Through irrigation dilator and related methods

Abstract

The dilator (100) includes a shaft (102), an irrigation lumen (108), and an inlet port (118). The shaft (102) includes a proximal end portion (104) and a distal end portion (106). An irrigation lumen (108) extends longitudinally through the shaft (102) from the proximal end portion (104) to the distal end portion (106) and is configured for injecting liquid through the dilator (100). An inlet port (118) is within the proximal end portion (104) of the rod (102) and is in fluid communication with the irrigation lumen (108).

Description

Cross Reference to Related Applications

[0001] This application claims priority to U.S. Provisional Patent Application Serial No. 63 / 531,893, filed August 10, 2023, the disclosure of which is incorporated herein by reference in its entirety. TECHNICAL FIELD

[0002] The present application generally relates to closure devices and methods for sealing a puncture or other opening in a blood vessel, such as the common carotid artery formed during a direct approach to a neurological treatment. The devices and methods can also be used during other therapeutic or surgical procedures. BACKGROUND

[0003] Traditionally, a dilator is used in conjunction with a guidewire and an introducer sheath to access a blood vessel. The guidewire is inserted through a central lumen of the dilator, and the dilator is inserted through the introducer sheath. Typically, a needle is used to puncture the blood vessel, creating an opening in the blood vessel. The guidewire is inserted through the opening and into the blood vessel. The dilator is introduced along the guidewire to dilate the opening in the blood vessel so that a portion of the introducer sheath can pass through the opening and into the interior of the blood vessel. The distal end of the dilator is tapered to dilate the opening in the blood vessel as it is advanced through the blood vessel. For example, once the introducer sheath is inside the blood vessel, the surgeon can need to inject a contrast agent or other liquid into the blood vessel for better visualization of the procedure. Traditionally, to inject the contrast agent through an injection port of the introducer sheath, the guidewire and / or the dilator must be removed from the introducer sheath. Neither of these options is ideal if the guidewire and / or the dilator need to be reinserted to continue the procedure. Removing the guidewire and / or the dilator from the introducer sheath can prolong the procedure and / or damage the introducer sheath and / or the patient.

[0004] To overcome these limitations, some dilators include a second lumen that can be used to flush or inject a contrast agent. These dilators include a separate flushing port because the second lumen is not configured to be in fluid communication with a flushing port of the introducer sheath.

[0005] Accordingly, despite the various advances in the art, there remains a need for further improvements in devices, systems, and methods related to flushable dilators. SUMMARY

[0006] Generally, a dilator is provided. The dilator includes a shaft, a flushing lumen, and an inlet port. The shaft has a proximal end portion and a distal end portion. The flushing lumen extends longitudinally through the shaft from the proximal end portion to the distal end portion. The flushing lumen is configured for injection of a liquid through the dilator. The inlet port is located in the proximal end portion of the shaft and is in fluid communication with the flushing lumen.

[0007] In some embodiments, a dilator can be configured for use with an introducer sheath. The inlet port can be configured to be in fluid communication with the introducer sheath. The inlet port can be configured to be in fluid communication with a flush port of the introducer sheath. The dilator can include a locking device on the proximal end portion of the shaft that is configured to engage the introducer sheath and couple the dilator to the introducer sheath. The dilator can have a hub on the proximal end portion of the shaft that includes a locking device configured to engage the introducer sheath and couple the dilator to the introducer sheath. The dilator can include an outlet port in the distal end portion of the shaft that is in fluid communication with the flush lumen. The dilator can have a first outlet port and a second outlet port in the distal end portion of the shaft that are in fluid communication with the flush lumen. The dilator can have a tip portion on the distal end portion of the shaft. The tip portion can include an outlet port in fluid communication with the flush lumen. The tip portion can include a first outlet port and a second outlet port in fluid communication with the first flush lumen and the second flush lumen, respectively. The dilator can have a central lumen extending longitudinally through the shaft from the proximal end portion to the distal end portion. The central lumen can be configured to receive a guidewire therethrough.

[0008] In alternative or other aspects, a dilator can have a first flush lumen and a second flush lumen. The dilator can have a first inlet port and a second inlet port in a proximal end portion of a shaft. The first inlet port can be in fluid communication with the first flush lumen. The second inlet port can be in fluid communication with the second flush lumen. The dilator can have a first outlet port and a second outlet port in a distal end portion of the shaft. The first outlet port can be in fluid communication with the first flush lumen. The second outlet port can be in fluid communication with the second flush lumen. The dilator can have a tip portion on the distal end portion of the shaft. The tip portion can include a first outlet port in fluid communication with the first flush lumen and a second outlet port in fluid communication with the second flush lumen. The dilator can have a central axis, and the first flush lumen can be located opposite the second flush lumen along the central axis.

[0009] An alternative dilator is provided. The alternative dilator includes a shaft, a flush lumen, an inlet port, and a central lumen. The shaft includes a proximal end portion and a distal end portion. The flush lumen extends longitudinally through the shaft from the proximal end portion to the distal end portion and is configured for injection of a liquid through the dilator. The inlet port is in the proximal end portion of the shaft and is in fluid communication with the flush lumen. The central lumen extends longitudinally through the shaft from the proximal end portion to the distal end portion.

[0010] In some embodiments, the central cavity is configured to receive a guidewire passing therethrough. The dilator may be configured for use with an inlet sheath. The inlet port may be configured to be in fluid communication with the inlet sheath. The inlet port may be configured to be in fluid communication with a flushing port of the inlet sheath. The dilator may include a locking device located on the proximal end portion of the shaft, the locking device being configured to engage the inlet sheath and couple the dilator to the inlet sheath. The dilator may have a hub located on the proximal end portion of the shaft, the hub including a locking device configured to engage the inlet sheath and couple the dilator to the inlet sheath. The dilator may have an outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber. The dilator may have a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber. The dilator may include an end portion located on the distal end portion of the shaft. The end portion may include an outlet port in fluid communication with the flushing chamber. The end portion may include a first outlet port and a second outlet port in fluid communication with the flushing chamber.

[0011] In alternative or other aspects, the dilator may have a first flushing chamber and a second flushing chamber. The dilator may have a first inlet port in the proximal end portion of the shaft and in fluid communication with the first flushing chamber. The dilator may have a second inlet port in the proximal end portion of the shaft and in fluid communication with the second flushing chamber. The dilator may have a first outlet port in the distal end portion of the shaft and in fluid communication with the first flushing chamber. The dilator may have a second outlet port in the distal end portion of the shaft and in fluid communication with the second flushing chamber. The dilator may include a distal portion of the distal end portion of the shaft. The distal portion may include a first outlet port in fluid communication with the first flushing chamber. The distal portion may include a second outlet port in fluid communication with the second flushing chamber. The dilator may have a central axis, and the first flushing chamber may be located along the central axis opposite to the second flushing chamber.

[0012] An alternative dilator is provided. This alternative dilator includes a shaft, a first flush chamber, a second flush chamber, a first inlet port, a second inlet port, and a central cavity. The shaft includes a proximal end portion and a distal end portion. The first and second flush chambers extend longitudinally from the proximal end portion through the shaft to the distal end portion and are configured for injecting fluid through the dilator; the first and second inlet ports are located in the proximal end portion of the shaft and are in fluid communication with the first and second flush chambers, respectively. The central cavity extends longitudinally from the proximal end portion through the shaft to the distal end portion.

[0013] In some embodiments, the central cavity is configured to receive a guidewire passing therethrough. The dilator may be configured for use with an inlet sheath. A first inlet port and a second inlet port may be configured to be in fluid communication with the inlet sheath. The first inlet port and the second inlet port may be configured to be in fluid communication with a flushing port of the inlet sheath. The dilator may include a locking device located on the proximal end portion of the shaft, the locking device being configured to engage the inlet sheath and couple the dilator to the inlet sheath. The dilator may include a hub located on the proximal end portion of the shaft, the hub including a locking device configured to engage the inlet sheath and couple the dilator to the inlet sheath. The dilator may include a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the first flushing chamber and the second flushing chamber, respectively. The dilator may have an end portion located on the distal end portion of the shaft. The end portion may include a first outlet port and a second outlet port in fluid communication with the first flushing chamber and the second flushing chamber, respectively. The dilator may have a central axis. The first flushing chamber may be located opposite the second flushing chamber along the central axis.

[0014] A method of using a dilator is provided, comprising introducing the dilator into an inlet sheath and injecting fluid into the inlet sheath through the dilator. The method may include coupling the dilator to the inlet sheath. The method may include injecting the fluid into an injection port of the inlet sheath. The fluid may be a contrast agent. The method may include introducing a guidewire into a lumen of the dilator.

[0015] A method of manufacturing an expander is provided, comprising forming a shaft including a proximal end portion and a distal end portion, forming a flushing chamber within the shaft, the flushing chamber extending longitudinally from the proximal end portion of the shaft through the shaft to the distal end portion of the shaft, and forming an inlet port in the proximal end portion of the shaft and in fluid communication with the flushing chamber.

[0016] In some embodiments, the method may include sealing the proximal end of the flushing chamber. Sealing the proximal end of the flushing chamber may include sealing the proximal end of the flushing chamber with epoxy resin. The method may include forming an outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber. The method may include forming an end portion of the distal end portion of the shaft. The method may include forming an outlet port located in the end portion of the shaft and in fluid communication with the flushing chamber. The flushing chamber formed in the shaft may include forming a first flushing chamber and a second flushing chamber. The method may include sealing the proximal ends of the first flushing chamber and the second flushing chamber. Sealing the proximal ends of the first flushing chamber and the second flushing chamber may include sealing the proximal end of the flushing chamber with epoxy resin. Forming an inlet port may include forming a first inlet port and a second inlet port in fluid communication with the first flushing chamber and the second flushing chamber, respectively. The method may include forming a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the first flushing chamber and the second flushing chamber, respectively. The method may include forming an end portion of the distal end portion of the shaft. The method may include forming a first outlet port and a second outlet port in the end portion of the shaft and in fluid communication with a first flushing chamber and a second flushing chamber, respectively. The method may include forming a central cavity in the shaft. The central cavity may be configured to receive a guidewire passing therethrough. The method may include hub coupling to the proximal end portion of the shaft. The method may include coupling a locking device to the proximal end portion of the shaft, the locking device being configured to engage the inlet sheath and coupling the dilator to the inlet sheath.

[0017] Any features and functions described herein can be applied to any disclosed implementation or method. Other features and advantages of the inventive aspects disclosed herein will become more apparent when read in conjunction with the accompanying drawings, which illustrate illustrative and exemplary embodiments. Attached Figure Description

[0018] Figure 1 This is a perspective view of an exemplary through-flow flushing dilator configured for use with an inlet sheath.

[0019] Figure 2 yes Figure 1 A perspective view of the shaft of a through-type flushing expander.

[0020] Figure 3 yes Figure 1 and Figure 2 A cross-sectional view of the shaft of a through-type flushing expander.

[0021] Figure 4 yes Figure 1 A perspective view of the through-type flushing expander inserted into the inlet sheath.

[0022] Figure 5 yes Figure 4 A cross-sectional view of the through-type flushing expander and inlet sheath. Detailed Implementation

[0023] Figure 1 This is a perspective view of an exemplary through-feed dilator 100 configured for use with an inlet sheath, according to at least some aspects of this disclosure. In this exemplary embodiment, the dilator 100 includes an elongated shaft 102, an end portion 130, and a dilator hub 140. Figure 2 This is a perspective view of shaft 102. Figure 3 This is a cross-sectional view of shaft 102, all of which are based on at least some aspects of this disclosure.

[0024] The elongated shaft 102 has a proximal end portion 104 and a distal end portion 106. An end portion 130 is located on the distal end portion 106 of the shaft 102, and a hub 140 is connected to the proximal end portion 104 of the shaft 102. As used herein, to describe various embodiments from the perspective of a user of the surgical device, "proximal" may refer generally towards the user of the device, and "distal" may refer generally away from the user of the device. Similarly, in the case of inserting the surgical device into a patient's body, from the user's perspective, "proximal" may refer generally away from the patient's body, and "distal" may refer generally towards the patient's body. For reference, arrow 2 generally points proximal, and arrow 4 generally points distal.

[0025] See Figure 2 and Figure 3In this exemplary embodiment, the shaft 102 has a first flushing chamber 108 and a second flushing chamber 110, and a central cavity 112 extending longitudinally from the proximal end portion 104 through the shaft 102 to the distal end portion 106. The central cavity 112 defines the central axis of the shaft 102. The first flushing chamber 108 is located opposite the second flushing chamber 110 along the central axis of the shaft 102. Some embodiments may have one flushing chamber, while other embodiments may have more than two flushing chambers. The dilator 100 includes outlet ports 114, 116 located in the distal end portion 106 of the shaft 102. The outlet ports 114, 116 are connected to and in fluid communication with the flushing chambers 108, 110, respectively. In some embodiments, the outlet ports 114, 116 may be located in the end portion 130 of the dilator 100. Some embodiments may have one outlet port, while other embodiments may have more than two outlet ports. The dilator 100 includes inlet ports 118 and 120 on the outer diameter 126 of the proximal end portion 104 of the shaft 102. Inlet ports 118 and 120 are connected to and in fluid communication with flushing chambers 108 and 110, respectively. Some embodiments may have one inlet port, while other embodiments may have more than two inlet ports. Figure 3 As shown, flushing chambers 108 and 110 are sealed at the proximal end portion 104 of shaft 102 with plugs 122 and 124. The proximal ends of flushing chambers 108 and 110 are sealed to prevent liquid from flowing in the proximal direction and draining from the proximal ends of flushing chambers 108 and 110. For example, the plugs 122 and 124 sealing the proximal ends of flushing chambers 108 and 110 may be epoxy resin. The plugs 122 and 124 may be any material that effectively seals the proximal ends of flushing chambers 108 and 110. In some embodiments, shaft 102 may have a flushing chamber that is in fluid communication with one or more outlet ports and / or inlet ports.

[0026] See Figure 1 In this exemplary embodiment, the distal portion 130 is located on the distal end portion 106 of the shaft 102. The distal portion 130 is tapered, allowing the dilator to expand tissue as the distal portion 130 is advanced through tissue (e.g., such as a blood vessel wall).

[0027] Refer again Figure 1 The expander hub 140 is coupled to the proximal end portion 104 of the shaft 102. The expander hub 140 includes an expander hub cavity 142 aligned with the shaft center cavity 112 (see [link]). Figure 2The shaft center cavity 112 is configured for use with a guidewire, and the hub cavity 142 is configured to facilitate the introduction of the guidewire into the shaft center cavity 112. The hub 140 has an expander locking device 144, which is configured to engage the expander 100 to the guide sheath 200 (see...). Figure 4 In this exemplary embodiment, the expander locking device 144 is one or more locking protrusions. In alternative embodiments, the expander locking device 144 can be any device configured to engage the expander 100 to the insertion sheath 200. In some embodiments, the outer surface of the hub 210 may include a groove 146 or other features on the side of the hub 140, for example, to improve the ergonomics of the hub 140 and / or to facilitate engagement of the expander 100 to the insertion sheath 200.

[0028] Figure 4 This is a perspective view of an exemplary expander 100 inserted into an infeed sheath 200. Figure 5 This is a cross-sectional view of an exemplary expander 100 inserted into an inlet sheath 200, all of which are in accordance with at least some aspects of this disclosure.

[0029] In this exemplary embodiment, the infusion sheath 200 is configured to enter a blood vessel. The infusion sheath 200 has a proximal end 202, a distal end 204, a hub 210, a central lumen 230, and a sheath 240. The hub 210 includes a front hub body 212, a rear hub body 214, an injection port 216, a stress relief element 218, a seal 220, and an infusion sheath locking device 222.

[0030] For example, a user can use a guidewire, dilator, and interventional device to enter the central cavity 230 of the inlet sheath at the proximal end 202 of the hub 210 without worrying about backflow. The seal 220 is designed to seal the outer surface of a device (such as dilator 100) mounted in the inlet sheath 200. The seal 220 prevents blood or other bodily fluids from flowing proximally through the central cavity 230 of the inlet sheath 200 and around the mounted device. The seal 220 also prevents blood or other bodily fluids from flowing proximally through the central cavity 230 of the inlet sheath 200 when the device (such as dilator 100) is not mounted in the inlet sheath 200. The seal 220 remains in the closed position when the device (e.g., dilator 100) is not in the central cavity 230. For example, the seal 220 eliminates the need for an external valve (such as a Tuohy Borst valve). The inlet sheath locking device 222, located within the rear hub 214, allows, for example, a device (e.g., dilator 100) to be attached to the inlet sheath 200 prior to a procedure (e.g., vasodilation). The inlet sheath locking device 222 also allows for easy removal of the device (e.g., dilator 100) from the inlet sheath 200 after the procedure is completed.

[0031] See Figure 4 andFigure 5 Injection port 216 can be used to remove air from the infusion sheath 200 at the start of the procedure and before a device (such as dilator 100) is installed into the infusion sheath 200. Injection port 216 can also be used to inject contrast agents or other liquids through the central cavity 230 of the infusion sheath 200. In this exemplary embodiment, the infusion sheath 200 is shown, along with a tube 250 and a 3-way valve 252 connected to injection port 216. Tube 250 and 3-way valve 252 provide additional functionality to injection port 216. When dilator 100 is installed in the infusion sheath 200, as... Figure 4 and Figure 5 As shown, the flushing chambers 108 and 110 are in fluid communication with the injection port 216 of the inlet sheath 200. When a conventional dilator is installed in the inlet sheath 200, the user cannot inject fluid into the injection port 216 due to the extremely small gap between the outer diameter of the dilator and the inner diameter of the inlet sheath's central cavity 230. However, when the dilator 100 is installed in the inlet sheath 200, the user can inject contrast agent or other fluids into the injection port 216 due to the flushing chambers 108 and 110. The fluid injected into the injection port 216 flows into the inlet sheath hub 210 and enters the inlet ports 118 and 120 of the dilator 100. Arrows 6 and 8 show the direction in which the flushing fluid enters the inlet ports 118 and 120, see [reference]. Figure 2 The injected liquid flows into the flushing chambers 108 and 110 through inlet ports 118 and 120, and exits through outlet ports 114 and 116 at the distal end of the expander 100. Arrows 10 and 12 indicate the direction in which the liquid exits from outlet ports 114 and 116, see [reference]. Figure 2 The inlet sheath seal 220 prevents liquid from flowing proximally through the central cavity 230 of the inlet sheath 200.

[0032] This document describes an exemplary method of using the expander 100. The expander 100 is inserted into the central cavity 230 of the insertion sheath 200 (see [link to document]). Figure 5The dilator locking device 144 engages with the inlet sheath locking device 222, thereby connecting the dilator 100 to the inlet sheath 200. A guidewire is inserted into the dilator hub 142 and through the central lumen 112 of the dilator 100. In this example, a blood vessel and a suitable entry point are identified. A needle and guidewire are inserted into the identified entry point on the blood vessel. The needle is inserted into the blood vessel, creating an opening. The guidewire is inserted through the opening and into the blood vessel. The dilator 100 is guided along the guidewire to dilate the opening in the blood vessel, allowing the distal end 204 of the inlet sheath 200 to enter the interior of the blood vessel. For example, at this point in the procedure, the surgeon may need to inject contrast agent into the blood vessel for better visualization of the procedure. With the guidewire in the central lumen 112 and the dilator 100 in the inlet sheath 200, the surgeon can inject contrast agent into the injection port 216. The injected fluid flows into the hub 210 and into the inlet ports 118, 120 of the dilator 100. The injected fluid flows into the irrigation chambers 108 and 110 through inlet ports 118 and 120, and exits through outlet ports 114 and 116 at the distal end of the dilator 100. Injecting contrast agent at this point in the procedure allows the surgeon to continue the procedure without first removing the guidewire and / or dilator 100 from the delivery sheath 200. By not removing the guidewire and / or dilator 100 from the delivery sheath 200, the surgeon can continue the procedure and minimize damage to the delivery sheath 200 and the patient.

[0033] This document describes an exemplary method of manufacturing an expander 100. For example, the shaft 102 of the expander 100 may be extruded, and the first flushing chamber 108, the second flushing chamber 110, and the central cavity 112 may be formed as part of an extrusion process. For example, after the shaft 102 is extruded, an end portion 130 may be formed on the distal end portion 106 of the shaft 102. For example, the proximal ends of the first flushing chamber 108 and the second flushing chamber 110 may be sealed with epoxy resin. Alternatively, the proximal ends of the first flushing chamber 108 and the second flushing chamber 110 may be sealed with plugs 122 and 124, which may be made of any material that effectively seals the proximal ends of the flushing chambers 108 and 110. Outlet ports 114 and 116 are formed in the distal end portion 106 of the shaft 102, respectively connected to and in fluid communication with the flushing chambers 108 and 110. In some embodiments, the outlet ports 114 and 116 may be formed in the end portion 130. Inlet ports 118 and 120 are formed in the proximal end portion 104 of the shaft 102 and are connected to and in fluid communication with flushing chambers 108 and 110, respectively. Hub 140 has a hub cavity 142 and an expander locking device 144 and is connected to the proximal end portion of the shaft 102.

[0034] While the invention has been described through a particular embodiment of which has been described in considerable detail, it is not intended to limit the scope of the appended claims or in any way restrict it to such details. The various features discussed herein can be used individually or in any combination within and between the various embodiments. Other advantages and modifications will readily emerge for those skilled in the art. Therefore, the invention, in its broader aspects, is not limited to the specific details, representative devices and methods, and exemplary examples shown and described. Consequently, deviations from such details may be made without departing from the overall scope or spirit of the invention.

Claims

1. An expander, comprising: A shaft, the shaft including a proximal end portion and a distal end portion; A flushing chamber, which extends longitudinally from the proximal end portion through the shaft to the distal end portion, is configured to inject liquid through the dilator; and An inlet port is located in the proximal end portion of the shaft and is in fluid communication with the flushing chamber.

2. The expander according to claim 1, wherein, The expander is configured for use with an inlet sheath, and The inlet port is configured to be in fluid communication with the inlet sheath.

3. The expander according to claim 2, wherein, The inlet port is configured to be in fluid communication with the flushing port of the inlet sheath.

4. The expander of claim 2, further comprising a locking device located at the proximal end portion of the shaft, the locking device being configured to engage the inlet sheath and connect the expander to the inlet sheath.

5. The expander of claim 2, further comprising a hub located at the proximal end portion of the shaft, the hub including a locking device configured to engage the inlet sheath and connect the expander to the inlet sheath.

6. The expander of claim 1, further comprising an outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber.

7. The expander of claim 1, further comprising a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber.

8. The expander according to claim 1, wherein, The expander further includes an end portion located at the distal end portion of the shaft, and the end portion includes an outlet port in fluid communication with the flushing chamber.

9. The expander according to claim 1, wherein, The expander further includes an end portion located at the distal end portion of the shaft, and the end portion includes a first outlet port and a second outlet port in fluid communication with the flushing chamber.

10. The expander according to claim 1, wherein, The flushing chamber is a first flushing chamber, and The expander further includes a second flushing chamber.

11. The expander according to claim 10, wherein, The inlet port is a first inlet port that is in fluid communication with the first flushing chamber, and The expander further includes a second inlet port in the proximal end portion of the shaft and in fluid communication with the second flushing chamber.

12. The expander according to claim 10, wherein, The outlet port is a first outlet port that is in fluid communication with the first flushing chamber, and The expander further includes a second outlet port located in the distal end portion of the shaft and in fluid communication with the second flushing chamber.

13. The expander according to claim 10, wherein, The expander further includes an end portion located at the distal end portion of the shaft. The terminal portion includes a first outlet port in fluid communication with the first flushing chamber, and The end portion includes a second outlet port that is in fluid communication with the second flushing chamber.

14. The expander according to claim 10, wherein, The expander has a central axis, and The first flushing chamber is located at a position opposite to the second flushing chamber along the central axis.

15. The expander of claim 1, further comprising a central cavity extending longitudinally from the proximal end portion through the shaft to the distal end portion.

16. The expander according to claim 15, wherein, The central cavity is configured to receive a guidewire passing through it.

17. An expander, comprising: A shaft, the shaft including a proximal end portion and a distal end portion; A flushing chamber, which extends longitudinally from the proximal end portion through the shaft to the distal end portion, is configured to inject liquid through the dilator; An inlet port is located in the proximal end portion of the shaft and is in fluid communication with the flushing chamber; and A central cavity that extends longitudinally from the proximal end portion through the shaft to the distal end portion.

18. The expander according to claim 17, wherein, The central cavity is configured to receive a guidewire passing through it.

19. The expander according to claim 17, wherein, The expander is configured for use with an inlet sheath, and The inlet port is configured to be in fluid communication with the inlet sheath.

20. The expander according to claim 19, wherein, The inlet port is configured to be in fluid communication with the flushing port of the inlet sheath.

21. The expander of claim 19, further comprising a locking device located on the proximal end portion of the shaft, the locking device being configured to engage the inlet sheath and connect the expander to the inlet sheath.

22. The expander of claim 19, further comprising a hub located on the proximal end portion of the shaft, the hub including a locking device configured to engage the inlet sheath and connect the expander to the inlet sheath.

23. The expander of claim 17, further comprising an outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber.

24. The expander of claim 17, further comprising a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the flushing chamber.

25. The expander according to claim 17, wherein, The expander further includes an end portion located at the distal end portion of the shaft, and the end portion includes an outlet port in fluid communication with the flushing chamber.

26. The expander according to claim 17, wherein, The expander further includes an end portion located at the distal end portion of the shaft, and the end portion includes a first outlet port and a second outlet port in fluid communication with the flushing chamber.

27. The expander according to claim 17, wherein, The flushing chamber is a first flushing chamber, and The expander further includes a second flushing chamber.

28. The expander according to claim 27, wherein, The inlet port is a first inlet port that is in fluid communication with the first flushing chamber, and The expander further includes a second inlet port in the proximal end portion of the shaft and in fluid communication with the second flushing chamber.

29. The expander according to claim 27, wherein, The outlet port is a first outlet port that is in fluid communication with the first flushing chamber, and The expander further includes a second outlet port located in the distal end portion of the shaft and in fluid communication with the second flushing chamber.

30. The expander according to claim 27, wherein, The expander further includes an end portion located at the distal end portion of the shaft. The terminal portion includes a first outlet port in fluid communication with the first flushing chamber, and The end portion includes a second outlet port that is in fluid communication with the second flushing chamber.

31. The expander according to claim 27, wherein, The expander has a central axis, and The first flushing chamber is located at a position opposite to the second flushing chamber along the central axis.

32. An expander, comprising: A shaft, the shaft including a proximal end portion and a distal end portion; A first flushing chamber and a second flushing chamber, the first flushing chamber and the second flushing chamber extending longitudinally from the proximal end portion through the shaft to the distal end portion, and configured for injecting liquid through the expander; The first inlet port and the second inlet port are located in the proximal end portion of the shaft and are in fluid communication with the first flushing chamber and the second flushing chamber, respectively. and A central cavity that extends longitudinally from the proximal end portion through the shaft to the distal end portion.

33. The expander according to claim 32, wherein, The central cavity is configured to receive a guidewire passing through it.

34. The expander according to claim 32, wherein, The expander is configured for use with the inlet sheath, and the first inlet port and the second inlet port are configured to be in fluid communication with the inlet sheath.

35. The expander according to claim 34, wherein, The first and second inlet ports are configured to be in fluid communication with the flushing port of the inlet sheath.

36. The expander of claim 34, further comprising a locking device located on the proximal end portion of the shaft, the locking device being configured to engage the inlet sheath and connect the expander to the inlet sheath.

37. The expander of claim 34, further comprising a hub located at the proximal end portion of the shaft, the hub including a locking device configured to engage the inlet sheath and connect the expander to the inlet sheath.

38. The expander of claim 32, further comprising a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the first flushing chamber and the second flushing chamber, respectively.

39. The expander according to claim 32, wherein, The expander further includes an end portion located at the distal end portion of the shaft, and the end portion includes a first outlet port and a second outlet port that are in fluid communication with the first flushing chamber and the second flushing chamber, respectively.

40. The expander according to claim 32, wherein, The expander has a central axis, and The first flushing chamber is located at a position opposite to the second flushing chamber along the central axis.

41. A method of using an expander, comprising: The expander is inserted into the inlet sheath; and Liquid is injected into the inlet sheath and passed through the dilator.

42. The method of claim 41, further comprising coupling the expander to the inlet sheath.

43. The method of claim 41, further comprising injecting the liquid into the injection port of the infeeding sheath.

44. The method according to claim 41, wherein, The liquid is a contrast agent.

45. The method of claim 41, further comprising introducing a guidewire into the cavity of the dilator.

46. ​​A method of manufacturing an expander, comprising: Forming a shaft comprising a proximal end portion and a distal end portion; A flushing chamber is formed within the shaft, the flushing chamber extending longitudinally from the proximal end portion of the shaft through the shaft to the distal end portion of the shaft; and An inlet port is formed in the proximal end portion of the shaft and is in fluid communication with the flushing chamber.

47. The method of claim 46, further comprising sealing the proximal end of the flushing chamber.

48. The method according to claim 47, wherein, The sealing of the proximal end of the flushing chamber includes sealing the proximal end of the flushing chamber with epoxy resin.

49. The method of claim 46, further comprising forming an outlet port in the distal end portion of the shaft and in fluid communication with the flushing chamber.

50. The method of claim 46, further comprising forming an end portion, said end portion being the distal end portion of the shaft; and An outlet port is formed in the end portion of the shaft and is in fluid communication with the flushing chamber.

51. The method according to claim 46, wherein, The flushing chamber formed in the shaft includes a first flushing chamber and a second flushing chamber.

52. The method of claim 51, further comprising sealing the proximal ends of the first flushing chamber and the second flushing chamber.

53. The method according to claim 52, wherein, Sealing the proximal ends of the first and second flushing chambers includes sealing the proximal ends of the flushing chambers with epoxy resin.

54. The method according to claim 51, wherein, Forming the inlet port includes forming a first inlet port and a second inlet port that are in fluid communication with the first flushing chamber and the second flushing chamber, respectively.

55. The method of claim 51, further comprising forming a first outlet port and a second outlet port located in the distal end portion of the shaft and in fluid communication with the first flushing chamber and the second flushing chamber, respectively.

56. The method of claim 51, further comprising an end portion formed on the distal end portion of the shaft; and A first outlet port and a second outlet port are formed in the end portion of the shaft and are in fluid communication with the first flushing chamber and the second flushing chamber, respectively.

57. The method of claim 46, further comprising a central cavity formed in the shaft.

58. The method according to claim 57, wherein, The central cavity is configured to receive a guidewire passing through it.

59. The method of claim 46, further comprising connecting a hub to the proximal end portion of the shaft.

60. The method of claim 46, further comprising coupling a locking device to the proximal end portion of the shaft. in, The locking device is configured to engage the inlet sheath and attach the expander to the inlet sheath.

61. Any device, method or combination thereof disclosed herein.

62. Any two or more of the preceding claims in any combination.

63. Any combination of elements from one or more of the preceding claims.

64. An apparatus comprising any combination of the elements disclosed herein.

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