the heart in advance the ischemic focus will probably be very limited. Fine there resulting oxygen bubbles, which are absorbed faster than nitrogen in the blood will hardly reach the pulmonary capillary network, but will also get stuck there and become harmless through rapid resorption. Hundreds of cubic centimeters of air I have given some dogs intravenously and have not caused any major damage can.
Natürlich muß bei Einsatz hyperbaren Sauerstoffes in die Coronarien über den Katheter der Patient bezüglich auch beginnender cerebraler Auffälligkeit beobachtet werden und geringste Veränderungen und Zeichen dieser Art müssen sofort Anlaß sein, die Zufuhr hyperbaren Sauerstoffs zu stoppen.Of course, if hyperbaric oxygen is used, the coronary must be used the patient via the catheter with regard to incipient cerebral abnormalities be observed and the slightest changes and signs of this nature must be observed immediately Be a reason to stop the supply of hyperbaric oxygen.
Claims (17)
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE3326648A DE3326648C2 (en) | 1983-07-23 | 1983-07-23 | Balloon catheter |
DE19843402573 DE3402573A1 (en) | 1983-07-23 | 1984-01-26 | Balloon dilation apparatus with a cutting tool on a primarily single-lumen multi-purpose catheter |
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DE3326648A DE3326648C2 (en) | 1983-07-23 | 1983-07-23 | Balloon catheter |
Publications (2)
Publication Number | Publication Date |
---|---|
DE3326648A1 true DE3326648A1 (en) | 1985-02-07 |
DE3326648C2 DE3326648C2 (en) | 1986-02-27 |
Family
ID=6204781
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
DE3326648A Expired DE3326648C2 (en) | 1983-07-23 | 1983-07-23 | Balloon catheter |
Country Status (1)
Country | Link |
---|---|
DE (1) | DE3326648C2 (en) |
Cited By (15)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3421390A1 (en) * | 1984-06-08 | 1985-12-12 | Werner Dr.med. 4330 Mülheim Schubert | High-pressure catheter with a cutting and/or abrasion device |
US4871356A (en) * | 1987-06-27 | 1989-10-03 | B. Braun Melsungen Ag | Catheter device |
EP0369012A1 (en) * | 1987-07-23 | 1990-05-23 | Terumo Kabushiki Kaisha | Catheter tube |
DE3930600A1 (en) * | 1989-09-07 | 1991-04-04 | Schubert Werner | Expansible probe for blood vessel, etc. treatment - is used for pressure shock and coupling of wave energy imparting medium |
US5078681A (en) * | 1989-10-23 | 1992-01-07 | Olympus Optical Co., Ltd. | Balloon catheter apparatus with releasable distal seal and method of operation |
EP0570517A4 (en) * | 1991-02-05 | 1993-09-15 | Target Therapeutics Inc | Single lumen low profile valved balloon catheter. |
EP0564747A1 (en) * | 1992-04-09 | 1993-10-13 | BALT, société anonyme | Catheter for arterial dilatation |
EP0567976A2 (en) * | 1992-04-27 | 1993-11-03 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
US5324260A (en) * | 1992-04-27 | 1994-06-28 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
US5616149A (en) * | 1990-07-03 | 1997-04-01 | Cedars-Sinai Medical Center | Balloon catheter with cutting edge |
EP0963765A2 (en) * | 1998-06-11 | 1999-12-15 | Angiodynamics, Inc. | catheter assembly with occluding wire |
WO2005082444A2 (en) * | 2004-02-24 | 2005-09-09 | Boston Scientific Limited | Catheter having an improved distal tip |
EP1977684A1 (en) * | 2007-03-16 | 2008-10-08 | Fujinon Corporation | Endoscope |
DE102008007453A1 (en) | 2008-02-02 | 2009-08-06 | Philipps-Universität Marburg | feeder |
WO2012050992A1 (en) * | 2010-10-13 | 2012-04-19 | Cook Medical Technologies Llc | Hemodialysis catheter with thrombus blocker |
Families Citing this family (3)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3635183A1 (en) * | 1986-10-16 | 1988-04-28 | Medizintechnik Wedel Gmbh & Co | Mobile intestinal probe |
DE3743139C2 (en) * | 1987-12-18 | 1997-03-27 | Gsf Forschungszentrum Umwelt | Catheters, for example for cardiac catheterization |
DE4328249A1 (en) * | 1993-08-23 | 1994-01-05 | Mark Dr Med Schweizer | Device for medical and physical-chemical removal of masses from deteriorated blood circuit vessels - includes inflatable balloon pressure-controlled from outside patient and located before blood vessel section,thus producing treatment chamber |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE168467C (en) * | 1900-01-01 | |||
GB512456A (en) * | 1938-03-09 | 1939-09-15 | Helena Sadilkova | An apparatus for widening narrow or constricted internal organs of the body or their parts |
DE1744099U (en) * | 1957-03-05 | 1957-05-02 | Martin Dr Med Zeidler | EASTIC CATHETER. |
DE2817972A1 (en) * | 1977-09-15 | 1979-03-29 | Pevsner Paul H | MINIATURE BALLOON CATHETER AND METHOD OF ITS MANUFACTURING |
DE2934841A1 (en) * | 1978-09-01 | 1980-03-13 | Alain J M Durand | BALLOON CATHETER |
-
1983
- 1983-07-23 DE DE3326648A patent/DE3326648C2/en not_active Expired
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE168467C (en) * | 1900-01-01 | |||
GB512456A (en) * | 1938-03-09 | 1939-09-15 | Helena Sadilkova | An apparatus for widening narrow or constricted internal organs of the body or their parts |
DE1744099U (en) * | 1957-03-05 | 1957-05-02 | Martin Dr Med Zeidler | EASTIC CATHETER. |
DE2817972A1 (en) * | 1977-09-15 | 1979-03-29 | Pevsner Paul H | MINIATURE BALLOON CATHETER AND METHOD OF ITS MANUFACTURING |
DE2934841A1 (en) * | 1978-09-01 | 1980-03-13 | Alain J M Durand | BALLOON CATHETER |
Cited By (29)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE3421390A1 (en) * | 1984-06-08 | 1985-12-12 | Werner Dr.med. 4330 Mülheim Schubert | High-pressure catheter with a cutting and/or abrasion device |
US4871356A (en) * | 1987-06-27 | 1989-10-03 | B. Braun Melsungen Ag | Catheter device |
EP0369012A1 (en) * | 1987-07-23 | 1990-05-23 | Terumo Kabushiki Kaisha | Catheter tube |
EP0369012A4 (en) * | 1987-07-23 | 1990-12-27 | Terumo Kabushiki Kaisha | Catheter tube |
US5152277A (en) * | 1987-07-23 | 1992-10-06 | Terumo Kabushiki Kaisha | Catheter tube |
DE3930600A1 (en) * | 1989-09-07 | 1991-04-04 | Schubert Werner | Expansible probe for blood vessel, etc. treatment - is used for pressure shock and coupling of wave energy imparting medium |
US5078681A (en) * | 1989-10-23 | 1992-01-07 | Olympus Optical Co., Ltd. | Balloon catheter apparatus with releasable distal seal and method of operation |
US5616149A (en) * | 1990-07-03 | 1997-04-01 | Cedars-Sinai Medical Center | Balloon catheter with cutting edge |
EP0570517A4 (en) * | 1991-02-05 | 1993-09-15 | Target Therapeutics Inc | Single lumen low profile valved balloon catheter. |
EP0570517A1 (en) * | 1991-02-05 | 1993-11-24 | Target Therapeutics Inc | Single lumen low profile valved balloon catheter. |
EP0564747A1 (en) * | 1992-04-09 | 1993-10-13 | BALT, société anonyme | Catheter for arterial dilatation |
US5620418A (en) * | 1992-04-27 | 1997-04-15 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
US5395331A (en) * | 1992-04-27 | 1995-03-07 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter having a ribbed balloon |
US5324260A (en) * | 1992-04-27 | 1994-06-28 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
EP0567976A2 (en) * | 1992-04-27 | 1993-11-03 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
EP0841073A2 (en) * | 1992-04-27 | 1998-05-13 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
US5807326A (en) * | 1992-04-27 | 1998-09-15 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
EP0841073A3 (en) * | 1992-04-27 | 1998-10-21 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
EP0567976B1 (en) * | 1992-04-27 | 1999-07-28 | Minnesota Mining And Manufacturing Company | Retrograde coronary sinus catheter |
EP0963765A3 (en) * | 1998-06-11 | 2000-06-28 | Angiodynamics, Inc. | catheter assembly with occluding wire |
EP0963765A2 (en) * | 1998-06-11 | 1999-12-15 | Angiodynamics, Inc. | catheter assembly with occluding wire |
US6283950B1 (en) | 1998-06-11 | 2001-09-04 | Angiodynamics, Inc. | Occluding wire assembly |
WO2005082444A2 (en) * | 2004-02-24 | 2005-09-09 | Boston Scientific Limited | Catheter having an improved distal tip |
WO2005082444A3 (en) * | 2004-02-24 | 2006-03-02 | Boston Scient Ltd | Catheter having an improved distal tip |
US8221387B2 (en) | 2004-02-24 | 2012-07-17 | Boston Scientific Scimed, Inc. | Catheter having an improved distal tip |
EP1977684A1 (en) * | 2007-03-16 | 2008-10-08 | Fujinon Corporation | Endoscope |
DE102008007453A1 (en) | 2008-02-02 | 2009-08-06 | Philipps-Universität Marburg | feeder |
WO2012050992A1 (en) * | 2010-10-13 | 2012-04-19 | Cook Medical Technologies Llc | Hemodialysis catheter with thrombus blocker |
US9987461B2 (en) | 2010-10-13 | 2018-06-05 | Cook Medical Technologies Llc | Hemodialysis catheter with thrombus blocker |
Also Published As
Publication number | Publication date |
---|---|
DE3326648C2 (en) | 1986-02-27 |
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