Integrated expandable access for medical device introducer

A sheath assembly comprising:

• a medical device configured to be inserted into a blood vessel, a first portion of the medical device having a first width, and a second portion of the medical device having a second width that is smaller than the first width, the second portion of the medical device being proximal of the first portion of the medical device;
• a first sheath having a first lumen extending between proximal and distal ends of the first sheath configured to allow for passage of the second portion of the medical device, wherein the first sheath is tapered from the proximal end of the first sheath to the distal end of the first sheath;
• a first hub coupled to the proximal end of the first sheath;
• an expandable second sheath dimensioned for insertion into a femoral artery through an arteriotomy and having a second lumen extending between proximal and distal ends of the expandable second sheath, the second lumen being configured to have a first inner diameter at rest, and to be elastically expandable from the first inner diameter to a second inner diameter;
• and
• a second hub coupled to the proximal end of the expandable second sheath,
• wherein the second lumen is configured to expand to the second inner diameter during passage of the first portion of the medical device, and to elastically contract from the second inner diameter during the passage of the second portion of the medical device,
• wherein the first sheath forms a seal between an inner surface of the expandable second sheath and the second portion of the medical device when the expandable second sheath is inserted in the blood vessel through the arteriotomy and the first sheath is inserted into the second lumen over the second portion of the medical device, wherein the first sheath is advanced into the expandable second sheath such that blood from the blood vessel is substantially prevented from migrating past the seal;
• and
• wherein the expandable second sheath comprises either a porous material or a mesh material.

A sheath assembly comprising:

• a medical device configured to be inserted into a blood vessel, a first portion of the medical device having a first width, and a second portion of the medical device having a second width that is smaller than the first width, the second portion of the medical device being proximal of the first portion of the medical device;
• a first sheath having a first lumen extending between proximal and distal ends of the first sheath configured to allow for passage of the second portion of the medical device, wherein the first sheath is tapered from the proximal end of the first sheath to the distal end of the first sheath;
• a first hub coupled to the proximal end of the first sheath;
• an expandable second sheath dimensioned for insertion into a femoral artery through an arteriotomy and having a second lumen extending between proximal and distal ends of the expandable second sheath, the second lumen being configured to have a first inner diameter at rest, and to be elastically expandable from the first inner diameter to a second inner diameter;
• and
• a second hub coupled to the proximal end of the expandable second sheath,
• wherein the second lumen is configured to expand to the second inner diameter during passage of the first portion of the medical device, and to elastically contract from the second inner diameter during the passage of the second portion of the medical device,
• wherein the first sheath forms a seal between an inner surface of the expandable second sheath and the second portion of the medical device when the expandable second sheath is inserted in the blood vessel through the arteriotomy and the first sheath is inserted into the second lumen over the second portion of the medical device, wherein the first sheath is advanced into the expandable second sheath such that blood from the blood vessel is substantially prevented from migrating past the seal, and
• wherein the first sheath is configured to be inserted into the expandable second sheath by moving the first sheath and the expandable second sheath axially relative to one another along a longitudinal axis of the first sheath and the expandable second sheath.