U.S. patent number 3,623,484 [Application Number 04/843,517] was granted by the patent office on 1971-11-30 for telescoping shunt system for physiological fluid.
Invention is credited to Rudolf R. Schulte.
United States Patent |
3,623,484 |
Schulte |
November 30, 1971 |
**Please see images for:
( Certificate of Correction ) ** |
TELESCOPING SHUNT SYSTEM FOR PHYSIOLOGICAL FLUID
Abstract
This invention relates to an auxiliary device for use with and
in physiological shunt circuits for the drainage of unwanted fluids
from one part of the body to another. According to this invention a
telescopic section is incorporated into a shunt catheter so that
when one end of the system is implanted in an area of the body to
be drained (such as the ventricles of the brain) and the other end
of the system is implanted in a portion of the body into which the
fluid must be drained (such as the heart), then, when there is
bodily growth which would require elongation of the system, the
telescopic portion will elongate and thus prolong the period before
the system or some part of it must be replaced to compensate for
normal growth. The catheter incorporating the telescopic section is
made in two segments having flanged ends which contact the inside
of a silicone rubber cylinder and are fluidtight, but can move
longitudinally under tensile loads applied as a consequence of the
growth of the child. The flanged ends may be radiopaque in order
that the elongation may be checked by X-ray. These ends are held
against withdrawal.
Inventors: |
Schulte; Rudolf R. (Santa
Barbara, CA) |
Family
ID: |
25290236 |
Appl.
No.: |
04/843,517 |
Filed: |
July 22, 1969 |
Current U.S.
Class: |
604/8;
285/302 |
Current CPC
Class: |
A61M
39/10 (20130101); A61M 27/006 (20130101) |
Current International
Class: |
A61M
27/00 (20060101); A61M 39/10 (20060101); A61M
39/00 (20060101); A61m 027/00 () |
Field of
Search: |
;128/350,35V
;285/302 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Truluck; Dalton L.
Claims
I claim:
1. A catheter for use in a physiological fluid shunt system, said
catheter comprising: a first and a second tubular catheter portion,
said tubular catheter portions each having an enlarged cylindrical
flange; a pair of tubular retaining sleeves, each of said tubular
retaining sleeves having a cylindrical inner wall with a reduced
end adapted to overhang and retain against removal a respective one
of said flanges and to make a close engagement with the outer wall
of the respective catheter portion, said flanges making a sliding
fluid-sealing fit with respective inner walls of said retaining
sleeves; and an outer sleeve, said outer sleeve being bonded to and
joining together and fluidly sealing the retaining sleeves, the
retaining sleeves projecting beyond the ends of the outer
sleeve.
2. A catheter according to claim 1 in which a groove is provided in
the outer wall of one of said retainer sleeves to provide a point
of attachment for a suture.
3. A catheter according to claim 1 in which one of said catheter
portions carries protrusions on its surface near its end away from
the sleeves, said protrusions being adapted to engage with fibrous
body materials to prevent too-easy withdrawal.
4. A catheter described in claim 1 in which said enlarged shoulders
on said tubular catheter segments are radiopaque.
5. A catheter according to claim 1 in which said tubular catheter,
said retaining sleeves, and said sleeves are made of silicone
rubber.
6. A catheter according to claim 3 in which said enlarged shoulders
on said tubular catheter are radiopaque, and in which the catheter
and said sleeves are made of silicone rubber.
7. A physiological fluid shunt system which comprises: a collector
catheter; pump means draining fluid from said collector catheter; a
drainage catheter receiving fluid from said pump means, said
drainage catheter having a first portion and a second portion, and
a telescopic coupling means connecting said portions for enabling
the length of the drainage catheter to increase, said telescopic
coupling means comprising: an enlarged cylindrical flange on each
of the catheter portions; a pair of tubular retaining sleeves, each
of said tubular retaining sleeves having a cylindrical inner wall
with a reduced end adapted to overhang and retain against removal a
respective one of the said flanges and to make a close engagement
with the outer wall of the respective catheter portion, said
flanges making a sliding fluid-sealing fit with respective inner
walls of said retaining sleeves; and an outer sleeve, said outer
sleeve being bonded to and joining together and fluidly sealing the
retaining sleeves, the retaining sleeves projecting beyond the ends
of the outer sleeve.
8. A system according to claim 7 in which a groove is provided in
the outer wall of one of said retainer sleeves to provide a point
of attachment for a suture.
9. A system according to claim 7 in which one of said catheter
portions carries protrusions on its surface near its end away from
the sleeves, said protrusions being adapted to engage with fibrous
body materials to prevent too-easy withdrawal.
Description
This invention relates to auxiliary devices for use in
physiological shunt circuits.
The drainage of fluid from one part of the body where it is
unwanted to another from which it can be disposed of by providing a
shunt passage for the fluid is well known. An example of a catheter
for such a purpose is shown in U.S. Pat. No. 3,020,913 to
Heyer.
In the usage of such catheters (sometimes called "shunts"),
auxiliary means are often provided for supplemental functions. An
example of one such auxiliary means is shown in U.S. Pat. No.
3,111,125 to Schulte. In this patent, a lozenge is combined with a
shunt, which lozenge, while permitting unimpeded flow therethrough
and through the shunt, is also actuable as a pump for aiding the
expulsion of the fluid, to act as a check valve, and to test the
openness of the upstream end of the system.
It is an object of this invention to provide new and additional
auxiliary means between the region to be drained and the receiving
region for the drained fluid in individuals subject to growth so as
to permit the shunt system to elongate with the growth of the
individual, thus prolonging the period before such shunt circuit
may have to be removed and replaced with a longer mechanism. This
further results in a new system with improved properties over prior
art systems.
A further object of the invention is to provide means in a
telescopic catheter which permits the use of radioscopy to
determine the extension of the telescopic section, and thus to
determine whether the function of the element has been fully
expended.
Still another object of the invention is to provide means on one
end of the catheter to prevent too-easy withdrawal of the tube,
thus aiding it in exerting a tensile load upon the telescopic
portion and thereby providing elongation.
The above and other features of this invention will be fully
appreciated from the following detailed description and the
accompanying drawings in which:
FIG. 1 shows the presently preferred embodiment of the invention in
the body of a child;
FIG. 2 is a cross section of a portion of the invention shown in
Fig. 1, taken at line 2--2 therein; and
FIG. 3 is a cross section taken at line 3--3 of FIG. 2.
A telescopic catheter 10, as shown in FIG. 1, is incorporated in a
shunt system, and is fixed to the body at a location between the
two ends of one arm of the system (the arm sometimes herein called
a "drainage catheter"), which arm is divided into two adjacent
portions in this device.
The portions of the drainage catheter are called the proximal
catheter 11 and the distal catheter 12. As seen in FIG. 2, the
proximal catheter 11 and the distal catheter 12 have enlarged
cylindrical flanges 13 and 14 which act as pistons and make a
sliding sealing fit inside of retainer sleeves 15 and 16. Flanges
13 and 14 may be made radiopaque by applying a coating of, or by
impregnation with, radiopaque material such as barium sulphate in
order to visualize the flanges to X-ray in the implanted
device.
The drainage catheter has a central passage and an outlet port from
it, which outlet port is placed in a region such as the atrium of
the heart, into which unwanted fluid is to be drained. A check
valve of the slit-type shown in the said Heyer valve, or of any
other type, may be included in the drainage catheter. The outer
ends of the retainer sleeves overhang the outer faces of the
flanges so as to hold them inside the retainer sleeves. Preferably
the outer ends make a close fit with the outer walls of the
catheter portions. An outer sleeve 17 encases the retaining sleeves
15 and 16. The three sleeves may be held assembled by an air-curing
silicone rubber cement. All sleeves and the catheter tubes 11 and
12 may conveniently be made of silicone rubber.
In use in a shunt system another catheter 18 (sometimes herein
called a "drainage catheter") is implanted so as to drain a region
having unwanted fluids, such as the ventricles of the brain in
cases of hydrocephalus. This catheter has a central passage and
openings thereinto so as to collect fluid from this region.
A clearing pump in the shape of a lozenge 19 is sutured in position
in a cavity in the cranium. This is preferably but not necessarily
the pump and check valve of the said Schulte patent. The drainage
and collection catheters meet at the pump, which interconnects
them.
The proximal catheter portion 11 is sutured to the lozenge 19,
which fixes its free end. Retainer sleeve 16 is sutured to the
jugular vicinity by attachment of a suture to a groove 19a provided
for that purpose, this suturing being done at the entry to the
vein. The free end 20 of the distal catheter 12 is imbedded in the
superior vena cava. Small irregularities 21 in the nature of
protrusions are formed on the surface of the free end 20, and these
will become encased in fibrous tissue in the superior vena cava,
and thereby prevent too-easy withdrawal therefrom.
The telescopic portion of the catheter assembly is assembled by
slipping the retaining sleeves 15 and 16 over the distal and
proximal segments of the catheter so that the reduced portions 22
and 23 closely engage the outer diameter of the catheter, while the
cylindrical enlarged flanges 13 and 14 of the catheter tubes 11 and
12 are in sliding, fluid-sealing fit with the inside walls of the
retaining sleeves 15 and 16. The outer sleeve 17 is then slipped
over the retaining sleeves 15 and 16 and cemented into place with
an air-curing silicone rubber cement, thus holding the telescopic
catheter parts assembled in proper relative position.
In use, with the distal and proximal segments of the catheter fixed
to the clearing pump and to the jugular vein, and with an end
embedded in the vena cava and retained by the protrusions'
engagements with fibrous material, growth of the child will place a
tensile load on the proximal and distal portions of the catheter,
thereby causing the cylindrical flanged ends 13 and 14 to slip
apart within the retaining sleeves 15 and 16. The position of the
flanged ends 13 and 14, because of their radiopaque properties,
enables the physician to X-ray the child and determine how much
movement has occured within the telescopic portion of the catheter,
and how much growth remains to be allowed before the device must be
replaced with longer catheter portions.
The flanges are held against removal by the reduced portions 22 and
23, which are smaller than the flanges, so the device cannot be
disassembled by an axial pull.
This telescopic joint markedly improves the function of the system
and provides a feature of growth not heretofore available. It is,
however, useful apart from pumps and check valves, for example, in
a single-line shunt such as shown in the Heyer patent, wherein no
pump is used.
The device is easily manufactured, and elegant in concept. It
reduces the number of operations to which a person must be
subjected. The importance of this should not be underestimated. It
happens often that a new catheter cannot be inserted in the same
jugular vein in which an "outgrown" catheter had been encased. Then
the other jugular or another vein must be used. Obviously the
choice of sites and frequency of the procedure are thereby
circumscribed and the surgeons alternatives are limited. This
invention restores some of these by reducing the frequency of the
event.
The operation of the device is obvious. Sealing between two
silicone rubber surfaces is a regular and routine matter. If
desired, one may be made a bit more flexible than the other but
this is not essential. The material is dimensionally stable, and
once the seal has been tested, the reliability of the function may
be assumed.
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