Dialysis Catheter

Abstract

A catheter assembly includes catheter having proximal and distal ends and at least one lumen extending between the ends. At least one end of the catheter is formed from a material that can be trimmed to achieve a selected length for the catheter. A tubular connector is telescoped over the catheter and a hub is joined to the tubular connector. Proximal portions of the hub are configured for connection to a medical apparatus. A cuff is mounted around the tubular connector or the catheter. The cuff is formed from a material that will permit or promote the growth of scar tissue for anchoring the catheter device at least on a semi-permanent basis in a patient.

1 . A catheter assembly for at least semi-permanent retention in a patient, said assembly comprising: 
 an elongate catheter having a proximal end for disposition externally of the patient, a distal end for disposition in the patient and at least one lumen extending between the ends, the proximal end of the catheter being trimmable for achieving a selected length between the proximal and distal ends of the catheter;    a first subassembly having a hub and an inner subcutaneous tube with a proximal end connected to the hub, a distal end and a lumen extending between the ends, the lumen of the inner subcutaneous tube being slidably disposed over portions of the catheter adjacent the proximal end of the catheter; and    a second subassembly having an outer subcutaneous tube having opposite proximal and distal ends and lumen extending between the ends, a fibrosing means disposed on the outer subcutaneous tube for promoting a growth of scar tissue for anchoring the catheter assembly in the patient, the second subassembly further having a cap with opposite proximal and distal ends and a lumen extending between the ends, portions of the outer subcutaneous tube adjacent the proximal end thereof being secured to the cap so that the lumens of the cap and the outer subcutaneous tube communicate, the lumens of the cap and the outer subcutaneous tube surrounding a portion of the inner subcutaneous tube, and the cap being releasably engageable with the hub for squeezing the inner subcutaneous tube into secure engagement with the catheter.    
   
   
       2 . The catheter assembly of  claim 1 , wherein the hub is threadedly engageable with the cap.  
   
   
       3 . The catheter assembly of  claim 2 , wherein the distal end of the inner subcutaneous tube extends substantially to the distal end of the outer subcutaneous tube when the cap and the hub are releasably engaged with one another.  
   
   
       4 . The catheter assembly of  claim 3 , wherein the hub further comprises at least one cannula extending therefrom and projecting through the inner subcutaneous tube substantially to the distal end of the inner subcutaneous tube, the cannula projecting from the hub being dimensioned for telescoping into the lumen of the catheter.  
   
   
       5 . The catheter assembly of  claim 1  wherein the lumen through the inner subcutaneous tube is dimensioned at locations in proximity to the distal end of the inner subcutaneous tube for achieving a substantially fluid tight engagement with the catheter for preventing fluid flow between the catheter and the inner subcutaneous tube.  
   
   
       6 . The catheter assembly of  claim 1  wherein the proximal end of the inner subcutaneous tube is flares outwardly at locations adjacent the hub.  
   
   
       7 . A method for implanting a catheter in a patient, the method comprising the steps of: 
 providing a catheter having a proximal end, a distal end and at least one lumen extending between the ends;    inserting the catheter in a patient so that the distal end of the catheter is at a targeted location in a blood vessel of a patient, the proximal end of the catheter is disposed externally of the patient and an intermediate portion of the catheter passes through a subcutaneous tunnel spaced from the blood vessel;    mounting a fibrosing cuff around the intermediate portion of the catheter in the subcutaneous tunnel;    trimming portions of the catheter adjacent the proximal end to define a trimmed proximal end; and    affixing a hub to the trimmed proximal end.    
   
   
       8 . The method of  claim 7 , wherein the step of mounting the fibrosing cuff around the intermediate portion of the catheter comprises providing a subcutaneous tube having the fibrosing cuff disposed thereon, sliding the subcutaneous tube into the subcutaneous tunnel and over the catheter prior to trimming the proximal end of the catheter.  
   
   
       9 . The method of  claim 8 , wherein the subcutaneous tunnel has a first end in proximity to the blood vessel and a second end remote from the blood vessel, the step of inserting the catheter in a patient comprises inserting the distal end of the catheter into the second end of the subcutaneous tunnel, passing the distal end of the catheter from the first end of the subcutaneous tunnel, and inserting the distal end of the catheter into the blood vessel and to the targeted location so that the proximal end of the catheter extends from the patient adjacent the second end of the subcutaneous tunnel.  
   
   
       10 . The method of  claim 8 , wherein the subcutaneous tunnel has a first end in proximity to the blood vessel and a second end remote from the blood vessel, the step of inserting the catheter in a patient comprises, inserting the distal end of the catheter into the blood vessel and to the targeted location so that the proximal end of the catheter extends from the patient at the second end of the subcutaneous tunnel, inserting the proximal end of the catheter into the subcutaneous tunnel and passing the proximal end of the catheter from the subcutaneous tube adjacent the second end of the subcutaneous tunnel.