Abstract: Valved ports for accessing blood vessels and other body lumens include a lock mechanism which locks the valve fully open when a needle or other access tube is placed into the port. The lock mechanism includes a latch typically comprising one or more laterally deflectable elements, such as a pair of opposed balls. The deflected elements are pushed outwardly by the needle to engage a recess in the port which locks the valve open until the needle is removed.

Abstract: Valved ports for accessing blood vessels and other body lumens include a lock mechanism which locks the valve fully open when a needle or other access tube is placed into the port. The lock mechanism includes a latch typically comprising one or more laterally deflectable elements, such as a pair of opposed balls. The deflected elements are pushed outwardly by the needle to engage a recess in the port which locks the valve open until the needle is removed.

Abstract: Methods and apparatus for percutaneously accessing an implanted port using an access tube which is periodically introduced to the implanted port. The apparatus is preferably an implantable port having a pressure-responsive valve element. It has been found that repeated passage of the access tube through the same tissue tract to the implantable port reduces patient trauma, with minimized bleeding and reduction in sensitivity. The tract may be initially formed by percutaneously placing a penetrating element through intact skin to the port and leaving the element in place for a time sufficient to created the tract.

Abstract: Methods and apparatus for percutaneously accessing an implanted port using an access tube which is periodically introduced to the implanted port. The apparatus is preferably an implantable port having a pressure-responsive valve element. It has been found that repeated passage of the access tube through the same tissue tract to the implantable port reduces patient trauma, with minimized bleeding and reduction in sensitivity. The tract may be initially formed by percutaneously placing a penetrating element through intact skin to the port and leaving the element in place for a time sufficient to created the tract.

Abstract: The present invention provides devices, systems, and methods for positioning an article, such as a graft or catheter, in a subcutaneous tunnel between skin and muscle tissue of a patient to establish improved access to the patient's vascular system for hemodialysis, hemofiltration, or other extracorporeal blood treatments. In particular, the present invention provides devices, systems, and methods which minimize longitudinal forces or friction acting against the vascular graft as it is being subcutaneously positioned while still providing a tight seal between the graft and the subcutaneous tissue, which in turn minimizes hematomas, bleeding, and infections and enhances needle accessibility of the graft for extracorporeal treatment. A system for subcutaneously positioning an article comprises a tunneling tool, a pair of nested tubes coupleable to a trailing end of the tunneling tool, and a flexible article which can be slidably received within the pair of nested tubes.

Abstract: A system and method for positioning an article, such as a graft or catheter, in a subcutaneous tunnel between skin and muscle tissue of a patient. The system comprises a tunneling tool, a pair of nested tubes coupleable to a trailing end of the tunnel tool, and a flexible article which can be slidably received within the pair of nested tubes. The nested tubes each have a leading end, a trailing end, and a longitudinal opening.

Abstract: Implanted catheters are locked with a solution comprising a lower alcohol, typically ethanol, propanol, or butanol, in a range from 1% to 99% by volume, and an additive in a range from 1% to 99% by volume, the additive comprising an anti-microbial, typically taurolidine or triclosan, or an anti-coagulant, typically riboflavin, sodium citrate, ethylene diamine tetraacetic acid, or citric acid. The use of an alcohol and additive solution can effectively reduce fouling of the catheter, particularly clotting and thrombus in intravascular catheters, as well as eradicate existing infections and/or reduce the risk of potential infections. Existing infections and/or potential infections can be further reduced by employing a catheter body which permits an anti-microbial solution to penetrate into the catheter body and preferably through the catheter into tissue surrounding the implanted catheter.

Abstract: The present invention provides improved methods for establishing vascular access to a patient's body lumen or other target location, particularly blood vessels, for performing extracorporeal treatments, such as hemodialysis, hemofiltration, hemodiafiltration, plasmapheresis, apheresis, and the like, on circulating blood. In particular, the present invention provides improved methods which may enhance extracorporeal blood flow rates, reduce instances of fibrin sheath or thrombosis formation, and minimize recirculation effects. Methods for recirculating blood to a patient include placing a draw catheter so that a distal tip thereof is positioned in a right atrium of the patient's heart. A return catheter is placed so that a distal tip thereof is positioned in a superior vena cava. Extracorporeal blood flow from the draw catheter to the return catheter may then be established.

Abstract: Implanted catheters are locked with a solution comprising a lower alcohol, typically ethanol, propanol, or butanol, most preferably isopropanol, and an additive, the additive comprising an anti-microbial, typically taurolidine or triclosan, or an anti-coagulant, typically riboflavin, sodium citrate, ethylene diamine tetraacetic acid, or citric acid. The use of an alcohol and additive solution can effectively reduce fouling of the catheter, particularly clotting and thrombus in intravascular catheters, as well as reduce the risk of infection. The risk of infection can be further reduced by employing a catheter body which is sufficiently porous to permit the anti-microbial solution of a lower alcohol and another anti-microbial or anti-coagulant compound to penetrate into the catheter body and preferably through the catheter into tissue surrounding the implanted catheter.

Abstract: Implanted catheters are locked with a solution comprising a lower alcohol, typically ethanol, propanol, or butanol, most preferably isopropanol. The use of an alcohol can both reduce fouling of the catheter, particularly clotting and thrombus in intravascular catheters, as well as reducing the risk of infection. The risk of infection can be further reduced by employing a catheter body which is sufficiently porous to permit the lower alcohol or other anti-microbial solution to penetrate into the catheter body and preferably through the catheter into tissue surrounding the implanted catheter.

Abstract: The present invention provides devices, systems, and methods for positioning an article, such as a graft or catheter, in a subcutaneous tunnel between skin and muscle tissue of a patient to establish improved access to the patient's vascular system for hemodialysis, hemofiltration, or other extracorporeal blood treatments. In particular, the present invention provides devices, systems, and methods which minimize longitudinal forces or friction acting against the vascular graft as it is being subcutaneously positioned while still providing a tight seal between the graft and the subcutaneous tissue, which in turn minimizes hematomas, bleeding, and infections and enhances needle accessibility of the graft for extracorporeal treatment. A system for subcutaneously positioning an article comprises a tunneling tool, a pair of nested tubes coupleable to a trailing end of the tunneling tool, and a flexible article which can be slidably received within the pair of nested tubes.

Abstract: Methods, apparatus, and kits are provided for performing peritoneal dialysis. In a first aspect, subcutaneous and transcutaneous systems are described for performing continuously cycling peritoneal dialysis. In a second aspect, fully implanted systems are described for performing flow-through peritoneal dialysis.

Abstract: A dual port vascular access assembly comprises a first access port and a second access port. The linkage is coupled between the first access port to close the second access port in the absence of an access tube in the first access port. Such port assemblies are particularly useful for implantation in patients receiving hemodialysis. By connecting the first access port to the blood withdrawal side of the system, blood withdrawal will be automatically terminated upon cessation of blood returned to due loss of the return access tube in the port assembly.

Abstract: Implantable ports and other devices are cleansed by the injection of a washing solution into a region in the device or in a tissue pocket surrounding the device. In a first embodiment, the washing solution is injected through an aperture in the device to flush internal regions of the device before infusing the tissue pocket and flushing outwardly through a tissue tract leading to the device. In other embodiments, the washing solution is injected directly to a target site on the exterior of the device. Implantable devices may include special, usually hardened, target regions for receiving the sharpened end of a needle used to inject the washing solution. Kits will include devices, syringes, access devices, and instructions for cleansing according to the methods of the present invention.

Abstract: Implantable ports and other devices are disinfected by the injection of an anti-microbial agent into a region in the device or in a tissue pocket surrounding the device. In a first embodiment, the anti-microbial agent is injected through an aperture in the device to flush internal regions of the device before infusing the tissue pocket and flushing outwardly through a tissue tract leading to the device. In other embodiments, the anti-microbial agent is injected directly to a target site on the exterior of the device. Implantable devices may include special, usually hardened, target regions for receiving the sharpened end of a needle used to inject the anti-microbial agent. Kits will include devices, syringes, access devices, and instructions for disinfection according to the methods of the present invention.

Abstract: A catheter with valve for implantation in a vascular structure of a living being. The catheter is in the general shape of a “T” with the top of the “T” implanted within the lumen of a vascular structure, and the leg of the “T” extending out of the vascular structure through an incision in the vascular structure. The lumen of the implanted portion of the catheter completely occupies the lumen of the vascular structure, causing all blood flow through the vascular structure to be directed through the implanted portion of the catheter. A valve is placed in the wall of the implanted portion of the catheter which opens into the lumen of the leg of the “T” of the catheter upon application of sufficient differential pressure between the lumens of the two portions of the catheter.

Abstract: A catheter with valve for implantation in a vascular structure of a living being. The catheter is in the general shape of a “T” with the top of the “T” implanted within the lumen of a vascular structure, and the leg of the “T” extending out of the vascular structure through an incision in the vascular structure. The lumen of the implanted portion of the catheter completely occupies the lumen of the vascular structure, causing all blood flow through the vascular structure to be directed through the implanted portion of the catheter. A valve is placed in the wall of the implanted portion of the catheter which opens into the lumen of the leg of the “T” of the catheter upon application of sufficient differential pressure between the lumens of the two portions of the catheter.

Abstract: Implantable ports and other devices are cleansed by the injection of a washing solution into a region in the device or in a tissue pocket surrounding the device. In a first embodiment, the washing solution is injected through an aperture in the device to flush internal regions of the device before infusing the tissue pocket and flushing outwardly through a tissue tract leading to the device. In other embodiments, the washing solution is injected directly to a target site on the exterior of the device. Implantable devices may include special, usually hardened, target regions for receiving the sharpened end of a needle used to inject the washing solution. Kits will include devices, syringes, access devices, and instructions for cleansing according to the methods of the present invention.

Abstract: Implantable ports and other devices are disinfected by the injection of an anti-microbial agent into a tissue pocket surrounding the device. In a first embodiment, the anti-microbial agent is injected through an aperture in the device to flush internal regions of the device before infusing the tissue pocket. In other embodiments, the anti-microbial agent is injected directly to a target site on the exterior of the device. Implantable devices may include special, usually hardened, target regions for receiving the sharpened end of a needle used to inject the anti-microbial agent.

Abstract: Methods, systems, and kits for extracorporeally circulating and processing blood are described. The systems include a pump, a processing unit, and blood drawn return lines for accessing a patient's vasculature. Blood flow through the return line is measured and pump speed controlled to maintain a desired blood flow rate. Alarm conditions can be initiated when expected pump performance differs from that needed to maintain the control point flow rate. By using a ultrasonic flow detector, gas bubbles in the blood flow can be detected.