Implantable Shunt System and Method
20210353921 · 2021-11-18
Inventors
Cpc classification
A61M2025/0004
HUMAN NECESSITIES
A61M2205/3344
HUMAN NECESSITIES
A61M27/006
HUMAN NECESSITIES
International classification
Abstract
The present invention provides a novel shunt device and methods of use, and in particular a cerebral shunt device. The cerebral shunt device includes an outer tube member forming a first lumen, the outer tube member having a drainage outlet and at least one opening to the first lumen in a distal region along the length of the outer tube member. The shunt also includes an inner tube member forming a second lumen, the inner tube member having at least one opening to the second lumen along the length of the inner tube member. The inner tube member is positioned within the first lumen and a pump unit fluidly connected to the second lumen to force fluid from the first lumen, which clears obstructions in the shunt.
Claims
1. A shunt device, comprising: (a) an outer tube member forming a first lumen, the outer tube member having a drainage outlet and at least one opening to the first lumen in a distal region along a length of the outer tube member; (b) an inner tube member forming a second lumen, the inner tube member having at least one opening to the second lumen along the length of the inner tube member, wherein the inner tube member is positioned within the first lumen; (c) a pump unit fluidly connected to the second lumen; and, (d) at least one flow sensor; wherein the shunt device is a cerebral shunt device.
2. The shunt device of claim 1, wherein the inner tube member and the outer tube member are coaxial with each other.
3. The shunt device of claim 1, wherein the at least one opening along a length of the outer tube member is larger than the at least one opening along a length of the inner tube member.
4. The shunt device of claim 1, wherein the at least one opening along the length of the inner tube member is sized to permit only flow of a gas therethrough.
5. The shunt device of claim 1, further comprising a valve positioned at the drainage outlet of the outer tube member.
6. The shunt device of claim 5, further comprising a controller communicatively connected to the pump unit and the valve.
7. The shunt device of claim 1, wherein the pump unit comprises an air pump.
8. The shunt device of claim 1, wherein the pump unit comprises a hydraulic pump.
9. The shunt device of claim 1, further comprising at least one pressure sensor.
10. (canceled)
11. The shunt device of claim 1, wherein the outer tube member includes between 4 and 10 distal region openings to the first lumen positioned around a circumference of the outer tube member.
12. The shunt device of claim 1, wherein the inner tube member includes between 8 and 12 distal region openings to the first lumen positioned around the circumference of the outer tube member.
13. The shunt device of claim 1, wherein the at least one opening of the outer tube member has an average diameter of between 0.5 mm and 1 mm.
14. The shunt device of claim 1, wherein the at least one opening of the inner tube member has an average diameter of between 0.2 mm and 0.6 mm.
15. The shunt device of claim 1, further comprising a valve positioned at the drainage outlet of the outer tube member; further comprising a controller communicatively connected to the pump unit and the valve; further comprising at least one pressure sensor; wherein the inner tube member and the outer tube member are coaxial; wherein the at least one opening along a length of the outer tube member is larger than the at least one opening along a length of the inner tube member; wherein the pump unit comprises at least one of an air pump and an hydraulic pump; wherein the outer tube member includes between 4 and 10 distal region openings to the first lumen positioned around a circumference of the outer tube member; wherein the at least one openings of the outer tube member has an average diameter of between 0.5 mm and 1 mm; and, wherein the at least one opening of the inner tube member has an average diameter of between 0.2 mm and 0.6 mm.
16. A method of removing fluid from a subject, comprising the steps of: (a) inserting the distal region of the shunt device of claim 1 into a bodily space of a subject; (b) positioning the at least one opening along the length of the outer tube member within a region of the bodily space; (c) drawing fluid from bodily space through the at least one opening along the length of the outer tube member and into the first lumen; (d) upon determining that the at least one opening along the length of the outer tube member is obstructed, activating the pump unit to inject a fluid into the second lumen to generate enough pressure within the first lumen to force the fluid from the first lumen out through the at least one opening along the length of the outer tube member, thereby clearing the obstruction; and (e) deactivating the pump unit to permit drawing the fluid from a bodily space through the at least one opening along a length of the outer tube member and into the first lumen.
17. The method of claim 16, wherein the pump unit is activated at a set time interval.
18. The method of claim 16, wherein the fluid is cerebrospinal fluid.
19. The method of claim 16, wherein the fluid is cerebrospinal fluid and the bodily space is ventricle space.
20. The method of claim 16, further comprising the steps of: monitoring at least one control factor, and controlling flow of the fluid based at least in part on monitored control factor.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
[0023] The foregoing summary, as well as the following detailed description of several embodiments will be better understood when read in conjunction with the appended drawings. It should be understood, however, that the invention is not limited to the precise arrangements and instrumentalities of the embodiments shown in the drawings. In the drawings:
[0024]
[0025]
[0026]
[0027]
[0028]
[0029]
[0030]
[0031]
DETAILED DESCRIPTION
[0032] The present embodiments relate to a ventricular shunt for the treatment of hydrocephalus, and methods of use for improved drainage of CSF from a subject. The present embodiments also comprise novel systems and methods for clearing obstructions in order to maintain continuous flow of CSF from a subject.
Definitions
[0033] Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art. Although any methods and materials similar or equivalent to those described herein can be used in the practice or testing of the present embodiments, preferred methods and materials are described. As used herein, each of the following terms has the meaning associated with it in this section.
[0034] The terminology used herein is for the purpose of describing particular embodiments only, and is not intended to be limiting of the invention. As used herein, the singular forms “a,” “an,” and “the” are intended to include the plural forms as well, unless the context clearly indicates otherwise. It will be further understood that the terms “comprises” and/or “comprising,” or “includes” and/or “including” when used in this specification, specify the presence of stated features, regions, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, regions, integers, steps, operations, elements, components, and/or groups thereof.
[0035] “About” or “Substantially” as used herein when referring to a measurable value such as an amount, a temporal duration, and the like, is meant to encompass variations of 20%, +10%, ±5%, +1%, or ±0.1% from the specified value, as such variations are appropriate to perform the disclosed methods.
[0036] Ranges: throughout this disclosure, various aspects of the embodiments can be presented in a range format. It should be understood that the description in range format is merely for convenience and brevity and should not be construed as an inflexible limitation on the scope of the invention. Accordingly, the description of a range should be considered to have specifically disclosed all the possible subranges as well as individual numerical values within that range. For example, description of a range such as from 1 to 6 should be considered to have specifically disclosed subranges such as from 1 to 3, from 1 to 4, from 1 to 5, from 2 to 4, from 2 to 6, from 3 to 6 etc., as well as individual numbers within that range, for example, 1, 2, 2.7, 3, 4, 5, 5.3, and 6. This applies regardless of the breadth of the range.
[0037] Furthermore, relative terms, such as “lower” or “bottom,” “upper” or “top,” “left” or “right,” “above” or “below,” “front” or “rear,” may be used herein to describe one element's relationship to another element as illustrated in the Figures. It will be understood that relative terms are intended to encompass different orientations of the device in addition to the orientation depicted in the Figures.
[0038] It will be understood that when an element is referred to as being “on” another element, it can be directly on the other element or intervening elements may be present therebetween. As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items.
[0039] It will be understood that, although the terms first, second, third etc. may be used herein to describe various elements, components, regions, layers, and/or sections, these elements, components, regions, layers, and/or sections should not be limited by these terms. These terms are only used to distinguish one element, component, region, layer, and/or section from another element, component, region, layer, and/or section.
[0040] It will be understood that the elements, components, regions, layers and sections depicted in the figures are not necessarily drawn to scale.
[0041] Exemplary embodiments are described herein with reference to idealized embodiments of the present invention. As such, variations from the shapes of the illustrations as a result, for example, of manufacturing techniques and/or tolerances, are to be expected. Thus, embodiments should not be construed as limited to the particular shapes of regions illustrated herein but are to include deviations in shapes that result, for example, from manufacturing. The embodiments illustratively disclosed herein suitably may be practiced in the absence of any elements that are not specifically disclosed herein.
Description
[0042] The present embodiments provide a novel shunt device and methods for draining fluid from bodily spaces, and in particular, draining cerebral spinal fluid from cerebral ventricles. The cerebral shunt device of the present invention prevents the blockage of fluid flow, thereby maintaining continuous removal of cerebral spinal fluid from the ventricular space of a subject. It should also be appreciated that the present invention is not limited to use as a drain of CSF, but rather may be used in any portion of the subject's body requiring drainage of a fluid, and particularly where the fluid to be drained includes larger particulates or debris that can clog or obstruct the primary drainage holes of a typical shunt, catheter or other drainage tube.
[0043] Referring now to
[0044] In some embodiments, outer tube member 100 and inner tube member 200 are substantially coaxial, such that outer lumen 102 extends annularly around the entirety of the exterior wall surface of inner tube member 200. In other embodiments, at least a portion of the exterior wall surface of inner tube member 200 is connected to or in contact with a portion of the interior wall surface of outer tube member 100.
[0045] There is no limitation to the particular size of device 10. For example, in one embodiment, the diameter of the outer lumen can be in a range of 2.2 to 2.7 mm, such as about 2.5 mm. In another embodiment, the diameter of the inner lumen can be in a range of 0.3 to 0.8 mm, such as about 0.5 mm. In one embodiment the length of the device is in the range of 10 cm to 20 cm, and preferably, approximately 14 cm, with the pump unit 300 adding an additional 1 cm to 5 cm in length, preferably approximately 2.5 cm. In some embodiments, at least the distal ends of outer and inner tube members 100 and 200, respectively, include one or more openings leading into the outer lumen 102, 202 of each tube member 100, 200. In some embodiments, these openings are only in the distal region 12 of device 10. In other embodiments, the openings 114, 214 are additionally positioned in a middle region of device 10. In other embodiments, the openings are additionally positioned in a proximal region of device 10. In still other embodiments, the openings are positioned anywhere along the length of device 10. For example, as shown in
[0046] There is no limitation to the number of holes 114, or the pattern of holes 114 at distal end 12 of outer tube member 100. For example, the number of holes 114 positioned around the circumference of the outer tube member 100 can be in the range of 4-10. In one embodiment, the number of holes 114 positioned around the circumference of the outer membrane 100 is six. In some embodiments, holes 114 are sized such that CSF can freely pass through the holes but cells such as cells of the choroid plexus are restricted from passing into outer lumen 102. Likewise, distal end 12 of inner tube member 200 may include at least one, and preferably a plurality of holes 214 sized such that they are capable of delivering a suitable gas, liquid or other fluid from inner tube lumen 202 of inner tube member 200 into outer lumen 102 of outer tube member 100. There is no limitation to the number of holes 214, or the pattern of holes 214 at the distal end of inner tube member 200. In some embodiments, the number of holes 214 positioned around the circumference of the inner tube member 200 can be in the range of 8-12. In one embodiment, the number of holes 214 positioned around the circumference of the inner membrane 200 is ten. In some embodiments, holes 214 are sized such that gaseous fluids such as air can freely pass through the holes, but liquid fluids such as CSF have limited or no transport across holes 214. For example, in some embodiments, holes 214 are sized such that only pressurized air or other gas is capable of passing therethrough. In other embodiments, holes 214 are sized such that air or other gas types are capable of passing through, and the targeted liquid being drained may also pass through when a threshold pressure is generated in inner tube lumen 202. In still other embodiments, holes 214 may be sized such that liquid may pass therethrough, albeit at a slower rate than the passage of liquid through holes 114. In some embodiments, holes 114 are generally circular and can be in the range of about 0.5-1 mm in diameter, more preferably holes 114 are about 0.6 mm in diameter. In some embodiments, holes 214 are also generally circular and can be in the range of about 0.2-0.6 mm in diameter, more preferably holes 214 are about 0.3 mm in diameter. In still other embodiments, inner tube member 200 does not include any holes along its length, and instead is constructed of an expandable material. In such embodiments, when pump unit 300 drives a fluid into inner lumen 202, inner tube member 200 expands, thereby reducing the space within outer lumen 102 and generating the desired pressure in outer lumen 102 to temporarily reverse the flow of CSF back through holes 114 to dislodge the obstructing debris.
[0047] Referring now to
[0048] Pump 302 may be any suitable compressor or pump for increasing the pressure in inner lumen 202. In some embodiments, pump 302 is an air pump capable of driving air or another gas into inner lumen 202 to generate pressure. In other embodiments, pump 302 is a hydraulic pump capable of driving a liquid into inner lumen 202 to generate pressure. In some embodiments, pump 302 is directly connected to device 10 (as shown in
[0049] The pump 302 may be powered by any number of means, including a battery. The battery may be a rechargeable battery, rechargeable by wireless means. This feature would be especially useful because the patient would not have to visit the hospital to check the power level of the battery, as they could check the battery level themselves. Battery levels and other diagnostics may be checked by pairing the device with handheld devices such as Apple® or Android® phones, or can be another handheld device such as a watch or other gadget. The handheld device can have the capacity to warn patients of critically low battery levels, whereby the patient could change the battery themselves by pressing a battery release button. The battery may incorporate features such being a self-charging battery, as are known the art. The device may include at least one control factor that the user has the ability to control via the handheld, or other device. The at least one control factor may be transmitted to an app on a handheld device or other devices, and included, but are not limited to: CSF pressure, flow of the CSF, power level of the pump 302, speed of the circulating member 304 (and abilities to control speed via the app). The device may also include sensors that detect the level of circulating choroid plexus and debris in the ventricle of the brain.
[0050] Conduit 306 fluidly connects pump 302 to inner lumen 202. In some embodiments, circulating member 304 is also connected to the walls of conduit 306. In some embodiments, all or a portion of conduit 306 rotates with circulating member 304. In some embodiments, all or a portion of conduit 306 is fixed in one or more positions. In some embodiments, conduit 306 may include a one-way valve to prevent any backflow of air or liquid to pump 302.
[0051] Circulating member 304 may include any number of rotating blades or saddles that rotate about an axis perpendicular to the inner and outer lumens to promote directional flow of air and/or liquid passing through inner lumen 202. In some embodiments, pump unit 300 may include a motor to drive circulating member 304.
[0052] In some embodiments, pump unit 300 also includes a feedback sensor for detecting the pressure within inner lumen 202, such that pump 302 can shut off or reduce output when a threshold pressure is detected in inner lumen 202. In some embodiments, pump unit 300 may include a flow sensor. In some embodiments, pump unit 300 may include a flow regulator. In some embodiments, pump unit 300 may include a power source and a controller or computer processing unit for storing data, receiving signals and sending instructional signals to/from one or more sensors, valves or regulating components. Such features in generic pumps are well known in the art. In such embodiments, the controller or processing unit may be communicatively connected (wired or wirelessly) to any computing device, such as a smartphone, so that device 10 can send data to the computing device for display, and operational instructions can likewise be sent from the computing device to device 10.
[0053] In some embodiments, cerebral shunt device 10 may also include a valve 310 positioned within the proximal region of outer lumen 102. Valve 310 may be any suitable valve for regulating flow of a fluid, such as a one-way valve, ball valve, gate valve, butterfly valve, plug valve, globe valve, punch valve, check valve, and the like.
[0054] Valve 310 may be communicatively connected to a controller or processing unit, if present, such that valve 310 may be partially or fully opened and closed based on signals received from the controller or processing unit. As contemplated herein, valve 310 may be opened and closed to regulate fluid flow from outer tube lumen 102 to drainage tube 400. For example, when device 10 is drawing a targeted fluid through holes 114 into outer lumen 102 to be drained, valve 310 may be in a fully or partially open position so that the fluid passes through valve 310 into drainage tube 400. Then, when holes 114 become obstructed by debris, valve 310 is capable of moving to a closed position, so that pressure within inner and outer lumens 202 and 102 can be increased via activation of pump unit 300.
[0055] In traditional existing cerebral shunts, the valve is a separate component that is attached between the ventricular catheter and the distal catheter. However, in the present embodiments described, there is no need for a separate valve since the power generated circulating member 304 prevents backflow of CSF from the distal end 12 of the device as it forces the flow of the CSF in a forward direction. In the present embodiments, valve 310 has been included in case CSF were to flow backwards at a time when the circulating member 304 were to stop for a brief period of time, since the circulating member's 304 speed would be adjusted based on the CSF flow, CSF pressure, and the amount of choroid plexus or debris present in the ventricle.
[0056] In some embodiments, cerebral shunt device 10 also includes a mechanism for aspirating fluid from outer tube lumen 102, for example an aspiration syringe, a vacuum pump, or any other mechanism for creating a syphon, may be used to actively pull liquid through holes 114 into outer lumen 102. This aspirating mechanism may form part of pump unit 300, or may be fluidly connected to drainage tube 400. In some embodiments, device 10 may include a fluid collecting reservoir connected to drainage tube 400 for collecting and/or disposing the drained fluid. In some embodiments, the drained fluid may be returned to one or more regions within the subject.
[0057] In some embodiments, cerebral shunt device 10 includes an anchoring mechanism for attaching device 10 to the subject, such as by suture, clip, adhesive, etc., to decrease unwanted movement of device 10 when implemented in a subject. As contemplated herein, cerebral shunt device 10 may be constructed from any suitable material known in the art used in the construction of shunts, and particularly shunts suitable for insertion into the cerebral ventricle of a subject. That is, device 10 is constructed from any suitable material known in the art that is flexible enough to be positioned around anatomical structures of the ventricle space, while being rigid and incompressible enough to be inserted into the ventricle space by means such as applied pressure and/or tension. For example, outer tube member 100 may be constructed from any suitable material known in the art that is flexible enough to navigate anatomical structures of the ventricle space while being rigid and incompressible enough to be positionable within the ventricle space using means such as applied pressure and/or tension. Outer tube member 100 is also rigid and impressible enough to maintain a fluid clearance in outer lumen 102 while cerebral shunt device 10 is positioned within the ventricle space. Accordingly, outer tube member 100 may be constructed from one or more suitable polymeric materials including silicone, thermoplastic material, such as polyethylene block amide copolymer, polyvinyl chloride, polyethylene, polyethylene terephthalate, polyamide, polyurethane and/or a thermoset polymer, such as polyimide. In some embodiments, inner tube member 200 is constructed from any suitable material known in the art that is flexible enough to allow device 10 to be positioned around anatomical structures of the ventricle space while being rigid and incompressible enough to reinforce the structure of outer tube member 100 during placement into and use within the ventricle space. In some embodiments, inner tube member 200 may be expandable, and therefore be constructed of an expandable material. Likewise, inner tube member 200 may be constructed from one or more suitable polymeric materials including silicone, thermoplastic material, such as polyethylene block amide copolymer, polyvinyl chloride, polyethylene, polyethylene terephthalate, polyamide, polyurethane and/or a thermoset polymer, such as polyimide. Any standard manufacturing technique, such as extrusion or injection molding, may be used to construct the structural, housing components of device 10 as would be understood by those skilled in the art. In some embodiments, all or a portion of outer and/or inner tube members may optionally be reinforced with a wire, mesh or other framework to add additional support to the tube structure.
[0058] Methods of Use
[0059] The present embodiments also relate to methods for enhancing proper drainage of fluid from a bodily space, an in particular, CSF from the ventricle space of a subject by maintaining the free flow of draining CSF. For example, as outlined in
[0060] Accordingly in step 540, activating the pump unit generates a pressure within the inner and outer lumens of the device to push the CSF out into the outer lumen by creating a high pressure in the inner lumen. This process pushes the debris and the choroid plexus away from the pores on the outer lumen, thus preventing the undesired blockage. Lastly is the step of deactivating the pump unit to again permit flow of fluid (e.g. CSF) through the outer lumen holes and into the outer lumen of the device to flow proximally from a space (e.g. the ventricle) into the drainage tube 550. In some embodiments, the cerebral shunt is introduced into the ventricle space of a subject through a peripheral incision. In one embodiment, the method comprises the step of inserting the catheter using a guidance mechanism, for example, but not limited to, a guide wire, an X-ray guidance system, an ultrasound guidance system.
[0061] Referring now to
[0062] The device 10 has numerous advantageous features over present day shunt devices, as described above. In particular, the use of two tube members 100, 200 unlike previous device that only use a single tube. The presence of two tube members 100, 200 allows increased and better flow of CSF through the device. In addition, the power generated circulating member (turbine) 304, controls the flow of CSF, and prevents backflow, which normally would be accomplished by a valve (as used in prior devices). However, the present embodiments do not require a valve to prevent backflow because the circulating member 304 directs and forces fluid in a direction that prevents backflow and obstructions. The ability to control the flow of CSF and fluid pressure allows for controlled prevention of obstruction in the shunt in a superior manner compared to current shunts.
[0063] The following reference numerals are used throughout
[0087] While the embodiments have been described in terms of exemplary embodiments, it is to be understood that the words that have been used are words of description and not of limitation. As is understood by persons of ordinary skill in the art, a variety of modifications can be made without departing from the scope of the invention defined by the following claims, which should be given their fullest, fair scope.