Cutting device and related systems and methods

An apparatus, comprising:

• a cutting device including:
• a body defining a longitudinal axis;
• a cutting element coupled to a distal end of the body and extending distally therefrom, the cutting element including a cutting edge that is angled with respect to the longitudinal axis by an angle of less than about 45 degrees;
• a plurality of couplers configured to reversibly couple the cutting device to a dilator at a predetermined position relative to the dilator, the cutting device and the dilator when coupled being advanceable along a guidewire that has been inserted into a puncture site formed in tissue,
• the plurality of couplers, when the cutting device and the dilator are being advanced along the guidewire, being configured to maintain the cutting device at the predetermined position in which a distal end of the cutting element is positioned distal to a distal end of the dilator and angled toward the guidewire, such that the cutting element is configured to contact tissue followed by the dilator to form an incision in the tissue that is adjacent to the puncture site and the guidewire;
• and
• a guard slidably coupled to the body, the guard configured to move between an extended position in which the guard covers the cutting element and a retracted position in which the cutting edge of the cutting element is exposed and configured to form the incision in the tissue.

An apparatus, comprising:

• a cutting device including:
• a body defining a longitudinal axis;
• a plurality of couplers configured to reversibly couple the cutting device to a dilator at a predetermined position relative to the dilator, the cutting device and the dilator when coupled being advanceable along a guidewire that has been inserted into a puncture site formed in tissue;
• a cutting element coupled to a distal end of the body and extending distally therefrom, the cutting element including first and second edges that are angled with respect to the longitudinal axis, the first edge being a cutting edge that faces away from the dilator when the cutting device is coupled to the dilator, the second edge being configured to substantially follow a tapered shape of a distal end of the dilator, the first and second edges terminating at a sharp distal end,
• the plurality of couplers, when the cutting device and the dilator are being advanced along the guidewire, being configured to maintain the cutting device at the predetermined position in which the distal end of the cutting element is positioned distal to the distal end of the dilator with the cutting edge and the inner edge being angled toward the guidewire, such that the cutting element is configured to contact tissue followed by the dilator to form an incision in the tissue that that is adjacent to the puncture site and the guidewire;
• and
• a guard slidably coupled to the body, the guard configured to move between an extended position in which the guard covers the cutting element and a retracted position in which the first edge is exposed and configured to form the incision in the tissue.

A method, comprising:

• advancing a dilator and a cutting device coupled thereto, over a guidewire positioned through a puncture site formed in tissue, toward the puncture site, the cutting device including a cutting element configured to cut the tissue;
• moving a guard of the cutting device from an extended position in which the guard is covering the cutting element to a retracted position in which a portion of the cutting element including a cutting edge is exposed, the cutting edge being at an angle relative to a longitudinal axis of the cutting device and extending distally beyond a distal end of the dilator;
• and
• inserting, after moving the guard to the retracted position and by further advancing the cutting device and the dilator toward the tissue, a distal end of the cutting edge followed by the distal end of the dilator into the tissue to form an incision adjacent to the puncture site and the guidewire and sized to receive a surgical instrument.