Abstract: Transvascular access devices and methods for transvascular access are provided. The transvascular access devices can include a guidewire lumen and a guide tube and stylet disposed in a second lumen. The guide tube can be used to control the orientation of the stylet and provide additional support for the stylet. The methods include providing a second entry point in a vessel of a patient remote from a first entry point. A vascular catheter can enter the vascular system of a patient at a first entry point and be advanced to a second entry point. A guide tube can be advanced out the second lumen of the vascular catheter with a stylet advanced out of the guide tube to pierce the vessel wall and skin of the patient at the second entry point. A catheter can be introduced to the vascular system at the second entry point.

Abstract: Various methods employing transvascular access devices are described, including a method of placing a central catheter in a peripheral vein in an arm of a patient; a method of providing percutaneous access to the heart of a patient; a method of clearing a clotted arteriovenous dialysis graft; a method of creating multiple access points into a single blood vessel; a method of creating an AV fistula in a patient; and a method of providing a bypass to a blockage in a popliteal artery in a patient.

Abstract: Transvascular access devices and methods for transvascular access are provided. The transvascular access devices can include a guidewire lumen and a guide tube and stylet disposed in a second lumen. The guide tube can be used to control the orientation of the stylet and provide additional support for the stylet. The methods include providing a second entry point in a vessel of a patient remote from a first entry point. A vascular catheter can enter the vascular system of a patient at a first entry point and be advanced to a second entry point. A guide tube can be advanced out the second lumen of the vascular catheter with a stylet advanced out of the guide tube to pierce the vessel wall and skin of the patient at the second entry point. A catheter can be introduced to the vascular system at the second entry point.

Abstract: A system for providing transvascular retrograde access in a central blood vessel of a patient. In some embodiments, the system has a handle; a catheter extending from the handle; and a tissue piercing element extending from the handle through the catheter, the tissue piercing element having a sharp distal tip adapted to extend from a distal portion of the catheter, the catheter and handle being adapted to be separated from the tissue piercing element, a distal portion of the tissue piercing element being adapted to serve as a guide for introduction of a device into the central blood vessel. The invention also includes a method of providing transvascular retrograde access to a central blood vessel of a patient.

Abstract: A system for providing transvascular retrograde access in a central blood vessel of a patient. In some embodiments, the system has a handle; a catheter extending from the handle; and a tissue piercing element extending from the handle through the catheter, the tissue piercing element having a sharp distal tip adapted to extend from a distal portion of the catheter, the catheter and handle being adapted to be separated from the tissue piercing element, a distal portion of the tissue piercing element being adapted to serve as a guide for introduction of a device into the central blood vessel. The invention also includes a method of providing transvascular retrograde access to a central blood vessel of a patient.

Abstract: A system for providing transvascular retrograde access in a central blood vessel of a patient. In some embodiments, the system has a handle; a catheter extending from the handle; and a tissue piercing element extending from the handle through the catheter, the tissue piercing element having a sharp distal tip adapted to extend from a distal portion of the catheter, the catheter and handle being adapted to be separated from the tissue piercing element, a distal portion of the tissue piercing element being adapted to serve as a guide for introduction of a device into the central blood vessel. The invention also includes a method of providing transvascular retrograde access to a central blood vessel of a patient.

Abstract: A system for providing transvascular retrograde access in a central blood vessel of a patient. In some embodiments, the system has a handle; a catheter extending from the handle; and a tissue piercing element extending from the handle through the catheter, the tissue piercing element having a sharp distal tip adapted to extend from a distal portion of the catheter, the catheter and handle being adapted to be separated from the tissue piercing element, a distal portion of the tissue piercing element being adapted to serve as a guide for introduction of a device into the central blood vessel. The invention also includes a method of providing transvascular retrograde access to a central blood vessel of a patient.

Abstract: The present invention relates to methods of transvascular retrograde access placement and to devices that facilitate these methods. For purposes of the present invention, transvascular retrograde access placement generally comprises the insertion of a vascular catheter into a central blood vessel through the puncturing of the central blood vessel from the inside of the central blood vessel with a needle or other similarly configured device, or a needle-tipped guidewire of the present invention, and exiting that needle from the patient through the skin rather than the traditional approach of inserting a needle from the outside of the skin surface to the inside of a blood vessel.

Abstract: The invention relates to methods of transvascular retrograde access placement into a central blood vessel and to devices that facilitate these methods. The method includes positioning a vascular catheter within the vessel such that its distal end faces a desired exit site on the vessel wall, passing a penetrating device from the catheter through the vascular exit site and skin of the patient; and passing a secondary vascular catheter through the exit site and into the central blood vessel. In another aspect, the method includes penetrating outward from within the vessel to form a pass-through site on a wall of the vessel that exits the patient; and placing the vascular access device into the vessel through the pass-through site. Typical vessels that may be accessed include central veins, but may include other veins as well as arteries.