Systems and methods for neurovascular interventions
Methods and devices are configured for neurointerventional procedures. The methods and devices enable safe and rapid access to the cerebral or intracranial arteries for the introduction of interventional devices such as to treat stroke and/or other disease conditions. The methods and devices include a vascular access and retrograde flow system that can be used safely and rapidly in the neurointerventional procedures.
1 . A transcarotid access system configured for treatment of a neurovascular condition, comprising: an arterial access sheath having a sheath body defining an internal lumen, the sheath body sized and shaped to be introduced into an opening in a common carotid artery and receive blood flow from the carotid artery; an adapter positioned at a proximal end of the sheath body, the adapter having a hub adapted to be removably connected to a flow shunt line, the adapter further having a valve positioned adjacent to an internal lumen of the transcarotid access system, wherein the valve regulates fluid flow out of the internal lumen of the arterial access sheath toward the hub; and a proximal extension connected to a proximal end of the adapter, the proximal extension having an internal lumen in fluid communication with the internal lumen of the arterial access sheath via the adapter, the proximal extension formed of an elongated body that defines a proximal opening that communicates with the internal lumen of the proximal extension, wherein the proximal opening is completely unimpeded.
2 . A transcarotid access system as in claim 1 , wherein the adapter and the proximal extension are removably connected to the arterial access sheath at a connection site.
3 . A transcarotid access system as in claim 2 , further comprising a first connector component positioned at the proximal end of the sheath body and a second connector component positioned at a distal end of the adaptor.
4 . A transcarotid access system as in claim 2 , wherein the connection site is positioned between the adapter and the arterial access sheath.
5 . A transcarotid access system as in claim 2 , wherein the at least one of the first connector component and the second connector component is a hemostasis valve adapter.
6 . A transcarotid access system as in claim 1 , wherein the arterial access sheath has a total length less than 20 cm.
7 . A transcarotid access system as in claim 1 , further comprising an eyelet located on a connector that connects the proximal extension to the adapter.
8 . A transcarotid access system as in claim 1 , wherein the valve transitions between an open state that permits flow out of the internal lumen of the arterial access sheath and a closed state that blocks flow out of the internal lumen of the transcarotid access system.
9 . A transcarotid access system as in claim 1 , further comprising an interventional catheter configured to be inserted into a neurovasculature via the arterial access sheath.
10 . A transcarotid access system as in claim 1 , further comprising a reverse flow shunt removably connected to the adapter via the hub.
11 . A transcarotid access system as in claim 10 , further comprising a flow control assembly coupled to the reverse flow shunt, the flow control assembly configured to regulate blood flow through the reverse flow shunt.
12 . A transcarotid access system as in claim 11 , further comprising a venous return device fluidly coupled to the reverse flow shunt, the venous return device being insertable into a vein.
13 . A transcarotid access system as in claim 12 , wherein the venous return device is insertable into a femoral vein.
14 . A method of treating an intracranial artery comprising: inserting an arterial access device into a carotid artery via an opening in the carotid artery and access location in a neck of a patient, the arterial access device including: an arterial access sheath having a sheath body defining an internal lumen, the sheath body sized and shaped to be introduced into an opening in a common carotid artery and receive blood flow from the carotid artery; an adapter positioned at a proximal end of the sheath body, the adapter having a hub adapted to be removably connected to a flow shunt line, the adapter further having a valve positioned adjacent to an internal lumen of the transcarotid access system, wherein the valve regulates fluid flow out of the internal lumen of the arterial access sheath toward the hub; and a proximal extension connected to a proximal end of the adapter, the proximal extension having an internal lumen in fluid communication with the internal lumen of the arterial access sheath via the adapter, the proximal extension formed of an elongated body that defines a proximal opening that communicates with the internal lumen of the proximal extension, wherein the proximal opening is completely unimpeded; deploying an interventional device into the carotid artery via the arterial access device and treating an intracranial artery using the interventional device; detaching the adapter and proximal extension from the arterial access sheath such that the arterial access sheath remains inserted in the carotid artery without the adapter and proximal extension; inserting a closure element into the arterial access sheath; and deploying the closure element to achieve hemostasis in the opening of the carotid artery.
15 . A method as in claim 14 , wherein the opening in the carotid artery is in the common carotid artery.
16 . A method as in claim 14 , wherein the opening in the carotid artery is percutaneously formed.
17 . A method as in claim 14 , wherein the arterial access sheath has a length of 20 cm.
18 . A method as in claim 14 , wherein the arterial access sheath has a length of 16 cm.
19 . A method as in claim 14 , further comprising a first connector component positioned at the proximal end of the sheath body and a second connector component positioned at a distal end of the adaptor, wherein the first connector component and the second connector component removably attach to one another.
20 . A method as in claim 19 , wherein at least one of the first connector component and the second connector component is a hemostasis valve adapter.