Method and apparatus for treating a carotid artery
One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery.
1. A method of treating a carotid artery, comprising:
forming an incision in the neck to expose the common carotid artery;
forming an opening through a wall of the common carotid artery;
positioning through the opening an arterial access sheath and dilator system, wherein the arterial access sheath and dilator system comprises an arterial access sheath and a dilator inside the arterial access sheath, wherein the arterial access sheath comprises a first occlusion element adapted to occlude the common carotid artery and wherein the dilator comprises a tapered distal end;
removing the dilator from the arterial access sheath; and
expanding the first occlusion element to occlude the common carotid artery.
2. A method as in claim 1 , wherein the arterial access sheath includes a shunt that provides a pathway for blood to flow out of the arterial access sheath from the common carotid artery further comprising:
connecting the shunt to a return site having a lower pressure relative to the common carotid artery, the return site being a venous return site or an external reservoir;
reversing the direction of natural blood flow in the common carotid artery; and
shunting blood from the common carotid artery toward the return site via the arterial access sheath and the shunt.
3. A method as in claim 1 , further comprising:
introducing a therapeutic catheter through the arterial access sheath; and
treating the carotid artery.
4. A method as in claim 2 , wherein the therapeutic catheter is a stent delivery catheter and treating the carotid artery comprises deploying a stent using the stent delivery catheter.
5. A method as in claim 1 , wherein the arterial access sheath comprises a second occlusion element distal of the first occlusion element, and further comprising:
positioning the second occlusion element in an external carotid artery branching from the common carotid artery; and
expanding the second occlusion element to occlude the external carotid artery.
6. A method as in claim 5 , further comprising:
introducing a therapeutic catheter into the carotid artery through an exit port located on the side of the arterial access sheath between the first and second occlusion elements; and
treating the carotid artery.
7. A method as in claim 1 , wherein the first occlusion element is an inflatable balloon.
8. A method as in claim 1 , wherein the dilator comprises an internal lumen configured to receive a guidewire.
9. A method as in claim 1 , wherein positioning through the opening an arterial access sheath and dilator system comprises inserting the arterial access sheath and dilator system through the opening without previously inserting an introducer sheath through the puncture.
10. A method as in claim 1 , wherein positioning through the opening an arterial access sheath and dilator system comprises inserting the arterial access sheath through the opening without riding the sheath over a guidewire.
11. A method as in claim 1 , wherein the arterial access sheath includes a shunt that provides a pathway for blood to flow out of the arterial access sheath from the common carotid artery further comprising:
connecting the shunt to an aspiration device;
reversing the direction of natural blood flow in the common carotid artery by activating the aspiration device.