Methods of transvascular retrograde access placement and devices for facilitating the placement

A method of providing transvascular retrograde access to a central blood vessel of a patient, the method comprising:

• inserting a distal end of a catheter into a blood vessel other than the central blood vessel,
• a proximal end of the catheter being connected to a handle disposed outside of the patient;
• advancing the distal end of the catheter into the central blood vessel;
• orienting the distal end of the catheter to an exit location within the central blood vessel;
• actuating a tissue piercer actuator of the handle to advance a tissue piercing element from the catheter through the central blood vessel at the exit location;
• introducing a device over the tissue piercing element through the exit location into the central blood vessel;
• and
• wherein actuating the tissue piercer actuator comprises releasing a spring within the handle, further comprising actuating a spring release element to release the spring.