Unsung Heroes of Vascular Interventions:

By Chamfr Team

May 8, 2024

Exploring Differences Between Introducers for Venous & Arterial Access

Brian Loushine is a medical device leader with a unique background in engineering, marketing/strategy, and business development. With more than two decades of experience, he has extensive knowledge of early-stage product development and industry trends within the interventional procedures market. Connect with Brian on LinkedIn to stay updated on the latest advancements and discussions shaping the future of medtech trends and product development.  

I’ve spent most of my career on the minimally invasive side of medical devices, specifically in vascular interventions. The first step in these procedures is to gain access to the vasculature using a small introducer. I like to think of these devices as the unsung heroes of vascular interventions. If the vascular system is the body’s highways, the introducer provides the on-ramp.

Introducers play a crucial role in facilitating the insertion of devices like catheters into the venous or arterial system. For those new to the intricacies of this product, it’s important to understand the distinctions between introducers used for venous vs. arterial access. (I won’t get into micro access introducers in this post.)

Venous Access: Selecting the Right Introducer

Two main types of introducers are used for venous access:

• Non-valved tearaway (or “peelable”) introducers
  These introducers are designed for simplicity and effectiveness. They simply help the physician to enter the vasculature and place devices like catheters, after which they are peeled away. However, the absence of a valve means that the physician needs to be vigilant about preventing complications like blood loss or introducing air into the venous system.

• Valved tearaway introducers
  These introducers incorporate a valve mechanism to prevent backflow of blood and reduce the risk of air embolism. They’re particularly useful in procedures that require a controlled environment in which the physician is inserting or exchanging multiple devices. The valve ensures that the introducer maintains hemostasis throughout the procedure, enhancing patient safety.
  
  In some procedures, a device (such as a cardiac lead) is implanted into the body and the introducer must be cracked and torn away without compromising the placement of the implant. Designing a proper bond between the handle and sheath is important to ensure that the physician can remove the device without issue.

Arterial Access: The Role of Valved Introducers

Valved introducers are commonly used for accessing the arterial system. These introducers are designed to withstand arterial pressure, which prevents blood loss and minimizes the risk of air embolism. The valve is crucial to allowing the physician to maintain the precise control needed in arterial access to ensure a safe and efficient procedure. The valved introducer remains in the body throughout the procedure and is the final device removed before arterial access closure.

Examples:

• Central venous catheterization: Non-valved peelable introducers are usually the device of choice for their simplicity and effectiveness in creating a straightforward path for catheter insertion.
• Pacemaker and defibrillator lead insertion: Valved peelable introducers offer the advantage of maintaining hemostasis during the insertion of pacing leads, which may require multiple adjustments.
• Angiography and percutaneous interventions: In arterial access, valved introducers are essential for managing the high-pressure environment and ensuring the safety of procedures that involve frequent device exchanges.

The choice of introducer for venous and arterial access depends on the clinical requirements and goals of the medical procedure. Each type of introducer offers advantages that can enhance the physician experience, procedural outcome, and patient safety. Understanding the differences between these “unsung heroes” is essential for healthcare professionals and others in the medical technology industry.

Get quick access to a range of valved and non-valved introducer sheaths on Chamfr for your R&D needs.