Methods and devices for transcarotid access

A device system for introducing an interventional device into a carotid artery, the system comprising: an arterial access sheath (220) adapted to introduce a catheter into an artery, the arterial access sheath (220) includes a sheath body (222) sized and shaped to be introduced into a common carotid artery through a site carotid artery access, sheath body (222) defining an internal lumen providing a passageway for introducing a catheter into the common carotid artery when sheath body (222) is positioned in the common carotid artery; a first elongated dilator (260A) positionable within the internal lumen of the sheath body, the first dilator (260A) having a tapered distal tip sized and shaped to dilate the needle puncture site to a larger diameter for inserting the arterial access sheath (220) into the artery, the first dilator (260A) having an internal lumen to allow the dilator to be inserted over a sheath guide wire (300) into an artery, wherein at least a portion of the first dilator (260A) has a first flexural stiffness, wherein the arterial access sheath (220) and first dilator (260A) are collectively insertable into the common carotid artery; characterized in that the system further comprises a sheath stop (1105) slidably mounted on the exterior of the distal portion of the sheath body (222) to create a positive stop for contacting an arterial wall, wherein a distal end of the sheath stop forms a rim (1115) angled to contact the arterial wall.