Transvascular access device and method

• US 9,220,874 B2
• Filed: 05/30/2013
• Issued: 12/29/2015
• Est. Priority Date: 05/30/2012
• 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, Burt, Patrick, Lunsford, John, Stiggelbout, John
• Primary Examiner(s): STIGELL, THEODORE J
• Application Number:
  US13/906,122
• Publication Number:
  US 20130324967A1
• Time in Patent Office: 943 Days
• Field of Search: 604/95.04, 604/164.01, 604/272, 604/528, 606/167, 606/170, 606/172, 606/185
• US Class Current: 1/1
• CPC Class Codes: A61B 17/3415 for introducing tubes or catheters, e.g. gastrostomy tubes, drain catheters A61B17/3417 takes precedence; body piercing catheter guide needles A61M25/06
• CPC Class Codes: A61M 2025/0095 being one or more needles protruding from the distal tip and which are not used for injection nor for electro-stimulation, e.g. for fixation purposes
• CPC Class Codes: A61M 25/0082 Catheter tip comprising a tool
• CPC Class Codes: A61M 25/01 Introducing, guiding, advancing, emplacing or holding catheters A61M25/10 takes precedence
• CPC Class Codes: A61M 25/0102 Insertion or introduction using an inner stiffening member, e.g. stylet or push-rod
• CPC Class Codes: A61M 25/0662 Guide tubes
• CPC Class Codes: A61M 25/09 Guide wires
• CPC Class Codes: A61M 25/09041 Mechanisms for insertion of guide wires

Abstract

Transvascular access devices and methods for transvascular access are provided. The transvascular access devices can include a guidewire lumen and a guide tube and stylet disposed in a second lumen. The guide tube can be used to control the orientation of the stylet and provide additional support for the stylet. The methods include providing a second entry point in a vessel of a patient remote from a first entry point. A vascular catheter can enter the vascular system of a patient at a first entry point and be advanced to a second entry point. A guide tube can be advanced out the second lumen of the vascular catheter with a stylet advanced out of the guide tube to pierce the vessel wall and skin of the patient at the second entry point. A catheter can be introduced to the vascular system at the second entry point.

Claims

1. A method of providing a second entry point in a vessel of a patient remote from a first entry point, the method comprising:

deploying a vascular guidewire into the vessel from the first entry point toward the second entry point, the first entry point selected from the group consisting of;

the femoral vein and femoral artery, and the second entry point selected from the group consisting of;

the internal jugular vein, subclavian vein, carotid artery, axillary artery, and subclavian artery;

inserting the guidewire into a first lumen of a vascular catheter;

advancing the vascular catheter over the guidewire from the first entry point toward the second entry point;

advancing a guide tube out of a distal end of a second lumen of the vascular catheter;

directing a distal opening of the guide tube towards a wall of the vessel at the second entry point;

advancing a stylet out of the distal end of the guide tube, through the vessel wall and skin of the patient; and

inserting a device over the stylet and into the vessel at the second entry point.

2. The method of claim 1, wherein directing the distal opening of the guide tube towards the wall of the vessel at the second entry point includes placing the distal opening of the guide tube against the wall of the vessel at the second entry point.

3. The method of claim 1 wherein the guide tube has a preformed curve at its distal end, the step of advancing the guide tube comprising permitting the guide tube distal end to assume its preformed curve as the guide tube distal end is advanced out of the distal end of the second lumen of the vascular catheter.

4. The method of claim 1 wherein the second lumen of the vascular catheter extends in a curve at its distal end, the step of advancing the guide tube comprising engaging a camming surface in the curve of the second lumen with a distal end of the guide tube to advance the distal end of the guide tube away from a longitudinal axis of the vascular catheter and toward a wall of the vessel.

5. The method of claim 1 wherein the step of advancing the guide tube comprises moving an actuator in a handle at the proximal end of the vascular catheter.

6. The method of claim 5, wherein moving the actuator advances the guide tube relative to the second lumen of the vascular catheter.

7. The method of claim 5, wherein moving the actuator proximally retracts the vascular catheter relative to the guide tube.

8. The method of claim 1 wherein the step of advancing the stylet comprises operating a stylet actuator in a handle at the proximal end of the vascular catheter.

9. The method of claim 8 wherein the step of operating an actuator comprises releasing a spring.

10. The method of claim 9 further comprising loading the spring prior to the step of releasing the spring.

11. The method of claim 1, further comprising verifying the positioning of the guide tube after placing the distal opening of the guide tube against the wall of the vessel at the second entry point and prior to advancing the stylet.

12. The method of claim 11, wherein verifying includes using fluoroscopy to verify the position of the guide tube.

13. The method of claim 1, further comprising adjusting the orientation of the handle prior to advancing the guide tube to orient the vascular catheter such that when the guide tube is advanced out of the distal end of the second lumen, the guide tube extends from the vascular catheter towards the skin of the patient at the second entry point.