There are many medical procedures where one or more guidewires, catheters, sheaths, and/or other medical devices or instruments may be introduced into a patient's body cavity, recess, vessel, organ, and/or other body lumen. In many of these procedures, multiple devices are used and consequently multiple access sites are needed to introduce the instruments.
Generally, during a cardiac, vascular, or other procedure involving the patient's vascular system, an introducer sheath is placed percutaneously into the patient's vasculature, e.g., through the patient's skin into a peripheral artery or vein, such as the femoral artery, carotid artery, or other blood vessel, to provide access into the patient's body. For example, a hollow needle may be inserted through a patient's skin and overlying tissue into a blood vessel. A guide wire may be passed through the needle lumen into the blood vessel, whereupon the needle may be removed.
An introducer sheath may then be advanced over the guide wire into the vessel, e.g., in conjunction with or subsequent to one or more dilators. One or more catheters and/or other instruments may then be advanced individually through the introducer sheath over the guide wire into a position for performing a medical procedure. Thus, the introducer sheath may facilitate accessing and/or introducing various instruments separately into the vessel, while minimizing trauma to the vessel wall and/or minimizing blood loss.
If multiple instruments are needed substantially simultaneously during a procedure, multiple introducer sheaths are generally used, with each introducer sheath placed in different blood vessels to provide access for the devices. If more than one instrument is introduced through a single introducer sheath, e.g., adjacent one another, the seal within the introducer sheath may not provide sufficient hemostasis around the multiple instruments, risking loss of blood, low blood pressure, undesired introduction of air, and/or other potential problems for the patient. The use of multiple sheaths in a vessel may also lead to more risk of bleeding complications from repeated needle access attempts and/or the need for multiple closure devices at the end of the procedure.
Therefore, apparatus and methods that may facilitate delivery of multiple instruments through a single sheath during a medical procedure would be useful.