US20110311337A1 - Access port identification systems and methods - Google Patents

Abstract

An access port for subcutaneous implantation is disclosed. Such an access port may comprise a body for capturing a septum for repeatedly inserting a needle therethrough into a cavity defined within the body. Further, the access port may include at least one feature structured and configured for identification of the access port subsequent to subcutaneous implantation. Methods of identifying a subcutaneously implanted access port are also disclosed. For example, a subcutaneously implanted access port may be provided and at least one feature of the subcutaneously implanted access port may be perceived. Further, the subcutaneously implanted access port may be identified in response to perceiving the at least one feature. In one embodiment, an identification feature is engraved or otherwise defined by the access port, so as to be visible after implantation via x-ray imaging technology.

Description

RELATED APPLICATIONS
• This application is a continuation of U.S. application Ser. No. 12/420,028, filed Apr. 7, 2009, now U.S. Pat. No. 7,947,022, which is a continuation-in-part of U.S. application Ser. No. 11/368,954, filed Mar. 6, 2006, now U.S. Pat. No. 7,785,302, which claims the benefit of U.S. Provisional Application No. 60/658,518, filed Mar. 4, 2005. Each of the afore-referenced applications is incorporated, in its entirety, by this reference.
BRIEF DESCRIPTION OF THE DRAWINGS
• FIG. 1A shows a perspective view of an embodiment of an access port according to the instant disclosure;
• FIG. 1B shows a schematic side cross-sectional view the access port shown inFIG. 1A;
• FIG. 2 shows a perspective view of an embodiment of an access port according to the instant disclosure;
• FIG. 3 shows a perspective view of an access port according to the instant disclosure;
• FIG. 4 shows a perspective view of an access port according to the instant disclosure;
• FIG. 5 shows a perspective view of an access port according to the instant disclosure;
• FIG. 6A shows a perspective view of an access port according to the instant disclosure;
• FIG. 6B shows a side view of the access port shown inFIG. 6A;
• FIG. 7 shows a perspective view of an access port according to the instant disclosure;
• FIG. 8 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 9 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 10 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 11 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 12 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 13 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 14 shows a simplified perspective view of a cap for forming an access port according to the instant disclosure;
• FIG. 15A shows a perspective view of an embodiment of an access port according to the instant disclosure;
• FIG. 15B shows a top elevation view of the access port shown inFIG. 15A;
• FIG. 16 shows a perspective view of an access port according to the instant disclosure;
• FIG. 17 shows a perspective view of an access port according to the instant disclosure;
• FIG. 18 shows a perspective view of an access port according to the instant disclosure;
• FIG. 19 shows a perspective view of an access port according to the instant disclosure;
• FIG. 20 shows a perspective view of an access port according to the instant disclosure;
• FIG. 21 shows a perspective view of an access port according to the instant disclosure;
• FIG. 22 shows a perspective view of another embodiment of an access port according to the instant disclosure;
• FIG. 23 shows a top elevation view of the assembled access port shown inFIG. 22;
• FIG. 24 shows a simplified representation of a transverse cross section of the access port shown inFIGS. 22 and 23;
• FIGS. 25-51 show perspective views of additional embodiments of an access port.
• FIG. 52 shows a bottom perspective view of an access port according to one embodiment;
• FIG. 53A shows a top view of the access port shown inFIG. 52;
• FIG. 53B shows a bottom view of the access port shown inFIG. 52;
• FIG. 54A represents a radiographic image of the access port shown inFIG. 52 when viewed from above the access port;
• FIG. 54B represents a radiographic image of the access port shown inFIG. 52 when viewed at an angle of approximately 20 degrees;
• FIG. 54C represents a radiographic image of the access port shown inFIG. 52 when viewed at an angle of approximately 50 degrees;
• FIG. 55 shows a cross-sectional view of the access port shown inFIG. 52;
• FIGS. 56A and 56B show cross-sectional views of example embodiments of engraved features on an access port surface;
• FIG. 57A shows a top perspective view of an access port according to one embodiment;
• FIG. 57B shows a bottom perspective view of the access port shown inFIG. 57A;
• FIG. 57C shows a bottom view of the access port shown inFIG. 57A;
• FIG. 58A shows a top perspective view of another embodiment of an access port;
• FIG. 58B shows a bottom perspective view of the access port shown inFIG. 58A;
• FIG. 58C shows a bottom view of the access port shown inFIG. 58A;
• FIG. 59A shows a side view of an embodiment of an access port;
• FIG. 59B shows a bottom view of the access port shown inFIG. 59A;
• FIG. 60A shows a bottom perspective view of an additional embodiment of an access port;
• FIG. 60B shows a bottom view of the access port shown inFIG. 60A;
• FIG. 61A shows a bottom perspective view of an additional embodiment of an access port;
• FIG. 61B shows a bottom view of the access port shown inFIG. 61A;
• FIG. 62A shows a bottom view of an additional embodiment of an access port;
• FIG. 62B shows a side view of the access port shown inFIG. 62A;
• FIG. 62C shows an end view of the access port shown inFIG. 62A;
• FIG. 63A shows a bottom view of another embodiment of an access port;
• FIG. 63B shows a side view of the access port shown inFIG. 63A; and
• FIG. 63C shows an end view of the access port shown inFIG. 63A.
DETAILED DESCRIPTION
• The instant disclosure relates generally to percutaneous access and, more specifically, to methods and devices associated with percutaneous access. Generally, the instant disclosure relates to an access port for subcutaneous implantation. In one embodiment, an access port may allow a physician or other medical personnel to obtain long term percutaneous access to the interior of a patient's body. Employing an access port for percutaneous access may reduce the opportunity for infection by inhibiting fluid connections (that extend into the interior of a patient's body) from the patient's skin and from the external environment. The access device allows access to the interior of the patient without requiring a needle to pierce the skin. Further, internal components, such as a catheter or a valve, may be replaced without a surgical procedure. Features or aspects of the instant disclosure may apply to any such access ports for subcutaneous access to a patient, without limitation. The access port may be injected by hand (e.g., via a syringe including a needle) for example, or may be injected and pressurized by mechanical assistance (e.g., a so-called power injectable port).
• Power injectable ports may be employed in, among other processes, for example, computed tomography (“CT”) scanning processes. More particularly, a so-called “power injector” system may be employed for injecting contrast media into a peripherally inserted intravenous (IV) line. For example, such power injectors or injection systems may be commercially available from Medrad, Inc., a subsidiary of Schering AG, Germany and may be marketed under the trademark STELLANT®. Because fluid infusion procedures are often defined in terms of a desired flow rate of contrast media, such power injection systems are, in general, controllable by selecting a desired flow rate.
• More specifically, the instant disclosure relates to an access port having at least one perceivable or identifiable feature for identifying the access port, wherein the identifiable feature is perceivable after the access port is implanted within a patient. For example, at least one or perhaps multiple identifiable feature(s) of an access port contemplated by the instant disclosure may be correlative to information (e.g., a manufacturer's model or design) pertaining to the access port. Thus, an identifiable feature from an access port of a particular model may be unique in relation to most if not all other identifiable features of another access port of a different models or design. Of course, the at least one identifiable feature of an access port contemplated by the instant disclosure may be further correlative with any information of interest, such as type of port, catheter type, date of manufacture, material lots, part numbers, etc. In one example, at least one identifiable feature of an access port may be correlative with the access port being power injectable. In this way, once at least one identifiable feature of an access port is observed or otherwise determined, correlation of such at least one feature of an access port may be accomplished, and information pertaining to the access port may be obtained.
• In one embodiment, at least one feature may be perceived by palpation (i.e., to examine by touch), by way of other physical interaction, or by visual observation. Accordingly, a person of interest may touch or feel the access port through the skin to perceive at least one identifying characteristic thereof. In another embodiment, at least one identifiable feature may be perceived via x-ray or ultrasound imaging. In yet a further embodiment, at least one identifiable feature may be perceived through magnetic, light, or radio energy interaction or communication with the access port.
• Turning to the embodiment wherein at least one feature may be perceived through palpation, other physical interaction, or visual observation, a topography or exterior surface feature of an access port contemplated by the instant disclosure may be configured for perception. For example, referring toFIGS. 1A and 1B, anexemplary access port10 contemplated by the instant disclosure is shown.FIGS. 1A and 1B show a perspective view and a schematic side cross-sectional view, respectively, of anaccess port10 for allowing percutaneous or otherwise internal access to a patient's body.Access port10 includes a housing orbody20 defined by acap14 and abase16.Cap14 andbase16, as known in the art, may be configured for capturing therebetween aseptum18. As shown inFIG. 1A,cap14 andbase16 may matingly engage one another along amating line15.Cap14 andbase16 may be secured or affixed to one another via mechanical fasteners such as screws or other fastening devices, may be adhesively affixed to one another, or may be affixed to one another as known in the art. Further,cap14,base16, andseptum18 may collectively define acavity36 in fluid communication with alumen29 ofoutlet stem31.
• Thebody20 may be implanted in a patient7, as shown inFIG. 1B, to dispose thecavity36 subcutaneously within the patient7. Also, suture apertures66 (FIG. 1A) may be used to affix theaccess port10 within the patient7, if desired. After thebody20 is implanted in a patient7, the upper surface of theseptum18 may be substantially flush with the surface of the skin6 of the patient7 and may be repeatedly punctured for creating a percutaneous passageway from the exterior of the skin of the patient into thecavity36. The outlet stem31 may create a fluid-communicative passageway from thecavity36 through theoutlet stem31 and into the interior of the patient7. A catheter may be coupled to theoutlet stem31 for fluid communication with thecavity36 and for transferring fluid from thecavity36 to a desired remote location from thecavity36 and within a patient7.
• Body20 ofaccess port10 may comprise a bio-compatible material such as polysulfone, titanium, or any other suitably bio-compatible material as known in the art. Accordingly, thebody20 may be formed from a bio-compatible plastic material. If desired, thebody20 may comprise a penetrable material for penetration by sutures or needles. In another embodiment, and as discussed further hereinbelow,body20 may comprise an impenetrable material such as, for instance, a metal if desired.Body20 may include a concave bottom or, in another embodiment, may include a flat bottom, without limitation.
• According to the instant disclosure,access port10 may comprise abody20 exhibiting at least one identifiable feature. More particularly, as shown inFIG. 1A,body20 may exhibit a partial generally pyramidal shape (i.e., a polygonal base having surfaces for each side of the polygon extending toward a common vertex otherwise known as a frustum). Generally, abody20 of anaccess port10 may exhibit a partial pyramidal shape extending between a generally quadrilateral shaped base positioned atreference plane11 and a generally quadrilateral shaped upper base positioned atreference plane9.Reference planes9 and11 will not be shown inFIGS. 2-21, for clarity; however, reference toplanes9 or11 with respect toFIGS. 2-21, as used herein, will refer to corresponding reference planes analogous toreference planes9 and11 as shown inFIGS. 1A and 1B.
• As shown inFIG. 1A, the exterior ofaccess port10 is substantially defined by four substantially planar side surfaces50 connected to one another byradiuses32. In addition, theupper topography61 ofaccess port10 is defined byupper surface60 in combination withchamfers46A and46B and may be further defined by the upper surface ofseptum18. Explaining further, the outer periphery ofupper topography61 may be described as a generally quadrilateral exterior formed byside regions54 and having roundedcorner regions30adjacent side regions54. Such a configuration may provide an access port having at least one feature that may be perceived by palpation.
• It may be appreciated that there are many variations to the geometry ofaccess port10 as shown inFIG. 1A. For instance, while thebody20 ofaccess port10 may be described as a partially pyramidal shape or frustum, the instant disclosure is not so limited. Rather, one or more of side surfaces50 may be oriented at as may be desired, without reference to any other side surfaces50. Accordingly, for example, one ofsurfaces50 may be substantially vertical while the remainingsurfaces50 may be oriented at respective, selected angles. Furthermore, it should be understood thatFIG. 1A is merely exemplary and that the dimensions and shape as shown inFIG. 1A may vary substantially while still being encompassed by the instant disclosure.
• FIG. 2 shows a perspective view of another embodiment ofaccess port10 according to the instant disclosure. As shown inFIG. 2, the exterior ofaccess port10 is substantially defined by a generally parallelogram-shaped base (positioned atreference plane11 as shown inFIGS. 1A and 1B) extending generally pyramidally to a generally parallelogram-shaped upper surface (positioned atreference plane9 as shown inFIGS. 1A and 1B). As shown inFIG. 2, radiuses42 may be larger thanradiuses32 as shown inFIG. 1A. Furthermore, theupper topography61 ofaccess port10 as shown inFIG. 2 may include roundedcorner regions40 which are larger than roundedcorner regions30 as shown inFIG. 1A. Thus,FIG. 2 shows an exemplary embodiment of anaccess port10 that may be perceivably distinguishable fromaccess port10 as shown inFIGS. 1A and 1B. For example, a difference between one exterior of an access port contemplated by the instant disclosure and another exterior of a different access port contemplated by the instant disclosure may be determined by way of palpation.
• In another embodiment, in another aspect contemplated by the instant disclosure, a template may be employed for perceiving at least one feature of an access port. For instance, a complementarily-shaped template may be positioned over and abutted against an access port contemplated by the instant disclosure so as to determine if the access port matches or substantially corresponds to the shape of the template. Such a process may reliably indicate or perceive at least one feature of an access port contemplated by the instant disclosure. Of course, a plurality of templates corresponding to different models of access ports may be serially engaged with an unknown access port so as to perceive at least one feature thereof. Such a process may allow for identification (e.g., of a model or manufacturer) of an access port contemplated by the instant disclosure.
• In another aspect contemplated by the instant disclosure, an upper topography of an access port may include at least one feature for identifying the access port. For example, as shown inFIG. 3,upper surface60 ofaccess port10 may be nonplanar. More specifically,upper surface60 may be tapered or may arcuately extend downwardly (i.e., towardreference plane11 as shown inFIGS. 1A and 1B) as it extends radially inwardly towardseptum18. Otherwise,access port10, as shown inFIG. 3, may be configured substantially as described hereinabove with reference toFIGS. 1A and 1B. Thus,upper surface60 is one exemplary example of at least one perceivable feature for identification of an access port contemplated by the instant disclosure.
• In yet a further embodiment of an access port contemplated by the instant disclosure,side regions54 extending betweenrounded corner regions30 may exhibit at least one perceivable feature. For example, as shown inFIG. 4,access port10 may include one ormore side regions54 that extend arcuately between adjacentrounded corner regions30. Otherwise,access port10, as shown inFIG. 4, may be configured substantially as described hereinabove with reference toFIGS. 1A and 1B.Side regions54 may be congruent or symmetric with respect to one another or, in another embodiment, may be configured differently with respect to one another, without limitation.
• FIG. 5 shows a further exemplary embodiment of an access port contemplated by the instant disclosure. More specifically,access port10, as shown inFIG. 5, includesside regions54 that form recessedregions72 between adjacentrounded corner regions30. Put another way, theupper topography61 may include alternating recessedregions72 and protrudingregions70 positioned generally about a periphery ofseptum18. Otherwise,access port10, as shown inFIG. 5, may be configured substantially as described hereinabove with reference toFIGS. 1A and 1B. Such a configuration may provide an access port having at least one identifiable feature.
• In a further embodiment of an access port contemplated by the instant disclosure,FIGS. 6A and 6B show a perspective view and a side view, respectively, of anaccess port10 generally configured as is described with reference toFIG. 5 but having anelongated body20E. More specifically,elongated body20E ofaccess port10, as shown inFIGS. 6A and 6B, includes aside surface50E that extends generally fromupper topography61 downwardly (i.e., towardreference plane11 as shown inFIGS. 1A and 1B) and having a slope (e.g., an angle with respect to a vertical axis normal to an upper surface of septum18) which is different from the other side surfaces50. Otherwise,access port10, as shown inFIG. 6, may be configured substantially as described hereinabove with reference toFIGS. 1A and 1B. Such a configuration may provide anelongated body20E of anaccess port10 having an elongated side portion.
• Of course, one or more side surfaces of an access port according to the instant disclosure may be configured for forming a body exhibiting a selected shape as may be desired. An elongated body portion of an access port contemplated by the instant disclosure may form, in combination with other features as described hereinabove or, in another embodiment, taken alone, at least one perceivable feature for identification of an access port according to the instant disclosure.
• FIG. 7 shows a further embodiment of an access port encompassed by the instant disclosure. Particularly, as shown inFIG. 7,access port10 may include anupper body portion20aand alower body portion20b.Furthermore, each ofupper body portion20aandlower body portion20bmay exhibit a partial pyramidal shape (i.e., a frustum), wherein thebody portions20aand20bare stacked vertically with respect to one another. Accordingly,upper body portion20amay form an overhangingrim feature76 extending along a periphery ofaccess port10. Explaining further,lower body portion20bmay have an exterior substantially defined byside surfaces50band roundedcorner regions30b,whileupper body portion20amay have an exterior substantially defined byside surfaces50a,roundedcorner regions30a,andupper topography61. It may be appreciated that overhangingrim feature76 may be sized and configured for perception via palpation. Such a configuration may provide a suitable access port for delivery of a beneficial or medicinal substance, the access port being identifiable (e.g., by model number, manufacturer, etc.) after implantation.
• It should be understood that the instant disclosure contemplates access ports having an exterior geometry that is not quadrilateral in nature. Rather, the instant disclosure contemplates that an access port may have an exterior which is generally cylindrical, generally conical, generally elliptical, generally oval, or an exterior that is otherwise arcuate in nature. Specifically, the instant disclosure contemplates that an access port having a substantially rounded or arcuate exterior may include at least one feature configured for identification of the access port after implantation. For example, as shown inFIG. 8, shows acap14 that exhibits anexterior surface78 that is substantially conical.Cap14 may be assembled to a suitable base (not shown) for capturing a septum (not shown) as described hereinabove to form anaccess port10 as generally described with reference toFIGS. 1-7.
• The instant disclosure further contemplates that at least one protrusion, protruding region, recess, recessed region, undulation, or adjacent features of different elevation may comprise a feature for identifying an access port contemplated by the instant disclosure. More specifically,upper topography61C, as shown inFIG. 8, may include a plurality ofprotrusions80.Protrusions80 may exhibit partially spherical upper surfaces that transition into a lower portion ofcap14. In further detail,protrusions80 may be circumferentially spaced about the periphery of septum (not shown) as may be desired. In one embodiment, a plurality ofprotrusions80 may be symmetrically circumferentially spaced about the periphery of septum (not shown). More generally, at least oneprotrusion80 may be sized, configured, and positioned for forming at least one identifiable feature of an access port. Of course, at least oneprotrusion80 may be structured for facilitating comfort of a patient within which the access port is implanted. As may be appreciated, at least oneprotrusion80 or more than oneprotrusion80 may be included in anupper topography61C of an access port (not shown) contemplated by the instant disclosure.
• FIG. 9 shows another embodiment of acap14 including at least oneprotrusion80E for forming and identifying an access port contemplated by the instant disclosure after implantation thereof within a patient.Protrusions80E may extend circumferentially about a center of revolution. Thus,protrusions80E may exhibit abody87 portion circumferentially extending between rounded ends83. Further,cap14 may have anexterior surface78 that is substantially symmetric about an axis of revolution. More generally,body20 may extend from a generally circular, generally elliptical, or generally oval base positioned at alower extent71 of thecap14 to an upper generally circular, generally elliptical, or generally oval cross section that is smaller than a cross section of the base and is positioned at an upper extent73 (without consideringprotrusions80E) of thecap14. In addition,side surface51, as shown inFIG. 9, extends arcuately between the base and theupper topography61 ofcap14.Side surface51 may extend in a generally tapered or conical fashion, may exhibit a radius or other arcuate shape, or may otherwise transition between a cross section of the base of the access port to a cross section proximate theupper topography61C thereof.
• Further,FIG. 10 shows an embodiment of acap14 for forming an access port contemplated by the instant disclosure having anupper topography61C thereof comprising alternating circumferentially extendingprotrusions80E and circumferentially extendingrecesses82, wherein thecircumferentially extending protrusions80E are circumferentially larger than thecircumferentially extending recesses80E. In another embodiment of an access port contemplated by the instant disclosure,FIG. 11 shows a perspective view of acap14 having anupper topography61C thereof comprising alternating circumferentially extendingprotrusions80E and circumferentially extendingrecesses82, wherein thecircumferentially extending protrusions80E and thecircumferentially extending recesses82 are substantially equal in (circumferential) sized or extension. In yet a further embodiment of acap14 for forming an access port contemplated by the instant disclosure,FIG. 12 shows a perspective view of acap14 having anupper topography61C thereof comprising three circumferentially extendingprotrusions80E and three circumferentially extendingrecesses82, arranged so as to alternate circumferentially, wherein thecircumferentially extending protrusions80E and thecircumferentially extending recesses82 are substantially equal in (circumferential) size.
• FIG. 13 shows a perspective view of an additional embodiment of ancap14 for forming an access port contemplated by the instant disclosure including anupper topography61C including circumferentially extendingprotrusions80T and circumferentially extendingrecesses82T, wherein transition regions81 are provided between circumferentially extendingprotrusions80T and circumferentially extendingrecesses82T. Such transition regions81, as shown inFIG. 13, may taper or generally smoothly transition between a circumferentially extendingprotrusion80T and a circumferentially extendingrecess82T. Also,FIG. 14 shows a perspective view of an additional embodiment of acap14 for forming an access port contemplated by the instant disclosure including anupper topography61C includingprotrusion regions96 and recessedregions98 that transition between one another and alternate circumferentially so as to form an undulating topography comprisingupper topography61C. Such an undulating topography, as shown inFIG. 14, generally smoothly transitions between circumferentiallyadjacent protrusion regions96 and recessedregions98.
• In a further embodiment of an access port contemplated by the instant disclosure,FIGS. 15A and 15B show a perspective view and a top elevation view, respectively, of anaccess port10 generally configured as is described with reference toFIG. 5 but may include at least one nonplanar side surface. In another embodiment,access port10 as shown inFIG. 15 may be configured as shown inFIGS. 1-4 orFIGS. 6-7, or any embodiments described hereinbelow, without limitation. More specifically,elongated body20 ofaccess port10, as shown inFIGS. 15A and 15B, includes threeside surfaces50R that extend arcuately (as shown inFIG. 15B). Such a configuration may provide anaccess port10 that is identifiable subsequent to implantation. In yet another embodiment of an access port contemplated by the instant disclosure,FIG. 16 shows a perspective view of anaccess port10 including aside wall100 that truncates a portion of aradius32 formed between side surfaces50 ofaccess port10. It may also be noted that such anaccess port10 may include threesuture apertures66, which may, taken alone or in combination with at least one other feature, comprise at least one identifiable feature of an access port contemplated by the instant disclosure. In addition, as shown inFIG. 16, outlet stem31 may extend fromside wall100.
• In a further embodiment of an access port contemplated by the instant disclosure,FIG. 17 shows a perspective view of anaccess port10 whereincap14 andbase16, when assembled to one another alongmating line15, form a flange feature or lip feature102 that extends about at least a portion of the periphery of theaccess port10. As shown inFIG. 17, lip feature102 extends substantially about the periphery of theaccess port10, proximate to themating line15 betweencap14 andbase16. Such a feature may comprise at least one identifiable feature of an access port contemplated by the instant disclosure. Thus, it may be appreciated that a peripheral discontinuity between thecap14 andbase16 may be formed generally along themating line15 therebetween. In the embodiment of an access port as shown inFIG. 7, an overhangingrim feature76 may comprise a peripheral discontinuity or, in the embodiment of an access port as shown inFIG. 17, a lip feature102 may comprise a peripheral discontinuity.
• In a further embodiment of an access port contemplated by the instant disclosure,FIG. 18 shows a perspective view of anaccess port10 wherein at least a portion of at least oneside surface50 is concave. As shown inFIG. 18,concave region106 ofside surface50 is concave. Concavity (i.e., a concave region106) may be exhibited over at least a portion of a side surface of an access port of any of the embodiments as shown herein, without limitation. Thus, at least oneside surface50 of an access port contemplated by the instant disclosure having at least at least a portion thereof that is concave is one exemplary example of at least one perceivable feature for identification of an access port contemplated by the instant disclosure.
• In a further embodiment of an access port contemplated by the instant disclosure,FIG. 18 shows a perspective view of anaccess port10 wherein at least a portion of at least oneside surface50 is concave. As shown inFIG. 18,region106 ofside surface50 is concave. Concavity may be exhibited over at least a portion of a side surface of an access port of any of the embodiments as shown herein, without limitation. Thus, at least oneside surface50 of an access port contemplated by the instant disclosure having at least at least a portion thereof that is concave is one exemplary example of at least one perceivable feature for identification of an access port contemplated by the instant disclosure.
• In a further embodiment of an access port contemplated by the instant disclosure,FIG. 19 shows a perspective view of anaccess port10 generally configured as is described with reference toFIGS. 6A and 6B. More specifically, elongated body20ER, as shown inFIG. 19 includes a side surface50ER that extends arcuately fromupper topography61 ofaccess port10 downwardly (i.e., towardreference plane11 as shown inFIGS. 1A and 1B). Such a configuration may provide anelongated body20E of anaccess port10 having an elongated side portion.
• It should be understood from the above-described various embodiments of an access port contemplated by the instant disclosure that many variations, additions, or different features may be encompassed by the instant disclosure. Thus, the instant disclosure is not limited to the several above-described exemplary embodiments.
• For example, as shown inFIG. 20, which shows a top elevation view of anaccess port10 contemplated by the instant disclosure, anaccess port10 may include aside wall100 that at least partially truncates aradius32 between side surfaces50, outlet stem31 extending fromside wall100, and at least one of aconcave region106 and anarcuate surface50R. Further, as shown inFIG. 20,suture apertures66 may be positioned so as to identify theaccess port10 after subcutaneous implantation.
• Additionally, the instant disclosure contemplates access ports having an exterior geometry that is polygonal in nature. Specifically, the instant disclosure contemplates that an access port contemplated by the instant disclosure may exhibit a generally triangular exterior. Thus, as shown inFIG. 21,body20 may exhibit a generally pyramidal or tapered shape (i.e., a polygonal base having surfaces for each side of the polygon extending toward a common vertex). Generally, abody20T of anaccess port10 may extend between a generally triangularly-shaped base and a relatively smaller, generally triangularly-shaped upper base. Accordingly, the exterior ofaccess port10 may be substantially defined by three side surfaces (e.g.,50,50R,102,50E) havingradiuses32 extending therebetween. In addition, theupper topography61 ofaccess port10 may be defined byupper surface60 in combination withside regions54 and roundedcorner regions30. Such a configuration may provide an access port having at least one feature that may be perceived by palpation.
• FIGS. 22 and 23 show a perspective view and a top elevation view of another embodiment of an access port including a generally triangular exterior geometry. More particularly, as shown inFIGS. 22 and 23, acap14 and base16 (collectively forming a housing) may capture aseptum118 to form anaccess port10. Further, outlet stem31 may include a stem base that may be positioned within and sealed to anoutlet recess93 formed withinbase16. The outlet stem31 may be in fluid communication with a cavity formed within theaccess port10. Optionally, suture plugs89 may be positioned withinsuture cavities91 formed inbase16. Suture plugs89 may comprise a pliant material (e.g., silicone, rubber, etc.) that may provide some resilience between sutures coupling the access port10 (i.e., the base16) to a patient. In further detail, a side periphery95 (e.g., one or more side walls) ofaccess port10 may be generally triangular. Thus,cap14 andbase16 may collectively form a generally triangular housing or body ofaccess port10. Also, the instant disclosure contemplates thatside periphery95 may increase or decrease in cross-sectional size (e.g., by tapering or arcuately transforming) betweenupper surface161 ofcap14 andlower surface151 ofbase16. As shown inFIGS. 22 and 23, a transverse cross section (taken in a selected plane substantially parallel tolower surface151 of base16) ofaccess port10 may be larger proximate to lowersurface151 ofbase16 and may be relatively smaller proximateupper surface161 ofcap14.
• Additionally,FIG. 24 shows a simplified representation of a transverse cross section ofaccess port10. As shown inFIG. 24,side periphery95 ofaccess port10 may define threeside regions103 that extend between associatedvertex regions101. In addition, in one embodiment and as shown inFIG. 24,side periphery95 may define a substantially equilateral generally triangular shape. As one of ordinary skill in the art will appreciate,side regions103 may arcuately extend between associatedvertex regions101; thus,side regions103 may form “sides” of a generally triangular shape. Further, althoughvertex regions101 are rounded, it may be appreciated thatsuch vertex regions101 form an intersection betweenadjacent side regions103. Accordingly, one of ordinary skill in the art will appreciate that the phrase “generally triangular,” as used herein, encompasses any generally three-sided geometry wherein adjacent sides intersect, without limitation. For example, the phrase “generally triangular” encompasses three sided polygons, circular triangles, equilateral triangles, etc., without limitation.
• The instant disclosure also contemplates that at least one feature of an access port contemplated by the instant disclosure may not be observable visually or by palpation but, rather, may be otherwise observable. For example, the instant disclosure contemplates that at least one feature of an access port may be observable through interaction with an imaging technology such as x-ray or ultrasound. For example, in one embodiment, a metal feature (e.g., a plate or other metal geometry) may be included by an access port contemplated by the instant disclosure. As may be appreciated, such a metal feature may be represented on an x-ray generated by exposure of the access port to x-ray energy while simultaneously exposing x-ray sensitive film to x-ray energy passing through the access port. Further, the instant disclosure contemplates that a size, shape, or both size and shape of a metal feature of an access port may be configured for enhancing identification of an access port. For example, assuming that a metal feature comprises a metal plate, a size, shape, or both may be selectively tailored for identification of an access port. Similarly, a feature of an access port contemplated by the instant disclosure may be tailored for detection via ultrasound interaction. Such a feature may comprise an exterior topographical feature. In another embodiment, such a feature may comprise a composite structure including two or more materials that form an interface surface that may be identified by ultrasound imaging.
• One example embodiment of a feature observable through interaction with imaging technology contemplated by the instant disclosure is shown inFIGS. 52,53A, and53B.FIG. 52 depicts a bottom perspective view of anaccess port10.FIG. 53A shows a top view of theaccess port10, whileFIG. 53B shows a bottom view of the access port. Theaccess port10 ofFIGS. 52,53A, and53B is similar in some respects to theaccess port10 as seen inFIGS. 22 and 23, including acap14 and a base16 that cooperate to define a body. In the present example embodiment, however, thelower surface151 of thebase16 includes anidentification feature200, as seen inFIGS. 52 and 53B. It is contemplated that theidentification feature200 can be one or more alphanumeric characters, such as the “CT” depicted. Additionally, the instant disclosure contemplates the use of other markings, such as one or more symbols, patterns, characters, designs, a combination thereof, etc. Theidentification feature200 can be of any size, shape, or both in order to tailor the identification feature for the specific identification of one or more of a variety of characteristics of the access port. Specifically, in one embodiment theidentification feature200 can convey information to a practitioner regarding the power-injectability of the implanted access port. Note that in the present embodiment, theidentification feature200 is defined as a recessed feature, whereas in other embodiments the identification feature may be defined in other ways, as discussed hereafter.
• As mentioned above,FIG. 53A depicts a top view of theaccess port10. Note that theidentification feature200 is not observable through theupper surface161 of thecap14 or through theseptum118 without the interaction of imaging technology. As seen inFIG. 53B, the alphanumeric characters of theidentification feature200, “CT,” are engraved mirror-reversed on thelower surface151 of thebase16. The “CT” is engraved mirror-reversed so that when imaging technology, such as x-ray imaging, is used to identify a subcutaneously implanted access port, the “CT” will be visible in the proper orientation. By engraving a desired identification feature mirror-reversed on the bottom surface of an access port, a practitioner will be able to determine if there is a problem with the port after implantation, such as if the access port has flipped or otherwise become mis-oriented while in the body of the patient. Thus, if the identification feature is seen mirror-reversed or askew in an x-ray image, the practitioner can correct the problem before attempts are made to use the access port.
• Although also useful in access ports where only a portion of a port includes a metallic material, e.g., a metal plate, the engraving technique is well-suited in one embodiment for access ports that are composed of solid metal, such as titanium, stainless steel, or other materials that are typically radiopaque, i.e., non-transmissive to x-rays in sufficient thickness.FIGS. 54A-54C are representative images of theaccess port10 ofFIG. 52, which includes titanium or other metallic material, as seen via x-ray imaging after implantation into the patient. Theaccess port10 includes theidentification feature200 as seen inFIGS. 52 and 53B. Due to the relative thickness of theaccess port10, the material of thebase16 andcap14 surrounding acavity periphery36A of thecavity36, which is a fluid cavity, is substantially non-transmissive to x-rays and therefore appears relatively dark in the x-ray image ofFIG. 54A. However, the material of theaccess port10 within thecavity periphery36A is relatively thinner through a cavity base220 (as seen inFIG. 55) than through the material of thecap14 andbase16. Thus, additional thinning of the material when creating theidentification feature200 enables the identification feature to appear relatively more radiographically transmissive than the surrounding material of the cavity base under x-ray imaging. Note that theidentification feature200 inFIG. 54A is visible in the proper orientation, indicating that the access port is not flipped.
• FIGS. 54B and 54C are additional representative x-ray images of theidentification feature200 of theaccess port10, wherein the access port is tilted at angles of approximately 20 and 50 degrees, respectively. Thus, theidentification feature200 is also useful for determining relative orientation of theaccess port10 after implantation.
• FIG. 55 shows a cross-sectional view taken at line55-55 of theaccess port10 inFIG. 52. In this example embodiment, theidentification feature200 is disposed beneath theseptum118 and thecavity36.FIGS. 56A and 56B further depict enlarged cross-sectional views of potential cut profiles of the recessedidentification feature200.FIG. 56A shows arounded engraving profile201, engraved on thelower surface151 of thebase16 and used for purposes of aesthetics and ease of manufacturing. For a relatively more defined contrast under imaging technology, however, a sharp-edgedengraving profile202 may be used, as seen inFIG. 56B. Note that a variety of cross-sectional recessed profiles may be employed. This disclosure further contemplates that although engraving is discussed here, other methods of marking the identification feature may be used, such as milling, machining, chemical or laser etching, molding, stamping, etc.
• Regardless of the cut profile used, better contrast is achieved generally with greater engraving depth X. The optimal engraving depth X will depend, however, on the thickness of theoverall cavity base220, which is the portion of the base directly below thecavity36, as shown inFIG. 55. For example, in an embodiment of an access port including titanium, if the overall thickness of thecavity base220 is approximately 0.020″ then sufficient contrast for x-ray imaging purposes can be obtained in one embodiment by engraving theidentification feature200 to a depth X (FIGS. 56A,56B) of between about 0.009″ and about 0.011″. In another example embodiment of an access port including titanium, where the overall thickness of thecavity base220 is approximately 0.030″, sufficient contrast can be obtained by engraving theidentification feature200 to a depth X of between about 0.015″ and about 0.021″. One of ordinary skill in the art will appreciate that the depth of an engraved identification feature can be varied substantially in order to comply with a product's safety requirements and still remain within the scope contemplated by this disclosure. In addition, the depth X of the identification feature can vary according to the position of the feature on the access port, the thickness of material to be penetrated by the imaging technology, the type of material included in the access port, etc.
• It is also contemplated by this disclosure that the use of an identification feature in a metallic or other radiopaque access port can be applied to access ports having a variety of possible configurations, such as is seen inFIGS. 57A-58C, for example.FIGS. 57A-57C depict one embodiment, wherein theaccess port10 includes anidentification feature200 on alower surface251 of a base orbody116. Theaccess port10 inFIGS. 57A-57C includes a retainingring230, which seals theseptum118 to the base orbody116, over thecavity36. In one embodiment, the retainingring230 is press fit into the base orbody116 to hold theseptum118 in place.FIGS. 58A-58C show yet another embodiment, wherein theaccess port10 includes anidentification feature200 on thecavity base220 and wherein the cavity base is mated to and flush with alower surface252 of acap114 to define a body. In a particular embodiment, thecavity base220 is press fit into thecap114, though other mating configurations can also be employed.
• In another embodiment contemplated by the instant disclosure,FIGS. 59A and 59B show that the location of theidentification feature200 can vary as well. Rather than placing theidentification feature200 under thecavity36, it is possible to place the identification feature under another portion of theaccess port10, such as under theoutlet stem31 and between the septum plugs89, i.e., proximate the outer periphery of the access port bottom surface. Though the overall thickness of the access port structure above theidentification feature200 is greater in this location than if engraved under thecavity36, the change in location allows for a relatively deeper engraving, which will increase contrast without risk of excessive thinning of thecavity base220. Additionally, in one embodiment, it is possible to define the identification feature compositely by engraving into both the bottom and top surfaces, such that the engravings are vertically aligned. This enables the remaining material thickness to be substantially reduced in order to provide relatively greater radiographic transmission through the identification feature.
• Additionally, the instant disclosure contemplates access ports having any variety or combination of desired identification features for indicating power-injectability or other aspect or characteristic of an access port. Specifically,FIGS. 60A-61B depict different types of identification features200, according to example embodiments.FIGS. 60A-60B depict asymbolic identification feature200.FIGS. 61A-61B depict an exemplary embodiment of anaccess port10 including a combination of identification features200, namely analphanumeric identification feature200A and a patternedidentification feature200B. A patterned or symbolic identification feature can also be used to help indicate the orientation of the port or for any other desired reason. It is understood by the instant disclosure that other symbols, patterns, marks, and alphanumeric characters can be used both alone and in any combination with each other on a variety of access port configurations.
• In additional embodiments, the identification feature can be defined on aninside bottom surface36B of thecavity36 of anaccess port10, or in addition to theidentification feature200 provided on thebottom surface251. In another embodiment, the material surrounding the defining edges of the desired radiopaque alphanumeric character, symbol, pattern, etc., can be removed instead of removing the desired feature shape itself so as to define a “positive” relief image of the identification feature. Such a positive relief identification feature can be defined on a lower surface of an access port body or on the inside bottom surface of the cavity, for example.
• In addition to the various types of symbols, patterns, marks, and alphanumeric characters that are contemplated by the instant disclosure,FIGS. 62A-63C disclose additional example embodiments of identifying features on access ports that are observable via x-ray or other suitable imaging technology. Specifically, the instant disclosure contemplates the use of shelled-outcavities204, wherein portions of theaccess port10 are hollowed out. This results in shelled-outcavities204 extending inward from thelower surface251 of the base orbody116 or corresponding port lower surfaces of the other embodiments described herein, including thelower surface151 of thebase16, as inFIG. 151, and thelower surface252 of acap114, as inFIGS. 58A-58C. This is done by removing the material surrounding thecavity36 without disrupting thecavity periphery36A or the outer side surfaces250 of theaccess port10. As seen inFIG. 62B,ribs240 may be left to support the remaining “shelled” frame of theaccess port10. The definition ofsuch cavities204 provides a relative difference in radiopacity of theaccess port10 that can be identified via x-ray imaging. As such, thecavities204 can be arranged to define a pattern or to form an indicia for identification of an aspect or characteristic of theaccess port10. Note that in other embodiments, the cavities can be defined so as to extend from other surfaces of the access port, including the top and sides thereof.
• In a further aspect contemplated by the instant disclosure, it is contemplated that a communicative technology may be utilized wherein information is encompassed by an access port contemplated by the instant disclosure. Generally, a communication device (e.g., a radio beacon, a light-emitting element, an ultrasound emitting transducer, etc.), may be imbedded or otherwise affixed to an access port contemplated by the instant disclosure. Such a communication device may be configured for transmitting information in response to a given impetus. More specifically, the instant disclosure contemplates that an access port contemplated by the instant disclosure may be exposed to a request signal (e.g., a sound, an impact or an acceleration, light, radio waves, etc.). Such a request signal may cause the communication device to transmit information therefrom via sound, light, radio waves, or as otherwise known in the art. Such information may be employed for identifying an access port contemplated by the instant disclosure.
• In one exemplary example, it is contemplated that radio frequency identification technology may be employed for identification of an access port contemplated by the instant disclosure. Particularly, so-called active RFID tags are powered by an internal battery and are typically read/write devices. Currently, a suitable cell coupled to suitable low power circuitry can ensure functionality for as long as ten or more years, depending upon the operating temperatures and read/write cycles and usage. So-called passive RFID tags operate without a separate external power source and obtain operating power generated from the reader. Passive RFID tags are typically programmed with a unique set of data (usually 32 to 128 bits) that cannot be modified. Read-only tags may operate as an identifier comparable to linear barcodes which may contain selected product-specific information. Thus, passive RFID tags may be much lighter than active RFID tags, less expensive, and may offer a virtually unlimited operational lifetime. The tradeoff is that they have shorter read ranges than active tags and require a higher-powered reader.
• One advantage of RFID approach is the noncontact, non-line-of-sight nature of the technology. Tags can be read through a variety of substances such as snow, fog, ice, paint, crusted grime, and other visually and environmentally challenging conditions, where other optically read technologies may be less effective. RFID tags can also be read in challenging circumstances at rapid speeds, in most cases responding in less than about 100 milliseconds.
• While certain representative embodiments and details have been shown for purposes of illustrating aspects contemplated by the instant disclosure, it will be apparent to those skilled in the art that various changes in the methods and apparatus disclosed herein may be made without departing form the scope contemplated by the instant disclosure, which is defined in the appended claims. For example, other access port sizes and shapes may be employed; and various other embodiments and structures may be employed for forming at least one identifiable feature of an access port contemplated by the instant disclosure. In particular,FIGS. 25-51 illustrate a number of additional exemplary embodiments ofaccess port10. As is apparent from these figures,access port10 may be formed in any number of shapes and sizes, such that any number of modifications and changes are possible to any of the embodiments described and illustrated herein without departing from the spirit and scope of the instant disclosure.

Claims (18)

1. A method of making an access port for providing subcutaneous access to a patient, comprising:

providing a metallic body defining a fluid cavity accessible by inserting a needle through a septum; and

creating a recessed identification feature in a bottom surface of the metallic body, the recessed identification feature observable via x-ray imaging technology subsequent to subcutaneous implantation of the access port, the recessed identification feature identifying the access port as a power-injectable port.

2. The method according toclaim 1, wherein the creating step includes utilizing a marking method selected from the group consisting of: engraving, milling, machining, chemical etching, laser etching, molding, stamping, and combinations thereof.

3. The method according toclaim 1, wherein the bottom surface is an external surface of the metallic body.

4. The method according toclaim 1, wherein the bottom surface is an internal surface of the fluid cavity.

5. The method according toclaim 1, wherein the recessed identification feature includes one or more alphanumeric characters.

6. The method according toclaim 5, wherein the one or more alphanumeric characters includes the letters “C” and “T.”

7. The method according toclaim 1, wherein the recessed identification feature indicates an orientation of the access port when the access port is imaged by x-ray imaging technology.

8. The method according toclaim 1, wherein the recessed identification feature is created below the fluid cavity, and is bound by an outer perimeter of the fluid cavity.

9. The method according toclaim 1, wherein the provided metallic body comprises titanium.

10. The method according toclaim 9, wherein the created recessed identification feature has a depth in the range of about 0.009 inch to about 0.011 inch when the thickness of the bottom surface is about 0.020 inch.

11. The method according toclaim 9, wherein the created recessed identification feature has a depth in the range of about 0.015 inch to about 0.021 inch when the thickness of the bottom surface is about 0.030 inch.

12. The method according toclaim 1, wherein the providing step includes:

providing a metallic base defining the fluid cavity; and

coupling a cap to the base such that a septum is disposed between the cap and the base, and the septum is accessible through an opening in the cap.

13. The method according toclaim 13, wherein the bottom surface is an external surface of the base.

14. The method according toclaim 14, wherein the coupling step includes press-fitting the base into the cap such that the external surface of the base is flush with a lower surface of the cap.

15. The method according toclaim 1, wherein the recessed identification feature is created below an outlet stem of the port, outside an outer perimeter of the fluid cavity.

16. The method according toclaim 15, further comprising creating a second recessed identification feature in a top surface of the metallic body such that the second recessed identification is vertically aligned with the first recessed identification feature.

17. The method according toclaim 15, wherein the recessed identification feature includes one or more alphanumeric characters.

18. The method according toclaim 17, wherein the one or more alphanumeric characters includes the letters “C” and “T.”

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