U.S. patent number 3,833,003 [Application Number 05/269,069] was granted by the patent office on 1974-09-03 for intravascular occluding catheter.
Invention is credited to Alfred Taricco.
United States Patent |
3,833,003 |
Taricco |
September 3, 1974 |
INTRAVASCULAR OCCLUDING CATHETER
Abstract
A balloon type intravascular occluding catheter comprising a
first and second flexible tube and a tapered nose at one terminal
end of the tubes. An elastic annulus circumscribes the tubes
rearwardly of, but adjacent to the nose and is connected in such a
manner as to be inflatable to form a balloon by fluid applied
through apertures in the first of the tubes which underlies the
annulus of flexible material. A trocar is removably disposed in the
second tube, the trocar having a vessel piercing tip thereon, and
an aperture in the nose which is aligned with the trocar to permit
entrance and egress of the tip beyond the nose so as to engage the
vessel wall for penetration thereof and entry of the catheter
thereinto. Thereafter the balloon may be inflated so as to occlude
the vessel and, if desired, the trocar may be removed to inject
medication or the like through the second tube.
Inventors: |
Taricco; Alfred (Poughkeepsie,
NY) |
Family
ID: |
23025664 |
Appl.
No.: |
05/269,069 |
Filed: |
July 5, 1972 |
Current U.S.
Class: |
604/509; 606/192;
604/103.11; 604/907; 604/915 |
Current CPC
Class: |
A61B
17/12045 (20130101); A61B 17/12136 (20130101); A61B
17/12109 (20130101); A61M 25/06 (20130101); A61M
25/10 (20130101); A61M 2025/0089 (20130101); A61M
2025/0008 (20130101); A61B 17/34 (20130101); A61M
2025/1052 (20130101) |
Current International
Class: |
A61B
17/12 (20060101); A61M 25/06 (20060101); A61M
25/10 (20060101); A61B 17/34 (20060101); A61M
25/00 (20060101); A61b 017/34 (); A61m
025/00 () |
Field of
Search: |
;128/347,348,349B,344,325,214.4,221,1R |
References Cited
[Referenced By]
U.S. Patent Documents
Other References
Hunter et al. - Annals of Surg., Feb. 1970, pp. 315-320 .
Hughes - Surgery - Vol. 36, No. 1, July, 1954, pp. 65-68 .
Dow Corning Bulletin - July 1960, Vol. 2, No. 3, p. 9.
|
Primary Examiner: Truluck; Dalton L.
Attorney, Agent or Firm: Dick; William J.
Claims
What is claimed is:
1. An intravascular occluding catheter comprising a flexible
tubular member having a tapered nose at one terminal end of said
members, said flexible tubular member comprising a first tube; a
second tube in said first tube, extending into said nose and
defining a first passageway between said first and second tubes; a
second passageway in said second tube; an elastic annulus having
marginal edge portions, said annulus circumscribing said first tube
adjacent said nose, said annulus connected along its marginal
terminal portions to form an inflatable balloon; apertures in said
first tube connecting said first passageway underlying said annulus
and providing fluid communication between said first passageway and
said annulus; a trocar disposed in said second passageway, said
trocar including a terminal end having a vessel piercing tip
thereon; and an aperture in said nose dimensioned to embrace said
trocar and permit entrance and egress of said tip of said
trocar.
2. An intravascular occluding catheter in accordance with claim 1
wherein said nose is integral and forms part of said first
tube.
3. An intravascular occluding catheter in accordance with claim 2
including a circumferential recess in the exterior of said first
tube for receiving said annulus.
4. An intravascular occluding catheter in accordance with claim 3
wherein said nose is substantially bullet shaped.
5. An intravascular occluding catheter in accordance with claim 3
wherein said nose includes an axially offset wall.
6. An intravascular occluding catheter in accordance with claim 3
wherein said aperture in said nose is axially offset, and said nose
includes an offset tapered wall, said wall of said nose merging
towards said offset aperture and terminating therewith.
7. An intravascular occluding catheter in accordance with claim 1
including a flexible sheath circumscribing said tubes and forming a
housing therefore.
8. An intravascular occluding catheter in accordance with claim 7
wherein said sheath terminates in a radially and circumferentially
extending end wall, a circumferentially extending second wall on
said nose axially spaced from said first wall to define a recess
therebetween for receipt of said annulus therein.
9. An intravascular occluding catheter in accordance with claim 7
wherein the axis of said second tube is displaced radially from the
axis of said first tube.
10. An intravascular occluding catheter in accordance with claim 9
wherein said aperture in said nose is aligned with the passageway
of said second tube, and said nose includes a tapered wall which
terminates at said aperture.
11. An intravascular occluding catheter in accordance with claim 1
wherein the axis of said first tube is offset from the axis of said
second tube, and including a flexible sheath circumscribing said
tubes.
12. An intravascular occluding catheter in accordance with claim 11
wherein said nose extends over said first and second tubes and is
coextensive with said sheath.
13. An intravascular occluding catheter in accordance with claim 12
including a circumferentially extending recess in said sheath for
housing said annulus.
14. An intravascular occluding catheter in accordance with claim 1
wherein said tip includes a point, and a concave cutting edge
extending rearwardly of said point and merging into the sidewall of
said nose.
15. An intravascular occluding catheter in accordance with claim 14
wherein said cutting edge extends onto the surface of said
nose.
16. A method of intravascular occlusion utilizing a catheter, said
catheter comprising a flexible tubular member having a tapered nose
at one terminal end of said member, said tubular member comprising
a first tube; a second tube in said first tube, extending into said
nose and defining between said first and second tubes a first
passageway; a second passageway in said second tube, an elastic
annulus having marginal edge portions, said annulus circumscribing
said first tube adjacent said nose, said annulus connected along
its marginal terminal portions to form an inflatable balloon;
apertures in said first tube connecting said first passageway
underlying said annulus and providing fluid communication between
said first passageway and said annulus; a trocar disposed in said
second passageway, said trocar including a terminal end having a
vessel piercing tip thereon; and an aperture in said nose
dimensioned to embrace said trocar and permit entrance and egress
of said tip of said trocar; comprising the steps of: piercing the
vessel wall with the tip of said trocar extending beyond said
aperture in said nose, inserting said catheter into said vessel
through the hole thus pierced and beyond the elastic annulus
circumscribing the first tube, and inflating said balloon; and
thereafter withdrawing said trocar from said second tube.
17. A method of intravascular occlusion in accordance with claim
16, including the step of applying medication internally of said
vessel through said second tube.
18. A method of intravascular occlusion in accordance with claim
16, including the step of withdrawing fluid from said vessel
through said second passageway.
Description
SUMMARY OF THE INVENTION AND STATE OF THE PRIOR ART
The present invention relates to an intravascular occluding
catheter and a method of utilizing the same to penetrate and enter
a vessel and occlude such vessel; and more particularly relates to
a balloon type intravascular occluding catheter having a removable
trocar with a vessel piercing tip thereon for permitting the
formation of an incision in the vessel walls and entry of the
catheter connected thereto past the balloon so that the balloon may
be expanded to thereby internally clamp or otherwise occlude fluid
flow in the vessel.
There are numerous catheters depicted in the prior art for use in
surgery. One of the most famous of the catheters is the Fogarty
catheter as illustrated in U.S. Pat. No. 3,435,826 which is
utilized for embolectomies or removal of an embolus that has broken
away from a thrombus. Another type of catheter depicted in the
prior art is illustrated in U.S. Pat. No. 3,087,493 wherein the
catheter is utilized as an endotracheal tube to maintain a free air
way or breathing passage for the patient during surgical
operations. Modifications and variations of catheter types are
exhibited in such patents as U.S. Pat. No. 2,936,761 wherein the
catheter is designed specifically for use in the urinary bladder,
or in U.S. Pat. No. 3,547,119 wherein the catheter is in essence a
cannula (a small tube for insertion into a duct or vessel) with a
stylet which is slidably disposed therein and has a point thereon
for making an incision in a vessel.
There are many instances in the human body where, in repairing
vascular ruptures or removing blockages therein, it is necessary to
stop blood flow in order to repair the rupture or remove the
blockage in the vessel. Conventional practice is to clamp the
vessel being repaired, at least at the higher pressure end, to keep
the area to be repaired free of blood so that the repair may be
made or blockage removed, while simultaneously preventing a loss of
blood which would otherwise have to be replaced. When the vessel
being clamped, for example, is in a relatively young person, the
vessel is usually soft and pliable and there is little (in most
instances) calcium formation in the vessel. However, in older
people that have minor arterial diseases, or calcium formations
within the artery, placing a clamp on the artery causes the calcium
to break up. After the repair has been made and the clamp removed,
the calcium tends to move in the artery in the direction of blood
flow and may act as an occluding embolus, whose affect is dependent
upon the place where it lodges. Additionally, as the arteries and
veins become older they tend to become less pliable and the
placement of a clamp thereon tends to create a crease in the vessel
wall which causes weakening thereof, many times resulting in an
increase in the original atheromatous process at that point.
Accordingly, it is desirable to provide an intravascular occluding
device that will expand radially from within the vessel to thereby
occlude flow in the vessel whether it be blood or any other body
fluid, to thereby inhibit weakening of the vessel lining and
thereby preventing the release of calcium and/or atheroma and the
possible damage to the vessel wall by an external occluding clamp,
as heretofore mentioned, while form fitting to the internal shape
of the vessel.
Additionally, because operations which are performed to repair, for
example, ruptured aortic aneurysms are usually conducted on an
emergency basis, the implement being used to occlude the vessel
should preferably be one which may enter the vessel and occlude as
rapidly as possible so as to permit clearing of the ruptured area
to facilitate repairs, and to effect rapid but noninjurious
clamping of the vessel from at least its high pressure end.
In view of the above, it is a principal object of the invention to
provide an intravascular occluding catheter which may rapidly and
effectively be applied to stem fluid flow or isolate a region of
the vessel which is to be surgically addressed.
Another object of the present invention is to provide a catheter of
the balloon type which may rapidly make an incision in the wall of
a vessel and enter therein to permit expansion of the balloon so as
to occlude further passage of fluids.
Another object of the present invention is to provide a novel
method of occluding a vessel with a catheter having an expansible
balloon adjacent one end thereof and a vessel wall piercing tip
thereon, including the steps of piercing the vessel wall with the
tip, inserting the catheter into the vessel through the incision
thus made, and exppanding the balloon to thereby occlude flow in
the vessel.
Yet another object of the present invention is to provide a method
of intravascular occlusion utilizing a balloon-type catheter, as
above set forth, which includes a trocar disposed in the catheter
and having a vessel piercing tip on one end thereof, whereby after
the balloon on the catheter has entered into the vessel and
internally clamped the vessel to prevent further flow, removing the
trocar will provide a passage for medication into the vessel, or
permit fluid samples to be taken through the passage.
Yet another object of the present invention is to provide a novel
intravascular occluding catheter having a pair of tubes, one for
permitting the entry of fluid for expansion of the balloon and the
other for entrance and egress of a trocar having an incising tip
thereon.
Yet another object of the present invention is to provide a
catheter which may be used in pairs or more to isolate a vessel
section so as to permit entry of medication into the section so as
to prevent contamination of surrounding areas when it is desired to
surgically address the particular area isolated.
Other objects and a more complete understanding of the invention
may be had by referring to the following specification and claims
taken in conjunction with the accompanying drawings in which:
FIG. 1 is an enlarged fragmentary sectional view of a catheter
constructed in accordance with the present invention;
FIG. 2 is a sectional view taken along line 2--2 of FIG. 1;
FIG. 3 is an enlarged fragmentary sectional view of a portion of
the device illustrated in FIG. 1;
FIG. 4 is a sectional view taken along line 4--4 of FIG. 3;
FIG. 5 is an enlarged fragmentary sectional view of another
embodiment of a catheter constructed in accordance with the present
invention;
FIG. 6 is a sectional view taken along line 6--6 of FIG. 5;
FIG. 7 is an enlarged fragmentary sectional view of still another
embodiment of a catheter constructed in accordance with the present
invention;
FIG. 8 is an enlarged fragmentary perspective view illustrating the
construction of the catheter of FIG. 7;
FIG. 9 is a fragmentary schematic view of a catheter constructed in
accordance with the present invention and being used for
intravascular occlusion of the aorta so that a ruptured aortic
aneurysm may be repaired;
FIG. 10 is another view of a catheter constructed in accordance
with the present invention for repairing and rupture below the
renal arteries;
FIG. 11 depicts the use of a catheter constructed in accordance
with the present invention for occluding the aorta for clearing an
occluding clot at the branch of the aorta and the common iliac
(commonly called Leriche syndrome); and,
FIG. 12 is a fragmentary schematic view of a typical use of a pair
of catheters constructed in accordance with the present invention
and being utilized in conjunction with a conventional external
occluding clamp for repairing a rupture in a vessel.
Referring now to the drawing, and especially FIG. 1 thereof, the
distal end 11 of an intravascular occluding, balloon type catheter
10 constructed in accordance with the present invention is
illustrated therein. As shown, the catheter 10 comprises a flexible
tubular member or first tube 12 having a bore 12A, and defining a
first passageway between the inner wall of the tube and the
exterior of a second tube, the second tube also having a bore 13A
defining a second passageway. The catheter includes a tapered, in
the present instance bullet shaped, nose 14 to facilitate entry
thereof into an incision in a vessel (not shown). In the
illustrated instance the second tube 13 is mounted coaxially of the
first tube 12 and may be epoxied or otherwise connected to the
first tube at the interior portion 14A of the nose 14 adjacent the
terminal end of the second tube 13, as at 13B.
Disposed adjacent to but rearwardly of the nose 14 is an annular
recess 15, which houses a balloon forming thin elastic annulus 16,
to this end, and in the illustrated instance, the recess 15 is
disposed circumferentially of and in the first tube 12 to provide a
relatively smooth continuous exterior in conjunction with the
elastic annulus 16. As shown, apertures 19 underly the annulus and
extend radially through the wall of the tube 12 to permit fluid
communication between the annulus 16 and the bore 12A. The annulus
includes laterally displaced marginal edge portions 17 and 18, the
annulus being connected along its marginal edge portions, in the
illustrated instance as by thread or the like 20 to form an
inflatable balloon upon a pressurized fluid entry into the bore
12A. A suitable air drying cement or the like may be soaked onto
the bindings or thread 20 to provide a smooth surface thereon. In
this connection a similar type structure with regard to binding may
be employed as illustrated in the patent to Fogarty No.
3,435,826.
In accordance with the invention, means are provided for
cooperation with the catheter 10 to make an incision in a vessel
for immediate insertion of the catheter into the vessel to a point
at least rearwardly of the balloon forming annulus 16. To this end,
and referring first to FIGS. 1 and 3, an aperture 21 is formed in
the nose 14, in the illustrated instance centrally of the nose so
as to be aligned with the bore 13A of the second tube 13. Disposed
in the bore 13A of the second tube 13 is a trocar 22 having a
vessel piercing tip or end 23 thereon. The vessel piercing end 23
has preferably a piercing point 24 with a cutting edge 25 on the
upper surface thereof, the cutting edge being slightly concave as
illustrated in FIG. 2 and including side scalloped or tapered
portions 26 and 27 respectively. The underside 28 of the tip is
preferably smoothly convex so as to provide a camming surface which
gently merges into the bullet shaped nose 14. The cutting edge 25,
on the other hand, is concave so as to merge into the exterior of
the nose 14. In this manner, by disposing the distal end 11 of the
catheter 10 at an obtuse angle along the axis of the vessel to be
pierced, the tip 23 will easily enter through a wall of the vessel,
and even if accidentally striking a nonintended interior portion of
the vessel, will be cammed by the smooth underside 28, the edge 25
serving to make an incision in the wall of the vessel to permit
easy entrance of the nose 14 into the vessel.
The trocar 22 may be made of a flexible wire to give stability to
the catheter 10 for ease of entry into the vessel. After entry of
the distal end 11 of the catheter 10 into the vessel through the
incision thus made, beyond the balloon forming annulus, a fluid
such as a saline solution or air may be pressurized in the bore 13A
to cause expansion of the elastic annulus thereby forming an
internally occluding clamp. Thereafter the trocar may be removed to
permit a supply of medication, anticoagulant or the like to enter
the vessel through the bore 13A of second tube 13. Additionally,
after removing the trocar, specimens of blood or other fluid in the
occluded vessel may be taken through the bore 13A.
Although the embodiment illustrated in FIGS. 1-4 is the preferred
embodiment, other embodiments lend themselves to the practice of
the method of the present invention and incorporate apparatus
constructed in accordance therewith. For example, in FIG. 5, the
distal end 41 of an intravascular occluding, balloon type catheter
40, constructed in accordance with the present invention, is
illustrated therein. As shown, the catheter 40 comprises a first
tube 42 and a second tube 43, the tube 42 having a bore 42A and a
second tube having a bore 43A including a tapered nose 44 to
facilitate entry of the catheter into an incision in a vessel (not
shown). As shown the second tube 43 is mounted interiorly of the
first tube 42 and projects forwardly into the interior of the nose
44. In the present instance, and unlike the preferred embodiment
heretofore described, the nose is seperable from the catheter
proper, and contains an aperture 51 which is radially offset from
the central axis of the first tube 42 but aligned with the bore 43A
thereof. The nose 44, therefore, has an offset tapered wall which
merges towards the offset aperture 41 and terminates therewith.
In order to provide a smooth exterior on the catheter which merges
into the nose 44, a flexible sheath 45 is provided circumscribing
the tubes, and in contact with the wall of the first tube 42. The
sheath terminates in an end wall 46, short of the axial end 42B of
the first tube 42, thereby forming a circumferentially extending
recess 47 intermediate the end wall 44A of the nose 44 and the end
wall 46 of the sheath 45. As best illustrated in FIG. 6, underlying
the recess 47 and extending through the wall of the first tube 42
is a plurality of apertures 48 which provide fluid communication
between the bore 42A of the first tube 42 and the recess 47.
Disposed in the recess 47 is a balloon forming thin elastic annulus
52 which extends circumferentially of the catheter in the recess to
provide a relatively smooth continuous exterior intermediate the
sheath 45 and the nose 44. The elastic annulus 52 includes
laterally displaced, marginal edge portions 53 and 54 which are
reinforced or thick relative to the thin section 54 intermediate
the marginal edge portions. The marginal edge portions 53 and 54
may be epoxyed or otherwise connected to both the end walls 44A and
46 as well as the first tube 42. The thinner wall of the elastic
annulus will permit the balloon, when thus formed, to conform more
easily to the internal configuration of the vessel into which the
catheter has been inserted. It should be recognized that the
structure of the annulus 52 may be also utilized in conjunction
with the structure of the catheter illustrated in the preferred
embodiment in FIGS. 1-4.
As with the embodiment described in FIGS. 1-4, means are provided
for cooperation with the catheter 40 to make an incision in a
vessel for immediate insertion of the catheter into the vessel to a
point at least rearwardly of the balloon forming annulus 52. To
this end, disposed in the bore 43A of the second tube 43 is a
trocar 55 having a vessel piercing tip or end 56 thereon. The
vessel piercing end 56 may have the identical configuration as that
shown in FIG. 3 and accordingly need not be described further.
To prevent fluid which passes through the apertures 48 to expand
the elastic annulus 52, thereby forming a balloon from entering
into the bore 43A of the tube 43, the terminal end 43B of the tube
is preferably epoxyed as at 57 to the interior of the nose 44,
thereby sealing the bore 43A. Additionally, the nose 44 at the same
time, may be sealed to the first tube 42.
In still another embodiment of the invention as shown in FIGS. 7
and 8, the distal end 61 of an intravascular balloon type catheter
60 is shown therein. As before, the catheter 60 comprises a first
tube 62 and a second tube 63, the tube 62 having a bore 62A and the
second tube having a bore 63A and including a tapered nose portion
64 similar to the nose 44 shown in the embodiment of FIGS. 5 and 6,
to facilitate entry of the catheter 10 into an incision in a vessel
(not shown). In the illustrated instance the second tube 63 is
disposed adjacent to the first tube 62, both tubes being housed in
a sheath or the like 65 which circumscribes the tubes. In this
embodiment, as shown, the end of the tube 62 is closed as at 62B so
as to prevent fluid from entering the interior of the nose 64.
Disposed adjacent to but rearwardly of the nose 64 is an annular
recess 66 which houses a balloon forming, thin elastic annulus 67.
To this end, and in the illustrated instance, the recess 66 is
disposed circumferentially of and in the sheath 65 to provide a
relatively smooth continuous exterior in conjunction with the
elastic annulus 67. As shown, apertures 69 underly the annulus and
extend radially through the wall of the tube 62 to permit fluid
communication between the annulus 67 and the bore 62A of the first
tube 62. The annulus 67 is similar to the annulus shown in FIG. 5
and includes laterally spaced marginal edge portions 67A and 67B,
and a relatively thin portion 67C. The annulus 67 is connected,
along its marginal edge portions, as by being epoxyed to the first
tube and the nose as well as the sheath 65. Alternatively, the
annulus may be secured in the manner similar to that illustrated
and described above relative to FIG. 1.
As before, means are provided for cooperation with the catheter 60
to make an incision in a vessel for immediate insertion of the
catheter into the vessel to a point at least rearwardly of the
balloon forming annulus 67. To this end, an aperture 71 is formed
in the nose 64, in the illustrated instance radially offset from
the central axis of catheter so as to be aligned with the bore 63A
of the second tube 63. Disposed in the bore 63A of the second tube
63 is a trocar 72 having a vessel piercing tip or end 73 thereon.
The vessel piercing end 73 is similar in structure to that
illustrated in FIG. 3 and therefore need not be described further.
In the embodiment illustrated in FIGS. 7 and 8, the catheter may be
formed as by molding, the bores 62A and 63A formed in the mold by
disposing a wire or the like therein so that upon cooling of the
material, such as a polyurethane or polyethylene, the wires may be
removed thereby forming the tubular structures heretofore
described.
In this connection it should be recognized that the embodiment
illustrated in FIG. 7, and the cross hatching shown therein was for
purposes of defining the structure and not to show particularly
that the structure contained separate adjacent tubes because the
walls of the tubes may be integral not only with each other but
with the sheath 65.
In certain instances it may be desirable to extend the cutting
surface of the trocar cutting end 73 by extending the cutting
surface from the tip onto the exterior wall of the nose 64. In this
instance, it is preferable to employ a nose similar to that
illustrated in FIGS. 5 and 7 wherein the aperture 71 is offset
axially from the central axis of the catheter 60. Thus, for example
in FIG. 7, the surface of the nose as at 74 may be extended to
provide an additional knife edge to make a somewhat longer incision
than would be available by the cutting surface 25 on the trocar
72.
While the distal end of the catheters have been described in some
detail, it should be recognized that the proximal end may be
terminated in any convenient, well known manner. In the illustrated
instance, and referring first to FIG. 9, the proximal end 80 of the
catheter may be bifurcated and include a pair of legs 81 and 82
respectively which may be connected to the first and second tubes
illustrated in FIGS. 1, 2, 5, 6, 7 and 8. For example, the leg 81
which is connected to the first tube of the catheter, may terminate
in a conventional Luer lock 83 which provides a connection for a
hypodermic 84 or the like which may be filled with a fluid for
pressurizing the elastic annulus, such as the elastic annulus 16,
to form a balloon. Alternatively, the leg 82 which is connected to
the second tube, may terminate in a like manner in a conventional
Luer lock 85 having a cap 86 thereon to which is connected the
trocar such as the trocar 22 illustrated in FIG. 1. Preferably the
trocar, with the cap 86 attached securely to the Luer lock 85,
should have its terminal or piercing end extending beyond the nose
of the catheter, the cap preferably having an alignment mark
thereon, when tightly secured to the Luer lock, such as at 87, to
indicate the position of the cutting tip of the trocar in alignment
with the mark.
The uses to which the apparatus of the present invention may be
put, and the novel method employing the novel apparatus are best
illustrated with real examples. For example, in FIGS. 9 and 10 is
illustrated a section of the main aorta 90 exhibiting in each
Figure a typical ruptured aortic aneurysm. The rupture 91
illustrated in FIG. 9 is just below and extends between the right
and left renal arteries, 92 and 93 respectively, the aneurysm
showing up in these instances as a ballooning in the wall of the
aorta as at 94. In this instance, the piercing point or tip (using
the preferred embodiment of the catheter as the example) makes an
incision as at 95 in the wall of the aorta to permit entry
thereinto of the catheter 10. Upon entry of the catheter into the
aorta 90, the syringe 84 is pressurized and the elastic annulus 16
expands effecting a form fitting balloon which occludes the
interior of the aorta 90. The balloon stops blood flow downwardly
in the aorta 90 by internal occlusion and permits the surgeon to
suture the ruptured area 91 or make other necessary repairs.
Thereafter, removal of the catheter permits, because of the very
small size of the incision 95, of easy repair to the incision 95
without harmful effect and with minimal loss of blood.
In the ruptured aortic aneurysm depicted in FIG. 10, and utilizing
like numerals to present like things, the rupture 91 is located
well below the left and right renal arteries 93 and 92 respectively
and slightly above and to the right of the left common iliac 96.
The incision 95 is made in precisely the same way as the incision
made by the catheter 10 in FIG. 9.
In FIG. 11 is shown a typical example of what is known as the
Leriche Syndrome wherein an occluding clot occurs at the
bifurcation in the aorta 90 at the juncture of the left and right
common iliac arteries 96 and 97. As before, an incision 95 may be
made by the end 24 of the trocar associated with the catheter 10
and the clot removed in the normal conventional manner by the
surgeon, the balloon 16 serving to occlude blood flow in the aorta
without utilizing external clamps.
The catheters of the present invention may also be utilized in
pairs or more to isolate a particular section which is to be
surgically addressed. To this end, and referring now to FIG. 12, a
defect 101 is shown being closed with a patch graft 102 between the
common femoral artery 103 and the superficial femoral artery 104,
adjacent or at the junction of the profunda femoris 105. For
illustrative purposes, and to illustrate the use of apparatus
constructed in accordance with the present invention to occlude in
pairs, as well as in conjunction with more conventional external
occluding clamps, such as the clamp 106, which is shown clamping
the profunda femorus, a pair of intravascular occluding catheters
constructed in accordance with the present invention are shown
isolating a section of the femoral artery on opposite sides of the
defect 101. As shown a first catheter 100A is inserted through a
selfmade incision 110, the balloon expanded to thereby internally
occlude the common femoral artery 103. Thereafter, a second
catheter 100B with its piercing point makes an incision 111 in the
superficial femoral artery and the balloon is then expanded to
internally occlude the superficial femoral artery. Thereafter a
patch 102 may be easily applied either from a vein graft or even
composed of a Dacron plastic. (Of course this type of repair is
common in instances where the internal lining of the artery must be
removed along with any buildup of atheromata and calcium, i.e.
endarterectomy).
In all instances of the examples heretofore described, it should be
understood that after the incision has been made by the trocar and
the balloon expanded so as to internally occlude the vessel, the
trocar may be removed and medication may be applied through the
second tube into the area. For example, it may be necessary to
insert heparin (an anti-coagulant) into the blood to prevent
clotting. Additionally, blood samples may be taken, in all the
examples illustrated, by placing a syringe on the Luer lock such as
the Luer lock 85 and aspirating the required sample.
After the repair has been completed, the fluid pressure in the
first tube is released and the elastic annulus retracts to its
previous housing, the catheter is removed and the incision thus
made by the piercing point of the trocar may be repaired.
It should be recognized that the catheter of the present invention
has many uses. For example, the radiologist may find the catheter
extremely useful for dye injection (through the second tube after
removal of the trocar) to selected vessels without diffusion of the
dye into nonselected vessels. Thus the catheter may be useful in
selective arteriography with minimum dye usage.
Another example of the use to which the catheter of the present
invention may be put is when a section of bowel must be removed it
is offtimes difficult and almost impossible to remove the bowel
section without contamination of the surrounding area due to
leakage as the section of bowel is removed. Conventionally, the
bowel is clamped at spaced intervals with six clamps, two clamps
being positioned adjacent one another on opposite sides of the
intended incision on one side of the bowel section to be removed,
and two more adjacently positioned clamps between which a second
incision is made on the opposite side of the bowel section to be
removed. An additional clamp is positioned spaced from each clamp
pair on each of the sections to be joined. Thereafter the fluid in
the remaining two isolated bowel sections may be neutralized by
inserting a catheter through the wall of each of the bowel sections
thus isolated, and expanding the balloon so as to occlude the
incision made by the catheters. After removal of the trocar, it is
a simple matter to pump a medication such as an antibiotic into
each of the bowel sections thereby neutralizing the possible
harmful effects of any leakage of the section when removing the
inwardly disposed clamps to sew the previously incised ends,
together. It should be understood for purposes of this disclosure,
that the bowel is to be considered a vessel.
Thus the catheter of the present invention makes its own incision
and permits the occlusion internally of a vessel to which the
catheter is applied. Additionally, the trocar may be removed and
medication may be applied into the tube from whence it was
removed.
Although the invention has been described with a certain degree of
particularity, it is understood that the present disclosure has
been made only by way of example and that numerous changes in the
details of construction, the combination and arrangement of parts,
and the method of operation may be made without departing from the
spirit and scope of the invention as hereinafter claimed.
* * * * *