Methods and systems for establishing retrograde carotid arterial blood flow

Patent metadata

Field	Value
Publication number	US-10543307-B2
Application number	US-201816008703-A
Country	US
Kind code	B2
Filing date	Jun 14, 2018
Priority date	Jul 18, 2007
Publication date	Jan 28, 2020
Grant date	Jan 28, 2020

Abstract

Interventional procedures on the carotid arteries are performed through a transcervical access while retrograde blood flow is established from the internal carotid artery to a venous or external location. A system for use in accessing and treating a carotid artery includes an arterial access device, a shunt fluidly connected to the arterial access device, and a flow control assembly coupled to the shunt and adapted to regulate blood flow through the shunt between at least a first blood flow state and at least a second blood flow state. The flow control assembly includes one or more components that interact with the blood flow through the shunt.

First claim

What is claimed is:

1. A method for accessing and treating a carotid artery, comprising:
inserting an arterial access sheath into a patient's neck and through a wall of a common carotid artery at an arterial access site, wherein the arterial access sheath has a structural configuration that limits a depth of insertion of a distal portion of the arterial access sheath into the common carotid artery;
positioning a filter in an internal carotid artery distal of a location of treatment; and
inserting an interventional device into the common carotid artery via the arterial access sheath;
wherein structural configuration of the arterial access sheath limits the distal portion the from being inserted into the common carotid artery beyond a length such that the distal portion would contact a bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.

2. The method of claim 1 , wherein the arterial access site is located at distance of 5 cm to 7 cm below the bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.

3. The method of claim 2 , wherein the arterial access sheath has a working length of 5 cm to 15 cm and further comprising inserting no more than the working length of the arterial access sheath into the common carotid artery.

4. The method of claim 1 , wherein the structural configuration of the arterial access sheath includes a stopper member that at least partially covers the distal portion and that limits insertion of the distal portion into the common carotid artery.

5. The method of claim 1 , further comprising establishing reverse blood flow through the common carotid artery.

6. The method of claim 1 , further comprising blocking blood flow through at least a portion of the common carotid artery.

7. A system for use in accessing and treating a carotid artery, said system comprising:
an arterial access sheath adapted to be introduced into a common carotid artery via a neck of a patient and receive blood flow from the common carotid artery, the arterial access sheath including a distal sheath portion adapted to enter the common carotid artery, wherein the distal sheath portion has a structural configuration that limits a depth of insertion of a distal portion of the arterial access sheath into the common carotid artery; and
a filter adapted to be positioned in an internal carotid artery distal of a location of treatment;
wherein the structural configuration of the arterial access sheath limits the distal portion from being inserted into the common carotid artery beyond a length such that the distal portion would contact a bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.

8. The method of claim 7 , wherein structural configuration of the arterial access sheath limits the distal portion the from being inserted into the common carotid artery beyond a length that would disrupt plaque in the common carotid artery.

9. The system of claim 7 , wherein the arterial access sheath has a distal region with a reduced luminal diameter to facilitate introduction into the common carotid artery and a proximal region having a larger luminal diameter relative to the distal region to decrease overall flow resistance through the arterial access sheath.

10. The system of claim 7 , wherein the structural configuration comprises a stopper member that at least partially covers the distal portion and that limits insertion of the distal portion into the common carotid artery.

11. The system of claim 7 , wherein the arterial access site is located at distance of 5 cm to 7 cm below the bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.

12. The system of claim 11 , wherein the arterial access sheath has a working length of 5 cm to 15 cm and further comprising inserting no more than the working length of the arterial access sheath into the common carotid artery.

13. The system of claim 7 , further comprising:
a shunt fluidly connected to the arterial access sheath, wherein the shunt provides a pathway for blood to flow from the arterial access sheath to a return site.

14. A method for accessing and treating a carotid artery, comprising:
inserting an arterial access sheath into a patient's neck and through a wall of a common carotid artery at an arterial access site, wherein the arterial access sheath has a structural configuration that limits a depth of insertion of a distal portion of the arterial access sheath into the common carotid artery;
positioning a filter in an internal carotid artery distal of a location of treatment; and
inserting an interventional device into the common carotid artery via the arterial access sheath;
wherein structural configuration of the arterial access sheath limits the distal portion the from being inserted into the common carotid artery beyond a length that would disrupt plaque in the common carotid artery.

15. The method of claim 14 , wherein the arterial access site is located at distance of 5 cm to 7 cm below the bifurcation location where the patient's common carotid artery bifurcates into an internal carotid artery and external carotid artery.

16. The method of claim 15 , wherein the arterial access sheath has a working length of 5 cm to 15 cm and further comprising inserting no more than the working length of the arterial access sheath into the common carotid artery.

17. The method of claim 14 , wherein the structural configuration of the arterial access sheath includes a stopper member that at least partially covers the distal portion and that limits insertion of the distal portion into the common carotid artery.

18. The method of claim 14 , further comprising establishing reverse blood flow through the common carotid artery.

19. The method of claim 14 , further comprising blocking blood flow through at least a portion of the common carotid artery.

20. A system for use in accessing and treating a carotid artery, said system comprising:
an arterial access sheath adapted to be introduced into a common carotid artery via a neck of a patient and receive blood flow from the common carotid artery, the arterial access sheath including a distal sheath portion adapted to enter the common carotid artery, wherein the distal sheath portion has a structural configuration that limits a depth of insertion of a distal portion of the arterial access sheath into the common carotid artery; and
a filter adapted to be positioned in an internal carotid artery distal of a location of treatment;
wherein structural configuration of the arterial access sheath limits the distal portion the from being inserted into the common carotid artery beyond a length that would disrupt plaque in the common carotid artery.

21. The system of claim 20 , wherein the arterial access sheath has a distal region with a reduced luminal diameter to facilitate introduction into the common carotid artery and a proximal region having a larger luminal diameter relative to the distal region to decrease overall flow resistance through the arterial access sheath.

22. The system of claim 20 , wherein the structural configuration comprises a stopper member that at least partially covers the distal portion and that limits insertion of the distal portion into the common carotid artery.

Assignees

• Silk Road Medical Inc

Inventors

• Criado Enrique
• Chou Tony M
• Garrison Michi E
• Hyde Gregory M
• Schaer Alan
• Renati Richard

Classifications

• A61F2/95

  Instruments specially adapted for placement or removal of stents or stent-grafts · CPC title

• A61M2205/3334

  Measuring or controlling the flow rate · CPC title

• A61M2205/3331

  Pressure; Flow · CPC title

• A61B8/488

  involving Doppler signals · CPC title

• A61B2017/320716

  comprising means for preventing embolism by dislodged material · CPC title