Portacatheters with improved stability that utilize small incisions and are easy to implant
Embodiments comprise novel portacatheter structural extensions, wherein a core port with extensions more fully utilizes the port incision, is more stable in the pocket, and fits through the same incision versus the core port without extensions. Extensions resist port flipping by limiting rotation around the port long axis, which enhances the stability of a port with a broad base and permits the design of a stable port with a narrow or absent base. A narrow or absent base enables the port to fit through a small incision. Implantation is further enhanced by expanding the use of the Seldinger technique including the use of dilators and/or balloons in place of blunt dissection to fashion a subcutaneous pocket for a port. In embodiments, the back of the port comprises a closeable aperture, so that the entire portacatheter, with the port and catheter attached, can be inserted over a guidewire.
1 . A portacatheter for implantation in a patient through a port incision, comprising:
a catheter in communication with the portacatheter,
a base having a width, a length, a back end, and a front end,
a geometric core port and one or more structural extensions,
wherein the geometric core port has a shape comprising a left side, a right side, a front, a back, a circular base having a diameter, a circular top having a diameter, a height between the circular base and the circular top, and the left side and the right side extend between the circular base and the circular top,
wherein the one or more structural extensions are selected from the group consisting of one or more base extensions, one or more wing extensions, and one or more lateral extensions that are in contiguity with the geometric core port,
wherein the geometric core port defines an incision circle, wherein the one or more lateral extensions project from the right side and the left side of the geometric core port, and the shape of the geometric core port combined with the one or more lateral extensions define a side width, a base width, and a top width of the portacatheter, wherein the side width of the portacatheter is greater than both the base width and the top width of the portacatheter by at least about 2 mm,
wherein the combined geometric core port and one or more structural extensions fit through the same size incision as does the geometric core port without the one or more structural extensions; and
wherein the portacatheter base is defined by a base plane and a base plane rectangle, wherein the base plane rectangle is defined as a rectangular subset of the base plane having corners, wherein the base plane rectangle comprises the one or more base extensions and the circular base of the geometric core port, wherein the one or more base extensions project from the circular base of the geometric core port within the base plane, and comprise a shape, a height, and a configuration, wherein the shape and the configuration of the one or more base extensions comprises surfaces that project from the circular base of the geometric core port and completely include surfaces at the corners of the base plane rectangle.
2 . The portacatheter of claim 1 , wherein the portacatheter base is further defined by a core base plane square encompassing the circular base of the geometric core port, wherein the base plane rectangle extends beyond the core base plane square both in front of and behind the core base plane square by about 2 mm to about 10 mm, wherein the portacatheter base further comprises a rectangular shape, multiple rectangle shapes, curved shapes, or any combination of said shapes thereof in front of or behind the base plane rectangle, while comprising flat surfaces at the corners of the base plane rectangle.
3 . The portacatheter of claim 1 , wherein at least one or more of the base extensions are planar, and the height is about 1 mm, about 2 mm, about 3 mm, about 4 mm, or about 5 mm.
4 . The portacatheter of claim 3 , wherein the one or more base extensions has a height greater than 3 mm, and is contiguous with either:
a) the one or more lateral extensions that are defined by a side width that is greater than both a base width and a top width by at least about 2 mm, or
b) the one or more wing extensions that project from the front, back, or top, or in any combination thereof, or
c) a combination of a) and b).
5 . The portacatheter of claim 1 , wherein the one or more wing extensions project from the front, back, or top, or in any combination thereof, of the geometric core port and wherein the one or more wing extensions comprise a shape, a height, and a configuration.
6 . The portacatheter of claim 1 , wherein the diameter of the geometric core port circular base is larger, about the same size, smaller, or is a single point as compared to the diameter of the circular top of the geometric core port.
7 . The portacatheter of claim 1 , wherein the shape of the geometric core port combined with the one or more lateral extensions comprise a side width that is greater than both the width of the base and the diameter of the top by about 2 mm to about 10 mm.
8 . The portacatheter of claim 1 , wherein the incision circle has a transverse diameter along a minor axis, wherein the portacatheter has a maximum width at about the transverse diameter of the incision circle that is about equal to or greater than the diameter of the incision circle by about 1 mm to about 10 mm.
9 . The portacatheter of claim 1 , wherein the portacatheter is further defined as having a port long-axis silhouette comprising a top, a base, and sides, wherein the top is flat, the base and sides are rounded or roughly circular.
10 . The portacatheter of claim 9 , wherein the sides of the port long-axis silhouette are fully bilaterally symmetrical about a mid-sagittal plane of the portacatheter.
11 . The portacatheter of claim 10 , wherein the portacatheter has an equatorial level, wherein the equatorial level corresponds to a plane parallel with the base of the port located near midway between the circular top and the circular base, and wherein the portacatheter has a maximum width at the equatorial level that is about equal to the diameter of the incision circle.
12 . The portacatheter of claim 10 , wherein the portacatheter has an equatorial level, wherein the equatorial level corresponds to a plane parallel with the base of the port located near midway between the circular top and the circular base, and wherein the portacatheter has a maximum width at the equatorial level that is greater than the diameter of the incision circle by about 1 mm to about 10 mm.
13 . The portacatheter of claim 10 , wherein the portacatheter has an equatorial level, wherein the equatorial level corresponds to a plane parallel with the base of the port located near midway between the circular top and the circular base, and wherein the portacatheter has a maximum width at the equatorial level that is greater than the diameter of the incision circle by 2 mm to 3 mm.
14 . The portacatheter of claim 1 , wherein the portacatheter is further defined as having a port long-axis silhouette comprising a top that is flat having a width, and a base that is flat having a width, wherein the width of the base is about the same size as or less than the width of the top.
15 . The portacatheter of claim 1 , wherein the one or more lateral extensions are further defined by lateral sidewall rectangles that define the position at which lateral sidewalls project from the geometric core port, wherein the lateral sidewalls have a planar shape, multiple planar shapes, rounded shapes, or any combination of said shapes thereof, each having a length.
16 . The portacatheter of claim 15 , wherein the lateral sidewalls are wider than the diameter of the geometric core port base and the diameter of the geometric core port top over the length of the portacatheter or over a subset of the length of the portacatheter, wherein the length of the lateral sidewalls are longer than either the diameter of the geometric core port base or the diameter of the geometric core port top, and wherein the lateral sidewalls extend in front of, behind, or both in front of and behind the geometric core port.
17 . The portacatheter of claim 1 , having a back end of the portacatheter and a front end of the portacatheter, comprising a retention cuff located either at the back end of the portacatheter, the front end of the portacatheter, or the front end and the back end of the portacatheter.
18 . The portacatheter of claim 1 , wherein the one or more wing extensions are fixed structures and extend either in front of, behind, or both in front of and behind the geometric core port by about 3 mm to about 10 mm.
19 . The portacatheter of claim 1 , wherein the one or more wing extensions are expanding and made of plastic or a metal comprising nitinol.
20 . The portacatheter of claim 1 , wherein the catheter extends into a space of a subject, wherein the space of the subject is other than an intravenous space.
21 . The portacatheter of claim 1 , further comprising one or more port drums and lumens, wherein the port drum is aligned along a major axis of the geometric core port.
22 . A portacatheter for implantation in a patient through a port incision, comprising:
a catheter in communication with the portacatheter;
a base having a width, a length, a back end, and a front end; wherein the length is longer than the width;
a geometric core port and one or more structural extensions,
wherein the geometric core port has a shape comprising a left side, a right side, a front, a back, a circular base having a diameter, a circular top having a diameter, a height between the circular base and the circular top, and an equatorial level, wherein the left side and the right side extend between the circular base and the circular top;
wherein the equatorial level corresponds to a plane parallel with the base of the port located near midway between the circular top and the circular base;
wherein the one or more structural extensions comprise one or more lateral extensions in contiguity with the geometric core port, and optionally comprise one or more base extensions and/or one or more wing extensions;
wherein one or more lateral extensions project from the right side and the left side of the geometric core port, and the shape of the geometric core port combined with the one or more lateral extensions define a side width, a base width, and a top width, wherein the side width is greater than both the base width and the top width by at least about 2 mm;
wherein a widest portion of the combined geometric core port and the one or more structural extensions is at or near an equatorial level;
wherein the portacatheter has a long-axis silhouette in a generally ovoid shape comprising a left side, a right side, and a mid-sagittal plane, wherein over a range from the level of the circular base up to the equatorial level, a lateral distance from the mid-sagittal plane of the portacatheter to an exterior contour of the combined geometric core port and the one or more structural extensions, excluding any base extension, is increasing with increasing height from the level of the circular base; and
wherein any base extension and any wing extension, when present, does not extend laterally beyond the long-axis silhouette of the geometric core port combined with the one or more lateral extensions.
23 . The portacatheter for implantation in a patient through a port incision of claim 22 , wherein, over the range from the level of the circular base up to the equatorial level, a lateral distance from the mid-sagittal plane of the portacatheter to an exterior contour of the combined geometric core port and the one or more structural extensions, excluding any base extensions, does not define any corner having an included angle less than 90 degrees.
24 . The portacatheter for implantation in a patient through a port incision of claim 22 , wherein the one or more structural extensions comprise an equatorial planar surface projecting laterally from at least one of the left side and the right side at or near the equatorial level.
25 . The portacatheter for implantation in a patient through a port incision of claim 22 , wherein the port incision is defined by an incision circle having a diameter, and wherein a maximum transverse width at or near the equatorial level is equal to the diameter of the incision circle.
26 . The portacatheter for implantation in a patient through a port incision of claim 22 , wherein the port incision is defined by an incision circle having a diameter, and wherein a maximum transverse width at or near the equatorial level of the portacatheter is greater than the diameter of the incision circle by about 1 mm to about 10 mm.