Abstract:
There is provided a connector for coupling to a guiding catheter including a housing defining a conduit communicating with the interior of the guiding catheter, the housing including first and second housing portions which are manually positionable in various relative mutual axial orientations, a selectably openable normally closed valve associated with the conduit for selectable sealing thereof, the selectably openable valve having an open state, a closed state and at least one partially open state realized by suitable relative mutual axial orientation of the first and second housing portions and permitting at least one elongate element to extend therethrough, even when the valve is, in the closed state, the selectably openable valve including a spring which urges the valve towards the closed state and an automatically engageable and manually disengageable valve state governing mechanism operative for automatically retaining the valve in, a state other than the closed state against the urging of the spring.

Description:
FIELD OF THE INVENTION  
       [0001]     The present invention relates to catheter devices generally.  
       BACKGROUND OF THE INVENTION  
       [0002]     The following U.S. patents are believed to represent the current state of the art: U.S. Pat. Nos. 6,817,995; 6,562,023; 6,488,674; 6,254,589; 6,190,372; 5,993,437; 5,667,490; 5,632,729; 5,562,618; 5,531,723; 5,290,277; 5,188,607; 4,950,255 and 4,769,017.  
       SUMMARY OF THE INVENTION  
       [0003]     The present invention seeks to provide an improved catheter connection device.  
         [0004]     There is thus provided in accordance with a preferred embodiment of the present invention a connector for coupling to a guiding catheter including a housing defining a conduit communicating with the interior of the guiding catheter, the housing including first and second housing portions which are manually positionable in various relative mutual axial orientations, a selectably openable normally closed valve associated with the conduit for selectable sealing thereof, the selectably openable valve having an open state, a closed state and at least one partially open state realized by suitable relative mutual axial orientation of the first and second housing portions and permitting at least one elongate element to extend therethrough, even when the valve is in the closed state, the selectably openable valve including a spring which urges the valve towards the closed state and an automatically engageable and manually disengageable valve state governing mechanism operative for automatically retaining the valve in a state other than the closed state against the urging of the spring.  
         [0005]     In accordance with a preferred embodiment of the present invention the valve includes an elastomeric element having at least one slit therethrough. Additionally or alternatively, the connector includes at least one selectable retainer for selectably retaining the at least one elongate element against sliding motion relative to at least one of the first and second housing portions.  
         [0006]     In accordance with another preferred embodiment of the present invention the automatically engageable and manually disengageable valve state governing mechanism is operative for fully closing the valve in a single stage operation of a user. Additionally or alternatively, the automatically engageable and manually disengageable valve state governing mechanism includes an engagement arm formed on the second housing element and having formed thereon a tooth and a serrated surface associated with the first housing element for engagement with the tooth.  
         [0007]     There is also provided in accordance with another preferred embodiment of the present invention a connector for coupling to a guiding catheter including a housing defining a conduit communicating with the interior of the guiding catheter, the housing including first and second housing portions which are manually positionable in various relative mutual axial orientations, a selectably openable normally closed valve associated with the conduit for selectable sealing thereof, the selectably openable valve having an open state, a closed state and at least one partially open state realized by suitable relative mutual axial orientation of the first and second housing portions and permitting at least one elongate element to extend therethrough, even when the valve is in the closed state and a selectable retainer for selectably retaining the at least one elongate element against sliding motion relative to at least one of the first and second housing portions.  
         [0008]     In accordance with a preferred embodiment of the present invention the selectable retainer is fixedly mounted onto the first housing portion. Alternatively, the selectable retainer is fixedly mounted onto the second housing portion. Preferably, the selectable retainer includes a manually operable locking mechanism for locking the at least one elongate element thereto.  
         [0009]     In accordance with another preferred embodiment of the present invention the valve includes an elastomeric element having at least one slit therethrough. Preferably, the at least one selectable retainer includes at least one notch. Additionally or alternatively, the at least one selectable retainer includes at least one slot.  
         [0010]     In accordance with a further preferred embodiment of the present invention the at least one selectable retainer includes at least one slot which is rotationally offset from the at least one notch. Preferably, the at least one elongate element includes at least first and second elongate elements, such that the first elongate element is retained in the at least one notch and is maintained separated from the second elongate element which is retained in the at least one slot. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0011]     The present invention will be understood and appreciated more fully from the following detailed description, taken in conjunction with the drawings in which:.  
         [0012]      FIG. 1  is a simplified exploded view illustration of a catheter connection device constructed and operative in accordance with a preferred embodiment of the present invention;  
         [0013]      FIGS. 2A and 2B  are simplified respective rearward facing and forward facing pictorial illustrations of a rear housing element which forms part of the catheter connection device of  FIG. 1 ;  
         [0014]      FIGS. 3A and 3B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines IIIA-IIIA in  FIG. 2A ;  
         [0015]      FIGS. 4A and 4B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines IVA-IVA in  FIG. 2B ;  
         [0016]      FIGS. 5A and 5B  are simplified respective rearward facing and forward facing pictorial illustrations of an intermediate element which forms part of the catheter connection device of  FIG. 1 ;  
         [0017]      FIGS. 6A and 6B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines VIA-VIA in  FIG. 5A ;  
         [0018]      FIGS. 7A and 7B  are, respectively, a simplified pictorial illustration and a simplified sectional illustration of a branched connector which forms part of the catheter connection device of  FIG. 1 , the sectional illustration being taken along section lines VIIB-VIIB in  FIG. 7A ;  
         [0019]      FIGS. 8A and 8B  are rearward facing and forward facing pictorial view illustrations of the preferred embodiment of the catheter connection device of  FIG. 1 ;  
         [0020]      FIGS. 9A, 9B  and  9 C are simplified sectional illustrations of the catheter connection device of  FIGS. 8A and 8B  in various operative orientations, which are taken along respective section lines IXA-IXA in  FIG. 8A ;  
         [0021]      FIG. 10  is a simplified exploded view illustration of a catheter connection device constructed and operative in accordance with another preferred embodiment of the present invention;  
         [0022]      FIGS. 11A and 11B  are simplified respective rearward facing and forward facing pictorial illustrations of a rear housing element which forms part of the catheter connection device of  FIG. 10 ;  
         [0023]      FIGS. 12A and 12B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines XIIA-XIIA in  FIG. 11A ;  
         [0024]      FIGS. 13A and 13B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines XIIIA-XIIIA in  FIG. 11B ;  
         [0025]      FIGS. 14A and 14B  are simplified respective rearward facing and forward facing pictorial illustrations of an intermediate element which forms part of the catheter connection device of  FIG. 10 ;  
         [0026]      FIGS. 15A and 15B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines XVA-XVA in  FIG. 14A ;  
         [0027]      FIGS. 16A and 16B  are, respectively, a simplified pictorial illustration and a simplified sectional illustration of a branched connector which forms part of the catheter connection device of  FIG. 10 , the sectional illustration being taken along section lines XVIB-XVIB in  FIG. 16A ;  
         [0028]      FIGS. 17A, 17B  and  17 C are partially cutout partially pictorial illustrations of the preferred embodiment of the catheter connection device of  FIG. 10  in various operative orientations;  
         [0029]      FIG. 18  is a simplified exploded view illustration of a catheter connection device constructed and operative in accordance with yet another preferred embodiment of the present invention;  
         [0030]      FIGS. 19A and 19B  are simplified respective rearward facing and forward facing pictorial illustrations of a rear housing element which forms part of the catheter connection device of  FIG. 18 ;  
         [0031]      FIGS. 20A and 20B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines XXA-XXA in  FIG. 19A ;  
         [0032]      FIGS. 21A and 21B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines XXIA-XXIA in  FIG. 19B ;  
         [0033]      FIGS. 22A and 22B  are simplified pictorial illustrations of an intermediate element which forms part of the catheter connection device of  FIG. 18 ;  
         [0034]      FIGS. 23A and 23B  are, respectively, a simplified pictorial sectional illustration and a simplified sectional illustration taken along section lines XXIIIA-XXIIIA in  FIG. 22A ;  
         [0035]      FIGS. 24A and 24B  are, respectively, a simplified pictorial illustration and a simplified sectional illustration of a branched connector which forms part of the catheter connection device of  FIG. 18 , the sectional illustration being taken along section lines XXIVB-XXIVB in  FIG. 24A ;  
         [0036]      FIGS. 25A and 25B  are simplified respective top view and side view planar illustrations of the branched connector of  FIGS. 24A and 24B ;  
         [0037]      FIGS. 26A, 26B  and  26 C are partially cutout partially pictorial illustrations of the preferred embodiment of the catheter connection device of  FIG. 18  in various operative orientations.  
     
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS  
       [0038]     Reference is now made to  FIGS. 1-9C , which illustrate a catheter connection device constructed and operative in accordance with a preferred embodiment of the present invention. Turning to  FIG. 1 , it is seen that the catheter connection device comprises a rear housing element  10 , inside of which is located a spring  12 , such as a coil spring, an intermediate element  20  and an elastomeric element  22 , in the shape of a disc portion  24  and having a forward facing cross-shaped protrusion  26  integrally formed therewith and centered thereon. Cross-shaped protrusion  26  is formed with a throughgoing slit  28  and disk portion  24  is formed with a halfway going slit, positioned at a 90 degree angle with respect to slit  28 . Mounted on intermediate element  20  is a branched connector  30 , onto a forward end of which is mounted a tube connector assembly, such as catalog number 590205 which is commercially available from ELCAM MEDICAL AGRICULTURAL COOPERATIVE ASSOCIATION LTD of Kibbutz Baram, Israel.  
         [0039]     Reference is now made to  FIGS. 2A-4B , which illustrate the rear housing element  10 . As seen in  FIGS. 2A-4B , the rear housing element  10  comprises a generally cylindrical rearward facing portion  102  having formed therein a pair of notches  104  mutually separated by 180 degrees and a pair of elongate slots  106 , mutually separated by 180 degrees and offset from the notches  104  by 90 degrees. Alternatively, any other suitable offset angle may be provided between notches  104  and slots  106 .  
         [0040]     Positioned at each of slots  106  is a clamp  108 , which includes an outer bridge portion  110 , which spans the slot  106  at an rearward facing edge  112  of rearward facing portion  102 , and an arm portion  114 , which partially spans the slot  106  at rearward facing edge  112  and has a free end  116 .  
         [0041]     Integrally formed with rearward facing portion  102  is a forward facing portion  122  which includes a tapered section  124  followed by a generally cylindrical section  126 . A plurality of mutually spaced, generally parallel radially outward facing rings  128  are formed at or near outer surfaces of tapered section  124  and generally cylindrical section  126  for improving grip of the catheter connection device by the user. Alternatively, the rings  128  may be obviated. A bulkhead  130  is defined between rearward facing portion  102  and forward facing portion  122  and is formed with a central aperture  132  which communicates between the interior of the rearward facing portion  102  and a forward facing generally cylindrical conduit  134 , which is centered within tapered section  124  and generally cylindrical section  126 . Forward facing generally cylindrical conduit  134  includes a main portion  136  and a forward facing tapered portion  138 . A forward-facing ring  140  is formed on bulkhead  130 , symmetrically about forward facing generally cylindrical conduit  134  and defines a seat for spring  12  ( FIG. 1 ).  
         [0042]     Formed on forward facing generally cylindrical section  126  is a pair of elongate slots  146 , which are typically mutually separated by 180 degrees and which may be circumferentially aligned with notches  104 . Disposed forwardly of and aligned with elongate slots  146  there are preferably formed inwardly and forwardly facing tapered recesses  148 .  
         [0043]     Formed on a radially outward surface of forward facing generally cylindrical section  126  is a ridge  150  having a serrated surface  152  on one side wall thereof. Ridge  150  may be circumferentially separated from elongate slots  146  by  90  degrees.  
         [0044]     Reference is now made to  FIGS. 5A-6B , which illustrate the intermediate element  20 . As seen in  FIGS. 5A-6B , intermediate element  20  comprises a rearward facing, generally cylindrical portion  200 , which is arranged to be disposed about forward facing generally cylindrical conduit  134  of the rear housing element  10  ( FIGS. 2A-4B ), and about which spring  12  ( FIG. 1 ) is disposed.  
         [0045]     Integrally formed with rearward facing portion  200  is a forward facing cylindrical portion  202 , including a forward facing surface  203 . A bulkhead  204  is defined between rearward facing portion  200  and forward facing cylindrical portion  202  and is formed with a central aperture  206  which communicates therebetween. Forward facing cylindrical portion  202  is formed with a pair of radially outwardly extending protrusions  208 . The interior surface of forward facing cylindrical portion  202  includes a relatively narrower rear portion  210  in which elastomeric element  22  ( FIG. 1 ) is seated, and communicating with a relatively wider forward portion  212 .  
         [0046]     Reference is now made to  FIGS. 7A &amp; 7B , which illustrate the branched connector  30 . As seen in  FIGS. 7A &amp; 7B , the branched connector  30  comprises a generally cylindrical rear portion  300  having a rearward facing surface  301  and a flange  302 . Rear portion  300  is arranged to be seated within forward portion  212  of intermediate element  20  ( FIGS. 5A-6B ). Communicating with the interior of rear portion  300  is a generally cylindrical conduit  304 , having a main portion  306  and a forward facing conical portion  308 . Communicating with main portion  306 , is a branch conduit  310 .  
         [0047]     Integrally formed with an outer surface of the branched connector  30  is a ratchet engagement arm  320  having a sideways facing outwardly extending tooth  322  for selectable engagement with serrated surface  152  of ridge  150  formed on rear housing element  10  ( FIGS. 2A-3B ). Ratchet engagement arm  320  is integrally formed with a finger engagement extension  324 , which has a radially inwardly extending protrusion  326  formed on an underside thereof, to act as a stop and thus to limit radially outward positioning of tooth  322 . Ratchet engagement arm  320  and finger engagement extension  324  are together mounted onto main portion  306  by an integrally formed flexible connection  328 .  
         [0048]     Reference is now made to  FIGS. 8A and 8B , which are rearward facing and forward facing pictorial illustration of the catheter connection device of  FIG. 1  and to  FIGS. 9A, 9B  and  9 C which are simplified sectional illustrations of the catheter connection device of  FIGS. 8A and 8B  in various operative orientations, which are taken along respective section lines IXA-IXA in  FIG. 8A .  
         [0049]     Turning to  FIG. 9A , the catheter connection device is shown in a closed operative orientation which is suitable for storage. In this orientation, cylindrical conduit  134  of rear housing element  10  is disposed within rearward facing portion  200  of intermediate element  20 , and forward facing portion  202  of intermediate element  20  is disposed within cylindrical portion  126  of forward facing portion  122  of rear housing element  10 . Protrusions  208  formed on forward facing cylindrical portion  202  (not shown) slidingly engage elongate slots  146  formed in cylindrical section  126  of rear housing element  10  (not shown). Spring  12  is preferably disposed about cylindrical conduit  134  of rear housing element  10  and rearward facing portion  200  of intermediate element  20 .  
         [0050]     Elastomeric element  22  is seated within forward portion  202  of intermediate element  20 , against bulkhead  204 . As seen clearly in  FIG. 9A , in this operative orientation slit  28  is closed.  
         [0051]     Rear portion  300  of branched connector  30  is seated in forward portion  202  of intermediate element  20 , such that surface  203  thereof engages a rearward facing surface of flange  302  of branched connector  30 , thus maintaining intermediate element  20  in place. Rearward facing surface  301  of rear portion  300  of branched connector  30  preferably engages disk portion  24  of elastomeric element  22 , thus maintaining the elastomeric element in place.  
         [0052]     Conical portion  308  of conduit  304  of branched connector  30  is disposed within a cylindrical portion of tube connector assembly  40 .  
         [0053]     Turning now to  FIG. 9B , the catheter connection device is shown in a partially open operative orientation which is suitable for insertion of a narrow tube or guide wire  500  therethrough. In this orientation, branched connector  30  is rearwardly displaced, such that tooth  322  formed on ratchet arm  320  slides along serrated surface  152  of ridge  150  of rear housing element  10 , stopping at a generally central part thereof.  
         [0054]     Forward displacement of rear housing element  10  relative to branched connector  30  causes relative rearward displacement of intermediate element  20  within rear housing element  10 , which is accompanied by relative rearward displacement of protrusions  208  within elongate slots  146  (Not shown). The relative rearward displacement of intermediate element  20  causes spring  12  to be partially-axially compressed.  
         [0055]     Elastomeric element  22 , which is seated between branched connector  30  and intermediate element  20 , is relatively rearwardly displaced together with branched connector  30 . Relative rearward displacement of elastomeric element  22  causes forward facing tapering portion  138  of cylindrical conduit  134  to partially extend through slit  28 , thus creating a narrow passage between the rear end of the catheter connector device and the forward end thereof.  
         [0056]     As seen in  FIG. 9B , the narrow tube  500  may be inserted from the rear end of the catheter connector device to the forward end thereof via cylindrical conduit  134 , slit  28 , cylindrical conduit  304 , and tube connector assembly  40 . As shown clearly in  FIG. 9B , once the narrow tube  500  is inserted through the catheter connector device, it may be engaged and retained in one of notches  104  formed in rearward facing portion  102 , thus preventing axial movement of the tube  500  relative to rear housing element  10  and branched connector  30 . Additionally, since the slit  28  is not fully opened, blood leakage is at least partially prevented.  
         [0057]     Turning now to  FIG. 9C , the catheter connection device is shown in an open operative orientation which is suitable for insertion of a tube  502  or a balloon catheter thereinto. In this orientation, branched connector  30  is further rearwardly displaced, such that tooth  322  formed on ratchet arm  320  slides along serrated surface  152  of ridge  150  of rear housing element  10 , engaging the rearward portion thereof.  
         [0058]     Relative rearward displacement of branched connector  30  causes rearward displacement of intermediate element  20  within rear housing element  10 , which is accompanied with rearward displacement of protrusions  208  within elongate slots  146 . The rearward displacement is limited by the engagement of protrusions  208  with the rearward facing surfaces of slots  146  (not shown). The rearward displacement of intermediate element  20  causes spring  12  to compress.  
         [0059]     Elastomeric element  22 , which is seated between branched connector  30  and intermediate element  20 , is rearwardly displaced together with branched connector  30 . Rearward displacement of elastomeric element  22  causes forward facing tapering portion  138  of cylindrical conduit  134  to fully extend through slit  28  of protrusion  26 , thus creating a wide passageway through the catheter connector device.  
         [0060]     As seen in  FIG. 9C , a plurality of tubes  500  and  502  may be inserted from the rear end of the catheter connector device to the forward end thereof via cylindrical conduit  134 , slit  28 , cylindrical conduit  304 , and tube connector assembly  40 . As shown clearly in  FIG. 9C , once the tubes  500  and  502  are inserted through the catheter connector device, at least one tube may be engaged and retained in one of notches  104  formed in rearward facing portion  102 , thus preventing axial movement of the tube relative to rear housing element  10  and branched connector  30 . Alternatively or additionally, at least one tube may be clamped by clamps  108 , such that axial movement is enabled. The 90-degree separation of notches  104  and clamps  108  retains the tubes inserted through the catheter connector device in separate locations such that they do not get tangled.  
         [0061]     It is appreciated that the catheter connector device may be manually returned to the closed orientation of  FIG. 9A  by a user pressing finger engagement extension  324  of ratchet engagement arm  320 , thus releasing tooth  322  from serrated surface  152  of ridge  150 . When the engagement between branched connector  30  and rear housing element  10  is released, spring  12  is released and returns to its extended rest position, thus forwardly displacing intermediate element  20 , elastomeric element  22  and branched connector  30 . It is appreciated that pressing the finger engagement extension  324  of the ratchet engagement arm  320  fully releases tooth  322 , such that the tooth cannot get caught again in a manner that the catheter connector device is in a partially closed orientation.  
         [0062]     It is appreciated that at the end of the catheterization and following removal of tubing and/or wires, forward displacement of the branched connector  30  releases the elastomeric element  22  thus allowing the elastomeric element  22  to return to its closed position by virtue of its elastomeric properties.  
         [0063]     Reference is now made to  FIGS. 10-17C , which illustrate a catheter connection device constructed and operative in accordance with another preferred embodiment of the present invention. Turning to  FIG. 10 , it is seen that the catheter connection device comprises a rear housing element  1010 , inside of which is located a spring  1012 , such as a coil spring, an intermediate element  1020  and an elastomeric element  1022 , in the shape of a disc portion  1024  and a forward facing cross-shaped protrusion  1026  integrally formed therewith and centered thereon. Cross-shaped protrusion  1026  is formed with a throughgoing slit  1028  and disk portion  1024  is formed with a partial slit, positioned at a 90 degree angle with respect to slit  1028 . Mounted on intermediate element  1020  is a branched connector  1030 , onto a forward end of which is mounted a tube connector assembly  1040 , such as catalog number 590205 which is commercially available from ELCAM MEDICAL AGRICULTURAL COOPERATIVE ASSOCIATION LTD of Kibbutz Baram, Israel.  
         [0064]     Reference is now made to  FIGS. 11A-13B , which illustrate the rear housing element  1010 . As seen in  FIGS. 12A-13B , the rear housing element  1010  comprises a main portion  1122  which includes a tapered section  1124  followed by a generally cylindrical section  1126 . A plurality of mutually spaced, generally parallel radially outward facing rings  1128  are formed at or near outer surfaces of tapered section  1124  and generally cylindrical section  1126  for improving the grip of the catheter connector device by the user. It is appreciated that rings  1128  may be obviated.  
         [0065]     Main portion  1122  terminates at a rearward end thereof in a wall portion  1130 , which is formed with a central aperture  1132 . Two generally concave slots  1133  are defined in wall portion  1130 , surrounding aperture  1132 . A forward facing generally cylindrical conduit  1134 , which is centered within tapered section  1124  and generally cylindrical section  1126 , extends forwardly of wall portion  1130  in fluid flow connection with central aperture  1132 . Forward facing generally cylindrical conduit  1134  includes a main portion  1136  and a forward facing tapered portion  1138 . A forward-facing ring  1140  is formed on wall portion  1130 , symmetrically about forward facing generally cylindrical conduit  1134  and defines a seat for spring  1012  ( FIG. 10 ).  
         [0066]     Formed on forward facing generally cylindrical section  1126  is a pair of elongate slots.  1146 , which are typically mutually separated by 180 degrees. Disposed forwardly of and aligned with elongate slots  1146  there are preferably formed inwardly and forwardly facing tapered recesses  1148 .  
         [0067]     Formed on a radially outward surface of forward facing generally cylindrical section  1126  is a ridge  1150  having a serrated surface  1152  on one side wall thereof. Ridge  1150  may be circumferentially separated from elongate slots  1146  by 90 degrees.  
         [0068]     Reference is now made to  FIGS. 14A-15B , which illustrate the intermediate element  1020 . As seen in  FIGS. 14A-15B , intermediate element  1020  comprises a rearward facing, generally cylindrical portion  1200 . Integrally formed with rearward facing portion  1200  is a forward facing cylindrical portion  1202  including a forward facing surface  1203 . A bulkhead  1204  is defined between rearward facing portion  1200  and forward facing cylindrical portion  1202  and is formed with a central aperture  1206  which communicates therebetween.  
         [0069]     Forward facing cylindrical portion  1202  is formed with a pair of radially outwardly extending protrusions  1208 . The interior surface of forward facing cylindrical portion  1202  includes a relatively narrower rear portion  1210  in which elastomeric element  1022  is seated, and communicating with a relatively wider forward portion  1212 .  
         [0070]     Extending rearwardly of rearward facing cylindrical portion  1200 , are two generally concave wall portions  1220 , separated by slots  1224 . Wall portions  1220  have formed therein a pair of notches  1226  mutually separated by 180 degrees. The slots  1224  are offset from notches  1226  by 90 degrees.  
         [0071]     Rearward facing ends of concave wall portions  1220  are adapted to be seated in slots  1133  about main portion  1136  of forward facing generally cylindrical conduit  1134  of the rear housing element  1010 , and forward facing ends of concave wall portions  1220  and rearward facing cylindrical portion  1200  are arranged to be disposed about forward facing tapered portion  1138  of forward facing generally cylindrical conduit  1134  of the rear housing element  1010  ( FIGS. 11A-13B ). Spring  1012  ( FIG. 10 ) is disposed about an outer surface of concave wall portions  1220  and rearward facing cylindrical portion  1200 .  
         [0072]     Reference is now made to  FIGS. 16A &amp; 16B , which illustrate the branched connector  1030 . As seen in  FIGS. 16A &amp; 16B , the branched connector  1030  comprises a generally cylindrical rear portion  1300  having a rearward facing surface  1301  and a flange  1302 . Rear portion  1300  is arranged to be seated within forward portion  1212  of intermediate element  1020  ( FIGS. 14A-15B ). Communicating with the interior of rear portion  1300  is a generally cylindrical conduit  1304 , having a main portion  1306  and a forward facing conical conduit  1308 . Communicating with main portion  1306  is a branch conduit  1310 .  
         [0073]     Integrally formed with an outer surface of the branched connector  1030  is a ratchet engagement arm  1320  having a sideways facing outwardly extending tooth  1322  for selectable engagement with serrated surface  1152  of ridge  1150  formed on rear housing element  1010  ( FIGS. 11A-13B ). Ratchet engagement arm  1320  is integrally formed with a finger engagement extension  1324 , which has a radially inwardly extending protrusion  1326  formed on an underside thereof, to act as a stop and thus to limit radially outward positioning of tooth  1322 . Ratchet engagement arm  1320  and finger engagement extension  1324  are together mounted onto main portion  1306  by an integrally formed flexible connection  1328 .  
         [0074]     Reference is now made to  FIGS. 17A, 17B  and  17 C which are simplified sectional illustrations of the catheter connection device of  FIG. 10  in various operative orientations.  
         [0075]     Turning to  FIG. 17A , the catheter connection device is shown in a closed operative orientation which is suitable for storage. In this orientation, cylindrical conduit  1134  of rear housing element  1010  is disposed within rearward facing portion  1200  and concave wall portions  1220  of intermediate element  1020 , and forward facing portion  1202  of intermediate element  1020  is disposed within cylindrical portion  1126  of forward facing portion  1122  of rear housing element  1010 . Protrusions  1208  formed on forward facing cylindrical portion  1202  (not shown) slidingly engage elongate slots  1146  formed in cylindrical section  1126  of rear housing element  1010  (not shown). Spring  1012  is preferably disposed about concave wall portions  1220  and rearward facing portion  1200  of intermediate element  1020 . As described hereinabove, concave wall portions  1220  engage the concave slots  1133  of the rear housing element  1010 .  
         [0076]     Elastomeric element  1022  is seated within forward portion  1202  of intermediate element,  1020 , against bulkhead  1204 . In this operative orientation slit  1028  is closed.  
         [0077]     Rear portion  1300  of branched connector  1030  is seated in forward portion  1202  of intermediate element  1020 , such that surface  1203  thereof engages a rearward facing surface of flange  1302  of branched connector  1030 , thus maintaining intermediate element  1020  in place. Rearward facing surface  1301  of rear portion  1300  of branched connector  1030  preferably engages disk portion  1024  of elastomeric element  1022 , thus maintaining the elastomeric element in place.  
         [0078]     Conical portion  1308  of conduit  1304  of branched connector  1030  is disposed within a cylindrical portion of tube connector assembly  1040 .  
         [0079]     Turning now to  FIG. 17B , the catheter connection device is shown in a partially open operative orientation which is suitable for insertion of a narrow tube or guide wire  1500  therethrough. In this orientation, branched connector  1030  is rearwardly displaced, such that tooth  1322  formed on ratchet arm  1320  slides along serrated surface  1152  of ridge  1150  of rear housing element  1010 , stopping at a generally central part thereof.  
         [0080]     Forward displacement of rear housing element  1010  relative to branched connector  1030  causes relative rearward displacement of intermediate element  1020  within rear housing element  1010 , which is accompanied by relative rearward displacement of protrusions  1208  within elongate slots  1146  (not shown). The relative rearward displacement of intermediate element  1020  causes spring  1012  to be partially-axially compressed.  
         [0081]     Elastomeric element  1022 , which is seated between branched connector  1030  and intermediate element  1020 , is relatively rearwardly displaced together with branched connector  1030 . Relative rearward displacement of elastomeric element  1022  causes forward facing tapering portion  1138  of cylindrical conduit  1134  to partially extend through cross-shaped slit  1028  of protrusion  1026 , thus creating a narrow passage between the rear end of the catheter connector device and the forward end thereof.  
         [0082]     As seen in  FIG. 17B , the narrow tube  1500  may be inserted from the rear end of the catheter connector device to the forward end thereof via cylindrical conduit  1134 , slit  1028 , cylindrical conduit  1304 , and tube connector assembly  1040 . As shown clearly in  FIG. 17B , once the narrow tube  1500  is inserted through the catheter connector device, it may be engaged and retained in one of notches  1226 , thus preventing axial movement of the tube  1500  relative to rear housing element  1010  and branched connector  1030 . Additionally, since the slit  1028  is not fully opened, blood leakage is at least partially prevented.  
         [0083]     Turning now to  FIG. 17C , the catheter connection device is shown in an open operative orientation which is suitable for insertion of a tube or a balloon catheter therethrough. In this orientation, branched connector  1030  is further rearwardly displaced, such that tooth  1322  formed on ratchet arm  1320  slides along serrated surface  1152  of ridge  1150  of rear housing element  1010 , engaging the rearward portion thereof.  
         [0084]     Relative rearward displacement of branched connector  1030  causes rearward displacement of intermediate element  1020  within rear housing element  1010 , which is accompanied by rearward displacement of protrusions  1208  within elongate slots  1146 . The rearward displacement is limited by the engagement of protrusions  1208  with the rearward facing surfaces of slots  1146  (Not shown). The rearward displacement of intermediate element  1020  causes spring  1012  to further compress.  
         [0085]     Elastomeric element  1022 , which is seated between branched connector  1030  and intermediate element  1020 , is rearwardly displaced together with branched connector  1030 . Rearward displacement of elastomeric element  1022  causes forward facing tapering portion  1138  of cylindrical conduit  1134  to fully extend through slit  1028  of protrusion  1026 , thus creating a wide passageway through the catheter connector device.  
         [0086]     As seen in  FIG. 17C , a plurality of tubes  1500  and  1502  may be inserted from the rear end of the catheter connector device to the forward end thereof via cylindrical conduit  1134 , slit  1028 , cylindrical conduit  1304 , and tube connector assembly  1040 . As shown clearly in  FIG. 17C , once the tubes  1500  and  1502  are inserted through the catheter connector device, at least one tube may be engaged and retained in one of notches  1226 , thus preventing axial movement of the tube relative to rear housing element  1010  and branched connector  1030 . Alternatively or additionally, at least one tube may be held in slots  1224 , such that axial movement is enabled. The  90  degree separation of notches  1226  and slots  1224 , retains the tubes inserted through the catheter connector device in separate locations such that they do not get tangled.  
         [0087]     It is appreciated that the catheter connector device may be manually returned to the closed orientation of  FIG. 17A  by a user pressing finger engagement extension  1324  of ratchet engagement arm  1320 , thus releasing tooth  1322  from serrated surface  1152  of ridge  1150 . When the engagement between branched connector  1030  and rear housing element  1010  is released, spring  1012  is released and returns to its fully extended rest position, thus forwardly displacing intermediate element  1020 , elastomeric element  1022  and branched connector  1030 . It is appreciated that pressing the finger engagement extension  1324  of the ratchet engagement arm  1320  fully releases tooth  1322 , such that the tooth cannot get caught again in a manner that the catheter connector device is in a partially closed orientation.  
         [0088]     It is appreciated that at the end of the catheterization and following removal of tubing and/or wires, forward displacement of the branched connector  1030  releases the elastomeric element  1022  thus allowing the elastomeric element  1022  to return to its closed position by virtue of its elastomeric properties.  
         [0089]     Reference is now made to  FIGS. 18-26C , which illustrate a catheter connection device constructed and operative in accordance with yet another preferred embodiment of the present invention. Turning to  FIG. 18 , it is seen that the catheter connection device comprises a rear housing element  2010 , inside of which is located a spring  2012 , such as a coil spring, an intermediate element  2020  and an elastomeric element  2022  in the shape of a disc portion  2024  and a forward facing cross-shaped protrusion  2026  integrally formed therewith and centered thereon. Cross-shaped protrusion  2026  is formed with a throughgoing slit  2028  and disk portion  2024  is formed with a partial slit, positioned at a 90 degree angle with respect to slit  2028 . Mounted on intermediate element  2020  is a branched connector  2030  onto a forward end of which is mounted a tube connector assembly  2040 , such as catalog number 590205 which is commercially available from ELCAM MEDICAL AGRICULTURAL COOPERATIVE ASSOCIATION LTD of Kibbutz Baram, Israel.  
         [0090]     Reference is now made to  FIGS. 19A-21B , which illustrate the rear housing element  2010 . As seen in  FIGS. 19A-21B , the rear housing element  2010  comprises a generally cylindrical main portion  2122  having formed thereon a plurality of mutually spaced, generally parallel radially outward facing rings  2128  for improving the grip of the catheter connector device by the user. Alternatively, the rings  2128  may be obviated.  
         [0091]     Main portion  2122  terminates at a rearward end thereof in a wall portion  2130 , which is formed with a central aperture  2132 . A forward facing generally cylindrical conduit  2134 , which is centered within main portion  2122 , extends forwardly of wall portion  2130  in fluid flow connection with central aperture  2132 . Forward facing generally cylindrical conduit  2134  includes a main portion  2136  and a forward facing tapered portion  2138 . An inner surface  2140  of wall portion  2130  defines a seat for spring  2012  ( FIG. 18 ).  
         [0092]     Formed on main portion  2122  is a pair of elongate slots  2146 , which are typically mutually separated by 180 degrees. Disposed forwardly of and aligned with elongate slots  2146  there are preferably formed inwardly and forwardly facing tapered recesses  2148 .  
         [0093]     Formed on a radially outward surface of forward facing generally cylindrical section  2126  is a ridge  2150  having a serrated surface  2152  on one side wall thereof. Ridge  2150  may be circumferentially separated from elongate slots  2146  by 90 degrees. Disposed forwardly of and aligned with ridge  2150  is preferably formed an elongate generally rectangular cutout portion  2154 .  
         [0094]     Reference is now made to  FIGS. 22A-23B , which illustrate the intermediate element  2020 . As seen in  FIGS. 22A-23B , intermediate element  2020  comprises a rearward facing, generally cylindrical portion  2200 , which is arranged to be disposed about forward facing generally cylindrical conduit  2134  of the rear housing element  2010  ( FIGS. 19A-21B ), and about which spring  2012  is disposed ( FIG. 18 ).  
         [0095]     Integrally formed with rearward facing portion  2200  is a forward facing cylindrical portion  2202  including a forward facing surface  2203 . A bulkhead  2204  is defined between rearward facing portion  2200  and forward facing cylindrical portion  2202  and is formed with a central aperture  2206  which communicates therebetween. Forward facing cylindrical portion  2202  is formed with a pair of radially outwardly extending protrusions  2208 . The interior surface of forward facing cylindrical portion  2202  includes a relatively narrower rear portion  2210  in which elastomeric element  2022  is seated, and communicating with a relatively wider forward portion  2212 .  
         [0096]     Reference is now made to  FIGS. 24A-25B , which illustrate the branched connector  2030 . As seen in  FIGS. 24A-25B , the branched connector  2030  comprises a generally cylindrical rear portion  2300  having a rearward facing surface  2301  and a flange  2302 . Rear portion  2300  is arranged to be seated within forward portion  2212  of intermediate element  2020  ( FIGS. 22A-23B ). Communicating with the interior of rear portion  2300  is a generally cylindrical conduit  2304 , having a main portion  2306  and a forward facing conical portion  2308 . Communicating with main portion  2306  is a branch conduit  2310 .  
         [0097]     Integrally formed with an outer surface of the branched connector  2030  is an arm portion  2312 , including a wide connection surface  2314  connecting the arm portion  2312  with main portion  2306  and branch conduit  2310 . Arm portion  2312  additionally includes a generally axially extending substantially flat arm  2320  having a sideways facing outwardly extending tooth  2322  formed on an inwardly facing surface  2323  of arm  2320 , for selectable engagement with serrated surface  2152  of ridge  2150  formed on rear housing element  2010  ( FIGS. 19A-21B ). An outward-facing end  2324  of arm  2320  preferably has a notch  2326  extending therethrough.  
         [0098]     Reference is now made to  FIGS. 26A, 26B  and  26 C which are simplified sectional illustrations of the catheter connection device of  FIG. 18  in various operative orientations.  
         [0099]     Turning to  FIG. 26A , the catheter connection device is shown in a closed operative orientation which is suitable for storage. In this orientation, cylindrical conduit  2134  of rear housing element  2010  is disposed within rearward facing portion  2200  of intermediate element  2020 , and forward facing portion  2202  of intermediate element  2020  is disposed within main portion  2122  of rear housing element  2010 . Protrusions  2208  formed on forward facing cylindrical portion  2202  slidingly engage elongate slots  2146  formed in main portion  2122  of rear housing element  2010  (not shown). Spring  2012  is preferable disposed about cylindrical conduit  2134  of rear housing element  2010  and rearward facing portion  2200  of intermediate element  2020 .  
         [0100]     Elastomeric element  2022  is seated within forward portion  2202  of intermediate element  2020 , against bulkhead  2204 . In this operative orientation cross-shaped slit  2028  formed in protrusion  2026  is closed, and thus a user can pass catheterization tools through the slit without opening it, resulting in reduced bleeding.  
         [0101]     Rear portion  2300  of branched connector  2030  is seated in forward portion  2202  of intermediate element  2020 , such that surface  2203  thereof engages a rearward facing surface of flange  2302  of branched connector  2030 , thus maintaining intermediate element  2020  in place. Rearward facing surface  2301  of rear portion  2300  of branched connector  2030  preferably engages disk portion  2024  of elastomeric element  2022 , thus maintaining the elastomeric element in place.  
         [0102]     Conical portion  2308  of conduit  2304  of branched connector  2030  is disposed within a cylindrical portion of tube connector assembly  2040 .  
         [0103]     Turning now to  FIG. 26B , the catheter connection device is shown in a partially open operative orientation which is suitable for insertion of a narrow tube or guide wire therethrough. In this orientation, branched connector  2030  is rearwardly displaced, such that tooth  2322  formed on arm  2320  slides along serrated surface  2152  of ridge  2150  of rear housing element  2010 , stopping at a generally central part thereof.  
         [0104]     Forward displacement of rear housing element  2010  relative to branched connector  2030  causes relative rearward displacement of intermediate element  2020  within rear housing element  2010 , which is accompanied by relative rearward displacement of protrusions  2208  within elongate slots  2146  (not shown). The relative rearward displacement of intermediate element  2020  causes spring  2012  to be partially-axially compressed.  
         [0105]     Elastomeric element  2022 , which is seated between branched connector  2030  and intermediate element  2020 , is relatively rearwardly displaced together with branched connector  2030 . Relative rearward displacement of elastomeric element  2022  causes forward facing tapering portion  2138  of cylindrical conduit  2134  to partially extend through cross-shaped slit  2028  of protrusion  2026 , thus creating a narrow passage between the rear end of the catheter connector device and the forward end thereof.  
         [0106]     As seen in  FIG. 26B , the narrow tube  2500  may be inserted from the rear end of the catheter connector device to the forward end thereof via cylindrical conduit  2134 , slit  2028 , cylindrical conduit  2304 , and tube connector assembly  2040 . As shown clearly in  FIG. 26B , once the narrow tube  2500  is inserted through the catheter connector device, it may be engaged and retained in notch  1326 , thus preventing axial movement of the tube relative to rear housing element  2010  and branched connector  2030 .  
         [0107]     Turning now to  FIG. 26C , the catheter connection device is shown in an open operative orientation which is suitable for insertion of a tube or a balloon catheter therethrough. In this orientation, branched connector  2030  is further rearwardly displaced, such that tooth  2322  formed on arm  2320  slides along serrated surface  2152  of ridge  2150  of rear housing element  2010 , engaging the rearward portion thereof.  
         [0108]     Relative rearward displacement of branched connector  2030  causes relative rearward displacement of intermediate element  2020  within rear housing element  2010 , which is accompanied by relative rearward displacement of protrusions  2208  within elongate slots  2146 . The relative rearward displacement is limited by the engagement of protrusions  2208  with the rearward facing surfaces of slots  2146  (not shown). The relative rearward displacement of intermediate element  2020  causes spring  2012  to be compressed.  
         [0109]     Elastomeric element  2022 , which is seated between branched connector  2030  and intermediate element  2020 , is rearwardly displaced together with branched connector  2030 . Rearward displacement of elastomeric element  2022  causes forward facing tapering portion  2138  of cylindrical conduit  2134  to fully extend through slit  2028  of protrusion  2026 , thus creating a wide passageway through the catheter connector device.  
         [0110]     As seen in  FIG. 26C , at least one tube  2500  may be guided from the rear end the catheter connector device and the forward end thereof via cylindrical conduit  2134 , slit  2028 , cylindrical conduit  2304 , and tube connector assembly  2040 . As shown clearly in  FIG. 26C , once the tubes are inserted through the catheter connector device, at least one tube may be engaged and retained in notch  2326 , thus preventing axial movement of the tube relative to rear housing element  2010  and branched connector  2030 . It is appreciated that pressing the finger engagement extension  2324  of the ratchet engagement arm  2320  fully releases tooth  2322  such that the tooth cannot get caught again in a manner that the catheter connector device is in a partially closed orientation.  
         [0111]     It is appreciated that at the end of the catheterization and following removal of tubing and/or wires, forward displacement of the branched connector  2030  releases the elastomeric element  2022  thus allowing the elastomeric element  2022  to return to its closed position by virtue of its elastomeric properties.  
         [0112]     It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove as well as modifications and variations thereof as would occur to a person of skill in the art upon reading the foregoing specification and which are not in the prior art.