Devices and methods for catheter placement within a vein

Abstract

An apparatus includes an introducer defining a lumen and a catheter movably disposed in the lumen. The introducer has a distal end portion configured to operably couple to an indwelling peripheral intravenous line at least partially disposed in a vein. The catheter is configured to be moved between a first position, in which the catheter is proximal to the peripheral intravenous line when the introducer is operably coupled thereto, and a second position, in which a distal surface of the catheter is distal to the introducer and disposed at a predetermined distance from a distal tip of the peripheral intravenous line. The predetermined distance defined between the distal surface of the catheter and the distal tip of the peripheral intravenous line is based at least in part on a venous anatomy associated with the vein.

1 .- 30 . (canceled) 
     
     
         31 . An apparatus, comprising:
 an introducer defining a lumen, a distal end portion of the introducer configured to couple to an indwelling peripheral intravenous line at least partially disposed in a vein; and   a catheter at least partially disposed in the lumen of the introducer, the catheter configured to be moved relative to the introducer between a first position, in which the catheter is proximal to the indwelling peripheral intravenous line when the introducer is coupled thereto, and a second position, in which a distal surface of the catheter is distal to the introducer,   the catheter having a length sufficient to place the distal surface of the catheter a distance from a distal tip of the indwelling peripheral intravenous line, the distance based at least in part on a predetermined average distance between the distal tip of the indwelling peripheral intravenous line and a branch vessel coupled to the vein.   
     
     
         32 . The apparatus of  claim 31 , wherein at least one of a valve or the branch vessel is disposed at a position along the vein between the distal surface of the catheter and the distal tip of the indwelling peripheral intravenous line. 
     
     
         33 . The apparatus of  claim 31 , wherein the branch vessel has a volumetric flow rate greater than a volumetric flow rate threshold. 
     
     
         34 . The apparatus of  claim 31 , wherein the distance is between about 0.0 millimeters (mm) and about 50.0 mm. 
     
     
         35 . The apparatus of  claim 34 , wherein the distal surface of the catheter is distal to the distal tip of the indwelling peripheral intravenous line when the catheter is in the second position. 
     
     
         36 . The apparatus of  claim 34 , wherein the distal surface of the catheter is proximal to the distal tip of the indwelling peripheral intravenous line when the catheter is in the second position. 
     
     
         37 . The apparatus of  claim 31 , wherein the catheter is in a distal most position relative to the introducer when the catheter is in the second position such that the distance is about 30.0 mm. 
     
     
         38 . The apparatus of  claim 31 , wherein the catheter is in a distal most position relative to the introducer when the catheter is in the second position such that the distance is about 15.0 mm. 
     
     
         39 . The apparatus of  claim 31 , wherein the indwelling peripheral intravenous line includes a hub opposite the distal tip of the indwelling peripheral intravenous line, the distal surface of the catheter being disposed in a distal position relative to the hub and one of a proximal position relative to the distal tip of the indwelling peripheral intravenous line or flush with the distal tip of the indwelling peripheral intravenous line when the catheter is in the second position. 
     
     
         40 . The apparatus of  claim 31 , further comprising:
 an actuator movably coupled to the introducer, a portion of the actuator disposed in the lumen of the introducer and coupled to a proximal end portion of the catheter, the actuator configured to be moved relative to the introducer to move the catheter between the first position and the second position.   
     
     
         41 . The apparatus of  claim 31 , wherein the distal tip of the indwelling peripheral intravenous line is disposed in a first portion of the vein and the branch vessel is coupled to a second portion of the vein, the distal surface of the catheter being disposed in the second portion of the vein when the catheter is in the second position,
 wherein a volume of blood accessible via the second portion of the vein is greater than a volume of blood accessible via the first portion of the vein.   
     
     
         42 . An apparatus, comprising:
 an introducer defining a lumen, a distal end portion of the introducer configured to be coupled to an indwelling peripheral intravenous line at least partially disposed in a vein;   a catheter having a proximal end portion and a distal end portion and defining a lumen extending through the proximal end portion of the catheter and the distal end portion of the catheter, at least a portion of the catheter being movably disposed in the lumen of the introducer; and   an actuator movably coupled to the introducer, a portion of the actuator disposed in the lumen of the introducer and coupled to the proximal end portion of the catheter, the actuator configured to be moved relative to the introducer to move the catheter between a first position, in which the catheter is proximal to the indwelling peripheral intravenous line when the introducer is coupled thereto, and a second position, in which a distal surface of the catheter is distal to the indwelling peripheral intravenous line and within the vein such that at least one valve of the vein is disposed between a distal tip of the indwelling peripheral intravenous line and the distal surface of the catheter.   
     
     
         43 . The apparatus of  claim 42 , wherein the distal surface of the catheter is disposed a predetermined distance from the distal tip of the indwelling peripheral intravenous line when the catheter is in the second position. 
     
     
         44 . The apparatus of  claim 43 , wherein the predetermined distance is between about 0.0 millimeters (mm) and about 50.0 mm. 
     
     
         45 . The apparatus of  claim 43 , wherein the catheter is in a distal most position relative to the introducer when the catheter is in the second position such that the predetermined distance is at least 15.0 mm. 
     
     
         46 . The apparatus of  claim 42 , wherein the distal surface of the catheter is disposed a predetermined distance from the distal tip of the indwelling peripheral intravenous line when the catheter is in the second position, the predetermined distance is based at least in part on a length of the indwelling peripheral intravenous line. 
     
     
         47 . The apparatus of  claim 42 , wherein the distal end portion of the introducer is coupled to a lock, the lock is configured to be coupled to at least one of a hub of the indwelling peripheral intravenous line or an adapter coupled to the hub of the indwelling peripheral intravenous line to couple the introducer to the indwelling peripheral intravenous line. 
     
     
         48 . The apparatus of  claim 47 , wherein the catheter has a length sufficient to dispose the distal surface of the catheter at a predetermined distance from the distal tip of the indwelling peripheral intravenous line when the lock is coupled to the adapter. 
     
     
         49 . An apparatus, comprising:
 an introducer defining a lumen, a distal end portion of the introducer configured to couple to an indwelling peripheral intravenous line at least partially disposed in a first portion of a vein; and   a catheter at least partially disposed in the lumen of the introducer, the catheter configured to be moved a distance relative to the introducer between a first position, in which the catheter is proximal to the indwelling peripheral intravenous line when the introducer is coupled thereto, and a second position, in which a distal surface of the catheter is distal to and spaced apart from a distal tip of the indwelling peripheral intravenous line such that the distal surface of the catheter is disposed in a second portion of the vein, a volume of blood accessible via the second portion of the vein being greater than a volume of blood accessible via the first portion of the vein.   
     
     
         50 . The apparatus of  claim 49 , wherein the first portion of the vein is a first compartment of the vein and the second portion of the vein is a second compartment of the vein, the vein including a valve separating the first compartment from the second compartment, and
 the distal surface of the catheter is spaced apart from the distal tip of the indwelling peripheral intravenous line when in the second position such that the valve is disposed between the distal tip of the indwelling peripheral intravenous line and the distal surface of the catheter.   
     
     
         51 . The apparatus of  claim 50 , wherein a portion of the peripheral intravenous line dwelling in the first compartment of the vein results in a reduction in the volume of blood accessible via the first compartment of the vein. 
     
     
         52 . The apparatus of  claim 50 , wherein the second compartment of the vein is in fluid communication with a branch vessel such that a volume of blood flowing through the branch vessel results in an increase in the volume of blood accessible via the second compartment of the vein, the branch vessel having a volumetric flow rate greater than a volumetric flow rate threshold. 
     
     
         53 . The apparatus of  claim 49 , wherein the vein includes at least one branch vessel, a portion of the indwelling peripheral intravenous line is disposed within the vein such that the distal tip of the peripheral intravenous line is spaced apart from the branch vessel, the first portion of the vein being a portion closer to the distal tip of the peripheral intravenous line and the second portion of the vein being a portion closer to the branch vessel. 
     
     
         54 . The apparatus of  claim 49 , wherein the distal surface of the catheter is spaced apart from the distal tip of the indwelling peripheral intravenous line by about 0.0 millimeters (mm) and about 50.0 mm when the catheter is in the second position. 
     
     
         55 . The apparatus of  claim 49 , wherein the catheter is in a distal most position relative to the introducer when the catheter is in the second position such that the distal surface of the catheter is spaced apart from the distal tip of the indwelling peripheral intravenous line by about 30.0 mm. 
     
     
         56 . The apparatus of  claim 49 , wherein the catheter is in a distal most position relative to the introducer when the catheter is in the second position such that the distal surface of the catheter is spaced apart from the distal tip of the indwelling peripheral intravenous line by about 15.0 mm. 
     
     
         57 . The apparatus of  claim 49 , further comprising:
 an actuator movably coupled to the introducer, a portion of the actuator disposed in the lumen of the introducer and coupled to a proximal end portion of the catheter, the actuator configured to be moved relative to the introducer to move the catheter the distance between the first position and the second position.   
     
     
         58 . The apparatus of  claim 49 , wherein the distal end portion of the introducer is coupled to a lock, the lock is configured to be coupled to a hub of the indwelling peripheral intravenous line. 
     
     
         59 . The apparatus of  claim 49 , wherein the distal end portion of the introducer is coupled to a lock, the lock is configured to be coupled to an adapter coupled to a hub of the indwelling peripheral intravenous line to couple the introducer to the indwelling peripheral intravenous line,
 the distance that the catheter is moved is sufficient to place the distal surface of the catheter in a distal position relative to the distal tip of the indwelling peripheral intravenous line when the catheter is placed in the second position.   
     
     
         60 . The apparatus of  claim 49 , wherein the distance that the catheter is moved is based at least in part on a combined length of the indwelling peripheral intravenous line and a predetermined average length between the distal tip of the indwelling peripheral intravenous line and at least one of the valve or the branch vessel.