Embolic protection in connection with transcarotid carotid artery revascularization
Systems and methods are configured for accessing and treating carotid arterial vasculature and establishing retrograde blood flow during performance of carotid artery stenting and other procedures. A system includes a clamping structure movably coupled to an elongated shaft of the system, wherein the clamping structure includes a distal portion configured to clamp a blood vessel when a blood vessel is positioned between the distal portion of the clamping structure and the vessel support structure, wherein the distal portion clamps the blood vessel in a manner that flattens the blood vessel.
1 . A method of compressing a blood vessel, comprising:
inserting an arterial access device into a carotid artery, the arterial access device having a distal sheath portion;
coupling a vessel compression device to the carotid artery, the vessel compression device formed of:
an elongated shaft having an internal lumen, the elongated shaft extending along a first long axis;
a tubular vessel support structure formed of a rigid tube of fixed shape positioned on a distal end of the shaft, wherein the vessel support structure defines an atraumatic outer surface, the rigid tube of the vessel support structure fixedly extending along a second long axis transverse to the first long axis of the elongated shaft;
a clamping structure movably coupled to the elongated shaft, wherein the clamping structure includes a hook-shaped distal portion that bends greater than ninety degrees and that is configured to clamp the carotid artery when the carotid artery is positioned between the hook-shaped distal portion of the clamping structure and the vessel support structure, wherein the hook-shaped distal portion clamps the carotid artery in a manner that flattens the carotid artery without bunching;
wherein at least a section of the hook-shaped distal portion is disposed distally of the rigid tube; and
compressing the carotid artery between the hook-shaped distal portion of the clamping structure and the vessel support structure of the vessel compression device.
2 . The method of claim 1 , further comprising sliding at least a portion of the clamping structure within the elongated shaft of the vessel compression device.
3 . The method of claim 2 , wherein the clamping structure is rigid.
4 . The method of claim 2 , wherein the clamping structure is flexible.
5 . The method of claim 2 , wherein the clamping structure includes a tourniquet.
6 . The method of claim 2 , wherein the hook-shaped distal portion of the clamping structure can be positioned to at least partially wrap around the vessel support structure.
7 . The method of claim 1 , wherein the clamping structure has a proximal portion extending proximally from the hook shaped distal portion that is slidably positioned within the internal lumen of the elongated shaft.
8 . The method of claim 1 , wherein the hook shaped distal portion of the clamping structure is positioned on a distal end of an elongated proximal rod that slidably extends through the internal lumen of the elongated shaft.
9 . The method of claim 8 , wherein the elongated proximal rod exits the internal lumen of the elongated shaft through a side hole in the elongated shaft.
10 . The method of claim 1 , wherein the hook shaped distal portion is configured to shift between a distal configuration and a clamping configuration.
11 . The method of claim 10 , wherein the hook shaped distal portion has a distal end, and wherein the distal end of the hook shaped distal portion is disposed distally of a distal end of the rigid tube when the hook shaped distal portion is in the distal configuration.
12 . The method of claim 11 , wherein the distal end of the hook shaped distal portion is disposed proximally of the distal end of the rigid tube when the hook shaped distal portion is in the clamping configuration.