US3334629A - Occlusive device for inferior vena cava - Google Patents

Description

Aug. 8, 1967 B. D. COHN OCCLUSIVE DEVICE FOR INFERIOR VENA CAVA 5 Sheets-Sheet 1 Filed Nov. 9, 1964 INVENTOR BERTRAM D. COHN BY MORGAN, FINNEGAN, DURHAM E PINE ATTOMQEYS Aug. 8, 1967 B, m. czowm OCCLUSIVE DEVICE FOR INFERIOR VENA CAVA 5 Sheets-Sheet 2 Filed Nov. 9, 1964 FIG."5

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INVENTOR. BERTRAM D. COHN BY MORGAN, FINNEGAN, DURHAM 8\ PINE ATTORNEYS Aug. 8, 1967 B. D. COHN 3,334,629

OCCLUSIVE DEVICE FOR INFERIOR VENA CAVA Filed Nov. 9, 1964 3 Sheets-Sheet 3 INVENTOR. BERTRAM D. COHN BY MORGAN, FINNEGAN, DURHAM 8 PiME ATTORNEY? United States Patent 3,334,629 OCCLUSIVE DEVICE FOR INFERIOR VENA CAVA Bertram D. Cohn, 835 Ocean Ave, Brooklyn, N.Y. 11226 Filed Nov. 9, 1964, Ser. No. 409,737 2 Claims. (Cl. 128325) The present invention relates to a novel and improved device for restricting the flow of blood through a blood vessel, especially the inferior vena cava.

Objects and advantages of the invention will be set forth in part hereinafter and in part will be obvious herefrom, or may be learned by practice with the invention, the same being realized and attained by means of the instrumentalities and combinations pointed out in the appended claims.

The invention consists in the novel parts, constructions, arrangements, combinations and improvements herein shown and described.

The accompanying drawings, referred to herein and constituting a part hereof, illustrate embodiments of the invention, and together with the description, serve to explain the principles of the invention.

Of the drawings:

FIGURE 1 is a longitudinal section through a preferred embodiment of the present invention;

FIGURE 2 is fragmentary, detailed sectional view showing the preferred form of occlusive device according to the present invention;

FIGURE 3 is an end elevation of the device shown in FIGURE 2;

FIGURE 4 is a longitudinal sectional view through a modified embodiment of the occlusive device;

FIGURE 5 is an end elevation of the device shown in FIGURE 4; and

FIGURE 6 is a fragmentary, schematic view showing portions of the circulatory system of the human body, including the exterior jugular vein, superior and inferior vena cava and the heart.

The present invention has for its object the provision of a novel and improved device for simplifying the surgical operation which comprises partially occluding the inferior vena cava so that the circulation of venous blood to the heart is restricted. A further object of the invention is the provision of a novel and improved device by which an occulsive device may be introduced into a blood vessel, usually the inferior vena cava, by entry of the device into the circulatory system, normally through the exterior jugular vein, usually under the influence of only a local anesthetic. From there the device may proceed into the inferior vena cava where it is separated from its positioning and control member and is ejected and allowed to remain in the desired position, after which the positioning and control member is removed, and the opening into the exterior jugular vein may be sutured and dressed, thereby completing the operation.

In the operation involving the partial or complete occlusion of the inferior vena cava, sometimes necessary in the treatment of phlebitis or in the prevention of pulmonary emboli, it has heretofore been necessary to perform the relatively complex, and major abdominal operation requiring general anesthesia, and extensive surgery within the abdominal cavity, in order to restrict or partially or totally occlude the inferior vena cava, thereby restricting the flow of venous blood to the heart.

The present invention avoids most of the complications formerly inherent in such an operation, and requires only that there be the percutaneous insertion of the device of the present invention into the exterior jugular vein, after which the device may be lowered into the superior vena cava and into the inferior vena cava, while its progress is observed by fluoroscopy or other radiography.

3,334,629 Patented Aug. 8, 1967 It will be understood that the foregoing general description and the following detailed description as well are exemplary and explanatory of the invention but are not restrictive thereof.

Referring now in detail to the present preferred and illustrative'embodiment of the present invention, FIG- URES 1, 2 and 3 show the introducing or carrying and positioning member and one form of the occlusive device.

The occlusive device comprises a shaft or mounting member 10 on which are positioned a plurality of particonical or parti-pyramidal members 12, each of which is provided with several vanes or wing-like portions 14 connected together by a central web 17 which is apertured to be mounted on and fixedly held to the shaft-like member 10. The wing-like members 14 are so dimensioned that, in their expanded condition, they have an exterior dimension which is slightly larger than the normal interior dimension of the inferior vena cava, and the space betweenadjacent wings 14 is also so proportioned as to occlude the interior of the vena cava to the desired extent. Thus, the occluding device may be adapted to provide a small, or a high, or a substantially complete occlusion of the inferior vena cava, depending upon the amount of space provided between theadjacent wings 14 of each one of the plural sets.

The shaft member 10 and the members 12 may be formed of various relatively inert materials, such as thin stainless steel, Vitallium or other inert alloys which may be formed into thin resilient sheet material, or of inert plastic, such as nylon, polyethylene, polyvinyl chlorideacetate copolymer, or polypropylene. Where the members are formed of metal, they may be permanently fixed to the mounting shaft by peening over the ends of the shaft 10 as at 16 and 18, and by forming the metal at the intermediate web member 17, as by rolling to form a locatingcollar 20, or they may be welded to the shaft member 10. If the occlusive device is made of thermoplastic material, it may be formed as a unitary construction by injection molding, or may be assembled from its component parts which are welded to the central shaft 10 by means of suitably applied heat.

Thewing members 14 are sufficiently thin that they may be easily partially collapsed into a conical or pyramidal position, as shown in FIGURES l and 2, and yet expand with considerable force to have an enlarged exterior periphery, with the edges of the wings preferably being provided withpoints 22 which are preferably barbed so that the expanded occlusive device is firmly embedded in the interior wall of the inferior vena cava, thereby insuring that the occlusive device will not be dislocated from the desired position where it is left upon completion of the operation.

The means for introducing the occlusive device into the exterior jugular vein and eventually into the inferior vena cava, preferably comprises an elongatedcylindrical chamber 24, sufiiciently small in diameter to be readily pushed through the jugular vein and into the inferior vena cava. Thiscylindrical member 24 has anopen end 25 having a slightly inturned lip which insures a smooth end of the cylinder and also insures against premature ejection of the occluding device. The interior diameter of thecylinder 24 is such that it holds thewings 14 of the occlusive device contained therein in a compressed position, as shown in FIGURE 1. At its other end, the cylinder is connected to a relatively fine tube 26 which serves as a shield and manipulative member for the cylinder, as well as a guide for the cable orpush rod 28 by which the occlusive device is expelled and allowed to be fixed in its permanent position within the inferior vena cava. The inner end of the tube 26 is preferably formed integrally with thecylinder 24, and the tube is of a sufiicient length to extend from well beyond the local cut-down of the exterior jugular vein to the desired position of the occlusive device in inferior vena cava. Thecylinder 24 and the tube 26 are formed of flexible, relatively inert material, such as gum rubber, polyethylene, or polyvinyl chloride-acetate copolymer, which can be properly sterilized. The cable orpush rod 28 may likewise be formed on a relatively stifl, flexible material, such as polyethylene, nylon, or a fine stainless steel wire, having suitable compressive strength to allow the occlusive device to be ejected from thecylinder 24 when desired, by pushing on the other end of the cable orpush rod 28. The inner end 30 of the cable orpush rod 28 is preferably formed with an enlarged head 32 to engage the end of the occlusive device, and may be provided with a small recess to insure proper seating of the end of the push rod on the occlusive device when ejection is desired.

At its outer end, the tube 26 is provided with aclamp 34 by which the tube may be firmly compressed against the cable or push-rod 28 to immobilize the two with respect to each other, and the outer end of the cable orpush rod 28 is preferably provided with an enlargedknob 36 by which the cable orpush rod 28 may be pushed to eject the occlusive device.

Entry of blood into the tube 26 is'prevented by means of a resilient collar 38 compressed between the inner Wall of the tube and thecable 28, which collar may be formed of soft gum rubber.

FIGURES 4 and illustrate a modified embodiment of the occlusive device of the present invention, which like the embodiment of FIGURES 2 and 3, may be used in connection with a positioning apparatus similar to that shown in FIGURE 1.

As illustrated in FIGURES 4 and 5, the occlusive device comprises an integral member comprising acentral portion 40 from which extend a plurality of slightly diverging fiat vanes orfingers 42, which are formed of inert, resilient material, preferably an inert plastic, such as nylon, polyethylene, polypropylene or a polyvinyl chloride-acetate copolymer. The overall length of the occlusive device is'relatively long with respect to its diameter so that it is in no danger of becoming substantially tilted when it is left in position in the inferior vena cava, and itsfingers 42 are resilient and tendto expand outwardly, so that they expand when the occlusive device is ejected and released from the positioningcylinder 24 by actuation of thepush rod 28. The ends ofv thefingers 42 are each preferably provided on their outer surfaces with a plurality ofsmall teeth 44 which serve to insure permanent location of the occlusive device within the inferior vena cava. While thefinger 42 of the occlusive device in this embodiment are shown as occupying slightly less than one-half of the area of the interior of the inferior vena cava, the fingers may be made in various Widths so as to. provide the desired degree of occluslon.

The embodiment shown in FIGURES 4 and 5 is used in the same manner as described in connection with FIG- URES 1, 2 and 3.

FIGURE 6 is a schematic drawing of the human body, with many details omitted, and showing principally only a portion of the circulatory system, emphasizing the relative positions of the externaljugular vein 50, thesuperior vena cava 52, theinferior vena cava 54 and theheart 56. The positioning device as described in connection with FIGURE 1, and using the occlusive device of FIGURES 2 and 3, or FIGURES 4 and 5, is inserted through alocal cutdown 58 over the external jugular vein in the neck, thus avoiding a major anesthetic as well as a major operation. The positioning device is then pushed downwardly through the jugular vein, into the superior vena cava, through the right artioventricular orifice of the heart and intothe inferior vena cava, all the while being manipulated as guided by fluoroscopy or radiography. When the occlusive device has been properly positioned, it is ejected from the conveying cylinder, thereby allowing it to expand into firm engagement with the interior wall of the inferior vena cava, after which the positioning means is removed, the cutdown wound sutured and dressed.

To prevent coagulation of blood within the operating mechanism during introduction and placement of the occluding device, it and thecylinder 24 may be coated with heparin or other anti-coagulant agent prior to use.

The invention in its broader aspects is not limited to the specific mechanisms shown and described but departures may be made therefrom within the scope of the accompanying claims without departing from the principles of the invention and without sacrificing its chief advantages.

What is claimed is:

1. A surgical device for partially occluding a blood vessel comprising a relatively long flexible tubular member having an open-ended hollow elongated member at one end thereof, a flexible push rod member movable within said tubular member, and an expansible occlusive member within said elongated member adapted to expand when expelled from said hollow member by longitudinal movement of said push rod relative to its enclosing tubular member, said expansible occlusive member comprising several resiliently expansible vanes, the outer ends of which have outwardly extending teeth to engage the interior wall of the blood vessel, thereby permanently locating the occlusive member in a blood vessel.

2. A surgical occlusive member to be positioned within a blood vessel comprising a central member and several outwardly extending and resiliently extendable outwardly widening vanes'attached to said central member, said vanes having outwardly extending teeth to engage the interior walls of a blood vessel to locate the occlusive devicetherein, the teeth at the ends of the vanes engaging the interior wall of the blood vessel into which the. occlusive device is inserted to permanently locate the occlusive member therein.

References Cited UNITED STATES PATENTS 3,108,593 10/1963 Glassman 128328 FOREIGN PATENTS 782,496 9/1957 Great Britain.

RICHARD GAUDET, Primary Examiner.

G. E. MCNEILL, Assistant Examiner.

Claims (1)

1. A SURGICAL DEVICE FOR PARTIALLY OCCLUDING A BLOOD VESSEL COMPRISING A RELATIVELY LONG FLEXIBLE TUBULAR MEMBEAR HAVING AN OPEN-ENDED HOLLOW ELONGATED MEMBER AT ONE END THEREOF, A FLEXIBLE PUSH ROD MEMBER MOVABLE WITHIN SAID TUBULAR MEMBER, AND AN EXPANSIBLE OCCULSIVE MEMBER WITHIN SAID ELONGATED MEMBER ADAPTER TO EXPAND WHEN EXPELLED FROM SAID HOLLOW MEMBER BY LONGITUDINAL MOVEMENT OF SAID PUSH ROD RELATIVE TO ITS ENCLOSING TUBULAR MEMBER, SAID EXPANSIBLE OCCLUSIVE MEMBER COMPRISING SEVERAL RESILIENTLY EXPANSIBLE VANES, THE OUTER ENDS OF WHICH HAVE OUTWARDLY EXTENDING TEETH TO ENGAGE THE INTERIOR WALL OF THE BLOOD VESSEL, THEREBY PERMANENTLY LOCATING THE OCCLUSIVE MEMBER IN A BLOOD VESSEL.

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