Abstract: A body lumen access system comprises a distal access cannula and a proximal access cannula. The distal access cannula is attached to or within the body lumen and the proximal access cannula is attached to an implantable port or is transcutaneously positioned and attached to a luer or other external connector. The distal and proximal access cannulas are usually implanted separately, cut to length, and attached at a subcutaneous junction location. Preferably, the proximal access cannula has a larger lumen diameter than that of the distal access cannula in order to reduce flow resistance within the cannula system. In some cases the distal and proximal access cannulas may be formed integrally. Replacement of a proximal portion or distal end may be performed by accessing the cannula, removing either the proximal portion or distal end, and reattaching a replacement portion of the cannula.

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: The present invention is generally directed to delivering liquid compositions to an interior site in the body. More particularly, the present invention provides devices, systems, and methods for facilitating percutaneous access to an implantable port for performing peritoneal dialysis in a sterile condition. In one aspect, the present invention provides an apparatus for use in peritoneal dialysis comprising a first container and a second container, wherein at least one of the containers is filled with unused dialysis fluid. The first and second containers are fluidly coupled by a first tube and a second tube to a junction, respectively. A single common tube fluidly coupled to the junction provides a fluid pathway to a percutaneous access member connected to the end of the single common tube. The access member has a minimum bore diameter of 1.16 mm capable of providing high volumetric flow rates.

Abstract: Systems for draining retained body fluids comprise an implantable port in an access tube. Usually, a drainage cannula for connecting the implantable port to a site of fluid retention is also provided. The implantable port and drainage cannula are implanted subcutaneously with one end of the cannula within the site of fluid retention and the port located remotely from such site. Drainage may then be effected by percutaneously introducing the access tube to the port and optionally applying a vacuum. Kits comprise the implantable port together with instructions for implanting the port as described above. Kits also comprise an access tube with instructions for use for accessing an implanted port as described above.

Abstract: Methods and apparatus for percutaneously accessing an implanted port use an access cannula which is periodically introduced to an aperture on the implanted port so that the cannula passes through the same tissue tract. It has been found that repeated passage of the cannula through the same tissue tract reduces patient trauma, with minimized bleeding, 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: An implantable device grafted directly to vascular structures for high volume blood and/or fluid infusion and/or removal for such purpose as hemodialysis, apheresis, exchange transfusion, or large volume fluid infusion. The device is also adaptable to intermittent access to the venous or arterial circulations for purpose of blood sampling or giving medications. The device is comprised of an implantable fluid chamber connected to a vascular shunt which is then grafted directly to the vascular structure (e.g. artery or vein). The vascular end of the device employs a value to prevent reflux of blood and subsequent washout of anticoagulant during periods when the device is not in use. The device is accessed percutaneously with a needle or needle-introduced catheter and is filled with anti-coagulant prior to needle withdrawal to prevent thrombosis.

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 or anastomotically attached to a vascular structure. The lumen of the implanted portion of the catheter completely occupies or may be aligned with 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. The leg of the "T" may be connected to the side wall of the implant portion of the catheter at an angle, such that the axis of the lumen of the leg of the "T" intersects the axis of the lumen of the implanted portion of the catheter at approximately a 45.degree. angle.

Abstract: An access port comprises a base and a flexible conduit. The port is subcutaneously implanted and the conduit is attached directly or indirectly to a blood vessel or other body lumen or cavity. An actuator mechanism is provided with a linkage which opens a valve in the port in response to percutaneous insertion of a needle into the access port. In particular, insertion of the needle opens the clamping mechanism to permit flow through the conduit between the blood vessel and the needle.

Abstract: An access catheter for percutaneously connecting to a subcutaneously implanted port comprises a catheter body having a distal end and a proximal end. A needle or other access tube is connected to the distal end of the catheter body through a fitting, optionally at a right angle relative to the catheter body. A compressible element impregnated with an antiseptic, antibiotic, anesthetic, or other active agent, is provided adjacent the distal end of the catheter body and surrounding the needle. When the needle is percutaneously introduced to the port, the compressible element will be compressed to express the agent onto the skin surface surrounding the penetration site.

Abstract: Methods and apparatus for percutaneously accessing an implanted port use a large bore coring needle. The coring needle is periodically introduced to an aperture on the implanted port so that the needle passes through the same tissue tract. It has been found that repeated passage of the needle through the same tissue tract reduces patient trauma, with minimized bleeding, reduction in sensitivity, in contrast to the use of non-coring needles.

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: A body lumen access system comprises a distal access cannula and a proximal access cannula. The distal access cannula is attached to or within the body lumen and the proximal access cannula is attached to an implantable port or is transcutaneously positioned and attached to a luer or other external connector. The distal and proximal access cannulas are usually implanted separately, cut to length, and attached at a subcutaneous junction location. Preferably, the proximal access cannula has a larger lumen diameter than that of the distal access cannula in order to reduce flow resistance within the cannula system. In some cases the distal and proximal access cannulas may be formed integrally.

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: An implantable device grafted directly to vascular structures for high volume blood and/or fluid infusion and/or removal for such purpose as hemodialysis, apheresis, exchange transfusion, or large volume fluid infusion. The device is also adaptable to intermittent access to the venous or arterial circulations for purpose of blood sampling or giving medications. The device is comprised of an implantable fluid chamber connected to a vascular shunt which is then grafted directly to the vascular structure (e.g. artery or vein). The vascular end of the device employs a valve to prevent reflux of blood and subsequent washout of anticoagulant during periods when the device is not in use. The device is accessed percutaneously with a needle or needle-introduced catheter and is filled with anti coagulant prior to needle withdrawal to prevent thrombosis.

Abstract: An implantable device grafted directly to vascular structures for high volume blood and/or fluid infusion and/or removal for such purpose as hemodialysis, apheresis, exchange transfusion, or large volume fluid infusion. The device is also adaptable to intermittent access to the venous or arterial circulations for purpose of blood sampling or giving medications. The device is comprised of an implantable fluid chamber connected to a cannula or shunt segment which is then grafted directly to the vascular structure (e.g. artery or vein) using a sewable cuff located at the vascular end of the cannula or shunt segment. The vascular end of the device employs a valve which is directly adjacent to the vascular structure after grafting, in order to prevent reflux of blood and subsequent washout of anticoagulant during periods when the device is not in use. The device is accessed percutaneously with a needle or needle-introduced catheter and is filled with anti-coagulant prior to needle withdrawal to prevent thrombosis.