Systems, kits, and methods for establishing percutaneous access are described.A system typically includes a deformable variable diameter cannula sleeve (DVDCS)and a guidewire. The DVDCS will generally have two states, an initial, un-activatedcondition and a second, activated condition, brought about and controlled underthe discretion of the operator. The methods comprise creating an initial accesspoint and tissue tract with a needle, positioning a guidewire through the initialtissue tract, passing the deformable variable diameter cannula sleeve overthe guidewire through the tissue tract to a target blood vessel or cavity, andactivating the DVDCS to effect radial deformation of the surrounding tissue.Use of the DVDCS reduces the risk of injuring tissue surrounding the tissue tractby lessening the axial forces imparted to the tissue. Kits comprise at least onedeformable variable diameter cannula sleeve together with instructions foruse.
