Methods and apparatus for inhibiting introduction of air into the vasculature during a percutaneous procedure

1. A system for use with a medical device defining a longitudinal axis, the system comprising:

a device defining a distal end and a proximal end and including a distal hemostasis valve associated with the distal end, a proximal hemostasis valve associated with the proximal end, an instrument passage lumen located between the hemostasis valves and defining a degassing region with a degassing region distal end and a degassing region proximal end that is longitudinally spaced from and proximal of the degassing region distal end, an inlet port at the degassing region distal end and an outlet port at the degassing region proximal end such that fluid flows only from the degassing region distal end to the degassing region proximal end;

a source of fluid; and

a supply line having a first end in fluid communication with the fluid source and a second end in fluid communication with the inlet port.

2. A system as claimed in claim 1 , wherein

the fluid source comprise a container at least partially filled with fluid; and

the system further comprises a return line having a first end in fluid communication with the outlet port and a second end in fluid communication with the container such that fluid flowing through the outlet port is discharged into the container.

3. A system as claimed in claim 2 , wherein the return line is at least partially disposed coaxially within the supply line.

4. A system as claimed in claim 1 , further comprising:

a circulation pump along the supply line.

5. A system as claimed in claim 1 , wherein

the device comprises an introducer sheath including a proximal handle and a guide sheath that defines the instrument passage lumen and degassing region; and

the inlet and outlet ports are associated with the handle.

6. A system as claimed in claim 1 , wherein

the degassing region distal end abuts the distal hemostasis valve; and

the degassing region proximal end abuts the proximal hemostasis valve.

7. A system for use with a medical device defining a longitudinal axis, the system comprising:

a device defining a distal end and a proximal end and including

a proximal hemostasis valve associated with the proximal end,

a tube extending through the device and defining an instrument passage lumen with a perimeter and a degassing region with a degassing region distal end and a degassing region proximal end that is longitudinally spaced from and proximal of the degassing region distal end, the tube being free of apertures in the degassing region,

an inlet port at the degassing region distal end that delivers fluid into degassing region from a plurality of locations around the perimeter of the instrument passage lumen, and

an outlet port at the degassing region proximal end such that fluid flows only from the degassing region distal end to the degassing region proximal end;

a container at least partially filled with a fluid;

a supply line having a first end in fluid communication with the fluid container and a second end in fluid communication with inlet port; and

a return line having a first end in fluid communication with the instrument passage lumen and a second in fluid communication with the fluid container.

8. A system as claimed in claim 7 , further comprising:

a circulation pump operatively coupled to the supply line.

9. A system as claimed in claim 7 , wherein

the device comprises an introducer sheath including a proximal handle and a guide sheath that defines the instrument passage lumen; and

the inlet and outlet ports are associated with the handle.

10. A system as claimed in claim 7 , wherein the return line is at least partially disposed coaxially within the supply line.

11. A system as claimed in claim 7 , wherein the inlet port includes an annular lumen that extends around the perimeter of the instrument passage and a plurality of spaced openings that are connected to the annular lumen.

12. A system as claimed in claim 7 , further comprising:

a distal hemostasis valve associated with the distal end of the device.

13. A device for use in a vascular access procedure, the device comprising:

a housing defining a distal end and a proximal end and having an instrument passage lumen extending from the distal end to the proximal end;

a distal hemostasis valve associated with the distal end of the housing;

a proximal hemostasis valve associated with the proximal end of the housing;

an inlet port associated with the housing distal end, proximal of the distal hemostasis valve and in fluid communication with the instrument passage lumen;

an outlet port proximal of the inlet port and in fluid communication with the instrument passage lumen; and

at least one brush located within the instrument passage lumen.

14. A device as claimed in claim 13 , wherein

the instrument passage lumen defines a longitudinal axis and a perimeter that extends around the longitudinal axis; and

the inlet port delivers fluid from a plurality of locations around the perimeter of the instrument passage lumen.

15. A device as claimed in claim 14 , wherein the inlet port includes an annular lumen that extends around the perimeter of the instrument passage lumen and a plurality of spaced openings that are connected to the annular lumen.

16. A device as claimed in claim 15 , wherein the inlet port is associated with the distal end of the instrument passage lumen.

17. A device as claimed in claim 13 , wherein

the housing comprises a vascular access device handle; and

the instrument passage lumen is defined by a sheath having a portion thereof within the vascular access device handle.

18. A device as claimed in claim 13 , wherein the housing is configured to be secured to a vascular access device.

19. A system as claimed in claim 1 , wherein the degassing region extends continuously from the distal hemostasis valve to the proximal hemostasis valve.

20. A system as claimed in claim 7 , wherein the degassing region distal end and the degassing region proximal end are not equidistant from the inlet port.