Trans-jugular corotid artery access methods

Abstract

Methods and devices for trans-jugular carotid access are disclosed. Methods within the scope of this disclosure include methods of trans-jugular carotid access originating in the leg of a patient or other location remote to the jugular vein and carotid artery and methods originating at the neck of a patient. Devices used in connection with the disclosed methods may comprise access catheters, lumens, and stylets.

1 . A method of accessing the carotid artery of a patient comprising:
 accessing a jugular vein of a patient;   accessing a carotid artery of a patient by piercing the carotid artery through the jugular vein of the patient to create an opening between the jugular vein and the carotid artery; and   advancing a treatment device to the carotid artery.   
     
     
         2 . The method of  claim 1 , further comprising advancing a guidewire from a femoral vein of a patient to the jugular vein of the patient and piercing the jugular vein and the carotid artery of the patient to access to carotid artery. 
     
     
         3 . The method of  claim 2 , further comprising advancing a puncture needle through the neck of a patient into the jugular vein and the carotid artery of the patient. 
     
     
         4 . The method of  claim 3 , further comprising advancing a guidewire through the puncture needle to the carotid artery; and
 removing the puncture needle.   
     
     
         5 . The method of  claim 4 , further comprising advancing an interventional sheath over the guidewire and into the carotid artery. 
     
     
         6 . The method of  claim 5 , wherein the treatment device is advanced to the carotid artery via the interventional sheath. 
     
     
         7 . The method of  claim 6 , further comprising introducing a bioabsorable mesh into the jugular vein to close the opening between the jugular vein and the carotid artery. 
     
     
         8 . The method of  claim 7 , wherein the bioabsorable mesh is disposed adjacent a first opening and a second opening in the jugular vein. 
     
     
         9 . The method of  claim 7 , wherein the bioabsorable mesh is introduced through a third opening in the jugular vein. 
     
     
         10 . The method of  claim 7 , wherein the bioabsorable mesh is introduced through a femoral vein. 
     
     
         11 . The method of  claim 1 ,
 wherein accessing the jugular vein of a patient comprises advancing a catheter along a jugular vein; and   wherein accessing the carotid artery comprises:
 abutting a curved distal tip of the catheter against a vessel wall of the jugular vein adjacent a defined access location of a carotid artery; 
 displacing a stylet through a lumen of the catheter; and 
 piercing the vessel wall of the jugular vein and a vessel wall of the carotid artery with the stylet thereby establishing access to the carotid artery. 
   
     
     
         12 . The method of  claim 11 , wherein the catheter is coupled to a handle and the stylet is coupled to a spring disposed within the handle, and
 wherein piercing the wall of the jugular vein and the wall of the carotid artery corresponds to a release of spring energy.   
     
     
         13 . The method of  claim 11 , wherein the catheter is a first catheter, and
 wherein the method further comprises advancing a second catheter along the jugular vein.   
     
     
         14 . The method of  claim 13 , wherein the second catheter is advanced over a guidewire extending along a vasculature from an entry location to at least a location within the jugular vein adjacent the defined access location of the carotid artery. 
     
     
         15 . The method of  claim 13 , wherein the first catheter is disposed within a lumen of the second catheter. 
     
     
         16 . The method of  claim 13 , further comprising advancing a third catheter along the stylet into the carotid artery to introduce a treatment tool to the carotid artery. 
     
     
         17 . A method of accessing the carotid artery of a patient comprising:
 advancing a first catheter from a vasculature entry point to a jugular vein;   advancing a second catheter through a lumen of the first catheter so as to extend a curved distal tip of the second catheter beyond a distal end of the lumen of the first catheter;   orienting the curved distal tip toward a carotid artery;   displacing a stylet through a lumen of the second catheter; and   creating an access opening in a vessel wall of the carotid artery by piercing a vessel wall of the jugular vein and the vessel wall of a carotid artery with the stylet at an angle at least partially defined by the curved distal tip.   
     
     
         18 . The method of  claim 17 , wherein upon piercing the vessel wall of the carotid artery, the stylet is angled toward the direction of blood flow within the carotid artery such that a force exerted on the stylet by the blood flow urges the stylet away from an opposite vessel wall of the carotid artery. 
     
     
         19 . The method of  claim 17 , further comprising advancing an access catheter along the stylet into the carotid artery; and
 removing the stylet.   
     
     
         20 . The method of  claim 17 , wherein upon piercing of the vessel wall of the carotid artery, a flap of the vessel wall of the carotid artery is created inside the carotid artery, and
 wherein the flap is configured such that upon removal of the access catheter, the blood flow within the carotid artery urges the flap toward the vessel wall of the carotid artery so as to inhibit a flow of blood through the access opening of the carotid artery.