Methods of Transvascular Retrograde Access Placement and Devices For Facilitating Therein

• US 20120136366A1
• Filed: 06/14/2006
• Published: 05/31/2012
• Est. Priority Date: 05/02/2006
• Status: Active Grant

• Current Assignee: Vascular Access Technologies, Inc (Merit Medical Systems, Inc.)
• Original Assignee: Vascular Access Technologies, Inc (Merit Medical Systems, Inc.)
• Inventors: Pillai, Lakshmikumar
• Granted Patent: US 9,511,214 B2
• Time in Patent Office: Days
• US Class Current: 606/108
• CPC Class Codes: A61M 2025/0681 Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2025/09116 Design of handles or shafts or gripping surfaces thereof for manipulating guide wires
• CPC Class Codes: A61M 2025/09125 Device for locking a guide wire in a fixed position with respect to the catheter or the human body
• CPC Class Codes: A61M 2025/09175 having specific characteristics at the distal tip
• CPC Class Codes: A61M 2025/09183 having tools at the distal tip
• CPC Class Codes: A61M 2039/0258 for vascular access, e.g. blood stream access
• CPC Class Codes: A61M 2039/0273 for introducing catheters into the body
• CPC Class Codes: A61M 2039/0282 with implanted tubes connected to the port
• CPC Class Codes: A61M 25/0068 Static characteristics of the catheter tip, e.g. shape, atraumatic tip, curved tip or tip structure
• CPC Class Codes: A61M 25/0133 Tip steering devices
• CPC Class Codes: A61M 25/0136 Handles therefor
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires
• CPC Class Codes: A61M 39/0247 Semi-permanent or permanent transcutaneous or percutaneous access sites to the inside of the body peritoneal dialysis catheters A61M1/285; tracheostomy devices A61M16/0465; measuring pressure within the body A61B5/03; colostomy devices A61F5/445; gastrotomy feeding tubes A61J15/0015; means for fixing a feeding tube outside of the body A61J15/0053

Abstract

The present invention relates to methods of transvascular retrograde access placement and to devices that facilitate these methods. For purposes of the present invention, transvascular retrograde access placement generally comprises the insertion of a vascular catheter into a central blood vessel through the puncturing of the central blood vessel from the inside of the central blood vessel with a needle or other similarly configured device, or a needle-tipped guidewire of the present invention, and exiting that needle from the patient through the skin rather than the traditional approach of inserting a needle from the outside of the skin surface to the inside of a blood vessel.

Claims

1. A method of performing transvascular retrograde access placement in a central blood vessel of a patient, said method comprising:

positioning a vascular catheter within said central blood vessel such that a portion of said vascular catheter faces a desired exit site on a wall of said central blood vessel, the vascular catheter comprising an angled-tip;

passing a needle from said vascular catheter through said desired exit site on said wall of said central blood vessel and skin of said patient; and

passing an end of a secondary vascular catheter through said exit site and into said central blood vessel.

2. The method of claim 1, further comprising providing a diagnostically-opaque substance into a vascular system of said patient prior to the positioning step.

3. The method of claim 1, wherein said central blood vessel is a jugular vein or a subclavian vein.

4. The method of claim 3, wherein the positioning step comprises inserting the vascular catheter into a femoral vein or an antecubital vein.

5. The method of claim 1, wherein said needle is supported by a guidewire.

8. The method of claim 1, further comprising introducing said needle through a channel exterior to said vascular catheter.

10. The method of claim 8, further comprising advancing an angled-tip stiff obturator through said vascular catheter.

21. The method of claim 1, prior to the positioning step, further comprising inserting the vascular catheter into a primary blood vessel of said patient and advancing said vascular catheter to said desired exit site on said wall of said central blood vessel.

22. The method of claim 1, prior to the passing said needle through the exit site, further comprising advancing said needle through said vascular catheter to said desired exit site.

23. The method of claim 22, wherein advancing said needle through said vascular catheter to the desired exit site comprises advancing a needle-tipped guidewire through a channel exterior to said vascular catheter.

24. The method of claim 1, prior to passing said needle through said exit site, further comprising forming an opening at said desired exit site in said wall of said central blood vessel with said needle.

25. The method of claim 1, wherein passing an end of the secondary vascular catheter through said exit site comprises passing said secondary vascular catheter over the needle.

26. The method of claim 1, after passing said needle through said exit site, further comprising pulling said vascular catheter and said needle through said skin;

and removing said vascular catheter from said patient while leaving said needle in position.

27. The method of claim 1, further comprising visualizing diagnostically-opaque markers on said vascular catheter prior to passing the needle through said desired exit site.

28. The method of claim 10, wherein a distal tip of said angled-tip stiff obturator comprises an angle with respect to a proximal length of said obturator, and wherein advancing said obturator through said vascular catheter comprises advancing said obturator to a distal end of the catheter;

and altering said an angle of the distal end of the catheter in accordance with said angle of said angled tip.

6-7. -7. (canceled)

9. (canceled)

11-20. -20. (canceled)