Transfemoral transcaval liver access and devices

A kit for obtaining a tissue sample from the liver of a patient, the kit comprising:

• an outer flexible vascular sheath having a length that extends from a femoral vein to an intrahepatic portion of the inferior vena cava (IVC) of the patient;
• a hollow sheath capable of passing through the outer flexible sheath, wherein the sheath is preshaped with one or more bends and/or is capable of being shaped in vivo to provide an angle between the tip of the sheath and a longitudinal axis of the sheath between >30 degrees to 90 degrees, and wherein the hollow sheath is longer than the outer flexible vascular sheath;
• and
• a flexible biopsy needle capable of passing through the hollow sheath to penetrate the wall of the IVC and pass into the liver to obtain a tissue sample from the liver, wherein the flexible biopsy needle is longer than the hollow sheath.