the present invention is a permanent or semipermanent hemodialysis access sheath and an adapter for a hemodialysis catheter . fig1 shows the hemodialysis access sheath 10 and a modified hemodialysis catheter 12 as envisioned by the current invention . the broken line in fig1 indicates where the modified hemodialysis catheter 12 inserts into the access sheath 10 . the adapter 14 , as shown in fig2 can be affixed to any standard hemodialysis catheter . the hemodialysis catheter 12 has a catheter tube 30 , a distal end 26 , and a proximal end 28 as shown in fig1 and 2 . the adapter 14 consists of a hub 16 , a flange 18 , a first restriction band 20 , and a second restriction band 22 . ideally , the flange has a first interlocking tab 24 . the hub 16 rotatably circumnavigates the tube of the catheter and has a threaded receptor opened towards the distal end 26 for receiving the threaded lip 34 of the sheath orifice 32 as discussed hereinafter . the flange 18 rotatably circumnavigates the catheter tube 30 , as shown in fig3 , and 5 . the flange 18 is located proximal to the hub 16 as shown in fig2 . the flange 18 is flanked by the first and second restriction bands 20 and 22 thus preventing axial movement of the flange 18 along the catheter tube . the first and second restriction bands 20 and 22 are tightly connected to the catheter tube . the hemodialysis access sheath 10 has an elongated tube 36 . the elongated tube 36 has a distal end 38 and a proximal end 40 , the distal end 38 having a tapered opening as shown in fig1 and 11 . on the proximal end 40 of the elongated tube 36 of the hemodialysis access sheath 10 there is a sheath orifice 32 . the sheath orifice 32 has a threaded lip 34 which is received into the hub 16 of the adapter 14 . also , just inside the sheath orifice 32 is a thin slit membrane 33 as shown in fig9 and 11 . the access sheath 10 has a t - shaped side tube 42 having a base 44 , a first side arm 46 with a first side orifice 53 , a second side arm 48 with a second side orifice 50 opposite the first side orifice 52 , and an access orifice 55 opposite the base 44 as shown in fig6 and 8 . the base 44 is disposed at an angle to the elongated tube 36 and adjoining the proximal end 40 thereof . the side tube 42 has the arms 46 and 48 aligned with and in the same plane as the elongated tube 36 . the side tube 42 has a flush valve 52 rotatably inserted into the first side orifice 53 extending therethrough the first and second arms 46 and 48 to the second side orifice 50 . the flush valve 52 has a flush lever 54 and a syringe orifice 56 . the flush valve 52 being of a cylindrical shape having two sides 58 and 59 , as shown in fig6 with the syringe orifice 56 being an opening extending perpendicular through the cylindrical shape such that when the syringe orifice 56 is exposed at the access orifice 55 there is an opening into the t - shaped side tube 42 through to the elongated tube 36 and when the syringe orifice 56 is not exposed at the access orifice 55 the t - shaped side tube 42 is closed and sealed . the flush lever 54 is disposed on and attached to the side 58 of the cylindrical shape of the flush valve 52 towards the proximal end 40 of the elongated tube 36 in order to facilitate the opening and closing of the t - shaped side tube 42 with the closed position having the flush lever 54 laying alongside the t - shaped side tube 42 thus approaching the elongated tube 36 and the open position having the flush lever 42 perpendicular to the t - shaped side tube 42 . ideally , the flush lever 54 of the flush valve 52 has a second interlocking tab 68 . in order to avoid having the flush valve 52 open accidently , a means for attaching and interconnecting the second interlocking tab 68 with the first interlocking tab 24 is essential , as shown in fig8 . the two tabs 24 and 68 can be attached by stitches , wire ties , plastic ties , staples , or other means . a stitch loop 60 interconnects towards the distal side 38 of the elongated tube 36 and the base 44 of the side tube 42 for receiving means to surgically secure the access sheath 10 to the patient . the stitch loop 60 may be secured by stitches , staples or other surgical means and is designed to hold the access sheath 10 in place until the patients body can heal around the access sheath 10 and enclose it . a dacron ™ polyester fiber cuff 62 circumnavigating the elongated tube 36 distal to the stitch loop 60 is provided for the patients body to attach to and heal around thus securing the access sheath 10 in the patients body . the dacron ™ polyester fiber cuff 62 is clearly shown in fig1 and 11 . the access sheath 10 comes in a variety of lengths for optimization of placement . after venipuncture , a 0 . 035 wire is placed . the tract is dilated . an inner introducer with the dilator - access sheath combined is advanced into a central vein . the introducer is then removed . a stitch is placed in the stitch loop 60 and secures the sheath until ingrowth into the dacron ™ polyester fiber cuff 62 is established . the hemodialysis catheter 12 is placed through the access sheath 10 with the hub being rotated onto the threaded lip of the sheath orifice . the flush valve is closed and secured into place by the interlocking tabs to prevent accidental removal of the hemodialysis catheter 12 and inadvertent opening of the flush valve . to replace a malfunctioning hemodialysis catheter 12 , a physician removes the stitch or cable tie securing the flange and valve lever , twists the hub and removes the catheter 12 . the sheath is flushed out and a new catheter is inserted and secured in place as before .
a permanent or semipermanent hemodialysis access sheath that is placed in a central vein , secured and left in place for easy access by a removable hemodialysis catheter . the hemodialysis catheter has an adapter which secures the catheter to the sheath temporarily permitting the easy removal and replacement of the catheter as needed . the sheath has a side tube with a rotating flush valve . the sheath has a threaded opening which may be engaged by a threaded hub on the hemodialysis catheter for temporaraily securing the catheter to the sheath .