Devices for transvascular retrograde access placement
The present invention relates to methods of transvascular retrograde access placement and to devices that facilitate these methods. For purposes of the present invention, transvascular retrograde access placement generally comprises the insertion of a vascular catheter into a central blood vessel through the puncturing of the central blood vessel from the inside of the central blood vessel with a needle or other similarly configured device, or a needle-tipped guidewire of the present invention, and exiting that needle from the patient through the skin rather than the traditional approach of inserting a needle from the outside of the skin surface to the inside of a blood vessel.
1. A vascular catheter for use in performing transvascular retrograde access placement in a patient, the vascular catheter comprising:
a first guidewire lumen extending longitudinally through the vascular catheter from a proximal end of the vascular catheter to an opening at a distal portion of the vascular catheter, the distal portion extending at an angle from a longitudinal axis of the vascular catheter, and the vascular catheter being adapted to be inserted into a blood vessel over a first guidewire disposed within the first guidewire lumen;
a second guidewire lumen positioned exteriorly from the proximal end of the vascular catheter to the distal portion of the vascular catheter, a distal portion of the second guidewire lumen extending at an angle from the longitudinal axis of the vascular catheter to a distal opening, the distal opening of the second guidewire lumen facing a wall of the blood vessel when the vascular catheter has been inserted into the blood vessel; and
a penetrating guidewire adapted to be advanced into the second guidewire lumen such that the penetrating guidewire may be advanced distally through the distal opening of the second guidewire lumen to cause a needle tip of the penetrating guidewire to puncture the blood vessel wall and pass through subcutaneous tissue and skin of the patient, the penetrating guidewire having a diameter permitting a secondary catheter to be advanced over the penetrating guidewire through the skin and subcutaneous tissue into the blood vessel, the vascular catheter and penetrating guidewire being configured such that the vascular catheter may be removed from the blood vessel while leaving the penetrating guidewire in place in the blood vessel.
2. The vascular catheter of claim 1 wherein the vascular catheter has a length permitting the vascular catheter to extend from an opening in the patient's femoral vein into the patient's jugular vein.
3. The vascular catheter of claim 1 wherein the vascular catheter has a length of 150-300 cm.
4. The vascular catheter of claim 1 wherein the vascular catheter has a length permitting the vascular catheter to extend from an opening in the patient's femoral vein into the patient's subclavian vein.
5. The vascular catheter of claim 1 wherein the vascular catheter has a diameter of 4-5 french.
6. The vascular catheter of claim 1 wherein the second guidewire lumen is a channel on an exterior of the vascular catheter.
7. The vascular catheter of claim 1 , wherein the angle at which the distal portion of the vascular catheter extends and the angle at which the distal portion of the second lumen extends are the same.