JP2003512893A - Valve ports and methods for vascular access - Google Patents

Abstract

SUMMARY OF THE INVENTION A valve port 10 for accessing blood vessels and other body lumens is a locking device that locks the valve fully open when a needle or other access tube is placed in the port. Includes a mechanism. The locking mechanism includes a latch that typically includes one or more laterally deflectable elements, such as, for example, a set of opposed balls 40. The deflected element is pushed outward by a needle to engage the deep recess 44 in the port 10 and locks the valve open until the needle N is removed.

Description

Detailed Description of the Invention

(Cross-Reference of Related Applications) This application is a non-provisional application serial number 08/9 filed on Oct. 2, 1997.
42,990 pending applications. The non-provisional application claims priority to provisional application serial number 60 / 036,124, filed January 21, 1997. The entire disclosure of the above application is incorporated herein by reference.

BACKGROUND OF THE INVENTION 1. Field of the Invention The present invention relates generally to the design and use of medical devices. More specifically, it relates to the design and use of implantable ports to establish temporary access to a patient's vasculature for hemodialysis and other extracorporeal blood treatments.

Access to a patient's vasculature can be established by a variety of temporary and permanent infusion devices. Briefly, temporary access may be provided by percutaneously introducing a needle directly through the patient's skin and into a blood vessel. The direct approach as described above is relatively simple and suitable for applications such as intravenous administration, intravenous drug delivery, and other applications where time is limited. But these uses are
It is not suitable for hemodialysis and extracorporeal treatments that need to be repeated periodically, and is sometimes poor for the life of the patient.

Various implantable ports have been proposed for many years in the prescription of hemodialysis and other extracorporeal treatments. Ports typically include chambers and access areas (eg, septa). In this access area, the chamber is attached to an implanted catheter. The implanted catheter is then secured to the blood vessel. In the case of veins, the catheter is typically indwelling. In the case of arteries, the catheter may be attached with a conventional anastomosis.

A particular subject matter of the present invention is that the implantable port comprises a septum, typically pierceable by a needle. The septum allows percutaneous penetration of the needle into the inner chamber. The chamber is then connected to one end of the catheter, the other end of which remains in the blood vessel. Workable, but such designs suffer from many problems. Repeated penetration of the partition often causes deterioration over time. This presents a significant risk of particulates getting into the bloodstream and / or requires periodic port replacement. Second, the passage or filling of blood through the chamber often results in regions of turbulent or slow flow. Either way, it may lead to deterioration of blood quality over time.

To overcome these problems, some implantable ports have an internal valve structure that separates the interior of the port from the lumen of the implanted catheter when the port is not in use. However, such valved ports are a drawback in their own right. For example, a self-piercing needle may be damaged by the port and / or
Or it causes damage to the port, which sometimes makes it unusable. In such cases, frequent use of catheters in combination with removable stylets is required. Such catheters are more expensive and inconvenient than using simple needles. Moreover, many valved ports have no way or mechanism to ensure that the valve is fully open, especially when opening the valve by inserting an access needle. In such cases, partial insertion of the needle can result in partial opening of the valve.

Needle actuated valved ports are described in many of the patents listed below. For example, US Pat. Nos. 5,741,228 and 5,702,3.
The port described in No. 63 is shown with a duckbill valve. The port with the duckbill valve is opened by an elastic plug stretched by needle insertion. As long as the needle is fully inserted, the valve will be fully open. However, it is possible to only partially insert the needle, which will only partially open the duckbill valve. Such partial opening can significantly degrade and change valve performance.

For these reasons, it is desirable to provide an improved valved implantable access port for percutaneous access to a patient's blood vessels, including both arteries and veins. The access port comprises a valve structure to separate the port from the associated implanted catheter when the port is not in use. Preferably, the valve provides little or no intraluminal structure of blood flow at the access port. More preferably, the valve does not require a needle passageway or even another access tube through the valve attachment to open the valve. Moreover, the structure of the port, including the components of the valve in the structure, has a substantially uniform cross-sectional area and does not exhibit significant contraction or expansion that impedes flow. Preferably, the port design allows percutaneous access using a conventional needle, such as a fistula needle that does not damage either the port or the needle. Still more preferably, the port comprises means for locking the valve structure open in response to insertion of a needle or other access device. The ports and valves according to the invention fulfill at least some of these objectives.

2. Description of the Background Art US Pat. No. 5,562,617 and WO 95/19200 are assigned to the assignee of the present application and have an internal slit or duckbill valve to prevent backflow into the port. An implantable vascular access system with a port is described.
Vascular access ports with multiple valves to isolate the port from the vasculature lacking an external percutaneous connection to the port are described in US Pat. Nos. 5,954,691 and 5,741, No. 228, No. 5,702,363, No. 5,527,2
No. 78, No. 5,527,277, No. 5,520,643, No. 5,50.
No. 3,630, No. 5,476,451, No. 5,417,656, No. 5
, 350, 360, 5,281, 199, 5,263, 930,
No. 5,226,879, No. 5,180,365, No. 5,057,08
4 and 5,053,013. Other patents and published applications showing implantable ports with valve structures that are opened by needle insertion are US Pat. Nos. 4,569,675, 4,534,759 and 4
, 181,132, 3,998,222 and WO96 / 31246. US Pat. No. 5,637,088 describes a septum-type implantable port that uses dual needles to help prevent movement.

SUMMARY OF THE INVENTION The present invention provides devices and methods for percutaneous access to a body lumen through an implanted access port. More specifically, the present invention provides a method and apparatus for opening and locking a valve assembly inside an access port by the insertion action of an access tube. Insertion may include simply advancing the access tube in the anterior direction. Alternatively, it may include additional or alternative movements (eg rotation). Reverse needle movement and / or removal of the access tube in turn unlocks and closes the valve assembly. The present invention provides a "positive" locking action, reducing some variability of access such as "half-open" valves.
It also reduces the risk of blood loss due to the valve being closed during fluid transfer.

Preferably, the implantable access port using the present invention is particularly for extracorporeal blood therapy (eg, hemodialysis, hemofiltration, hemodiafiltration, apheresis, etc.).
Higher amounts of blood or other fluids can be collected and / or returned for patients experiencing a. The vascular access port therefore allows a high percentage of blood or other flow volumetric measurements. Allows rates of typically higher than 250 ml / min, usually higher than 300 ml / min, preferably at least 400 ml / min, and sometimes 500 ml / min or higher, using one needle or other access device To do. Such a high volumetric flow rate reduces the time required for performing extracorporeal blood treatments, especially for other very long treatments (eg hemofiltration) that require a high total volume of treated blood. That's a big advantage. It is useful to know that the valve is fully open to ensure a high flow rate and minimize the time required. It then allows full access to the body lumen through the conduit while the access tube is in place. Similarly, it is useful to know that the valve is fully closed when the access tube is removed either by inadvertent or accidental withdrawal. that is,
At such high flow rates, inadvertent opening of the valve will cause a significant loss of fluid.

According to the first aspect of the method of the present invention, the lumen of the patient's body can be accessed by percutaneously inserting an access tube into the implantable access port. The access tube can be percutaneously inserted into the access port so that the access tube engages a valve lock having a latch that opens the valve structure inside the port or conduit. Alternatively, the latch may open the valve structure during or after insertion as a result of rotation or other movement of the access tube. The valve structure may be located remotely from the portion of the access port into which the access tube is inserted and may reside on the conduit itself within the port, or in a separate assembly. The latch can be mechanical or hydraulic. The latch is typically mechanically connected to a spring-loaded valve assembly, or a spring-loaded plunger assembly, which mechanically opens the valve. Alternatively, a hydraulic latch may be provided in which the force pushing the plunger assembly is hydraulically induced or the insertion of the access tube opens the valve.

In a more detailed aspect of the invention, the implantable port includes a base having a passageway for receiving an access tube. The valve assembly is located in the base and has a bore. The bore is aligned with the passageway in the base and further receives the access tube. The valve assembly is locked in response to movement of the access tube by the action of a latch that moves into position to lock the valve assembly open. The latch is located between the passage in the base and the bore in the valve. The latch typically comprises at least one space filling element. One,
Or some of the space-filling elements move into one receptacle, adjacent to the passageway, by movement of the access tube in the passageway, where the space-filling elements (typically facing balls) in the receptacle are One is to lock the valve open. When the valve is opened by the action of the plunger (for example, the plunger sticks out through a duck bill, or miter valve), a ball or other space-filling element moves downwards to push down the plunger and open the plunger. Move outwards to lock in.

The space-filling element of a latch typically includes a pair of balls, usually opposed stainless steel balls, similar to a small ball bearing. The stainless steel ball in this orientation is placed between the passage in the base and the bore in the valve. For valve assemblies that open and close in response to the action of a spring loaded plunger, the balls are spring biased to close one another between a passage and a bore in the valve assembly. In one embodiment,
Insertion of the access tube through the passage forces the ball apart and the access tube passes into the bore of the valve assembly. As the ball moves away (outward), it also moves downward into the receptacle. This movement is
Oriented by an outer sloped inner wall between the passage and the bore. Such action pushes down on the plunger and opens the valve. When the access tube is inserted, the ball is held against the tube by the spring loaded plunger and the sloping inner wall and in the receptacle. In addition to locking the valve open in this way, the static friction of the ball against the tube can help hold the access tube in the passageway. It has been found that an inner wall at an angle of 50 degrees or more (relative to the lateral plane through the port) provides higher frictional force for needle retention. Removal of the tube allows the ball to move out of the receptacle in an upward direction due to the movement of the spring loaded plunger. And, the inward movement directed by the angled inner wall is possible. As a result, the balls come into contact again in the passage. In an alternative embodiment, insertion of the access tube may be combined with rotational movement of the access tube. Such a rotating motion experiences a force that forces the ball into and out of the receptacle and facilitates movement of the ball. Therefore, the valve opens. Reverse of such movement by the access tube and / or removal of the access tube subsequently closes the valve.

According to a second aspect of the method of the present invention, percutaneous access to a blood vessel of a patient is provided by maintaining a conduit between the implanted access port and the blood vessel. The access tube is percutaneously inserted into the tubesheet inside the access port to establish the general fluid therein. When inserted, the access tube actuates the valve block to open the valve structure so that it can flow through the conduit. The valve structure is usually inside the port, but in some cases,
Can be placed outside the port. Preferably, the tubesheet includes a tapered bore inside the access port, the access port rubbingly engaging the outer access tube as the tube is inserted into the bore. More preferably, the insertion of the access tube into the tubesheet pushes the tubesheet down against the base of the access port to actuate the valve block that opens the conduit. The valve block can take many forms, including the operation of a latch as described above.

The tubesheet remains fixed in the depressed state until the access tube is removed from the base. Forming the tubesheet (or lining the tubesheet with a stiff material) from a stiff material, preferably one that is stiffer than the needle or other access device to be used, increases the chance of damaging the valve Can be reduced. Moreover, the tapered tubesheet designs do not tend to damage the needles when they are inserted into the ports. Thus, the port of the present invention, unlike many prior art ports, is particularly suitable for use with a self-piercing, sharp needle (eg, a fistula needle).

A further understanding of the nature and advantages of the present invention will become apparent by reference to the remaining portions of the specification and drawings.

DESCRIPTION OF SPECIFIC EMBODIMENTS The present invention provides methods and devices for facilitating percutaneous access to a lumen of a patient's body. Exemplary body lumens include blood vessels, peritoneal cavities, and the like. The method is particularly useful for accessing blood vessels, including both venous and arterial blood vessels. The rest of the description relates specifically to blood vessels, but it is understood that the present invention applies to all body lumens and cavities where selective percutaneous access may be required. For example, the port can be used in peritoneal dialysis procedures for the introduction and removal of dialysate. The access port according to the invention is implanted subcutaneously, the passageway therein having a short distance beneath the patient's skin surface (typically 3 mm to 20 mm from the skin surface).
(between mm). The access tube can then be percutaneously inserted into a passageway in the access port for communicating with the blood vessel, or other body lumen, through the access port. Such access may be provided for a variety of purposes, typically including collecting blood, extracorporeal treatment of the collected blood, and / or returning the treated blood to the patient. Such extracorporeal blood treatment is most often for hemodialysis, but can also be for hemofiltration, hemodiafiltration, apheresis, and the like. In addition to extracorporeal procedures, the access ports of the present invention can be used to perfuse drugs, fluids, and other substances directly into the blood circulation of a patient for a variety of purposes.

The present invention relies on the implantation of an access port and the connection of that port to a blood vessel of the subject, or other body lumen, via a conduit regulated by a valve. The valve is opened by the movement of the access tube in the port and closed by the reverse of that movement. Such movement may include simple insertion of the access tube, or rotational movement, or the like. When motion is imparted, the access tube engages a valve block having a latch that moves to a position that locks the valve assembly open. Locking the valve open ensures both that the valve is fully open and that it remains open to avoid accidental closing. When the tube is removed, the latch returns to its original position and is unlocked, ensuring that the valve is fully closed and avoiding the possibility of accidental leaks.

The access tube is typically a needle that can be perforated (percutaneously introduced) through the patient's skin and directly into the implanted port. Therefore, the needle typically has a pointed tip to allow it to be self-introduced through the skin. Of course, an access tube with a blunted distal end can be used by first piercing the skin with a separate blade, stylet, needle, etc. Then, the access tube is introduced into the obtained incision or hole. The access tube can also be introduced using an internal stylet, which can be subsequently removed, leaving the tube in place in the port. The ports of the present invention can accept a wide variety of access tubes, including standard hypodermic needles, standard fistula needles, large fistula needles (eg, 16 gauge, 14 gauge, or larger). It is important that it can be used. Conventional port designs with septa require the use of relatively small coreless Huber needles or combined tube / stylet use to avoid significant damage to the septum. The same applies to ports. The port uses a slit valve through which the tube must pass, eg many of Ensminger's designs have been described above. In all cases, to activate the connection, which reduces the clamping of the conduit,
The needle or other access tube is stiff and has sufficient column strength. A more detailed description is given below.

The port of the present invention is also advantageous because it generally does not suffer damage from the use of improperly sized needles or other access tubes. While most conventional ports can be damaged with the use of the wrong type or size needle, the ports of the present invention do not allow larger needles (easily engaging the access aperture and passing into the port). ) Or a smaller needle (which enters the access aperture, but passes undamaged into the interior of the base). In particular, the passageway in the access port that receives the needle or other access tube is at least one bend (typically 90
Degrees of elbow) to provide a surface that is engaged by the smaller needle. By forming or lining the passage with a stiffer material (eg, stainless steel) than the needle, the port is protected from any damage due to improper insertion of a small needle.

An exemplary access port 10 including a base 12 and a flexible conduit 14 is shown in FIG.
, FIG. 2, FIG. 2A, FIG. 3 and FIG. 3A. As seen in FIG. 1, flexible conduit 14 extends from base 12 and terminates at distal end 16. The distal end 16 is suitable for direct anastomosis (suture) to a blood vessel. Suitable conduit constructions are described in US Pat. No. 5,562,617, the entire disclosure of which is incorporated herein by reference. The exemplary conduit structure may be constructed from silicone rubber.

The base 12 of the access port 10 includes an upper shell 18, a base plate 20,
With the inner cylinder 22 and a vertically reciprocating plunger 23 located within the actuator block 24, the plunger and actuator block assembly is located together inside the cylinder 22. As seen in FIGS. 2 and 2A, spring 26 biases plunger 23 and actuator block 24 upwards relative to base 20. When the plunger 23 and the actuator block 24 are located above, the conduit 14 is sandwiched and closed between an upper lip 28, which is part of the wall of the cylinder 22, and a lower lip 30, which is part of the actuator block 24. To be The proximal end of conduit 14 is connected to the lower end of tube 32, which depends on the internal volume of actuator block 24. The volume dependent tube 32 provides an axial bore 34 for receiving the needle N, as illustrated in FIGS. 3 and 3A. As best seen in FIG. 3, the tapered region 33 is formed near the upper end of the axial bore 34 to engage the outer surface of the needle or other access tube introduced into the bore, It is sized to seal.

The needle N is introduced through an opening 36 at the upper end of the axial bore 34. Typically, but not necessarily, the opening 36 has a slight chamfer (triangular pyramid) that allows the needle N to be introduced into the bore 34. As seen in FIG. 2, a pair of balls 40 are disposed on top of the tube 32, and when the pair of balls 40 is in the raised configuration, the circular aperture of the shell 18 above the actuator block 24. Included within 42. As can be seen in FIG. 3, the needle N has an opening 3
When introduced through 6, the needle N encounters the ball 40 and pushes down on the plunger 23 and actuator block 24 until the block reaches its lowest position.
At that time, the ball 40 is moved to the expanded portion of the aperture 42, that is, the ramp 44.
Moves radially outward into. Thus, as long as the needle N is in place, the ball 40 is secured within the flared portion or ramp 44, holding the actuator block 24 in the lowered position.

As seen in FIGS. 3 and 3A, when the actuator block 24 is in the lowered position, the opposed lips 28 and 30 are opened to release the clamps external to the conduit 14. . Therefore, the needle N is connected to the access port 10
When inserted therein, the clamping mechanism that previously closed the flexible conduit 14 is opened. When needle N is removed, spring 26 causes actuator block 24 to move.
, And the access port returns to the configuration as seen in FIGS. 2 and 2A.

Conveniently, a silicone overmold 50 is provided around the base of the access port to facilitate implantation of the access port 10. A flange 52 radiating outwardly from the base plate 20 includes holes (not shown) for anastomosis into tissue. Encapsulation of the silicone overmold 50 prevents tissue from extending into the holes. Preferably,
A silicone seal 54 is provided between the interior surface of the upper shell 18 and the top of the tube 32. Silicone seal 54 prevents the ingress of blood or other fluids that may leak from the surrounding tissue and / or through needle N into the interior of access port 10.

In a preferred aspect of the access port 10 of the present invention, the axial bore 34 tapers downwardly. The size of the bore and the degree of taper are selected to frictionally engage a conventional needle or other access tube so that a seal is formed as the access tube is inserted into the axial bore 34. It
The taper also provides a stop so that the needle N does not pierce into the horizontal lumen defined by the conduit 14.

Accordingly, the combination of needle, access port 10 and flexible conduit 14 provides a sufficiently continuous and smooth flow path for fluids from and / or to the patient's vasculature. Can be understood to provide. In particular, by the use of an external clamp to close the flow through conduit 14, the valve mechanism inside the conduit or elsewhere in the access port defining the valve seat (ie, to block flow therein). Eliminates the need for part of the valve to close). The particular connection found to release the clamp from the flexible conduit is simple, secure, and relatively inexpensive to manufacture. Fewer parts need to be moved, and more reliably, a positive seal is achieved each time the needle N is withdrawn from the access port 10. Moreover, once the needle N is introduced into the access port 10, the clamping mechanism is locked in its open configuration and the total flow rate through the lumen of the flexible tubing and other portions of the access port. Guarantee that is maintained.

Referring now to FIGS. 4A and 4B, a further embodiment of an access port 500 constructed in accordance with the principles of the present invention includes a body 512 having a nipple 514 that extends laterally outwardly from the body 512. including. The nipple 514 is suitable for connection with a flexible conduit (not shown). The body 512 includes an upper shell 518, a base plate 520, an inner cylinder 522, a vertically reciprocating plunger 523, and an actuator block 524.
Plunger 523 / actuator block 524 is seen in a vertically raised position in FIG. 4A and vertically depressed or in an underlying configuration in FIG. 4B.

Because the conduit does not extend into the base 512, the port embodiment 500 of FIGS. 4A and 4B uses a separate pinch tube 525. The pinch tube is closed and sandwiched between an upper lip 528 that is part of the cylinder 522 and a lower lip 530 that is part of the reciprocating actuator block 524. As seen in FIG. 4B, when the actuator block 524 is down, the clamp outside the pinch tube 525 is released.

As shown in FIG. 4B, the actuator block 524 is biased upward by a spring 526 attached to a pin 527. And the plunger 5
23 includes an axial bore 534 that receives the needle N. Needle N continues through aperture 536 and into passageway 534 of plunger 523. As shown in FIG. 4B, as the needle enters passage 534, it passes through opposed balls 540. The opposed balls 540 are first lowered onto the plunger 523 and the actuator block 524 and then caught on the flared portion or ramp 544 of the passageway 545.

Insertion of needle N through opposed balls 540 into passage 534 can be easily accomplished by inserting the needle vertically downward, but once the needle is fully lowered, the taper of passage 534 is achieved. The valve is "locked" open by the ball 540 by being engaged by a flat wall (as seen in FIG. 4B). The needle is in the passage 534
It is held in place by frictional engagement in the tapered region of. In addition, the static friction of the ball against the tube can help keep the access tube in the passageway. Such holding force protects the patient from accidental loss of the needle. It has been found that with a simple removal technique it is possible for the needle to be pulled out of the port without significant interference. Thus, the combination of the facing ball 540 and the flared portion 544 for catching the ball not only locks the valve open but also locks the needle in place until removal of the needle is desired.

Referring now to FIGS. 5A and 5B, an alternative valve structure for use with the implantable port of the present invention is illustrated. Instead of using the pinch valve described above, the port may use a sliding valve 600, or a reciprocating block 602 is formed inside a base enclosure 604 (only a portion of which is shown). The reciprocating block 602 has an entrance 606 to the passageway through the port.
Stipulate. An exit 608 of the passageway is also provided to the port. Initially, in the absence of the needle, the spring 610 biases the reciprocating block 602 upwards so that the side portions 612 of the passage are not aligned with the outlet portion 608. Therefore, the sliding valve structure 600 is closed. By introducing a needle N or other access tube into the valve structure 600, as shown in FIG. 5B, the reciprocating block 602 is lowered, so that the lateral branch 612 of the passageway is coupled to the outlet section 608. Line up in a row. Therefore, the valve is opened. In general, the valve may be maintained in the open position by a pair of opposed balls 620 that are received in flared recesses 622, as described above in connection with previous embodiments.

Referring now to FIGS. 6A and 6B, an alternative valve structure for use with the implantable port of the present invention is illustrated. Instead of using the pinch valve or sliding valve described above, the port may use a duckbill valve or a miter valve. Exemplary Port 70 with Duck Bill Valve Assembly
0 comprises a base having a passage 701, a ball 702, a receptacle or ramp 703, an axial bore 704, a vertically reciprocating plunger 705, and a duck bill valve 707. The spring 706 biases the plunger 705 upward with respect to the duckbill valve 707. When the plunger 705 is in the up position, the duckbill valve 707 is closed and the conduit 708 is inaccessible. The tapered region 709 is formed near the upper end of the axial bore 704, and
04 is sized to engage and seal the exterior wall of a needle or other access tube that is introduced into 04.

The needle N is introduced through an opening 710 at the upper end of the axial bore 704.
While not typically required, opening 710 has a slight chamfer (triangular pyramid) that allows needle N to be introduced into bore 704. As seen in FIG. 6A, a pair of balls 702 are positioned in the passage 701 and held in place by the plunger 705 in an elevated position. As shown in FIG. 6B, when the needle N is introduced through the opening 710, the needle encounters the ball 702 and biases and engages the ball forward, causing the plunger 705 to engage the duckbill valve valve 707. Depress plunger 705 downward until it reaches the lowest position to open. At that point, the ball 702 moves radially outward into the receptacle 703. Thus, as long as the needle N remains in place, the ball 702 is locked inside the receptacle 703, holding the plunger 705 in the lowered position.

In a preferred aspect of the access port 700 of the present invention, the axial bore 70.
4 is downwardly tapered. The size of the bore and the degree of taper are selected to frictionally engage a conventional needle or other access tube so that a seal is formed as the access tube is inserted into the axial bore 704. It The taper also provides a stop so that the needle N does not pierce the distal end of the plunger 705. In a further preferred aspect of the access port 700 of the present invention, the plunger assembly 705 includes an end cap 711 attached to its distal end. The cap 711 is adapted to withstand repeated contact with the access tube and resists the passage of the tube so that the tube does not pierce or damage the valve 707.

Although the foregoing invention has been described in some detail with the aid of figures and examples for purposes of clarity of understanding, it will be apparent that certain changes and modifications may be practiced within the scope of the claims. .

[Brief description of drawings]

FIG. 1 is a perspective view of an access port having a flexible conduit extending from the access port constructed in accordance with the principles of the present invention.

2 is a cross-sectional side view of the access port of FIG. 1 showing the internal clamp structure closed.

[FIG. 2A]   2A is a partial cross-sectional view taken along the line 2A-2A of FIG.

FIG. 3 shows the internal clamp structure opened in response to insertion of an access needle,
2 is a lateral cross-sectional view of the access port of FIG.

FIG. 3A   3A is a partial cross-sectional view taken along the line 3A-3A of FIG.

FIG. 4A   FIG. 4A shows an alternative pinch tube connection design.

FIG. 4B   FIG. 4B shows an alternative pinch tube connection design.

FIG. 5A illustrates an embodiment of an implantable port slide valve of the present invention.

FIG. 5B illustrates an embodiment of an implantable port slide valve of the present invention.

FIG. 6A shows an access port having a valve lock mechanism that operates with a duckbill valve.

FIG. 6B shows an access port with a valve lock mechanism operating on a duckbill valve.

─────────────────────────────────────────────────── ─── Continued front page    (81) Designated countries EP (AT, BE, CH, CY, DE, DK, ES, FI, FR, GB, GR, IE, I T, LU, MC, NL, PT, SE), OA (BF, BJ , CF, CG, CI, CM, GA, GN, GW, ML, MR, NE, SN, TD, TG), AP (GH, GM, K E, LS, MW, MZ, SD, SL, SZ, TZ, UG , ZW), EA (AM, AZ, BY, KG, KZ, MD, RU, TJ, TM), AE, AG, AL, AM, AT, AU, AZ, BA, BB, BG, BR, BY, BZ, C A, CH, CN, CR, CU, CZ, DE, DK, DM , DZ, EE, ES, FI, GB, GD, GE, GH, GM, HR, HU, ID, IL, IN, IS, JP, K E, KG, KP, KR, KZ, LC, LK, LR, LS , LT, LU, LV, MA, MD, MG, MK, MN, MW, MX, MZ, NO, NZ, PL, PT, RO, R U, SD, SE, SG, SI, SK, SL, TJ, TM , TR, TT, TZ, UA, UG, UZ, VN, YU, ZA, ZW (72) Inventor Bragger, James M.             United States Massachusetts             01950, Newbury Port, Hirusa             Id Avenue 5 Bee F-term (reference) 4C077 AA05 BB01 BB02 DD20 EE01                       FF04

Claims (11)

[Claims] 1. A base having a passage for receiving an access tube and a valve assembly in the base, the valve assembly having a bore for receiving the access tube, wherein the valve assembly has the access. An implantable valve assembly that opens in response to movement of the tube; and a valve block having a latch that moves into position to lock the valve assembly in response to movement of the access tube. port. 2. The implantable port of claim 1, wherein the valve assembly opens in response to needle movement. 3. The latch comprises at least one space-filling element that is moved from the passage into a receptacle adjacent the passage as the access tube is inserted into the passage, wherein the space. The implantable port of claim 1, wherein a filling element remains in the receptacle to lock the valve assembly open as long as the access tube remains in the bore. 4. The valve assembly comprises a plunger, a set of space-filling elements facing downward to lower the plunger to open the valve and to lock the plunger in the open. 4. Moving inward outwards.
Embeddable port as described in. 5. The fixed valve comprises a pair of laterally moving balls,
The implantable port of claim 3. 6. The implantable port according to claim 1, wherein the valve is selected from the group consisting of a pinch valve, a sliding valve, a slit valve, a duckbill valve, and a leaflet valve. 7. The implantable port of claim 1, wherein the bore comprises a tapered bore that occludes the access tube as the access tube is inserted therein. 8. A method for percutaneously accessing a body lumen, the method comprising maintaining a conduit between an implanted access port and the body lumen. The conduit is opened and closed by a valve in the port, and percutaneously inserting an access tube into the implanted access port, wherein the step of inserting the access tube. Opening the valve and moving the at least one space-filling element into the receptacle so as to lock the valve open until the access tube is removed. 9. The method of claim 8, wherein the space filling element is a ball. 10. The step of inserting the access tube comprises laterally moving at least two opposed balls into the receptacle and locking the ball in place until the access tube is removed. The method according to 8. 11. The method of claim 8, wherein the bore comprises a tapered bore that closes the access tube as the access tube is inserted therein.