Methods and systems for establishing retrograde carotid arterial blood flow
Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and 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. The flow control assembly includes one or more components that interact with the blood flow through the shunt.
1. A device for use in accessing and treating a carotid artery, said device comprising:
a distal sheath having a distal section with a distal end adapted to be introduced into the common carotid artery, a proximal end, and a lumen extending between the distal and proximal ends;
a proximal extension having a distal end, a proximal end, and a lumen therebetween, wherein the distal end of the proximal extension is connected to the proximal end of the sheath at a junction so that the lumens of each are contiguous;
a flow line having a lumen, said flow line connected near the junction so that blood flowing into the distal end of the sheath can flow into the lumen of the flow line;
a hemostasis valve at the proximal end of the proximal extension, said hemostasis valve being adapted to inhibit blood flow from the proximal extension while allowing catheter introduction through the proximal extension and into the distal sheath; and
a stopper member that covers a portion of a distal section of the sheath such that a portion of the distal section of the sheath is covered by the stopper member and a portion of the distal section of the sheath is exposed, wherein the stopper member, when coupled to the sheath, limits insertion of the sheath into the carotid artery to the exposed portion, and wherein the stopper member is removable from the distal section of the sheath.
2. A device as in claim 1 , further comprising a flush line connected to the proximal extension to provide access to the lumen of the proximal extension.
3. A device as in claim 1 , wherein the distal sheath is circumferentially reinforced to increase hoop strength with a minimal loss of axial flexibility.
4. A device as in claim 1 , further comprising a dilator having a central guide wire lumen and a tapered distal end and being removably insertable through the hemostasis valve so that the tapered distal end extends out of the distal end of the distal sheath.
5. A device as in claim 1 , further comprising a tube having a central passage which is coaxially received over the distal sheath and adapted to engage an adaptor which connects the proximal end of the sheath to the distal end of the proximal extension and the distal end of the flow line.
6. A device as in claim 1 , wherein the proximal extension is removably connected to the sheath at the junction.
7. A device as in claim 1 , further comprising a filter coupled to the flow line, wherein the filter filters fluid flow through the flow line.
8. A device as in claim 1 , further comprising a one-way valve coupled to the flow line, wherein the valve prevents fluid flow through the flow line in one direction.
9. A device for use in accessing and treating a carotid artery, said device comprising:
a distal sheath having a distal end adapted to be introduced into the common carotid artery, a proximal end, and a lumen extending between the distal and proximal ends;
a proximal extension having a distal end, a proximal end, and a lumen therebetween, wherein the distal end of the proximal extension is connected to the proximal end of the sheath at a junction so that the lumens of each are contiguous and wherein the proximal extension has a diameter that is greater than a diameter of the distal sheath;
a flow line having a lumen, said flow line connected near and proximal the junction so that blood flowing into the distal end of the sheath can flow into the lumen of the flow line; and
a stopper member that covers a portion of a distal section of the sheath such that a portion of the distal section of the sheath is covered by the stopper member and a portion of the distal section of the sheath is exposed, wherein the stopper member, when coupled to the sheath, limits insertion of the sheath into the carotid artery to the exposed portion, and wherein the stopper member is removable from the distal section of the sheath.
10. A device as in claim 9 , further comprising a flush line connected to the proximal extension to provide access to the lumen of the proximal extension.
11. A device as in claim 9 , wherein the distal sheath is circumferentially reinforced to increase hoop strength with a minimal loss of axial flexibility.
12. A device as in claim 9 , further comprising a dilator having a central guide wire lumen and a tapered distal end and being removably insertable through the hemostasis valve so that the tapered distal end extends out of the distal end of the distal sheath.
13. A device as in claim 9 , wherein the proximal extension is removably connected to the sheath at the junction.