Search Images Maps Play YouTube News Gmail Drive More »
Sign in
Screen reader users: click this link for accessible mode. Accessible mode has the same essential features but works better with your reader.

Patents

  1. Advanced Patent Search
Publication numberUS3638649 A
Publication typeGrant
Publication dateFeb 1, 1972
Filing dateJul 7, 1969
Priority dateJul 7, 1969
Publication numberUS 3638649 A, US 3638649A, US-A-3638649, US3638649 A, US3638649A
InventorsRobert A Ersek
Original AssigneeUniv Minnesota
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Implantable prosthetic pass-through device
US 3638649 A
Abstract
An implantable through-the-skin prosthetic device for the permanent entry into the body for passage of liquid, conductors or the like. The device includes a roughened synthetic resinous member that courses through the skin and subcutaneous tissues and into the body. This special roughening promotes tissue ingrowth and thus effects a firm mechanical seal. Animal experimentation and clinical success imply that the seal is also dry and germproof. One form of such a device is an arteriovenous shunt for use in artificial dialysis. A roughened plastic cannula passes through the skin into the blood vessel itself. A ball joint fitting for connection to the external circuits allows for one-handed operation by a trained patient. A special reamer is provided for use with the shunt.
Images(1)
Previous page
Next page
Description  (OCR text may contain errors)

United States atent Ersek [541 IMPLANTABLE PROSTHETIC PASS- THROUGH DEVICE [72] Inventor: Robert A. Ersek, St. Louis Park, Minn.

[73] Assignee: The Regents of the University of Minnesota, Minneapolis, Minn.

[22] Filed: July 7, 1969 211 Appl. No.: 839,297

[ 1 Feb. 1, 1972 3,508,554 4/1970 Sheridan 1 28/348 3,521,620 7/1970 Cook ..128/348 X OTHER PUBLICATIONS McDonald et :11, Trans. Amer. Soc. Artif. lnt. Organs, V01. XlVJune 1968,pp. 176-180 Primary ExaminerDalton L. Truluck Attorney-Burd, Braddock 8L Bartz 5 7] ABSTRACT An implantable through-the-skin prosthetic device for the permanent entry into the body for passage of liquid, conductors or the like. The device includes a roughened synthetic resinous member that courses through the skin and subcutaneous tissues and into the body. This special roughening promotes tissue ingrowth and thus effects a firm mechanical seal. Animal experimentation and clinical success imply that the seal is also dry and germproof. One form of such a device is an arteriovenous shunt for use in artificial dialysis. A roughened plastic cannula passes through the skin into the blood vessel itself. A ball joint fitting for connection to the external circuits allows for one-handed operation by a trained patient. A special reamer is provided for use with the shunt.

11 Claims, 4 Drawing Figures PATENTED nae 1m 1638.649

.2 1 C5. 4 INVIa/v'mR.

ROBERT A. ERSEK AT TORNEYS IMPLANTABLE PROSTHETIC PASS-THROUGH DEVICE This invention relates to device for the permanent entry into the body for passage of liquids, conductors, or the like where a permanent firm mechanical dry and germproof seal with the skin and subcutaneous tissues is desired. Such devices are use ful, for example, in artificial dialysis where a shunt is inserted into a vein in the arm or leg of the patient and maintained for long periods of time. Other devices such as heart pacemakers, bladder stimulators, blood pumps, and the like, which are externally powered require conducting cables or wires to extend through the skin. These have been a source of irritation and infection since, prior to the present invention, no safe dry and germproof mechanical seal through the skin was possible. The invention is described with particular reference to an implantable tubular arteriovenous shunt for use by patients suffering from renal failure and undergoing artificial dialysis, although it must be understood that the invention is not so limited.

There are approximately 50,000 Americans contracting renal failure each year. Of these, some l0,000 are qualified for dialysis or transplantation. Each year as patients are saved by these modalities, additional facilities are needed to accommodate the new patients as well as those previously helped. Thus, there is an expanding need for improvement in the treatment of renal failure.

Since the demonstration of the feasibility of artificial dialysis by Kolff, in the mid l940s, great efforts have been directed to the improvement of methods for gaining access to the bloodstream. In 1960, Quinton and Scribner (Quinton, W., Dillard, D. H. and Scribner, B. H., Cannulation of blood vessels for prolonged hemodialysis. Trans. Am. Sm. for Artzf. Int. Organs, 6: 104, l960.) described a Teflon shunt system that allowed long term implantation and repeated dialysis. Although many minor variations have been brought forth, the basic device remains similar to the original design except that silicone rubber tubing is used for the subcutaneous and exterior sections. Successful cannulations have been reported for as long as years.

In 1961, Quinton and Scribner (Quinton, W. E., Dillard, D. d., Cole, J. J. and Scribner, B. H. Possible improvements in the technique of long term cannulation of blood vessels. Trans, Am. Soc. for Artzf. Int. Organs, 7: 60, 1960.) defined the ideal cannula as having major properties. They are: (l) The inner surface should minimize clotting; (2) The exterior surface should give minimal tissue reaction; (3) The exterior surface should allow some attachment to the tissues in order to anchor the cannula firmly in place; (4) The skin at the exit site should surround the cannula so that a seal is formed and weeping and granulation tissue are absent, (5) Cannula material should be elastic and move freely with the tissue as the arm is rotated; (6) Cannula should be able to withstand extended trauma without permanent damage, (7) Cannula should not occlude vessels at the cannulation site; (8) Cannula should have an easily replaceable tip to facilitate fitting any size vessel; (9) A simple clamp or method of attachment to the external circuit is needed; and (10) The cannula should lie close to the skin.

In spite of many refinements, several problems have remained unsolved in the prior art shunts. The exit sites of the silicone rubber cannula are usually long sinus tracts that must be meticulously cleaned and are a constant septic threat to the patient. The junction means for connection to the external circuits are cumbersome, undependable, and require at least two hands to manipulate. The many turned lumen prevents easy reaming of those shunts should an occlusion occur. The newly developed shunt which is the subject of the present invention is directed toward solving these problems.

The arteriovenous shunt, according to the present invention, is illustrated in the accompanying drawings in which:

H6. 1 is a schematic plan view showing the shunt in place in the arm of a patient;

FIG. 2 is an enlarged schematic illustration of the arterial portion ofthe shunt showing details of construction and showing the arterial cannula implanted in the body tissue;

F K]. 3 is a section on a somewhat enlarged scale on the line 3-3 ofFlG. 2; and

FIG. 4 is an illustration of the reaming device used with the shunt.

Referring now to the drawings, the shunt, including an implantable through-the-skin seal device, according to the present invention, indicated generally at 10 in FIG. 1 and shown in place in a foreami 11, comprises an arterial cannula 12 extending into the artery 13, a flexible occlusion member 14, a distal arterial segment 15 connected through a disengageable junction means 16 to a distal venous segment 17 connected by means of an occlusion member 18 to a venous cannula 19 inserted through the skin into a vein 20. As is well understood, the shunt remains in place in the arm (or leg) of the patient between treatments, the blood flowing from the artery through one cannula through the shunt to the other cannula and back into the vein. During his periodic dialysis treatments, the junction means 16 is disengaged and the distal arterial segment l5 and distal venous segment 17 of the shunt are connected to the dialysis apparatus, the so-called artificial kidney."

As best seen in FIG. 2, the semirigid arterial cannula 12 extends through an opening 21 in the skin 22 through the subcutaneous tissue 23 and into the end of severed artery 13. The interior of the cannula is smooth throughout. The intravascular tip portion 24 of the cannula is smooth and slightly tapered to facilitate insertion into the vessel. The intermediate portion 25 of the cannula from adjacent the tapered smooth tip 24 to beyond its point of exit through the skin is roughened to create a myriad of hairy projections to enable an attachment to be achieved between the body tissue and the cannula. A portion of the roughened surface extends into the vessel 13 to anchor the cannula and keep the vessel sealed around it.

After the cannula exits the skin, it is again smooth and is fitted to a collapsibly deformable tubular occlusion member 14 which can be squeezed closed by any suitable clamp during attachment of the shunt device to and release from the dialysis apparatus. The cannula-occlusion member junction can be made in the standard fashion using a steel crimp ring 27, or a suture, or similar means. Desirably, however, the smooth end 26 of the cannula is provided with a cufi 28 in the form of an externally thickened ring in order to assure a positive strong grip between the cannula and occlusion tubing. The distal arterial segment 15 is similarly connected to the opposite end of the occlusion tubing 14. The junctions are permanent, leakproof and pressureproof.

The disengageable junction means 16 connecting the distal arterial and venous segments 15 and 16, respectively, is in the form of a ball joint. One of the distal segments has a bulbous male end 29. The other segment is provided with mating bulbous socket 30 having a slightly outwardly flaring mouth forming the female end of the ball joint. This ball joint junction means allows rapid and certain engagement and disengagement. The ball joint junction members are relatively thin walled such that they may be deformed slightly when fit together so that the narrowest part of the mouth of the socket may have a slightly lesser diameter than the greatest diameter of the male member. Any pressure within the lumen tends to force the outer walls of the smaller male fitting 29 against the inner walls of the slightly larger female fitting 30, thus increasing the leakproofness and better seating the seal. The inner blood path remains nearly uniform through such a connection. [t-is possible to disengage and reengage the ball joint with just one hand, allowing for self-dialysis by a trained patient. Apart from the male-female ball joint members, the venous portion of the shunt essentially duplicates the arterial portion already described in detail.

The cannula segments and distal segments of the shunt are preferably formed from polytetrafluoroethylene (Teflon) which has the requisite properties of inertness, chemical resistance, compatibility with body tissues, workability, strength, and the like. Other suitable materials, though less desirable, include nylon, acetal resin (Delrin), polycarbonate resin (Leaxan), polyvinylchloride, polyvinylidenechloride, and the like, compounded so as to have the requisite semirigidity to form a noncollapsible tube. Similarly, medical grade silicone rubber (Siliastic) is the preferred material for the occlusion members although other flexible natural and synthetic rubber or rubberlike materials having the required properties of inertness chemical resistance, etc., may be used.

The desired roughness of the intermediate portion of the cannula segments which transverse the blood vessel lumen and the subcutaneous tract was achieved by turning the tubing on a lathe and applying a roughening tool. The tube is inserted over a steel mandrel to prevent deformation of the tubing, the lathe was rotated at about 600 rpm. and the machining tool was made from a hacksaw blade and piece of brass stock. The teeth of the hacksaw blade are allowed to very carefully gouge just the outer few thousandths of an inch of the tubing. As the tubing spins in contact with the roughening tool, thousands of roughened hairy projections are created. As is apparent, the hairy projections are integral with the body of the tubing. Great care, of course, is exercised in order that the lumen is not entered or the tubing deformed.

The cuff 28 at the ends of the cannula and distal segments can be formed by forcing the tubing back on itself while being heated and placed within a forming jig.

The shunt may be reamed by use of a flexible elongated wire, as shown in FIG. 4. The reamer 35 comprises an elongated central flexible wire core 36, which may be a singlestrand or a multiple-strand cable. The core 36 is wrapped along its length by a coil spring 37 of small diameter. The reamer has a smooth bulbous termination 38 at one end and a manipulative device in the form of a small ball configuration 39 at the other end. The first end has a permanent slightly angled bend 40 deviating by about 40 to 50 from the longitudinal axis of the cable and spaced inwardly about 1 to 3 inches from the bulbous end. The reamer ranges in length from about 2 to 3 feet. The remotely angled bend can be controlled from the opposite end by manipulation of the ball element 39. By pushing the reamer into the lumen of the shunt and flexing and straightening the ball end, any turns can be followed and the smooth finish of he reamer protects the inner lumen from scratches.

In order to assess the efficacy of the pass through design, animal experiments were conducted to determine if the connective tissue would grow into and become attached to the roughened cannula (Teflon) surface, if sepsis could be avoided, and if strength could be expected from such a seal. In the initial series, a single U-shaped piece of Teflon tubing with one limb of the U roughened and the other smooth, was implanted beneath the skin of two dogs. The skin was completely closed over the tubing, since previous tests were thwarted by the dogs removing the device, no matter what steps were taken to restrain them. A single U-shaped piece of Teflon was employed in order that the very same piece of stock would be used and thus serve as its own control, and so that photomicrographs could be taken of the two limbs of the U.

When the skin and subcutaneous tissue containing the tubes were removed, a firm grip of the roughened segment was noted and no grip of the smooth area was seen. Photomicrographs of the two ends of the same U-shaped piece of tubing show connective tissue tenaciously involved with the roughened portion and the smooth portion remaining discretely uninvolved.

In a second series of experiments guinea pigs were used and a roughened and a smooth Teflon tube was implanted into the dorsal surface thereof through a small skin puncture into the underlying tissue. Two percent Xylocaine was infiltrated into the area for anesthesia and each animal received five drops of a mixture of 1 million units penicillin and 1 gram streptomycin orally. These devices were then removed after l4 to days for inspection. The skin and underlying connective tissue grew into the roughened tube but all smooth segments fell out spontaneously, even though a circumferential bandage was applied in order to prevent the dislodgment by the guinea pigs, and the roughened tubes just a few millimeters away remained intact.

In other experiments 10 guinea pigs received a roughened Teflon tube but herein were allowed 21 days to become embedded and a Zby 4 inch circle of skin was removed and pressure applied by pneumatic piston to determine what force was needed to disrupt the skin-Teflon seal. The 21-day implanted rough Teflon segments were disrupted by pressure calculated at 720 mm. Hg. The skin Teflon seal was watertight until the bursting pressure was attained.

Shunts incorporating the roughened Teflon cannula were then implanted in three uremic patients. The shunt in one patient remained clot free for more than 8 weeks. In the first case the shunt clotted several times after 1 day and 1 night. and was replaced by a prior art shunt, which also clotted several times. The patient went on to recovery of his acute tubular necrosis in 24 days. The second patient, a 45-year-old white female with acute tubular necrosis following pancreatitis was placed on dialysis acutely and after 4 weeks began to have urine output and her uremia slowly receded. Her shunt remained patent through this course and the skin ans subcutaneous tissue became well involved within the roughened surface of the shunt. Photomicrographs show that a good junction was formed between the epithelial layers of the skin and the exit site of the cannula. There was never any pain associated with this shunt and the patient remained afebrile with a dry exit site throughout her hospital course. No infection was noted in either of these two, even though the second patient forgot about her shunt and completely submerged the arm in her bath water during the sixth week.

The leak pressure of the ball joint was tested by placing a closed ball joint seal in series with a mercury manometer and pumping the system full of fluid and measuring the pressure on the mercury manometer. Five ball joints were subjected to 300 mm. HG pressure without leak or bursting.

The use of all Teflon members to transverse the vessel lumen and the subcutaneous tract enables an attachment to be achieved between the tissue and the rosthesis if the Teflon has been roughened. The seal obtained appears to be a mechanical seal but a tight one, as evidenced by the tests. This is a logical result if we examine the basic processes of wound healing by secondary intention whereby new cells are added to the advancing wound edge, thus the roughened surface presents many facets, angles and geometric projections .for the advancing connective tissue cells to become entangled in and mechanically intertwine.

As the cells multiply at the circular wound edge, the potential defect herein occupied by the prosthesis becomes smaller and smaller, until pressure exerted by advancing cells exceeds that pressure under which they can continue to proliferate. By that time a firm mechanical seal is effected. The strength of the seal is related to the number of surface grooves and projections on the rough Teflon surface and the strength of the fibrous tissue that embraces them. The guinea pig skin accepting the roughened tube is a measure of the affinity for implantation, since all the smooth tubes fell out of the guinea pigs skin. To withstand pressures without leaks points out the intimacy of the seal as is further implied in photomicrographs where a close juxtaposition of the tissues and the Teflon is shown.

The slight taper and smooth leading edge of the intravascular portion of the cannula facilitates its insertion, since the roughened surface requires some force for sliding but follows the few smooth millimeter at its tip with ease. The skin itself grows into the roughened surface and forms a seal. Study of the photomicrographs, in addition to showing the mechanical interdigitation between the tissue and the Teflon, points out the germproof nature of this seal since the cells adjacent to the Teflon seem to be mostly fibroblasts without significant inflammation or foreign body reaction. The short (2 to 3 cm.) subcutaneous path and gentle turns of this shunt decrease the tissue damage and scar formation at a given shunt site, and hence allows greater number of shunt sites per limb. This is especially important in the chronic uremic whose life is dependent on the availability of shunt sites.

The new arteriovenous shunt, according to this invention, meets the -point criteria outlined by Scribner as wellas current materials will allow. Since there are fewer parts than other designs, and since mass production can be simple, significant cost reduction can be effected.

In the case of a lead-through for electrical conductors, as for a cardiac pacemaker or the like, the prosthetic device may be made in tubular form, as a cannula. Then, after implantation of the roughened tubular member through the skin and subcutaneous tract, the conductors may be mechanically sealed within the tubular passage. The device may be utilized whenever a permanent or semipermanent sealed passage through the skin is desirable or necessary.

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows:

1. An implantable through-the-skin prosthetic cannula device for making a firm dry germproof mechanical seal, said device comprising:

A. a flexible inert nontoxic synthetic resinous tube of length and subcutaneous tissue ofa living being,

B. at least a portion of the length of said tube at least sufficient to extend through said cutaneous and subcutaneous tissue having a roughened outer surface,

C. said roughened surface consisting of a plurality of integral closely spaced hairlike projecting fibers whereby tissue ingrowth into and among said projecting fibers is promoted when said tube is implanted into living body tissue.

2. A device according to claim 1 further characterized in that said synthetic resinous tube is formed from polytetrafluoroethylene resin.

3. A method of making a firm dry germproof mechanically sealed passage through the skin of a living being which comprises implanting a tubular device according to claim 1 extending through the cutaneous and subcutaneous tissue of a living being and maintaining therein by means of attachment between the body tissues and roughened surface of the tube.

4. An arteriovenous shunt comprising:

A. a pair of cannula segments according to claim 1, each having a roughened outer surface intermediate of their ends,

B. a distal arterial segment and a distal venous segment,

C. occlusion means connecting each of said distal segments with a cannula segment, and

D. disengageable junction means between said distal segments.

5. An arteriovenous shunt according to claim 4 further characterized in that said junction means comprises a bulbous male member on one of said distal segments and a mating female socket member on the other of said distal segments.

6. An arteriovenous shunt according to claim 4 further characterized in that the outer surface of the tip of each of said cannula segments opposite from said occlusion means is smooth and tapered.

7. An arteriovenous shunt according to claim 4 further characterized in that:

A. said occlusion means comprises a length of flexible tubing extending telescopically over the ends of the cannula segments and distal segments connected thereby,

B. the ends of said cannula segments and distal segments telescoped within the ends of the occlusion means are provided with a cuff of enlarged exterior diameter, and

C. means are provided to secure the ends of said occlusion means to the ends of said cannula segments and distal segments spaced inwardly from said cuffs.

8. An arteriovenous shunt according to claim 4 further characterized in that said cannula segments and said distal segments are formed from polytetrafluoroethylene resin.

9. An arteriovenous shunt according to claim 4 further characterized in that said occlusion means is formed from silicone rubber tubing.

An arteriovenous shunt according to claim 5 further characterized in that:

A. said mating male and female members are relatively thin walled,

B. said male member mates with a close sealing fit in said female member, and

C. the open end of said female member is of diameter less than the outer diameter of the bulbous male member such that slight deformation of said members occurs during engagement and disengagement of the members.

11. An arteriovenous shunt comprising:

A. a semirigid tubular arterial cannula segment and a semirigid tubular venous cannula segment formed from polytetrafiuoroethylene resin,

B. a roughened outer surface composed of a plurality of closely spaced hairlike projecting fibers intermediate of the ends of each of said cannula segments,

C. a smooth and tapered outer surface intravascular tip on each of said cannula segments,

D. a distal arterial segment and a distal venous segment formed from polytetrafluoroethylene resin,

E. tubular silicone rubber occlusion means extending telescopically over the ends of each of said respective cannula segments and distal segments connecting the same, and

F. disengageable junction means between said distal segments comprising a bulbous male member on one of said segments and a mating female socket member on the other of said segments.

g g UNITED STATES PATENT OFFICE CERTIFICATE OF CORRECTION Patent No. 3 ,638 ,649 Dated February 1 1972 Inventor) Robert A. Ersek It is certified that error appears in the above-identified patent and that said Letters Patent are hereby corrected as shown below:

Column 1, line 1, after "to", an implantable through-theskin prostheticis omitted.

Column 1, lines 39-40, "Dillard, D. d." should be -Dillard, D. H.

Column 3, line 40, "he" should be the-- Column 4, line 22, "ans" should be -and- Column 5, line 2 1, after "length", -at least sufficient to extend through the cutaneousis omitted.

Signed and sealed this 13th day of June 1972.

(small) Attest:

EDWARD MELETCHEEJR. ROBERT GQTTSCHALK Attesting @fficer Commissioner of Patents

Patent Citations
Cited PatentFiling datePublication dateApplicantTitle
US1661759 *Apr 18, 1925Mar 6, 1928King Frank RPipe cleaner
US2118631 *Apr 3, 1935May 24, 1938Charles Wappler FrederickCatheter stylet
US2462765 *Dec 13, 1944Feb 22, 1949Harnischfeger CorpWelded motor frame
US3447161 *Aug 1, 1966Jun 3, 1969Avco CorpDisinfectant dispensing percutaneous connector
US3461869 *Apr 5, 1966Aug 19, 1969Bio Medical Systems IncPermanent skin exit device
US3482574 *Jan 12, 1967Dec 9, 1969Eastman Kodak CoArtificial kidney system provided with a lever actuated shunt coupling mechanism
US3484121 *Sep 26, 1966Dec 16, 1969Quinton Wayne ECannula extension and connector apparatus
US3508554 *Nov 4, 1968Apr 28, 1970David S SheridanMedico-surgical tubes having frosted surface
US3521620 *Oct 30, 1967Jul 28, 1970Cook William AVascular coil spring guide with bendable tip
Non-Patent Citations
Reference
1 *McDonald et al., Trans. Amer. Soc. Artif. Int. Organs., Vol. XIV June 1968, pp. 176 180
Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US3765032 *Sep 27, 1972Oct 16, 1973J PalmaImplant
US3826257 *Jul 14, 1972Jul 30, 1974T BuselmeierProsthetic shunt
US3882862 *Jan 11, 1974May 13, 1975Olga BerendArteriovenous shunt
US4192302 *Sep 12, 1978Mar 11, 1980Boddie Arthur WHepatic isolation and perfusion circuit assembly
US4447237 *May 7, 1982May 8, 1984Dow Corning CorporationValving slit construction and cooperating assembly for penetrating the same
US4479798 *Dec 4, 1980Oct 30, 1984Research Against Cancer, Inc.Subcutaneous implant useful in effecting hyperthermic treatment
US4676782 *May 13, 1986Jun 30, 1987Vitaphore CorporationPositionable tissue interfacing device for the management of percutaneous conduits
US4899414 *Sep 19, 1988Feb 13, 1990Irwin James KPolished surface protective sleeve for covering the electrical cord of a car wax polishing and buffing machine
US5141499 *Oct 9, 1991Aug 25, 1992Zappacosta Anthony RPeritoneal dialysis catheter
US5147483 *Apr 13, 1990Sep 15, 1992Therex CorporationImplantable infusion device and method of manufacture thereof
US5336263 *Apr 22, 1993Aug 9, 1994Robert A. ErsekTreatment of urological and gastric fluid reflux disorders by injection of mmicro particles
US5468221 *Jun 20, 1994Nov 21, 1995Schoener; WolfgangImplantable catheter made of high cold flow material
US5603698 *Aug 23, 1995Feb 18, 1997Boston Scientific CorporationProsthesis delivery system
US5792478 *Jul 8, 1996Aug 11, 1998Advanced Uro ScienceTissue injectable composition and method of use
US5848987 *Apr 30, 1996Dec 15, 1998Medtronic, Inc.Microtextured catheter and method for preventing catheter fluid reflux
US5882341 *Oct 25, 1996Mar 16, 1999Bousquet; Gerald G.Method of providing a long-lived window through the skin to subcutaneous tissue
US5902333 *Aug 21, 1995May 11, 1999Boston Scientific CorporationProsthesis delivery system with dilating tip
US5984896 *Oct 28, 1997Nov 16, 1999Ojp #73, Inc.Fixated catheter
US5984964 *Oct 31, 1996Nov 16, 1999Boston Scientific CorporationProthesis delivery system
US6086553 *Jul 1, 1999Jul 11, 2000Akbik; Mohamad J.Arteriovenous shunt
US6099508 *Sep 21, 1998Aug 8, 2000Bousquet; Gerald G.Transcutaneous access device
US6338724Mar 29, 1999Jan 15, 2002Christos D. DossaArterio-venous interconnection
US6459917May 22, 2000Oct 1, 2002Ashok GowdaApparatus for access to interstitial fluid, blood, or blood plasma components
US7361158 *Jan 4, 2000Apr 22, 2008Medicinvent, LlcCatheter including textured interface
US7377278May 24, 2004May 27, 2008Portaero, Inc.Intra-thoracic collateral ventilation bypass system and method
US7398782Nov 19, 2004Jul 15, 2008Portaero, Inc.Method for pulmonary drug delivery
US7406963Jan 17, 2006Aug 5, 2008Portaero, Inc.Variable resistance pulmonary ventilation bypass valve and method
US7426929May 12, 2004Sep 23, 2008Portaero, Inc.Intra/extra-thoracic collateral ventilation bypass system and method
US7507230 *May 16, 2003Mar 24, 2009Boston Scientific Scimed, Inc.Medical catheter assembly including multi-piece connector
US7533667May 20, 2004May 19, 2009Portaero, Inc.Methods and devices to assist pulmonary decompression
US7682332Jun 30, 2004Mar 23, 2010Portaero, Inc.Methods to accelerate wound healing in thoracic anastomosis applications
US7686013Feb 12, 2008Mar 30, 2010Portaero, Inc.Variable resistance pulmonary ventilation bypass valve
US7726305Feb 12, 2008Jun 1, 2010Portaero, Inc.Variable resistance pulmonary ventilation bypass valve
US7753052Feb 6, 2008Jul 13, 2010Portaero, Inc.Intra-thoracic collateral ventilation bypass system
US7766881Feb 27, 2004Aug 3, 2010Roche Diagnostics International AgImplant with surface structure
US7789083Jan 31, 2008Sep 7, 2010Portaero, Inc.Intra/extra thoracic system for ameliorating a symptom of chronic obstructive pulmonary disease
US7811274Apr 27, 2004Oct 12, 2010Portaero, Inc.Method for treating chronic obstructive pulmonary disease
US7824366Dec 10, 2004Nov 2, 2010Portaero, Inc.Collateral ventilation device with chest tube/evacuation features and method
US7828789Apr 7, 2008Nov 9, 2010Portaero, Inc.Device and method for creating a localized pleurodesis and treating a lung through the localized pleurodesis
US7896008Aug 6, 2007Mar 1, 2011Portaero, Inc.Lung reduction system
US7909803Feb 18, 2009Mar 22, 2011Portaero, Inc.Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US7927324Feb 18, 2009Apr 19, 2011Portaero, Inc.Aspirator and method for pneumostoma management
US7931641Feb 21, 2008Apr 26, 2011Portaero, Inc.Visceral pleura ring connector
US8021320Feb 18, 2009Sep 20, 2011Portaero, Inc.Self-sealing device and method for delivery of a therapeutic agent through a pneumostoma
US8029492Apr 7, 2008Oct 4, 2011Portaero, Inc.Method for treating chronic obstructive pulmonary disease
US8062315 *Feb 12, 2008Nov 22, 2011Portaero, Inc.Variable parietal/visceral pleural coupling
US8104474Aug 23, 2005Jan 31, 2012Portaero, Inc.Collateral ventilation bypass system with retention features
US8163034Feb 21, 2008Apr 24, 2012Portaero, Inc.Methods and devices to create a chemically and/or mechanically localized pleurodesis
US8187253Nov 25, 2009May 29, 2012Boston Scientific Scimed, Inc.Low profile adaptor for use with a medical catheter
US8220460Nov 19, 2004Jul 17, 2012Portaero, Inc.Evacuation device and method for creating a localized pleurodesis
US8231581Jan 25, 2011Jul 31, 2012Portaero, Inc.Enhanced pneumostoma management device and methods for treatment of chronic obstructive pulmonary disease
US8252003Feb 18, 2009Aug 28, 2012Portaero, Inc.Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US8277418Nov 22, 2010Oct 2, 2012Alcon Research, Ltd.Ophthalmic valved trocar cannula
US8308713Mar 23, 2009Nov 13, 2012Boston Scientific Scimed, Inc.Medical catheter assembly including multi-piece connector
US8323230Jan 20, 2010Dec 4, 2012Portaero, Inc.Methods and devices to accelerate wound healing in thoracic anastomosis applications
US8336540Feb 12, 2009Dec 25, 2012Portaero, Inc.Pneumostoma management device and method for treatment of chronic obstructive pulmonary disease
US8343106Nov 22, 2010Jan 1, 2013Alcon Research, Ltd.Ophthalmic valved trocar vent
US8347880Feb 18, 2009Jan 8, 2013Potaero, Inc.Pneumostoma management system with secretion management features for treatment of chronic obstructive pulmonary disease
US8347881Jan 8, 2010Jan 8, 2013Portaero, Inc.Pneumostoma management device with integrated patency sensor and method
US8348906Feb 18, 2009Jan 8, 2013Portaero, Inc.Aspirator for pneumostoma management
US8365722Feb 18, 2009Feb 5, 2013Portaero, Inc.Multi-layer pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8430094Feb 18, 2009Apr 30, 2013Portaero, Inc.Flexible pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8453637Feb 18, 2009Jun 4, 2013Portaero, Inc.Pneumostoma management system for treatment of chronic obstructive pulmonary disease
US8453638Feb 18, 2009Jun 4, 2013Portaero, Inc.One-piece pneumostoma management system and methods for treatment of chronic obstructive pulmonary disease
US8464708Feb 18, 2009Jun 18, 2013Portaero, Inc.Pneumostoma management system having a cosmetic and/or protective cover
US8474449Feb 18, 2009Jul 2, 2013Portaero, Inc.Variable length pneumostoma management system for treatment of chronic obstructive pulmonary disease
US8475389Jun 8, 2010Jul 2, 2013Portaero, Inc.Methods and devices for assessment of pneumostoma function
US8491602Feb 18, 2009Jul 23, 2013Portaero, Inc.Single-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US8506577Jul 6, 2012Aug 13, 2013Portaero, Inc.Two-phase surgical procedure for creating a pneumostoma to treat chronic obstructive pulmonary disease
US8518053Feb 11, 2010Aug 27, 2013Portaero, Inc.Surgical instruments for creating a pneumostoma and treating chronic obstructive pulmonary disease
US8679064Aug 13, 2012Mar 25, 2014Alcon Research, Ltd.Ophthalmic valved trocar cannula
EP0202917A2 *May 20, 1986Nov 26, 1986Kureha Kagaku Kogyo Kabushiki KaishaImplant device
EP1481650A2 *May 20, 2004Dec 1, 2004Cordis CorporationIntra/extra-thoracic collateral ventilation bypass system
WO1995007111A1 *Sep 10, 1993Mar 16, 1995Jean P AngelchikMethod and apparatus removing fluid from abdomen
WO1999065559A1 *Jun 18, 1999Dec 23, 1999Jadranka Buturovic-PonikvarHose for making an artificial vessel
WO2003020342A1 *Aug 23, 2002Mar 13, 2003Disetronic Licensing AgImplant with a surface structure
Classifications
U.S. Classification604/8, 604/175, 138/177
International ClassificationA61M39/10, A61M1/36, A61M1/00, A61L29/06
Cooperative ClassificationA61M2039/0261, A61M1/3655, A61M39/0247, A61L29/06
European ClassificationA61L29/06, A61M1/36C7A, A61M39/02T
Legal Events
DateCodeEventDescription
Aug 25, 1986ASAssignment
Owner name: AMERICAN PACEMAKER CORPORATION A CORP OF MA
Effective date: 19860804
Owner name: AMERICAN PACEMAKER CORPORATION, A MASSACHUSETTS CO
Owner name: CALCITEK, INC., A TEXAS CORP.
Effective date: 19860813
Owner name: CALCITEK, INC., ALL TEXAS CORPS
Owner name: CARBO-MEDICS, INC.
Owner name: CARBOMEDICS, INC., A TEXAS CORP.
Owner name: INTERMEDICS CARDIASSIST, INC.
Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:CHASE COMMERCIAL CORPORATION;REEL/FRAME:004605/0581
Effective date: 19860804
Owner name: INTERMEDICS CARDIASSIST, INC., A TEXAS CORP.
Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:B. A. LEASING CORPORATION;REEL/FRAME:004603/0607
Owner name: INTERMEDICS INTRAOCULAR, INC.
Owner name: INTERMEDICS INTRAOCULAR, INC., A TEXAS CORP.
Owner name: INTERMEDICS, INC.
Owner name: INTERMEDICS, INC., A TEXAS CORP.
Owner name: NEUROMEDICS, INC.
Owner name: NEUROMEDICS, INC., A TEXAS CORP.
Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:B. A. LEASING CORPORATION;REEL/FRAME:004603/0607
Owner name: SURGITRONICS CORPORATION
Owner name: SURGITRONICS CORPORATION, A TEXAS CORP.
Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:B. A. LEASING CORPORATION;REEL/FRAME:004603/0607
Effective date: 19860813
Owner name: INTERMEDICS CARDIASSIST, INC., A TEXAS CORP., STAT
Owner name: INTERMEDICS, INC., A TEXAS CORP., STATELESS
Owner name: INTERMEDICS INTRAOCULAR, INC., A TEXAS CORP., STAT
Owner name: SURGITRONICS CORPORATION, A TEXAS CORP., STATELESS
Owner name: CARBOMEDICS, INC., A TEXAS CORP., STATELESS
Owner name: NEUROMEDICS, INC., A TEXAS CORP., STATELESS
Owner name: CALCITEK, INC., A TEXAS CORP., STATELESS
Jun 9, 1986ASAssignment
Owner name: INTERMEDICS, INC.
Free format text: RELEASED BY SECURED PARTY;ASSIGNOR:CITICORP MULTILEASE (SEF), INC.;REEL/FRAME:004576/0516
Effective date: 19860515
Owner name: INTERMEDICS, INC., INTERMEDICS CARDIASSIST, INC.,
Free format text: SECURED PARTY HEREBY RELEASE THE SECURITY INTEREST IN AGREEMENT RECORDED AUGUST 5, 1985. REEL 4434 FRAMES 728-782;ASSIGNOR:CITIBANK, N.A.;REEL/FRAME:004592/0394
Effective date: 19860502
Free format text: SAID PARTIES RECITES OBLIGATIONS RECITED IN SECURITY AGREEMENT RECORDED SEPTEMBER 17, 1984 REEL 4303 FRAMES 077-127 HAVE BEEN PAID IN FULL ALL;ASSIGNOR:CITIBANK, N.A., INDIVIDUALLY AND AS AGENT FOR BANK OF AMERICA NATIONAL TRUST AND SAVINGS ASSOCIATION, THE CHASE MANHATTAN BANK, N.A., THE FIRST NATIONAL BANK OF CHICAGO, TRUST COMPANY BANK, FIRST FREEPORT NATIONAL BANK OF BRAZOSPORT BANK OF TEXAS;REEL/FRAME:004592/0424
Aug 5, 1985ASAssignment
Owner name: B.A. LEASING CORPORATION
Free format text: SECURITY INTEREST;ASSIGNORS:INTERMEDICS, INC., A CORP. OF TEXAS;INTERMEDICS CARDIASSIST, INC.;INTERMEDICS INTRAOCULAR, INC., A CORP. OF TEXAS;AND OTHERS;REEL/FRAME:004449/0424
Owner name: CHASE COMMERCIAL CORPORATION
Free format text: SECURITY INTEREST;ASSIGNORS:INTERMEDICS, INC., A CORP. OF TEXAS;INTERMEDICS CARDIASSIST, INC., A CORP OF TX.;INTERMEDICS INTRAOCULAR, INC., A CORP. OF TEXAS;AND OTHERS;REEL/FRAME:004449/0501
Owner name: CITIBANK, N.A.
Free format text: SECURITY INTEREST;ASSIGNORS:INTERMEDICS, INC., A TX CORP;INTERMEDICS CARDIASSIST, INC., A TX CORP.;INTERMEDICS INTRAOCULAR, INC., A TX CORP.;AND OTHERS;REEL/FRAME:004434/0728
Owner name: CITICORP MILTILEASE (SEF), INC.
Free format text: SECURITY INTEREST;ASSIGNORS:INTERMEDICS, INC.;INTERMEDICS CARDIASSIST, INC.;INTERMEDICS INTRAOCULAR, INC., A CORP. OF TEXAS;AND OTHERS;REEL/FRAME:004452/0900
Effective date: 19850703
Sep 17, 1984ASAssignment
Owner name: BANK OF AMERICA NATIONAL TRUST AND SAVINGS ASSOCIA
Owner name: BRAZOSPORT BANK OF TEXAS
Owner name: CHASE MANHATTAN BANK, N.A., THE
Free format text: SECURITY INTEREST;ASSIGNORS:INTERMEDICS, INC.;INTERMEDICS CARDIASSIST, INC.;INTERMEDICS INTRAOCULAR, INC.;AND OTHERS;REEL/FRAME:004303/0077
Effective date: 19840726
Owner name: CITIBANK, N.A., AS AGENT
Owner name: FIRST FREEPORT NATIONAL BANK
Owner name: FIRST NATIONAL BANK OF CHICAGO, THE
Owner name: TRUST COMPANY BANK
Sep 17, 1984AS06Security interest
Owner name: BANK OF AMERICA NATIONAL TRUST AND SAVINGS ASSOCIA
Owner name: CITIBANK, N.A., AS AGENT
Owner name: INTERMEDICS CARDIASSIST, INC.
Effective date: 19840726
Owner name: INTERMEDICS INTRAOCULAR, INC
Owner name: INTERMEDICS, INC.
Mar 5, 1981ASAssignment
Owner name: NEUROMEDICS, INC., A CORP. OF TX
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST.;ASSIGNOR:MED GENERAL, INC.,;REEL/FRAME:003834/0020
Effective date: 19801229
Owner name: NEUROMEDICS, INC., A CORP. OF TX, TEXAS
Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNOR:MED GENERAL, INC.,;REEL/FRAME:003834/0020