Dialysis access system and method

• US 6,544,206 B1
• Filed: 10/13/2000
• Issued: 04/08/2003
• Est. Priority Date: 10/14/1999
• Status: Expired due to Fees

• Current Assignee: Robert H. Johnston Jr
• Original Assignee: Robert H. Johnston Jr
• Inventors: Johnston, Robert H. Jr.
• Primary Examiner(s): Walton, George L.
• Application Number:
  US09/687,874
• Time in Patent Office: 907 Days
• Field of Search: 210/646, 210/651, 210/782, 604/4.01, 604/5.01, 604/5.04, 604/6.01, 604/6.07, 604/6.16, 604/28, 604/43, 604/96.01, 604/174, 604/175, 604/256, 604/264, 604/266, 604/98.01, 604/269, 604/915
• US Class Current: 604/4.01
• CPC Class Codes: A61M 2039/0258 for vascular access, e.g. blood stream access
• CPC Class Codes: A61M 2039/0273 for introducing catheters into the body
• CPC Class Codes: A61M 2039/0276 for introducing or removing fluids into or out of the body
• CPC Class Codes: A61M 2039/0285 with sterilisation means, e.g. antibacterial coatings, disinfecting pads, UV radiation LEDs or heating means in the port
• CPC Class Codes: A61M 2039/0288 protectors, caps or covers therefor
• 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

Abstract

A method of and system for providing vascular access in a patient for hemodialysis involves attaching the distal end of an access catheter to the abdominal aorta of the patient and the proximal end of the access catheter to a portion of the patient to allow selective access to an interior portion of the access catheter. A blood-withdrawal catheter and a blood-return catheter are placed into the access catheter until their distal ends are in the patients abdominal aorta and blood may be removed and return to the aorta. When finished, the blood catheters are removed. Selective access to the proximal end of the access catheter is provided, preferably, by a cutaneous port assembly that includes a screwable cap and anti-infection cuff.

Claims

1. A method of providing vascular access in a patient for hemodialysis, the method comprising the steps of:

providing an access catheter with a proximal end and a distal end;

attaching the distal end of the access catheter to the abdominal aorta of the patient;

attaching the proximal end of the access catheter to a portion of the patient to allow selective access to an interior portion of the access catheter;

providing a blood-withdrawal catheter having a proximal end and a distal end;

providing a blood-return catheter having a proximal end and a distal end;

inserting the blood-withdrawal catheter into the interior portion of the access catheter until the distal end of the withdrawal catheter is within the patient'"'"'s abdominal aorta;

attaching the proximal end of the blood-withdrawal catheter to a dialysis machine;

inserting the blood-return catheter into the interior portion of the access catheter until the distal end of the blood-return catheter is within the patient'"'"'s abdominal aorta; and

attaching the proximal end of the blood-return catheter to the dialysis machine.

2. The method of claim 1 wherein the step of attaching the proximal end of the access catheter to the patient to allow selective access to the interior of the access catheter comprises attaching a cutaneous port assembly to the patient.

3. The method of claim 1 wherein the distal end of the blood-withdrawal catheter is curved and wherein the step of inserting the blood-withdrawal catheter further comprises inserting the blood withdrawal catheter into the abdominal aorta with the curved portion oriented to place an aperture on the distal end of the blood-withdraw catheter so that faces bloodflow in the abdominal aorta.

4. A hemodialysis system for performing a hemodialysis treatment on a patient, the system comprising:

an access catheter having a proximal end and a distal end, the distal end of the access catheter sized and configured for coupling to a patient'"'"'s abdominal aorta and the proximal end coupled near an exterior portion of the patient for gaining selective access to an interior portion of the access catheter;

a blood-withdrawal catheter having a proximal end and a distal end, the blood-withdrawal catheter sized and configured to be disposed at least in part in the interior portion of the access catheter through the first or second aperture in the end cap and the distal end of the withdrawal catheter sized and configured to be placed in the patient'"'"'s abdominal aorta;

a blood-return catheter having a proximal end and a distal end, the blood-return catheter sized and configured to be disposed at least in part in the interior portion of the access catheter through the first or second aperture in the end cap and the distal end of the blood return catheter sized and configured to be placed in the patient'"'"'s abdominal aorta; and

a hemodialysis machine fluidly coupled to the proximal end of the blood-withdrawal catheter and fluidly coupled to the proximal end of the blood-return catheter.

5. The system of claim 4 further comprising a cutaneous port assembly coupled to the proximal end of the access catheter for allowing selective access to the interior of the access catheter.

6. The system of claim 4 wherein the distal end of the blood-withdrawal catheter is formed with a curve and the distal end of the blood-return catheter is formed with a curve.

7. A method for gaining access to a patient'"'"'s blood to perform hemodialysis, the method comprising the steps of:

providing an access catheter formed of an implantable graft and having a distal end and a proximal end;

attaching by astemosis the distal end of the access catheter to the abdominal aorta between the patient'"'"'s renal arteries and the patient'"'"'s aortic bifuracation;

providing a cutaneous port assembly, wherein the cutaneous port assembly comprises;

a hollow cylindrical member having a first end, second end, and an intermediate portion therebetween, the cylindrical member for attaching the proximal end of the access catheter, the second end of the cylindrical member formed with threads,

a shield member attached to an intermediate portion of the cylindrical member,

an end cap coupled to the second end of the cylindrical member, the end cap formed with a first aperture and a second aperture,

an infection avoidance collar coupled proximate the first end of the cylindrical member, the collar for facilitating tissue growth and avoiding infection, and

a removeable sealing cap having threads and sized and configured to mate with the threads on the second end of cylindrical member and to form a liquid-tight seal when so mated;

attaching the proximal end of the access catheter to the first end of the cylindrical member of the cutaneous port assembly;

providing a blood-withdrawal catheter having a distal end and a proximal end and sized to be inserted into the first or second aperture of the end cap of the cutaneous port assembly;

inserting the distal end of the blood-withdrawal catheter through the first or second aperature of the cutaneous port assembly and into the abdominal aorta of the patient;

providing a blood-return catheter having a distal end and a proximal end and sized to be inserted into the first or second aperture of the end cap of the cutaneous port assembly; and

inserting the distal end of the blood-return catheter through the first or second aperture of the cutaneous port assembly and into the abdominal aorta of the patient.

8. The method of claim 7 wherein the step of providing a blood-withdrawal catheter comprises providing a blood-withdrawal catheter having a curved distal end and wherein the step of inserting the blood-withdrawal catheter comprises inserting the distal end of the blood-withdrawal catheter so that the curve of the distal end is toward an upstream position with respect to blood flow.

9. The method of claim 7 wherein the step of providing a blood-return catheter comprises providing a blood-return catheter having a curved distal end wherein the step of inserting the blood-return catheter comprises inserting the distal end of the blood-return catheter so that the curve of the distal end is toward a downstream position with respect to blood flow.

10. The method of claim 7 wherein:

the step of providing a blood-withdrawal catheter comprises providing a blood-withdrawal catheter having a curved distal end;

the step of inserting the blood-withdrawal catheter comprises inserting the distal end of the blood-withdrawal catheter so that the curve of the distal end is toward an upstream position with respect to blood flow;

the step of providing a blood-return catheter comprises providing a blood-return catheter having a curved distal end; and

the step of inserting the blood-return catheter comprises inserting the distal end of the blood-return catheter so that the curve of the distal end is toward a downstream position with respect to blood flow.