Liquid circulation system

Abstract

To provide a liquid circulation system that can early obtain the effect of injection and discharge of liquid while restraining a burden on a patient.SOLUTION: A liquid circulation system 2 comprises: an injection line 21 for injecting liquid into a housing cavity in which cerebrospinal fluid is housed; a discharge line 22 for discharging the liquid to the outside of the housing cavity from the inside of the housing cavity; and a liquid delivery part 23 provided in the injection line 21 or the discharge line 22, and circulating the liquid. At least one of the injection line 21 and the discharge line 22 is inserted into the housing cavity via an internal jugular vein 41.SELECTED DRAWING: Figure 1

Description

[Technical Field]

[0001] The present invention relates to a fluid circulation system used in the treatment of brain diseases. [Background technology]

[0002] When a brain disease, such as cerebral infarction, occurs, the blood flow that supplies oxygen to brain cells is blocked, potentially damaging the cells. Therefore, when a cerebral infarction occurs, early reperfusion of blood flow is necessary. One proposed treatment for cerebral infarction involves injecting oxygenated cerebrospinal fluid or other fluids into the body cavity where the cerebrospinal fluid is present, and then draining the fluid outside the body cavity to circulate the fluid and directly supply oxygen to oxygen-starved brain cells.

[0003] Patent Document 1 discloses that the subarachnoid space is accessed from the lumbar spine to treat and circulate cerebrospinal fluid. However, when the lumbar spine is used as a location for accessing the subarachnoid space from outside the living body, there are the following advantages and disadvantages.

[0004] That is, when the lumbar spine is used as the location for accessing the subarachnoid space from outside the living body, the subarachnoid space can be accessed simply by puncturing with a device, which has the advantage of placing less strain on the patient.However, there is a disadvantage in that it takes a certain amount of time to see the effects of injecting and draining fluid because there is a certain distance between the lumbar spine, which is the puncture site, and the brain, which is the treatment site.

[0005] It is also possible to use the ventricles and cisterns as locations for accessing the subarachnoid space from outside the body. This has the advantage that the effects of injecting and draining fluid can be obtained quickly because the fluid is supplied directly to the brain. However, it has the disadvantage that accessing the ventricles and cisterns requires inserting a device into the head or performing craniotomy to remove part of the skull, which places a heavy burden on the patient. [Prior art documents] [Patent documents]

[0006] [Patent Document 1] Special Publication No. 2020-536618 Summary of the Invention [Problem to be solved by the invention]

[0007] The present invention has been made in consideration of the above circumstances, and aims to provide a liquid circulation system that can quickly obtain the effects of injecting and discharging liquid while reducing the burden on the patient. [Means for solving the problem]

[0008] The present invention is (1) a liquid circulation system that circulates a liquid by injecting the liquid into a storage cavity that contains cerebrospinal fluid and discharging the liquid to the outside of the storage cavity, the liquid circulation system comprising an injection line that injects the liquid into the inside of the storage cavity, a discharge line that discharges the liquid from the inside of the storage cavity to the outside of the storage cavity, and a liquid delivery section that is provided in the injection line or the discharge line and circulates the liquid, wherein at least one of the injection line and the discharge line is inserted into the inside of the storage cavity via the internal jugular vein.

[0009] According to the liquid circulation system of (1) above, at least one of the infusion line and the drainage line is inserted into the cavity containing cerebrospinal fluid via the internal jugular vein. Therefore, the liquid circulation system of (1) above allows at least one of the infusion line and the drainage line to access the interior of the cavity without burr hole or craniotomy, and can circulate the liquid by the liquid delivery unit by connecting the interior of the cavity with the outside of the living body. This allows the liquid circulation system of (1) above to quickly obtain the effects of injecting and draining the liquid while minimizing the burden on the patient.

[0010] (2) It is preferable that the liquid circulation system of (1) above further comprises a treatment unit that performs a predetermined treatment on the liquid discharged to the outside of the accommodation cavity.

[0011] According to the liquid circulation system of (2) above, the liquid discharged to the outside of the accommodation cavity can be subjected to a predetermined treatment by the treatment section, and then the liquid can be injected into the accommodation cavity.

[0012] (3) In the liquid circulation system of (1) or (2) above, it is preferable that at least one of the infusion line and the discharge line is inserted from the internal jugular vein through the inferior petrosal sinus and from the inferior petrosal sinus into the cerebellopontine angle cistern.

[0013] According to the fluid circulation system (3) above, at least one of the infusion line and the drainage line is inserted from the internal jugular vein through the inferior petrosal sinus adjacent to the dura mater, and from the inferior petrosal sinus through the dura mater and into the cerebellopontine angle cistern. Therefore, the fluid circulation system (3) above allows at least one of the infusion line and the drainage line to access the cerebellopontine angle cistern located on the periphery of the brain without burr hole or craniotomy, and can circulate fluid by connecting the cerebellopontine angle cistern to the outside of the body. This allows the fluid circulation system (3) above to achieve the effects of fluid infusion and drainage more quickly while minimizing the burden on the patient.

[0014] (4) It is preferable that the liquid circulation system of (3) above further comprises a fixing portion for fixing the infusion line and the discharge line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern.

[0015] According to the liquid circulation system of (4) above, the fixing portion fixes the injection line and drainage line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern, preventing the injection line from coming off the inferior petrosal sinus and the cerebellopontine angle cistern during liquid injection, and preventing the drainage line from coming off the inferior petrosal sinus and the cerebellopontine angle cistern during liquid drainage. This allows the injection line to more reliably inject liquid into the cerebellopontine angle cistern, and the drainage line to more reliably drain liquid from the cerebellopontine angle cistern.

[0016] (5) In any of the liquid circulation systems (1) to (4) above, it is preferable that at least the other of the inlet line and the outlet line is inserted into the interior of the housing cavity via either the head or the back.

[0017] According to the fluid circulation system (5) above, at least the other of the infusion line and the drainage line is inserted into the cavity containing cerebrospinal fluid via either the head or the back, rather than via the internal jugular vein. This allows the site where the fluid is infused and the site where the fluid is drained to be located apart from each other. This prevents the formation of a flow of fluid injected from the infusion line into the cavity toward the drainage line (i.e., a local steady flow). This allows the infusion line to efficiently inject fluid, and the drainage line to efficiently drain fluid.

[0018] (6) In the liquid circulation system of (5) above, the head is preferably at least one of a cerebral cisterna and a cerebral ventricle.

[0019] According to the fluid circulation system of (6) above, at least the other of the infusion line and the drainage line is inserted into the cavity containing cerebrospinal fluid via at least one of the cistern and the ventricle, rather than via the internal jugular vein. This prevents the formation of a local steady flow. This allows the infusion line to efficiently inject fluid and the drainage line to efficiently drain fluid.

[0020] (7) In the liquid circulation system of (5) above, the back is preferably the spinal cavity near the lumbar vertebrae.

[0021] According to the fluid circulation system of (7) above, at least the other of the infusion line and the drainage line is inserted into the cavity containing cerebrospinal fluid via the spinal cavity near the lumbar vertebrae, rather than via the internal jugular vein. This prevents the formation of a local steady flow. This allows the infusion line to efficiently inject fluid, and the drainage line to efficiently drain fluid.

[0022] (8) In the liquid circulation system of any one of (1) to (4) above, it is preferable that at least the other of the inlet line and the outlet line is inserted into the interior of the accommodation cavity via the internal jugular vein.

[0023] According to the fluid circulation system (8) above, both the infusion line and the drainage line are inserted into the cavity containing cerebrospinal fluid via the internal jugular vein. Therefore, the fluid circulation system (8) above can access the interior of the cavity without burr hole or craniotomy, and can circulate the fluid by injecting and draining the fluid by connecting the interior of the cavity with the outside of the living body. This allows the fluid circulation system (8) above to achieve the effects of injecting and draining the fluid quickly while further reducing the burden on the patient.

[0024] (9) In the liquid circulation system of any one of (1) to (8) above, it is preferable that at least one of the inlet line and the outlet line is inserted into the internal jugular vein by puncturing it through the skin.

[0025] According to the above-mentioned (9) fluid circulation system, at least one of the infusion line and the discharge line can be inserted into the internal jugular vein through the skin, thereby providing access to the interior of the cavity containing the cerebrospinal fluid, thereby further reducing the burden on the patient. [Effects of the Invention]

[0026] According to the present invention, it is possible to provide a liquid circulation system that can quickly obtain the effects of injecting and discharging liquid while reducing the burden on the patient. [Brief explanation of the drawings]

[0027] [Figure 1] 1 is a schematic diagram illustrating a liquid circulation system according to a first embodiment of the present invention. [Figure 2] FIG. 4 is a schematic diagram illustrating a liquid circulation system according to a second embodiment of the present invention. [Figure 3] FIG. 1 is a schematic diagram illustrating a device according to an embodiment of the present invention. [Figure 4] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 5] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 6] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 7] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 8] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 9] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 10] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 11] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 12] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 13] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 14] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 15] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 16] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 17] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 18] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of the present embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. [Figure 19] 1 is a schematic diagram showing the spinal cord and vertebrae of a living organism. [Figure 20] 20 is a cross-sectional view taken along the cutting plane A21-A21 shown in FIG. 19. [Figure 21] FIG. 1 is a schematic diagram showing a first specific example of an access position and an access method for a cerebral ventricle. [Figure 22] FIG. 1 is a schematic diagram showing a first specific example of an access position and an access method for a cerebral ventricle. [Figure 23] FIG. 10 is a schematic diagram showing a second specific example of an access position and an access method to the ventricle. [Figure 24] FIG. 10 is a schematic diagram showing a second specific example of an access position and an access method to the ventricle. DETAILED DESCRIPTION OF THE INVENTION

[0028] Preferred embodiments of the present invention will now be described in detail with reference to the drawings. The embodiments described below are preferred examples of the present invention, and therefore various technically preferable limitations are applied thereto, but the scope of the present invention is not limited to these aspects unless otherwise specified in the following description to the effect that the present invention is particularly limited. Furthermore, in each drawing, similar components are designated by the same reference numerals, and detailed descriptions thereof will be omitted as appropriate.

[0029] FIG. 1 is a schematic diagram showing a liquid circulation system according to a first embodiment of the present invention. The fluid circulation system 2 according to this embodiment circulates a fluid by injecting the fluid into a cavity containing the subject's cerebrospinal fluid (CSF) and then discharging the fluid to the outside of the cavity. Cerebrospinal fluid is primarily contained in the subarachnoid space and the ventricles. That is, the cavities containing cerebrospinal fluid include the subarachnoid space and the ventricles. One of the subarachnoid spaces of the cisterns is the cerebellopontine angle cisterna (CP Angle cisterna). Therefore, the cerebellopontine angle cisterna is also included in the cavities of this embodiment.

[0030] The liquid injected into the cavity may be, for example, a liquid with an oxygen concentration higher than that of normal cerebrospinal fluid (i.e., a highly oxygenated solution). However, the liquid injected into the cavity is not limited to a highly oxygenated solution. For example, the liquid injected into the cavity may be a drug-containing liquid in which a drug has been added to cerebrospinal fluid during extracorporeal circulation, or may be cerebrospinal fluid that has been filtered to remove undesirable substances during extracorporeal circulation. Alternatively, the liquid injected into the cavity may be cerebrospinal fluid that has been subjected to some kind of treatment, such as irradiation with energy or heating.

[0031] Furthermore, in the initial stage of treatment, the liquid injected into the containing cavity may be lactated Ringer's solution as a substitute for cerebrospinal fluid. In this embodiment, cerebrospinal fluid, artificial cerebrospinal fluid such as lactated Ringer's solution, a mixture of cerebrospinal fluid and lactated Ringer's solution, physiological saline, medicinal solutions, and distilled water for injection may be collectively referred to as liquid. In the following description, for convenience of explanation, a case where the liquid injected into the containing cavity is a highly oxygenated solution may be given as an example.

[0032] 1, the liquid circulation system 2 includes an inlet line 21, an outlet line 22, and a liquid delivery unit 23. The liquid circulation system 2 may also include an oxygenation mechanism 24, an oxygen supply source 25, and a heat exchanger 26. Each of the oxygenation mechanism 24, the oxygen supply source 25, and the heat exchanger 26 is an example of a "treatment unit" of the present invention.

[0033] Infusion line 21 has a catheter and is inserted into the housing cavity through either the head or back of the subject, and injects a liquid into the housing cavity as indicated by arrow A1 in FIG. 1. As illustrated in FIG. 1, an example of the back into which infusion line 21 is inserted is the spinal cavity near the lumbar vertebrae. Specific examples of access locations and methods for the spinal cavity near the lumbar vertebrae will be described later. Also, as illustrated in FIG. 1, an example of the head into which infusion line 21 is inserted is at least one of the cistern and the ventricle. Specific examples of access locations and methods for the cistern and the ventricle will be described later.

[0034] The drainage line 22 includes the device 3 and is inserted into the housing cavity via the subject's internal jugular vein 41. As shown in FIG. 1 , for example, the drainage line 22 passes from the internal jugular vein 41 through the inferior petrosal sinus 42 and is inserted into the housing cavity from the inferior petrosal sinus 42. Details of the access of the drainage line 22 to the inside of the housing cavity will be described below.

[0035] The cavity containing cerebrospinal fluid (e.g., the subarachnoid space and the ventricles) is a substantially closed space. A certain pressure, such as intracranial pressure, is applied inside the cavity. Therefore, when the drain line 22 is inserted into the cavity, the fluid inside the cavity (e.g., cerebrospinal fluid) is drained to the outside of the cavity, as indicated by arrows A2 and A3 in FIG. 1 .

[0036] The device 3 has a guiding sheath 31, a guiding catheter 32, and a drainage catheter 33. The liquid drained through the drainage catheter 33 is supplied to the oxygenation mechanism 24.

[0037] The oxygenation mechanism 24 is connected to the oxygen supply source 25 via the first pipe 271. The oxygenation mechanism 24 mixes a liquid such as cerebrospinal fluid supplied through the discharge line 22 with oxygen supplied from the oxygen supply source 25 through the first pipe 271, as indicated by arrow A4 in FIG. 1, to generate oxygenated cerebrospinal fluid.

[0038] The oxygenation mechanism 24 is also connected to the heat exchanger 26 via a second pipe 272 and a third pipe 273. As indicated by arrow A5 in FIG. 1 , the oxygenation mechanism 24 supplies oxygenated cerebrospinal fluid to the heat exchanger 26 via the second pipe 272. The heat exchanger 26 adjusts the temperature of the cerebrospinal fluid supplied from the oxygenation mechanism 24 via the second pipe 272. As indicated by arrow A6 in FIG. 1 , the heat exchanger 26 supplies the temperature-adjusted cerebrospinal fluid to the oxygenation mechanism 24 via the third pipe 273. The oxygenation mechanism 24 then supplies the oxygenated, temperature-adjusted cerebrospinal fluid to the infusion line 21 as a highly oxygenated solution. An example of the oxygenation mechanism 24 is a hollow fiber membrane oxygenator for adding oxygen to blood.

[0039] The liquid delivery unit 23 is provided in the infusion line 21 and circulates the liquid supplied from the oxygenation mechanism 24. The liquid delivery unit 23 may be provided in the discharge line 22, or may be provided in both the infusion line 21 and the discharge line 22. Examples of the liquid delivery unit 23 include an infusion pump and a syringe pump.

[0040] As shown by arrow A1 in FIG. 1, the fluid delivery unit 23 delivers fluid to the infusion line 21, and the fluid is infused into the cavity through the infusion line 21 from either the head or back of the subject. As described above, the cavity containing cerebrospinal fluid (e.g., the subarachnoid space and the ventricle) is a substantially closed space. A certain amount of pressure, such as intracranial pressure, is applied inside the cavity. Therefore, when the infusion line 21 injects fluid into the cavity, the fluid (e.g., cerebrospinal fluid) inside the cavity is pushed out of the cavity through the discharge line 22, which includes the device 3, as shown by arrows A2 and A3 in FIG. 1. In this manner, the fluid delivery unit 23 circulates the fluid.

[0041] Next, a second embodiment of the present invention will be described. In addition, in cases where the components of the liquid circulation system 2A according to the second embodiment are similar to the components of the liquid circulation system 2 according to the first embodiment described above with reference to Figure 1, duplicate explanations will be omitted as appropriate, and the following explanation will focus on the differences.

[0042] FIG. 2 is a schematic diagram showing a liquid circulation system according to a second embodiment of the present invention. The liquid circulation system 2A according to this embodiment includes an inlet line 21A, an outlet line 22, and a liquid delivery unit 23. The outlet line 22 and the liquid delivery unit 23 are as described above with reference to Fig. 1. The liquid circulation system 2A may also include an oxygenation mechanism 24, an oxygen supply source 25, and a heat exchanger 26. The oxygenation mechanism 24, the oxygen supply source 25, and the heat exchanger 26 are as described above with reference to Fig. 1.

[0043] In this embodiment, the infusion line 21A includes a device 3A similar to the device 3 included in the discharge line 22. The device 3A includes a guiding sheath 31, a guiding catheter 32, and an injection catheter 34. The infusion line 21A is inserted into the interior of the housing cavity via the subject's internal jugular vein 41 and injects a liquid into the interior of the housing cavity as indicated by arrows A7 and A8 in FIG. 2. As shown in FIG. 2, for example, the infusion line 21A passes from the internal jugular vein 41 through the inferior petrosal sinus 42 and is inserted from the inferior petrosal sinus 42 into the interior of the housing cavity. The access of the infusion line 21A to the interior of the housing cavity is similar to the access of the discharge line 22 to the interior of the housing cavity.

[0044] In the liquid circulation system 2A according to this embodiment, the infusion line 21A is inserted from either the right or left internal jugular vein 41 of the subject through one inferior petrosal sinus 42 and into the interior of the housing cavity from that inferior petrosal sinus 42. The drainage line 22 is inserted from either the right or left internal jugular vein 41 of the subject through the other inferior petrosal sinus 42 and into the interior of the housing cavity from that inferior petrosal sinus 42. As described above with reference to FIG. 1, details of the access of the drainage line 22 to the interior of the housing cavity will be described later. The other configurations are similar to those of the liquid circulation system 2 according to the first embodiment described above with reference to FIG. 1.

[0045] The fluid circulation system 2A according to this embodiment has the advantages of reducing the burden on the patient by eliminating the need for cranial puncture, and delivering treated fluid directly to the brain, making it easier to achieve a rapid therapeutic effect. Furthermore, by separating the infusion line 21A and the drainage line 22 from each other and placing them in the left and right inferior petrosal sinuses 42, the injected fluid can be prevented from being immediately drained.

[0046] FIG. 3 is a schematic diagram showing the device of this embodiment. 1 and 2, the device 3 of this embodiment is included in the discharge line 22. As described above with reference to FIG. 2, the device 3A of this embodiment is included in the infusion line 21A. The structure and shape of the infusion catheter 34 of the device 3A are similar to the structure and shape of the discharge catheter 33 of the device 3. Therefore, the device of this embodiment will be described below using the device 3 included in the discharge line 22 as an example.

[0047] The device 3 includes a guiding sheath 31, a guiding catheter 32, a drainage catheter 33, and a fixing portion 35. The guiding sheath 31 penetrates the skin 48 from the outside 49 of the living body, passes through the internal jugular vein 41, and is positioned in the inferior petrosal sinus 42. In the example shown in Fig. 3 , a distal end portion 311 of the guiding sheath 31 is positioned at a junction 411 between the internal jugular vein 41, the inferior petrosal sinus 42, and the jugular bulb 44.

[0048] 3, the distal end 321 of the guiding catheter 32 passes through the lumen of the guiding sheath 31, i.e., penetrates the skin 48 from the outside 49 of the living body, passes through the internal jugular vein 41, and is positioned in the inferior petrosal sinus 42. Also, as shown in FIG. 3, the distal end 331 of the drainage catheter 33 passes through the lumen of the guiding catheter 32, i.e., penetrates the skin 48 from the outside 49 of the living body, passes through the internal jugular vein 41, penetrates the dura mater 46 and the arachnoid mater 47, and is positioned in the cerebellopontine angle cistern 43 between the arachnoid mater 47 and the brainstem 45.

[0049] For example, when the injection lines 21, 21A inject liquid into the receiving cavity, the liquid inside the cerebellopontine angle cistern 43 passes through the lumen of the discharge catheter 33 from the tip 331 of the discharge catheter 33 as shown by arrow A11 in Figure 3, and is discharged from the base end 333 of the discharge catheter 33 to the outside of the cerebellopontine angle cistern 43, i.e., the outside 49 of the living body, as shown by arrow A12 in Figure 3.

[0050] When the infusion line 21A injects liquid into the interior of the accommodation cavity using the device 3A, the liquid passes through the lumen of the injection catheter 34 from the base end of the injection catheter 34 in the direction opposite to the arrow A12 shown in FIG. 3, and is injected into the interior of the cerebellopontine angle cistern 43 from the tip end of the injection catheter 34 in the direction opposite to the arrow A11 shown in FIG. 3.

[0051] Here, the device 3 further includes a fixing portion 35 having a long wire 351. As shown in Fig. 3, the fixing portion 35 is expanded and positioned inside the inferior petrosal sinus 42 in the vicinity of the junction 411, and fixes the infusion line 21A (see Fig. 2) and the drainage line 22 inserted from the inferior petrosal sinus 42 into the cerebellopontine angle cistern 43. Specifically, the fixing portion 35 functions as an anchor in the expanded state, and suppresses movement of the guiding catheter 32 in the longitudinal direction (i.e., the extension direction) and rotational movement about the central axis.

[0052] A connector 36 is attached to the hub of the guiding sheath 31. The connector 36 has a valve body made of an elastic material, and holds the wire 351 of the fixed part 35 and the guiding catheter 32 together.

[0053] The fixing portion 35 itself has an expandable function, and when released from the constraint, it expands by elastic force and returns to its pre-contracted shape. That is, the fixing portion 35 of this embodiment functions as a self-expanding fixing portion, similar to, for example, a self-expanding stent. The fixing portion 35 has struts as thin, linear wires, similar to, for example, a stent, and is formed into a tubular skeleton as a whole.

[0054] The fixing part 35 is contracted when housed in the lumen of the guiding sheath 31. On the other hand, when the fixing part 35 passes through an opening formed in the distal end 311 of the guiding sheath 31 and comes out of the guiding sheath 31, the applied stress is released and the fixing part 35 expands by its own elastic force, restoring it to its pre-contracted shape. When the fixing part 35 is housed in the lumen of the guiding sheath 31 through the opening formed in the distal end 311 of the guiding sheath 31, it contracts again.

[0055] The fixing portion 35 functions as an anchor in the expanded state to fix the guiding catheter 32 in an appropriate position, thereby preventing the infusion line 21A from coming off the inferior petrosal sinus 42 and the cerebellopontine angle cistern 43 during fluid injection, and preventing the drainage line 22 from coming off the inferior petrosal sinus 42 and the cerebellopontine angle cistern 43 during fluid drainage. This allows the infusion line 21A to more reliably inject fluid into the cerebellopontine angle cistern 43. The drainage line 22 to more reliably drain fluid from the cerebellopontine angle cistern 43.

[0056] Next, the procedure by which the discharge line 22 having the device 3 discharges the liquid from the inside of the receiving cavity to the outside of the receiving cavity will be described with reference to the drawings. The procedure for injecting liquid into the storage cavity using the injection line 21A with the device 3A differs only in that the direction of liquid flow is opposite to the direction of liquid flow in the discharge line 22, but is otherwise the same as the procedure for discharging liquid to the outside of the storage cavity using the discharge line 22 with the device 3.

[0057] 4 to 18 are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges liquid from the inside of the housing cavity to the outside of the housing cavity. The drainage line 22 is inserted into the internal jugular vein 41 through the skin 48 of the subject. Specifically, as shown in FIGS. 4 and 5 , first, a needle 51 is inserted into the internal jugular vein 41 through the skin 48. Next, as shown in FIG. 6 , a guidewire 52 is passed through the lumen of the needle 51 and inserted into the inferior petrosal sinus 42 via the internal jugular vein 41.

[0058] Next, as shown in Fig. 7, the needle 51 is removed. Next, as shown in Fig. 8, the guide wire 52 is inserted into the lumen of the guiding sheath 31, and the guiding sheath 31 is advanced along the guide wire 52. As a result, the guiding sheath 31 is inserted into the inferior petrosal sinus 42 via the internal jugular vein 41. That is, the distal end portion 311 of the guiding sheath 31 is delivered to the inferior petrosal sinus 42.

[0059] Next, the dilator 335 and the guidewire 52 inserted into the lumen of the guiding sheath 31 are removed from the guiding sheath 31, and as shown in Fig. 9, the fixing part 35 is inserted into the lumen of the guiding sheath 31 and delivered along the guiding sheath 31 through the internal jugular vein 41 to the inferior petrosal sinus 42. At this time, the fixing part 35 is advanced to a position deeper than the planned puncture site of the needle 53 (see Fig. 13).

[0060] Next, the guiding sheath 31 is slightly retracted as shown in Fig. 10. That is, the guiding sheath 31 is moved slightly toward the proximal end as indicated by arrow A13 in Fig. 10. Then, as shown in Fig. 10, the fixing part 35 passes through an opening formed in the distal end part 311 of the guiding sheath 31 and goes out of the guiding sheath 31, thereby expanding. At this time, it is preferable that the fixing part 35 be expanded and positioned inside the inferior petrosal sinus 42, deeper than the intended puncture site of the needle 53 (see Fig. 13).

[0061] 11 , the guiding catheter 32 is inserted into the lumen of the guiding sheath 31 and advanced along the guiding sheath 31. At this time, because the outer diameter of the guiding catheter 32 is smaller than the inner diameter of the guiding sheath 31, the guiding catheter 32 advances through the lumen of the guiding sheath 31 in parallel with the wire 351 of the fixing part 35 inserted into the lumen of the guiding sheath 31. As a result, the guiding catheter 32 is inserted into the inferior petrosal sinus 42 via the internal jugular vein 41. That is, the tip portion 321 of the guiding catheter 32 is delivered to the inferior petrosal sinus 42.

[0062] The distal end 321 of the guiding catheter 32 is positioned so as to abut against the blood vessel wall on the cerebellopontine angle cistern 43 side. Thereafter, the wire 351 of the fixing part 35 and the guiding catheter 32 are grasped and fixed together at the base end side by the connector 36. This fixes the relative positions of the guiding catheter 32 and the fixing part 35 in the longitudinal and circumferential directions. Note that a preferred means for fixing the wire 351 of the fixing part 35 and the guiding catheter 32 at the base end side is, for example, a connector 36 having a valve body formed from an elastic member.

[0063] Next, as shown in Figure 12, the drainage catheter 33 is inserted into the lumen of the guiding catheter 32 and advanced. Because the outer diameter of the drainage catheter 33 is smaller than the inner diameter of the guiding catheter 32, the drainage catheter 33 can advance through the lumen of the guiding catheter 32. As shown in Figure 12, a needle 53 is inserted into the lumen of the drainage catheter 33. That is, with the needle 53 inserted into the lumen of the drainage catheter 33, the drainage catheter 33 is inserted into the lumen of the guiding catheter 32 and advanced.

[0064] 13, the drainage catheter 33 and the needle 53 are further advanced. As a result, the tip 531 of the needle 53 punctures the dura mater 46 and the arachnoid mater 47, penetrating the dura mater 46 and the arachnoid mater 47. The tip 331 of the drainage catheter 33 is also inserted from the inferior petrosal sinus 42 into the cerebellopontine angle cistern 43. In this way, the tip 331 of the drainage catheter 33 passes through the internal jugular vein 41, the inferior petrosal sinus 42, and is inserted from the inferior petrosal sinus 42 into the cerebellopontine angle cistern 43.

[0065] Next, as shown in Fig. 14, the needle 53 is removed. Then, the fluid inside the cerebellopontine angle cistern 43 passes from the distal end 331 of the drainage catheter 33 through the lumen of the drainage catheter 33 as indicated by arrow A11 in Fig. 15, and is drained from the proximal end 333 of the drainage catheter 33 to the outside of the cerebellopontine angle cistern 43, i.e., the outside 49 of the living body, as indicated by arrow A12 in Fig. 15. Alternatively, when the infusion lines 21, 21A inject fluid into the receiving cavity, the fluid inside the cerebellopontine angle cistern 43 passes from the distal end 331 of the drainage catheter 33 through the lumen of the drainage catheter 33 as indicated by arrow A11 in Fig. 15, and is drained from the proximal end 333 of the drainage catheter 33 to the outside of the cerebellopontine angle cistern 43, i.e., the outside 49 of the living body, as indicated by arrow A12 in Fig. 15.

[0066] Next, after circulating the liquid for a predetermined time, the drainage catheter 33 is removed, as shown in Fig. 16. Next, as shown in Fig. 17, the guiding catheter 32 and the fixing part 35 are retracted while the guiding sheath 31 is held down. That is, as shown by arrows A14 and A15 in Fig. 17, the guiding catheter 32 and the wire 351 of the fixing part 35 are moved toward the proximal end while the guiding sheath 31 is held down. As a result, the fixing part 35 is housed in the lumen of the guiding sheath 31 through the opening formed in the distal end 311 of the guiding sheath 31 and contracts again.

[0067] Next, as shown in FIG. 18, the guiding catheter 32, the fixing part 35, and the guiding sheath 31 are removed.

[0068] As described above, in the liquid circulation system 2 according to the first embodiment, the drain line 22 is inserted into the interior of the cavity containing cerebrospinal fluid via the internal jugular vein 41. Therefore, the liquid circulation system 2 can access the interior of the cavity via the drain line 22 without trepanning or craniotomy, and can circulate the liquid by the liquid delivery unit 23 by communicating the interior of the cavity with the outside 49 of the living body. This allows the liquid circulation system 2 to quickly obtain the effects of injecting and draining the liquid while minimizing the burden on the patient.

[0069] Furthermore, in the liquid circulation system 2A according to the second embodiment, both the infusion line 21A and the discharge line 22 are inserted into the interior of the cavity containing cerebrospinal fluid via the internal jugular vein 41. Therefore, the liquid circulation system 2A can access the interior of the cavity without burr hole or craniotomy, and can circulate the liquid by the liquid delivery unit 23 by communicating the interior of the cavity with the outside 49 of the living body. This allows the liquid circulation system 2A to quickly obtain the effects of injecting and discharging the liquid while further reducing the burden on the patient.

[0070] In addition, when a treatment section such as an oxygenation mechanism 24, an oxygen supply source 25, and a heat exchanger 26 is provided, the liquid circulation system 2, 2A can perform a predetermined treatment on the liquid discharged to the outside of the storage cavity using the treatment section, and then inject the liquid into the storage cavity.

[0071] According to the liquid circulation system 2 of the first embodiment, the drainage line 22 (specifically, the distal end 331 of the drainage catheter 33) is inserted from the internal jugular vein 41 through the inferior petrosal sinus 42, and from the inferior petrosal sinus 42 into the cerebellopontine angle cistern 43. Therefore, the liquid circulation system 2 can access the cerebellopontine angle cistern 43, which is located on the periphery of the brain, using the drainage line 22 without trepanning or craniotomy, and can circulate liquid by connecting the cerebellopontine angle cistern 43 to the outside 49 of the living body. This allows the liquid circulation system 2 to obtain the effects of liquid injection and drainage more quickly while minimizing the burden on the patient.

[0072] Furthermore, according to the liquid circulation system 2A of the second embodiment, both the infusion line 21A (specifically, the distal end of the infusion catheter 34) and the drainage line 22 (specifically, the distal end 331 of the drainage catheter 33) are inserted from the internal jugular vein 41 through the inferior petrosal sinus 42 and from the inferior petrosal sinus 42 into the cerebellopontine angle cistern 43. Therefore, the liquid circulation system 2A can access the cerebellopontine angle cistern 43, which is located on the periphery of the brain, without trepanning or craniotomy, and can circulate the liquid by communicating the cerebellopontine angle cistern 43 with the outside 49 of the living body. This allows the liquid circulation system 2A to obtain the effects of injecting and draining the liquid more quickly while further reducing the burden on the patient.

[0073] Next, a specific example of the position and method by which the injection line 21 of the liquid circulation system 2 according to the first embodiment described above with reference to FIG. 1 accesses the spinal cavity near the lumbar vertebrae will be described with reference to the drawings.

[0074] FIG. 19 is a schematic diagram showing the spinal cord and vertebrae of a living organism. FIG. 20 is a cross-sectional view taken along the cutting plane A21-A21 shown in FIG.

[0075] When the injection line 21 of the liquid circulation system 2 according to the first embodiment described above with reference to FIG. 1 accesses the spinal cavity near the lumbar vertebrae, the injection line 21 is inserted and positioned in the subarachnoid space (i.e., the spinal cavity 61) near the lumbar vertebrae with the patient in a lateral position. The distal end of the injection line 21 is inserted and positioned by inserting a spinal needle into a position between the fourth lumbar vertebra (L4) and the fifth lumbar vertebra (L5), for example, in consideration of safety during insertion. Alternatively, the distal end of the injection line 21 is inserted and positioned by inserting a spinal needle into a position between the third lumbar vertebra (L3) and the fourth lumbar vertebra (L4), for example, in consideration of safety during insertion.

[0076] For example, as shown by arrow A22 in FIG. 20, the infusion line 21 accesses the spinal cavity 61 by inserting the spinal needle perpendicular to the back, i.e., along the median plane 62 of the body. The access method shown by arrow A22 in FIG. 20 is called a midline puncture or the like. Alternatively, as shown by arrow A23 in FIG. 20, the infusion line 21 accesses the spinal cavity 61 by inserting the spinal needle from about 5 mm to the side of the median plane 62 of the body at an angle of about 10 degrees to the median plane 62. The access method shown by arrow A23 in FIG. 20 is called a paramedian puncture or the like.

[0077] The access positions and access methods for the spinal cavity near the lumbar vertebrae described in Figures 19 and 20 are merely examples, and the access positions and access methods for the spinal cavity near the lumbar vertebrae are not limited to these.

[0078] According to the access position and access method of this specific example, infusion line 21 is inserted into the cavity containing cerebrospinal fluid via spinal canal 61 near the lumbar vertebrae, rather than via internal jugular vein 41. This makes it possible to suppress the formation of a flow (i.e., a local steady flow) of the liquid injected into the cavity from infusion line 21 toward drain line 22. This allows infusion line 21 to efficiently inject the liquid, and drain line 22 to efficiently drain the liquid.

[0079] Next, specific examples of the positions and methods by which the injection line 21 of the liquid circulation system 2 according to the first embodiment described above with reference to FIG. 1 accesses the ventricles and cisterns will be described with reference to the drawings.

[0080] 21 and 22 are schematic diagrams showing a first specific example of an access position and an access method for the ventricle. When the infusion line 21 of the fluid circulation system 2 according to the first embodiment described above with reference to Figure 1 accesses a cerebral ventricle, as indicated by arrow A24 in Figures 21 and 22, the infusion line 21 accesses the ventricle by inserting a spinal needle from position L11, which is a dimension L1 (approximately 3 cm) laterally from the median plane 62, a dimension L2 (approximately 1 cm) anteriorly from the coronal suture 64, and a dimension L3 (approximately 11 cm) superiorly from the nasion 65, toward the vicinity of the foramen of Monro 68, which connects the lateral ventricle and the third chamber. This specific example of the access method is also called an anterior horn puncture.

[0081] 23 and 24 are schematic diagrams showing a second specific example of an access position and an access method to the ventricle. When the infusion line 21 of the fluid circulation system 2 according to the first embodiment described above with reference to Figure 1 accesses the ventricles, the infusion line 21 is inserted with a spinal needle from a position L12, a dimension L4 (approximately 6 cm) upward from the occipital protuberance 66, a dimension L5 (approximately 7 cm) upward and a dimension L6 (approximately 7 cm) posteriorly from the external auditory canal 67, and a dimension L7 (approximately 3 cm) laterally from the sagittal suture 63, toward the vicinity of the foramen of Monro 68 (see Figures 21 and 22), as indicated by arrow A25 in Figures 23 and 24. This specific example of the access method is called a posterior horn puncture.

[0082] The access positions and access methods to the ventricles described in Figures 21 to 24 are merely examples, and the access positions and access methods to the ventricles are not limited to these. The position and method of accessing the cistern are not particularly limited as long as they are positions and methods that allow clinical access to the cistern.

[0083] According to the access positions and access methods of the first specific example described in Figures 21 and 22 and the second specific example described in Figures 23 and 24, the infusion line 21 is inserted into the cavity containing cerebrospinal fluid via the ventricle or cistern, rather than the internal jugular vein 41. This prevents the formation of a local steady flow. This allows the infusion line 21 to efficiently inject fluid, and the discharge line 22 to efficiently discharge fluid.

[0084] The above describes the embodiments of the present invention. However, the present invention is not limited to the above embodiments, and various modifications can be made without departing from the scope of the claims. The configurations of the above embodiments can be partially omitted or arbitrarily combined in a different manner from the above. [Explanation of symbols]

[0085] 2: Fluid circulation system, 2A: Fluid circulation system, 3: Device, 3A: Device, 21: Infusion line, 21A: Infusion line, 22: Drain line, 23: Fluid delivery section, 24: Oxygenation mechanism, 25: Oxygen supply source, 26: Heat exchanger, 31: Guiding sheath, 32: Guiding catheter, 33: Drain catheter, 34: Infusion catheter, 35: Fixation section, 36: Connector, 41: Internal jugular vein, 42: Inferior petrosal sinus, 43: Cerebellopontine angle cistern, 44: Jugular bulb, 45: Brainstem, 46: Dura mater, 47: Arachnoid mater, 48: Skin, 49: Exterior, 51: Needle, 52: Guidewire, 53: Needle, 61: Spinal cavity, 62: Median plane, 63: Sagittal suture, 64: Coronal suture, 65: nasion point, 66: occipital prominence, 67: external auditory canal, 68: foramen of Monro, 271: first canal, 272: second canal, 273: third canal, 311: tip, 321: tip, 323: base end, 331: tip, 333: base end, 335: dilator, 351: wire, 411: joint, 531: tip

Claims

1. A liquid circulation system that circulates a liquid by injecting the liquid into a cavity that contains cerebrospinal fluid and discharging the liquid to the outside of the cavity, an injection line for injecting the liquid into the interior of the receiving cavity; a discharge line that discharges the liquid from the inside of the housing cavity to the outside of the housing cavity; a liquid delivery unit provided in the injection line or the discharge line to circulate the liquid; Equipped with A fluid circulation system, characterized in that at least one of the infusion line and the discharge line is inserted into the interior of the accommodation cavity via the internal jugular vein.

2. 2. The liquid circulation system according to claim 1, further comprising a treatment unit that performs a predetermined treatment on the liquid discharged to the outside of the accommodation cavity.

3. 2. The fluid circulation system of claim 1, wherein at least one of the infusion line and the drainage line is inserted from the internal jugular vein through the inferior petrosal sinus and from the inferior petrosal sinus into the cerebellopontine angle cistern.

4. The fluid circulation system according to claim 3, further comprising a fixing portion for fixing the infusion line and the discharge line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern.

5. 2. The liquid circulation system according to claim 1, wherein at least the other of the inlet line and the outlet line is inserted into the interior of the accommodation cavity via one of the head and the back.

6. 6. The fluid circulation system according to claim 5, wherein the head is at least one of a cistern and a ventricle.

7. 6. The fluid circulation system according to claim 5, wherein the back is the spinal canal near the lumbar spine.

8. 2. The liquid circulation system according to claim 1, wherein at least the other of the infusion line and the discharge line is inserted into the interior of the accommodation cavity via the internal jugular vein.

9. 2. The liquid circulation system according to claim 1, wherein at least one of the infusion line and the discharge line is inserted into the internal jugular vein by puncturing the internal jugular vein through the skin.

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