US 4,666,426 AGrant
Double Lumen Catheter for a Device for in-Vivo Purification of Blood
Issue Date:1987-05-19
•4 Claims
•2 Drawing Sheets
Abstract
An especially designed double lumen catheter (10) for use in a device for in-vivo purification of blood, by means of which blood pumped out of a vein is subjected to intensive ultrafiltration and the retentate, together with a quantity of a substitute fluid roughly corresponding, volumetrically, to the filtrate, is returned to the vein. The double lumen catheter (10) with a coaxial arrangement of the two catheter tubes (13, 14) is so designed that the outer tube (14) is shorter than the inner tube (13) which latter forms the open catheter tip (12). The inner tube (13) is 4-6 cm longer than the outer tube (14) and, beginning from the tip (12), it has 4 pairs of lateral openings (11) at mutual spacings of between 8 and 12 mm. The outer tube (14) at its end has, over a length of 3.5-6 cm, 4 pairs of lateral openings (11) at a spacing of 8-12 mm each and at the smooth transition from the outer tube (14) to the inner tube (13) there is provided a contrast ring (15), of a material which under X-ray radiation is detectable through contrast formation. At the other end of the catheter (10) the inner tube (13) is made longer than the outer tube (14), for the connection of a two-way connecting member.
Metadata
Inventor
- Karl Aigner
Application Information
Application Number:US 8854092
Filing Date:1986-07-14
Priority Date:1983-07-29
Art Unit:336
Classifications
IPC:
A61M 500
Field of Search:
6044;5;27;43;45;158;280;283
Patent Drawings (2 sheets)
Description
BRIEF DESCRIPTION OF THE DRAWINGS
The invention will now be described in greater detail with reference to the drawings.
FIG. 1 shows a longitudinal section through the catheter according to the invention.
FIG. 2 shows a cross-section through the coaxially disposed catheter tubes.
FIG. 3 shows the two-way connecting member in longitudinal section.
FIG. 4 shows a schematic overall view of the device which is employed in combination with the catheter.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
FIG. 1 shows the double lumen cather (10) in longitudinal section with the open end (12) of the inner tube (13) and the lateral openings (11) which are provided in pairs in the vicinity of the end. The outer catheter tube (14) surrounds the inner tube (13) over the main length of the catheter and it ends removed by approximately 6 cm from the tip of the inner tube (13). At the conical transition from the inner tube (13) to the outer tube (14) at the end of the outer tube a contrast ring (15) is provided. This ring makes it possible to detect the position of the catheter as inserted in the vein. The outer tube (14), too, has, in the vicinity of its end, 4 outlet openings (11) which are provided in pairs. At the rear end the inner tube (13) is formed longer than the outer tube (14) in order to make the connection to a two-way member possible.
FIG. 2 shows the coaxial arrangement of inner tube (13) and outer tube (14) along the main length of the catheter.
FIG. 3 shows, in schematic presentation, a longitudinal section through the two-way connecting member (16). The sleeve (17) has an inner bore (19) which is larger than the outer diameter of the catheter inner tube (13) and is approximately equal to the inner diameter of the catheter outer tube (14). At the rear end of the sleeve (17) the inner bore (19) is enlarged for the insertion of a conical stopper (20). The transition to the larger diameter is conical to enable the clamping, at this conical surface, of the inner tube (13) by means of the conical front face of the stopper (20). The stopper (20) has an inner bore extending therethrough and, at its other end, has a coupling for further hose connections, preferably a Luer coupling. A connecting stud (18) extends laterally from the inner bore (19) of the sleeve (17). In FIG. 3 this stud is shown extending at a right angle, however an acute angle is also possible. This stud, too, at its end preferably has a Luer coupling for the attachment of connecting hoses. The front end of the sleeve (17) is conically formed in order to enable the outer tube (14) of the catheter at this surface to be clamped by means of a cap cone (21). In order to make possible the connection of the cap cone (21) and the conical stopper (20) with the sleeve (17), correspondingly fitting threads, not shown in FIG. 3, are provided. Also an outer thread on the sleeve (17) in the vicinity of its front end, for enabling the cap nut (21) with an inner thread to be received, and at the end of the inner tube (19) on the portion with the larger diameter an inner thread, for enabling the conical stopper (20) with an outer thread to be screwed in. By means of a correspondingly conical design of the surfaces, clamping connections are possible which, if desired, may be improved, in their holding effect, by means of threads. In order to make the clamping connections permanent, the catheter tubes are additionally provided, on the inside as well as the outside, with suitable adhesive materials. However, the connection may also be effected by injection molding the connecting member to the hose ends.
FIG. 4 shows, in schematic presentation, the device which is employed in combination with the catheter. The double lumen catheter shown in FIG. 1 is connected to the hose connections (8,9) in such a fashion that the suction line is connected to hose (8) and the return line to hose (9). Venous blood is aspirated from the catheter outer tube by hose pump (2) by way of hose connection (8) and is pressed through the connecting hose into the ultrafiltration filter (1) and thence arrives at the catheter inner tube by way of hose connection (9). Supply line (14) for anticoagulant agents coming from an automatic injection apparatus terminates before the filter (1) in hose connection (8). Inserted in hose connection (8) before and after hose pump (2), respectively, are bordered rubber diaphragms (3), in order to make injectidns possible or to enable control samples to be drawn off by means of injection needles. Similar rubber diaphragms are provided in the filtrate line between the filter (1) and the valve (5) and in the hose connection (9) behind coil (7) which is placed in a water bath.
Numeral (4) denotes the elastic pillows for the control of the filling. From ultrafilter (1) there extends the filtrate line in which the precisely adjustable valve (5) is provided and which terminates in a collecting container (6) for the storage of the filtrate. The collecting container has an indicating scale and it has a capacity of 1-3 liters. Behind the ultrafiltration filter (1) there is provided in hose connection (9) the supply location for substitute fluid which is introduced by a second hose pump (2a). Hose pump (2a) aspirates the substitute fluid out of one or more storage vessels of sufficient capacity which are connected by means of hose connections. If desired, forks are provided by means of T-members, in order to enable a plurality of different substitute fluids to be used. The pumping in of the substitute fluid for which so-called Ringer solutions are preferably used is necessary because otherwise the large quantities of substitute fluid cannot be introduced into the system with the desired precision and speed. The power of the second hose pump (2a) is matched to the quantity of fluid leaving the system through the adjustable valve (5) in such a manner that volumetrically a loss of fluid is avoided as much as possible. As a matter of principle, however, it is also possible to introduce smaller or larger quantities of substitute fluids if this is required, in a special case, within the framework of the overall therapy.
In order to compensate for cooling losses there is preferably provided in hose line (9) a hose coil (7) which is disposed in a water bath the temperature of which is kept at approximately 40.degree. C. In this fashion possible heat losses can be compensated in a simple manner so that the retentate, upon filtration, can be returned to the vein at the desired temperature. The hose connection between the catheter and the hose pump has a length of approximately 1.5 m, the hose distance between hose pump and filter is approximately 1 m, and approximately 2 m of hose connections without the hose coil are required for the connection of hose (9) to the catheter. The hose connections have an inner diameter of about 5 mm and an outer diameter of about 7 mm.
The connecting locations of the two-way connecting member have, the same as the hoses, color markings, for example red and blue, in order to avoid a transposition of connections.
The overall device is formed as a so-called filtration set together with the catheter. Preferably the set is marketed as a whole, sterile packaging being preferred in order to make instantaneous use of the entire combination possible. As a matter of principle, however, the set may also be separated into sterile and non-sterile packaged parts.
List of Reference Numerals
1--Ultrafilter, hemofilter
2,2a--Hose pumps
3--Inserted rubber diaphragm
4--Soft hose section for optical level monitoring, Hose pillow
5--Precisely adjustable valve
6--Collecting container for ultrafiltrate (measuring container)
7--Hose coil in water bath
8--Hose line from catheter
9--Hose line to catheter
10--Catheter
11--Paired openings
12--Front opening
13--Inner tube, catheter inner tube
14--Outer tube, catheter outer tube
15--Contrast ring
16--Two-way connecting member
17--Sleeve
18--Lateral connection
19--Inner bore
20--Conical stopper
21--Cap cone, Cap nut
Claims
I claim:
1. A double lumen catheter for the simultaneous withdrawal from and introduction into the vena cava, in the vicinity of the heart, of blood at a rate of at least 600 ml/min, while minimizing flow disturbances in the vein, in intra-arterial chemotherapy, with a coaxial arrangement of the two catheter tubes, in which the outer tube is shorter than the inner tube forming the open catheter tip, and has lateral suction openings, wherein the inner tube (13) is 4-6 cm longer than the outer tube (14), wherein, beginning from the tip (12) there are provided 4 pairs of lateral openings (11) at mutual spacings of between 8 and 12 mm each, wherein the outer tube (14) at its end has, over a length of 3.5-6 cm, 4 pairs of lateral openings (11) at a mutual spacing of 8-12 mm each, and wherein the transition from the outer tube (14) to the inner tube (13), which is smooth, includes a ring (15) of a material which is detectable, through contrast formation, under X-ray radiation.
2. A double lumen catheter as claimed in claim 1, with a branch connection at its rear end, wherein at the rear end of the catheter there is provided a connecting member (16) in the form of a sleeve (17) into which the end of the inner catheter tube (13) is inserted and to which the ends of the catheter tubes (13,14) are attached by clamping, the inner bore (19) of said sleeve being larger than the outer diameter of the catheter inner tube (13) so that between the catheter inner tube (13) as inserted into the sleeve (17) and the bore wall there is provided an annular gap, wherein said sleeve (17) has a lateral connecting stud (18) having a bore which is in communication with said annular gap.
3. A double lumen catheter insertable into the vena cava up to the vicinity of the heart, for use in a system for the in-vivo purification of blood in intra-arterial chemotherapy, in which large amounts of blood pumped out of the vena cava are subjected to ultrafiltration and, simultaneously with the withdrawal of blood from the vena cava, the filtrate is returned to the vena cava together with a requisite amount of substitute fluid; wherein the double lumen catheter (10) is in the form of a coaxial arrangement of two substantially cylindrical catheter tubes (13,14) with the inner tube (13), which forms the open catheter tip (12), at its front end being 4-6 cm longer than the outer tube (14), wherein, beginning from the tip (12), there are provided in said inner tube (13) 4 pairs of lateral openings (11) at mutual spacings of between 8 and 12 mm each, wherein the outer tube (14) at its front end has, over a length of 3.5-6 cm, 4 pairs of lateral openings (11) at a mutual spacing of 8-12 mm each , and wherein the transition from the outer tube (14) to the inner tube (13), which is smooth, includes a ring (15) of a material which is detectable, through contrast formation, under X-ray radiation.
4. An in-vivo blood purification system for use in intra-arterial chemotherapy, said system comprising: a double lumen catheter insertable into the vena cava up to the vicinity of the heart, the double lumen catheter (10) being in the form of a coaxial arrangement of two substantially cylindrical catheter tubes (13,14) forming an annular space therebetween, the inner tube (13), which forms the open catheter tip (12), at its front end being 4-6 cm longer than the outer tube (14), there being provided in said inner tube (13), beginning from the tip (12) 4 pairs of lateral openings (11) at mutual spacings of between 8 and 12 mm each, the outer tube (14) at its front end having, over a length of 3.5-6 cm, 4 pairs of lateral openings (11) at a mutual spacing of 8-12 mm each, and the transition from the outer tube (14) to the inner tube (13), which is smooth, including a ring (15) of a material which is detectable, through contrast formation, under X-ray radiation, and said system also comprising: means (8, etc.) connectable to said annular space for pumping large amounts of blood out of the vena cava through said annular space, means (1, etc.) for subjecting said blood to ultrafiltration, and means (9, etc.) connectable to said inner tube (13) for returning, simultaneously with the withdrawal of blood from said annular space, the filtrate to the vena cava through said inner tube (13) together with a requisite amount of substitute fluid.