Methods of transvascular retrograde access placement and devices for facilitating the placement

• US 8,409,236 B2
• Filed: 08/23/2010
• Issued: 04/02/2013
• Est. Priority Date: 08/21/2009
• 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, LaDuca, Robert, LaDuca, Paul A., Alavar, Frederich L.
• Primary Examiner(s): Severson, Ryan
• Assistant Examiner(s): EASTWOOD, DAVID C
• Application Number:
  US12/861,716
• Publication Number:
  US 20120136320A1
• Time in Patent Office: 953 Days
• Field of Search: 606/108, 606/159, 606/167, 606/170, 606/185, 606/192, 606/194, 606/195, 604/43, 60416401-16412, 604506-510, 604/532, 600114-115, 600/424, 600/433
• US Class Current: 606/185
• CPC Class Codes: A61B 17/3403 Needle locating or guiding means guides for suture needles A61B17/0482; guiding or tracking by nuclear magnetic resonance G01R33/285
• 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 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

A system for providing transvascular retrograde access in a central blood vessel of a patient. In some embodiments, the system has a handle; a catheter extending from the handle; and a tissue piercing element extending from the handle through the catheter, the tissue piercing element having a sharp distal tip adapted to extend from a distal portion of the catheter, the catheter and handle being adapted to be separated from the tissue piercing element, a distal portion of the tissue piercing element being adapted to serve as a guide for introduction of a device into the central blood vessel. The invention also includes a method of providing transvascular retrograde access to a central blood vessel of a patient.

Claims

1. A method of providing transvascular retrograde access to a central blood vessel of a patient, the method comprising:

inserting a distal end of a catheter into a blood vessel other than the central blood vessel,

a proximal end of the catheter being connected to a handle disposed outside of the patient;

advancing the distal end of the catheter into the central blood vessel;

orienting the distal end of the catheter to an exit location within the central blood vessel;

actuating a tissue piercer actuator of the handle to advance a tissue piercing element from the catheter through the central blood vessel at the exit location;

introducing a device over the tissue piercing element through the exit location into the central blood vessel; and

wherein actuating the tissue piercer actuator comprises releasing a spring within the handle, further comprising actuating a spring release element to release the spring.

2. The method of claim 1 wherein orienting comprises rotating the catheter with respect to the patient.

3. The method of claim 2 wherein rotating comprises rotating the handle and catheter together.

4. The method of claim 1 wherein orienting comprises bending the distal end of the catheter with respect to a longitudinal axis of the catheter.

5. The method of claim 4 wherein bending comprises moving a bending actuator of the handle.

6. The method of claim 4 further comprising preventing actuation of the tissue piercer actuator if catheter distal end is not bent.

7. The method of claim 1 further comprising changing an interlock from a first state to a second state to permit the tissue piercer actuator to be actuated.

8. The method of claim 1 further comprising locking the tissue piercing element to the tissue piercer actuator prior to actuating the tissue piercing actuator.

9. A method of providing transvascular retrograde access to a central blood vessel of a patient, the method comprising:

inserting a distal end of a catheter into a blood vessel other than the central blood vessel,

a proximal end of the catheter being connected to a handle disposed outside of the patient;

advancing the distal end of the catheter into the central blood vessel;

orienting the distal end of the catheter to an exit location within the central blood vessel;

actuating a tissue piercer actuator of the handle by releasing a spring within the handle to advance a tissue piercing element from the catheter through the central blood vessel at the exit location; and

introducing a device over the tissue piercing element through the exit location into the central blood vessel.

10. The method of claim 9 wherein orienting comprises rotating the catheter with respect to the patient.

11. The method of claim 10 wherein rotating comprises rotating the handle and catheter together.

12. The method of claim 9 wherein orienting comprises bending the distal end of the catheter with respect to a longitudinal axis of the catheter.

13. The method of claim 12 wherein bending comprises moving a bending actuator of the handle.

14. The method of claim 12 further comprising preventing actuation of the tissue piercer actuator if catheter distal end is not bent.

15. The method of claim 9 further comprising changing an interlock from a first state to a second state to permit the tissue piercer actuator to be actuated.

16. The method of claim 9 further comprising locking the tissue piercing element to the tissue piercer actuator prior to actuating the tissue piercing actuator.