Subcutaneous vascular access ports and related systems and methods
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.
1. A method of securing an access port to a vessel having a lumen, the method comprising:
making an incision in a skin area such that the incision is substantially parallel to the vessel;
exposing the vessel such that access to an outer wall of the vessel is maintained;
positioning an access port adjacent to the wall of the vessel, the access port having a base and a body attached to the base, the base including a plurality of attachment passages, and a guidance passageway extending through the body and the base;
securing the access port to the vessel by inserting an attachment device through at least one of the plurality of attachment passages and into the vessel; and
closing the incision,
wherein the guidance passageway is not in fluid communication with the lumen of the vessel.
2. The method of claim 1 , wherein the attachment device is a running suture that is inserted through all of the attachment passages in the securing step.
3. The method of claim 2 , wherein the running suture is passed through all layers of the vessel in the securing step.
4. The method of claim 1 , wherein the attachment device includes a plurality of sutures each of which is inserted individually into each attachment passage to secure the access port to the vessel.
5. The method of claim 1 , wherein the attachment device is a pinch ring, a hook, or a wire.
6. The method of claim 1 , wherein the incision is not made directly over the vessel.
7. The method of claim 1 , wherein the vessel is a vein associated with an arteriovenous fistula.
8. The method of claim 7 , wherein the attachment device is a running suture that is inserted through all of the attachment passages in the securing step.
9. The method of claim 8 , wherein the running suture is passed through all layers of the vessel in the securing step.
10. The method of claim 7 , wherein the attachment device includes a plurality of sutures each of which is inserted individually into each attachment passage to secure the access port to the vessel.
11. A method of securing an access port to a vessel, the method comprising:
making a first incision in a skin area such that the incision is substantially parallel to the vessel, the vessel having an adventitia layer, a media layer, an intima layer, and a lumen;
exposing the vessel such that access to the adventitia layer of the vessel is maintained;
separating the adventitia layer from the underlying media layer;
making a second incision in the adventitia layer;
inserting an access port through the second incision;
positioning the access port adjacent to the vessel, the access port having a base and a body attached to the base, the base including a plurality of attachment passages, and a guidance passageway extending through the body and the base;
securing the access port to the vessel by inserting one or more attachment devices through the plurality of attachment passages and into the vessel; and
closing the first incision,
wherein the adventitia layer extends over the guidance passageway and the guidance passageway is not in fluid communication with the lumen of the vessel.
12. The method of claim 11 , wherein the attachment device is a running suture that is inserted through all of the attachment passages in the securing step.
13. The method of claim 12 , wherein the running suture is passed through the adventitia layer, the media layer, and the intima layer of the vessel in the securing step.
14. The method of claim 11 , wherein the attachment device includes a plurality of sutures each of which is inserted individually into each attachment passage to secure the access port to the vessel.
15. The method of claim 11 , wherein, in the separating step, a portion of the adventitia layer remains attached to the media layer and the access port is placed on the attached portion of the adventitia layer in the positioning step.
16. The method of claim 11 , wherein the incision is not made directly over the vessel.
17. The method of claim 11 , wherein the vessel is a vein associated with an arteriovenous fistula.
18. The method of claim 17 , wherein the attachment device is a running suture that is inserted through all of the attachment passages in the securing step.
19. The method of claim 17 , wherein, in the separating step, a portion of the adventitia layer remains attached to the media layer and the access port is placed on the attached portion of the adventitia layer in the positioning step.
20. The method of claim 17 , wherein the attachment device includes a plurality of sutures each of which is inserted individually into each attachment passage to secure the access port to the vessel.