Liquid drainage system
The fluid drainage system addresses the challenge of rapid cerebrospinal fluid treatment by using internal jugular vein access to achieve efficient fluid infusion and drainage without invasive procedures, ensuring quick therapeutic effects and reduced patient burden.
Patent Information
- Application Number
- PCT/JP2025/009442
- Authority / Receiving Office
- WO · WO
- Patent Type
- Applications
- Current Assignee / Owner
- Priority Date
- 2024-03-14
- Filing Date
- 2025-03-12
- Publication Date
- 2025-09-18
AI Technical Summary
Existing methods for treating cerebral infarction by injecting and draining cerebrospinal fluid face challenges in achieving quick effects while minimizing patient burden, as they often require invasive procedures like lumbar puncture or craniotomy.
A fluid drainage system that uses injection and discharge lines inserted via the internal jugular vein, accessing the cerebellopontine angle cistern without burr holes or craniotomy, allowing for rapid cerebrospinal fluid replacement with oxygenated or treated liquids.
The system enables efficient fluid infusion and drainage with reduced patient burden by avoiding invasive procedures, ensuring quick therapeutic effects and minimizing complications.
Smart Images

Figure JP2025009442_18092025_PF_FP_ABST
Abstract
Description
Liquid Discharge System
[0001] The present invention relates to a fluid drainage system used in the treatment of brain disorders.
[0002] When a brain disease, such as cerebral infarction, occurs, the blood flow that supplies oxygen to brain cells is blocked, potentially damaging the brain 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 liquid into the patient's body cavity where the cerebrospinal fluid is present, and then draining the cerebrospinal fluid out of the body cavity to replace the cerebrospinal fluid with a liquid, thereby directly supplying oxygen to oxygen-deficient 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.
[0006] Special table 2020-536618 publication
[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.
[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 housing cavity containing cerebrospinal fluid and discharging the cerebrospinal fluid to the outside of the housing cavity, the liquid discharge system comprising an injection line that injects the liquid into the interior of the housing cavity, and a discharge line that discharges the cerebrospinal fluid from the interior of the housing cavity to the outside of the housing cavity, wherein at least one of the injection line and the discharge line is inserted into the interior of the housing cavity via the internal jugular vein.
[0009] According to the liquid drainage system of (1), 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) 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) 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, thereby connecting the cerebellopontine angle cistern with the outside of the body and replacing cerebrospinal fluid with liquid. 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) Preferably, the liquid drainage system of (2) above further comprises a fixing portion for fixing the infusion line and the drainage line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern.
[0013] According to the fluid drainage system of (3) above, the fixing portion fixes the infusion line and the drainage line inserted from the inferior petrosal sinus to the cerebellopontine angle cistern, preventing the infusion 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 infusion 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 storage 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 infused 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 cerebral cisterna and a cerebral 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, thereby preventing an increase in the volume of the housing cavity as a closed space and preventing 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 the liquid and discharging the cerebrospinal fluid.
[0026] (10) It is preferable that the liquid discharge system according to any one of (1) to (9) above further comprises a liquid delivery section provided in at least one of the inlet line and the outlet line, for delivering the liquid.
[0027] According to the liquid drainage system of (10), at least one of the infusion line and the drainage line can access the inside of the accommodation cavity without puncturing or opening the craniotomy, and the inside of the accommodation cavity can be connected to the outside of the living body, allowing the liquid to be circulated by the liquid delivery unit. As a result, the liquid drainage system of (10) can quickly obtain the effects of injecting and draining the liquid while minimizing the burden on the patient.
[0028] (11) It is preferable that any of the liquid discharge systems (1) to (10) above further comprises a treatment unit that performs a predetermined treatment on the liquid discharged to the outside of the storage cavity and injects the treated liquid into the inside of the storage cavity through the injection line.
[0029] According to the liquid discharge system of (11) above, it is possible to perform a predetermined treatment on the liquid discharged to the outside of the accommodation cavity by the treatment section, and then inject the liquid into the accommodation cavity.
[0030] 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.
[0031] FIG. 1 is a schematic diagram showing a liquid discharge system according to a first embodiment of the present invention. FIG. 2 is a schematic diagram showing a liquid discharge system according to a modified example of the first embodiment. FIG. 3 is a schematic diagram showing a liquid discharge system according to a second embodiment of the present invention. FIG. 4 is a schematic diagram showing a liquid discharge system according to a third embodiment of the present invention. FIG. 5 is a schematic diagram showing a liquid discharge system according to a fourth embodiment of the present invention. FIG. 6 is a schematic diagram showing a device according to the present embodiment. FIG. 7 is a schematic diagram explaining an example of a procedure in which a discharge line according to the present embodiment discharges cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity. FIG. 8 is a schematic diagram explaining an example of a procedure in which a discharge line according to the present embodiment discharges cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity. FIG. 9 is a schematic diagram explaining an example of a procedure in which a discharge line according to the present embodiment discharges cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity. FIG. 10 is a schematic diagram explaining an example of a procedure in which a discharge line according to the present embodiment discharges cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity. FIG. 1 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. FIG. 1 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. FIG. 2 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. FIG. 3 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. FIG. 4 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. FIG. 5 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. FIG. 6 is a schematic diagram illustrating an example of a procedure for discharging cerebrospinal fluid from the inside of a housing cavity to the outside of the housing cavity using the discharge line of this embodiment. 1 is a schematic diagram showing the spinal cord and vertebrae of a living organism.Fig. 23 is a cross-sectional view taken along the cutting plane A21-A21 in Fig. 22. Fig. 24 is a schematic diagram showing a first specific example of an access position and an access method for a ventricle. Fig. 25 is a schematic diagram showing a first specific example of an access position and an access method for a ventricle. Fig. 26 is a schematic diagram showing a second specific example of an access position and an access method for a ventricle. Fig. 27 is a schematic diagram showing a second specific example of an access position and an access method for a ventricle.
[0032] Preferred embodiments of the present invention will be described in detail below with reference to the drawings. The embodiments described below are preferred specific examples of the present invention, and therefore various technically preferable limitations are applied. However, 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 specifically limited. Furthermore, in each drawing, similar components are designated by the same reference numerals, and detailed descriptions thereof will be omitted where appropriate.
[0033] FIG. 1 is a schematic diagram illustrating a liquid drainage system according to a first embodiment of the present invention. The liquid drainage system 2 according to this embodiment replaces cerebrospinal fluid (CSF) of a subject by injecting a liquid into a cavity containing the cerebrospinal fluid and then draining the cerebrospinal fluid out of the cavity. CSF 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 cistern is the cerebellopontine angle cisterna (CP Angle cisterna). Therefore, the cerebellopontine angle cisterna is also included in the cisterna of this embodiment.
[0034] 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 medicated liquid in which a medicinal agent is added to cerebrospinal fluid, or cerebrospinal fluid that has been filtered to remove undesirable substances. 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.
[0035] 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.
[0036] 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.
[0037] The infusion line 21 has a long member with an inner lumen including, for example, 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 shown by arrow A1 in FIG. 1 . As shown in FIG. 1 , an example of the back into which the infusion line 21 is inserted is the spinal cavity near the lumbar vertebrae. Specific examples of access locations and access methods for the spinal cavity near the lumbar vertebrae will be described later. Also, as shown in FIG. 1 , an example of the head into which the infusion line 21 is inserted is at least one of the cistern and the ventricle. Specific examples of access locations and access methods for the cistern and the ventricle will be described later.
[0038] 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 Figure 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.
[0039] The cavity (e.g., the subarachnoid space and the ventricle) containing the cerebrospinal fluid 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 .
[0040] 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.
[0041] 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.
[0042] 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 is not necessarily provided.
[0043] As indicated 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. Furthermore, a certain pressure, such as intracranial pressure, is applied inside the cavity. Therefore, when the infusion line 21 injects 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 indicated by arrows A2 and A3 in FIG. 1 .
[0044] Next, a modified example of the first embodiment will be described. Note that, in cases where the components of a liquid discharge system 2B according to this modified example are the same as the components of the liquid discharge system 2 according to the first embodiment described above with reference to Figure 1, redundant explanations will be omitted as appropriate, and the following description will focus on the differences.
[0045] 2 is a schematic diagram showing a liquid discharge system according to a modification 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, the "interior of the living body other than the storage cavity" mentioned in FIG. 1 is taken as an example to be the interior of a vein.
[0046] 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 Fig. 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.
[0047] 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.
[0048] The fluid discharge system 2B according to this modification has fewer device portions exposed to the outside of the living body compared to the fluid discharge system 2 according to the first embodiment, thereby reducing the risk of infection, etc. Another advantage is that the drainage path for cerebrospinal fluid can be shortened, thereby reducing the stress on the living body, such as the risk of large fluctuations in intracranial pressure.
[0049] Next, a second embodiment of the present invention will be described. In cases where the components of a liquid discharge system 2A according to the second embodiment are the same as the components of the liquid discharge system 2 according to the first embodiment described above with reference to Figure 1, redundant explanations will be omitted as appropriate, and the following description will focus on the differences.
[0050] Figure 3 is a schematic diagram showing a liquid discharge system according to a second embodiment of the present invention. The liquid discharge system 2A according to this embodiment includes an injection line 21A and a discharge line 22. The discharge line 22 is as described above with reference to Figure 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 Figure 1.
[0051] 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 into the interior of the housing cavity from the inferior petrosal sinus 42. 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.
[0052] 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 storage 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 storage 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 storage cavity will be described later. The other configurations are similar to those of the fluid drainage system 2 according to the first embodiment described above with reference to FIG. 1 .
[0053] 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 therapeutic effect more quickly. 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.
[0054] Next, a third embodiment of the present invention will be described. In addition, when the components of a liquid discharge system 2C according to the third embodiment are the same as the components of the liquid discharge system 2 according to the first embodiment described above with reference to FIG. 1, redundant explanations will be omitted as appropriate, and the following description will focus on the differences.
[0055] 4 is a schematic diagram showing a liquid discharge system according to a third embodiment of the present invention. The liquid discharge system 2C according to this embodiment circulates the liquid by injecting the liquid into a storage cavity that stores the cerebrospinal fluid of a subject and discharging the liquid to the outside of the storage cavity. Because the liquid discharge system 2C according to this embodiment is a system that circulates the liquid, it is also referred to as a "liquid circulation system."
[0056] As shown in Fig. 4, the liquid discharge system 2C includes an infusion line 21, a discharge line 22, and a liquid delivery unit 23. The infusion line 21, the discharge line 22, and the liquid delivery unit 23 are as described above with reference to Fig. 1. The liquid discharge system 2C 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 each an example of a "treatment unit" of the present invention.
[0057] The infusion line 21 has a long member with an inner lumen including, for example, 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 shown by arrow A1 in FIG. 4 . As shown in FIG. 4 , an example of the back into which the infusion line 21 is inserted is the spinal cavity near the lumbar vertebrae. Specific examples of access locations and access methods for the spinal cavity near the lumbar vertebrae will be described later. Also, as shown in FIG. 4 , an example of the head into which the infusion line 21 is inserted is at least one of the cistern and the ventricle. Specific examples of access locations and access methods for the cistern and the ventricle will be described later.
[0058] 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 Figure 4, 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 later.
[0059] The cavity containing cerebrospinal fluid (e.g., the subarachnoid space and the ventricle) 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 (e.g., cerebrospinal fluid) inside the cavity is drained to the outside of the cavity, as indicated by arrows A2 and A3 in FIG. 4 .
[0060] 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.
[0061] The oxygenation mechanism 24 is connected to the oxygen supply source 25 via a 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 an arrow A4 in Fig. 4, to generate oxygenated cerebrospinal fluid.
[0062] The oxygenation mechanism 24 is also connected to the heat exchanger 26 via a second pipe 272 and a third pipe 273, which do not intersect with the inlet line 21, the outlet line 22, and the first pipe 271. The heat exchanger 26 adjusts the temperature of a fluid other than the cerebrospinal fluid. The temperature-adjusted fluid is supplied to the oxygenation mechanism 24 through the third pipe 273, as indicated by arrow A6 in FIG. 4, and returns to the heat exchanger 26 through the second pipe 272, as indicated by arrow A5 in FIG. 4. At this time, the temperature-adjusted fluid in the oxygenation mechanism 24 indirectly adjusts the temperature of the cerebrospinal fluid by passing through a flow path adjacent to the cerebrospinal fluid flow path inside the oxygenation mechanism 24. The oxygenated and temperature-adjusted cerebrospinal fluid is then supplied to the inlet line 21 as a highly oxygenated solution. Examples of the oxygenation mechanism 24 include a hollow fiber membrane oxygenator for adding oxygen to blood.
[0063] 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.
[0064] As shown by arrow A1 in FIG. 4 , 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. Therefore, when the infusion line 21 injects fluid into the cavity, the volume of the fluid contained in the closed space increases, and the fluid (e.g., 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. 4 . In this manner, the fluid delivery unit 23 circulates the fluid.
[0065] Next, a fourth embodiment of the present invention will be described. In cases where the components of a liquid discharge system 2D according to the fourth embodiment are the same as the components of the liquid discharge system 2C according to the third embodiment described above with reference to Figure 4, redundant explanations will be omitted as appropriate, and the following description will focus on the differences.
[0066] FIG. 5 is a schematic diagram showing a liquid discharge system according to a fourth embodiment of the present invention. The liquid discharge system 2D according to this embodiment includes an injection line 21A, an exhaust line 22, and a liquid delivery unit 23. The injection line 21A is as described above with reference to FIG. 3. The exhaust line 22 and the liquid delivery unit 23 are as described above with reference to FIG. 1. The liquid discharge system 2D 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. 4. Since the liquid discharge system 2D according to this embodiment is a system that circulates liquid, it is also referred to as a "liquid circulation system."
[0067] 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. 5 . As shown in FIG. 5 , for example, the infusion line 21A passes from the internal jugular vein 41 through the inferior petrosal sinus 42 and is inserted into the interior of the housing cavity from the inferior petrosal sinus 42. 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.
[0068] In the fluid drainage system 2D 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 storage 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 storage cavity from that inferior petrosal sinus 42. As described above with reference to FIG. 4 , details of the access of the drainage line 22 to the interior of the storage cavity will be described later. The other configurations are similar to those of the fluid drainage system 2C according to the third embodiment described above with reference to FIG. 4 .
[0069] The fluid drainage system 2D 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 therapeutic effects quickly. 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, it is possible to prevent the injected fluid from being immediately drained.
[0070] 6 is a schematic diagram showing the device of this embodiment. As described above with reference to FIGS. 1 and 3, device 3 of this embodiment is included in discharge 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 discharge catheter 33 of device 3. Therefore, the device of this embodiment will be described below using device 3 included in discharge line 22 as an example.
[0071] 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 passes through 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. 6 , 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.
[0072] 6 , 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. 6 , 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 brain stem 45.
[0073] For example, when the infusion lines 21, 21A inject liquid into the interior of the receiving cavity, the cerebellopontine angle cistern 43 passes from the tip 331 of the discharge catheter 33 through the lumen of the discharge catheter 33 as indicated by arrow A11 in FIG. 6, 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 indicated by arrow A12 in FIG. 6.
[0074] When the injection 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. 6, 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. 6.
[0075] Here, the device 3 further includes a fixing portion 35 having a long wire 351. As shown in Fig. 6 , 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, which are 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.
[0076] 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 fixing part 35 and the guiding catheter 32 together.
[0077] 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.
[0078] 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.
[0079] 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.
[0080] Next, a procedure for draining cerebrospinal fluid from the inside of the housing cavity to the outside of the housing cavity using drain line 22 having device 3 will be described with reference to the drawings. Note that the procedure for injecting a liquid into the inside of the housing cavity using infusion line 21A having device 3A is the same as the procedure for draining cerebrospinal fluid to the outside of the housing cavity using drain line 22 having device 3, except that the flow direction of the liquid is opposite to the flow direction of cerebrospinal fluid in drain line 22.
[0081] 7 to 21 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 discharge line 22 is inserted into the internal jugular vein 41 through the subject's skin 48. Specifically, as shown in FIGS. 7 and 8 , a needle 51 is first inserted into the internal jugular vein 41 through the skin 48. Next, as shown in FIG. 9 , 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.
[0082] Next, as shown in Fig. 10 , the needle 51 is removed. Next, as shown in Fig. 11 , a 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.
[0083] Next, the dilator 335 and the guide wire 52 inserted into the lumen of the guiding sheath 31 are removed from the guiding sheath 31, and as shown in Fig. 12, the fixing part 35 is inserted into the lumen of the guiding sheath 31 and delivered along the guiding sheath 31 via 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. 16).
[0084] Next, the guiding sheath 31 is slightly retracted as shown in Fig. 13. That is, the guiding sheath 31 is moved slightly toward the proximal end as indicated by arrow A13 in Fig. 13. Then, as shown in Fig. 13, the fixing portion 35 passes through an opening formed in the distal end portion 311 of the guiding sheath 31 and goes outside the guiding sheath 31, thereby expanding. At this time, the fixing portion 35 is preferably expanded and positioned inside the inferior petrosal sinus 42, deeper than the intended puncture site of the needle 53 (see Fig. 16).
[0085] 14 , 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.
[0086] 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 proximal end 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 proximal end is, for example, the connector 36 having a valve body made of an elastic member.
[0087] Next, as shown in Fig. 15 , 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 Fig. 15 , the 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.
[0088] 16 , 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 them. 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 from the internal jugular vein 41 through the inferior petrosal sinus 42, and is inserted from the inferior petrosal sinus 42 into the cerebellopontine angle cistern 43.
[0089] Next, as shown in Fig. 17, the needle 53 is removed. Then, the cerebrospinal fluid inside the cerebellopontine angle cistern 43 passes from the distal end 331 of the discharge catheter 33 through the lumen of the discharge catheter 33 as indicated by arrow A11 in Fig. 18, and is discharged from the proximal 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 indicated by arrow A12 in Fig. 18. Furthermore, when the infusion lines 21, 21A inject liquid into the receiving cavity, the cerebrospinal fluid inside the cerebellopontine angle cistern 43 passes from the distal end 331 of the discharge catheter 33 through the lumen of the discharge catheter 33 as indicated by arrow A11 in Fig. 18, and is discharged from the proximal 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 indicated by arrow A12 in Fig. 18.
[0090] As described above with respect to FIG. 1 , the cerebrospinal fluid within 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 .
[0091] Next, after draining the cerebrospinal fluid and injecting the liquid for a predetermined time, the drainage catheter 33 is removed as shown in Fig. 19. Next, as shown in Fig. 20, 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. 20, 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.
[0092] Next, as shown in FIG. 21, the guiding catheter 32, the fixing part 35, and the guiding sheath 31 are removed.
[0093] 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.
[0094] 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. This allows access to the interior of the cavity without burr hole or craniotomy, and allows the interior of the cavity to communicate with the outside 49 of the living body, replacing the cerebrospinal fluid with liquid. 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.
[0095] 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 cerebrospinal fluid with liquid by communicating the cerebellopontine angle cistern 43 with the outside 49 of the living body. This allows the fluid drainage system 2 to achieve the effects of fluid injection and drainage more quickly while minimizing the burden on the patient.
[0096] Furthermore, with the fluid drainage system 2A according to 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, located on the periphery of the brain, without trepanning or craniotomy, and can connect the cerebellopontine angle cistern 43 to the outside 49 of the living body, thereby replacing cerebrospinal fluid with liquid. This allows the fluid drainage system 2A to more quickly obtain the effects of injecting and draining fluid while further reducing the burden on the patient.
[0097] 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.
[0098] Furthermore, in the fluid drainage system 2C according to the third embodiment, the drainage line 22 is inserted into the interior of the cavity containing cerebrospinal fluid via the internal jugular vein 41. Therefore, the fluid drainage system 2C can access the interior of the cavity via the drainage line 22 without trepanning or craniotomy, and can communicate the interior of the cavity with the outside 49 of the living body to circulate the fluid via the fluid delivery unit 23. This allows the fluid drainage system 2C to quickly obtain the effects of injecting and draining the fluid while minimizing the burden on the patient.
[0099] Furthermore, with the fluid drainage system 2D according to the fourth embodiment, both the infusion line 21A and the drainage line 22 are inserted into the interior of the cavity containing cerebrospinal fluid via the internal jugular vein 41. Therefore, the fluid drainage system 2D can access the interior of the cavity without burr hole or craniotomy, and can communicate the interior of the cavity with the outside 49 of the living body to circulate the fluid by the fluid delivery unit 23. This allows the fluid drainage system 2D to quickly obtain the effects of injecting and draining the fluid while further reducing the burden on the patient.
[0100] Furthermore, when treatment units such as an oxygenation mechanism 24, an oxygen supply source 25, and a heat exchanger 26 are provided, the liquid discharge systems 2C and 2D can inject the liquid into the storage cavity after performing a predetermined treatment on the liquid discharged to the outside of the storage cavity using the treatment units.
[0101] According to the fluid drainage system 2C of the third 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 2C can access the cerebellopontine angle cistern 43, which is located on the periphery of the brain, via the drainage line 22 without trepanning or craniotomy, and can circulate fluid by connecting the cerebellopontine angle cistern 43 to the outside 49 of the living body. This allows the fluid drainage system 2C to achieve the effects of fluid injection and drainage more quickly while minimizing the burden on the patient.
[0102] Furthermore, according to the fluid drainage system 2D of the fourth 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 2D can access the cerebellopontine angle cistern 43, which is located on the periphery of the brain, without trepanning or craniotomy, and can communicate the cerebellopontine angle cistern 43 with the outside 49 of the living body to circulate the fluid. This allows the fluid drainage system 2D to achieve the effects of fluid injection and drainage more quickly while further reducing the burden on the patient.
[0103] Fig. 22 is a schematic diagram showing the spinal cord and vertebrae of a living organism. Fig. 23 is a cross-sectional view taken along the cutting plane A21-A21 shown in Fig. 22.
[0104] 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 decubitus position. The distal end of the injection line 21 is positioned by inserting a spinal needle into a position between the fourth lumbar vertebra (L4) and the fifth lumbar vertebra (L5), for example, to ensure safety during insertion. Alternatively, the distal end of the injection line 21 is positioned by inserting a spinal needle into a position between the third lumbar vertebra (L3) and the fourth lumbar vertebra (L4), for example, to ensure safety during insertion.
[0105] For example, as shown by arrow A22 in FIG. 23 , 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. 23 is called a midline puncture or the like. Alternatively, as shown by arrow A23 in FIG. 23 , 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. 23 is called a paramedian puncture or the like.
[0106] The access positions and access methods for the spinal cavity near the lumbar vertebrae described in Figures 22 and 23 are merely examples, and the access positions and access methods for the spinal cavity near the lumbar vertebrae are not limited to these.
[0107] According to the access position and access method of this example, the infusion line 21 is inserted into the cavity containing cerebrospinal fluid via the spinal canal 61 near the lumbar vertebrae, rather than via the internal jugular vein 41. This prevents 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, while the drain line 22 can efficiently drain the cerebrospinal fluid.
[0108] 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.
[0109] 24 and 25 are schematic diagrams showing a first specific example of an access position and an access method for a cerebral 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 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, as indicated by arrow A24 in FIGS. 24 and 25 . This specific example of the access method is also called an anterior horn puncture.
[0110] 26 and 27 are schematic diagrams showing a second specific example of an access position and an access method for a cerebral 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, which is a distance L4 (approximately 6 cm) upward from the occipital protuberance 66, a distance L5 (approximately 7 cm) upward from the external auditory canal 67, a distance L6 (approximately 7 cm) posteriorly, and a distance L7 (approximately 3 cm) laterally from the sagittal suture 63, toward the vicinity of the foramen of Monro 68 (see FIGS. 24 and 25 ), as indicated by arrows A25 in FIGS. 26 and 27 . This specific example of the access method is also called a posterior horn puncture.
[0111] The access positions and access methods for the ventricles described in Figures 24 to 27 are merely examples. The access positions and access methods for the ventricles are not limited to these. The access positions and access methods for the cisterns are not particularly limited as long as they are positions and methods that allow clinical access to the cisterns.
[0112] According to the access positions and access methods of the first specific example described in Figures 24 and 25 and the second specific example described in Figures 26 and 27, 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 drainage line 22 to efficiently drain cerebrospinal fluid.
[0113] 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.
[0114] 2: Fluid drainage system, 2A: Fluid drainage system, 2B: Fluid drainage system, 2C: Fluid drainage system, 2D: Fluid drainage system, 3: Device, 3A: Device, 21: Infusion line, 21A: Infusion line, 22: Drain line, 22B: Drain shunt, 23: Fluid delivery section, 24: Oxygenation mechanism, 25: Oxygen supply source, 26: Heat exchanger, 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: External 51: needle, 52: guide wire, 53: needle, 61: spinal cavity, 62: median plane, 63: sagittal suture, 64: coronal suture, 65: nasion point, 66: occipital prominence, 67: external auditory foramen, 68: foramen of Monro, 94: external, 271: first canal, 272: second canal, 273: third canal, 311: tip, 321: tip, 331: tip, 333: base end, 335: dilator, 351: wire, 411: joint, 531: tip
Claims
1. A liquid discharge system that replaces cerebrospinal fluid with a liquid by injecting a liquid into the interior of a housing cavity containing cerebrospinal fluid and discharging the cerebrospinal fluid to the outside of the housing cavity, comprising: an injection line that injects the liquid into the interior of the housing cavity; and a discharge line that discharges the cerebrospinal fluid from the interior of the housing cavity to the outside of the housing cavity, wherein at least one of the injection line and the discharge line is inserted into the interior of the housing cavity via the internal jugular vein.
2. The fluid drainage system according to 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. 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. The liquid discharge system according to claim 4, wherein the head is at least one of a cistern and a ventricle.
6. The liquid drainage system according to claim 4, wherein the back is the spinal canal near the lumbar vertebrae.
7. The liquid discharge system of claim 1, characterized in that the discharge line discharges the cerebrospinal fluid into the interior of a living body other than the containment cavity, or into a reservoir located outside the living body.
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. 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.
10. The liquid discharge system according to claim 1, further comprising a liquid delivery section provided in at least one of the inlet line and the outlet line for delivering the liquid.
11. A liquid discharge system as described in claim 1, further comprising a treatment section that performs a predetermined treatment on the liquid discharged to the outside of the storage cavity and injects the treated liquid into the inside of the storage cavity through the injection line.
Citation Information
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