Sheathless Guide Catheter Assembly

Abstract

A guide catheter assembly includes a dilator and a guide catheter. The dilator includes a dilator lumen extending from a distal opening at a distal end to a proximal opening at a proximal end, and a side exit port proximal of the distal opening and in communication with the dilator lumen. The guide catheter includes a proximal end, a distal end, and a guide lumen extending therebetween. The dilator and the guide lumen are sized such that the dilator can pass through the guide lumen. The dilator and the guide catheter are sized such that with the proximal end of the dilator generally aligned along an axis with the proximal end of the guide catheter, the distal end of the dilator extends distally past the distal end of the guide catheter and the side exit port is disposed distal of the distal end of the guide catheter.

1 - 8 . (canceled) 
     
     
         9 . A guide catheter assembly comprising:
 a dilator including a proximal end, a distal end, a dilator lumen extending from a distal opening at the distal end to a side exit port proximal of the distal opening, wherein the dilator includes a tapered distal portion adjacent the distal end; and   a guide catheter including a proximal end, a distal end, and a guide lumen extending between the proximal end and the distal end of the guide catheter, wherein the dilator and the guide lumen are sized such that the dilator can pass through the guide lumen, and wherein the dilator and guide catheter are sized such that with the proximal end of the dilator generally aligned along an axis along an axis with the proximal end of the guide catheter, the distal end of the dilator extends distally past the distal end of the guide catheter and the side exit port is disposed distal of the distal end of the guide catheter.   
     
     
         10 . The guide catheter assembly of  claim 9 , wherein the dilator lumen is sized to receive a nominal 0.018-0.021 inch guidewire. 
     
     
         11 . The guide catheter assembly of  claim 9 , wherein the guide catheter is 90-150 cm long and the dilator is longer than the guide catheter. 
     
     
         12 . The guide catheter assembly of  claim 9 , wherein the tapered distal portion of the dilator is formed of a soft material to minimize trauma with a patient's vasculature. 
     
     
         13 . A method for accessing a vessel and delivering a guide catheter to a desired location in the vasculature of a patient, the method comprising the steps of:
 inserting a needle through a wall of the vessel at an access site to create an access opening, wherein the needle includes a needle lumen;   inserting a first wire through the needle lumen and into the vessel, wherein the first wire has a first diameter;   removing the needle from the vessel over the first wire and leaving a distal end of the first wire in a lumen of the vessel with the first wire extending through the access opening;   inserting a proximal end of the first wire into a distal opening of a dilator of a guide catheter assembly and into a dilator lumen of the dilator, wherein the guide catheter assembly includes the dilator and a guide catheter having a guide lumen sized to receive the dilator therein;   guiding the proximal end of the first wire out of a side exit port of the dilator, wherein the side exit port is located proximal of the distal opening and distal of a distal end the guide catheter when a proximal end of the dilator and a proximal end of guide catheter are generally aligned along an axis;   advancing the guide catheter assembly over the first wire until a distal portion of the dilator enters the vessel; and   removing the first wire from the vessel and the dilator by pulling the proximal end of the first wire such that the first wire retracts from the vessel, through the distal opening, and out of the side exit port.   
     
     
         14 . The method of  claim 13 , further comprising the step of withdrawing the dilator through the guide lumen after the distal portion of the guide catheter is disposed in the vessel. 
     
     
         15 . The method of  claim 14 , further comprising the step of advancing the guide catheter to the desired location in the vasculature. 
     
     
         16 - 20 . (canceled) 
     
     
         21 . The method of  claim 14 , further comprising the step of, after withdrawing the dilator through the guide lumen, inserting a second guidewire into a proximal opening at the proximal end of the guide catheter, through the guide lumen, and out of a distal opening at the distal end of the guide catheter into the vessel. 
     
     
         22 . The method of  claim 14 , wherein the second guidewire has a second diameter larger than the first diameter of the first guidewire. 
     
     
         23 . The method of  claim 22 , wherein the first guidewire has a nominal diameter of 0.018-0.021 inch and the second guidewire has a nominal diameter of 0.035 or 0.038 inch. 
     
     
         24 . The method of  claim 13 , wherein the dilator lumen extends only from the distal opening to the side exit port.