Medical procedures for the treatment of chronic diseases often require repeated and prolonged access to a patient's vascular system to inject therapeutic compounds and/or to sample or treat the patient's blood. Certain procedures are repeated often enough that it is impractical and dangerous to insert and remove the catheter and the needle from the patient's vein at every session. Many patients are thus fitted with a semi permanent catheter to permit repeated access to the patient's vascular system.
Semi-permanently implanted catheters are generally designed to be as small and thin as possible, to simplify the insertion procedure and to reduce discomfort to the patient. Access to such a catheter is typically provided by one or more ports, which are in fluid connection with the catheter and thus with the patient's vascular system. The port or ports generally have a very thin profile, so they may be implanted in the patient with a minimum of discomfort. In most cases, such a port is implanted subcutaneously, in a pocket formed surgically in the patient's chest or arm so that it lies just under the skin, in a location that is easily accessible to medical personnel. More specifically, a septum of the port is positioned just under the skin so that therapeutic agents may be injected into the port through the skin and through the surface of the septum.
Insertion of therapeutic agents into the catheter is typically carried out by injecting the fluid through the septum of the port, using the needle of a syringe or a similar device. The septum includes at least one surface that is capable of resisting damage cause by multiple piercings from the needle, while re-sealing itself after the needle is withdrawn. The service life of such ports is therefore limited by the durability of the septum. After a certain number of punctures, the septum becomes damaged and is no longer able to re-seal itself. Fluids flowing in the catheter, such as blood, can then leak from the septum necessitating replacement of the port and possibly of the entire catheter. This procedure involves surgically opening the subcutaneous pocket, removing the damaged port from the catheter, and reinserting a new port with an undamaged septum. Replacing the port adds considerable expense, inconvenience and discomfort to the procedure and increases the risk of infections and other complications.
In one aspect, the present invention is directed to an access port comprising a housing with a first opening formed therein and a septum mounted within the housing sealing the first opening, the septum including an outer surface covering the first opening and self-sealing after penetration by a needle and an attachment portion for securing the septum to the housing, the attachment portion including a chamfer which, when the septum is mounted within the housing is subject to a force oriented substantially perpendicularly with respect to a plane of the outer surface, the chamfered portion redirecting a portion of the force to compress the outer surface.
The present invention is further directed to a septum for an access port comprises an attachment portion adapted to abut a septum seat of the access port and an operative surface adapted to permit penetration by a needle and resealing itself after removal of the needle in combination with a chamfered portion providing a transition between the attachment portion and the operative surface, the chamfered portion re-directing a component of a force applied to the chamfered portion to compress the operative surface.
The present invention may be further understood with reference to the following description and the appended drawings, wherein like elements are referred to with the same reference numerals. The invention is related to medical devices used to introduce fluids into a venous catheter. Specifically, the devices according to the invention are used to increase the useful life of venous ports that may be implanted in a patient to interface with an implanted venous catheter. However, those skilled in the art will understand that the present invention is equally applicable to a wide range of applications in which a port with puncturing a self-sealing septum is implanted in the body. For example, although the invention is described for use with a port for the injection of fluids, the port may just as well be used to withdraw fluids with no change in structure.
As described above, catheters are often semi-permanently implanted to facilitate repeated access to a patient's vascular system. Such catheters may comprise a flexible elongated portion that extends through tissue to enter a blood vessel or other organ. The proximal end of the catheter may be connected to a port placed subcutaneously (e.g., in the chest or the arm) to provide access to the catheter.
The port allows fluids (e.g., chemotherapy agents, blood products, nutrients, therapeutic agents etc.) to be introduced into the patient's vascular system via a syringe or other similar device. The port is a thin element generally connected directly to the catheter through an outlet and having an inlet opening positioned so as to remain substantially flush with the patient's skin after implantation. When not in use, the inlet opening is sealed to prevent blood and other fluids from leaking from the catheter, and at the same time to prevent contaminants from entering into the catheter. To that end, septa have been used to cover and seal the inlet openings of such ports. Such a septum generally comprises a flexible membrane that overlies the inlet opening and seals it with the material forming the septum being selected for its ability to continue sealing the port even after repeated punctures by a needle. For example, silicone or other elastomeric materials have been used to form such septa.
In normal use, the septum is punctured with a needle whenever it is necessary to inject a fluid into the port. Over time, the cumulative damage degrades the material forming the septum so that, after being punctured a sufficient number of times, the septum is unable to re-seal itself after withdrawal of the needle. When the septum is still new, the elastic properties of the membrane tend to “bunch up” or push together the edges of the hole left in the membrane by the puncture. As the membrane is used and the number of holes formed therein increases, the amount of elastic membrane material present around new punctures to close the edges thereof decreases until new holes can no longer be fully closed. At this point, leakage through the operative membrane of the septum begins.
The undesirable result described above is exacerbated if the membrane of the septum is placed under tension as the openings left by punctures are stretched when the membrane is under tension. In addition, tension may tear the membrane around the holes, so that over time the puncture openings become larger and may tear through the membrane. The number of punctures that a septum may withstand depends on the size of the port, the material used, and the size of needles used to inject fluids therethrough. As would be expected, larger needles cause more damage while a larger surface area septum provides more room to spread out the punctures. High quality ports may withstand around 10,000 punctures before replacement is necessitated.
Exemplary embodiments of a septum according to the present invention improve the durability of the corresponding venous port by reducing degradation of the septum due to large numbers of punctures. As will be described in greater detail, an increase in puncture damage resistance is obtained by applying a compressive force to the septum membrane. The compressive force pushes together the edges of individual puncture holes and assists the elastic properties of the membrane in sealing such holes. According to the present invention, the improvement to the membrane forming the operative surface of the septum allows an increase in the number of punctures that can be withstood by the septum before excessive leakage requires replacement. Thus, the incidence of surgical procedures required to replace the port or the entire catheter is reduced.
The base 104 is designed to form a well 200 into injected into which fluid injected into the port 100 is temporarily collected. The well 200 is in fluid communication with an outlet opening 108 of the port 100, which in turn leads to a connection with a catheter (not shown). In one exemplary embodiment, a valve 110 may be placed at the opening of the outlet 108 to prevent undesired flow into or out of the catheter. In this exemplary embodiment, the cover 102 comprises a shroud portion 118 designed to form an outer surface of the port 100, and a top portion 120 defining an inlet opening 202. The top portion 120 is intended to be flush under the patient's skin when the device is implanted, so that a needle can enter the opening 202 after piercing the patient's skin and a septum 106 closing the opening 202. The shroud portion 118 may be shaped to interlock with the outlet portion 108 of the base 104, and may have a cutout portion around the outlet opening 108 and the inlet opening 202 is sized to substantially match the size of a septum 106, so that when the device is assembled, the inlet opening 202 is sealed by the septum 106.
The septum 106 comprises a top membrane 112 that acts as the operative surface of the port 100, through which the therapeutic compounds are injected. The septum 106 may also include an attachment portion 114 to secure the septum 106 in place within the port 100. In the exemplary embodiment, the attachment portion 114 is an annular element that surrounds a periphery of the top membrane 112 extending outward substantially perpendicularly therefrom. According to the present invention, a chamfer portion 208 provides a transition between the operative surface of the membrane 112, and the attachment portion 114. The purpose of the chamfer portion 208 is to apply a compressive force to membrane 112. In the exemplary embodiment, this force is provided by the compression of the septum 106 between the base 104 and the cover 102 when the port 100 is assembled. The shape and orientation of the chamfer portion 208 re-directs the force applied by the assembled components of the port 100 to the septum 106, so that a component of that force acts radially inward along the membrane 112.
More specifically, the chamfer portion 208 of the septum 106 comprises an annular surface 210 formed on an underside of the septum 106 facing the base 104. The annular surface 210 is adapted to overlie and abut a septum seat 204 of the base 104, when the port 100 is assembled. In this manner the septum seat 204 provides an inner support to the chamfer portion 208. When the port 100 is assembled by securing the cover 102 to the base 104, the septum 106 is squeezed between those two components. A bottom bearing surface 206 of the cover 102 presses down on the chamfer portion 208, squeezing it against the septum seat 204. The inner bearing surface 201 of the cover 102 also applies a force radially inward against the chamfer portion 208. The shape of the chamfer portion 208 causes a component of the downward force applied thereto by the inner bearing surface to be re-directed radially inward along the surface of the membrane 112 around the periphery thereof, so that a compressive force is applied to the operative surface of the septum 106. Thus, the chamfer portion 208 gives to the septum a shape similar to that of a top hat.
As shown in
The combination of a properly shaped chamfer portion of a septum, and of a venous port housing shaped to hold the septum in place thus provides an increased resistance to damage due to punctures through the septum. Although the present exemplary embodiment describes a port housing formed of two separate components, other housing configurations may be successfully used. According to the invention, when a force is applied to the septum by the components of the assembled venous port, the chamfer portion of the septum may be designed to convert a component of that applied force into a compressive force acting radially inward along the operative surface. Different configurations of the port's housing may thus be devised to apply the proper force to the septum when the port is assembled.
As will be understood by those of skill in the art, additional shapes of the septum's chamfer portion may be used. For example,
A third exemplary embodiment according to the invention is shown in
Additional benefits with respect to the useful life of the septum may be obtained by using an oversized septum, in relation to the inlet opening of the venous port. For example, as illustrated in
According to the present invention, the assembly details of the venous port being assembled may dictate some of the design features of the septum. For example, the angle taken by the surfaces of the chamfer portion may vary to match the corresponding surfaces of the port. The various dimensions and orientations of the septum's surfaces also may vary, in accordance with the size and shape of the port in which the septum is used. Accordingly, great latitude may be used within the general shape of the top hat-shaped septum, according to the present invention, to fit the device in an appropriate venous port. As described above, many shapes of chamfer portions may be used to apply a compressive force to the operative surface of the septum, by re-directing a component of the force applied during port assembly. The materials used in forming the septum, as well as cost and ease of assembly considerations may determine which specific design is selected.
The present invention has been described with reference to specific embodiments, and more specifically to a septum used in a venous catheter port. However, other embodiments may be devised that are applicable to other medical devices, without departing from the scope of the invention. Accordingly, various modifications and changes may be made to the embodiments, without departing from the broadest spirit and scope of the present invention as set forth in the claims that follow. The specification and drawings are accordingly to be regarded in an illustrative rather than restrictive illustrative rather than restrictive sense.
Number | Name | Date | Kind |
---|---|---|---|
3159175 | Macmillan | Dec 1964 | A |
3477438 | Allen et al. | Nov 1969 | A |
3525357 | Koreski | Aug 1970 | A |
3541438 | Nelsen et al. | Nov 1970 | A |
3669323 | Harker et al. | Jun 1972 | A |
3674183 | Venable et al. | Jul 1972 | A |
3811466 | Ohringer | May 1974 | A |
3853127 | Spademan | Dec 1974 | A |
3955594 | Snow | May 1976 | A |
3971376 | Wichterle | Jul 1976 | A |
4143853 | Abramson | Mar 1979 | A |
4447237 | Frisch et al. | May 1984 | A |
4543088 | Bootman et al. | Sep 1985 | A |
4610665 | Matsumoto et al. | Sep 1986 | A |
4692146 | Hilger | Sep 1987 | A |
4772270 | Wiita et al. | Sep 1988 | A |
4781680 | Redmond et al. | Nov 1988 | A |
4802885 | Weeks et al. | Feb 1989 | A |
4857053 | Dalton | Aug 1989 | A |
4886501 | Johnston et al. | Dec 1989 | A |
4886502 | Poirier et al. | Dec 1989 | A |
4892518 | Cupp et al. | Jan 1990 | A |
4897081 | Poirier et al. | Jan 1990 | A |
4904241 | Bark | Feb 1990 | A |
4908029 | Bark et al. | Mar 1990 | A |
4929236 | Sampson | May 1990 | A |
5009391 | Steigerwald | Apr 1991 | A |
5009644 | McDonald | Apr 1991 | A |
5045060 | Melsky et al. | Sep 1991 | A |
5053013 | Ensimger et al. | Oct 1991 | A |
5059186 | Yamamoto et al. | Oct 1991 | A |
5069206 | Crosbie | Dec 1991 | A |
5084015 | Moriuchi | Jan 1992 | A |
5092849 | Sampson | Mar 1992 | A |
5129891 | Young | Jul 1992 | A |
5137529 | Watson et al. | Aug 1992 | A |
5147483 | Melsky et al. | Sep 1992 | A |
5167638 | Felix et al. | Dec 1992 | A |
5180365 | Ensminger et al. | Jan 1993 | A |
5205834 | Moorehead et al. | Apr 1993 | A |
5242415 | Kantrowitz et al. | Sep 1993 | A |
5249598 | Schmidt | Oct 1993 | A |
5263930 | Ensminger | Nov 1993 | A |
5281199 | Ensminger et al. | Jan 1994 | A |
5312337 | Flaherty et al. | May 1994 | A |
5318545 | Tucker | Jun 1994 | A |
5350360 | Ensminger et al. | Sep 1994 | A |
5352204 | Ensminger | Oct 1994 | A |
5356381 | Ensminger et al. | Oct 1994 | A |
5387192 | Glantz et al. | Feb 1995 | A |
5396925 | Poli et al. | Mar 1995 | A |
5399168 | Wadsworth et al. | Mar 1995 | A |
5417656 | Ensminger et al. | May 1995 | A |
5423334 | Jordan | Jun 1995 | A |
5453097 | Paradis | Sep 1995 | A |
5476451 | Ensminger et al. | Dec 1995 | A |
5520643 | Ensminger et al. | May 1996 | A |
5527277 | Ensminger et al. | Jun 1996 | A |
5527278 | Ensminger et al. | Jun 1996 | A |
5531684 | Ensminger et al. | Jul 1996 | A |
5542923 | Ensminger et al. | Aug 1996 | A |
5554117 | Ensminger et al. | Sep 1996 | A |
5556381 | Ensminger et al. | Sep 1996 | A |
5558641 | Galntz et al. | Sep 1996 | A |
5562618 | Cai et al. | Oct 1996 | A |
5607393 | Ensminger et al. | Mar 1997 | A |
5613945 | Cai et al. | Mar 1997 | A |
5662616 | Bousquet | Sep 1997 | A |
5707357 | Mikhail et al. | Jan 1998 | A |
5741228 | Lambrecht et al. | Apr 1998 | A |
5755780 | Finch et al. | May 1998 | A |
5792104 | Speckman et al. | Aug 1998 | A |
5792123 | Ensminger | Aug 1998 | A |
5797886 | Roth et al. | Aug 1998 | A |
5814016 | Valley et al. | Sep 1998 | A |
5848989 | Villani | Dec 1998 | A |
5879322 | Lattin et al. | Mar 1999 | A |
5882341 | Bousquet | Mar 1999 | A |
5897528 | Schultz | Apr 1999 | A |
5906596 | Tallarida | May 1999 | A |
5911706 | Estabrook et al. | Jun 1999 | A |
5941856 | Kovacs et al. | Aug 1999 | A |
5944688 | Lois | Aug 1999 | A |
5944698 | Fischer et al. | Aug 1999 | A |
5954687 | Baudino | Sep 1999 | A |
5954691 | Prosl | Sep 1999 | A |
5961497 | Larkin | Oct 1999 | A |
5989216 | Johnson et al. | Nov 1999 | A |
6056717 | Finch et al. | May 2000 | A |
6086555 | Eliasen et al. | Jul 2000 | A |
6099508 | Bousquet | Aug 2000 | A |
6152909 | Bagaoisan et al. | Nov 2000 | A |
6190352 | Haarala et al. | Feb 2001 | B1 |
6210366 | Sanfilippo | Apr 2001 | B1 |
6287293 | Jones et al. | Sep 2001 | B1 |
6306124 | Jones et al. | Oct 2001 | B1 |
6527754 | Tallarida et al. | Mar 2003 | B1 |
6592571 | Verbeek et al. | Jul 2003 | B1 |
6610031 | Chin | Aug 2003 | B1 |
6726063 | Stull et al. | Apr 2004 | B2 |
6962577 | Tallarida et al. | Nov 2005 | B2 |
7033339 | Lynn | Apr 2006 | B1 |
20030141477 | Miller | Jul 2003 | A1 |
Number | Date | Country |
---|---|---|
2399057 | Aug 2001 | CA |
0128525 | Dec 1984 | EP |
0343910 | Nov 1989 | EP |
0366814 | May 1990 | EP |
0858814 | Aug 1998 | EP |
2508008 | Dec 1982 | FR |
2809315 | Nov 2001 | FR |
0966137 | Aug 1964 | GB |
2102398 | Feb 1983 | GB |
WO-9206732 | Apr 1992 | WO |
WO-9405351 | Mar 1994 | WO |
WO-9516480 | Jun 1995 | WO |
WO-9701370 | Jan 1997 | WO |
WO-9723255 | Jul 1997 | WO |
WO-9726931 | Jul 1997 | WO |
WO-9818506 | Aug 1997 | WO |
WO-9942166 | Aug 1999 | WO |
WO-0012171 | Mar 2000 | WO |
WO-0016844 | Mar 2000 | WO |
WO-0044419 | Aug 2000 | WO |
WO 2005068009 | Jul 2005 | WO |
Entry |
---|
International Search Report and Written Opinion mailed Mar. 29, 2005 for International Application No. PCT/US2004/043229 (9 pages). |
International Preliminary Report on Patentability mailed Jul. 10, 2006 for International Application No. PCT/US2004/043229 (7 pages). |
Number | Date | Country | |
---|---|---|---|
20050148957 A1 | Jul 2005 | US |