REPETITIVE ENTRY CONDUIT FOR BLOOD VESSELS

• US 20100274223A1
• Filed: 04/22/2010
• Published: 10/28/2010
• Est. Priority Date: 04/22/2009
• Status: Abandoned Application

• Current Assignee: George P. Teitelbaum, Samuel M. Shaolian, Scott L. Pool
• Original Assignee: George P. Teitelbaum, Samuel M. Shaolian, Scott L. Pool
• Inventors: Shaolian, Samuel M., Teitelbaum, George P., Pool, Scott L.
• Application Number:
  US12/765,158
• Publication Number:
  US 20100274223A1
• Time in Patent Office: Days
• US Class Current: 604/507
• CPC Class Codes: A61B 17/064 Surgical staples, i.e. penetrating the tissue
• CPC Class Codes: A61B 17/068 Surgical staplers , e.g. containing multiple staples or clampsstaplers containing only one staple A61B17/10; magazines or containers for staples A61B17/105; for performing anastomosis A61B17/115; staplers in general B25C5/00
• CPC Class Codes: A61B 17/11 for performing anastomosis; Buttons for anastomosis
• CPC Class Codes: A61B 2017/0647 having one single leg, e.g. tacks
• CPC Class Codes: A61B 2017/0649 Coils or spirals
• CPC Class Codes: A61B 2017/1107 for blood vessels
• CPC Class Codes: A61M 39/0208 Subcutaneous access sites for injecting or removing fluids transcutaneous access sites A61M39/0247; implantable infusion devices A61M5/14276
• CPC Class Codes: A61M 39/0247 Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053
• CPC Class Codes: A61M 5/3287 Accessories for bringing the needle into the body; Automatic needle insertion A61M5/20, A61M5/31525 take precedence

Abstract

A subcutaneous needle conduit attaches directly to a blood vessel or other biological boundary structure. The subcutaneous needle conduit is tapered such that a proximal end is wider than a distal end. A body of the subcutaneous needle conduit guides the tip of a needle or other canula from the proximal end to the distal end. The subcutaneous needle conduit may be funnel-shaped. An elongated funnel shape may be used to selectively provide access to a plurality of desired access sites along an axis of a blood vessel. Other shapes, such as sluice-shaped, may also be used. The subcutaneous needle conduit may be located beneath the skin surface using, for example, tactile sensation, magnetism, metal detection, detection of a signal emitted from a minute transponder, detection of light emission, or through other detection methods.

Claims

1. A subcutaneous conduit for implanting in a patient to allow repeated access to a blood vessel, comprising:

a tapered guide segment for guiding a needle through subcutaneous tissue to the blood vessel;

a proximal opening for receiving the needle into the guide segment; and

a distal opening for passing a tip of the needle out of the guide segment into the blood vessel, the distal opening sized and configured to be attached directly to a surface of the blood vessel,

wherein the proximal opening is wider than the distal opening such that a width of the guide segment tapers from the proximal opening to the distal opening.

2. The subcutaneous conduit of claim 1, further comprising:

a rigid proximal ring forming the proximal opening.

3. The subcutaneous conduit of claim 2, wherein the guide segment comprises eyelets for suturing the rigid proximal ring to the subcutaneous tissue.

4. The subcutaneous conduit of claim 2, wherein the rigid proximal ring is substantially circular.

5. The subcutaneous conduit of claim 2, wherein the guide segment comprises an elastic or superelastic material that allows the subcutaneous conduit to be in a collapsed state during implantation.

6. The subcutaneous conduit of claim 5, wherein the guide segment is configured to transform from the collapsed state to an open state after implantation.

7. The subcutaneous conduit of claim 5, wherein the guide segment is configured to remain in a coapted state after implantation until opened by a force of the needle or another canula being pushed through the guide segment.

8. The subcutaneous conduit of claim 1, wherein the guide segment is armored to resist puncturing thereof by the tip of the needle.

9. The subcutaneous conduit of claim 1, where in the guide segment includes one or more magnetic elements to assist in guiding the tip of the needle to the distal opening.

10. The subcutaneous conduit of claim 1, further comprising:

one or more tabs located near the distal opening for affixing the distal opening to the surface of the blood vessel.

11. The subcutaneous conduit of claim 10, further comprising:

helical wire comprising a superelastic material for affixing the one or more tabs to an adventitial layer of the blood vessel.

12. The subcutaneous conduit of claim 1, wherein a diameter of the distal opening is about equal to a diameter of the blood vessel.

13. The subcutaneous conduit of claim 1, wherein the subcutaneous conduit comprises an elongated funnel shape.

14. The subcutaneous conduit of claim 13, wherein a first axis of the subcutaneous conduit is substantially longer than a second axis of the subcutaneous conduit, the first axis being perpendicular to the second axis, and wherein the distal opening is configured to be attached to the surface of the blood vessel such that the first axis is about parallel to a cylindrical axis of the blood vessel.

15. The subcutaneous conduit of claim 14, wherein a width, in the direction of the second axis, of the distal opening narrows along the length of the first axis such that a first canula comprising a first outer diameter fits through a first end of the distal opening and a second canula comprising a second outer diameter fits through a second end of the distal opening, wherein the second outer diameter does not allow the second canula to fit through the first end of the distal opening.

16. The subcutaneous conduit of claim 15, wherein the tapered guide segment is sloped to guide the second canula from the first end of the distal opening to the second end of the distal opening.

17. The subcutaneous conduit of claim 13, wherein the guide segment comprises retaining tabs located near the distal opening, the subcutaneous conduit further comprising a base portion comprising:

a curved, flexible lattice configured for suturing to the wall of the blood vessel;

a pocket for receiving the distal opening; and

slots for engaging the retaining tabs of the guide segment to thereby attach the distal opening to the surface of the blood vessel.

18. The subcutaneous conduit of claim 13, further comprising:

a plurality of tabs each having a first end attached to the distal opening; and

a suture wire attached to a second end of each of the tabs, the suture wire configured to be sutured to the surface of the blood vessel.

19. A method for repeatedly accessing a blood vessel, comprising:

making an incision in a patient'"'"'s skin at an incision location;

at the incision location, excising a pouch in subcutaneous tissue for receiving a funnel-shaped conduit including a proximal opening, a distal opening, and a tapered guide segment extending between the proximal opening and the distal opening;

inserting the funnel-shaped conduit into the pouch;

securing the distal opening of the funnel-shaped conduit directly to a surface of the blood vessel;

securing the proximal opening to the subcutaneous tissue;

repairing the incision; and

after a healing period, inserting a needle through the patient'"'"'s skin so as to enter the guide segment through the proximal opening and advance a tip of the needle through the distal opening into the blood vessel.

20. The method of claim 19, further comprising:

inserting a guidewire through the incision into the blood vessel;

inserting a dilator over the guidewire into the blood vessel, the dilator comprising a retaining segment that is advanced into the blood vessel;

deploying the retaining segment to maintain a distal end of the dilator within the blood vessel;

inserting a sheath over the dilator into the pouch; and

wherein inserting the funnel-shaped conduit comprises inserting the funnel-shaped conduit over the dilator into the sheath.

21. The method of claim 20, wherein the funnel-shaped conduit comprises a tab located near the distal opening, the method further comprising:

attaching a distal end of a superelastic wire to the tab, the superelastic wire being restrained within a hypotube;

inserting the hypotube along with the funnel-shaped conduit into the sheath;

pressing a proximal plunger to force the superelastic wire out a distal end of the hypotube, wherein the superelastic wire reassumes a helical shape upon exiting the hypotube, and wherein forcing the superelastic wire out the distal end of the hypotube cases the distal end of the superelastic wire to repeatedly pass through the tab and an adventitial layer of the blood vessel to secure the distal opening to the distal surface of the blood vessel.

22. A subcutaneous conduit comprising:

an eyelet segment adapted to engage against the surface of a biological boundary structure;

a guide segment, including a puncture-resistant surface shaped to narrow such that a needle can first engage a larger segment and be guided by a shaped, narrowing surface towards the eyelet segment; and

tabs, located near the eyelet segment, adapted to engage a ligating mechanism for attaching the needle conduit to the biological boundary structure.

23. The subcutaneous conduit of claim 22, wherein the guide segment is funnel-shaped.

24. The subcutaneous conduit of claim 22, wherein the guide segment is shaped as an elongated funnel to selectively provide access to a plurality of different access sites along an axis of the biological boundary structure.

25. The subcutaneous conduit of claim 22, wherein the guide segment is sluice-shaped.

26. A subcutaneous conduit comprising:

an eyelet segment adapted to engage against the surface of a biological boundary structure;

a guide segment, including means for guiding the needle towards the eyelet segment; and

means, located near the eyelet segment, adapted to engage a ligating mechanism for attaching the needle conduit to the biological boundary structure.

27. The subcutaneous conduit of claim 26, wherein the guide segment is funnel-shaped.

28. The subcutaneous conduit of claim 26, wherein the guide segment is shaped as an elongated funnel to selectively provide access to a plurality of different access sites along an axis of the biological boundary structure.

29. The subcutaneous conduit of claim 26, wherein the guide segment is sluice-shaped.

30. A system for accessing a biological boundary structure at a desired entry site within a mammalian body, the system comprising:

one or more metal detector coils within a coil housing, the one or more metal detector coils configured to detect a metallic implant within the mammalian body; and

a guide canula attached to the coil housing at an angle such that placement of the one or more metal detector coils over the metallic implant aligns an opening through the guide canula with desired entry site.

31. The system of claim 30, wherein the angle of the guide canula is adjustable based on a detected depth of the metallic implant within the mammalian body.

32. The system of claim 30, wherein the angle of the guide canula is fixed.

33. The system of claim 30, further comprising the metallic implant affixed to a surface of the biological boundary structure within the mammalian body.

34. The system of claim 30, further comprising a subcutaneous conduit comprising the metallic implant, the subcutaneous conduit configured to be affixed directly to a blood vessel.