| 摘要 |
The present invention provides devices, systems, and methods for positioning an article, such as a graft or catheter, in a subcutaneous tunnel between skin and muscle tissue of a patient to establish improved access to the patient's vascular system for hemodialysis, hemofiltration, or other extracorporeal blood treatments. In particular, the present invention provides devices, systems, and methods which minimize longitudinal forces or friction acting against the vascular graft as it is being subcutaneously positioned while still providing a tight seal between the graft and the subcutaneous tissue, which in turn minimizes hematomas, bleeding, and infections and enhances needle accessibility of the graft for extracorporeal treatment. A system for subcutaneously positioning an article comprises a tunneling tool, a pair of nested tubes coupleable to a trailing end of the tunneling tool, and a flexible article which can be slidably received within the pair of nested tubes. The nested tubes each have a leading end, a trailing end, and a longitudinal opening.
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