Systems and methods for treating a carotid artery
Systems and methods are adapted for treating the carotid artery. The systems include interventional catheters and blood vessel access devices that are adapted for transcervical insertion into the carotid artery. Embodiments of the systems and methods can be used in combination with embolic protection systems including blood flow reversal mechanisms, arterial filters, and arterial occlusion devices.
1. A system for treating a carotid artery, comprising:
an arterial access device wherein the access device includes a distal sheath adapted to be transcervically introduced into a carotid artery through a penetration in a wall of the carotid artery;
an interventional catheter adapted for transcervical insertion into the carotid artery via the arterial access device, wherein the interventional catheter is adapted to deploy a stent;
a first hemostasis valve positioned on a proximal end of the arterial access device;
wherein the interventional catheter is formed of:
an elongated inner member having a distal region on which the stent may be mounted, the elongated inner member further having a protrusion on a proximal portion of the elongated inner member;
an elongated stent containment sheath coaxially positioned over the inner member, the stent containment sheath formed by an annular side wall, wherein an opening is formed through a proximal portion of the annular side wall of the stent containment sheath, and wherein the protrusion of the inner member extends outward through the opening such that the protrusion of the inner member may be accessed by a user at a location outside the stent containment sheath.
2. A system as in claim 1 , wherein the catheter has a working length suitable for deployment through a transcervical access sheath into the common carotid artery.
3. A system as in claim 2 , wherein the working length is within the range of approximately 40 cm to 60 cm.
4. A system as in claim 3 , wherein the working length is within the range of approximately 40 cm to 75 cm.
5. A system as in claim 1 , further comprising a second hemostasis valve positioned on a proximal region of the arterial access device.
6. A system as in claim 1 , wherein the opening in the annular side wall of the stent containment sheath is an elongated slot along which the protrusion of the inner member can be slid to achieve relative movement between the stent containment sheath and the inner member.
7. A system as in claim 1 , wherein the opening in the annular side wall of the stent containment sheath is located distal of a proximal end of the stent containment sheath.
8. A system as in claim 1 , wherein the protrusion of the inner member includes a tubular member that encircles a proximal region of the stent containment sheath.
9. A system as in claim 1 , further comprising a securement member attached to the first hemostasis valve, wherein the securement member can be actuated to engage to the protrusion on the inner member of the interventional catheter to secure the inner member to the arterial access device.
10. A system as in claim 9 , further comprising a proximal extension connected to the distal sheath and having a distal end, a proximal end, and a lumen therebetween, wherein the distal end of the proximal extension is connected to a proximal end of the distal sheath at a junction so that the lumens of each are contiguous.
11. A system as in claim 10 , wherein the distal end of the proximal extension is removably connected to a proximal end of the distal sheath at the junction.
12. A system as in claim 10 , wherein the proximal extension has a length from the junction to the first hemostasis valve sufficient to space the hemostasis valve away from the transcervical insertion site such that the exposure to radiation is minimized when the user introduces the interventional catheter into the arterial access device via the hemostasis valve while fluoroscopy is being performed in the area of the carotid artery.
13. A system as in claim 1 , further comprising a shunt fluidly connected to the arterial access device at the junction between the proximal extension and the distal sheath, wherein the shunt provides a pathway for blood to flow from the arterial access device to a return site.
14. A system as in claim 13 , wherein the arterial access device is adapted to receive blood flow from the carotid artery, and further comprising:
a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state, wherein the flow control assembly includes one or more components that interact with the blood flow through the shunt.