US3313291A

US3313291A - Apparatus for the injection of radioopaque liquid in angiography

Info

Publication number: US3313291A
Application number: US321884A
Authority: US
Inventors: Thomas R Marshall
Original assignee: SigmaMotor Inc
Current assignee: SigmaMotor Inc
Priority date: 1963-11-06
Filing date: 1963-11-06
Publication date: 1967-04-11
Anticipated expiration: 1984-04-11

Description

pri 1967 T. R. MARSHALL APPARATUS FOR THE INJECTION OF RADIO -OPAQUE LIQUID IN ANGIOGRAPHY Filed Nov. 6, 1963 2 Sheets-Sheet 1 INVENTOR- THOMAS R. MARSHALL ATTORNEY April 11, 3937 T. R. MARSHALL 3,313,291

APPARATUS FOR THE INJECTION OF RADIO-OPAQUE LIQUID IN ANGIOGRAPHY Filed Nov. 6, 1963 l v 2 Sheets-Sheet 2 I I I L 4% 5/ F75, 6 INVENTOR. I4 THOMAS R. MARSHALL United States Patent 3,313,291 APPARATUS FOR THE INJECTION 0F RADIO- OPAQUE LIQUID IN ANGIOGRAPHY Thomas R. Marshall, Louisville, Ky., assiguor to Sigmamotor, Inc., village of Middleport, N.Y., a corporation of New York Filed Nov. 6, 1963, Ser. No. 321,884 9 Claims. (Cl. 128-2) This invention relates to an apparatus for use in angiography and aortography. More specifically, this invention relates to an apparatus whereby one or more injections of radio-opaque liquid can be made without the use of a catheter and without reloading the syringe.

in order to obtain a good radiological contrast, it is necessary to utilize a radio-opaque substance in sufiicient amount to reach a certain degree of concentration in the blood. Such radio-opaque substances are iodine deriva- .tives which absonb X-rays and consequently are often referred to as contrast materials. The injections must be made very rapidly in order that the contrast material move in the form of a bolus to the desired area. It is thus necessary to use sufiicient pressure to overcome the blood pressure in the brachial artery or other site of injection so as to move against the flow of blood to the desired area of the vascular system. It has been found that in many instances it is necessary to utilize as high as 400 p.s.i. injection pressure in order to insure that a suificient quantity of contrast material reaches the desired area in sufiicient concentration for radiological examination.

In an article by T. R. Marshall and J. T. Ling in Radiology, vol. 80, No. 2, pp. 258-260, February 1963, direct percutaneous non-catheter left and right brachiolaugiography was described, wherein the injection site was below the arterial network around the eblow. In this technique, the injection site is in the antecubital fossa. In other instances, injections can be made in the femoral artery depending on the area selected for radiological examination. In the development of these techniques it has been found necessary in many instances to make multiple injections Within a relatively short period of time. A recurring problem with these procedures is the removal of air from the contrast material prior to making the injections.

It is an object of this invention, therefore, to provide a means whereby multiple injections may be given to the same patient without reloading the syringe.

Another object of this invention is the provision of a means whereby entrapped air in the contrast material is removed from the syringe prior to making the injection.

Still another object of this invention is the provision of an apparatus capable of injecting materials at pressures up to and exceeding 800 psi which is economical and of simple construction.

Still another object of this invention is the provision of an apparatus whereby the operation of the seriograph and the X-ray apparatus is synchronized with the injection.

Still other and further objects will occur to those skilled in the art from a review of the drawings and the detailed description which follows.

Referring now to the drawings:

FIG. 1 is a side elevation of my injection device.

FIG. 2 is an end view taken along lines 22 of FIG. 1.

FIG. 3 is a vertical cross-sectional View taken along lines 3-3 of FIG. 1.

FIG. 4 is a vertical cross-sectional view taken along lines 4-4 of FIG. 1.

FIG. 5 is a fragmentary horizontal section of my 3,313,291 Patented Apr. 11, 1967 device which illustrates the relation of the plunger assembly to the movable stop member and particularly to the switching mechanism during a stroke of said plunger.

FIG. 6 is a side elevational view partially in section, illustrating the relation of the movable stop members relative to the plunger shaft assembly and the piston rod assembly.

The apparatus of this invention comprises a frame 'which includes a front plate 1, a first transverse plate 2, a second transverse plate 3, and a rear plate 4. The front plate and the second transverse plate are connected together by

side rail members

5 and 8 in which the head of the rail member 5 is on the rear of the second transverse plate 3, and which is secured to the front of the front plate 1 by nut 6 in a similar manner. The head 10 of rail member 8 is disposed beyond second transverse plate 3 and is secured by nut 9 to the front plate. A third rail member 11 runs from the first transverse plate 2 to the front plate 1 and is secured thereto by means of nut 12. Additionally, the front plate is secured at the bottom to bottom plate 13 which runs the length of the apparatus to rear plate 4. Secured to the bottom plate is foot member 14 which disposes the entire apparatus at a slight angle from the horizontal surface on which it rests. Therefore, the front of the apparatus is slightly higher than the rear of the apparatus for purposes which will be hereinafter set forth. As will be noted by examination of FIGS. 2 and 3, the front plate 1 and the first transverse plate 2 contain cradling slots in the center for provision of the syringe barrel and

nozzle

18 and 19, respectively. Thus, slot 15 in the front plate 1 is comparatively narrow so that nozzle 19 projects therethrough. Slot 16 in first transverse plate 2 is wider and is arcuate in shape at the bottom for the provision of barrel 18 of the syringe. Projecting from nozzle 19 into the syringe barrel 18 (see FIG. 5) is the tubular member 20 which has an orifice 21 on its bottom surface. The outlet orifice 22 thus communicates between the orifice 21 with the internal surface of the syringe barrel. The tubular member 20 terminates on the outside with a threaded member 23 for provision of a coupling .24 for hose 25 to which a needle may be attached by conventional coupling means. Near the front of the syringe barrel 18 is a free space 26 which is bounded to the rear by annular shoulder 27 which acts to stop the stroke of plunger head 28. Thus, it will be seen that due to the angular disposition of the syringe barrel 18 and the free space 26, any air which is in the syringe will rise to the top and thus communicate by means of outlet orifice 79 of the needle valve 75. Thus, by manipulation of knob 76 the valve shaft 77 may be opened to allow any entrapped air to be removed through valve opening 78. In the event that all of the air is not removed, there remains about 30 cc. of liquid in the syringe in the free space 26 and, due to the lighter density of the air, this rises to the top and is not injected through orifice 21 through tubular member 20 to the outlet orifice 22, thus eliminating any appreciable danger of injecting air into the patients vascular system.

Slidably positioned in the syringe barrel 1% is the plunger assembly, including plunger head 28, plunge-r shaft 29, which is marked with calibrations 3t and which terminates with a circular flange 31 at the end of shaft 29. It will be noted that, due to the centrally disposed cradling slots in the front and first transverse plates 1 and 2, the entire syringe may be easily removed from the apparatus to be cleaned and sterilized.

The plunger assembly is driven by a pneumatic cylinder 32 which is secured at the rear to the rear plate 4 by cylinder housing 33, and at the front to the second transverse plate 3 by cylinder housing 34.

Support rails

35 and 36 connected to transverse plate 3 and rear plate 4 support the cylinder in operative relation so that the piston rod 37 which terminates in a circular flange 38 is in abutting relation with flange 31 of the plunger shaft. Connected through cylinder housing 33 is the air inlet connection 39 terminating in nipple 40 to which air line 41 is attached. Air line 41 is connected to a toggle valve of standard construction 42 which, in turn, is connected to air line 43 to the gas cylinder 44. The flow of gas from the cylinder is controlled by hand valve 45 through reducing valve 46 to high pressure gauge 47 and to low pressure gauge 48. Thus, it is possible to reduce the pressure of the gas coming from the cylinder from about 1800 p.s.i.g. to through the use of reducing valve 46. Normally, gas pressures in the range of 80 to 100 p.s.i. are used with the apparatus of this invention. Therefore, by manipulation of toggle valve 42, the piston rod 37 is extended, thus driving the plunger shaft 29 by reason of the abutting relationship of the plunger shaft flange 3-1 with the: piston rod flange 38.

In the particular embodiment shown, the area of the piston head 49 in the cylinder 32 is approximately four times the area of the plunger head 28, therefore, allowing for a mechanical advantage of about 4 to 1. In this manner, with a gas pressure of about 100 p.s.i. the contrast material is ejected from the syringe at a pressure of about 400 psi.

The stroke of the piston and plunger assembly is limited by means of movable stop 50 which consists of a metal block assembly mounted on rails and 8, respectively, and which contains a traveling nut 51 at the bottom. The block portion of the movable stop 50 contains a central opening 52 which is large enough to accommodate the

flange portions

31 and 38 of the piston and plunger assemblies. The block portion contains a front and rear

transverse slot

53 and 54 into which stop

plates

55 and 56 may be slidably positioned. Projecting through the traveling nut portion 51 is a Worm shaft 57 which is journaled in collars 58 and 59 of the second transverse plate and the rear plate, respectively, and which is connected to a crank member 60 and crank handle 61. It is, therefore, possible by manipulation of the crank to move the entire movable stop assembly axially in either direction along the side rails 5 and 8 of the frame.

Referring now to FIGS. 1 and 5, the switching mecha nism contained in housing 65 consists of a stop plate 62 which is adapted to slidably fit into

transverse slots

53 or 54 of the movable stop assembly 50. On the back portion of the stop plate 62 is a depression 63. Attached to stop plate 62 is a pair of guide rods 64 connected by connecting member 81, upon which housing 65 is slidably positioned, and which is secured in a particular position by set screw 66. Below the guide rod 64 and extending through the stop plate 62 is a slidable cam shaft 67 which is biased against spring member 80 and which has an annular restricted portion 68 and a cam surface 69. The cam follower 70 is supported on bracket 71 so as to open switch 72 when the follower is in position over the restricted portion 68 of the cam shaft. Contact of the cam follower 70 with the cam surface 69 closes switch 72 and thus actuates the seriograph and X-ray apparatus. The striking plate 73 is located at the end of the slidable cam shaft 67 and contains a pointer 74 at its lowermost end so that the apparatus may be positioned at any position along the calibrated plunger shaft 29. Upon contact of the flange 31 of the plunger shaft with the striking plate 73, the switch 72 is closed by reason of the contact of the cam follower 70 with the cam surface 69, thus energizing the seriograph and X-ray apparatus to produce multiple exposures.

It will be noted in the embodiment illustrated in FIG. 5 that the striking plate 73 has been set to be contacted by the flange 31 of the plunger shaft after about 10 cc. of fluid has been injected. In other words, the plunger will have moved from its position to the point indicated by the pointer 74 prior to the closing of switch 72 to actuate the seriograph. This offers certain advantages in that it is sometimes desirable to start the exposure an instant or two after the initial injection to enable the bolus of injectable material to reach the desired area of the vascular system. Thus, for example, if the injection were in the brachial artery, it would require more time for the fluid to reach the carotid artery than it would to reach the area of the subclavian artery. Thus, with the movable switching arrangement whereby the entire housing can be moved to actuate the switch at any desired point after injection of any desired amount of contrast material, it is possible for the operator to have precise control over the manner of exposure required for a particular radiological examination. It will be noted that the striking plate 73 fits into the recess 63 of stop plate 62 when the plunger assembly has gone the limited stroke.

Operation In the operation of the device, it is first necessary to load the previously sterilized syringe. This is accomplished by placing the

flange members

31 and 38 into abutment and thereafter moving the crank to place the movable stop 50 so that the two flange members are located between the first and second

transverse slots

53 and 54, respectively. This is best illustrated in FIG. 6. Thereafter, the

stop plates

55 and 56 are positioned into the transverse slots. The crank is then moved so as to force the plunger head 28 forward to annular shoulder 27. The needle attached to tube 25 is inserted into the contrast material and the crank handle 61 is then turned in the other direction to move the plunger assembly toward the rear and thus draw contrast material into the barrel 18 of the syringe. Normally, the syringe is loaded so the syringe contains about 35 cc. material more than is required for a particular series of injections. The crank handle 61 is then turned in the other direction after the knob 76 of the valve stem 77 is manipulated to open valve opening 78. The plunger assembly is moved forward until contrast material is seen to be coming out of valve opening 78. Thereafter, the knob 76 is turned to seat valve stem 77 on seat valve not shown. Stop plate 56 is then removed and the movable stop 50 is moved until stop plate 55 registers upon the calibration desired for the injection.

It is possible to load the syringe by the use of only one transverse slot and one slidable plate in the movable stop 50. Assuming this slot to be 54 and the plate to be 56 as illustrated in FIG. 6, the abutting

flanges

31 and 38 can be moved forwardly to expel air from the syringe. Thereafter the plate 56 is removed and stop 50 is moved forwardly so that slot 54 is in the position shown in FIG. 5. Plate 56 is then inserted in slot 54 and stop 50 is moved rearwardly to load the syringe. The plate 56 is removed and the stop 50 is moved rearwardly to the position shown in FIG. 6 and the plate 56 is reinserted. The stop 50 is then moved forwardly so that plate 56 pushes the plunger flange 31 and the piston rod flange 38 for wardly until liquid is expelled through needle valve 75. The needle valve is then closed and the plate 56 is again removed and the entire stop 50 is moved forwardly to the point on the calibrated shaft 50 desired for an injection. Plate 56 is inserted into slot 54 and the apparatus is ready for the first injection. It will be noted that, due to the slight angle of the syringe barrel, due to the foot 14 attached to the bottom plate 13, air having a lower density than the contrast material is thus concentrated in the upper end of the syringe barrel or area 26. Thereafter, by moving the plunger head forward, all the air is removed through the needle valve 75 prior to making the first injection. As a safety factor, the injectable material leaves via orifice 21 and tube 22 which is located in the lower portion of the free space 26; therefore, in the event that any entrapped air is still Within the syringe it will be concentrated at the top of free space 26 and thus will not be injected into the patient.

After the stop plate 55 has been accurately placed at the desired point along the calibrated shaft, the gas valve 45 is open and reducing valve 46 is set so that the pressure registering on gauge 48 is about 100 pounds. The needle is then inserted into the artery of the patient. Thereafter, the toggle valve 4-2 is opened and the pressurized gas forces the piston within cylinder 32 forward so that by means of the abutting relationship of piston flange 38 and plunger flange 31, the plunger shaft 30 and plunger head 28 is pushed forward until stopped by stop plate 55. Thus, an injection of any pre-determined size may be made. The toggle valve may be closed at will so that the exhaust pressure orifice is opened some time after the injection is made, so as not to frighten the patient. Should it be desired to make another injection, it is merely necessary to move the movable stop Sil by manipulation of crank 66 to another point on the calibrated shaft and thereafter open toggle valve 42 to make another injection. As previously indicated, it is possible to use stop plate 62 rather than stop plate 55 and to set the housing 65 at any desired point along rod members 64. Therefore, the striking plate 73 can be set so as to be contacted after initial injection of cc. of material has been made, the stop plate 62 serving to stop the full stroke of the plunger in the manner previously indicated. It is thus possible to make a series of inject-ions within a matter of seconds, each injection being of predetermined size and to synchronize the seriograph and X-ray apparatus to start the exposures at any pre-determined point during the course of the injection.

Many modifications will appear to those skilled in the art from the foregoing detailed description, which is intended to be illustrative and not limiting, except so as to be commensurate in scope with the appended claims.

What is claimed is:

1. A power-driven medical apparatus, adapted for use in percutaneous non-catheter angiography, which comprises;

(a) a frame;

(b) a diagnostic medical syringe mounted on said frame and including:

(i) a barrel having an outlet orifice and including a plunger assembly slidably mounted for axial reciprocation therein;

(ii) said plunger assembly comprising a head portion and a shaft in which one end of said shaft is connected to said head portion, and the other end of the shaft extends outside of said barrel;

e) a cylinder including a piston assembly slidably mounted for axial reciprocation in said cylinder and a gas orifice;

(i) said piston assembly including a head portion and a rod in which the rod is connected to said head portion at one end with the free end extending outside of said cylinder, said free end being positioned in operative relation with the shaft of said plunger assembly to drive same;

(d) a source of compressed gas connected to said gas orifice and valve means for controlling the flow of gas to said orifice; and

(e) a movable stop mounted for axial movement on said frame to physically stop the full stroke of the piston rod and plunger assembly, so that by movement of said stop, sequential injections can be made without reloading the syringe.

2. A power-driven medical apparatus, adapted for use in percutaneous non-catheter angiography, which comprises;

(a) a frame;

(b) a diagnostic medical syringe mounted on said frame and including;

(i) a barrel having an outlet orifice and containing a plunger assembly slidably mounted for axial reciprocation therein,

(ii) said plunger assembly comprising a head portion and a shaft in which one end of said shaft is connected to said head portion and the other end of the shaft extends outside of said barrel;

(c) a cylinder, including a piston assembly slidably mounted for axial reciprocation in said cylinder and a gas orifice,

(d) a source of compressed gas connected to said gas orifice and valve means for controlling the flow of gas to said gas orifice;

(e) a calibrated means to measure the amount of liquid in said syringe; and

(f) a movable stop mounted for axial movement on said frame in visual relation to said calibrated means to physically stop the full stroke of the piston rod and plunger assembly so that by movement of said stop, sequential injections of predetermined size can be made Without reloading the syringe.

3. A power-driven medical apparatus adapted for use in percutaneous non-catheter angiography, which comprises;

'(a) a frame, said frame comprising a front plate member and a back plate member and side rail members;

(b) a diagnostic medical syringe mounted on said frame and including:

(0) a cylinder including a piston assembly slidably mounted for axial reciprocation in said cylinder and a gas orifice,

(i) said piston assembly, including a head portion and a rod in which the rod is connected to said head portion at one end with the free end extending outside of said cylinder, said free end being positioned in operative relation with the shaft of said plunger assembly to drive same;

(e) a movable stop mounted on said rail members for axial movement thereon, to physically stop the full stroke of the piston rod and plunger assembly, so that by movement of said stop, sequential injections can be made without reloading the syringe.

4. A power-driven medical apparatus adapted for use in percutaneous non-catheter angiography, which comprises;

(a) a frame, said frame comprising a front plate member, an intermediate transverse plate member, and a rear plate member in which said front plate member and said intermediate plate member contain cradling slots;

(b) a diagnostic medical syringe detachably cradled in said slots of said front and intermediate transverse plate members, which comprises;

(c) a cylinder including a piston assembly slidably mounted for axial reciprocation in said cylinder and a gas orifice,

(i) said piston assembly, including a head portion and a rod in which the rod is connected to said head portion at one end, with the free end extending outside of said cylinder, said free end being positioned in operative relation with the shaft of said plunger assembly to drive same;

(e) a movable stop mounted for axial movement on said frame to physically stop the full stroke of the piston rod and plunger assembly, so that by movement of said stop, sequential injections can be made wit-bout reloading the syringe.

5. A pressure medical injector adapted for use for injecting radio-opaque liquid in the technique of angiography, which comprises;

(a) a frame,

(b) a diagnostic medical syringe, including a barrel having a plunger assembly slidably mounted therein for axial reciprocation,

(i) said barrel being mounted in said frame so that the front portion of the barrel is slightly elevated over the rear portion of the barrel,

(ii) said bar-rel having an escape valve mounted on the top and at the front thereof, which communicates with the inside of the barrel,

(iii) said barrel having an outlet orifice in the front thereof, said orifice being located in the lower portion of the front of said barrel,

(iv) said barrel being constricted on its internal surface near the front end, so as to physically prevent the plunger assembly going full stroke; and

(c) power means adapted to propel the plunger axially, whereby liquid contained in said barrel may be ejected under pressure.

6. A power driven medical apparatus as defined in claim 1, in which:

(a) said free end of said plunger shaft and said free end of said piston rod each contain flange members, adapted to fit in abutting relation;

(b) said movable stop comprises a block having an opening in the center through which the piston rod and the shaft of the plunger can move and which contains:

(1) two transverse slots, and

(2) two plates slidably positioned in said slots to engage with the flange members of said plunger shaft and said piston rod; and

(c) means for moving said block axially in either direction so as to extend the shaft of said plunger and retract the rod of said piston to load the syringe and thereafter to move the entire stop forward to expel air from the syringe.

7. A power driven medical apparatus as defined in claim 1, in which:

(a) said movable stop contains an opening in the center through which the piston rod and the shaft of the plunger can move and which contains at least one transverse slot;

(b) the further combination therewith of a switch and a switch actuating mechanism;

(1) said switch actuating mechanism comprising;

(a) a plate slidably positioned in said slot;

(b) an adjustable cam shaft extending through said plate, said cam shaft being responsive to the movement of said piston rod and plunger shaft; and

(c) a cam follower mounted in operative relation with said switch and said cam shaft;

(d) so that movement of said piston rod and plunger shaft moves said cam shaft and said cam follower follows the surface of said cam shaft to actuate said switch.

8. A power driven medical apparatus as defined in claim 1, in which:

(a) said movable stop comprises a block having an opening in the center through which the piston rod and the shaft of the plunger can move,

(1) said block containing a transverse slot;

(b) a plate slidably positioned in said slot and engageable with said piston rod and said shaft of said plunger to limit the stroke of each; and

(c) means for moving said block axially in either direction along said frame.

9. A pressure medical injector as defined in claim 5,

in which:

(a) said outlet orifice comprises a hollow tubular member which projects into said barrel,

(1) said tubular member being closed at the end located inside the barrel and containing an orifice near the closed end and on the underside thereof.

References Cited by the Examiner UNITED STATES PATENTS 2,602,446 7/1952 Glass et al. l282l8 2,734,504 2/1956 Crescas et al l282l8 2,896,621 7/1959 Rodrigues l282l8 3,156,236 10/1964 Williamson 1282.05

References Cited by the Applicant UNITED STATES PATENTS 2,865,371 12/1958 N. Dorbecker et al.

ROBERT E. MORGAN, Acting Primary Examiner. SIMON BRODER, Examiner.

Claims

1. A POWER-DRIVEN MEDICAL APPARATUS, ADAPTED FOR USE IN PERCUTANEOUS NON-CATHETER ANGIOGRAPHY, WHICH COMPRISES; (A) A FRAME; (B) A DIAGNOSTIC MEDICAL SYRINGE MOUNTED ON SAID FRAME AND INCLUDING: (I) A BARREL HAVING AN OUTLET ORIFICE AND INCLUDING A PLUNGER ASSEMBLY SLIDABLY MOUNTED FOR AXIAL RECIPROCATION THEREIN; (II) SAID PLUNGER ASSEMBLY COMPRISING A HEAD PORTION AND A SHAFT IN WHICH ONE END OF SAID SHAFT IS CONNECTED TO SAID HEAD PORTION, AND THE OTHER END OF THE SHAFT EXTENDS OUTSIDE OF SAID BARREL; (C) A CYLINDER INCLUDING A PISTON ASSEMBLY SLIDABLY MOUNTED FOR AXIAL RECIPROCATION IN SAID CYLINDER AND A GAS ORIFICE;