Devices for shunting blood
An apparatus includes a hub including a front port, a side port, and a back port including a hemostasis valve. The apparatus further includes a sheath extending from the hemostasis valve through the front port and shaped to define one or more lateral openings within the hub. The sheath is configured for insertion into a blood vessel such that, subsequently to the insertion, a rate of flow of blood between the side port and the blood vessel via the lateral openings is controllable using an instrument passing through the hemostasis valve and into the sheath such that the instrument closes at least a portion of the lateral openings. Other embodiments are also described.
1 . An apparatus, comprising:
a hub comprising a front port, a side port, and a back port comprising a hemostasis valve;
a sheath extending from the hemostasis valve through the front port and shaped to define one or more lateral openings within the hub,
the sheath being configured for insertion into a blood vessel; and
an instrument configured to reduce a rate of flow of blood between the side port and the blood vessel via the lateral openings without stopping the flow, subsequently to the insertion, by passing through the hemostasis valve and into the sheath such that the instrument closes at least a portion of the lateral openings.
2 . The apparatus according to claim 1 , wherein a cross-sectional area of a lumen of the side port is at least 3.8 mm 2 .
3 . The apparatus according to claim 1 , wherein a total area of the lateral openings is at least as large as an area of the side port.
4 . The apparatus according to claim 1 , wherein the sheath comprises:
a back sheath, which is disposed within the hub and is shaped to define the lateral openings; and
a front sheath, which is connected to the back sheath and is configured for insertion into the blood vessel.
5 . The apparatus according to claim 1 , wherein the sheath is connected to the back port.
6 . The apparatus according to claim 1 , further comprising a tube configured to connect to the side port.
7 . The apparatus according to claim 1 , wherein the instrument comprises a dilator configured to facilitate the insertion by dilating the blood vessel.
8 . The apparatus according to claim 1 , wherein the openings are arranged in one or more rows.
9 . The apparatus according to claim 1 , wherein the openings include one or more slots.
10 . The apparatus according to claim 1 , further comprising a blood filter disposed between the lateral openings and the side port such that the blood flows through the blood filter.
11 . The apparatus according to claim 1 , wherein the apparatus is for use with another hub including another front port, which is connected to another sheath, and another back port, which includes another hemostasis valve, and wherein the apparatus further comprises:
a tube configured to connect to the side port; and
an adapter configured to connect to the tube and configured for insertion through the other hemostasis valve such that, subsequently to an insertion of the other sheath into another blood vessel, the blood flows between the other blood vessel and the tube via the adapter.
12 . The apparatus according to claim 11 , wherein the adapter comprises one or more barbs configured to inhibit the adapter from exiting the other hub subsequently to the insertion of the adapter.
13 . The apparatus according to claim 11 , wherein the adapter comprises:
a straight connector, comprising:
a front end, configured for insertion through the other hemostasis valve; and
a back end; and
a tube connector, which comprises a front connector port connected to the back end of the straight connector and is configured to connect to the tube.
14 . The apparatus according to claim 13 , wherein the tube connector further comprises a back connector port configured to connect to the tube.
15 . The apparatus according to claim 13 , wherein the other hemostasis valve is a first other hemostasis valve, and wherein the tube connector further comprises:
a back connector port, comprising a second other hemostasis valve; and
one or more side connector ports, at least one of which is configured to connect to the tube.
16 . The apparatus according to claim 13 , wherein the tube connector comprises a T-connector.
17 . The apparatus according to claim 13 , wherein the tube connector comprises a Y-connector.
18 . The apparatus according to claim 1 , further comprising:
another sheath;
another hub, comprising another front port, which is connected to the other sheath, and another back port comprising another hemostasis valve;
an adapter passing through the other hemostasis valve; and
a tube configured to connect to the side port and connected to the adapter such that, subsequently to an insertion of the other sheath into another blood vessel, the blood flows between the other blood vessel and the tube via the adapter.
19 . The apparatus according to claim 1 , wherein the instrument comprises multiple markings configured to indicate different respective sizes of the portion of the lateral openings that is closed by the instrument, by virtue of the markings progressively entering the hub as the instrument is pushed through the hemostasis valve.
20 . A method, comprising:
inserting a sheath, which extends from a hemostasis valve at a back port of a hub through a front port of the hub, into a blood vessel, the sheath being shaped to define one or more lateral openings within the hub; and
subsequently to inserting the sheath, passing an instrument through the hemostasis valve and into the sheath, and using the instrument to close at least a portion of the lateral openings so as to control a rate of flow of blood between a side port of the hub and the blood vessel via the lateral openings.
21 . The method according to claim 20 , further comprising:
inserting an adapter, which is connected to a tube connected to the side port, through another hemostasis valve at another back port of another hub; and
inserting another sheath, which is connected to another front port of the other hub, into another blood vessel such that the blood flows between the other blood vessel and the tube via the adapter.
22 . The method according to claim 20 , wherein using the instrument comprises using the instrument to reduce the rate without stopping the flow, by closing the portion of the lateral openings.