Inferior vena cava interruption with the hunter-sessions balloon: Eighteen years' experience in 191 cases James A. Hunter, MD, Giacomo A. DeLaria, MD,

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Presentation transcript:

Inferior vena cava interruption with the hunter-sessions balloon: Eighteen years' experience in 191 cases James A. Hunter, MD, Giacomo A. DeLaria, MD, Marshall D. Goldin, MD, Cyrus Serry, MD, David O. Monson, MD, Michael J. DaValle, MD, Hassan Najafi, MD Journal of Vascular Surgery Volume 10, Issue 4, Pages 450-456 (October 1989) DOI: 10.1016/0741-5214(89)90420-5 Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 1 Diagram of Hunter-Sessions device for IVC interruption. The handle bears stopcocks for heparin (H) infusion, venography (V), and balloon inflation (B). The 6.3 mm diameter inserting catheter is 75 cm long. The extraction wheel on the handle withdraws the inflation needle from the balloon separating it. Journal of Vascular Surgery 1989 10, 450-456DOI: (10.1016/0741-5214(89)90420-5) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 2 A venogram obtained before balloon separation proves proper position. The elongated balloon is wider than the vena cava above and is immobile when traction is placed on the inserting catheter. The balloon is positioned with a segment of undistended vena cava between it and the renal veins. Journal of Vascular Surgery 1989 10, 450-456DOI: (10.1016/0741-5214(89)90420-5) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 3 Diagram shows detail of the side stopcocks (V and H) and their continuity with the venogram ports via the inserting catheter. Stopcock at the end of handle (B) distends balloon via the inflation needle. Top diagram shows device as supplied and ready for balloon inflation. Lower diagram shows detail of how the inflation needle is withdrawn from the (inflated) balloon by turning the extraction wheel. Journal of Vascular Surgery 1989 10, 450-456DOI: (10.1016/0741-5214(89)90420-5) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions

Fig. 4 Diagrams show the catheter-balloon junction with structural detail revealing how balloon is inflated, released, and balloon contents retained. Top, shows catheter-balloon assembly with the inflation needle (a) in balloon core and holding primary (b) and secondary (c) valves in open position. Balloon (d) can be inflated. Inflation needle flares collet (e), which locks catheter tip (f) to the balloon. Bottom, shows catheter-balloon assembly with the inflation needle (a) withdrawn from the balloon core. Spring (g) forces primary and secondary valves (b and c) to close, retaining balloon contents. When the inflation needle is withdrawn, the collet (e) is no longer held in the expanded position and the balloon is detached. Journal of Vascular Surgery 1989 10, 450-456DOI: (10.1016/0741-5214(89)90420-5) Copyright © 1989 Society for Vascular Surgery and International Society for Cardiovascular Surgery, North American Chapter Terms and Conditions