WO1989006986A1 - Y connector for angioplasty procedure - Google Patents
Y connector for angioplasty procedure Download PDFInfo
- Publication number
- WO1989006986A1 WO1989006986A1 PCT/US1988/003411 US8803411W WO8906986A1 WO 1989006986 A1 WO1989006986 A1 WO 1989006986A1 US 8803411 W US8803411 W US 8803411W WO 8906986 A1 WO8906986 A1 WO 8906986A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- seal
- spigot
- passageway
- catheter
- connector
- Prior art date
Links
- 238000000034 method Methods 0.000 title claims description 21
- 238000002399 angioplasty Methods 0.000 title claims description 10
- 239000012528 membrane Substances 0.000 claims abstract description 26
- 230000006835 compression Effects 0.000 claims description 5
- 238000007906 compression Methods 0.000 claims description 5
- 230000017531 blood circulation Effects 0.000 claims description 3
- 239000012530 fluid Substances 0.000 claims description 3
- 239000008280 blood Substances 0.000 description 11
- 210000004369 blood Anatomy 0.000 description 11
- 210000004204 blood vessel Anatomy 0.000 description 8
- 210000004351 coronary vessel Anatomy 0.000 description 8
- 239000002872 contrast media Substances 0.000 description 7
- 238000003780 insertion Methods 0.000 description 5
- 230000037431 insertion Effects 0.000 description 5
- 230000036772 blood pressure Effects 0.000 description 4
- 238000007789 sealing Methods 0.000 description 4
- 230000008878 coupling Effects 0.000 description 3
- 238000010168 coupling process Methods 0.000 description 3
- 238000005859 coupling reaction Methods 0.000 description 3
- 239000011780 sodium chloride Substances 0.000 description 3
- FAPWRFPIFSIZLT-UHFFFAOYSA-M Sodium chloride Chemical compound [Na+].[Cl-] FAPWRFPIFSIZLT-UHFFFAOYSA-M 0.000 description 2
- 210000001367 artery Anatomy 0.000 description 2
- 230000000694 effects Effects 0.000 description 2
- 239000000203 mixture Substances 0.000 description 2
- 206010001526 Air embolism Diseases 0.000 description 1
- 102100026933 Myelin-associated neurite-outgrowth inhibitor Human genes 0.000 description 1
- 230000000903 blocking effect Effects 0.000 description 1
- 229940039231 contrast media Drugs 0.000 description 1
- 108010036050 human cationic antimicrobial protein 57 Proteins 0.000 description 1
- 238000002347 injection Methods 0.000 description 1
- 239000007924 injection Substances 0.000 description 1
- 208000014674 injury Diseases 0.000 description 1
- 230000002452 interceptive effect Effects 0.000 description 1
- 238000012986 modification Methods 0.000 description 1
- 230000004048 modification Effects 0.000 description 1
- 239000004033 plastic Substances 0.000 description 1
- 230000000717 retained effect Effects 0.000 description 1
- 229910052710 silicon Inorganic materials 0.000 description 1
- 239000010703 silicon Substances 0.000 description 1
- 239000000243 solution Substances 0.000 description 1
- 239000002904 solvent Substances 0.000 description 1
- 238000001356 surgical procedure Methods 0.000 description 1
- 230000008733 trauma Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M25/00—Catheters; Hollow probes
- A61M25/10—Balloon catheters
- A61M25/104—Balloon catheters used for angioplasty
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61M—DEVICES FOR INTRODUCING MEDIA INTO, OR ONTO, THE BODY; DEVICES FOR TRANSDUCING BODY MEDIA OR FOR TAKING MEDIA FROM THE BODY; DEVICES FOR PRODUCING OR ENDING SLEEP OR STUPOR
- A61M39/00—Tubes, tube connectors, tube couplings, valves, access sites or the like, specially adapted for medical use
- A61M39/02—Access sites
- A61M39/06—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof
- A61M39/0613—Haemostasis valves, i.e. gaskets sealing around a needle, catheter or the like, closing on removal thereof with means for adjusting the seal opening or pressure
Definitions
- This invention relates to a Y connector for use in an angioplasty procedure.
- the angioplasty procedure for repair of a blood vessel has been known for many years.
- the procedure provides an opportunity to open up a clogged blood vessel, particularly a coronary artery, and thus avoid the expense and trauma of bypass surgery.
- a Y connector is attached to the free end of the guide catheter by means of a rotatable coupling of the type disclosed in U. S. Patent No. 4,254,773.
- the Y connector has a main passage through which the dilatation catheter is inserted.
- the Y connector has a branch passage to which a multiport manifold is connected.
- One port of the manifold is connected to a blood pressure monitor of the type disclosed in copending application Serial No. 07/072,909, filed July 14, 1987.
- Another port of the manifold is connected to a supply of contrast media which is a fluid injected into the blood vessel enabling a real time observation of the bloodvessel through X-ray.
- the angioplasty procedure involves the following steps: The guide catheter is inserted through a blood vessel in the patient's arm or leg into the heart.
- a blood pressure monitor is connected to the Y connector to provide a continuous monitor of a patient's blood pressure.
- the contrast medium is introduced into the blood vessel so that the blockage of the blood vessel can be identified.
- a dilatation catheter having a balloon on its free end is introduced through the main passage of the Y connector.
- a saline mixture is injected through the dilatation catheter to the balloon on its end to inflate it.
- T e dilatation catheter is thereafter removed and contrast medium again introduced and a post dilatation arteriogram is made to check the success of the procedure.
- the dilatation catheter may be reintroduced. It may be desired to use a larger catheter. It may be desired to introduce a small guide wire instead of a dilatation catheter. In any event, more than one insertion and withdrawal through the main passageway is normally required to complete the angioplasty procedure.
- Blood under normal body pressure is of course in the main passageway just as it is in the branch passageway where it is being continuously monitored.
- the blood will tend to escape through the main passageway as by directly flowing through the main passageway when a catheter is removed or by flowing by the catheter when it has been inserted.
- Tuohy Borst valve includes an O-ring-type element seated in a socket forming part of the main passage.
- a cap threaded on the end of the passage contains a spigot which com ⁇ presses the O-ring when the cap is rotated to drive the spigot inwardly.
- the compression closes down the opening in the O-ring around the catheter to prevent "flow-by.”
- the O-ring can be closed down enough to completely close off the opening in the main passage.
- An alternative form of seal employs a membrane having a small hole of about .045" diameter.
- the Tuohy Borst has the disadvantage that it requires manipulation in order to match the size of the opening in the ring to the outside di- ameter of the dilatation catheter. If the cardiol ⁇ ogist does not tighten it sufficiently, blood will flow by the valve. If it is too tight, the catheter can be inserted only with difficulty because of the friction or the catheter can be crushed.
- the membrane-type seal eliminates the foregoing disadvantages of the Tuohy Borst valve but has its own disadvantages. It cannot be completely closed off when a catheter is removed.
- a Y connector having, in the main passage, a socket that receives a Tuohy Borst
- a cap with a spigot projecting from it the cap being threaded onto the outside surface of the socket so that it can be screwed down to bring the spigot into contact with the Tuohy Borst ring to compress it.
- the cap has sealed into it a membrane having a .040" to .035" diameter opening for receipt of a catheter.
- the spigot and socket are provided with projecting and interfering collars or rims that limit the axial movement of the spigot out of the socket. The limitation is such that when the collars are touching, the spigot is in engagement with the Tuohy Borst ring to hold it in sufficient compression to block flow of blood around the external surface of the ring, that is, between the ring and the socket.
- the combination as described permits or facilitates a number of procedures that have hereto ⁇ fore not been possible with any Y connector.
- the dilatation catheter can be inserted through the membrane and no manipulation is required to effect the seal between the membrane and the catheter.
- the catheter can be removed and blood flow through the main passage blocked by tightening down on the Tuohy Borst ring to close it completely.
- the membrane-type seal is available without solvent-sealing of the membrane-containing cap to the connector, the external surface of the Tuohy Borst ring providing the seal against flow-by.
- An undersized catheter or thin wire can be used even though its outside diameter would be smaller than the I.D. of the membrane, for in this situation, the Tuohy Borst valve could be tightened.
- Fig. 1 is a diagrammatic view of the appara ⁇ tus for performing an angioplasty procedure
- Fig. 2 is a cross-sectional view of the Y connector
- Fig. 3 is an enlarged fragmentary view of the encircled portion of Fig. 2.
- a guide catheter 10 is 15 inserted, via a patient's arm or leg 13, into the heart 14 adjacent the coronary artery.
- a dilatation catheter 11 is positioned inside the bore of the guide catheter.
- a balloon 12 which is inflatable by the injection of a - ⁇ - saline-based solution.
- the guide catheter 10 has a hub 15 that is connected to a rotatable coupling 16 of the type disclosed in U. S. Patent No. 4,254,773.
- a Y connec ⁇ tor 20 is formed by a clear plastic casing 19 that has 5 a standard male Luer slip 21 which is inserted into the end of the rotator coupling 16.
- the Y connector has a main passage 22 and a branch passage 23.
- the branch passage terminates in a standard female Luer lock 24.
- a manifold 25 is connected by way of the Luer lock to the branch passage 23.
- the manifold has at least two ports 26 and 27 that are controlled by stopcocks 28.
- One port, 27, for example, is connected to a blood pressure monitor of the type described in patent application Serial No. 07/072,909, filed July 14, 1987.
- the manifold has another port 30 which is connected to a supply of contrast medium that is to be inserted into the coronary artery to provide the contrast for an arteriogram that is used throughout the procedure.
- the main branch 22 has a socket 35 which is threaded as at 36 on its external surface.
- the socket has an internal surface 37 having a tapered valve seat 38 at one end.
- a silicon or rubber O-ring 40 is seated at the bottom of the socket against the tapered seat 38.
- the cross section of the O-ring 40 is trapezoidal.
- One surface 41 of the trapezoid sits on the seat 38.
- the other surface 42 of the trapezoid is engaged by a frustoconical surface 45 at the end of a spigot 46.
- the O-ring has a circular opening which, in a relaxed condition, is about .080 inch.
- the spigot 46 is integral with a skirt 47 that surrounds the socket 35 and has internal threads by which it is threaded onto the threads 36 of the socket.
- the spigot and skirt form a closure 48.
- the spigot has a bore 50 which is coaxial with the main passageway 22 and a bore 51 through the
- the 50 is a membrane 55 having a tiny bore 56 of .040" to .035" diameter which grips the catheter 11 and forms a seal with it.
- the membrane 55 is retained on the closure 48 by means of a cap 57 that is ultrasonically welded to the spigot assembly to form a leak-tight seal with the spigot assembly.
- the socket 35 has an inwardly-directed collar 60 and the spigot 46 has an outwardly-directed collar or rim 61.
- the collar 61 is in engagement with the collar 60, thus defining the outer limit of movement of the spigot with respect to the socket.
- the seal against flow-by will always be maintained by the compression of the ring 40 against the seat 38 and the surface 42.
- the dilatation catheter 11 passes through the main passageway 22, the bore 51 in the O-ring, the bore 50 in the spigot, the bore 56 in the membrane and out of the proximal end of the Y connector.
- the free end of the dilatation catheter is connected to a supply of a saline mixture by which the balloon 12 in the dilatation catheter is inflated.
- the guide catheter is connect ⁇ ed to the Y connector and the manifold with its attachments are attached to the Y connector.
- the guide catheter is inserted via the patient's arm or leg into the patient's coronary artery. As it is snaked through that tortuous path, the rotator 16 permits it to twist while the Y connector and its attachments remain in a relatively fixed position.
- the contrast medium With the guide catheter in place, the contrast medium is inserted through the port 30 and the branch passageway 23. With the contrast medium in the coronary artery, an arteriogram shows the cardi ⁇ ologist the area of blockage.
- the dilatation catheter is then inserted into the coronary artery with the balloon 12 posi ⁇ tioned within the area of blockage. Possibly prelimi ⁇ nary to the insertion of the dilatation catheter, a small guide wire will have to be inserted in order to open the blocked artery sufficiently to permit the introduction of the balloon catheter.
- a small guide wire will have to be inserted in order to open the blocked artery sufficiently to permit the introduction of the balloon catheter.
- the dilata ⁇ tion catheter passes through the membrane 55, it is sealed with respect to the membrane and blood is prevented from exiting the Y connector via the membrane. Blood is also prevented from flowing between the spigot and socket surfaces by the slight compression of the O-ring 40 against the seat 38 and the frustoconical surface 45 on the spigot.
- the seal against flow-by at the rubber seal 40 will remain intact.
- the dilatation catheter Once the dilatation catheter is in place, it is gradually inflated to rupture the placque that is creating the blockage of the coronary artery. The catheter is thereafter withdrawn. When it is with ⁇ drawn, blood will want to exit through the membrane 50. However, by turning down the spigot onto the Tuohy Borst valve, the valve can be completely closed down, thereby blocking flow of blood out of the main passage 22.
- contrast medium is again injected and an arteriogram is viewed to determine the success of the procedure thus far. It may be determined that a larger dilata ⁇ tion catheter should be inserted. If so, that opera ⁇ tion is performed by partially inserting the catheter up to the Tuohy Borst valve, opening the Tuohy Borst valve and proceeding with the insertion of the cathe- ter. The inflation procedure is repeated.
- the leakage can be blocked by the turning down of the Tuohy Borst valve, care being exercised to prevent the crushing of the small catheter or impart ⁇ ing such a great friction to it or the wire that it cannot be threaded into the artery.
Abstract
The connector (20) has a main passage (23) through which a dilatation catheter (11) passes. Combined Tuohy-Borst valve (40) and membrane seals (55) are provided in the main passage to seal the catheter (11) against flow-by.
Description
Y Connector for Angioplasty Procedure Background of the Invention
This invention relates to a Y connector for use in an angioplasty procedure.
The angioplasty procedure for repair of a blood vessel has been known for many years. The procedure provides an opportunity to open up a clogged blood vessel, particularly a coronary artery, and thus avoid the expense and trauma of bypass surgery.
The procedure involves the insertion of a large guide catheter up to the blood vessel to be repaired. A Y connector is attached to the free end of the guide catheter by means of a rotatable coupling of the type disclosed in U. S. Patent No. 4,254,773. The Y connector has a main passage through which the dilatation catheter is inserted. The Y connector has a branch passage to which a multiport manifold is connected. One port of the manifold is connected to a blood pressure monitor of the type disclosed in copending application Serial No. 07/072,909, filed July 14, 1987. Another port of the manifold is connected to a supply of contrast media which is a fluid injected into the blood vessel enabling a real time observation of the bloodvessel through X-ray.
At a minimum, the angioplasty procedure involves the following steps:
The guide catheter is inserted through a blood vessel in the patient's arm or leg into the heart.
A blood pressure monitor is connected to the Y connector to provide a continuous monitor of a patient's blood pressure.
The contrast medium is introduced into the blood vessel so that the blockage of the blood vessel can be identified. A dilatation catheter having a balloon on its free end is introduced through the main passage of the Y connector. When the end of the dilatation catheter is in place in the area of the blockage caused by a growth of placque, a saline mixture is injected through the dilatation catheter to the balloon on its end to inflate it. As the balloon is inflated, it ruptures the placque in the coronary artery so as to permit normal or at least improved blood flow. T e dilatation catheter is thereafter removed and contrast medium again introduced and a post dilatation arteriogram is made to check the success of the procedure.
Thereafter, the dilatation catheter may be reintroduced. It may be desired to use a larger catheter. It may be desired to introduce a small guide wire instead of a dilatation catheter.
In any event, more than one insertion and withdrawal through the main passageway is normally required to complete the angioplasty procedure.
Blood under normal body pressure is of course in the main passageway just as it is in the branch passageway where it is being continuously monitored. The blood will tend to escape through the main passageway as by directly flowing through the main passageway when a catheter is removed or by flowing by the catheter when it has been inserted.
It is known in the prior art to provide sealing against the escape of blood through the main passageway of the Y connector. One seal is an adjust¬ able Tuohy Borst type valve. The Tuohy Borst valve includes an O-ring-type element seated in a socket forming part of the main passage. A cap threaded on the end of the passage contains a spigot which com¬ presses the O-ring when the cap is rotated to drive the spigot inwardly. The compression closes down the opening in the O-ring around the catheter to prevent "flow-by." When the catheter is absent, the O-ring can be closed down enough to completely close off the opening in the main passage.
An alternative form of seal employs a membrane having a small hole of about .045" diameter.
Catheters of a slightly larger outside diameter than the hole are inserted through the membrane, the membrane forming the seal against "flow-by."
Neither Y connector seal is completely satisfactory. The Tuohy Borst has the disadvantage that it requires manipulation in order to match the size of the opening in the ring to the outside di- ameter of the dilatation catheter. If the cardiol¬ ogist does not tighten it sufficiently, blood will flow by the valve. If it is too tight, the catheter can be inserted only with difficulty because of the friction or the catheter can be crushed. The membrane-type seal eliminates the foregoing disadvantages of the Tuohy Borst valve but has its own disadvantages. It cannot be completely closed off when a catheter is removed. Under those circumstances, when the dilatation catheter is remov- ed, the Y connector has to be removed and the mani¬ fold connected directly to the rotator. During this step, there is nothing to prevent the blood from flowing through the guide catheter and into the surgical area. Further, the smaller catheters, for example .036" O.D. , cannot properly be sealed by a membrane that has a hole that is .045" diameter. Brief Summary of the Invention
It is an objective of the invention to provide an improved seal for the Y connector, the improved seal eliminating the disadvantages of the Tuohy Borst and membrane-type seals of the prior art.
More specifically, it is an objective of the invention to provide a seal which permits insertion of
the dilatation catheter without need for manipulation of the connector to effect the seal and which pre¬ cludes blood flow-by; and which permits all steps of the procedure to be performed without requiring the disconnection of the Y connector.
The objects of the present invention are attained by providing a Y connector having, in the main passage, a socket that receives a Tuohy Borst
O-ring, a cap with a spigot projecting from it, the cap being threaded onto the outside surface of the socket so that it can be screwed down to bring the spigot into contact with the Tuohy Borst ring to compress it. The cap has sealed into it a membrane having a .040" to .035" diameter opening for receipt of a catheter. The spigot and socket are provided with projecting and interfering collars or rims that limit the axial movement of the spigot out of the socket. The limitation is such that when the collars are touching, the spigot is in engagement with the Tuohy Borst ring to hold it in sufficient compression to block flow of blood around the external surface of the ring, that is, between the ring and the socket.
This relationship is important to maintain a seal against flow-by when the membrane is used for the seal. In the prior art, the cap containing the membrane is solvent-sealed to the connector. Such a seal is ruled out when it is necessary to have the threaded connection for a Tuohy-Borst-type operation.
Therefore, the combination provides a seal for the membrane-type procedure that does not require the solvent sealing.
The combination as described permits or facilitates a number of procedures that have hereto¬ fore not been possible with any Y connector. The dilatation catheter can be inserted through the membrane and no manipulation is required to effect the seal between the membrane and the catheter. The catheter can be removed and blood flow through the main passage blocked by tightening down on the Tuohy Borst ring to close it completely. The membrane-type seal is available without solvent-sealing of the membrane-containing cap to the connector, the external surface of the Tuohy Borst ring providing the seal against flow-by. An undersized catheter or thin wire can be used even though its outside diameter would be smaller than the I.D. of the membrane, for in this situation, the Tuohy Borst valve could be tightened. Thus, the full range of catheters and guide wires is available with the single connector. There never would be a requirement for removal of the connector and reconnecting the manifold to the guide catheter as is the case with some procedures using the membrane. The need for a precise sealing adjustment as is required in the Tuohy Borst valve is eliminated for all but the smallest catheters. The possibility of air embolism that can occur when the connector is
removed and the manifold attached to the guide cathe¬ ter and vice versa is eliminated.
All of the foregoing objects, features and advantages of the invention will become more readily
5 apparent from the following detailed description taken in conjunction with the accompanying drawings in which:
Fig. 1 is a diagrammatic view of the appara¬ tus for performing an angioplasty procedure; 10 Fig. 2 is a cross-sectional view of the Y connector; and
Fig. 3 is an enlarged fragmentary view of the encircled portion of Fig. 2.
Referring to Fig. 1, a guide catheter 10 is 15 inserted, via a patient's arm or leg 13, into the heart 14 adjacent the coronary artery. A dilatation catheter 11 is positioned inside the bore of the guide catheter. At the end of the dilatation catheter is a balloon 12 which is inflatable by the injection of a -■ - saline-based solution.
The guide catheter 10 has a hub 15 that is connected to a rotatable coupling 16 of the type disclosed in U. S. Patent No. 4,254,773. A Y connec¬ tor 20 is formed by a clear plastic casing 19 that has 5 a standard male Luer slip 21 which is inserted into the end of the rotator coupling 16.
The Y connector has a main passage 22 and a branch passage 23. The branch passage terminates in a
standard female Luer lock 24. A manifold 25 is connected by way of the Luer lock to the branch passage 23. The manifold has at least two ports 26 and 27 that are controlled by stopcocks 28. One port, 27, for example, is connected to a blood pressure monitor of the type described in patent application Serial No. 07/072,909, filed July 14, 1987. The manifold has another port 30 which is connected to a supply of contrast medium that is to be inserted into the coronary artery to provide the contrast for an arteriogram that is used throughout the procedure.
The main branch 22 has a socket 35 which is threaded as at 36 on its external surface. As seen in Fig. 3, the socket has an internal surface 37 having a tapered valve seat 38 at one end. A silicon or rubber O-ring 40 is seated at the bottom of the socket against the tapered seat 38. The cross section of the O-ring 40 is trapezoidal. One surface 41 of the trapezoid sits on the seat 38. The other surface 42 of the trapezoid is engaged by a frustoconical surface 45 at the end of a spigot 46. The O-ring has a circular opening which, in a relaxed condition, is about .080 inch.
The spigot 46 is integral with a skirt 47 that surrounds the socket 35 and has internal threads by which it is threaded onto the threads 36 of the socket. The spigot and skirt form a closure 48. By
rotating the spigot assembly on the socket, the spigot
46 will move axially toward and away from the flexible
O-ring 40 to compress it or relieve the pressure against the seat 38, thus creating a Tuohy Borst-type valve.
The spigot has a bore 50 which is coaxial with the main passageway 22 and a bore 51 through the
O-ring 40. At the outer or proximal end of that bore
50 is a membrane 55 having a tiny bore 56 of .040" to .035" diameter which grips the catheter 11 and forms a seal with it. The membrane 55 is retained on the closure 48 by means of a cap 57 that is ultrasonically welded to the spigot assembly to form a leak-tight seal with the spigot assembly. The socket 35 has an inwardly-directed collar 60 and the spigot 46 has an outwardly-directed collar or rim 61. When the spigot 46 is inserted into the socket far enough to slightly compress the soft ring 40 on the seat 38, the collar 61 is in engagement with the collar 60, thus defining the outer limit of movement of the spigot with respect to the socket. As long as the spigot goes no farther outward with respect to the socket, the seal against flow-by will always be maintained by the compression of the ring 40 against the seat 38 and the surface 42.
During a procedure, the dilatation catheter 11 passes through the main passageway 22, the bore 51
in the O-ring, the bore 50 in the spigot, the bore 56 in the membrane and out of the proximal end of the Y connector. The free end of the dilatation catheter is connected to a supply of a saline mixture by which the balloon 12 in the dilatation catheter is inflated.
In operation, the guide catheter is connect¬ ed to the Y connector and the manifold with its attachments are attached to the Y connector. The guide catheter is inserted via the patient's arm or leg into the patient's coronary artery. As it is snaked through that tortuous path, the rotator 16 permits it to twist while the Y connector and its attachments remain in a relatively fixed position.
With the guide catheter in place, the contrast medium is inserted through the port 30 and the branch passageway 23. With the contrast medium in the coronary artery, an arteriogram shows the cardi¬ ologist the area of blockage.
The dilatation catheter is then inserted into the coronary artery with the balloon 12 posi¬ tioned within the area of blockage. Possibly prelimi¬ nary to the insertion of the dilatation catheter, a small guide wire will have to be inserted in order to open the blocked artery sufficiently to permit the introduction of the balloon catheter. As the dilata¬ tion catheter passes through the membrane 55, it is sealed with respect to the membrane and blood is prevented from exiting the Y connector via the
membrane. Blood is also prevented from flowing between the spigot and socket surfaces by the slight compression of the O-ring 40 against the seat 38 and the frustoconical surface 45 on the spigot. As long as collar 61 has not moved outwardly past the collar 60, the seal against flow-by at the rubber seal 40 will remain intact.
Once the dilatation catheter is in place, it is gradually inflated to rupture the placque that is creating the blockage of the coronary artery. The catheter is thereafter withdrawn. When it is with¬ drawn, blood will want to exit through the membrane 50. However, by turning down the spigot onto the Tuohy Borst valve, the valve can be completely closed down, thereby blocking flow of blood out of the main passage 22.
With the catheter removed, contrast medium is again injected and an arteriogram is viewed to determine the success of the procedure thus far. It may be determined that a larger dilata¬ tion catheter should be inserted. If so, that opera¬ tion is performed by partially inserting the catheter up to the Tuohy Borst valve, opening the Tuohy Borst valve and proceeding with the insertion of the cathe- ter. The inflation procedure is repeated.
If it is desired to use a catheter or wire smaller than the .040" to .035" diameter bore in the
membrane 55, the leakage can be blocked by the turning down of the Tuohy Borst valve, care being exercised to prevent the crushing of the small catheter or impart¬ ing such a great friction to it or the wire that it cannot be threaded into the artery.
From the above disclosure of the general principles of the present invention and the preceding detailed description of a preferred embodiment, those skilled in the art will readily comprehend the various modifications to which the present invention is susceptible. Therefore, we desire to be limited only by the scope of the following claims and equivalents thereof:
Claims
1. A Y-connector for an angioplasty procedure comprising, a casing having a bore forming a main passageway for a catheter and having a branch passage¬ way intersecting the main passageway, a Tuohy-Borst valve in the main passageway, and a membrane disposed in said main passageway, said membrane being coaxial with and spaced from said Tuohy-Borst valve, said membrane having a small hole for receiving a dilatation catheter.
2. A Y-connector for an angioplasty procedure comprising, a casing having a bore forming a main passageway for a catheter and having a branch passage¬ way intersecting the main passageway, a first seal in said main passageway having a circular opening therethrough, means for adjusting the diameter of said opening to any diameter between about .050 inch and zero, and a second elastomeric seal in said main passageway having a fixed circular opening having a diameter in the range of about .040 to .035 inch, said second seal preventing blood flow by a dilatation catheter inserted in said passageway, said first seal being adapted to close said passageway when a catheter is removed.
3. A connector as in claim 2 further compris¬ ing, a closure on said passageway at one end of said casing, said second seal being mounted on said closure, said closure being threaded onto said casing, a spigot on said closure projecting into passageway and in contact with said first seal, said spigot being operative to close the opening in said seal when moved toward said seal by rotating said closure.
4. A connector as in claim 3 in which said first seal provides a seal against flow of fluids between the outside of said spigot and said casing.
5. A connector as in claim 4 further compris- ing, detent means limiting axial movement of said closure and spigot away from said first seal whereby to maintain pressure of said spigot on said first seal.
6. A Y-connector for an angioplasty procedure comprising, a casing having a bore forming a main passageway for a catheter and having a branch passage- way intersecting said main passageway, a shoulder forming a seat in said main passageway, a compressible O-ring on said seat, a closure at one end of said passageway and threaded on said casing, a spigot on said closure extending into said passageway to compress said O-ring against said seat and to prevent fluid flow between the outside of said spigot and said casing, said spigot adapted, upon screwing down said closure, to close said O-ring, a membrane in said closure spaced from and axially aligned with said O-ring, said membrane having a circular opening about .040 inch in diameter to receive and seal a catheter, and detent means between said spigot and passageway to restrict movement of said spigot away from said O-ring and thus to maintain said O-ring always under some compression.
Priority Applications (1)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
DK069090A DK69090D0 (en) | 1988-02-01 | 1990-03-16 | Connector piece with Y-shape for use in angioplasty |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US150,778 | 1988-02-01 | ||
US07/150,778 US4886507A (en) | 1988-02-01 | 1988-02-01 | Y connector for angioplasty procedure |
Publications (1)
Publication Number | Publication Date |
---|---|
WO1989006986A1 true WO1989006986A1 (en) | 1989-08-10 |
Family
ID=22535953
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US1988/003411 WO1989006986A1 (en) | 1988-02-01 | 1988-10-03 | Y connector for angioplasty procedure |
Country Status (6)
Country | Link |
---|---|
US (1) | US4886507A (en) |
EP (1) | EP0366733A1 (en) |
CA (1) | CA1293666C (en) |
DK (1) | DK69090D0 (en) |
ES (1) | ES2012256A6 (en) |
WO (1) | WO1989006986A1 (en) |
Cited By (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
EP0449510A2 (en) * | 1990-03-22 | 1991-10-02 | Critikon, Inc. | Bloodless catheter with self-shielding needle |
US5203774A (en) * | 1990-01-30 | 1993-04-20 | C. R. Bard Ireland Limited | Device for use with a catheter |
WO1994001169A1 (en) * | 1992-07-01 | 1994-01-20 | Advanced Cardiovascular Systems, Inc. | Sheath to prevent backbleed through a hemostatic valve |
US5334160A (en) * | 1992-05-04 | 1994-08-02 | Scimed Life Systems, Inc. | Intravascular catheter with sleeve and method for use thereof |
EP0654282A1 (en) * | 1993-11-19 | 1995-05-24 | David D. Dr Henderson | Improvement intravenous catheter assembly |
WO2023049174A1 (en) * | 2021-09-21 | 2023-03-30 | Bard Access Systems, Inc. | Introducer adapters and introducer assemblies |
Families Citing this family (62)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5304156A (en) * | 1988-06-02 | 1994-04-19 | C. R. Bard, Inc. | Self-sealing guidewire and catheter introducer |
US5088991A (en) * | 1988-07-14 | 1992-02-18 | Novoste Corporation | Fuseless soft tip angiographic catheter |
US5226898A (en) * | 1989-08-30 | 1993-07-13 | The Kendall Company | Catheter adapter with strain relief |
US5125915A (en) * | 1990-03-02 | 1992-06-30 | Cardiopulmonics, Inc. | Locking y-connector for selective attachment to exterior of medical tubing |
US5163922A (en) * | 1991-04-29 | 1992-11-17 | Charles E. McElveen, Jr. | Dual-valved connector for intravenous systems |
US5769812A (en) | 1991-07-16 | 1998-06-23 | Heartport, Inc. | System for cardiac procedures |
US6482171B1 (en) | 1991-07-16 | 2002-11-19 | Heartport, Inc. | Multi-lumen catheter |
US5584803A (en) | 1991-07-16 | 1996-12-17 | Heartport, Inc. | System for cardiac procedures |
US5167636A (en) * | 1991-10-24 | 1992-12-01 | Mectra Labs, Inc. | Cannula sealing mechanism |
US5207647A (en) * | 1991-11-05 | 1993-05-04 | Phelps David Y | Needle device |
US5209740A (en) * | 1991-11-22 | 1993-05-11 | Abbott Laboratories | Catheter adapter having retention notches |
US6224619B1 (en) * | 1991-12-17 | 2001-05-01 | Heartport, Inc. | Blood vessel occlusion trocar having size and shape varying insertion body |
US5624414A (en) * | 1992-02-18 | 1997-04-29 | St. Francis Research Institute | Needleless straight infusion port |
US5464399A (en) * | 1992-02-18 | 1995-11-07 | St. Francis Research Institute | Needleless intravenous infusion system |
US5352215A (en) * | 1992-08-26 | 1994-10-04 | Scimed Life Systems, Inc. | Y-adapter with a sideport radius |
US5549576A (en) * | 1993-05-07 | 1996-08-27 | C. R. Bard, Inc. | Vascular introducer valve with proximal self-lubrication |
US5413561A (en) * | 1993-05-13 | 1995-05-09 | Cathco, Inc. | Guiding catheter with sealing cap system for reducing blood loss when inserting guiding catheters |
US5338308A (en) * | 1993-06-30 | 1994-08-16 | Wilk Peter J | Method and apparatus for inhibiting catheter sepsis |
ES2052459B1 (en) * | 1993-07-02 | 1995-02-01 | Biomed S A | VARIABLE GEOMETRY OCCLUSING BALL FOR TEMPORARY OR FINAL CLOSURE OF SEPTAL DEFECTS AND OTHER APPLICATIONS. |
AU1331595A (en) * | 1993-11-30 | 1995-06-19 | Medex, Inc. | Anti-reflux valve with environmental barrier |
WO1995015195A1 (en) * | 1993-11-30 | 1995-06-08 | Medex, Inc. | Plastic needleless valve housing for standard male luer locks |
US5403284A (en) * | 1994-01-27 | 1995-04-04 | The Kendall Company | Automatic lumen shut-off |
US5478331A (en) * | 1994-05-11 | 1995-12-26 | Localmed, Inc. | Multi-function proximal end adapter for catheter |
US5478309A (en) | 1994-05-27 | 1995-12-26 | William P. Sweezer, Jr. | Catheter system and method for providing cardiopulmonary bypass pump support during heart surgery |
US5613954A (en) * | 1994-11-21 | 1997-03-25 | Stryker Corporation | Laparoscopic surgical Y-tube cannula |
JP3795591B2 (en) * | 1996-09-19 | 2006-07-12 | テルモ株式会社 | Catheter connector |
US5895376A (en) | 1996-10-23 | 1999-04-20 | Mayo Foundation For Medical Education And Research | Hemostasis valve, system and assembly |
US5807330A (en) * | 1996-12-16 | 1998-09-15 | University Of Southern California | Angioplasty catheter |
US5755687A (en) | 1997-04-01 | 1998-05-26 | Heartport, Inc. | Methods and devices for occluding a patient's ascending aorta |
US6090096A (en) | 1997-04-23 | 2000-07-18 | Heartport, Inc. | Antegrade cardioplegia catheter and method |
US5957898A (en) | 1997-05-20 | 1999-09-28 | Baxter International Inc. | Needleless connector |
US6261282B1 (en) | 1997-05-20 | 2001-07-17 | Baxter International Inc. | Needleless connector |
US6159178A (en) | 1998-01-23 | 2000-12-12 | Heartport, Inc. | Methods and devices for occluding the ascending aorta and maintaining circulation of oxygenated blood in the patient when the patient's heart is arrested |
US6331176B1 (en) | 1999-03-11 | 2001-12-18 | Advanced Cardiovascular Systems, Inc. | Bleed back control assembly and method |
US6254061B1 (en) * | 1999-04-30 | 2001-07-03 | Scimed Life Systems, Inc. | Medical suction valve |
US6613014B1 (en) * | 2000-06-09 | 2003-09-02 | Advanced Cardiovascular Systems, Inc. | Catheter hub with detachable push device |
US6908459B2 (en) | 2001-12-07 | 2005-06-21 | Becton, Dickinson And Company | Needleless luer access connector |
US6834842B2 (en) * | 2002-01-09 | 2004-12-28 | Scimed Life Systems, Inc. | Fluid management valve |
US8137317B2 (en) * | 2002-03-15 | 2012-03-20 | Oscor Inc. | Locking vascular introducer assembly with adjustable hemostatic seal |
US6712798B2 (en) * | 2002-03-18 | 2004-03-30 | Corazon Technologies, Inc. | Multilumen catheters and methods for their use |
US20040172008A1 (en) * | 2002-11-19 | 2004-09-02 | Gmp/Cardiac Care, Inc. | Hemostasis valve and method of using a hemostasis valve |
US7582070B2 (en) * | 2004-04-09 | 2009-09-01 | Cook Vascular Incorporated | Modular hemostatic valve |
US7914519B2 (en) * | 2005-06-23 | 2011-03-29 | Elcam Medical Agricultural Cooperative Association, Ltd. | Catheter device |
US7621946B2 (en) * | 2006-03-06 | 2009-11-24 | Boston Scientific Scimed, Inc. | Implantable medical endoprosthesis delivery system with hub |
CA2677343C (en) | 2007-02-05 | 2016-06-21 | Boston Scientific Limited | Thrombectomy apparatus and method |
US9011412B2 (en) * | 2008-05-16 | 2015-04-21 | Ford Albritton, IV | Apparatus, system and method for manipulating a surgical catheter and working device with a single hand |
US7717900B2 (en) * | 2008-05-28 | 2010-05-18 | Angio Dynamics, Inc. | Locking clamp |
US20100036329A1 (en) * | 2008-08-07 | 2010-02-11 | Nasser Razack | Hemostasis valve |
US9510854B2 (en) | 2008-10-13 | 2016-12-06 | Boston Scientific Scimed, Inc. | Thrombectomy catheter with control box having pressure/vacuum valve for synchronous aspiration and fluid irrigation |
US20110112375A1 (en) * | 2009-11-12 | 2011-05-12 | Tyco Healthcare Group Lp | Portal apparatus including conformable cup seal |
CN103237571A (en) * | 2011-02-25 | 2013-08-07 | 泰尔茂株式会社 | Medical connector |
US9005266B2 (en) | 2011-10-10 | 2015-04-14 | Robert Feldtman | Vascular delivery methods |
EP2793722A1 (en) | 2011-12-22 | 2014-10-29 | DePuy Synthes Products, LLC | Length-adjustable vertebral body balloon |
EP2931131B1 (en) * | 2012-12-13 | 2022-11-09 | Philips Image Guided Therapy Corporation | Rotational catheter with extended catheter body drive shaft support |
US9675792B2 (en) | 2013-08-05 | 2017-06-13 | Cook Medical Technologies Llc | Hemostasis mechanism and method |
US9883877B2 (en) | 2014-05-19 | 2018-02-06 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US10561440B2 (en) | 2015-09-03 | 2020-02-18 | Vesatek, Llc | Systems and methods for manipulating medical devices |
WO2017075528A1 (en) | 2015-10-30 | 2017-05-04 | ECMOtek, LLC | Devices for endovascular access through extracorporeal life support circuits |
US10492805B2 (en) | 2016-04-06 | 2019-12-03 | Walk Vascular, Llc | Systems and methods for thrombolysis and delivery of an agent |
US10716880B2 (en) | 2018-06-15 | 2020-07-21 | Incuvate, Llc | Systems and methods for aspiration and monitoring |
US11678905B2 (en) | 2018-07-19 | 2023-06-20 | Walk Vascular, Llc | Systems and methods for removal of blood and thrombotic material |
US20230270988A1 (en) * | 2022-02-25 | 2023-08-31 | Boston Scientific Medical Device Limited | Dual arm hemostasis valve hub for introducer sheaths |
Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4254773A (en) * | 1978-11-24 | 1981-03-10 | Medex Inc. | Swivel coupling for a catheterization system |
US4424833A (en) * | 1981-10-02 | 1984-01-10 | C. R. Bard, Inc. | Self sealing gasket assembly |
US4430081A (en) * | 1981-01-06 | 1984-02-07 | Cook, Inc. | Hemostasis sheath |
US4626245A (en) * | 1985-08-30 | 1986-12-02 | Cordis Corporation | Hemostatis valve comprising an elastomeric partition having opposed intersecting slits |
US4723550A (en) * | 1986-11-10 | 1988-02-09 | Cordis Corporation | Leakproof hemostasis valve with single valve member |
US4726374A (en) * | 1985-12-09 | 1988-02-23 | Cordis Corporation | Leakproof hemostasis valve |
Family Cites Families (4)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4311137A (en) * | 1980-04-30 | 1982-01-19 | Sherwood Medical Industries Inc. | Infusion device |
JPS6145774A (en) * | 1984-08-07 | 1986-03-05 | テルモ株式会社 | Medical instrument |
US4769017A (en) * | 1985-04-04 | 1988-09-06 | Fath John J | Self-sealing infusion manifold and catheter connector |
CH671159A5 (en) * | 1986-06-20 | 1989-08-15 | Contempo Products |
-
1988
- 1988-02-01 US US07/150,778 patent/US4886507A/en not_active Expired - Lifetime
- 1988-09-15 CA CA000577448A patent/CA1293666C/en not_active Expired - Lifetime
- 1988-10-03 WO PCT/US1988/003411 patent/WO1989006986A1/en not_active Application Discontinuation
- 1988-10-03 EP EP89901669A patent/EP0366733A1/en not_active Withdrawn
-
1989
- 1989-01-31 ES ES8900335A patent/ES2012256A6/en not_active Expired - Lifetime
-
1990
- 1990-03-16 DK DK069090A patent/DK69090D0/en unknown
Patent Citations (6)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4254773A (en) * | 1978-11-24 | 1981-03-10 | Medex Inc. | Swivel coupling for a catheterization system |
US4430081A (en) * | 1981-01-06 | 1984-02-07 | Cook, Inc. | Hemostasis sheath |
US4424833A (en) * | 1981-10-02 | 1984-01-10 | C. R. Bard, Inc. | Self sealing gasket assembly |
US4626245A (en) * | 1985-08-30 | 1986-12-02 | Cordis Corporation | Hemostatis valve comprising an elastomeric partition having opposed intersecting slits |
US4726374A (en) * | 1985-12-09 | 1988-02-23 | Cordis Corporation | Leakproof hemostasis valve |
US4723550A (en) * | 1986-11-10 | 1988-02-09 | Cordis Corporation | Leakproof hemostasis valve with single valve member |
Cited By (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5203774A (en) * | 1990-01-30 | 1993-04-20 | C. R. Bard Ireland Limited | Device for use with a catheter |
EP0449510A2 (en) * | 1990-03-22 | 1991-10-02 | Critikon, Inc. | Bloodless catheter with self-shielding needle |
EP0449510A3 (en) * | 1990-03-22 | 1992-01-02 | Critikon, Inc. | Bloodless catheter with self-shielding needle |
US5334160A (en) * | 1992-05-04 | 1994-08-02 | Scimed Life Systems, Inc. | Intravascular catheter with sleeve and method for use thereof |
WO1994001169A1 (en) * | 1992-07-01 | 1994-01-20 | Advanced Cardiovascular Systems, Inc. | Sheath to prevent backbleed through a hemostatic valve |
EP0654282A1 (en) * | 1993-11-19 | 1995-05-24 | David D. Dr Henderson | Improvement intravenous catheter assembly |
WO2023049174A1 (en) * | 2021-09-21 | 2023-03-30 | Bard Access Systems, Inc. | Introducer adapters and introducer assemblies |
Also Published As
Publication number | Publication date |
---|---|
DK69090A (en) | 1990-03-16 |
ES2012256A6 (en) | 1990-03-01 |
EP0366733A1 (en) | 1990-05-09 |
CA1293666C (en) | 1991-12-31 |
US4886507A (en) | 1989-12-12 |
DK69090D0 (en) | 1990-03-16 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
US4886507A (en) | Y connector for angioplasty procedure | |
US4838269A (en) | Manifold for angioplasty balloon catheter | |
US5575767A (en) | Method and apparatus for high pressure one-way fluid valving in angiography | |
US5197952A (en) | Auto-inflating catheter cuff | |
US4857062A (en) | Catheter introducer valve | |
US6221057B1 (en) | Hemostasis valve, system and assembly | |
US7226433B2 (en) | Thrombectomy catheter device having a self-sealing hemostasis valve | |
US5669881A (en) | Vascular introducer system incorporating inflatable occlusion balloon | |
US4730616A (en) | Multiple probe angioplasty apparatus and method | |
EP0906135B1 (en) | Low profile catheter valve | |
EP0900105B1 (en) | Hemostasis valve | |
US4726374A (en) | Leakproof hemostasis valve | |
US5336192A (en) | Self-sealing valve device for angiographic catheters | |
CA2172001C (en) | Luer-type connector | |
US6270489B1 (en) | Anti-clotting methods and apparatus for indwelling catheter tubes | |
US5125903A (en) | Hemostasis valve | |
US4235232A (en) | Hub device for preventing liquid leakage | |
JP3893246B2 (en) | Blood backflow control valve | |
US5395330A (en) | Auto-inflating catheter cuff | |
US7377909B2 (en) | Connection assembly for use with splittable sheath | |
US20070276434A1 (en) | Vascular sheath | |
US7094218B2 (en) | Valved catheter | |
US20020103473A1 (en) | Intravascular occlusion balloon catheter | |
EP1198262A1 (en) | Catheter with check valve | |
EP0607343B1 (en) | Rotatable medical valve closure |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
AK | Designated states |
Kind code of ref document: A1 Designated state(s): DK |
|
AL | Designated countries for regional patents |
Kind code of ref document: A1 Designated state(s): AT BE CH DE FR GB IT LU NL SE |
|
WWE | Wipo information: entry into national phase |
Ref document number: 1989901669 Country of ref document: EP |
|
WWP | Wipo information: published in national office |
Ref document number: 1989901669 Country of ref document: EP |
|
WWW | Wipo information: withdrawn in national office |
Ref document number: 1989901669 Country of ref document: EP |