RETROGRADE ENTRY ANTEGRADE PLACEMENT FOR FEMORAL ARTERY ACCESS

摘要

A Retrograde Entry Antegrade Placement (REAP™) method and apparatus facilitate the antegrade (i.e., in the direction of blood flow) placement of endovascular devices for treatment of lower extremity arterial disease. Initially, a retrograde entry is made into the arterial system of a patient at an entry point with a curved needle, which then exits at an exit point proximal to the entry point, with a first wire then passed through the lumen of the curved needle. From the skin exit point, a Dual-Lumen Access Director (DAD) device is advanced in the antegrade direction down the first wire in a first lumen and enters the CFA 1 lumen. A second wire is passed down a second lumen in the DAD device and follows the SFA lumen in the antegrade direction. The DAD device is removed, and a standard dilator sheath is inserted over the second wire and the endovascular treatment begins.

主权项

1. An apparatus for aiding vascular access comprising:
a sheath having a first and second lumen;
the first lumen extending from a head of the sheath to a tip of the sheath; andthe second lumen extending from the head of the sheath to a point proximal to the tip that ends in an oval orifice; wherein the first lumen receives a wire introduced into the skin of a subject at an entry point, into and out of a vascular channel of the subject, and out of the skin of a subject at an exit point, and the tip of the sheath is advanced in a first direction over the wire through the skin and bleed-back is observed out of the head of the sheath when the oval orifice enters the vascular channel, and bleed-back ceases when the oval orifice exits the vascular channel, and further wherein retracting the sheath a short distance in a second direction opposite the first direction ensures that the oval orifice is within the vascular channel, wherein a second wire is advanced through the head and into the second lumen and exits the second lumen out of the oval orifice and into the vascular channel.