An access device for placing a medical article within a body space, the access device comprising: a syringe comprising: a barrel defining a fluid chamber and a plunger slidingly disposed in the barrel , the plunger having a channel sized and shaped to receive a guide wire therethrough; an interior needle portion at least partially disposed in the channel and comprising an aperture through a side wall of the interior needle portion and into the fluid chamber ; a barrel tip supporting a needle which comprises an exterior needle portion comprising a first barrel tip section and a piercing point extending from the first barrel tip section , the first barrel tip section being in flow communication with the interior needle portion and the fluid chamber , the barrel tip comprising a second barrel tip section configured to releasably secure the first barrel tip section and the needle to the barrel, the second barrel tip section being in flow communication with the interior needle portion and the exterior needle portion ; and an intermediate channel formed between the first barrel tip section and the second barrel tip section ; characterized in that the access device further comprises a sheath coaxially disposed about the exterior needle portion and slideable along the exterior needle portion , a distal end of the sheath being positioned proximal to a distal end of the exterior needle portion ; and a dilator disposed about the exterior needle portion and within the sheath , the dilator comprising a dilator hub and a dilator body , a distal end of the dilator body positioned distal to the distal end of the sheath . a syringe comprising: a barrel defining a fluid chamber and a plunger slidingly disposed in the barrel , the plunger having a channel sized and shaped to receive a guide wire therethrough; an interior needle portion at least partially disposed in the channel and comprising an aperture through a side wall of the interior needle portion and into the fluid chamber ; a barrel defining a fluid chamber and a plunger slidingly disposed in the barrel , the plunger having a channel sized and shaped to receive a guide wire therethrough; an interior needle portion at least partially disposed in the channel and comprising an aperture through a side wall of the interior needle portion and into the fluid chamber ; a barrel tip supporting a needle which comprises an exterior needle portion comprising a first barrel tip section and a piercing point extending from the first barrel tip section , the first barrel tip section being in flow communication with the interior needle portion and the fluid chamber , the barrel tip comprising a second barrel tip section configured to releasably secure the first barrel tip section and the needle to the barrel, the second barrel tip section being in flow communication with the interior needle portion and the exterior needle portion ; and an intermediate channel formed between the first barrel tip section and the second barrel tip section ; characterized in that the access device further comprises a sheath coaxially disposed about the exterior needle portion and slideable along the exterior needle portion , a distal end of the sheath being positioned proximal to a distal end of the exterior needle portion ; and a dilator disposed about the exterior needle portion and within the sheath , the dilator comprising a dilator hub and a dilator body , a distal end of the dilator body positioned distal to the distal end of the sheath . <EOS>