Rapid exchange dilator for sheathless catheterization

Abstract

A dilator for sheathless access to a vessel of a patient having a tubular distal member with a skived portion on the proximal end and a proximal member with a skived portion on the distal end. The respective skived portions overlap at a transition region and form a rapid exchange port that communicates with the lumen of the distal member. The proximal member and the distal member may be secured together with transition tubing that is coaxially disposed over the distal and of the proximal member and extends over the skived portion of the distal member within a projected circumference of the distal member.

1 - 14 . (canceled) 
     
     
         15 . A method for accessing a vessel of a patient, the method comprising:
 preparing a dilator having a tubular distal member that extends along a longitudinal axis with a distal member skived portion, a proximal member that extends longitudinally from a distal end having a proximal member skived portion, and a rapid exchange port at a transition region formed by an overlap of the proximal member skived portion and the distal member skived portion, and a lumen that extends longitudinally between the rapid exchange port and the distal end of the distal member;   positioning a guide wire within the vessel of the patient;   advancing the dilator over the guide wire so that the guide wire exits the rapid exchange port; and   removing the guide wire from the vessel of the patient through the rapid exchange port with the dilator remaining in the vessel of the patient.   
     
     
         16 . The method of  claim 15 , further comprising advancing a catheter over the dilator and into the vessel of the patient. 
     
     
         17 . The method of  claim 16 , wherein the catheter is a guide catheter. 
     
     
         18 . The method of  claim 16 , wherein the catheter is advanced into the vessel of the patient over the dilator after the guide wire is removed via the rapid exchange port. 
     
     
         19 . The method of  claim 18 , further comprising removing the dilator from the catheter while the catheter remains in the vessel of the patient. 
     
     
         20 . The method of  claim 19 , wherein the dilator is removed from the catheter when a distal end of the catheter is adjacent a junction between a tapered distal end of the distal member and a maximal outer diameter of the distal member. 
     
     
         21 . The method of  claim 15 , wherein the vessel of the patient is a radial artery. 
     
     
         22 . The method of  claim 21 , wherein the dilator and catheter are advanced to a patient's subclavian artery and the dilator is removed from the catheter. 
     
     
         23 . The method of  claim 22 , wherein the guide wire is removed with the dilator and the catheter and a second guide wire is re-inserted into the catheter and advanced to a target site. 
     
     
         24 . The method of  claim 15 , further comprising:
 activating a hydrophilic coating of the distal member prior to advancing the dilator into the vessel of the patient.   
     
     
         25 . A method for accessing an artery of a patient, the method comprising:
 using a dilator having a tubular distal member that extends along a longitudinal axis with a distal member skived portion, a proximal member that extends longitudinally from a distal end having a proximal member skived portion, and a rapid exchange port at a transition region formed by an overlap of the proximal member skived portion and the distal member skived portion, and a lumen that extends longitudinally between the rapid exchange port and the distal end of the distal member;   puncturing the artery of the patient via a needle;   advancing a guide wire through a lumen of the needle;   advancing the dilator over the guide wire so that the guide wire exits the rapid exchange port; and   removing the guide wire from the artery of the patient through the rapid exchange port with the dilator remaining in the artery of the patient.   
     
     
         26 . The method of  claim 25 , further comprising, advancing the distal member of the dilator via the proximal member, wherein the distal member is more flexible than the proximal member, which improves pushablity and ease of navigation though an anatomy of the patient. 
     
     
         27 . The method of  claim 25 , further comprising, advancing a catheter over the dilator and into the vessel of the patient. 
     
     
         28 . The method of  claim 27 , wherein the catheter is a guide catheter. 
     
     
         29 . The method of  claim 27 , wherein the catheter is advanced into the vessel of the patient over the dilator after the guide wire is removed via the rapid exchange port. 
     
     
         30 . The method of  claim 29 , further comprising, removing the dilator from the catheter while the catheter remains in the vessel of the patient. 
     
     
         31 . The method of  claim 30 , wherein the dilator is removed from the catheter when a distal end of the catheter is adjacent a junction between a tapered distal end of the distal member and a maximal outer diameter of the distal member. 
     
     
         32 . The method of  claim 25 , wherein the artery is the patient's radial artery. 
     
     
         33 . The method of  claim 32 , wherein the dilator and catheter are advanced to a patient's subclavian artery and the dilator is removed from the catheter. 
     
     
         34 . The method of  claim 33 , wherein the guidewire is removed with the dilator and the catheter and a second guidewire is re-inserted into the catheter and advanced to a target site.