CA2383619C - Catheter with a partly textured surface - Google Patents

Abstract

A catheter including a body for insertion into a blood vessel of a medical patient. The body including an interface thereon which is the portion of the body that is inserted into and in contact with the skin or blood vessel of the patient. The interface includes texture on its exterior surface such that when the catheter body is inserted into the blood vessel, the texture secures the catheter body from migration at the point of entry of the catheter body into the patient. The texture is obtained by scoring or molding an irregular surface along the length of the interface. In the event that the catheter is configured for use with an introducer or cannula, portions of the introducer or cannula may also be textured in accordance with the invention.

Description

CATHETER WITH A PARTLY TEXTtlRED SURFACE
BACKGROITND OF THE INVBNTION
Field of the Invention The present invention relates ta the use of catheters for the introduction of fluids directly into the blood stream.

BackBropnd of the Invention Medical catheters are comtnonly eised for the introduction of fluids into the bloodstream during medical procedures. Such catheters are avaflable commercially in nuraerous embodiments designed specifically for such various medical procedures.
These catluters are commonly inserted into the blood vessel of the patient through the use of an intraducer or a needle and then held in place either by tape or by strturing the catheter to the blood vessel or surrotmding tissue.
One problem commonly encountered in such pracedures particulaily where the catheter is inserted directly into the blood vessel and particularly during pediatric surgery is that the portion of the catheter which intedaces with the blood vessel is sinooth, most generalfy comprised of plastic such that when an attempt is made to secure the catheter within the vessel, most co=nmonly by tying a suture around the interfacing Ixyrtion of the catheter, the pressure created by tightening of the suture causes the suturu to eject or squirt fivm the blood vessel before it can be secured thereon. As a result, thes pcissibiliry of contamination of the sterile catheter exists, not to mention the loss of vgluable and expensive surgical tirne. A need there.fore exists for a catheter which includes a texiured interface so as to provide a frictional component to rctain the catheter within the blood vessel wh.ile it is secured theroin.
In addition to the use of catheters, intravcnous stents (I.V.'s) are almost universally itsserted into the dorsal vein of the hand when a person is ad-nitted Zo a hospital or cluring the ad.ministration of a medical procedure. These intravenou:s sterrts, as weA as masJy types of catheters, are desi,gaed to be maimtained in the patient's bodq for a period of time which could exceed several days, weeks, or longer. In sucb situations the patient, if able, will be required to perfca,rm routine daily activities with the I.V. stent

2 PCT/US00/26134 or catheter inserted in his or her body. Such routine activity and movement causes the portion of the I.V. or catheter which interfaces with the skin or blood vessel to move or migrate therein. A known concern is that such movement of the interface within the skin tissue or blood vessel may allow the introduction of infection causing organisms to enter the body or blood vessel. Such organisms may potentially result in a serious bodily infection. A need therefor exists for an I.V. stent and catheter which includes a textured interface to allow secure placement of the I.V. or catheter within the patient's skin tissue or blood vessel.

Central venous catheters have unique requirements to be maintained in a fixed position in the body to avoid migration and infection. Migration may produce serious vascular perforations, complications, and catheter infection produces sepsis both of which may be fatal complications.

Both complications will be reduced by improved fixation of the catheter and natural tissue attachment to the textured surfaces. Pediatric patients have especially difficult fixation problems due to larger catheter size to body size ratios and inability of the patient to cooperate in catheter long term care.

In addition, as the distance the catheter (or I.V.) body interface is positioned or secured from the situs of penetration into the patient's skin tissue/blood vessel increases, an increase in the resultant migration thereof is realized. As stated, the result of increased migration of the catheter (or I.V.) body interface is an increased risk of infection. A need, therefore, exists for a catheter or I.V. which is textured to restrain the catheter body interface within or adjacent the situs of penetration.

3 3LfiAMA,RY OF THE TNVfiNTION

According to one aspect of the present inve:ntion, there is provided an indwelling intravascular device for insertion into the bodily tissue and vessel of a medical S patient thereby creating a puncture wound at the point of insertion and initiating the bodily process of healing the puncture wound, Gomprising: a body including an interface and a cannula; said cannula for extending into and terminating in the vessel; said body for at least partial insertion into the bodily tissue at the point of insertion;
said interface being the portion of said body which remains in contact with said bodily tissue adjacent said point of insertion while the device remains inserted in the bodily tissue; said interface having an exterior surface including texture thereon wherein micropZasts selected from the group consisting of fibroblasts, dermal, aubdermal, inflammatiDry, and collagen grow into engagement with said texture during the bodily proceas of healing the puncture wound to forrn a barrier against the migration of foreign matter past i3a:ld interface and to secure the catheter in place.

According to another aspect of the present invention, there is provided an intravenous stent for insertion into the bodily tissue of a medical patient at: a point of insertion thereby creating a puncture wound at the point of insertidn and initiating the bodily process of healing the puncture wound, compra.sing: a etent portion;
said stent portion capable of receiving a needle therethrough; said stent portion including an introducer and a cannula through which said needle extends; said introducer including a proximal portion and a distal portion; a segment of said proximal portion for contact with the bodily tissue at the point of insertion; said introducer including texture 3a on, said segment of said proximal portion for contact wiLh the bodily tissue at the point of insertion wherein microplasts selected from the group consisting of fibroblasts, dermal, subdermal, inflammatory, and collaqen grow into engagement with said texture during the bod:Ll-y process of healing the puncture wound to form a barrier against the migration of foreign matter paat said intEeri_ace and to secure the catheter in place.

According to still another aspect of the present invention, there is provided an intravascular device for insertion and retention in a severed vessel, comprisirig: a body, including an interface and a cannula; said cannula being frustocona.cal fox insertion into and terminating in the severed vessel; said interface being the portion of the body which contacts the severed vessel; said interface having an exterior surface having texture thereon wherein said texture provides friction so as to retain said body in the severed vessel.

3l~
The present inveAtion is a catheter including a body for insertion into a blood vessel of a medical parient. The body includes an interface thereon which is tkie portion of the body that is inserted into the blood vessel and is in contact therewittt. t~ cannula may extend from the inm2rface. The interface includes texrare on its e'xtetior stuface such that when the body is inserted into the blood vessel, it can be secured thereW
witbout being ejected from the blood vessel during the process of sec,rting the body within the blood vessel. As such, the textured interface provides $ufficient frictioaal coraact with the patient's slosf, or blood vessel so as to grip or retain the body therein while it is being 1.0 tied or suttued in place. The textxue thereby provides an increased surface area which is obtained by scoring or molding indenmtions withiu and along the length of rhe inrerface to provide sucii texpze. Examples of suitable texftue include diagonal cross -hatchi ng or knurl'mg, tbreazling, conceutric indentations cut along its length of cither a faic depth and spacing or a coarse depth and spacing thereby providing ridges or conccno:ic "donut"
shapes along the length of the inteiface, or a plurality of cells or ridges positioned along the exterior smrface of the interface. It is desirable that such textttre providi:s iacreased sur'ace area so as to acbieve frickional contact between the inzerfaee and ibe l)lood vessel without causing damage to the blood vessel or surrounding tissue.
The texuue of the present inventioa may also be used in alternate embodime-nt catheters which include a body having au interface thereon, a lumen for the introduccdon of Iiq>ads through the catheter, and wire guide obturator. Jr- such an eAabodinlent, the catheter is typically introduced through the skin and into the blood vessel such that the iAt.erface of the body is in direct contact with the sldn tissue of the patient while the cannula pierces theretbrough into and generally along the blood vessel. Catht:-ters of this type an~ generally instaIled for periods of soveral days, weeks or longer for tht long term introduclion of fluids directly into the blood vessel, In such cases, the texnire:d iaterface of the catheter body restricts movemeut of the catheter body within the sld.n dssue such that the tcndency of the piercing wound to heal allows the skin cells (micropls_st) to grow in the texture thereby securing the catheter body from migration. In this way, the textured interface reduces and may eliminate the introducrion of bacteria or #iu-gi which have rhe

4 potential of causing infection within the patient's body. A portion of the cannula may also be textured to further assist in securing the catheter from migration. It has been found that the catheter body should be fixed at the point of entry into the patient's body, as according to the present invention.
In addition, intravenous stents almost universally inserted into a patient's body during medical procedures may include a textured interface portion for the purpose of securing the stent within the patient's vein thereby also restricting the possibility of the introduction of infection causing organisms into the body or blood stream of the patient.
It is therefore an object of the present invention to include a catheter having a body including a portion which interfaces with the skin tissue or blood vessel of a patient during medical treatment wherein the interface is textured.
It is another object of the present invention to texture the interface of a catheter, and specifically an arterial or venous catheter to retain the catheter therein while it is secured in the patient's blood vessel.
It is still another object of the invention to provide an intravenous stent with a textured interface thereon.
A yet further object of the present invention is to provide a catheter or I.V.
with a textured body interface thereby restraining this body interface within the situs of penetration into the patient's skin tissue/blood vessel.

BRIEF DESCRIPTION OF THE DRAWINGS
FIGURE 1 depicts a central venous catheter which includes a textured interface of the present invention.
FIGURE 2 is the central venous catheter of FIG. 1 wherein the knurled textured

5 interface is depicted piercing and in contact with the skin of the patient.

FIGURE 3 is the central venous catheter of FIG. 1 configured with an alternate textured configuration including concentric rings cut in the length of the interface.
FIGURE 4 is the central venous catheter of FIG. 1 configured with a second alternate textured configuration concentric rings having deeper channels than the first alternate textured configuration of FIG. 3.
FIGURE 5 is the central venous catheter of FIG. 1 configured with a third alternate textured configuration including integral raised cells or bumps on the interface.
FIGURE 6 is the central venous catheter of FIG. 1 configured with a fourth alternate texture configuration including cells or bumps which are smaller than the cells or bumps of the third textured configuration of FIG. 5.

FIGURE 7 depicts a plan view of a peripherally inserted central venous catheter (PICC) including textured interface.
FIGURE 8 is a plan view of an intravenous stent which includes the textured interface of the present invention.

FIGURE 9 is an exploded view of the intravenous catheter of FIG. 8 wherein the stent portion includes the textured interface of the present invention.
FIGURE 10 is a plan view of a catheter inducer which includes the textured interface of the present invention.

FIGURE 11 is a view of a alternate embodiment catheter inducer which includes the textured interface of the present invention.

6 DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT
FIGURE 1 depicts a central venous catheter, and in particular, a peripherally inserted central venous catheter body 10 including lumen 12, wings 14 and 16, interface 18, and wire guide obturator 20 extending therefrom. Pursuant to the present invention, interface 18 includes a texture thereon such that when catheter 10 is inserted into a patient, the textured portion 22 of interface 18 is in contact with the patient's skin in order to keep catheter body 10 stationery therein. Referring more particularly to FIG. 2, where catheter body 10 is shown inserted through the skin 24 of a patient and into a vein 26. As such, cannula 20 extends from lumen 12 of catheter body 10 and into skin 24 and into vein 26. Interface 18 is the portion of catheter body 10 between cannula 20 and lumen 12. Interface 18 extends into the skin 24 of the patient. Texture 22 on interface 18 and or a portion of the first end of cannula 20 creates frictional contact between interface 18 (and cannula 20) of catheter body 10 and skin 24. Such frictional contact helps prevent catheter body 10 from moving or migrating within skin 24 or becoming dislodged therefrom.

Catheter body 10 is secured in place within the patient's body at the point of entry of interface 18 and cannula 20.

An additional important function of texture 22 is that the skin 24 (microplast) surrounding interface 18 will grow in an attempt to close or heal the hole (puncture) through which interface 18 and cannula 20 are inserted such that the cells will grow into engagement with the greater surface area of the interface caused by the texture in an attempt to close the puncture wound caused when the catheter was inserted.
This interface between the cells of skin 24 and texture 22 of interface 18 will help deter interface 18 from moving in and out of skin 24 when the patient moves through activity.

In this way, the possibility of infection causing germs from entering the puncture wound through skin 24 and the blood stream within vein 26 from the portion of interface 18 extending outside of skin 24 is greatly reduced. Such reduction in the possibility of the introduction of bacteria or fungus into the body is significant in the reduction of serious infection possibilities inherent in the use of the venous catheter. This infection risk is

7 generally heightened by the typically weakened state of the patient's immune system as a result of the medical condition necessitating the use of the catheter.

The style of texture 22 in the preferred embodiment of FIG. 1 is a cross-hatching or knurling wherein lines are cut into the surface of interface 18 in a diagonal fashion along the annular, semi-cylindrical circumference of interface 18. The diagonal lines are cut such that they cross thereby forming discreet square or most commonly diagonal patterns 28. In that the diagonal lines are cut into the surface of interface 18, their crossing thereby defmes discreet pattern 28 appearing raised above the circumference of interface 18. Each such discreet pattern 28 is separated from the next by the cross-hatched diagonal indentions. The particular geometric shape of individual pattern 28 is determined by the angle of the diagonal line cut in the surface of interface 18. For the purpose of exemplification, 500 microns is a suitable depth of texture 22, however, other depths are contemplated depending on the application.

Although texture 22 has been defmed herein as being formed by cutting diagonal lines in the surface of interface 18, it is understood that other methods of manufacture are contemplated such as by injection molding the texture into the surface of interface 18 or such other manufacturing processes known in the art.

In addition, it is understood that individual configuration 28 could be defined by other types of indentions in interface 18 such as curved lines or perpendicular lines.
Although the particular geometric design of FIG. 1 is preferred.

Referring next to FIG. 3, a first alternate embodiment texture is disclosed.
Interface 32 of catheter 30 includes first alternate embodiment texture 34.
First alternate texture 34 is defined by a series of concentric rings cut in the exterior circumference of interface 32. As with the preferred embodiment, the annular rings, as exemplified by ring 36 may be either cut in the surface of interface 32 or molded therein during the manufacture of catheter 30. Annular rings 36 and 38 of texture 34 bound and define a discreet raised annular slice of interface 32. Each independent slice 37 may have equal diameters or may increase or reduce in diameter along the length of interface 32 as desired.

8 Catheter 30 may be substituted for catheter 10 in FIG. 2 such that wire guide obturator 39 pierces skin 24 and extends into vein 26 such that interface 32 engages skin 24 at the surface thereof and provides frictional contact therein. Texture 34 further provides the protection against infection as described above.

FIG. 4 depicts a central venous catheter 40 including a second alternate embodiment texture 44 along interface 42. In this second alternate embodiment texture 42, the concentric rings, as exemplified by rings 46 and 48, are deeper in interface 42 defining a larger, more donut-shaped individual configuration as exemplified by configuration 47. Each individual "donut-shaped" texture configuration may be of equal size or increase or decrease in diameter along the length of interface 42 as desired for the required application or efficiency. Additionally, as stated above, texture 44 may be created in interface 42 at the time of its manufacture, typically by molding, or thereafter by a machine process.

Second alternate embodiment catheter 40 may be substituted for catheter 10 of FIG. 2 such that wire guide obturator 49 pierces skin 24 and enters vein 26 such that texture 44 pierces skin 24 in contact thereof.

Referring next to FIG. 5, wherein a central venous catheter 50 includes a third alternate embodiment texture 54 is disclose on interface 52. Third alternate texture embodiment texture 54 includes a series of cells or ridges 55-57 which extend above the cylindrical circumference of interface 52. Cells, or bumps, 55-57 may be formed in any known manner, however, it is believed that forming thereof during forming of interface 52 is the most efficient method. It is preferred that cells 55-57 be formed so as to provide a smooth texture and thereby rounded so as to minimize damage to the patient's tissue during use thereof. However, more pointed cells are contemplated in the invent that superior frictional capabilities of texture 54 are necessary.

Catheter 50 may be substituted for catheter 10 in FIG. 2 such that interface extends into skin 24 and is in frictional contact therewith.

Venous catheter 60 of FIG. 6 includes a plurality of smaller bumps, exemplified by bump 66 on interface 62. As can be seen, bump 66 is smaller than bump 55 of FIG.

9 5. As such, texture 64 of catheter 60 of FIG. 6 may be desirable for applications where less aggressive frictional contact between interface 62 and the surrounding patient's tissue is appropriate. The number of bumps such as bump 66 may be varied also as necessary. Bumps, such as bump 66, may be rounded or may have point thereon as desired for suitable applications.

Catheter 60 including texture 64 may be manufactured according to any suitable process. Catheter 60 may also be substituted for catheter 10 in FIG. 2 such that texture 64 of interface 62 is in contact with skin 24 upon insertion of catheter 60 through skin 24 into vein 26.

FIG. 7 depicts a peripherally inserted central venous catheter (PICC) 70 wherein interface 72 includes texture 74 thereon. As can be seen, the portion of wire guide obturator 76 adjoining interface 72 may also be textured to allow greater frictional interaction with the surrounding tissue. PICC 70 is configured in a dual lumen configuration including a larger lumen 78 and a small lumen 79.

FIG. 8 depicts an assembled intravenous stent assembly 80. Intravenous stent assembly 80 includes stent portion 82 and introducer/needle portion 84.
Intravenous stent assemblies such as assembly 80 are commonly used to provide intravenous access to a medical patient.

Taking FIG. 8 in combination with FIG. 9, intravenous stent assembly 80 includes stent portion 82, introducer/needle portion 84 and plug 86. In use, the assembled intravenous stent 80 (such as FIG. 8) is inserted into the patient's vein using needla 88.
Intravenous stent assembly such as 80 are commonly inserted into a vein in the top of the patient's hand, wherein needle 88 and surrounding cannula 90 are inserted into the vein.
Once inserted, intravenous fluids may be added by injection through plug 86 or by the removal of plug 86 and introduction through the hollow length of introducer 84.

Most commonly, however, once inserted, introducer/needle portion 84 is removed thereby leaving stent 82 within the hand of the patient such that cannula 90 and interface 92 extend into the vein. Once introduced, stent 82 is typically taped or sutured in place through holes 94 and wings 96. Introducer 92 of stent 82 includes texture 93 thereon.

Texture 93 helps prevent stent 82 from being ejected by the vein. A portion of cannula 90 may also be textured, preferably adjacent introducer 92. Texture 93 also reduces movement of introducer 92 and thereby stent 82 within the vein. Thus, a secure intravenous stent provided.

5 FIG. 10 depicts a catheter introducer assembly 100. An introducer is also known in the art as a sheath or introducer sheath designed to allow controlled access to the body, minimize trauma to vein or artery and prevent excessive blood loss during a procedure.
Introducers are available in many configurations to provide a sheath for introducing a catheter into the body.

10 Introducer 100 generally consists of two components, a sheath component 102 and a dilator component 104. Dilator 104 is longer than sheath 102 and is comprised of a smooth, stiff tube with a taper at its distal end 105. Dilator 104 fits within sheath 102.
Taper 105 when inserted into the patient acts to dilate the tissue in the skin and vein to allow the sheath to pass thereafter. Once the introducer is inserted into a vein through the skin and positioned therein, introducer 100 allows a catheter to be inserted into the vein.

Sheath 102 of introducer 100 includes texture 106 and 107 thereon in order to provide frictional engagement with the skin and vein when sheath 102 is inserted.
Texture 106 also restricts sheath 102 from movement within the vein in order to reduce the possibility of introduction of infection causing bacteria and fungi. A hub includes a valve therein to prevent blood from leaking from the vein. A
catheter is generally inserted through hub 108, sheath 102 and into the blood vessel to allow for the introduction of fluids therethrough. A side arm 110 terminating with a stop cock 112 is used to measure blood pressure and withdraw samples of blood for testing or otherwise.
FIG. 11 depicts introducer 120 for the insertion of guide wire 126 into a blood vessel to be followed by a catheter (such as PICC 70 of FIG. 7). Introducer body 120 is typically inserted directly into a severed vein such as in a angiogram procedure. Interface 122 of introducer body 120 includes texture 124 to provide frictional resistance while introducer body 120 is secured in the vein.

11 While the invention has been described with a certain degree of particularity, it is manifest that many changes may be made in the details of construction without departing from the spirit and scope of this disclosure. It is understood that the invention is not limited to the embodiment set forth herein for purposes of exemplification, but is to be limited only by the scope of the attached claim or claims, including the full range of equivalency to which each element thereof is entitled.

Claims (17)

CLAIMS:

1. An indwelling intravascular device for insertion into the bodily tissue and vessel of a medical patient thereby creating a puncture wound at the point of insertion and initiating the bodily process of healing the puncture wound, comprising:

a body including an interface and a cannula;

said cannula for extending into and terminating in the vessel;

said body for at least partial insertion into the bodily tissue at the point of insertion;

said interface being the portion of said body which remains in contact with said bodily tissue adjacent said point of insertion while the device remains inserted in the bodily tissue;

said interface having an exterior surface including texture thereon wherein microplasts selected from the group consisting of fibroblasts, dermal, subdermal, inflammatory, and collagen grow into engagement with said texture during the bodily process of healing the puncture wound to form a barrier against the migration of foreign matter past said interface and to secure the catheter in place.

2. The indwelling intravascular device of claim 1 wherein plurality of bumps are positioned on the exterior surface of said interface.

3. The indwelling intravascular device of claim 2 wherein the bumps are rounded.

4. The indwelling intravascular device of claim 2 wherein the bumps are pointed.

5. The indwelling intravascular device of claim 1 further including a wire guide obturator having a first end and a terminal end;

said first end being secured to said interface;
said first end including texture thereon.

6. An intravenous stent for insertion into the bodily tissue of a medical patient at a point of insertion thereby creating a puncture wound at the point of insertion and initiating the bodily process of healing the puncture wound, comprising:

a stent portion;

said stent portion capable of receiving a needle therethrough;

said stent portion including an introducer and a cannula through which said needle extends;

said introducer including a proximal portion and a distal portion;

a segment of said proximal portion for contact with the bodily tissue at the point of insertion;

said introducer including texture on said segment of said proximal portion for contact with the bodily tissue at the point of insertion wherein microplasts selected from the group consisting of fibroblasts, dermal, subdermal, inflammatory, and collagen grow into engagement with said texture during the bodily process of healing the puncture wound to form a barrier against the migration of foreign matter past said interface and to secure the catheter in place.

7. The intravenous stent of claim 6 wherein a portion of said cannula includes texture thereon.

S. The intravenous stent of claim 7 wherein a portion of said cannula adjacent said introducer is textured.

9. The intravenous stent of claim 6 wherein said texture is knurling.

10. The intravenous stent of claim 6 wherein said texture includes a plurality of grooves cut into the exterior of said interface.

11. The intravenous stent of claim 6 wherein said texture includes a plurality of bumps positioned on its exterior surface.

12. The indwelling intravascular device of claim 1 wherein said texture is a static texture.

13. The indwelling intravascular device of claim 1 wherein the depth of the majority of said texture ie between the range of 0.2 mm to 1.0 mm.

14. The indwelling intravascular device of claim 13 wherein the depth of the majority of said texture is between the range of 0.2 mm to 0.5 mm.

15. An intravascular device for insertion and retention in a severed vessel, comprising:

a body, including an interface and a cannula;
said cannula being frustoconical for insertion into and terminating in the severed vessel;

said interface being the portion of the body which contacts the severed vessel;

said interface having an exterior surface having texture thereon wherein said texture provides friction so as to retain said body in the severed vessel.

16. The intravascular device of claim 15 wherein the majority of said texture is between the range of 0.2 mm to 1.0 mm.

17. The intravascular device of claim 15 wherein the majority of said texture ie between the range of 0.2 mm to 0.5 mm.