RU2375083C2 - Intra-arterial carotid shunt - Google Patents

Abstract

FIELD: medical equipment.

SUBSTANCE: invention refers to medicine, namely to devices applied in vascular surgery. A shunt comprises a hollow PVC tube of diametre 5 mm and length 300 mm with a soft elastic cylinder distanced 150 mm from a distal part. In the middle of the cylinder, there are soldered in circumferential plastic rings functioning as stiffeners. In the cylinder wall up to level of stiffeners and in the same shunt there are holes of diametre 5-7 mm to ensure free blood flow. In the beginning of the shunt there is a cannula for drug introduction.

EFFECT: reduced cross-clamping of carotids and period of cerebral ischemia.

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Description

The device relates to medicine, namely to devices used in vascular surgery.

Intraluminal shunts are known, which are a plastic tube with a diameter of 4-6 mm and a length of 20-25 cm (Le Rich 1932). In recent years, it was improved due to the Teflon coating (Atlas of surgical operations. Solinger R.M. 1996).

However, this design has several disadvantages - a significant loss when installing the shunt; clamping of both carotid arteries, which can lead to the development of cerebral ischemia.

Known shunt Le Maitre (figure 1). It is a 3-lumen T-shaped tube with 2 elastic plastic cylinders at the ends (like Fororgarty cylinders). A shunt is implanted into the common and internal carotid arteries through an incision, where it is fixed by ballooning. In this case, blood flow through the central lumen is maintained.

However, the installation of this shunt is associated with a significant negative point - when it is implanted, a rather long (up to 3 min) stoppage of blood circulation through the carotid arteries and certain difficulties in extraction at the end of the operation are still required.

The closest in technical essence, the achieved effect and selected as a prototype is an intra-arterial carotid shunt containing a hollow tube with a soft elastic occlusal balloon (US application 2005154344).

An object of the present invention is to improve an intra-arterial carotid shunt.

The technical result consists in reducing the clamping of the carotid arteries and the duration of cerebral ischemia, as well as in the possibility of performing a carotid endarterectomy without the threat of removing the shunt from the arteriotomy hole, without the threat of re-clamping the carotid arteries at the final stage and avoiding significant blood loss.

The specified technical result is achieved due to the fact that the intra-arterial carotid shunt, including a hollow tube and a soft elastic occlusal balloon, characterized in that the tube is made of PVC, has a diameter of 5 mm and a length of 300 mm, the balloon is located at a distance of 150 mm from the distal part of the shunt ; plastic rings, which act as stiffeners, are soldered to the central part of the cylinder around the perimeter; openings with a diameter of 5-7 mm are made in the wall of the balloon to the level of the ribs and in the balloon of the tube for free blood flow, and at the beginning of the shunt is a cannula for administering drugs.

Figure 2 presents the intra-arterial shunt:

1 - hollow PVC pipe;

2 - soft elastic balloon;

4 - holes;

5 - cannula.

The intra-arterial shunt is a hollow PVC tube (1) with a diameter of 5 mm, a length of 300 mm and a soft elastic balloon (2) of the Fogarty type located at a distance of 150 mm from the distal part. The central part of the cylinder along the perimeter is made of plastic rings (3), which are soldered into the wall and act as stiffeners. In the wall of the balloon to the level of the ribs and in the tube itself, in the part located in the balloon, holes (4) with a diameter of 5-7 mm are applied for free current through the internal carotid artery. At the beginning of the shunt for drug administration is a standard cannula (5).

The device operates as follows: after mobilization of the carotid arteries and prophylactic intravenous administration of the anticoagulant, the marginal squeeze of the common carotid artery is 5-7 cm below the bifurcation level. In the squeezing area, a section of the anterior artery wall is 0.5-0.7 cm in size. A preventive Z-shaped ligature (or muslin suture) is applied. The proposed shunt with an elastic balloon is inserted into this hole. The external carotid artery is constricted by a vascular clamp. A “soft” temporary ligature is imposed on the internal carotid artery in the distal part, pinching it to the level of the shunt. Thanks to the stiffening ribs, the balloon occludes the lumen of the common carotid artery according to the type of opened umbrella. The blood flow through intracranial arteries is maintained through the shunt through the openings in the balloon and the balloon portion of the shunt. After that, the main stage of the proposed operation is performed (carotid endarterectomy with a patch, resection of the internal carotid artery with its reimplantation into the common carotid, eversion endarterectomy, etc.). In this case, similar manipulations are performed on a “dry” section of the internal carotid artery. At the end of the main stage of the operation, the shunt is removed through the area of its implantation. After that, the previously applied Z-shaped or purse-string suture is tightened.

The proposed shunt minimally injures the arteries, blood loss during its use is negligible. During the operation, adequate arterial blood flow through the internal carotid artery is maintained, and the time limit for surgery is significantly increased.

Claims (1)

An intra-arterial carotid shunt, including a hollow tube and a soft elastic occlusal balloon, characterized in that the tube is made of PVC, has a diameter of 5 mm and a length of 300 mm, the balloon is located at a distance of 150 mm from the distal part of the shunt; plastic rings, which act as stiffeners, are soldered to the central part of the cylinder around the perimeter; openings with a diameter of 5-7 mm are made in the wall of the balloon to the level of the ribs and in the balloon of the tube for free blood flow, and at the beginning of the shunt is a cannula for administering drugs.

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