U.S. patent number 3,690,323 [Application Number 05/094,069] was granted by the patent office on 1972-09-12 for device for draining ventricular fluid in cases of hydrocephalus.
This patent grant is currently assigned to The United States of America as represented by the Secretary of the Army. Invention is credited to Lawrence J. Mervis, Donald E. Wortman.
United States Patent |
3,690,323 |
Wortman , et al. |
September 12, 1972 |
DEVICE FOR DRAINING VENTRICULAR FLUID IN CASES OF HYDROCEPHALUS
Abstract
A modified ventricular end for a ventriculo-cardiac shunt used
in the treatment of hydrocephalus and similar conditions is
provided for removing fluids which accumulate in the cavity of the
brain and must be drained to the heart. An umbrella-shaped cover
protects an apertured end of the shunt for preventing the same from
becoming attachad to the ventricular walls by growth of brain
tissue thereon. The device, which is inserted into the brain in a
closed position and is subsequently opened, has supporting rib
structures which may carry various sensing elements for observing
conditions in the brain.
Inventors: |
Wortman; Donald E. (Rockville,
MD), Mervis; Lawrence J. (Milwaukee, WI) |
Assignee: |
The United States of America as
represented by the Secretary of the Army (N/A)
|
Family
ID: |
22242685 |
Appl.
No.: |
05/094,069 |
Filed: |
December 1, 1970 |
Current U.S.
Class: |
604/8;
604/268 |
Current CPC
Class: |
A61M
1/84 (20210501); A61M 27/006 (20130101) |
Current International
Class: |
A61M
1/00 (20060101); A61m 027/00 () |
Field of
Search: |
;128/1R,2H,2R,35OR,35OV |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
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|
|
|
|
|
1,166,977 |
|
Apr 1964 |
|
DT |
|
158,613 |
|
Apr 1957 |
|
SW |
|
Other References
Ellenwood, E. R. et al., "Central-Body Temperature Apparatus," IBM
Tech. closure Bulletin, Vol. 11, No. 11, Apr. 1969.
|
Primary Examiner: Pace; Channing L.
Claims
What is claimed is:
1. A device suitable for placement in a body cavity for draining
fluids therefrom, comprising:
a drainage tube having a closed distal end provided with lateral
passageways adjacent thereto, the tube being of sufficient length
so that its proximal end is adapted to extend beyond a body cavity
into the atmosphere;
porous means covering said distal end of said tube and said lateral
passageways therein, said porous means including expansible means
for providing an umbrella-like liner thereabout for permitting
passage therethrough of fluid but preventing obstruction of said
lateral passageways; and,
means for normally retaining said porous means in an unexpanded
state during insertion of said drainage tube into a body
cavity.
2. The device set forth in claim 1, further comprising means
supported on said porous means for sensing predetermined conditions
when inserted into a body cavity.
3. The device set forth in claim 2, wherein said porous means
comprises a plurality of elongate, resilient rib constructions
normally disposed on said tube parallel to the longitudinal axis
thereof and to each other when in said unexpanded state, with one
end of each of said ribs being secured to the outer wall of said
tube, said ribs being preconditioned to assume a funnel-shaped
configuration when the unsecured ends thereof are released by said
retaining means; and,
a porous material covering the same and attached thereto at spaced
intervals for permitting said ribs to expand into said
substantially funnel-shaped configuration.
4. The device set forth in claim 3, wherein said retaining means
comprises a sleeve member slidably disposed over said drainage tube
and said porous covering means,
said sleeve member having a stop therein for engaging said ribs
upon being fully extended thereover, and,
said sleeve member, upon withdrawal thereof at a predetermined
distance substantially equal to the length of said unsecured
portion of said ribs, permitting said porous covering means to
assume said funnel-shaped configuration.
5. The device set forth in claim 4, wherein said sensing means
comprises sensing devices disposed in cavities formed in said ribs,
and further including channels formed in said ribs and said sleeve
member communicating with said cavities for receiving connecting
leads to said sensing devices.
6. The device set forth in claim 5, wherein said sensing devices
are responsive to pressure.
7. The device set forth in claim 5 wherein said sensing devices are
responsive to temperature.
8. In an apparatus for draining cerebrospinal fluid into the
circulatory system, the combination of a resilient conduit adapted
to be connected to said circulatory system;
catheter means for connecting the proximate end of said conduit to
a source of cerebrospinal fluid;
porous means covering the end of said catheter means and including
expansible means for providing an umbrella-like liner thereabout
for permitting passage therethrough of said cerebrospinal fluid but
preventing the obstruction of said catheter means;
means for normally retaining said porous means in an unexpanded
state during insertion into said source of cerebrospinal fluid;
and,
means supported on said expandible porous means for sensing
predetermined conditions within said source of cerebrospinal
fluid.
9. The combination set forth in claim 8, wherein said catheter
means is substantially tubular having a closed distal end provided
with a plurality of lateral passageways adjacent to said distal
end; and,
said porous means comprises a plurality of elongate rib
constructions normally disposed on said catheter tube parallel to
the longitudinal axis thereof and to each other when in said
unexpanded state, with one end of each of said ribs being secured
to the outer wall of said catheter tube on the side of said
passageways opposite said distal end, said ribs being
preconditioned to assume a conical configuration when the unsecured
ends thereof are released by said retaining means; and,
a porous material covering said rib constructions and attached
thereto at spaced intervals for permitting the same to expand to
said conical configuration while providing a tight porous cover
thereabout.
10. The combination set forth in claim 9, wherein said means for
normally retaining said porous means in an unexpanded state
comprises a substantially tubular-shaped sleeve member having a
stop therein for engaging said ribs upon being fully extended
thereover,
said sleeve member, upon withdrawal thereof a predetermined
distance substantially equal to the length of said unsecured
portion of said ribs, permitting the expansion of said porous
covering means, and,
said sensing means comprises sensing devices disposed in cavities
formed in said ribs, and channels formed in said ribs and said
sleeve member communicating with said cavities for receiving
connecting leads for said sensing devices.
Description
RIGHTS OF GOVERNMENT
The invention described herein may be manufactured, used, and
licensed by or for The United States Government for governmental
purposes without the payment to us of any royalty thereon.
BACKGROUND OF THE INVENTION
The invention relates generally to surgical devices for controlling
the drainage of fluids between different portions of the body of a
patient, and more particularly, to improvements in
ventriculo-cardiac shunts for draining cerebrospinal fluid from the
cerebral ventricles to other areas of the body in the treatment of
hydrocephalus and similar conditions in which there is difficulty
in the free circulation and absorption of cerebrospinal fluid.
The practice of treating communicating or obstructive hydrocephalus
by establishing communication between the cerebrospinal fluid
pathways and the vascular system is well known and several
mechanical devices are presently available for draining away the
cerebrospinal fluid which accumulates within the skull and exerts
pressure therein. Once inserted, it is desirable that these devices
permanently remain in the patient, to be replaced if some
maloperation occurs. These devices normally include a closed-end
drainage tube of quite small diameter which is inserted through an
opening in the skull into the cranial cavity of the head, or more
specifically, into a lateral cerebral ventricle of the patient, and
which is provided with a plurality of small apertures in the wall
thereof near the distal end of the tube in the brain of the patient
for permitting passage therethrough of fluids collected from the
cerebral ventricles to the bloodstream. It has been found, however,
that cerebral tissue ordinarily collects, or "grows," about the end
of these devices, or shunts, after they have been in use only a
reasonably short period of time, causing the same to become
attached to the ventricular or other membrane walls and thereby
obstructing the normal flow of fluids thereinto. As a result, the
patient often exhibits symptoms of intracranial hypertension (shunt
malfunction). When this occurs, or, if the shunt fails for any
other reason, it is necessary to replace the shunt, and this
requires additional surgical procedures which could be of some
danger to a patient.
SUMMARY OF THE INVENTION
Accordingly, it is an object of this invention to provide an
improved ventricular end portion for a ventriculo-cardiac shunt
which is simple in construction and highly reliable and can be
utilized with the maximum degree of safety to the patient.
Another object of this invention is to provide a device for
draining cerebral-spinal fluid from the cerebral ventricles into
other areas of the body for cases of hydrocephalus and similar
conditions which does not tend to become obstructed with cerebral
debris or tissue growths.
Still another object of this invention is to provide a
ventriculo-cardiac shunt for draining cerebrospinal fluid having an
improved ventricular end portion which is not susceptible to
becoming blocked or obstructed by brain tissue growth thereon and
which is capable of supporting sensing devices for detecting
various environmental conditions in the brain to assist in the
treatment of such illnesses as hydrocephalus, brain cancer, and
stroke.
The foregoing and other objects are attained by a
ventriculo-cardiac shunt having a tubular end portion which is
provided with a plurality of apertures for receiving fluid which
may have accumulated in the regions of the brain cavity and which
is enclosed within a novel umbrella-type cover slidably disposed
thereover that is normally closed during insertion of the same into
the brain cavity and may be readily opened once in place for
supporting the tubular end portion in a stand-up relation from the
ventricular walls. The umbrella includes a gauze-like or
cheesecloth type material porous to the cerebrospinal fluid and
suitably attached to or covering a plurality of elongate rib
constructions of a firm elastic material which are preconditioned
as a whole to form an open or conical configuration when supported
or retained at one end thereof and released at the other end for
permitting the same to expand, or "open." A tubular sleeve which is
slidably disposed over the tubular end portion and the umbrella
portion of the device is provided for the purpose of normally
maintaining the umbrella in a closed position and, whenever
desired, upon withdrawal of the same a predetermined amount, for
permitting the umbrella portion to be opened. The rib constructions
of the umbrella are designed to carry sensing devices and to
support the necessary connections thereto for observing conditions
such as pressure, temperature and the like within the brain for
conducting long-term study and treatment of hydrocephalus, brain
cancer, stroke, and similar illnesses.
BRIEF DESCRIPTION OF THE DRAWINGS
Other objects and many of the attendant features and advantages of
the present invention will be more readily appreciated as the same
becomes better understood from the following detailed description
when considered in connection with the accompanying drawings in
which like reference numerals indicate like or corresponding parts
throughout the several views thereof and wherein:
FIG. 1 is a longitudinal view in cross-section of a modified
ventricular end portion of a ventriculo-cardiac shunt constructed
in accordance with the teachings of the present invention and
showing the same in a closed position ready for insertion into the
brain cavity.
FIG. 2 is a similar cross-sectional view showing the umbrella
portion of the device in an expanded condition, such as occurs
following insertion of the device into the brain cavity, after the
outer sleeve has been withdrawn a predetermined amount;
FIG. 3 is an enlarged view of the embodiment shown in FIGS. 1 and 2
which illustrates a preferred arrangement of a condition-sensing
device in one of the rib constructions of the umbrella portion of
this embodiment; and,
FIG. 4 is a diagrammatic representation of the application of the
device in the establishment of a ventriculo-cardiac shunt.
DESCRIPTION OF AN ILLUSTRATED EMBODIMENT
Referring now to the drawings, and more particularly, to FIGS. 1
and 2 thereof, the end portion of a ventriculo-cardiac shunt is
generally indicated by the reference numeral 10. This ventricular
end portion 10 comprises a conventional elongated catheter member
12 of substantially tubular configuration which is provided with a
plurality of radial, or lateral, passageways 14 near one end
thereof which are adapted to form communication between the
cerebral ventricles and the interior of the catheter, or main tube
12, for draining cerebrospinal fluid therefrom.
A protective cover for the end of the main tube 12 having the
passageways 14 therein is provided by a plurality of rib
constructions 16 which are arranged about the periphery of the main
tube 12 substantially aligned with respect to one another and in
parallel relation to the longitudinal axis of the main tube 12.
Each of the rib constructions 16 is secured at one end to the main
tube 12 by any suitable means, and the other ends of the rib
constructions extend beyond the end of the main tube 12 a
predetermined distance. A cheesecloth, or gauze-like, material 18
porous to the cerebrospinal fluids is suitably attached to the
rod-like rib constructions 16 in the same manner as the cloth
material of an umbrella is attached to the flexible, supporting
ribs thereof.
An elongated sleeve 20 formed from a cylinder having a bore 22 and
a counter-bore 24 is slidably disposed over the main tube 12 and
the rib constructions 16, with the main tube 12 being slidably
received within the bore 22 and the end of the sleeve member 20
having the counter-bore 24 therein being slidably disposed over the
rib constructions 16. As shown in FIG. 1, with the device in the
normal, inoperative condition, ready for insertion into the brain
cavity, one end of the sleeve member 20 extends beyond the end of
the main catheter tube 12 substantially the same amount as do the
rib constructions 16, and when the sleeve 20 is so fully extended,
the ends of the rib constructions 16 abut the shoulder 26 formed
between the bore 22 and the counter-bore 24 within the sleeve.
Both the sleeve 20 and the main tube 12 are made of material
compatible with body tissues such as rubber and nylon, which
preferably have the property of necessary yielding when being
inserted into a body cavity. The rib constructions 16 are
preconditioned to assume an angular, or conical, configuration
relative to the main catheter tube 12, as illustrated in FIG. 2,
whenever the sleeve member 20 is withdrawn or retracted, a
predetermined distance over such rib constructions. The rib
constructions 16 are made from firm, flexible material preferably
selected from such suitable plastic or metallic materials having
the desired resilient characteristics. It is contemplated also that
some of the new materials having plastic memory characteristics so
as to retain form and dimensions under normal temperature
conditions but which, upon heating to a critical temperature,
change their form and return to their pretreatment form and
dimension, may be readily adapted for constructing the ribs 16
herein.
Another important feature of the present invention, which is
illustrated in FIG. 3, the is provision of means for sensing
various conditions in the brain cavity such as, for example,
pressure, temperature and the like, for the purpose of observing
the same and thereby detecting the presence of infection, brain
damage, or the like. This is permitted by the provision of a
plurality of sensing devices 28 which are disposed in cavities
formed in the rib constructions 16. Connections to the sensing
devices 28 are strung through slots, or channels, 32 and 34,
respectively formed in the sleeve member 20 and the rib
constructions 16.
FIG. 4 is a simplified diagrammatic representation of the apparatus
of the present invention in use. It should be appreciated that
nothing shown therein is actually visible, the entire ventricular
end portion 10 containing the main catheter tube 12 is connected
through a trephined opening 36 in the skull to a source of
cerebrospinal fluid such as, for example, a lateral ventricle. The
other end of the device 10 is connected to a suitable tubular
valving arrangement 38, of conventional design, permitting flow in
one direction only, and this, in turn, is connected to an outlet
tube 40 which is directed to the circulatory system, such as, for
example by having its distal end inserted into and secured to the
the internal jugular vein or heart.
In the use of the device, therefore, the ventricular end portion 10
is inserted through the opening 36 in the skull to a cerebral
ventricle whereby it is connected to a source of cerebrospinal
fluid, and thereafter the sleeve member 20 is withdrawn, or
retracted, a predetermined distance, whereupon the rib construction
16 "opens," or assumes the predetermined position illustrated in
FIG. 2. The device 10 is now ready to receive cerebrospinal fluid
through the cheesecloth covering 18 and through the passageways 14
for draining the same from the cerebral ventricles. This novel
arrangement reduces shunt failure by preventing blockage or
obstruction of the passageways 14 in the catheter tube 12 due to
growth of brain tissue thereon, and hence cuts down on the number
of surgical procedures which, understandably, ought to be avoided.
Through the sensing devices 28, the present invention also permits
long term study and observation to readily be made when treating
illnesses such as hydrocephalus, brain cancer, and stroke.
It will be seen from the foregoing description that there has been
provided a number of new and useful improvements in
ventriculo-cardiac shuts for draining cerebrospinal fluids from he
cerebral ventricles to the jugular vein or to the heat in the
treatment of hydrocephalus and similar conditions.
We wish it to be understood that we do not desire to be limited to
the exact details of construction shown and described, for obvious
modifications will occur to a person skilled in the art.
* * * * *