Methods of Transvascular Retrograde Access Placement and Devices for Facilitating the Placement

• US 20120136247A1
• Filed: 02/05/2009
• Published: 05/31/2012
• Est. Priority Date: 05/02/2006
• Status: Abandoned Application

• Current Assignee: Vascular Access Technologies, Inc (Merit Medical Systems, Inc.)
• Original Assignee: Vascular Access Technologies, Inc (Merit Medical Systems, Inc.)
• Inventors: Pillai, Lakshmikumar
• Application Number:
  US12/366,517
• Publication Number:
  US 20120136247A1
• Time in Patent Office: Days
• US Class Current: 600/433
• CPC Class Codes: A61B 6/00 Apparatus or devices for radiation diagnosis; Apparatus or devices for radiation diagnosis combined with radiation therapy equipment instruments measuring radiation intensity for application in the field of nuclear medicine, e.g. in vivo counting, G01T1/161; apparatus for taking X-ray photographs G03B42/02
• CPC Class Codes: A61M 25/00 Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/06 Body-piercing guide needles or the like
• CPC Class Codes: A61M 25/09 Guide wires

Abstract

The invention relates to methods of transvascular retrograde access placement into a central blood vessel and to devices that facilitate these methods. The method includes positioning a vascular catheter within the vessel such that its distal end faces a desired exit site on the vessel wall, passing a penetrating device from the catheter through the vascular exit site and skin of the patient; and passing a secondary vascular catheter through the exit site and into the central blood vessel. In another aspect, the method includes penetrating outward from within the vessel to form a pass-through site on a wall of the vessel that exits the patient; and placing the vascular access device into the vessel through the pass-through site. Typical vessels that may be accessed include central veins, but may include other veins as well as arteries. Devices that facilitate the method include a stiff intravascular guidewire with a distally-mounted penetrating device such as a needle, and a two-channel vascular catheter with an angled tip.

Claims

1-36. -36. (canceled)

37. A device suitable for use in performing transvascular retrograde access placement comprising:

a vascular catheter comprising a channel having an inner diameter of at least about that of an external diameter of a 22-gauge needle;

a stiff intravascular guidewire disposed in the channel, the guidewire having a diameter greater than or equal to 0.014 inches and less than or equal to 0.035 inches; and

a vascular wall penetrating device supported on a distal end of the guidewire;

the vascular catheter, intravascular guidewire and vascular wall penetrating device being further adapted to cooperate to pass the penetrating device through a vascular wall, subcutaneous tissue and skin at an exit point of a patient.

38. The device of claim 37, wherein the vascular wall penetrating device is removably coupled to the guidewire.

39. The device of claim 38, wherein the vascular wall penetrating device is removably coupled to the guidewire with a threaded mechanism.

40. The device of claim 37, wherein the penetrating device is a needle.

41. The device of claim 40, wherein the needle has a length in the range of at least about 1 cm to about 2.5 cm.

42. The device of claim 37, wherein the penetrating device is a radiofrequency knife.

43. The device of claim 37, wherein the penetrating device is a laser.

44. The device of claim 37, wherein the penetrating device is a high frequency ultrasound device.

45. The device of claim 37, wherein the penetrating device is an electrosurgical device.

46. The device of claim 37, wherein the guidewire has a length that varies between about 150 cm and about 300 cm.

47. The device of claim 37, wherein the guidewire has a length that varies between about 225 cm and about 275 cm.

48. The device of claim 37, wherein the guidewire further comprises a lubricious coating.

49. A device suitable for use in performing transvascular retrograde access placement comprising a vascular catheter comprising an angled tip and two channels.

50. The device of claim 49, wherein at least one of the two channels has an inner diameter of at least about that of an external diameter of a 22-gauge needle.

51. The device of claim 49, wherein the angled-tip comprises an angled portion with an angle of about 30 to about 60 degrees with respect to the longitudinal axis of the catheter.

52. The device of claim 51, wherein the angled portion is sufficiently elastic to become substantially linear when the catheter is within the confines of a blood vessel and to elastically assume a more acute angle when a curved obturator with an angled portion is advanced into the angled portion of the vascular catheter.

53. The device of claim 49, wherein the vascular catheter further comprises one or more diagnostically-opaque markers.

54. The device of claim 53, wherein the diagnostically-opaque markers are positioned within or about the angled-tip of the angled-tip vascular catheter.