Subcutaneous vascular access ports and related systems and methods

• US 9,072,880 B2
• Filed: 01/29/2010
• Issued: 07/07/2015
• Est. Priority Date: 01/29/2009
• Status: Active Grant

• Current Assignee: Advent Access Pte. Ltd.
• Original Assignee: Vital Access Corporation
• Inventors: Phillips, Christopher M., Young, Nathaniel P., Perry, Trent J., Blatter, Duane D., Crawford, Mark A., Smith, G. Doug, Johnson, Steven
• Primary Examiner(s): Wiest, Philip R
• Assistant Examiner(s): KLEIN, BENJAMIN JACOB
• Application Number:
  US12/697,192
• Publication Number:
  US 20100191166A1
• Time in Patent Office: 1,985 Days
• Field of Search: 604 401- 616, 604/27, 604/18, 604/93.01, 604/162, 604/164.01, 604/175, 604/264, 60428801-28804
• US Class Current: 1/1
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 17/3423 Access ports, e.g. toroid shape introducers for instruments or hands access sites for liquids A61M39/0247
• CPC Class Codes: A61B 2017/00641 for closing fistulae, e.g. anorectal fistulae
• CPC Class Codes: A61B 2017/00654 entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/3425 for internal organs, e.g. heart ports
• CPC Class Codes: A61M 1/14 Dialysis systems; Artificial kidneys; Blood oxygenators semi-permeable membranes characterised by the material, manufacturing processes therefor B01D71/00; Reciprocating systems for treatment of body fluids, e.g. single needle systems for hemofiltration or pheresis
• CPC Class Codes: A61M 1/3653 Interfaces between patient blood circulation and extra-corporal blood circuit
• CPC Class Codes: A61M 1/3659 Cannulae pertaining to extracorporeal circulation
• CPC Class Codes: A61M 1/3661 for haemodialysis
• CPC Class Codes: A61M 2039/0223 having means for anchoring the subcutaneous access site
• CPC Class Codes: A61M 2039/0226 having means for protecting the interior of the access site from damage due to the insertion of a needle
• CPC Class Codes: A61M 2039/0238 having means for locating the implanted device to insure proper injection, e.g. radio-emitter, protuberances, radio-opaque markers
• CPC Class Codes: A61M 2205/0238 the material being a coating or protective layer
• CPC Class Codes: A61M 39/0208 Subcutaneous access sites for injecting or removing fluids transcutaneous access sites A61M39/0247; implantable infusion devices A61M5/14276

Abstract

Ports for accessing a vessels within a patient include passageways that can guide needles or other access devices directly into the vessels. The ports can be implanted subcutaneously within a patient. Some ports may be used in the creation and use of vascular access buttonholes.

Claims

1. A method of creating a buttonhole in an anatomical vessel that carries a fluid flow, the method comprising:

determining a position of a subcutaneous vascular access port that comprises a guidance passageway and is attached to a wall of the anatomical vessel such that an opening of the guidance passageway faces a portion of the wall of the anatomical vessel,

wherein the guidance passageway is devoid of any closure apparatus;

wherein the wall of the anatomical vessel to which the vascular access port is attached defines a lumen through which the anatomical vessel carries the fluid flow,

wherein a longitudinal axis of the anatomical vessel extends through the lumen such that the longitudinal axis of the anatomical vessel does not pass through the portion of the wall of the anatomical vessel that the opening of the vascular access port faces, and

wherein the guidance passageway extends through the vascular access port and defines a central axis that is oriented at an angle relative to the longitudinal axis of the anatomical vessel;

advancing a first needle through the skin of the patient and then into the guidance passageway of the vascular access port;

passing the first needle through the guidance passageway toward the opening along a path that is constrained by the guidance passageway;

advancing the first needle through the opening of the guidance passageway; and

passing the first needle through the wall of the anatomical vessel at an insertion site of the anatomical vessel.

2. The method of claim 1, further comprising:

advancing a second needle through the skin of the patient and into the guidance passageway of the vascular access port;

passing the second needle through the guidance passageway toward the opening along a path that is constrained by the guidance passageway;

advancing the second needle through the opening of the guidance passageway; and

passing the second needle through the wall of the anatomical vessel at the insertion site.

3. The method of claim 2, wherein said advancing the second needle through the skin of the patient comprises advancing the second needle through a well-defined insertion tract.

4. The method of claim 2, wherein the second needle comprises a blunt tip.

5. The method of claim 4, wherein advancing the second needle through the skin of a patient takes place after at least one access event in which a sharp needle is inserted through the insertion site of the vessel.

6. The method of claim 1, wherein the guidance passageway comprises a channel region that constrains the movement of the first needle so as to direct the first needle toward the opening of the guidance passageway.

7. The method of claim 1, wherein the vascular access port is attached to the wall of the anatomical vessel via one or more sutures.

8. The method of claim 1, wherein the guidance passageway comprises a funnel region, and wherein the method further comprises aligning a tip of the first needle with the insertion site via the funnel region.

9. The method of claim 1, wherein the anatomical vessel is associated with an arteriovenous fistula.

10. The method of claim 1, wherein the anatomical vessel comprises an artificial graft.

11. A method of creating a buttonhole in an anatomical vessel that carries a fluid flow, the method comprising:

advancing a first needle through the skin of the patient and then into a guidance passageway of a subcutaneous vascular access port that is attached to a wall of the anatomical vessel such that an opening of the guidance passageway faces the wall of the anatomical vessel, wherein the guidance passageway is devoid of any closure apparatus, wherein the wall of the anatomical vessel to which the vascular access port is attached defines a lumen through which a longitudinal axis of the anatomical vessel extends and through which the anatomical vessel carries the fluid flow, and wherein the vascular access port comprises a guidance passageway that extends through the vascular access port and defines a central axis that is oriented at an acute angle relative to the longitudinal axis of the anatomical vessel;

passing the first needle through the guidance passageway toward the opening of the guidance passageway;

advancing the first needle through the opening of the guidance passageway; and

passing the first needle through the wall of the anatomical vessel at an insertion site of the anatomical vessel.

12. The method of claim 11, further comprising:

advancing a second needle through the skin of the patient and into the guidance passageway of the vascular access port;

passing the second needle through the guidance passageway toward the opening along a path that is constrained by the guidance passageway;

advancing the second needle through the opening of the guidance passageway; and

passing the second needle through the wall of the anatomical vessel at the insertion site.

13. The method of claim 12, wherein said advancing the second needle through the skin of the patient comprises advancing the second needle through a well-defined insertion tract.

14. The method of claim 12, wherein the second needle comprises a blunt tip.

15. The method of claim 14, wherein advancing the second needle through the skin of a patient takes place after at least one access event in which a sharp needle is inserted through the insertion site of the anatomical vessel.

16. The method of claim 11, wherein the guidance passageway comprises a channel region that constrains the movement of the first needle so as to direct the first needle toward the opening of the guidance passageway.

17. The method of claim 11, wherein the vascular access port is attached to the wall of the anatomical vessel via one or more sutures.

18. The method of claim 11, wherein the guidance passageway comprises a funnel region, and wherein the method further comprises aligning a tip of the first needle with the insertion site via the funnel region.

19. The method of claim 11, wherein the anatomical vessel is associated with an arteriovenous fistula.

20. The method of claim 11, wherein the anatomical vessel comprises an artificial graft.

21. A method of creating a buttonhole in an anatomical vessel that carries a fluid flow, the method comprising:

advancing a first needle through the skin of the patient and then into a guidance passageway of a subcutaneous vascular access port that is attached to a wall of the anatomical vessel such that an opening of the guidance passageway faces the wall of the anatomical vessel, wherein the guidance passageway is devoid of any closure apparatus, wherein the wall of the anatomical vessel to which the vascular access port is attached defines a lumen through which a longitudinal axis of the anatomical vessel extends and through which the anatomical vessel carries the fluid flow, and wherein the vascular access port comprises a guidance passageway that extends through the vascular access port and defines a central axis that is oriented at an acute angle relative to the longitudinal axis of the anatomical vessel;

advancing the first needle through the opening of the guidance passageway to pass through the wall of the anatomical vessel at an insertion site;

removing the first needle from the vascular access port and from the patient;

advancing a second needle through the skin of the patient and into the guidance passageway of the vascular access port; and

advancing the second needle through the opening of the guidance passageway to pass through the wall of the anatomical vessel at the insertion site.

22. The method of claim 21, wherein said advancing the second needle through the skin of the patient comprises advancing the second needle through a well-defined insertion tract.

23. The method of claim 21, wherein the second needle comprises a blunt tip.

24. The method of claim 23, wherein advancing the second needle through the skin of a patient takes place after at least one access event in which a sharp needle is inserted through the insertion site of the anatomical vessel.

25. The method of claim 21, wherein the vascular access port is attached to the wall of the anatomical vessel via one or more sutures.

26. The method of claim 21, wherein the guidance passageway comprises a funnel region, and wherein the method further comprises aligning a tip of the first needle with the insertion site via the funnel region.