Embodiments of catheter placement systems described herein include a temporary splittable sheath anchor, disposed on an outer surface of a needle. The splittable anchor moves with respect to the needle when accessing the vessel, allowing for a temporary anchor to be created as soon as venous access is confirmed via flashback. The clinician can advance the anchor over the needle once vessel access has been confirmed by flashback. The needle can then be removed without further insertion into the vessel, mitigating accidental trauma. The guidewire can then be introduced through the anchor and advanced to a target location within the vasculature. The anchor can then be removed by splitting and withdrawing the anchor proximally. Embodiments further include a splittable advancement sheath including a guidewire and configured to be drawn thorough a housing and split to allow the guidewire to separate from the advancement sheath and advance into the vasculature.

Disclosed are access systems, devices, and methods for internal access to a patient's body. For example, an access device for placing an acute dialysis catheter can include a frame; a housing, a pair of guidewire clamps, and a needle disposed on the frame; a dilator coupled to the frame, and an access guidewire in a ready-to-deploy state of the access device. The pair of guidewire clamps can be disposed on the frame between an end portion of the frame and a distal end of the housing for clamping the access guidewire. A needle hub of the needle can be disposed on the frame between the pair of guidewire clamps. The dilator can distally extend from the end portion of frame. A needle shaft of the needle can distally extend beyond a distal end of the dilator allowing the needle to establish an insertion site for the acute dialysis catheter.

A catheter assembly may include a cannula. The cannula may include a distal tip, an elongated tubular shaft, and an inner lumen formed by the elongated tubular shaft. A first portion of the elongated tubular shaft may have a first outer diameter. The first portion may be proximate the distal tip. A second portion of the elongated tubular shaft may have a second outer diameter. The second outer diameter may be greater than the first outer diameter. The catheter assembly may also include a catheter adapter, which may include a catheter and a catheter hub. The second portion of the elongated tubular shaft may be at least partially disposed in the catheter hub.

A catheter and tissue cutting system percutaneously permits the creation of an anastomosis between a first and second anatomical structure, such as a vein and an artery. The system comprises a catheter having a main body with a lumen and tapered distal tip, configured to be moved distally into the first anatomical structure over a primary guidewire. A cutting electrode is nested in the main body, with a lumen which tracks over a secondary guidewire, and is insertable into the secondary anatomical structure. An energy supply is operative to energize the cutting electrode in order to cut a tissue wall defining the first anatomical structure.

An insertion set system includes a base configured to be secured to a patient, and a flexible tubing on the base. The flexible tubing has a distal end portion forming a cannula to be inserted into the patient. An inserter having a needle is received by the base. The needle has a channel in which the distal end portion of the flexible tubing is received. The needle is able to slide relative to the flexible tubing, to selectively withdraw the needle off of the distal end portion of the flexible tubing. The base may include a passage for fluid flow arranged transverse to the axial dimension of the distal end portion of the flexible tubing.

A catheter system may include a catheter lumen, first and second electrodes, and a sensor in communication with the first and second electrodes. The sensor may be configured to detect at least one of: a bulk volume of blood within a blood vessel and extravasation of a drug from the blood vessel into soft tissue adjacent the blood vessel. Other catheter systems may include a catheter lumen and a sensing chip coupled to the catheter lumen. The sensing chip may be configured to detect at least one of: a bulk volume of blood within a blood vessel and extravasation of a drug from the blood vessel into soft tissue adjacent the blood vessel.

Methods and apparatuses for peritoneal catheter placement are disclosed herein. An example method includes using a puncture device to create an access hole to a patient's peritoneal cavity. The puncture device includes a lumen that enables a guidewire to be inserted into the peritoneal cavity. The puncture device is then replaced with a catheter, which is inserted along the guidewire. A surgical seal is next applied to connect the catheter to adjacent patient muscle tissue. After the guidewire is removed, a tunneling device creates a pathway through fat tissue to anchor the catheter. An end of the tunneling device is aligned with an external piercing device to pierce the patient's skin from the outside, creating a catheter exit hole. An end of the catheter is connected to the tunneling device and pulled through the exit hole, thereby enabling the catheter to be connected to peritoneal dialysis tubing for a treatment.

A handheld vascular access device for gaining access to a patient's vessel includes a hub, a plurality of access needles and a manifold. The hub has an inner wall and side walls that define a plurality of ports. Each of the plurality of ports has a proximal port end and a distal port end. The proximal port ends define a proximal cross-sectional area and the distal port ends define a distal cross-sectional area. The proximal cross-sectional areas are greater than the distal cross-sectional areas. Each of the plurality of ports taper from the proximal port end to the distal port end. The plurality of hollow access needles is arranged along a plane and fixedly coupled to the distal end of the hub. Each of the plurality of needles has a tip. The manifold removably engages the hub at the proximal end of the hub.

Introducer needles can be used with rapidly insertable central catheters (“RICCs”) or even other central venous catheters (“CVCs”). An introducer needle can include a needle shaft, a sheath, and a needle hub. The needle shaft can include a needle slot extending from a proximal portion of the needle shaft through a distal needle tip. The sheath can be disposed over the needle shaft and fixed in location thereon. The sheath can seal the needle slot under the sheath but for a sheath opening in a proximal portion of the sheath. The needle hub can be around at least the proximal portion of the needle shaft. The introducer needle can be made by creating the needle slot in the needle shaft such as by cutting or grinding the needle slot therein, disposing the sheath over the needle shaft, and fixing the sheath on the needle shaft.

An integrated catheter assembly includes a housing member, an outer lumen member extending from the housing member, and a needle member having a needle slidably or movably coupled to the housing member, wherein the needle can be extended beyond the outer lumen. Once a flash of blood is confirmed the needle member is uncoupled from the housing member and removed from within the patent's vein or artery. An inner lumen member having an elongated member housing an inner lumen is then connected to the housing member. A thump slide supported within the elongated member and coupled to the inner lumen is advanced moving the inner lumen through the housing member and the outer lumen into the patient's vein or artery beyond the end of the outer lumen The end of the thump slide/elongated member is connected to tubing extending to a dialysis machine and this tubing is used to transfer clean or detoxed blood from the machine back into the patent. The outer lumen is connected to separate tubing to transfer blood out of the patent to the dialysis machine. The integrated catheter assembly therefore receives and delivers blood through a single injection site. Alternatively, another embodiment is shown where the needle remains within the patient during dialysis.