Systems, devices, and methods for accessing a subdural space

An apparatus for draining a subdural hematoma disposed in an intracranial extravascular space of a patient, the apparatus comprising:

• a suction catheter having a working length of at least 120 cm and including a distal portion having an inner diameter of up to about 0.060 inches such that the distal portion of the suction catheter is disposable within a middle meningeal artery (MMA) of the patient, the suction catheter defining a lumen;
• and
• a shaft configured to be advanced through the lumen of the suction catheter until a distal tip portion of the shaft is disposed within the MMA, the shaft including:
• a perforating element disposed at a distal end of the distal tip portion, the perforating element configured to cut through a wall of the MMA and dura of the patient to create a passageway from the MMA into the intracranial extravascular space,
• the perforating element configured to be angled with respect to the distal tip portion such that, when the perforating element is disposed distally beyond the distal end of the suction catheter, the perforating element can be directed toward the wall of the MMA and the dura and cut through the wall of the MMA and the dura at an oblique angle,
• the shaft is configured to be advanced within the intracranial extravascular space to the subdural hematoma, and
• the suction catheter configured to be advanced over the shaft such that the suction catheter is guided by the shaft through the passageway and to the subdural hematoma to allow fluid or matter from the subdural hematoma to be transvascularly drained out of the intracranial extravascular space via the lumen of the catheter.

An apparatus for draining a subdural hematoma disposed in an intracranial extravascular space of a patient, the apparatus comprising:

• a suction catheter disposable within an intracranial vessel of the patient, the suction catheter defining a lumen;
• and
• a shaft configured to be advanced through the lumen of the suction catheter until a distal tip portion of the shaft is disposed within the intracranial vessel, the shaft including:
• (1) a perforating element disposed at a distal end of the distal tip portion of the shaft, the perforating element configured to cut through a wall of the intracranial vessel and a dura of the patient to create a passageway from the intracranial vessel into the intracranial extravascular space;
• (2) a curved section of the shaft having a preset curvature, the curved section configured to be radially constrained within the lumen of the suction catheter and to curve toward the wall of the intracranial vessel and the dura upon exiting the lumen of the catheter;
• and
• (3) a partial helix or twist of the shaft disposed proximal of the curved section, the partial helix or twist configured to orient the preset curvature of the curved section to follow a curvature of the intracranial vessel as the shaft is advanced through the lumen of the suction catheter,
• the suction catheter configured to be advanced through the passageway and to the subdural hematoma to allow fluid or matter from the subdural hematoma to be transvascularly drained out of the intracranial extravascular space via the lumen of the catheter.