Liquid discharge system

Abstract

To provide a liquid discharge system that can early obtain the effect of injection of liquid and discharge of cerebrospinal fluid while restraining a burden on a patient.SOLUTION: A liquid discharge system 2 comprises an injection line 21 for injecting liquid into a housing cavity in which cerebrospinal fluid is housed, and a discharge line 22 for discharging the cerebrospinal fluid to the outside of the housing cavity from the inside of the housing cavity. 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 drainage system used in the treatment of brain disorders. [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 fluid into the body cavity where the cerebrospinal fluid is present, then draining the cerebrospinal fluid out of the body cavity to replace the cerebrospinal fluid with a liquid, thereby directly supplying 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 fluid drainage system that can quickly obtain the effects of fluid injection and cerebrospinal fluid drainage while reducing the burden on the patient. [Means for solving the problem]

[0008] The present invention is (1) a liquid discharge system that replaces cerebrospinal fluid with a liquid by injecting a liquid into the interior of a storage cavity containing cerebrospinal fluid and discharging the cerebrospinal fluid to the outside of the storage cavity, the liquid discharge system comprising an injection line that injects the liquid into the interior of the storage cavity, and a discharge line that discharges the cerebrospinal fluid from the interior of the storage cavity to the outside of the storage cavity, wherein at least one of the injection line and the discharge line is inserted into the interior of the storage cavity via the internal jugular vein.

[0009] According to the liquid drainage system of (1) above, at least one of the infusion line and the drainage line is inserted into the interior of the cavity containing cerebrospinal fluid via the internal jugular vein. Therefore, the liquid drainage 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 replace the cerebrospinal fluid with a liquid by communicating the interior of the cavity with the outside of the living body. As a result, the liquid drainage system of (1) above can quickly obtain the effects of injecting liquid and draining cerebrospinal fluid while minimizing the burden on the patient.

[0010] (2) In the liquid drainage system of (1) above, it is preferable that at least one of the injection 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.

[0011] According to the fluid drainage system of (2) 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 drainage system of (2) 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 replace cerebrospinal fluid by connecting the cerebellopontine angle cistern with the outside of the body. This allows the fluid drainage system of (2) above to achieve the effects of fluid infusion and cerebrospinal fluid drainage more quickly while minimizing the burden on the patient.

[0012] (3) It is preferable that the liquid drainage system of (2) above further comprises a fixing portion for fixing the injection line and the drainage line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern.

[0013] According to the above-described (3) fluid drainage system, 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 fluid injection, and preventing the drainage line from coming off the inferior petrosal sinus and the cerebellopontine angle cistern during cerebrospinal fluid drainage. This allows the injection line to more reliably inject fluid into the cerebellopontine angle cistern, and the drainage line to more reliably drain cerebrospinal fluid from the cerebellopontine angle cistern.

[0014] (4) In any of the liquid discharge systems (1) to (3) 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.

[0015] According to the fluid drainage system of (4) 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 injected and the site where the cerebrospinal fluid is drained to be located apart from each other. This prevents the formation of a flow (i.e., a local steady flow) of the fluid injected into the cavity toward the drainage line. This allows the infusion line to efficiently inject the fluid, while the drainage line to efficiently drain the cerebrospinal fluid.

[0016] (5) In the liquid discharge system of (4) above, the head is preferably at least one of a cistern and a ventricle.

[0017] According to the fluid drainage system of (5) 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 cerebrospinal fluid.

[0018] (6) In the liquid drainage system of (4) above, the back is preferably the spinal cavity near the lumbar vertebrae.

[0019] According to the fluid drainage 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 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 cerebrospinal fluid.

[0020] (7) In any of the liquid discharge systems (1) to (6) above, it is preferable that the discharge line discharges the cerebrospinal fluid into the interior of a living body other than the storage cavity, or discharges the cerebrospinal fluid into a reservoir provided outside the living body.

[0021] According to the liquid drainage system of (7) above, the cerebrospinal fluid present in the cavity is drained to a reservoir provided inside or outside the living body, which is different from the cavity, thereby preventing an increase in the volume of the cavity as a closed space and preventing an increase in intracranial pressure.

[0022] (8) In any of the liquid discharge systems described above in (7), the inside of the living body is preferably at least one of the inside of the abdominal cavity, a vein, and an atrium.

[0023] According to the fluid drainage system of (8) above, cerebrospinal fluid present in the housing cavity is drained to at least one of the abdominal cavity, the vein, and the atrium, which are different from the housing cavity. This prevents the volume of the housing cavity as a closed space from increasing, and also prevents an increase in intracranial pressure.

[0024] (9) In any of the liquid discharge systems (1) to (8) above, the liquid is preferably at least one of lactated Ringer's solution, artificial cerebrospinal fluid, physiological saline, a medicinal solution, and distilled water for injection.

[0025] According to the liquid discharge system of (9) above, the cerebrospinal fluid contained in the cavity can be replaced with at least one of lactated Ringer's solution, artificial cerebrospinal fluid, physiological saline, a medicinal solution, and distilled water for injection, thereby enabling the liquid discharge system of (9) above to quickly obtain the effects of injecting liquid and discharging cerebrospinal fluid. [Effects of the Invention]

[0026] According to the present invention, it is possible to provide a fluid drainage system that can quickly obtain the effects of fluid injection and cerebrospinal fluid drainage while reducing the burden on the patient. [Brief explanation of the drawings]

[0027] [Figure 1]1 is a schematic diagram illustrating a liquid discharge system according to a first embodiment of the present invention. [Figure 2] FIG. 10 is a schematic diagram illustrating a liquid discharge system according to a modified example of the first embodiment. [Figure 3] FIG. 10 is a schematic diagram illustrating a liquid discharge system according to a second embodiment of the present invention. [Figure 4] FIG. 1 is a schematic diagram illustrating a device according to an embodiment of the present invention. [Figure 5] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 6] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 7] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 8] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 9] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 10] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 11] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 12] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 13] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 14] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 15] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 16] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 17] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 18] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 19] 10A to 10C are schematic diagrams illustrating an example of a procedure in which the discharge line of this embodiment discharges cerebrospinal fluid from the inside of the storage cavity to the outside of the storage cavity. [Figure 20] 1 is a schematic diagram showing the spinal cord and vertebrae of a living organism. [Figure 21] 21 is a cross-sectional view taken along the cutting plane A21-A21 shown in FIG. 20. [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. 1 is a schematic diagram showing a first specific example of an access position and an access method for a cerebral 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. [Figure 25] 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 illustrating a liquid discharge system according to a first embodiment of the present invention. The fluid drainage system 2 according to this embodiment replaces the cerebrospinal fluid (CSF) of a subject by injecting a liquid into a cavity containing the cerebrospinal fluid and draining the cerebrospinal fluid out of the cavity. Cerebrospinal fluid is primarily contained in the subarachnoid space and ventricles. That is, the cavities containing cerebrospinal fluid include the subarachnoid space and 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 cavity of this embodiment.

[0030] The liquid injected into the containing 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 containing cavity is not limited to a highly oxygenated solution. For example, the liquid injected into the containing cavity may be a drug-containing liquid in which a drug has been added to cerebrospinal fluid, or may be cerebrospinal fluid that has been filtered to remove undesirable substances. Alternatively, the liquid injected into the containing 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 discharge system 2 includes an injection line 21 and a discharge line 22. The liquid discharge system 2 may also include a liquid delivery unit 23, a reservoir tank 27, and a storage unit 28.

[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 cerebrospinal fluid inside the cavity is drained to the outside of the cavity, as indicated by arrows A2 and A3 in FIG. 1 .

[0036] The device 3 includes a guiding sheath 31, a guiding catheter 32, and a drainage catheter 33. The cerebrospinal fluid drained through the drainage catheter 33 is supplied to a reservoir 28 provided outside the living body. Alternatively, the cerebrospinal fluid drained through the drainage catheter 33 may be drained into an interior of the living body other than the receiving cavity. In this case, the interior of the living body other than the receiving cavity is not particularly limited as long as it is a site that can generally absorb cerebrospinal fluid, and examples thereof include at least one of the abdominal cavity, vein, and atrium, which are used in shunt surgery for hydrocephalus.

[0037] The reservoir tank 27 stores the liquid to be injected into the housing cavity. Examples of the liquid stored in the reservoir tank 27 are as described above.

[0038] The liquid delivery unit 23 is provided in the infusion line 21 and delivers the liquid supplied from the reservoir tank 27. 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. Note that the liquid delivery unit 23 does not necessarily have to be provided.

[0039] 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 the 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 the fluid into the cavity, the cerebrospinal fluid inside the cavity is pushed out of the cavity through the discharge line 22 including the device 3, as shown by arrows A2 and A3 in FIG. 1.

[0040] Next, a modification of the first embodiment will be described. In addition, in cases where the components of the liquid discharge system 2B of this modified example are similar to the components of the liquid discharge system 2 of 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.

[0041] FIG. 2 is a schematic diagram showing a liquid discharge system according to a modified example of the first embodiment. Since the injection line 21 and the liquid delivery mechanism are the same as those in the first embodiment, a description of the injection line 21 and the liquid delivery mechanism will be omitted. In addition, in the description of this modification, a case will be taken as an example where the "interior of the living body other than the accommodation cavity" described above with reference to Figure 1 is the interior of a vein.

[0042] The fluid drainage system 2B according to this modification includes a drainage shunt 22B instead of the drainage line 22 described above with reference to Figure 1. One end of the drainage shunt 22B is disposed inside the cavity containing cerebrospinal fluid, and the other end of the drainage shunt 22B is disposed inside a vein.

[0043] The drainage shunt 22B may have a one-way valve to prevent venous blood from flowing back into the cavity containing cerebrospinal fluid, and may also have an anchor to stably place the drainage shunt 22B inside the vein.

[0044] Fluid drainage system 2B according to this modification has fewer device parts exposed to the outside of the living body compared to fluid drainage system 2 according to the first embodiment, which reduces the risk of infection, etc. Another advantage is that the drainage path for cerebrospinal fluid can be shortened, which reduces the stress on the living body, such as the risk of large fluctuations in intracranial pressure.

[0045] Next, a second embodiment of the present invention will be described. In addition, in cases where the components of the liquid discharge system 2A according to the second embodiment are similar to the components of the liquid discharge 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.

[0046] FIG. 3 is a schematic diagram illustrating a liquid discharge system according to a second embodiment of the present invention. The liquid discharge system 2A according to this embodiment includes an inlet line 21A and a discharge line 22. The discharge line 22 is as described above with reference to Fig. 1. The liquid discharge system 2A may also include a liquid delivery unit 23, a reservoir tank 27, and a storage unit 28. The liquid delivery unit 23, the reservoir tank 27, and the storage unit 28 are as described above with reference to Fig. 1.

[0047] 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. 3 . As shown in FIG. 3 , 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.

[0048] In the fluid drainage 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 the other internal jugular vein 41 of the subject's right or left side 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 the same as those of the fluid drainage system 2 according to the first embodiment described above with reference to FIG. 1.

[0049] The fluid discharge system 2A according to this embodiment has the advantages of reducing the burden on the patient by eliminating the need for head 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 positioning them in the left and right inferior petrosal sinuses 42, the injected fluid can be prevented from being immediately drained.

[0050] FIG. 4 is a schematic diagram showing the device of this embodiment. 1 and 3, device 3 of this embodiment is included in drain line 22. As described above with reference to FIG. 3, device 3A of this embodiment is included in infusion line 21A. The structure and shape of infusion catheter 34 of device 3A are similar to the structure and shape of drainage catheter 33 of device 3. Therefore, the device of this embodiment will be described below using device 3 included in drain line 22 as an example.

[0051] 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. 4 , a distal end 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.

[0052] 4, 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. 4, 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.

[0053] For example, when the infusion lines 21, 21A inject liquid into the interior of the receiving cavity, the cerebrospinal fluid 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 4, and is discharged from the base end 333 of the discharge catheter 33 to the outside of the cerebellopontine angle cistern 43, i.e., to the outside 49 of the living body as shown by arrow A12 in Figure 4.

[0054] 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. 4, 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. 4.

[0055] Here, the device 3 further includes a fixing portion 35 having a long wire 351. As shown in Fig. 4, 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. 3) 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 its 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.

[0056] 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.

[0057] 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.

[0058] 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.

[0059] The fixing portion 35 functions as an anchor in its 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 cerebrospinal 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 cerebrospinal fluid from the cerebellopontine angle cistern 43.

[0060] Next, the procedure for draining cerebrospinal fluid from the inside of the containment cavity to the outside of the containment cavity using drainage line 22 having device 3 will be described with reference to the drawings. The procedure for injecting liquid into the storage cavity using the infusion line 21A with the device 3A differs only in that the direction of flow of the liquid is opposite to the direction of flow of cerebrospinal fluid in the discharge line 22, but is otherwise the same as the procedure for discharging cerebrospinal fluid out of the storage cavity using the discharge line 22 with the device 3.

[0061] 5 to 19 are schematic diagrams illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of the housing cavity to the outside of the housing cavity using the discharge line of this embodiment. The drainage line 22 is inserted into the internal jugular vein 41 through the skin 48 of the subject. Specifically, as shown in FIGS. 5 and 6, first, a needle 51 is inserted into the internal jugular vein 41 through the skin 48. Next, as shown in FIG. 7, 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.

[0062] Next, as shown in Fig. 8, the needle 51 is removed. Next, as shown in Fig. 9, 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.

[0063] 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. 10, 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. 14).

[0064] Next, the guiding sheath 31 is slightly retracted as shown in Fig. 11. That is, the guiding sheath 31 is moved slightly toward the proximal end as indicated by arrow A13 in Fig. 11. Then, as shown in Fig. 11, the fixing part 35 passes through an opening formed in the distal end 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. 14).

[0065] 12 , 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.

[0066] 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.

[0067] Next, as shown in Figure 13, 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 13, 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.

[0068] 14, 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.

[0069] Next, as shown in FIG. 15, the needle 53 is removed. Then, the cerebrospinal fluid in 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. 16, 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. 16. Furthermore, when the infusion lines 21, 21A inject liquid into the receiving cavity, the cerebrospinal fluid in 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. 16, 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.

[0070] As described above with respect to FIG. 1, the cerebrospinal fluid inside the cerebellopontine angle cistern 43 is not limited to being discharged to the outside 49 of the body, but may be discharged to an interior of the body different from the cerebellopontine angle cistern 43.

[0071] Next, after draining the cerebrospinal fluid and injecting the liquid for a predetermined time, the drainage catheter 33 is removed as shown in Fig. 17. Next, as shown in Fig. 18, the guiding catheter 32 and the fixing part 35 are retracted while holding the guiding sheath 31. That is, as shown by arrows A14 and A15 in Fig. 18, the guiding catheter 32 and the wire 351 of the fixing part 35 are moved toward the proximal end while holding the guiding sheath 31. 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 retracts again.

[0072] Next, as shown in FIG. 19, the guiding catheter 32, the fixing part 35, and the guiding sheath 31 are removed.

[0073] As described above, according to the fluid drainage system 2 of the first embodiment, the drainage line 22 is inserted into the interior of the housing cavity containing cerebrospinal fluid via the internal jugular vein 41. Therefore, the fluid drainage system 2 can access the interior of the housing cavity via the drainage line 22 without trepanning or craniotomy, and can replace the cerebrospinal fluid with a liquid by communicating the interior of the housing cavity with the outside 49 of the living body. This allows the fluid drainage system 2 to quickly obtain the effects of injecting liquid and draining cerebrospinal fluid while minimizing the burden on the patient.

[0074] Furthermore, with the fluid drainage system 2A according to the second embodiment, both the infusion line 21A and the drainage line 22 are inserted into the cavity containing cerebrospinal fluid via the internal jugular vein 41. Therefore, the fluid drainage system 2A can access the inside of the cavity without trepanning or craniotomy, and can replace the cerebrospinal fluid with a liquid by connecting the inside of the cavity with the outside 49 of the living body. This allows the fluid drainage system 2A to quickly obtain the effects of injecting and draining the liquid while further reducing the burden on the patient.

[0075] According to the fluid drainage 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 fluid drainage 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 replace the cerebrospinal fluid with a liquid by communicating the cerebellopontine angle cistern 43 with the outside 49 of the living body. This allows the fluid drainage system 2 to obtain the effects of injecting and draining the fluid more quickly while minimizing the burden on the patient.

[0076] Furthermore, according to the fluid drainage 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 fluid drainage system 2A can access the cerebellopontine angle cistern 43, which is located on the periphery of the brain, without trepanning or craniotomy, and can replace the cerebrospinal fluid with a liquid by communicating the cerebellopontine angle cistern 43 with the outside 49 of the living body. This allows the fluid drainage system 2A to obtain the effects of injecting and draining the liquid more quickly while further reducing the burden on the patient.

[0077] According to the liquid discharge system 2 of the first embodiment and the liquid discharge system 2A of the second embodiment, cerebrospinal fluid that has been present inside the accommodation cavity is discharged to a reservoir 28 provided inside a living body different from the accommodation cavity or outside the living body 94. This makes it possible to prevent an increase in the volume of the accommodation cavity as a closed space, and to prevent an increase in intracranial pressure.

[0078] FIG. 20 is a schematic diagram showing the spinal cord and vertebrae of a living organism. FIG. 21 is a cross-sectional view taken along the cutting plane A21-A21 shown in FIG.

[0079] When the injection line 21 of the liquid drainage 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.

[0080] For example, as shown by arrow A22 in FIG. 21 , 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. 21 is called a midline puncture or the like. Alternatively, as shown by arrow A23 in FIG. 21 , 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. 21 is called a paramedian puncture or the like.

[0081] The access positions and access methods for the spinal cavity near the lumbar vertebrae described in Figures 20 and 21 are merely examples, and the access positions and access methods for the spinal cavity near the lumbar vertebrae are not limited to these.

[0082] According to the access position and access method of this specific example, the infusion line 21 is inserted into the cavity containing cerebrospinal fluid via the spinal canal 61 near the lumbar vertebrae, rather than the 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 the infusion line 21 toward the drain line 22. This allows the infusion line 21 to efficiently inject the liquid, and the drain line 22 to efficiently drain the cerebrospinal fluid.

[0083] Next, specific examples of the position and method by which the injection line 21 of the liquid discharge 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.

[0084] 22 and 23 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 liquid drainage 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 22 and 23, 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 called an anterior horn puncture.

[0085] 24 and 25 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 liquid drainage system 2 according to the first embodiment described above with reference to Fig. 1 accesses a cerebral ventricle, 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 Figs. 22 and 23), as indicated by arrow A25 in Figs. 24 and 25. This specific example of the access method is called a posterior horn puncture.

[0086] The access positions and access methods to the ventricles described in Figures 22 to 25 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.

[0087] According to the access positions and access methods of the first specific example described in Figures 22 and 23 and the second specific example described in Figures 24 and 25, the infusion line 21 is inserted into the cavity containing the 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 cerebrospinal fluid.

[0088] 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]

[0089] 2: Fluid drainage system, 2A: Fluid drainage system, 2B: Fluid drainage system, 3: Device, 3A: Device, 21: Infusion line, 21A: Infusion line, 22: Drainage line, 22B: Drainage shunt, 23: Fluid delivery section, 27: Reservoir tank, 28: Storage section, 31: Guiding sheath, 32: Guiding catheter, 33: Drainage 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: nasal base, 66: occipital eminence, 67: external auditory foramen, 68: foramen of Monroe, 94: external, 311: distal part, 321: distal part, 322: fixed part, 323: proximal part, 331: distal part, 333: proximal part, 335: dilator, 351: Wire, 411: Joint, 531: Tip

Claims

1. A liquid drainage system that replaces cerebrospinal fluid with a liquid by injecting a liquid into a cavity in which cerebrospinal fluid is contained and discharging the cerebrospinal fluid to the outside of the cavity, an injection line for injecting the liquid into the interior of the receiving cavity; a drain line for draining the cerebrospinal fluid from the inside of the cavity to the outside of the cavity; Equipped with A fluid drainage system, characterized in that at least one of the infusion line and the drainage line is inserted into the interior of the storage cavity via the internal jugular vein.

2. 2. The fluid drainage 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.

3. The liquid drainage system according to claim 2, further comprising a fixing portion for fixing the infusion line and the drainage line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern.

4. 2. The liquid discharge 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 storage cavity via either the head or the back.

5. 5. The liquid discharge system according to claim 4, wherein the head is at least one of a cistern and a ventricle.

6. 5. The fluid drainage system according to claim 4, wherein the back is the spinal canal near the lumbar spine.

7. The liquid discharge system according to claim 1, characterized in that the discharge line discharges the cerebrospinal fluid into the inside of a living body other than the storage cavity, or into a reservoir provided outside the living body.

8. 8. The liquid discharge system according to claim 7, wherein the inside of the living body is at least one of the inside of the abdominal cavity, a vein, and an atrium.

9. 2. The liquid discharge system according to claim 1, wherein the liquid is at least one of lactated Ringer's solution, artificial cerebrospinal fluid, physiological saline, a medicinal solution, and distilled water for injection.

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