КАТЕТЕРНОЕ УСТРОЙСТВО

FIELD: medicine. SUBSTANCE: invention refers to medical equipment, namely to a device for recanalisation of total occlusion of blood vessels and/or re-entry from one lumen into another lumen, including without limitation re-entry into the true lumen of the blood vessel from the extra-luminal or subintimal space of the vessel. Catheter device for passing through an occlusion in blood vessels or re-entering a true lumen of a blood vessel comprises a catheter shaft, a handle and a needle. Catheter rod comprises a distal end of the catheter. Handle is connected to a proximal portion of the catheter shaft. Needle passes through the lumen in the catheter shaft and the distal end of the catheter. Needle comprises a first straight portion connected to a handle, a curved portion extending in the distal direction from the first straight portion, a second straight portion extending in the distal direction from the curved portion, and a sharp end at the most distal end of the needle. EFFECT: invention has many applications, such as, without limitation, recanalisation of solid occlusion, recanalisation of solid curved or spiral occlusion, recanalisation of total occlusion, recanalisation of intra-stent restenosis, stent graft puncturing in order to provide blood flow in lateral vessels, re-entry into the true lumen during PTA (percutaneous transluminal angioplasty), PTCA (percutaneous transluminal coronary angioplasty) and any other percutaneous or other placement of the catheter between two adjacent layers of vessels, arteries, soft tissue or any other human tissue. 12 cl, 15 dwg РОССИЙСКАЯ ФЕДЕРАЦИЯ (19) RU (11) (13) 2 766 520 C1 (51) МПК A61M 25/00 (2006.01) A61M 25/01 (2006.01) A61M 25/06 (2006.01) ФЕДЕРАЛЬНАЯ СЛУЖБА ПО ИНТЕЛЛЕКТУАЛЬНОЙ СОБСТВЕННОСТИ (12) ОПИСАНИЕ ИЗОБРЕТЕНИЯ К ПАТЕНТУ (52) СПК A61M 25/0069 (2021.08); A61M 25/0074 (2021.08); A61M 25/0082 (2021.08); A61M 25/0606 (2021.08); A61M 2025/009 (2021.08); A61M 2025/0095 (2021.08); A61M 2025/0197 (2021.08) (21)(22) ...

Devices and methods for advancing a wire

Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

VASCULAR ACCESS DEVICES AND METHODS

Vascular access devices and methods of their use are provided. In one embodiment, a vascular access device includes a catheter (112) and at least one deployable wire (134). The catheter includes a primary lumen extending from a proximal end to a distal end of the catheter. The at least one deployable wire is secured to the catheter and configured to move relative to the catheter between a delivery configuration and a deployed configuration.

SHAPEABLE RE-ENTRY DEVICES AND ASSOCIATED SYSTEMS AND METHODS

Methods for treating a patient using intravascular devices, systems, and methods are disclosed herein. One aspect of the present technology is directed to an intravascular device having an elongated member coupled to and extending between a handle and an angled distal portion. The distal portion is moveable between a first configuration having a first shape configured for intravascular delivery and a second configuration having a second shape, different than the first shape, that is configured for intravascular delivery.

SYSTEM FOR RE-ENTERING A VESSEL LUMEN

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters (10) employ deflectable struts (20) to stabilize and support the distal tip (16) in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire.

WIRE-GUIDED RECANALIZATION SYSTEM

A recanalization catheter assembly for recanalization of an occluded blood vessel is disclosed. The recanalization catheter assembly includes an elongate shaft having a tubular portion, a guide member, and a rotary ablation tool. The tubular portion includes a distal opening, from where the rotary ablation tool extends distally. The guide member extends distal of the distal opening and includes a guidewire lumen to receive a guidewire therethrough. The guide member is configured to advance over the guidewire in a subintimal space between a first tissue layer and a second tissue layer of a wall of the blood vessel, while the rotary ablation tool is advanced in a true lumen of the blood vessel.

Occlusion bypassing apparatuses and methods for bypassing an occlusion in a blood vessel

Occlusion bypassing apparatuses are disclosed for re-entering the true lumen of a vessel after subintimally bypassing an occlusion in a vessel. The occlusion bypassing apparatuses include a shaft component and a needle component slidably disposed within the shaft component and having an angled configuration when deployed. In embodiments hereof, the needle component has an angled distal tip segment that may be utilized to selectively bend a flexible distal portion of the shaft component in order to extend the flexible distal portion towards the true lumen of the vessel. The needle component is distally advanced relative to the shaft component to pierce through the intima of the vessel and thereafter enter the true lumen.

METHODS FOR ROUTING A GUIDEWIRE FROM A FIRST VESSEL AND THROUGH A SECOND VESSEL IN LOWER EXTREMITY VASCULATURE

A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

Vorrichtung zum Tunnelieren

Die Erfindung betrifft eine Vorrichtung (10) umfassend mindestens ein Werkzeug (20) und mindestens ein Griffstück (50), wobei das Werkzeug (20) mindestens eine erste, werkzeugseitige Fügestelle (21) und das Griffstück (50) mindestens eine erste, griffseitige Fügestelle (51) aufweist, wobei die erste, werkzeugseitige Fügestelle (21) und die erste, griffseitige Fügestelle (51) miteinander mindestens eine Fügestelle (60) ausbilden. Überraschenderweise bewirkt ein Lösen der Aufgabe eine Erfindung für eine verkürzte und hygienische verbesserte medizinische, insbesondere chirurgischen Behandlung.Die Aufgabe wird von einer erfindungsgemäßen Vorrichtung dadurch gelöst, dass die Fügestelle (60) lösbar ist.

DEVICE FOR CROSSING VASKULAREN OKKLUSIONEN

Catheter systems and methods for re-entry in body vessels with chronic total occlusion

A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter includes components that are symmetric about the longitudinal axis and allow for reentry without the need to ensure a correct orientation of the cannula.

Subintimal re-entry catheter with an expandable structure

A subintimal recanalization catheter assembly for recanalizing a blood vessel having an occlusion in a lumen thereof. The catheter assembly includes a hub assembly, a catheter shaft including inner and outer tubular members extending distally from the hub assembly, and an expandable structure mounted on a distal portion of the catheter shaft which is configured to be actuated between a collapsed configuration and an expanded configuration by longitudinal movement of the inner tubular member relative to the outer tubular member. The catheter assembly is configured to be advanced into a subintimal space between adjacent tissue layers of a wall of the blood vessel to facilitate reentry into the blood vessel lumen by advancing a penetration member distally out of the lumen of the inner tubular member and through the tissue layer into the blood vessel lumen distal of the occlusion.

DEVICES AND METHODS FOR ADVANCING A WIRE

Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

The shape of the intima of the balloon with the controllable re-entering the conduit under the

SUBINTIMAL RECANALIZATION WITH BIO-ABSORBABLE STENT

A recanalization catheter assembly for establishing a subintimal pathway around an occlusion in a blood vessel. The recanalization catheter assembly an inflatable balloon structure (20) including a distal anchoring portion (60) configured to expand within a true lumen portion of the blood vessel distal of the occlusion to anchor the recanalization catheter from unintentional movement during expansion of a stent in the subintimal pathway. The expandable stent (40), such as a bioabsorbable stent, may be configured to promote native tissue regrowth around the stent to create a superficial intimal layer along the subintimal pathway.

Endovascular devices and methods

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing an intravascular device having a distal portion with a side port, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall, directing the distal portion within the vascular wall such that the distal portion moves at least partially laterally, and directing the side port towards the vascular lumen.

Reentry catheter and method thereof

The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery.

Re-entry device for peripheral arterial recanalization procedures

A re-entry device (1) for recanalization procedures of an arterial vessel by an intraluminal or subintimal technique includes a catheter (10) having a distal end (12) with a curved tip (13) by an angle (α) of between 30° and 90°, and an angled-tip stylet (2) insertable into the inner lumen of the catheter (10) to exit from a distal opening (14) thereof. The angled-tip stylet (2) is metal and has a distal end (22) with a curved tip (23) ending in a sharped apex (24). The distal end (22) of the an angled-tip stylet (2) is tapered and has a length of 3-5 cm, and the curved tip (23) is bent by an angle (β) of between 30° and 50°. The structure makes the apex (24) adjustable outside the two-dimensional plane defined by the curved tip (13) of the catheter (10) to facilitate penetration of the arterial wall.

Re-Entry Catheters and Related Methods

Catheter devices and methods useable for directing a guidewire from a subintimal position within the wall of an artery into the true lumen of that artery or other applications wherein it is desired to direct a guidewire or other elongate device from one location to another location within a subject's body.

Reentry catheter and method thereof

The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery.

System for re-entering a vessel lumen

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize 5 and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire. 11027683_1 (GHMatters) P104369.AU.2 18".. 24 _20 12 10 24 ' 20 FIG. 520 24 ...

System for re-entering a vessel lumen

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize and support the distal tip in a subintimal location while a passageway back into the 5 true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire. 18151007_1 (GHMatters) P104369.AU.4 ...

APPARATUS AND METHOD FOR DISSECTING AND RETRACTING ELONGATE STRUCTURES

A dissector/retractor device (10) comprising a balloon (12) having a deflated state, and an inflated state, is described for performing minimally invasive surgical procedures by creating a tunnel alongside a target tissue in the body. The balloon (12) in its inflated state forms an open space (16) extending transversely through the balloon (12). The balloon (12) is carried by an insertion assembly (14). The balloon (12) may be an elongate torus shape with an elongate open area in its interior. The insertion assembly includes a blunt dissection device, and a handle (22). In use, the dissector/retractor is inserted through a small incision, and bluntly tunneled (10) through body tissue to a desired location. The balloon (12) is inflated to create a space in the body tissue, and may also dissect tissue as necessary away from the tissue to be treated. The balloon (12) is left in place inflated to retract the space. Another incision may be made to provide more direct access to the target tissue ...

METHODS AND DEVICES FOR PERCUTANEOUS IMPLANTATION OF ARTERIO-VENOUS GRAFTS

Methods, devices, and kits for implanting a vascular graft to perform hemodialysis treatments on patients with renal failure are disclosed. The kits can include access devices comprised of an access catheter having a guidewire lumen and stylet lumen, a guide tube having a curved distal end, a stylet, an actuator handle and a vascular graft The methods describe techniques for using the described kits and devices for performing vascular procedures, such as percutaneous implantation of the vascular graft.

CATHETER DEPLYMENT DEVICE

An apparatus for deploying a needle within a lumen is provided. The apparatus includes a housing having a threaded bushing radially disposed therein. The bushing rigidly couples with a nose cone having a guide tip disposed at an end opposite the bushing for penetrating an arterial wall of a lumen. During operation, a user incrementally advances the bushing within the housing, thereby incrementally advancing the guide tip into the lumen. The nose cone also includes a flex guide having a slot configuration which couples with the guide tip which deploys into the lumen along with the guide tip.

Tunneler device and method of use

A tunneler device is provided. The tunneler device includes a handle formed on a proximal end thereof configured for operable engagement by a user, a shaft extending distally from the handle, a collet supported on the distal end of the shaft, the collet including a plurality of distally extending fingers defining a longitudinal opening, the opening being configured to receive an end of a catheter tube and a connector configured for operable engagement with the collet, wherein the connector is configured to bias the fingers of the collet radially inward upon engagement of the connector with the collet.

OCCLUSION BYPASSING APPARATUS WITH A RE-ENTRY NEEDLE AND A STABILIZATION TUBE

СИСТЕМЫ И СПОСОБЫ ДЛЯ ЧРЕЗКОЖНОГО ПРОХОЖДЕНИЯ ОККЛЮЗИИ

1. Медицинское устройство, содержащее:катетер с проксимальным и дистальным концами;полое долото, имеющее проход внутри долота, имеющий проксимальный и дистальный конец, с наконечником в дистальном конце, причем проксимальный конец долота является проксимальным дистальному концу катетера; иудлиненный элемент, аксиально подвижный по продольной оси катетера и долота, в котором наконечник является подвижным под действием селективного осевого перемещения удлиненного элемента, между первым положением, в котором наконечник расположен проксимальным к оси, и вторым положением, в котором наконечник разнесен от первого положения.2. Медицинское устройство по п.1, в котором наконечник имеет, по меньшей мере, два участка, по меньшей мере, один из которых является подвижным под действием селективного осевого перемещения удлиненного элемента.3. Медицинское устройство по п.2, в котором при удаленном из прохода долота удлиненном элементе образуется острый наконечник.4. Медицинское устройство по п.1, в котором для приведения в движение долота между острым наконечником и тупым наконечником удлиненный элемент может быть вдвинут и выдвинут из дистального конца долота.5. Медицинское устройство по п.1, в котором при проталкивании и выталкивании удлиненного элемента из дистального конца долота наконечник открывается, в общем, с возможностью приспосабливания к наружному диаметру проводника.6. Медицинское устройство по п.1, в котором при выталкивании удлиненного элемента из дистального конца долота катетер и долото, вместе, включают в себя поддерживающий катетер.7. Медицинское устройство по п.1, в котором долото содержит запоминающ�

Katheter-Kanülen-System für den Wiedereintritt vom subintimalen Raum in das wahre Gefäßlumen

Systems and methods for percutaneous occlusion crossing

The present invention provides methods and apparatuses for crossing or bypassing total or near total occlusions of vessels through the use of elongate members and specialized catheters that include a piercing catheter, a reentry catheter, a multilumen, reentry catheter, and combinations thereof. A piercing catheter comprises a distal tip used to pierce an occlusion in a crossing procedure and can be configured to microdissect the occlusion or provide support for an elongate member. A reentry catheter comprises a distal side port and ramp to facilitate the reentry or perforation of a vessel wall. A multi-lumen, reentry catheter comprises a tearable lumen divider and a distal side port and ramp.

System for treating blood vessels

The present disclosure is directed to a system for treating a blood vessel. The system may include a shaft assembly (202) including an orienting element (204). The system may also include a re-entry device (100) extending into the shaft lumen. The re-entry device may comprise a core wire (104) configured such that bending stresses created in the core wire during bending about a design bend radius are less than the elastic limit of the core wire so that the core wire will elastically recover from the bending upon release.

SOFT TISSUE TUNNELING DEVICE

A tissue tunneling device (20) is configured to be delivered within the body. The tunneling device (20) includes a shaft (24) with a blunt distal end (60) to prevent coring or other damage to tissue during the delivery of the tunneling device (20). The shaft (24), in some arrangements, includes one or more lumen (26), through which medication or another fluid may be administered. An anesthetic or other pain relieving medication may be delivered through the lumen (26) to lessen the discomfort of delivering the tunneling device (20) to the desired anatomical site. The shaft (24) may also include a retractable needle (70) for facilitating the advancement of the tunneling device (20) through skin or other tissue. The shaft (24) may also be provided with an outer sheath (40), which may be left within the anatomy after the tunneling device (20) has been removed. The shaft (24) may be malleable for custom-shaping the tunneling device (20) prior to and/or during delivery.

SYSTEMS AND METHODS FOR PERCUTANEOUS INTRAVASCULAR ACCESS AND GUIDEWIRE PLACEMENT

A device for creating intravascular access and guidewire placement includes a main body having a lumen and a piercing member disposed in the lumen. The piercing member moves distally out of the lumen and pierces tissue while moving. A needle guide is provided for guiding the piercing member, the needle guide having a distal end which comprises a first alignment member. A guidewire has a distal tip with a second alignment member disposed on the guidewire distal tip. The first alignment member may comprise a magnetic attachment, at least one magnetic implant, a proximity sensor, an ultrasonic sensor, or other suitable system for alignment of devices disposed on opposing sides of opaque tissue. Similarly, the second alignment member may comprise a magnetic attachment or implant, a proximity sensor, or an ultrasonic sensor.

METHODS AND DEVICES FOR VASCULAR ACCESS

Methods and devices for treating occlusive peripheral vascular diseases are described. The devices can include an access catheter having a guidewire lumen and stylet lumen, a guide tube having a curved distal end, a stylet, and an actuator handle. The methods describe techniques for using the described devices for performing vascular procedures, such as subintimal angioplasty.

SUBINTIMAL RE-ENTRY CATHETER AND RETROGRADE RECANALIZATION

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.

Catheter system

The present invention discloses a catheter system, comprising: a catheter head having a lumen, a proximal end and a distal end, and an opening positioned at a bottom of the distal end; and a rotatable inner tube having a lumen positioned in the lumen and at a proximal end of the catheter head, the inner tube including a front end having an arcuate opening; wherein the rotatable inner tube can be rotated so that the arcuate opening thereon can be made to engage or disengage with the opening at the bottom of the distal end of the catheter head. The invention also provides a catheter system and method for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way. The catheter system for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way effectively solve the problems of difficult operation, inaccurate positioning, long operation time and easiness to cause acute occlusion and internal hemorrhage of the branch vessel when ...

SUBINTIMAL CATHETER DEVICE AND ASSEMBLY

System for re-entering a vessel lumen

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize 5 and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire. 11027683_1 (GHMatters) P104369.AU.2 18".. 24 _20 12 10 24 ' 20 FIG. 520 24 ...

Systems and methods for percutaneous intravascular access and guidewire placement

A device for creating intravascular access and guidewire placement includes a main body having a lumen and a piercing member disposed in the lumen. The piercing member moves distally out of the lumen and pierces tissue while moving. A needle guide is provided for guiding the piercing member, the needle guide having a distal end which comprises a first alignment member. A guidewire has a distal tip with a second alignment member disposed on the guidewire distal tip. The first alignment member may comprise a magnetic attachment, at least one magnetic implant, a proximity sensor, an ultrasonic sensor, or other suitable system for alignment of devices disposed on opposing sides of opaque tissue. Similarly, the second alignment member may comprise a magnetic attachment or implant, a proximity sensor, or an ultrasonic sensor.

METHODS AND APPARATUS FOR CROSSING VASCULAR OCCLUSIONS

Methods and apparatus for crossing totally to substantially occluded blood vessels by passing a redirectable wire such as a guidewire from a relatively proximal point past the occlusion within a subintimal space formed between the intimal layer and the adventitial layer of a blood vessel wall. The wire may be advanced to a point distal to the occlusion, and thereafter deflected back into the blood vesel lumen, typically using a deflecting catheter which is advanced over the guidewire after it has been positioned within the subintimal space. The deflecting catheter may include a flapper valve assembly or preformed actuator wire for redirecting the guidewire. After the guidewire is returned to the blood vessel lumen, the deflecting catheter may be withdrawn, and the guidewire may be available for introduction of other inverventional and diagnostic catheters for performing procedures such as stenting.

SUBINTIMAL RE-ENTRY CATHETER AND RETROGRADE RECANALIZATION

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.

Catheter system and endovascular catheter

TISSUE CROSSING SYSTEM AND ANCHORS FOR USE THEREWITH

The present disclosure provides for novel ways of delivering tensioning elements, such as tethers, and deployable anchors, to a desired location within the anatomy of a patient. More specifically, the present disclosure provides a system and method for delivering deployable anchors to a desire location within the anatomy and tethering the anchors together through tissue. The deployable anchors may include anchors that have a pre-deployment elongate configuration and a post-deployment planar configuration.

INVERTED BALLOON NECK ON CATHETER

A method for thermal bonding of an inverted balloon neck on a catheter, including placing an inverted balloon neck ( 84 ) on a shaft ( 86 ) of a catheter, and characterized by applying heat at an internal hollow ( 85 ) of the shaft ( 86 ) where the inverted balloon neck ( 84 ) is placed, while applying internal pressure to attach an external surface of the shaft ( 86 ) to the inverted balloon neck ( 84 ).

Catheter with deflectable tip

A catheter having a distal balloon and a deformable guidewire shaft of the catheter. The deformable guidewire shaft is adjacent to and external to the balloon. Inflation of the balloon bends the deformable guidewire shaft in order to orient or deflect a distal tip of the deformable guidewire shaft in a desired direction to guide and direct a guidewire extending through the deformable guidewire shaft towards a specific endovascular region. For example, it may be desired to orient the distal tip of the guidewire shaft towards a target vessel of a bifurcation or the balloon catheter may be used to bypass a Chronic Total Occlusion (CTO).

SUBINTIMAL RE-ENTRY BALLOON CATHETER AND METHOD OF FORMING THEREOF

Tunneling catheter system for artificial ventricular wall conduit

Shapeable re-entry devices and associated systems and methods

Methods for treating a patient using intravascular devices, systems, and methods are disclosed herein. One aspect of the present technology is directed to an intravascular device having an elongated member coupled to and extending between a handle and an angled distal portion. The distal portion is moveable between a first configuration having a first shape configured for intravascular delivery and a second configuration having a second shape, different than the first shape, that is configured for intravascular delivery.

Subintimal re-entry catheter and retrograde recanalization

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.

Systems and methods for percutaneous occlusion crossing

The present invention provides methods and apparatuses for crossing or bypassing total or near total occlusions of vessels through the use of elongate members and specialized catheters that include a piercing catheter, a reentry catheter, a multilumen, reentry catheter, and combinations thereof. A piercing catheter comprises a distal tip used to pierce an occlusion in a crossing procedure and can be configured to microdissect the occlusion or provide support for an elongate member. A reentry catheter comprises a distal side port and ramp to facilitate the reentry or perforation of a vessel wall. A multi-lumen, reentry catheter comprises a tearable lumen divider and a distal side port and ramp.

CATHETER SYSTEMS AND METHODS FOR RE-ENTRY IN BODY VESSELS WITH CHRONIC TOTAL OCCLUSION

A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter includes components that are symmetric about the longitudinal axis and allow for reentry without the need to ensure a correct orientation of the cannula.

SOFT TISSUE TUNNELING DEVICE

A tissue tunneling device (20) is configured to be delivered within the body. The tunneling device (20) includes a shaft (24) with a blunt distal end (60) to prevent coring or other damage to tissue during the delivery of the tunneling device (20). The shaft (24), in some arrangements, includes one or more lumen (26), through which medication or another fluid may be administered. An anesthetic or other pain relieving medication may be delivered through the lumen (26) to lessen the discomfort of delivering the tunneling device (20) to the desired anatomical site. The shaft (24) may also include a retractable needle (70) for facilitating the advancement of the tunneling device (20) through skin or other tissue. The shaft (24) may also be provided with an outer sheath (40), which may be left within the anatomy after the tunneling device (20) has been removed. The shaft (24) may be malleable for custom-shaping the tunneling device (20) prior to and/or during delivery.

SYSTEMS AND METHODS FOR PERCUTANEOUS OCCLUSION CROSSING

The present invention provides methods and apparatuses for crossing or bypassing total or near total occlusions of vessels through the use of elongate members and specialized catheters that include a piercing catheter, a reentry catheter, a multilumen, reentry catheter, and combinations thereof. A piercing catheter comprises a distal tip used to pierce an occlusion in a crossing procedure and can be configured to microdissect the occlusion or provide support for an elongate member. A reentry catheter comprises a distal side port and ramp to facilitate the reentry or perforation of a vessel wall. A multi-lumen, reentry catheter comprises a tearable lumen divider and a distal side port and ramp.

METHODS AND DEVICES FOR CROSSING CHRONIC TOTAL OCCLUSIONS

The present disclosure is directed to a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing an intravascular device having a distal portion and a longitudinal axis and inserting the intravascular device into the vascular lumen. The method may further include positioning the distal portion in the vascular wall, rotating the intravascular device about the longitudinal axis, and advancing the intravascular device within the vascular wall.

Biopsy device

Aspects of the present invention are generally directed to a biopsy device configured to engage target tissue within a patient and to remove a sample of the target tissue from the patient. The biopsy device comprises an elongate catheter configured to be inserted into a patient. A coring component is disposed at the distal end of the catheter to sample the target tissue.

Drainage devices and methods for use

Devices and methods for draining excess lymph fluid are disclosed. The device can be fixed to the blood vessel adjacent to the thoracic duct. The device can have a port for withdrawing lymph fluid exiting the thoracic duct. The device can have a cannula and/or subcutaneous port to draw the lymph fluid away from the thoracic duct and reduce hemostatic pressure in the lymphatic system.

VORRICHTUNG ZUM DURCHQUEREN VON VASKULAREN OKKLUSIONEN

CATHETER DEVICE FOR LUMEN RE-ENTRY AND METHODS FOR USE THEREOF

A catheter device for lumen re-entry is provided. The catheter device includes a catheter shaft having a lumen extending from a proximal end to a distal end and an expandable member positioned at the distal end of the catheter shaft. The catheter shaft having interior walls defining a central lumen extending from a proximal end to a distal end along a longitudinal axis of the lumen. The expandable member configured to receive a fluid that selectively expands the expandable member from a first volume to a second volume, the second volume being larger than the first volume to provide a deflection surface that is oriented at an angle with respect to the longitudinal axis of the lumen. The deflection member provides a surface to angle a guidewire out of the distal opening at the tip of the catheter shaft (i.e., not a separate side-facing hole].

APPARATUS AND METHOD FOR DISSECTING AND RETRACTING ELONGATE STRUCTURES

A dissector/retractor device (10) comprising a balloon (12) having a deflated state, and an inflated state, is described for performing minimally invasive surgical procedures by creating a tunnel alongside a target tissue in the body. The balloon (12) in its inflated state forms an open space (16) extending transversely through the balloon (12). The balloon (12) is carried by an insertion assembly (14). The balloon (12) may be an elongate torus shape with an elongate open area in its interior. The insertion assembly includes a blunt dissection device, and a handle (22). In use, the dissector/retractor is inserted through a small incision, and bluntly tunneled (10) through body tissue to a desired location. The balloon (12) is inflated to create a space in the body tissue, and may also dissect tissue as necessary away from the tissue to be treated. The balloon (12) is left in place inflated to retract the space. Another incision may be made to provide more direct access to the target tissue ...

SUBINTIMAL RE-ENTRY CATHETER WITH AN EXPANDABLE STRUCTURE

A subintimal recanalization catheter assembly for recanalizing a blood vessel having an occlusion in a lumen thereof. The catheter assembly includes a hub assembly, a catheter shaft including inner and outer tubular members extending distally from the hub assembly, and an expandable structure mounted on a distal portion of the catheter shaft which is configured to be actuated between a collapsed configuration and an expanded configuration by longitudinal movement of the inner tubular member relative to the outer tubular member. The catheter assembly is configured to be advanced into a subintimal space between adjacent tissue layers of a wall of the blood vessel to facilitate reentry into the blood vessel lumen by advancing a penetration member distally out of the lumen of the inner tubular member and through the tissue layer into the blood vessel lumen distal of the occlusion.

Subintimal reentry system

A subintimal recanalization catheter system for recanalizing a blood vessel. The system includes a support catheter and a balloon catheter configured to extend through the support catheter. The support catheter includes a tubular portion and an extension segment extending distal of the distal opening of the tubular portion. The balloon catheter, having a balloon secured to a distal portion thereof, is positionable through the tubular portion of the support catheter to position the balloon alongside the extension segment. The system is configured to be advanced into a subintimal space between a first tissue layer and a second tissue layer of a blood vessel wall where the balloon may be inflated against the extension segment to cause a distal portion of the catheter shaft of the balloon catheter to deflect toward the vessel lumen within the subintimal space to facilitate reentry into the vessel lumen.

DEVICES AND METHODS FOR PERCUTANEOUS ENDARTERECTOMY

Devices and methods are provided for percutaneously treating atherosclerotic plaques within blood vessels. Atherosclerotic plaques cause significant morbidity and mortality by narrowing the arteries, which adversely affects blood flow, and by acting as a source for thrombi and emboli thus causing acute organ ischemia. Current treatments include open surgery with its inherent drawbacks, and stenting, which is less invasive but leaves the plaque material in the artery, which promotes restenosis. The present invention combines the advantages of both approaches. In general, the invention provides tools that enable percutaneously dissecting the plaque from the arterial wall and removing it from the body.

System and method for re-entering a vessel lumen

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire.

SYSTEM FOR RE-ENTERING A VESSEL LUMEN

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize 5 and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire. 8947421_1 (GHMatters) P104369.AU.1 18"., 24 20 F 1.~2 2 1 2 6 3 FIG. 520 24 ...

Soft tissue tunneling device

SYSTEMS AND METHODS FOR PERCUTANEOUS OCCLUSION CROSSING

TUNNELER DEVICE AND METHOD OF USE

A tunneler device is provided. The tunneler device includes a handle formed on a proximal end thereof configured for operable engagement by a user, a shaft extending distally from the handle, a collet supported on the distal end of the shaft, the collet including a plurality of distally extending fingers defining a longitudinal opening, the opening being configured to receive an end of a catheter tube and a connector configured for operable engagement with the collet, wherein the connector is configured to bias the fingers of the collet radially inward upon engagement of the connector with the collet.

A SYSTEM AND METHOD FOR SUBMUCOSAL TUNNELING OF THE GI TRACT FOR THE DIVERSION OF BODILY FLUIDS

A system for submucosal tunneling an intestinal wall (10) comprises a tunneling head (28) adapted to be inserted between a first layer (15) and an adjacent second layer (29) of the intestinal wall (10), a layer separation assembly (30) with a first layer guide (31) and a second layer guide (32) arranged to diverge the first layer (15) from the second layer (29) when the tunneling head (28) is moved in a forward direction, and an activating mechanism (33) operable to move the tunneling head (28) in the forward direction, thereby separating the first (15) and second layer (29) from each other.

CROSSING OCCLUSIONS IN BLOOD VESSELS

The present disclosure is directed a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing a first intravascular device (106) having a distal portion and at least one aperture (126) and positioning the distal portion of the first intravascular device in the vascular wall. The method may further include providing a reentry device (100) having a body (138) and a distal tip (132), the distal tip having a natural state and a compressed state and inserting the distal tip, in the compressed state, in the distal portion of the first intravascular device. The method may further include advancing the distal tip, in the natural state, through the at least one aperture of the first intravascular device.

Delivery methods for left ventricular conduit

Described herein are various methods and apparatuses for delivering stents or conduits and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the ...

CATHETER AND RECANALIZATION CATHETER SYSTEM

A catheter includes a shaft having a first lumen inside thereof, an expansion/contraction portion that is disposed on a distal end portion of the shaft and is expandable and contractible in a radial direction, and an actuation portion that expands and contracts the expansion/contraction portion. The expansion/contraction portion has a fixed portion fixed to the shaft, a sliding portion capable of sliding in a longitudinal direction of the shaft on an outer peripheral face of the shaft, and a suspension portion extending in the longitudinal direction of the shaft that connects the fixed portion with the sliding portion. When the sliding portion is slid toward the fixed portion by the actuation portion, the suspension portion expands in a radial direction of the shaft.

LANCET MICRO-CATHETER

A micro-catheter (10) including a hypo-tube including a proximal section (13) and a distal section (12) and a sharp tip (11) formed at a distal end of the distal section (12), characterized in that the proximal section (13) of the micro-catheter (10) is formed with a plurality of cuts (23) which are not perpendicular to a longitudinal axis of the proximal section (13), the cuts (23) being made partially around a circumference of the proximal section (13) with uncut portions separating the cuts (23) from one another.

Guidewires and methods for percutaneous occlusion crossing

Guidewires and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A guidewire can include a core member and a jacket member. The core member can extend from a proximal end portion to a distal end portion, with the distal end portion including a first segment, a more distal second segment and a more proximal third segment. The first segment can be configured to encourage prolapse by way of a short taper or a diameter-reduced portion. The jacket member can surround at least the distal end portion of the core member. A method can include advancing a distal end portion of the guidewire through the natural lumen of a blood vessel to a location near an occlusion. A longitudinal pushing force can be applied to a proximal end portion of the guidewire, thereby causing a first segment of the distal end portion to prolapse.

Fibroid treatment apparatus and method

Apparatus is provided, including a tube (22) that is configured to pass into a patient's vagina (26) and to penetrate vaginal tissue (24) until a distal tip (36) of the tube is outside of a uterine artery (28) of the patient, but in a vicinity of a portion (38) of the uterine artery that supplies a uterine fibroid (30). A balloon (40), disposed at the distal tip, is inflated to cause local squeezing of the portion of the uterine artery to an extent sufficient to occlude the uterine artery. Other embodiments are also described.

Devices and methods for advancing a wire

Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

Catheter device for lumen re-entry and methods for use thereof

A catheter device for lumen re-entry is provided. The catheter device includes a catheter shaft having a lumen extending from a proximal end to a distal end and an expandable member positioned at the distal end of the catheter shaft. The catheter shaft having interior walls defining a central lumen extending from a proximal end to a distal end along a longitudinal axis of the lumen. The expandable member configured to receive a fluid that selectively expands the expandable member from a first volume to a second volume, the second volume being larger than the first volume to provide a deflection surface that is oriented at an angle with respect to the longitudinal axis of the lumen. The deflection member provides a surface to angle a guidewire out of the distal opening at the tip of the catheter shaft (i.e., not a separate side-facing hole].

Catheter systems and methods for re-entry in body vessels with chronic total occlusion

A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter includes components that are symmetric about the longitudinal axis and allow for reentry without the need to ensure a correct orientation of the cannula. 12074827_1 (GHMatters)P105577.AU.1 C*4 0 C%% cv, CV) ,-m Nfff (54 0c Kd ...

System for re-entering a vessel lumen

... - 22 This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize 5 and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire. 12075243_1 (GHMatte) P104369.AU 18".. 24 _20 12 10 24 ' 20 FIG. 520 24 ...

Devices and methods for advancing a wire

Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia.

SYSTEMS AND METHODS FOR PERCUTANEOUS OCCLUSION CROSSING

The present invention provides methods and apparatuses for crossing or bypassing total or near total occlusions of vessels through the use of elongate members and specialized catheters that include a piercing catheter, a reentry catheter, a multilumen, reentry catheter, and combinations thereof. A piercing catheter comprises a distal tip used to pierce an occlusion in a crossing procedure and can be configured to microdissect the occlusion or provide support for an elongate member. A reentry catheter comprises a distal side port and ramp to facilitate the reentry or perforation of a vessel wall. A multi-lumen, reentry catheter comprises a tearable lumen divider and a distal side port and ramp.

SYSTEM FOR RE-ENTERING A VESSEL LUMEN

This disclosure is directed to systems for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire.

BALLOON CATHETER SYSTEM

A balloon catheter system is provided. The catheter includes a first balloon disposed around a second balloon which is movable within the first balloon.

The use of bio-absorbable support endomembrane-under heavy

REENTRY CATHETER AND METHOD THEREOF

The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery.

TUNNELING CATHETER SYSTEM FOR ARTIFICIAL VENTRICULAR WALL CONDUIT

L'invention concerne divers procédés et appareils pour l'introduction de stents ou de conduits dans le myocarde. Un système préféré d'introduction de stent permettant d'avoir accès au site d'insertion dans le myocarde consiste à pousser un cathéter d'introduction à travers ou autour d'un blocage dans un vaisseau coronaire ou à travers un tunnel formé autour du blocage. Suivant une forme d'exécution, un pliage est obtenu dans le cathéter en actionnant des moyens de guidage expansibles qui coopèrent avec les parois du vaisseau sanguin, de manière à provoquer la rotation du cathéter. Un guide souple est ensuite poussé à travers le cathéter d'introduction dans le myocarde. Suivant une autre forme d'exécution, un fil de traction à déviation de l'extrémité s'étend de l'extrémité distale du cathéter, lequel peut être actionné pour tourner vers l'avant et être inséré dans le myocarde. Suivant une variante d'exécution, un orifice de sortie faisant face au site d'insertion est prévu dans le cathéter ...

Vascular Re-entry Catheter

A catheter has a guide-tip including at least one wing for crossing a CTO lesion in an artery via exploring the subintimal space. The catheter can includes one or more exit port(s) and radiopaque marker(s) for steering a re-entry wire through one of the exit ports. The catheter may include a number of spiral-cut sections with varying characteristics to provide different strength and flexibility along the axial direction. 1. A catheter device comprising ,a distal tube portion having a distal tip and a longitudinal axis, the distal tube portion including a tube wall comprising at least one side port and at least one radiopaque marker, and at least one wing protruding radially outward from the tube wall.2. The catheter device of claim 1 , wherein the at least one wing comprises two wings protruding radially outward in diametrically opposing directions.3. The catheter device of claim 2 , wherein the at least one side port is radially offset from each of the two wings for about 90 degrees.4. The catheter device of claim 2 , wherein the at least one side port comprises a first side port and a second side port claim 2 , wherein the second side port is located distal the first side port and being longitudinally and radially offset from the first side port.5. The catheter device of claim 4 , wherein the at least one radiopaque maker includes a first radiopaque marker located longitudinally between the first side port and the second side port claim 4 , and a second radiopaque marker distal the second side port.6. The catheter device of claim 4 , wherein the first side port and the second side port are radially offset for about 180° degrees from each other.7. The catheter device of claim 1 , wherein the at least one wing is part of a guide-tip engaging a distal end portion of the distal catheter tube portion.8. The catheter device of claim 1 , wherein the catheter device includes at least one spiral-cut section claim 1 , and wherein the at least one side port is located in the ...

High Torque, Low Profile Catheters and Methods for Transluminal Interventions

Catheter devices having low profile shafts and laterally deployable members (e.g., cannulas, needles, etc.) that may be extended or advanced laterally from the catheter shaft. Also disclosed are methods for bypassing a vascular obstruction (e.g., a chronic total occlusion or other full or partial obstruction) wherein a guidewire is entrapped in a subintimal space adjacent to the obstruction. A catheter of the foregoing character is advanced over the entrapped guidewire and into the subintimal space. The laterally deployable member is then advanced or extended from the subintimal space back into the true lumen of the blood vessel distal to the obstruction. A second guidewire is then advanced through or along the laterally deployable member. The catheter and first guidewire are then removed and one or more working device(s) (balloons, atherectomy devices, setnts, etc.) is/are advanced over the second guidewire and used to establish a subintimal bypass channel through which blood may flow ...

Subintimal catheter device, assembly and related methods

Catheter devices, assemblies and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A catheter device can include a central catheter, two side tubes, and a distally-protruding, curved subintimal guidewire. The central catheter can define a central lumen that extends from a proximal end to a distal end of the central catheter. The lumen can be configured to receive a primary guidewire. The central catheter can also define at least one reentry aperture oriented transverse to the central lumen. The first and second side tubes can be coupled with the central catheter, extending along a longitudinal axis thereof, with the first side tube flanking an opposite side of the central catheter relative to the second side tube. The subintimal guidewire can extend from the first side tube, distally beyond the distal end of the central catheter, to the second side tube.

細長い構造を解剖及び開創するための装置及び方法

... 【解決手段】 収縮状態と膨張状態とを有するバルーン(12)を備えた解剖器具/開創器装置(10)が開示され、体内の標的組織の横側にトンネルを作成することによって、最少の侵襲性の外科手術手順が実行される。バルーン(12)はその膨張状態においては、バルーン(12)を横切って延びる開口空間(16)を形成する。バルーン(12)は挿入組立体(14)によって支えられる。バルーン(12)は細長いトーラス形状であってその内には細長い開部領域を有する。挿入組立体は、鈍い解剖装置とハンドル(22)とを含む。使用に際しては、解剖器具/開創器は小さい切開を通して挿入されて、体組織に鈍く堀られたトンネル(10)を通して所望の位置へ挿入される。バルーン(12)は体組織内において空間を作成するために膨張して、処置すべき組織からの必要に応じた組織の解剖を行なう。バルーン(12)は所定位置に膨張して残されて、空間を開創する。他の切開を行なって最初の切開よりもより直接的な標的組織へのアクセスを提供してもよい。標的組織はその後で、直接的なアクセス切開を通して、被覆組織を通して、バルーン(12)の開口空間(16)を通して、診断及び/又は処置される。 ...

経皮的閉塞横断システム及び方法

Methods and apparatus for crossing vascular occlusions

System for re-entering a vessel lumen

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters (10) employ deflectable struts (20) to stabilize and support the distal tip (16) in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire.

Subintimal re-entry catheter and retrograde recanalization

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.

Catheter systems and methods for re-entry in body vessels with chronic total occlusion

A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter includes components that are symmetric about the longitudinal axis and allow for reentry without the need to ensure a correct orientation of the cannula.

Subintimal recanalization with bio-absorbable stent

A recanalization catheter assembly for establishing a subintimal pathway around an occlusion in a blood vessel. The recanalization catheter assembly an inflatable balloon structure (20) including a distal anchoring portion (60) configured to expand within a true lumen portion of the blood vessel distal of the occlusion to anchor the recanalization catheter from unintentional movement during expansion of a stent in the subintimal pathway. The expandable stent (40), such as a bioabsorbable stent, may be configured to promote native tissue regrowth around the stent to create a superficial intimal layer along the subintimal pathway.

Tunneler device and method of use

GUIDEWIRE FOR CROSSING OCCLUSIONS OR STENOSES

A deflectable and torqueable hollow guidewire device is disclosed for removing occlusive material and passing through occlusions, stenosis, thrombus, plaque, calcified material, and other materials in a body lumen, such as a coronary artery. The hollow guidewire generally comprises an elongate, tubular guidewire body that has an axial lumen. A mechanically moving core element is positioned at or near a distal end of the tubular guidewire body and extends through the axial lumen. Actuation of the core element (e.g., oscillation, reciprocation, and/or rotation) creates a passage through the occlusive or stenotic material in the body lumen.

METHODS AND SYSTEMS FOR BYPASSING OCCLUSIONS IN A FEMORAL ARTERY

A system for deploying a stent-graft from the femoral artery into the femoral vein and back into the femoral artery in order to bypass a femoral occlusion comprises a penetration catheter and a guidewire capture and stabilization catheter. The penetration catheter may be advanced contralaterally to a location above the occlusion and the capture and stabilization catheter may be introduced upwardly through the femoral vein. The penetration tool on the penetration catheter is used in multiple steps to deploy guidewires which are then used to deploy the stent-graft in the desired location.

APPARATUS AND METHOD FOR PROMOTING ANGIOGENESIS IN ISCHEMIC TISSUE

A biologics delivery device and method of use for promoting angiogenesis in occluded vessels and ischemic tissue of a patient are provided, wherein the biologics delivery device includes a catheter having a proximal end, a distal region having a distal end, a lumen extending there between, and a plurality of through-wall apertures distributed along the distal region, the plurality of through-wall apertures in fluid communication with the proximal end and the lumen, and an expandable member disposed in the distal region, the expandable member configured to transition between a collapsed state and an expanded state. Methods of using the inventive biologics delivery device also are provided to achieve substantially uniform distribution of the biologic into a subintimal space.

Delivery methods for left ventricular conduit

Described herein are various methods and apparatuses for delivering stents or conduits and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the ...

SUBINTIMAL REENTRY SYSTEM

A subintimal recanalization catheter system for recanalizing a blood vessel. The system includes a support catheter and a balloon catheter configured to extend through the support catheter. The support catheter includes a tubular portion and an extension segment extending distal of the distal opening of the tubular portion. The balloon catheter, having a balloon secured to a distal portion thereof, is positionable through the tubular portion of the support catheter to position the balloon alongside the extension segment. The system is configured to be advanced into a subintimal space between a first tissue layer and a second tissue layer of a blood vessel wall where the balloon may be inflated against the extension segment to cause a distal portion of the catheter shaft of the balloon catheter to deflect toward the vessel lumen within the subintimal space to facilitate reentry into the vessel lumen. 1. A subintimal recanalization catheter system for recanalizing a blood vessel having an occlusion in a lumen thereof , the catheter system comprising:an elongate shaft including a tubular portion having a lumen extending therethrough to a distal opening and an extension segment extending distal of the distal opening; anda balloon catheter having a balloon secured to a distal portion of a catheter shaft, the balloon catheter extendable through the lumen of the elongate shaft to position the balloon of the balloon catheter distal of the distal opening;wherein the catheter system is configured to be advanced into a subintimal space between a first tissue layer and a second tissue layer of a wall of the blood vessel; andwherein the balloon is configured to be inflated against the extension segment to cause a distal portion of the catheter shaft to deflect toward the lumen of the blood vessel within the subintimal space to facilitate reentry into the lumen of the blood vessel.2. The subintimal recanalization catheter system of claim 1 , wherein the extension segment has a ...

Subintimal re-entry device

A subintimal recanalization catheter, including an elongate shaft including a first tubular member and a penetration member slidably disposed in a lumen of the first tubular member. The penetration member includes a distal tip positioned proximal of a distal nose of the first tubular member. The distal nose of the first tubular member includes a ramp and a guide wire lumen extending through the distal nose of the first tubular member. Longitudinal movement of the penetration member relative to the first tubular member causes the penetration member to contact the ramp to direct the distal tip of the penetration member away from the first tubular member.

RE-ENTRY DEVICE FOR PERIPHERAL ARTERIAL RECANALIZATION PROCEDURES

A re-entry device () for recanalization procedures of an arterial vessel by an intraluminal or subintimal technique includes a catheter () having a distal end () with a curved tip () by an angle (α) of between 30° and 90°, and an angled-tip stylet () insertable into the inner lumen of the catheter () to exit from a distal opening () thereof. The angled-tip stylet () is metal and has a distal end () with a curved tip () ending in a sharped apex (). The distal end () of the an angled-tip stylet () is tapered and has a length of 3-5 cm, and the curved tip () is bent by an angle (β) of between 30° and 50°. The structure makes the apex () adjustable outside the two-dimensional plane defined by the curved tip () of the catheter () to facilitate penetration of the arterial wall. 1. A re-entry device for arterial vessel recanalization procedures by an intraluminal or subintimal technique , comprising:a catheter with a body extending from a proximal portion to a distal end; said body having an inner lumen ending distally in a distal opening; said distal end being provided with a curved tip bent by an angle of between 30° and 90° with respect to a longitudinal axis of the body;an angled-tip stylet configured to be inserted into the inner lumen of the catheter to exit from the distal opening, having a body of a metal material, extending from a proximal portion to a distal end; said distal end comprising a curved tip ending in a sharp apex;wherein said distal end of the angled-tip stylet is tapered and has a length of between 3 cm and 5 cm, and the curved tip is bent by an angle of between 30° and 50° with respect to the longitudinal axis of the body so that the apex of the angled-tip stylet is also adjustable outside the two-dimensional plane defined by the curved tip of the catheter in order to facilitate the penetration of the arterial wall.2. Re-entry device according to claim 1 , wherein the body of the angled-tip stylet is a solid body claim 1 , made of stainless steel.3. ...

OCCLUSION BYPASSING APPARATUS WITH VARYING FLEXIBILITY AND METHODS FOR BYPASSING AN OCCLUSION IN A BLOOD VESSEL

An occlusion bypassing apparatus is disclosed for re-entering the true lumen of a vessel after subintimally bypassing an occlusion in a vessel. The apparatus includes an outer shaft component, an inner shaft component disposed within the outer shaft component, and a needle component slidably disposed within the inner shaft component. The inner shaft component includes a body portion and a needle housing, which is distal to the body portion. The needle housing is less flexible than the body portion. In order to smooth the transition between the body portion and the needle housing, the needle housing includes a transition portion that has a variable flexibility along its length that decreases in a distal direction. A curved distal end of the needle component is distally advanced relative to the inner shaft component to pierce through the intima of the vessel and thereafter enter the true lumen. 1. An apparatus for bypassing an occlusion in a blood vessel comprising:an outer shaft component having a side port proximal to a distal end thereof; andan inner shaft component disposed within the outer shaft component and defining a continuous lumen there-through, the inner shaft component havinga body portion that extends substantially parallel with a longitudinal axis of the apparatus, anda needle housing distally extending from a distal end of the body portion, the needle housing including a curved distal portion that bends from the longitudinal axis of the apparatus and terminates at the side port of the outer shaft component and a transition portion positioned between the body portion of the inner shaft component and the distal portion of the needle housing,wherein the transition portion has a variable flexibility along its length that decreases in a distal direction; anda needle component configured to be slidably disposed within the continuous lumen of the inner shaft component and removable therefrom, the needle component having a curved distal end with the same ...

INVERTED BALLOON NECK ON CATHETER

A method for thermal bonding of an inverted balloon neck on a catheter, including placing an inverted balloon neck () on a shaft () of a catheter, and characterized by applying heat at an internal hollow () of the shaft () where the inverted balloon neck () is placed, while applying internal pressure to attach an external surface of the shaft () to the inverted balloon neck (). 1. A lumen re-entry device , comprising:an elongate catheter shaft;an inflatable balloon mounted on a distal region of the catheter shaft;the catheter shaft including a first lumen in fluid communication with an interior of the balloon;the catheter shaft including a second lumen having a distal opening positioned proximal of a distal end of the inflatable balloon; andan elongate member slidably extendable through the second lumen to exit out the distal opening and alongside the balloon;wherein the balloon is configured to deflect a distal end portion of the elongate member upon inflation of the balloon.2. The lumen re-entry device of claim 1 , wherein the elongate member is a guidewire.3. The lumen re-entry device of claim 1 , wherein the catheter shaft further includes a third lumen having a distal opening positioned distal of the balloon.4. The lumen re-entry device of claim 3 , wherein the third lumen is a guidewire lumen.5. The lumen re-entry device of claim 1 , wherein the catheter shaft includes a first tubular member secured to a proximal waist of the balloon and a second tubular member secured to a distal waist of the balloon.6. The lumen re-entry device of claim 5 , wherein the second tubular member has a distal end located distal of a distal end of the first tubular member.7. The lumen re-entry device of claim 5 , wherein the second tubular member extends through a lumen of the first tubular member.8. The lumen re-entry device of claim 1 , wherein the balloon tapers radially outward in a distal direction in an inflated state.9. The lumen re-entry device of claim 8 , wherein the ...

REENTRY CATHETER AND METHOD THEREOF

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port, arranged on an exterior portion of the catheter configured to receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space. 136-. (canceled)37. A rapid exchange catheter system , comprising:a shaft having an inner lumen and an exchange port fluidly coupled with the inner lumen, the exchange port arranged on a distal portion of the rapid exchange catheter system, and the inner lumen and the exchange port configured to receive a first wire; anda rigid shroud coupled to the shaft on the distal portion of the rapid exchange catheter system, the rigid shroud comprising a second lumen and a lateral port fluidly coupled with the second lumen, the second lumen and the lateral port configured to receive a second wire;wherein, as viewed from an end view of the rapid exchange catheter system, the exchange port is exterior of the rigid shroud.38. The rapid exchange catheter system of claim 37 , further comprising a cannula disposed within the lumen claim 37 , the cannula configured to extend from the lateral port and receive the second wire.39. The rapid exchange catheter system of claim 37 , wherein the exchange port is disposed proximally relative to the rigid shroud.40. The rapid exchange catheter system ...

Balloon Catheter Systems and Methods for Bypassing an Occlusion in a Blood Vessel

A catheter for subintimally bypassing an occlusion in a vessel includes a catheter shaft including a guidewire lumen disposed therethrough and having a shaft longitudinal axis, at least two balloons coupled to an exterior of the catheter shaft such that longitudinal axes of the balloons are in a common plane with the shaft longitudinal axis when uninflated and with no external forces on the catheter. The balloons are configured such that when the catheter is disposed in the subintima of a vessel and the balloons are inflated, a tip of the catheter shaft is oriented towards a true lumen of the vessel distal of the occlusion. 1. A catheter for bypassing an occlusion via a subintimal approach , the catheter comprising:a catheter shaft including a guidewire lumen disposed therethrough, the catheter shaft having a shaft longitudinal axis;a first balloon coupled to an exterior of the catheter shaft, wherein a proximal portion of the first balloon is coupled to the catheter shaft at a first balloon proximal bond and a distal portion of the first balloon is coupled to the catheter shaft at a first balloon distal bond, wherein the first balloon is not coupled to the catheter shaft between the first balloon proximal bond and the first balloon distal bond, and wherein the catheter shaft is external to the first balloon between the first balloon proximal bond and the first balloon distal bond; anda second balloon coupled to an exterior of the catheter shaft opposite the first balloon relative to the catheter shaft, wherein a proximal portion of the second balloon is coupled to the catheter shaft at a second balloon proximal bond and a distal portion of the second balloon is coupled to the catheter shaft at a second balloon distal bond, wherein the second balloon is not coupled to the catheter shaft between the second balloon proximal bond and the second balloon distal bond, and wherein the catheter shaft is external to the second balloon between the second balloon proximal bond ...

Catheter Systems With a Blocking Mechanism and Methods for Bypassing an Occlusion in a Blood Vessel

A catheter for use with a subintimal reentry guidewire includes a proximal portion having a proximal guidewire lumen and a proximal inflation lumen, a distal portion having a distal guidewire lumen and a distal inflation lumen, and an intermediate portion disposed between the proximal portion and the distal portion and having an intermediate inflation lumen in fluid communication with the proximal and distal inflation lumens. The intermediate portion is devoid of a guidewire lumen. A blocking mechanism disposed in the distal portion of the catheter is transformable from a non-blocking configuration in which a guidewire is free to translate through the distal guidewire lumen and a blocking configuration in which a guidewire disposed in the distal guidewire lumen is prevented from translating through the distal guidewire lumen.

REENTRY CATHETER AND METHOD THEREOF

The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery. 120-. (canceled)21. A catheter system , comprising:a catheter body having a proximal end, a distal end, at least one catheter body lumen running along a longitudinal axis from the proximal end through the distal end, and a lateral opening disposed on a periphery of the catheter body and in communication with the at least one catheter body lumen; and a first sharp edge parallel to the longitudinal axis to permit cutting, wherein the first sharp edge is formed on at least a portion of a bottom distal edge and extending outwardly from a surface of the reentry member, wherein the bottom distal edge is parallel to the longitudinal axis, the bottom distal edge being opposite a top edge of the reentry member;', 'a second sharp edge to permit cutting, wherein the second sharp edge and the first sharp edge meet at an angle and form a distal tip of the distal end of the reentry member, wherein the angle is less than 90 degrees;', 'wherein the reentry member is configured to flex from a first position inside the at least one catheter body lumen to a second position outside of the at least one catheter body lumen and through the lateral opening of the catheter body when an axial eccentric load is placed on the top edge of the reentry member., 'a reentry member comprising a reentry member lumen and a distal end, the distal end comprising22. The catheter system of claim 21 , wherein the axial eccentric load is applied with at least one of a control wire claim 21 , a cabling device claim 21 , a ramp claim 21 , and an elastomeric member.23. The catheter system of claim 21 , wherein the reentry member comprises a material selected from the group consisting of an electroactive polymer claim 21 , a thermo-active polymer claim 21 , an electroactive ...

SUBINTIMAL RE-ENTRY CATHETER AND RETROGRADE RECANALIZATION

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion. 1. A catheter for recanalizing a blood vessel having an occlusion therein , the catheter comprising:a catheter shaft having a longitudinal axis, a proximal end, a distal end, and a distal end portion proximate the distal end;an expandable member coupled to the distal end portion of the catheter shaft;a flexible tubular member extending from the catheter shaft and along an exterior of the expandable member; anda guidewire lumen extending through the expandable member to the distal end of the catheter shaft;wherein expansion of the expandable member deflects the flexible tubular member into a deflected configuration away from the longitudinal axis of the catheter shaft.2. The catheter of claim 1 , wherein the expandable member includes an inflatable first wing portion and an inflatable second wing portion claim 1 , each of the first and second wing portions extending laterally away from the longitudinal axis on opposing sides of the longitudinal axis.3. The catheter of claim 2 , wherein the expandable member includes a bulbous portion located between the first and second wing portions.4. The catheter of claim 2 , wherein the first and second inflatable wings are configured to orient the flexible tubular member toward a center of the blood vessel.5. The catheter of claim 1 , wherein the expandable member is an inflatable balloon.6. The catheter of claim 5 , wherein the balloon is folded around the flexible tubular member in a ...

Vascular access devices and methods

Vascular access devices and methods of their use are provided. In one embodiment, a vascular access device includes a catheter and at least one deployable wire. The catheter includes a primary lumen extending from a proximal end to a distal end of the catheter. The at least one deployable wire is secured to the catheter and configured to move relative to the catheter between a delivery configuration and a deployed configuration.

METHODS FOR TREATING CANCEROUS TUMORS

Apparatuses and methods described herein relate to treating cancerous tumors using radiation therapy and chemotherapy. In some embodiments, a method of treatment includes administering radiation therapy targeting a tumor, isolating a segment of a vessel proximate to the tumor, and administering a dose of a chemotherapeutic agent to the segment of the vessel. The method can further include waiting a period of time after administering the radiation therapy before administering the dose of the chemotherapeutic agent. In some embodiments, a catheter device including first and second occluding elements can be used to isolate the segment of the vessel. 1. A chemotherapeutic agent comprising one or more compounds selected from any of: doxorubicin , erlotinib hydrochloride , everolimus , 5-FU , flurouracil , folfirinox , gemcitabine hydrochloride , gemcitabine-cisplatin , gemcitabine-oxaliplatin , irinotecan hydrochloride liposome , leucovorin , mitomycin C , mitozytrex , mutamycin , oxaliplatin , paclitaxel , paclitaxel albumin-stabilized nanoparticle formulation , or sunitinab malate , for use in treatment of a tumor , wherein the chemotherapeutic agent is administered subsequent to a course of radiation therapy applied to tissue surrounding the tumor after a period of time sufficient for the radiation therapy to reduce or devascularize the tissue.2. The chemotherapeutic agent of claim 1 , wherein the chemotherapeutic agent includes at least two compounds selected from any of: doxorubicin claim 1 , erlotinib hydrochloride claim 1 , everolimus claim 1 , 5-FU claim 1 , flurouracil claim 1 , folfirinox claim 1 , gemcitabine hydrochloride claim 1 , gemcitabine-cisplatin claim 1 , gemcitabine-oxaliplatin claim 1 , irinotecan hydrochloride liposome claim 1 , leucovorin claim 1 , mitomycin C claim 1 , mitozytrex claim 1 , mutamycin claim 1 , oxaliplatin claim 1 , paclitaxel claim 1 , paclitaxel albumin-stabilized nanoparticle formulation claim 1 , or sunitinab malate.3. The ...

SYSTEMS AND METHODS FOR PERCUTANEOUS OCCLUSION CROSSING

The present invention provides methods and apparatuses for crossing or bypassing total or near total occlusions of vessels through the use of elongate members and specialized catheters that include a piercing catheter, a reentry catheter, a multi-lumen, reentry catheter, and combinations thereof. A piercing catheter comprises a distal tip used to pierce an occlusion in a crossing procedure and can be configured to microdissect the occlusion or provide support for an elongate member. A reentry catheter comprises a distal side port and ramp to facilitate the reentry or perforation of a vessel wall. A multi-lumen, reentry catheter comprises a tearable lumen divider and a distal side port and ramp. 1. A medical device system comprising:a catheter with proximal and distal ends;a hollow chisel having a chisel passage therein, having a proximal and distal end, with a tip at the distal end, wherein the chisel's proximal end is proximate to the catheter's distal end; andan elongate member axially movable along the longitudinal axis of the catheter and chisel,wherein the tip is movable, in response to selective axial displacement of the elongate member, between a first position, in which the tip is disposed proximal to the axis, and a second position, in which the tip is spaced apart from the first position.2. The medical device system of claim 1 , wherein the tip has at least two portions claim 1 , at least one of which is moveable in response to selective axial displacement of the elongate member.3. The medical device system of claim 2 , wherein when the elongate member is withdrawn out of the chisel passage claim 2 , a sharp tip forms.4. The medical device system of claim 1 , wherein the elongate member can be reciprocated in and out of the chisel's distal end to actuate the chisel between a sharp tip and a blunt tip.5. The medical device system of claim 1 , wherein when the elongate member is pushed through and out of the distal end of the chisel claim 1 , the tip opens ...

ENDOVASCULAR DEVICES AND METHODS FOR EXPLOITING INTRAMURAL SPACE

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen. 1. A method of facilitating treatment via a vascular wall defining a vascular lumen , comprising:advancing an intravascular device into the vascular lumen, the intravascular device comprising an elongate shaft having a bulbous distal tip and a lumen extending through the elongate shaft to the bulbous distal tip;positioning a distal portion of the elongate shaft within a subintimal space of the vascular wall; andorienting the distal portion of the elongate shaft within the subintimal space such that a re-entry device advanced through the lumen is directed toward the vascular lumen.2. The method of claim 1 , wherein orienting the distal portion of the elongate shaft is done without visualization of the distal portion of the elongate shaft within the subintimal space.3. The method of claim 1 , wherein the intravascular device further comprises an actuation member extending through the elongate shaft to the bulbous distal tip.4. The method of claim 3 , wherein orienting the distal portion of the elongate shaft includes pulling the actuation member proximally to bend the distal portion of the elongate shaft.5. The method of claim 4 , wherein after pulling the actuation member claim 4 , the distal portion of the elongate shaft forms a compound bend.6. The method of claim 4 , wherein the elongate shaft includes one or more open areas oriented along the actuation member.7. The method of claim 6 , wherein the elongate shaft defines a single row of open areas.8. The ...

BYPASS CATHETER

An innovative medical device that permits rapid, minimally invasive restoration of blood flow across a vascular blockage. A system allowing for lysis or removal of said blockage. Said device creates a temporary bypass using longitudinal structure configured for insertion into the blood vessel and adapted to deliver a side hole to a target area. The side hole defines a distal first segment and a proximal second segment with a lumen to allow blood flow therethrough to the distal end hole. In an alternate embodiment, a slidable outer sheath can cover the side hole to permit reversal of blood flow from the distal end hole to a proximal end hole located outside a patient's body by means of an aspiration controller. Alternate embodiments include an optional anchoring balloon, a macerating stent or wires, perforations for fluid delivery, and an backflow valve. 18-. (canceled)9. An apparatus for bypassing a blocked vessel comprising a catheter body configured for insertion into a blood vessel , the catheter body including a distal opening and a circumferential outer wall with an inner surface circumscribing and defining a lumen , the circumferential outer wall including at least one perforation and a side hole in communication with the lumen such that blood flow is directed through the lumen so as to direct blood flow around a blockage in the vessel and thereby establish a bypass , the at least one perforation positioned between the side hole and the distal opening , the catheter having an outer wall and devoid of a balloon between the side hole and distal opening so outflow of clot dissolving fluid from the at least one perforation is unobstructed along a length of the catheter between the side hole and distal opening.10. The apparatus of claim 9 , wherein the lumen is configured so blood flow is directed through the side hole claim 9 , into the lumen claim 9 , and exclusively out through the distal opening of the catheter body to establish the bypass claim 9 , the distal ...

EXPANDABLE CARDIAC SHUNT

Disclosed are cardiac shunts and method of delivery, and in particular, to a shunt to reduce elevated left atrial pressure (LAP). The methods include forming a puncture hole between the left atrium and the coronary sinus, widening the puncture hole, and placing an expandable shunt within the widened puncture hole. A first catheter having a side-extending needle may be used to form a puncture into the left atrium. A second catheter extends along a guidewire and an expandable shunt with distal and proximal flanges is expelled therefrom into the puncture. The shunt defines a blood flow passage therethrough that permits shunting of blood from the left atrium to the coronary sinus when the LAP is elevated. The shunt is desirable formed of a super-elastic material and manipulated with control rods. The shunt defines a tilted flow tube that facilitates collapse into the catheter. 1. An expandable blood flow shunt formed of an elastic material and configured to be inserted into a puncture wound in a tissue wall between two anatomical chambers and expand from a collapsed state to an expanded state to maintain a blood flow opening therebetween , the tissue wall defining a reference plane generally perpendicular to the opening , the shunt comprising , in an expanded state:a central flow tube defined by an opposed pair of lateral side walls formed by struts extending between an opposed pair of end walls formed by struts, the central flow tube defining a central axis therethrough angled from a reference axis extending perpendicular through the reference plane;two distal flanges formed by struts each attached to a first axial end of the central flow tube, the distal flanges extending away from one another in opposite longitudinal directions generally parallel to the reference plane; andtwo proximal flanges formed by struts each attached to a second axial end of the central flow tube opposite the first end, the proximal flanges extend away from one another in opposite longitudinal ...

CROSSING OCCLUSIONS IN BLOOD VESSELS

The present disclosure is directed a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing a first intravascular device having a distal portion and at least one aperture and positioning the distal portion of the first intravascular device in the vascular wall. The method may further include providing a reentry device having a body and a distal tip, the distal tip having a natural state and a compressed state and inserting the distal tip, in the compressed state, in the distal portion of the first intravascular device. The method may further include advancing the distal tip, in the natural state, through the at least one aperture of the first intravascular device. 1. A method of crossing an occlusion in a true lumen of a blood vessel via a vascular wall , comprising:advancing an orienting device into a subintimal space of the vascular wall until a distal end of the orienting device is positioned distal of the occlusion, the orienting device including a shaft having a wall defining a lumen having a longitudinal axis, a first aperture through the wall in communication with the lumen, and a second aperture through the wall in communication with the lumen;wherein the first aperture opens in a first direction away from the longitudinal axis of the lumen of the orienting device, and the second aperture opens in a second direction away from the longitudinal axis of the lumen of the orienting device;advancing a re-entry device through the lumen of the orienting device to a position adjacent the first aperture; andadvancing a distal end of the re-entry device out the first aperture until the distal end of the re-entry device is positioned within the true lumen.2. The method of claim 1 , further comprising:observing, via fluoroscopy, a position of the distal end of the re-entry device relative to the first aperture and the second aperture;confirming that the first aperture is facing the ...

Systems, apparatus and methods for treating blood vessels

A system and method for treating a blood vessel that is at least partially obstructed by an occlusion which divides the lumen into a proximal lumen segment and a distal lumen segment. The system includes an orienting catheter having an orientation element positionable in an intrawall space of the vessel and an occlusion catheter having an occlusion balloon inflatable in the proximal lumen segment so as to isolate a target volume including the intrawall space. The pressure inside the target volume is reduced to a pressure below the pressure of the distal lumen segment so that the intima presses against the orienting element of the orienting catheter. A distal end of a reentry device may be advanced from the orienting catheter through the intima and into the distal lumen segment.

METHOD OF COUPLING A CATHETER TUNNELER ADAPTER TO A CATHETER

A method of coupling a catheter tunneler adapter to a catheter is provided. The method includes providing a catheter having a lumen divider at a proximal end thereof; forming a receiving notch in the lumen divider by removing a center portion thereof such that two divider side portions remain; providing a catheter tunneler adapter having a distal end including a radially inward step which defines a contact surface configured to be received in the proximal end of the catheter; positioning the distal end of the catheter tunneler adapter within the catheter until the radially inward step engages the receiving notch; and securing the catheter tunneler adapter to the catheter. 1. A method of coupling a catheter tunneler adapter to a catheter comprising:providing a catheter having a lumen divider at a proximal end thereof;forming a receiving notch in the lumen divider by removing a center portion thereof such that two divider side portions remain;providing a catheter tunneler adapter having a distal end including a radially inward step which defines a contact surface configured to be received in the proximal end of the catheter;positioning the distal end of the catheter tunneler adapter within the catheter until the radially inward step engages the receiving notch;securing the catheter tunneler adapter to the catheter.2. The method of wherein securing the catheter tunneler adapter to the catheter is selected from bonding claim 1 , welding and adhering.3. The method of wherein forming a receiving notch in the lumen divider by removing a center portion thereof includes cutting away the center portion.4. The method of wherein forming a receiving notch in the lumen divider by removing a center portion thereof during manufacture of the catheter.5. The method of further comprising aligning the two divider side portions with a pair of longitudinal grooves extending along a surface of the tunneler adapter from the distal end to the step. This application is a continuation of U.S. ...

DEVICES AND METHODS FOR ADVANCING A WIRE

Systems and methods for positioning a wire for advancement through a vessel wall, and advancing it through one or more vessel walls, generally include a delivery catheter and an alignment catheter or a receiving catheter, and a guidewire. In some variations, the systems and methods may be used to bypass an occlusion or other barrier that may prevent advancement of a wire or tools through an endoluminal space. In these variations, the systems and methods include a delivery catheter, a bypass catheter, a receiving catheter, and a guidewire. The delivery and receiving catheters each generally include a side aperture, a deflection surface, and an alignment element, and the bypass catheter generally includes two side apertures, two deflectors, and two alignment elements. In some variations, the systems and methods may assist in treatment of a patient suffering from critical limb ischemia. 1. A system for advancing a guidewire through a vessel wall comprising:a first catheter comprising a catheter body having a first lumen therethrough and a first side aperture, a first deflection surface, and a first alignment element;a second catheter comprising a catheter body having a second lumen therethrough and a second side aperture, a second deflection surface, and a second alignment element; anda guidewire,wherein the first and second alignment elements are configured to align the first and second side apertures to create a guidewire pathway through the first and second catheters.2. The system of claim 1 , wherein the first catheter is a delivery catheter and the second catheter is a receiving catheter.3. The system of claim 1 , wherein the first and second alignment elements each comprise a magnet or a magnetic array.4. The system of claim 1 , wherein the first catheter further comprises a third alignment element and the second catheter further comprises a fourth alignment element.5. The system of claim 4 , wherein the third and fourth alignment elements each comprise a magnet ...

Balloon Catheter with Dynamic Vessel Engaging Member

The technical disclosure relates to catheters useful for engaging a vessel from within a lumen defined by the vessel. A catheter includes an elongate shaft, an inflatable balloon disposed on the distal end of the elongate shaft, a guide disposed on the external surface of the balloon, and an engaging member having a distal end releasably secured by the guide such that the guide maintains the engaging member distal end adjacent the outer surface of the balloon when the balloon is in an uninflated configuration but releases the engaging member distal end as the balloon moves from an uninflated configuration to an inflated configuration. The technical disclosure also relates to methods of using a catheter. 1. A catheter , comprising:an elongate shaft having a proximal end, a distal end, a main body extending between the proximal end and the distal end, and a longitudinal axis, the main body defining an inflation lumen;a balloon disposed on the distal end of the elongate shaft, the balloon having an external surface, a proximal balloon neck and a distal balloon neck, the balloon defining an interior chamber in fluid communication with the inflation lumen and adapted to move from an uninflated configuration to an inflated configuration as fluid moves from the inflation lumen into the interior chamber;a guide disposed on the external surface of the balloon between the proximal balloon neck and the distal balloon neck with respect to the longitudinal axis of the elongate tubular member; andan engaging member having an engaging member proximal end and an engaging member distal end, the engaging member distal end releasably secured by the guide such that the guide maintains the engaging member distal end adjacent the outer surface of the balloon when the balloon is in an uninflated configuration but releases the engaging member distal end as the balloon moves from an uninflated configuration to an inflated configuration.2. The catheter of claim 1 , wherein the engaging ...

Lumen Re-Entry System And Method

A lumen re-entry system includes a catheter having an elongate tubular body defining a wire lumen extending from an open proximal end of the elongate tubular body to a distal opening through the elongate tubular body. An abrasion resistant tubular liner is positioned within the wire lumen and has a fixed position relative to the elongate tubular body. The abrasion resistant tubular liner defines a reduced wire lumen extending from an open proximal end of the abrasion resistant tubular liner to an open distal end of the abrasion resistant tubular liner. A puncture wire is configured for axial movement through the reduced wire lumen and has an angled distal segment terminating in a puncture tip. The angled distal segment is oriented at an angle between about 10 degrees to about 90 degrees relative to a central longitudinal axis of the puncture wire.

VASCULAR RE-ENTRY CATHETER

A catheter device having a distal tube portion having a longitudinal axis and a tube wall comprising at least one side port; and a guide tip mounted on the distal tube portion, the guide tip defining: a unitary body having an outer wall, and a plurality of indentations in the outer wall, wherein the indentations are oriented substantially parallel to the longitudinal axis, and wherein each indentation extends from a distal-most end of the guide tip to a proximal region of the guide tip. 1. A catheter device comprising:a distal tube portion having a longitudinal axis and a tube wall comprising at least one side port; anda guide tip mounted on the distal tube portion, the guide tip defining:a unitary body having an outer wall, anda plurality of indentations in the outer wall, wherein the indentations are oriented substantially parallel to the longitudinal axis, and wherein each indentation extends from a distal-most end of the guide tip to a proximal region of the guide tip.2. The catheter device of claim 1 , wherein each of the plurality of indentations extends along a substantial length of the guide tip in a proximal-to-distal direction.3. The catheter device of claim 1 , wherein each of the plurality of indentations defines an axial length smaller than an overall axial length of the guide tip.4. The catheter device of claim 1 , wherein each of the plurality of indentations defines a width that varies along an axial length thereof.5. The catheter device of claim 4 , wherein each of the plurality of indentations defines a width at a distal region thereof that is greater than a width at a proximal region thereof.6. The catheter device of claim 1 , wherein each of the plurality of indentations defines a substantially arcuate surface.7. The catheter device of claim 1 , wherein each of the plurality of indentations defines a height with respect to the outer wall that varies along an axial length of the indentation.8. The catheter device of claim 1 , wherein the plurality ...

SYSTEM FOR BYPASSING VASCULAR OCCLUSION HAVING PUNCTURING MECHANISM AND METHOD

A system for bypassing a vascular occlusion includes a catheter, and a puncturing mechanism within the catheter having a sleeve and a puncture wire positioned within the sleeve. The puncture wire is elastically deformable between an access configuration, and a deployed configuration. The puncture wire has a shape memory bias and is retracted within the sleeve and held by the sleeve in opposition to the bias in the access configuration. 1. A system for bypassing a vascular occlusion in a patient comprising:a catheter including an elongate catheter body having formed therein a longitudinally extending wire guide lumen and a longitudinally extending second lumen;a puncturing mechanism including a sleeve slidable within the second lumen, and a puncture wire positioned within the sleeve and including a proximal segment defining a longitudinal axis and a distal segment having a piercing tip;the puncture wire being elastically deformable between an access configuration where the distal segment is straightened and the piercing tip is positioned closer to the longitudinal axis, and a deployed configuration where the distal segment is curved and the piercing tip is positioned further from the longitudinal axis; andthe puncture wire further having a shape memory bias and being at a retracted position where the sleeve holds the puncture wire in opposition to the shape memory bias in the access configuration, and being slidable to an advanced position where the distal segment projects out of the sleeve and the shape memory bias positions the puncture wire in the deployed configuration.2. The system of wherein the shape memory bias is a subordinate shape memory bias claim 1 , and the sleeve includes a dominant shape memory bias.3. The system of wherein the sleeve includes a skeleton extending circumferentially around a central lumen claim 1 , and the puncture wire is slidable within the central lumen between the retracted and advanced positions.4. The system of wherein the ...

Subintimal recanalization with bio-absorbable stent

A recanalization catheter assembly and method for establishing a subintimal pathway around an occlusion in a blood vessel. The recanalization catheter assembly an inflatable balloon structure including a distal anchoring portion configured to expand within a true lumen portion of the blood vessel distal of the occlusion to anchor the recanalization catheter from unintentional movement during expansion of a stent in the subintimal pathway. The expandable stent, such as a bioabsorbable stent, may be configured to promote native tissue regrowth around the stent to create a superficial intimal layer along the subintimal pathway.

ENDOVASCULAR DEVICES AND METHODS FOR EXPLOITING INTRAMURAL SPACE

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen. 1. A method of bypassing an occlusion disposed in a lumen of a vessel having a vascular wall , the method comprising:inserting an intramural portion of an intravascular device into the lumen proximal of the occlusion;entering the vascular wall of the vessel with the intramural portion of the intravascular device at a location proximal of the occlusion;advancing the intramural portion between first and second tissue layers of the vascular wall to a location distal of the occlusion;advancing a re-entry device through the intravascular device, the re-entry device having a tissue penetrating distal tip;penetrating the first tissue layer of the vascular wall with the tissue penetrating distal tip of the re-entry device such that the tissue-penetrating distal tip enters the lumen of the vessel distal of the occlusion; andadvancing the intramural portion of the intravascular device from the vascular wall into the lumen of the vessel distal of the occlusion such that the intravascular device extends from the lumen of the vessel proximal of the occlusion, through a subintimal space between the first and second tissue layers along the occlusion, to the lumen of the vessel distal of the occlusion.2. The method of claim 1 , further comprising rotationally orienting the intramural portion of the intravascular device in the subintimal space after advancing the intramural portion between the first and second tissue layers of the vascular wall to the location distal of the ...

Catheter System

The present invention discloses a catheter system, comprising: a catheter head having a lumen, a proximal end and a distal end, and an opening positioned at a bottom of the distal end; and a rotatable inner tube having a lumen positioned in the lumen and at a proximal end of the catheter head, the inner tube including a front end having an arcuate opening; wherein the rotatable inner tube can be rotated so that the arcuate opening thereon can be made to engage or disengage with the opening at the bottom of the distal end of the catheter head. The invention also provides a catheter system and method for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way. The catheter system for re-entry of a vascular false lumen into a true lumen in a quick, accurate and low-risk way effectively solve the problems of difficult operation, inaccurate positioning, long operation time and easiness to cause acute occlusion and internal hemorrhage of the branch vessel when the guidewire is re-entering the true lumen in the prior art. 1. A catheter system , comprising:a catheter head having a lumen, a proximal end and a distal end, and an opening positioned at a bottom of the distal end; anda rotatable inner tube having a lumen positioned in the lumen and at a proximal end of the catheter head, the inner tube including a front end having an arcuate opening;wherein, the rotatable inner tube can be rotated so that the arcuate opening thereon can be made to engage or disengage with the opening at the bottom of the distal end of the catheter head.2. The catheter system as claimed in claim 1 , further comprising:a guidewire, located within the lumen of the rotatable inner tube;wherein the rotatable inner tube can be rotated so that, depending on the engagement or disengagement between the arcuate opening of the inner tube and the opening of the catheter head, the guidewire penetrates downwards out of the opening along a guide path of the rotatable inner ...

CATHETER TUNNELER ADAPTER

A catheter tunneling adapter including a longitudinal body having a distal end and a proximal end and a passageway extending from an entrance at the proximal end to an exit at the distal end. The passageway has a first hemisphere and a second hemisphere with the first hemisphere defining a generally unobstructed first passageway portion from the entrance to the exit. A guide ramp is positioned within the second passageway and tapers towards the first hemisphere moving from the proximal end to the distal end. The ramp defines a longitudinal notch therethrough such that a second passageway portion extends from the entrance to the exit. 1. A catheter tunneling adapter comprising:a longitudinal body having a distal end and a proximal end and a passageway extending from an entrance at the proximal end to an exit at the distal end, the passageway having a first hemisphere and a second hemisphere, with the first hemisphere defining a generally unobstructed first passageway portion from the entrance to the exit; anda guide ramp positioned within the second passageway and tapered towards the first hemisphere moving from the proximal end to the distal end, the ramp defining a longitudinal notch therethrough such that a second passageway portion extends from the entrance to the exit.2. The catheter tunneling adapter according to claim 1 , wherein the first passageway portion has a diameter greater than a width of the second passageway portion.3. The catheter tunneling adapter according to claim 1 , wherein the passageway entrance is configured to receive a portion of a syringe and a fluid expelled from the syringe passes through and exits both the first and second passageway portions at the distal end of the longitudinal body.4. The catheter tunneling adapter according to claim 1 , wherein the passageway entrance is configured to securably receive a distal end of a tunneler.5. The catheter tunneling adapter according to claim 1 , wherein the distal end of the longitudinal body ...

METHODS AND DEVICES FOR PERCUTANEOUS IMPLANTATION OF ARTERIO-VENOUS GRAFTS

Methods, devices, and kits for implanting a vascular graft to perform hemodialysis treatments on patients with renal failure are disclosed. The kits can include access devices comprised of an access catheter having a guidewire lumen and stylet lumen, a guide tube having a curved distal end, a stylet, an actuator handle and a vascular graft. The methods describe techniques for using the described kits and devices for performing vascular procedures, such as percutaneous implantation of the vascular graft. 1. A method of percutaneously implanting an arterio-venous graft , comprising:advancing a first guidewire into a lumen of a first artery from a second artery;advancing a second guidewire into a lumen of a first vein from a second vein;advancing a first access catheter over the first guidewire into the lumen of the first artery;advancing a second access catheter over the second guidewire into the lumen of the first vein;operating a first guide tube actuator to advance a first guide tube from the first access catheter toward a portion of a wall of the first artery;operating a second guide tube actuator to advance a second guide tube from the second access catheter toward a portion of a wall of the first vein;operating a first stylet actuator to advance a first stylet along a curved path through the first guide tube and through the wall of the first artery to form an arterial exit site; andoperating a second stylet actuator to advance a second stylet along a curved path through the second guide tube and through the wall of the first vein to form a venous exit site.2. The method of claim 1 , further comprising forming a subcutaneous tunnel between the arterial exit site and the venous exit site.3. The method of claim 2 , further comprising:advancing a guide catheter over the second stylet;wherein the guide catheter passes through the venous exit site and through the subcutaneous tunnel; andwherein a distal end of the guide catheter is disposed adjacent the arterial exit ...

SHAPEABLE RE-ENTRY DEVICES AND ASSOCIATED SYSTEMS AND METHODS

Methods for treating a patient using intravascular devices, systems, and methods are disclosed herein. One aspect of the present technology is directed to an intravascular device having an elongated member coupled to and extending between a handle and an angled distal portion. The distal portion is moveable between a first configuration having a first shape configured for intravascular delivery and a second configuration having a second shape, different than the first shape, that is configured for intravascular delivery. 1. An intravascular device , comprising:a handle at a proximal portion; an outer sheath; and', 'a hollow rotational member with the sheath, wherein the rotational member is coupled to the angled distal portion, and wherein rotation of the rotational member directly causes rotation of the angled distal portion; and, 'an elongated member coupled to and extending between the handle and an angled distal portion, wherein the elongated member includes—'} defines a lumen therethrough,', 'has a first section and a second section that extends distally at an angle from the first section, and', 'the angle between the first section and the second section remains the same when an interventional device is at least partially within the lumen of the distal portion and spans at least a portion of the first section and at least a portion of the second section., 'wherein the angled distal portion—'}2. The device of wherein the angle between the first section and the second section remains the same when a guidewire is at least partially within the lumen of the distal portion.3. The device of wherein the distal portion is not heat set.4. The device of wherein the angle is about 30 degrees.5. The device of wherein the distal portion further comprises an atraumatic distal tip.6. The device of wherein—the rotational member has a distal end and a proximal end;the distal end of the rotational shaft is coupled to the distal portion; andthe proximal end of the rotational shaft ...

SYSTEM AND METHOD FOR RE-ENTERING A VESSEL LUMEN

This disclosure is directed to systems and methods for re-entering the true lumen of a vessel. The re-entry catheters employ deflectable struts to stabilize and support the distal tip in a subintimal location while a passageway back into the true lumen is formed. Re-entry to the true lumen can be effected with a cutting element or with a conventional guidewire. 1. A re-entry catheter for facilitating formation of a passageway from a subintimal area to a lumen of a vessel , comprising an elongated outer tubular member having a distal end and a window adjacent the distal end , a plurality of deflectable struts arranged longitudinally within the window , and an actuating member coaxially disposed within the outer tubular member , wherein proximal ends of the deflectable struts are operatively connected to a distal end of the actuating member , such that axial motion of the actuating member relative to the outer tubular member deflects the struts radially outward.2. The re-entry catheter of claim 1 , further comprising a lateral port in the outer tubular member in a location opposing the window.3. The re-entry catheter of claim 1 , wherein the struts are formed from a nickel-titanium alloy.4. The re-entry catheter of claim 1 , wherein the outer tubular member has a circumference and wherein the window occupies a portion of the circumference corresponding to a range of approximately 120° to 240°.5. The re-entry catheter of claim 1 , wherein tension applied to the actuating member increases stiffness at the distal end of the elongated tubular member.6. The re-entry catheter of claim 1 , further comprising a membrane supported by the struts and configured to distribute force between the struts.7. The re-entry catheter of claim 2 , further comprising a cutting member coaxially disposed within the actuating member.8. The re-entry catheter of claim 7 , wherein the cutting member comprises a cannula configured to be advanced out of the lateral port.9. The re-entry catheter of ...

Bypass catheter

An innovative medical device that permits rapid, minimally invasive restoration of blood flow across a vascular blockage. A system allowing for lysis or removal of said blockage. Said device creates a temporary bypass using longitudinal structure configured for insertion into the blood vessel and adapted to deliver a side hole to a target area. The side hole defines a distal first segment and a proximal second segment with a lumen to allow blood flow therethrough to the distal end hole. In an alternate embodiment, a slidable outer sheath can cover the side hole to permit reversal of blood flow from the distal end hole to a proximal end hole located outside a patient's body by means of an aspiration controller. Alternate embodiments include an optional anchoring balloon, a macerating stent or wires, perforations for fluid delivery, and an backflow valve.

Catheter Systems With a Blocking Mechanism and Methods for Bypassing an Occlusion in a Blood Vessel

A catheter for use with a subintimal reentry guidewire includes a proximal portion having a proximal guidewire lumen and a proximal inflation lumen, a distal portion having a distal guidewire lumen and a distal inflation lumen, and an intermediate portion disposed between the proximal portion and the distal portion and having an intermediate inflation lumen in fluid communication with the proximal and distal inflation lumens. The intermediate portion is devoid of a guidewire lumen. A blocking mechanism disposed in the distal portion of the catheter is transformable from a non-blocking configuration in which a guidewire is free to translate through the distal guidewire lumen and a blocking configuration in which a guidewire disposed in the distal guidewire lumen is prevented from translating through the distal guidewire lumen.

Catheter Assemblies and Methods for Stabilizing a Catheter Assembly Within a Subintimal Space

Catheter assemblies include a stabilization mechanism disposed at a distal end of the catheter assembly for stabilizing the catheter assembly within a subintimal space. The stabilization mechanism includes a self-expanding support structure that is slidably positionable within an inflatable balloon. The catheter assemblies include an outer shaft which has the balloon at a distal end thereof and an inner shaft which has the support structure mounted on a distal end thereof. The inner shaft is slidably disposed within a lumen of the outer shaft and has a first configuration in which the support structure is held in a compressed state within the outer shaft and a second configuration in which the support structure is permitted to return to an expanded state within the inflatable balloon. In the expanded state, the stabilization mechanism has a flattened laterally-extending profile.

Method And Device For Lymphedema Treatment

Materials and methods are provided to direct the formation of new lymphatics and to reconnect the disrupted lymphatic network. These materials and methods enable to improve survival of lymph nodes and lymph node fragments and their integration into a lymphatic network, following lymph node and lymph node fragments transplantation. The treatment or prevention of lymphedema is also addressed. In certain embodiments, a bundle of fibers or fibrils presented in the composition is effective to stimulate and direct the formation of new lymphatic and blood vessels. The bundle of fibers or fibrils presented in the composition is effective to promote survival of the lymph node or lymph node fragments and integration of the lymph node or lymph node fragments into a lymphatic network in the mammalian subject, at the site of transfer or transplantation. 1. A surgical method for reconstruction and repair of the alymphatic area comprising: implantation of a composition into the area such that the composition promotes cell migration into the area and the growth of new lymphatic or blood vessels from its periphery.2. The method according to the claim 1 , the composition comprising at least one thread-like device bridging the alymphatic area.3. The method according to the claim 1 , the composition comprising at least one thread-like device bridging the alymphatic area and at least one autologous lymph node or lymph node fragment.4. The method according to the claim 1 , the composition comprising at least one thread-like device bridging the alymphatic area and at least one autologous lymph node or lymph node fragment such that the lymph node or the lymph node fragment is placed on the border of the area.5. The method according to the claim 1 , the composition comprising at least one thread-like device bridging the alymphatic area and at least one autologous lymph node or lymph node fragment such that the lymph node or the lymph node fragment is placed in close proximity to the ...

Method and Devices for Passing a Chronic Total Occlusion and Re-entry into a True Lumen

Methods and devices are disclosed for passing Chronic Total Occlusion (CTO) from subintimal location and re-entry into a true-lumen of the patient using transient fenestration approach. The transient fenestration is induced by balloon dilatation within the CTO, and a guidewire quickly trails into a true lumen. 112-. (canceled)13. A dual guidewire balloon catheter system , comprising:an elongated multi-lumen extruded catheter shaft having a distal portion with a distal end, a proximal portion with a proximal end and a plurality of inner lumens which include a first lumen, a second lumen and a third lumen, wherein the second lumen has a first entry port and the third lumen has a second entry port;a balloon positioned adjacent the distal end of the catheter shaft, wherein the first lumen of the catheter shaft is fluidly coupled to the balloon; anda first guidewire and a second a guidewire, wherein the first guidewire extends through the first entry port into the second lumen, and the second guidewire extends through the second entry port into the third lumen.14. The dual guidewire balloon catheter system of claim 13 , wherein the second lumen has a first exit port located proximally to the balloon claim 13 , and the third lumen has a second exit port located proximally to the balloon claim 13 , and wherein the first guidewire extends through the first exit port from the second lumen claim 13 , and the second guidewire extends through the second exit port from the third lumen.15. A dual guidewire balloon catheter system claim 13 , comprising:an elongated catheter shaft having a first lumen, a second lumen and a third lumen, the catheter shaft having a proximal portion with a proximal end and a distal portion with a distal end;a balloon positioned adjacent to the distal end of the catheter shaft, wherein the first lumen of the catheter shaft is fluidly coupled to the balloon;a first guidewire and a second guidewire, wherein the first guidewire extends through the second ...

Tunneled Catheter with Hemostasis Mechanism

A hemostasis component for an invasive medical device has an inflatable cylinder affixed to the medical device at a location aligned with an ingress point of a patient. An inflation source is in fluid communication with the inflatable cylinder and a flow control valve that is effective to regulate the flow of fluid from the inflation source to the inflatable cylinder is provided. The flexible cylinder is located on the proximal end of a tunneling catheter, where it exits the skin. A thin tube is provided to inflate the flexible cylinder. In the event of bleeding, the flexible cylinder is inflated for as long as is needed to achieve hemostasis, without having to place sutures. Inflation is a simple procedure that can be done by the patient, as opposed to having to place a suture, which must be performed by a physician or a physician's delegate, under sterile conditions. 1. A hemostasis component for an invasive medical device , comprising:an inflatable cylinder affixed to said medical device at a location aligned with an ingress point of a subject when said medical device is fully inserted;an inflation source in fluid communication with said inflatable cylinder; anda flow control valve effective to regulate the flow of fluid from said inflation source to said inflatable cylinder.2. The hemostasis component of wherein said inflatable cylinder is manufactured from silicone.3. The hemostasis component of wherein said fluid is saline.4. The hemostasis component of affixed to a proximal end of a tunneling catheter adjacent a first side of an anchor cuff5. The hemostasis component of wherein a second inflatable cylinder is affixed to said medical device adjacent an opposing second side of said anchor cuff6. A tunneled catheter comprising:a tunneling device affixed to a distal end of a catheter; anda hemostasis component affixed to a proximal end of said catheter.7. The tunneled catheter of wherein said hemostasis component is an inflatable foam.8. The tunneled catheter of ...

Magnet guided wire crossing system

A magnet guided crossing system includes a first magnet that defines a first guide passage and a second magnet that defines a second guide passage, which are positioned in respective body structures. A crossing guide includes a catheter, a direction change piece and a magnetic latch in series that together define a third guide passage that extends from a proximal end of the catheter through a latching side of the magnetic latch. The poles of the first and second magnets and the magnetic latch are oriented so that the first and second magnets and the magnetic latch have a stable magnetically latched stack configuration. A puncture wire is slidably received in the catheter.

AXIAL SHARP NEEDLE REENTRY DEVICE

A catheter, such as for use for total occlusion crossing and lumen reentry, incorporate a retractable long flexible nitinol curved needle at the catheter distal end. The needle is straight when withdrawn inside the catheter. When pushed forward, the needle is deployed by protruding axially out, directly from the distal tip, through a mechanism used to direct the curved needle into a specific radial direction. When pushed forward, the needle restores its curved shape and can penetrate the plaque or the media and intimal layers to reenter the true lumen. 1. A catheter device comprising:a catheter shaft comprising a distal portion;a handle coupled to a proximal portion of said catheter shaft;a needle that passes through a lumen in said catheter shaft and said distal portion, said needle comprising a first straight section coupled to said handle, a curved section that extends distally from said first straight section, a second straight section that extends distally from said curved section, and a sharp tip at a most distal end of said needle.2. The catheter device according to claim 1 , wherein said first straight section is longer than said second straight section.3. The catheter device according to claim 1 , wherein said distal portion of said catheter shaft has sufficient rigidity to deform said curved section to be less curved when inside said distal portion than when outside said distal portion and wherein said tip of said needle exits at a distal end of said distal portion of said catheter shaft.4. The catheter device according to claim 1 , wherein said lumen has a proximal eccentric portion and a non-circular distal portion.5. The catheter device according to claim 4 , wherein said non-circular distal portion is elliptical.6. The catheter device according to claim 1 , wherein said lumen and said needle are non-circular.7. The catheter device according to claim 1 , wherein said lumen and said needle are elliptical.8. The catheter device according to claim 1 , ...

Catheter device for lumen re-entry and methods for use thereof

A catheter device for lumen re-entry is provided. The catheter device includes a catheter shaft having a lumen extending from a proximal end to a distal end and an expandable member positioned at the distal end of the catheter shaft. The catheter shaft having interior walls defining a central lumen extending from a proximal end to a distal end along a longitudinal axis of the lumen. The expandable member configured to receive a fluid that selectively expands the expandable member from a first volume to a second volume, the second volume being larger than the first volume to provide a deflection surface that is oriented at an angle with respect to the longitudinal axis of the lumen. The deflection member provides a surface to angle a guidewire out of the distal opening at the tip of the catheter shaft (i.e., not a separate side-facing hole].

SUBINTIMAL RE-ENTRY CATHETER AND RETROGRADE RECANALIZATION

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion. 1. A method of recanalizing a blood vessel having an occlusion therein , the method comprising:advancing a guidewire through a lumen of a blood vessel to a location proximal of a proximal end of an occlusion;directing a distal end of the guidewire radially outward from the lumen of the blood vessel into a subintimal space between a first tissue layer and a second tissue layer of a wall of the blood vessel to a location distal of a distal end of the occlusion;advancing a recanalization catheter over the guidewire into the subintimal space to a position in the subintimal space in which a distal portion of the recanalization catheter is located distal of the distal end of the occlusion;re-entering the lumen of the blood vessel distal of the distal end of the occlusion with a flexible tubular member of the recanalization catheter with the guidewire maintained in position within the subintimal space.2. The method of claim 1 , wherein the distal portion of the recanalization catheter includes a balloon.3. The method of claim 1 , wherein a distal end of the flexible tubular member is disposed distal of a proximal end of the balloon as the recanalization catheter is advanced over the guidewire.4. The method of claim 3 , wherein the distal end of the flexible tubular member extends from the catheter at a location proximal of the balloon.5. The method of claim 4 , wherein the distal end of the flexible tubular member extends exterior of ...

CATHETER APPARATUS FOR CRANIAL CAVITY

Disclosed herein is a catheter apparatus for cranial cavities which exhibits the advantage of a conventional catheter structure in that a medicine and a bodily fluid are transferred along different paths, uniformizes the outer diameter of a catheter to easily use stereotactic equipment, and facilitates tunneling of the rear end of the catheter in a bypass space between the skull and the skin, so as to allow an operation to be simply and easily performed and thus to increase safety in operation. The catheter apparatus is advantageous in that no protrusion is formed on the outer surface of the catheter and thus the end of the catheter may be easily and accurately located in a cerebral ventricle using the stereotactic equipment, the catheter may be easily bent through the bypass space, and the rear end of the catheter may be easily exposed to the outside through a perforated part. 1. A catheter apparatus for cranial cavities , comprising:a catheter including a drain pipe formed at the center thereof to drain a bodily fluid including a hematoma or a cerebrospinal fluid to the outside, a plurality of drain holes formed at the front end of the drain pipe, a medicine transfer pipe formed at a designated region at the outside of the drain pipe, the rear end of the medicine transfer pipe being closed with a finishing member so that, after the catheter is installed within a cerebral ventricle, a plastic pipe is inserted into a designated portion of the medicine transfer pipe so as to inject a medicine; anda binding member configured to fix the plastic pipe and an extension tube without separation under the condition that the extension tube is coupled with the plastic pipe.2. The catheter apparatus for cranial cavities according to claim 1 , wherein a hole is formed through a designated portion of the rear end of the medicine transfer pipe so that the plastic pipe may be inserted into the hole claim 1 , and a temporary closing packing is inserted into the hole so as to ...

RE-ENTRY STYLET FOR CATHETER

A stylet for re-entry into a vessel includes an elongate body including a proximal portion, a middle curved portion, a pointed distal end, and a longitudinal axis extending through the proximal portion, the middle curved portion, and the pointed distal end. The proximal portion and the middle curved portion have substantially circular cross-sections. The middle curved portion has a pre-shaped curve along the longitudinal axis configured to match a curve of an occlusion-crossing device. The pointed distal end has an s-curve along the longitudinal axis and a flattened portion along the longitudinal axis, the flattened portion having a substantially oblong cross-section. 1. A stylet for re-entry into a vessel comprising:an elongate body having a proximal portion, a middle curved portion, a pointed distal end, and a longitudinal axis extending through the proximal portion, the middle curved portion, and the pointed distal end;wherein the proximal portion and the middle curved portion have substantially circular cross-sections, and wherein the middle curved portion has a pre-shaped curve along the longitudinal axis configured to match a curve of an occlusion-crossing device; andwherein the pointed distal end has an s-curve along the longitudinal axis and a flattened portion along the longitudinal axis, the flattened portion having a substantially oblong cross-section.2. The stylet of claim 1 , wherein the s-curve is within the flattened portion.3. The stylet of claim 1 , wherein at least one of the distal end or the middle curved portion comprises nitinol.4. The stylet of claim 1 , wherein the proximal portion comprises stainless steel.5. The stylet of claim 1 , wherein the pre-shaped curve forms an angle of 130 to 170 degrees.6. The stylet of claim 5 , wherein the angle is approximately 150 degrees.7. The stylet of claim 1 , wherein the s-shaped curve has two curves claim 1 , the first curve forming a first angle of 120 to 160 degrees and the second curve forming an ...

CATHETER TUNNELER ADAPTER AND METHOD OF COUPLING THEREOF

A method of coupling a catheter tunneler adapter to a catheter is provided. The method includes providing a catheter having a lumen divider at a proximal end thereof; forming a receiving notch in the lumen divider by removing a center portion thereof such that two divider side portions remain; providing a catheter tunneler adapter having a distal end including a radially inward step which defines a contact surface configured to be received in the proximal end of the catheter; positioning the distal end of the catheter tunneler adapter within the catheter until the radially inward step engages the receiving notch; and securing the catheter tunneler adapter to the catheter. 1. A catheter tunneling adapter comprising: a longitudinal body having a distal end and a proximal end and a passageway extending from an entrance at the proximal end to an exit at the distal end , the passageway having a first hemisphere and a second hemisphere , with the first hemisphere defining a generally unobstructed first passageway portion from the entrance to the exit; and a guide ramp positioned within the second passageway and tapered towards the first hemisphere moving from the proximal end to the distal end , the ramp defining a longitudinal notch therethrough such that a second passageway portion extends from the entrance to the exit.2. The catheter tunneling adapter according to claim 1 , wherein the first passageway portion has a diameter greater than a width of the second passageway portion.3. The catheter tunneling adapter according to claim 1 , wherein the passageway entrance is configured to receive a portion of a syringe and a fluid expelled from the syringe passes through and exits both the first and second passageway portions at the distal end of the longitudinal body.4. The catheter tunneling adapter according to claim 1 , wherein the passageway entrance is configured to securably receive a distal end of a tunneler.5. The catheter tunneling adapter according to claim 1 , ...

Subintimal entry catheters and methods for occlusion crossing

A subintimal entry catheter can be used for crossing an occlusion in a blood vessel of a patient. The catheter can include a distal end portion and a lumen extending longitudinally within the catheter and radially to an opening in a first radial side at the distal end portion of the catheter. The catheter can be used to cross at least a portion of an occlusion through a subintimal space. A wire can be provided through the lumen and to the opening to reenter the true lumen of the blood vessel.

DRAINAGE DEVICES AND METHODS FOR USE

Devices and methods for draining excess lymph fluid are disclosed. The device can be fixed to the blood vessel adjacent to the thoracic duct. The device can have a port for withdrawing lymph fluid exiting the thoracic duct. The device can have a cannula and/or subcutaneous port to draw the lymph fluid away from the thoracic duct and reduce hemostatic pressure in the lymphatic system. 1. A method for reducing interstitial volume in a patient using a device comprising a tubular member , the method comprising:placing a distal end of the tubular member into a patient's venous system such that the distal end is located adjacent the thoracic duct;draining fluid from the lymphatic system via the thoracic duct through a lumen of the tubular member to reduce fluid volume within the patient's body; anddiscontinuing draining fluid when the fluid volume is sufficiently reduced.2. The method of in claim 1 , further comprising substantially isolating the thoracic duct from the venous system using the device such that flow from the thoracic duct is directed through the tubular member to drain fluid from the lymphatic system.3. The method of claim 1 , wherein the distal end of the tubular member is introduced into the venous system until the distal end is advanced into the thoracic duct.4. The method of claim 1 , further comprising applying negative pressure to the lumen to increase fluid flow from the thoracic duct through the cannula.5. The method of claim 1 , wherein the device comprises a subcutaneous access port coupled to the tubular member for accessing fluid drained through the tubular member.6. The method of claim 1 , wherein the device comprises one or more balloons on the tubular member claim 1 , the method further comprising inflating the one or more balloons to maintain the tubular member in a substantially fixed position relative to the thoracic duct.7. The method of claim 1 , wherein the device comprises a Nitinol frame claim 1 , the method comprising expanding the ...

APPARATUS AND METHOD FOR PROMOTING ANGIOGENESIS IN ISCHEMIC TISSUE

A biologics delivery device and method of use for promoting angiogenesis in occluded vessels and ischemic tissue of a patient are provided, wherein the biologics delivery device includes a catheter having a proximal end, a distal region having a distal end, and a side wall defining a catheter lumen; an expandable member disposed in the distal region, the expandable member configured to support a subintimal space in an occluded blood vessel of a patient, and to transition between a collapsed state and an expanded state; and a hollow needle having a penetration tip deployable from inside the catheter lumen to outside the catheter lumen, and into tissue surrounding the occluded blood vessel, wherein the expandable member in the expanded state allows the flow of oxygenated blood to the occluded blood vessel. Methods of using the inventive biologics delivery device also are provided to deposit the biologic from a subintimal space to tissue surrounding the occluded blood vessel. 1. A biologics delivery device for delivering a biologic to tissue surrounding an occluded blood vessel of a patient , comprising:a catheter having a proximal end, a distal region having a distal end, and a side wall defining a catheter lumen;an expandable member disposed in the distal region, the expandable member configured to support a space in the occluded blood vessel, and to transition between a collapsed state and an expanded state; anda hollow needle having a penetration tip deployable from inside the catheter lumen to outside the catheter lumen, through the expandable member, and into the tissue,wherein the expandable member in the expanded state allows the flow of oxygenated blood to the occluded blood vessel.2. The biologics delivery device of claim 1 , further comprising a side opening formed through the side wall and disposed on the distal region claim 1 , wherein the hollow needle is deployed through the side opening.3. The biologics delivery device of claim 2 , wherein the catheter ...

Soft tissue tunneling device

A tissue tunneling device is configured to be delivered within the body. The tunneling device includes a shaft with a blunt distal end to prevent coring or other damage to tissue during the delivery of the tunneling device. In some arrangements, the shaft includes one or more lumen, through which medication or another fluid may be administered. An anesthetic or other pain relieving medication may be delivered through the lumen to lessen the discomfort of delivering the tunneling device to the desired anatomical site. The shaft may also include a retractable needle for facilitating the advancement of the tunneling device through skin or other tissue. The shaft may also be provided with an outer sheath, which may be left within the anatomy after the tunneling device has been removed. The shaft may be malleable for custom-shaping the tunneling device prior to and/or during delivery.

Bypass catheter

An innovative medical device that permits rapid, minimally invasive restoration of blood flow across a vascular blockage. A system allowing for lysis or removal of said blockage. Said device creates a temporary bypass using longitudinal structure configured for insertion into the blood vessel and adapted to deliver a side hole to a target area. The side hole defines a distal first segment and a proximal second segment with a lumen to allow blood flow therethrough to the distal end hole. In an alternate embodiment, a slidable outer sheath can cover the side hole to permit reversal of blood flow from the distal end hole to a proximal end hole located outside a patient's body by means of an aspiration controller. Alternate embodiments include an optional anchoring balloon, a macerating stent or wires, perforations for fluid delivery, and an backflow valve.

一种颅脑引流管潜行置入装置

本发明公开了一种颅脑引流管潜行置入装置，包括相互配合的外锥和锥芯，所述外锥上设有从前端延伸到中后部的沟槽，所述沟槽与锥芯配合，形成对锥芯前段侧面的半包结构，所述外锥和锥芯的前端部共同配合的形成尖端，所述外锥在靠近前端的沟槽边缘设有翼板，当锥芯后撤脱离沟槽后，所述翼板用于配合变径扩大的沟槽卡合引流管的膨大末端，后撤外锥时能有效地、可靠地牵引着引流管沿皮下隧道后撤达到潜行目的，一次性形成隧道，一次性完成引流管潜行。通过锥芯和外锥形成的一端半包裹式结构，切口大小与构建的潜行隧道的直径大小相近,隧道的距离、方向可精准控制，避免了采用血管钳等建立引流管潜行时引起的头皮剥离无法真正建立皮下隧道的问题。

用于治疗下肢脉管系统的设备和方法

一种导管系统能够包括管状主体、以及被耦接到管状主体的靶向系统、可扩张构件或流体注入端口中的至少一个。一种识别分叉的方法能够包括将导管系统插入到第一脉管内，将所述导管系统定位在第一位置处，扩张可扩张构件以闭塞所述第一脉管，递送对比物质因此所述对比物质靠近所述可扩张构件汇集，以及在荧光检查下回顾所述第一脉管中的所述对比物质的形状。

Subintimal re-entry device

Methods and apparatus for crossing vascular occlusions

Methods and apparatus for crossing totally to substantially occluded blood vessels by passing a redirectable wire such as a guidewire from a relatively proximal point past the occlusion within a subintimal space formed between the intimal layer and the adventitial layer of a blood vessel wall. The wire may be advanced to a point distal to the occlusion, and thereafter deflected back into the blood vessel lumen, typically using a deflecting catheter which is advanced over the guidewire after it has been positioned within the subintimal space. The deflecting catheter may include a flapper valve assembly or preformed actuator wire for redirecting the guidewire. After the guidewire is returned to the blood vessel lumen, the deflecting catheter may be withdrawn, and the guidewire may be available for introduction of other interventional and diagnostic catheters for performing procedures such as stenting.

Guidewire for crossing occlusions or stenoses

A deflectable and torqueable hollow guidewire device is disclosed for removing occlusive material and passing through occlusions, stenosis, thrombus, plaque, calcified material, and other materials in a body lumen, such as a coronary artery. The hollow guidewire generally comprises an elongate, tubular guidewire body that has an axial lumen. A mechanically moving core element is positioned at or near a distal end of the tubular guidewire body and extends through the axial lumen. Actuation of the core element (e.g., oscillation, reciprocation, and/or rotation) creates a passage through the occlusive or stenotic material in the body lumen.

Expansible Shunt device and delivery system

公开了心脏分流器和递送方法，特别是一种用以降低升高的左心房压力(LAP)的分流器。该方法包括在左心房和冠状窦之间形成穿刺，扩大穿刺孔，并在扩大的穿刺内放置可扩张分流器。具有侧面延伸针的第一导管可用于形成进入左心房的穿刺。第二导管沿着导丝延伸，并且具有远侧和近侧法兰的可扩张分流器从其中被排出到穿刺中。分流器限定穿过其中的血流通道，当LAP升高时，该血流通道允许血液从左心房分流至冠状窦。分流器理想地是由超弹性材料形成并通过控制杆操纵。分流器限定便于塌缩到导管中的倾斜的流管。

Methods for bypassing total or near-total obstructions in arteries or other anatomical conduits

Methods for bypassing total or near-total obstructions in arteries or other anatomical conduits. A guidewire is advanced through the lumen of the artery or anatomical conduit upstream of the obstruction and past the obstruction. In navigating past the obstruction, this guidewire may advance through tissue that is located within the wall of the artery or anatomical conduit and/or through tissue that is located outside of the wall of the artery or anatomical conduit. After this guidewire has been advanced past the obstruction, a penetrating catheter that is equipped with an orientation element is advanced over that guidewire. The orientation element is then used to aim a penetrator back into the lumen of the obstructed artery or conduit, downstream of the obstruction. The penetrator is then advanced into the lumen of the obstructed artery or conduit, downstream of the obstruction, and a final guidewire is advanced through the penetrator and into the lumen of the artery or conduit downstream of the obstruction. The catheter (and the guidewire that was initially used to pass the obstruction) may then be removed, leaving the final guidewire in place. A balloon or other tract enlarging device may be used to dilate or otherwise enlarge the bypass tract through which the final guidewire extends. Also, a covered or uncovered stent may be placed within the tract to facilitate flow from the lumen of the artery or anatomical conduit upstream of the obstruction, through the newly created bypass tract and back into the lumen of the artery or anatomical conduit downstream of the obstruction.

Vascular reinsertion catheter

Devices and methods for treating lower extremity vasculature

A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

Occlusal bypass device and method with variable flexibility for bypassing an intravascular occlusion

Subintimal re-entry catheter with shape controlled balloon

A recanalization catheter for facilitating re-entry into a lumen of a blood vessel from a subintimal space. The catheter includes an inflatable balloon mounted on a distal end region of the catheter shaft of the catheter. The catheter shaft includes a guidewire lumen having a distal opening and a lateral opening in a distal region of the catheter shaft proximal of the distal opening, and an inflation lumen in fluid communication with the balloon. The balloon is configured to be inflated in the subintimal space to a first inflation state at inflation pressures below a threshold inflation pressure to orient the lateral opening toward the lumen of the blood vessel, and inflated to a second inflation state at inflation pressures above the threshold inflation pressure. The catheter includes means for retaining the balloon in the first inflation state at pressures below the threshold inflation pressure.

Systems, devices and methods for treating blood vessel

本发明公开了治疗至少部分由闭塞阻塞的血管的系统(400)，该闭塞将腔分成近侧腔段和远侧腔段。系统包括定向导管(200)和闭塞导管(300)，定向导管具有可定位在血管的壁内空间中的定向元件(204)，闭塞导管具有可在近侧腔段中膨胀以隔离目标体积的闭塞球囊(302)，目标体积包括壁内空间。目标体积内的压力降低至低于远侧腔段的压力，使得内膜压在定向导管的定向元件上。再进入装置的远端可前进从定向导管穿过内膜并进入到远侧腔段中。

Apparatus and method for dissecting and retracting elongate structures

A dissector/retractor device comprising a balloon having a deflated state and an inflated state is described for performing minimally invasive surgical procedures by creating a tunnel alongside a target tissue in the body. The balloon in its inflated state forms an open space extending transversely through the balloon. The balloon is carried by an insertion assembly. The balloon may be an elongate torus shape with an elongate open area in its interior. The insertion assembly includes a blunt dissection device and a handle. In use, the dissector retractor is inserted through a small incision and bluntly tunneled through body tissue to a desired location. The balloon is inflated to create a space in the body tissue and may also dissect tissue as necessary away from the tissue to be treated. The balloon is left in place inflated to retract the space. Another incision may be made to provide more direct access to the target tissue than the original incision. The target tissue may then be diagnosed and/or treated through the direct access incision, through the overlying tissue and through the open space in the balloon.

Catheter systems for crossing total occlusions in vasculature

Medical devices and methods are described that include catheter systems for use in vasculature. The catheter systems include a re-entry catheter for use with numerous guide wires to direct the guide wire from the extraluminal or subintimal space back into a true lumen after the guide wire has entered the subintimal space. An example of the re-entry catheter is a single lumen catheter configured to facilitate placement and positioning of guide wires and catheters within vasculature. An embodiment places and positions guide wires and catheters within peripheral vasculature. More specifically, the re-entry catheter provides for re-entry of a guide wire back into the true lumen of peripheral vasculature from a subintimal space.

Stent delivery system and method of use

Described herein are various methods and apparatuses for delivering stents and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the insertion site is provided within the catheter or a balloon mounted on the catheter so that a guidewire may be directed through a lumen and out the exit port into the myocardium. Once the guidewire punctures into the myocardium, the guidewire is anchored using barbs, balloons or other actuatable members to secure the guidewire to the myocardium. Subsequently, using a push-pull mechanism, stents and other medical devices can be advanced over the guidewire into the myocardium.

Systems, apparatus and methods for treating blood vessels

A system and method for treating a blood vessel that is at least partially obstructed by an occlusion which divides the lumen into a proximal lumen segment and a distal lumen segment. The system includes an orienting catheter having an orientation element positionable in an intrawall space of the vessel and an occlusion catheter having an occlusion balloon inflatable in the proximal lumen segment so as to isolate a target volume including the intrawall space. The pressure inside the target volume is reduced to a pressure below the pressure of the distal lumen segment so that the intima presses against the orienting element of the orienting catheter. A distal end of a reentry device may be advanced from the orienting catheter through the intima and into the distal lumen segment.

Device and method for traversing a chronic total occlusion

Methods and devices for percutanaeos implantation of an arterio-venous graft

METHODS AND DEVICES FOR PERCUTANAEOS IMPLANTATION OF AN ARTERIO-VENOUS GRAFT Methods, devices, and kits for implanting a vascular graft to perform hemodialysis treatments on patients with renal failure are disclosed. The kits can include access devices comprised of an access catheter (42) having a guidewire lumen (46) and stylet lumen (50), a guide tube (60) having a curved distal end, a stylet (58), an actuator handle (44) and a vascular graft (80). The methods describe techniques for using the described kits and devices for performing vascular procedures, such as percutaneous implantation of the vascular graft (80). 12 _H 42' 18 24 60' 42' 53' 22 51'" 44' 10 30' 17 ---- 42 4 Qn FIG. RA

Wire-guided recanalization system

A recanalization catheter assembly for recanalization of an occluded blood vessel is disclosed. The recanalization catheter assembly includes an elongate shaft having a tubular portion, a guide member, and a rotary ablation tool. The tubular portion includes a distal opening, from where the rotary ablation tool extends distally. The guide member extends distal of the distal opening and includes a guidewire lumen to receive a guidewire therethrough. The guide member is configured to advance over the guidewire in a subintimal space between a first tissue layer and a second tissue layer of a wall of the blood vessel, while the rotary ablation tool is advanced in a true lumen of the blood vessel.

Catheter system for traversing a complete occlusion within a vascular structure

Delivery methods for left ventricular conduit

Described herein are various methods and apparatuses for delivering stents or conduits and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the insertion site is provided within the catheter or a balloon mounted on the catheter so that a guidewire may be directed through a lumen and out the exit port into the myocardium. Once the guidewire punctures into the myocardium, the guidewire is anchored using barbs, balloons or other actuatable members to secure the guidewire to the myocardium. Subsequently, using a push-pull mechanism, stents and other medical devices can be advanced over the guidewire into the myocardium.

Devices for treating lower extremity vasculature

Devices and methods for advancing a wire

Occlusion bypassing apparatus with a re-entry needle and a distal stabilization balloon

An occlusion bypassing apparatus 100 for re-entering the true lumen of a vessel includes an outer shaft component 102, a needle component 134, and an inflatable balloon 122. The outer shaft component has a side port proximal to a distal end thereof and a needle lumen there-through that includes a curved distal portion that terminates at the side port of the outer shaft component. The needle component is configured to be slidably disposed within the needle lumen of the outer shaft component. The inflatable balloon includes a body portion that is disposed distal to the side port of the outer shaft component, and the body portion of the balloon has a flattened profile in an inflated state with first and second chambers that laterally extend from opposing sides of the outer shaft component for stabilizing the apparatus within a subintimal space.

Stent delivery system and method of use

Described herein are various methods and apparatuses for delivering stents and other devices into the myocardium of a patient. One preferred stent delivery system provides access to the insertion site in the myocardium by advancing a delivery catheter through a blockage in a coronary artery, or around the blockage through a coronary vein or through a channel or tunnel formed around the blockage. In one embodiment, once the distal end of the delivery catheter is adjacent the myocardium, an angled bend is created in the catheter by actuating expandable steering guides mounted to the catheter which cooperate with the walls of the blood vessel to cause the catheter to turn. Then, a guidewire is advanced through the delivery catheter and into the myocardium. In another embodiment, a tip-deflecting pull wire extends from the distal end of the delivery catheter which may be actuated to turn towards and then inserted into the myocardium. In another embodiment, an exit port facing the insertion site is provided within the catheter or a balloon mounted on the catheter so that a guidewire may be directed through a lumen and out the exit port into the myocardium. Once the guidewire punctures into the myocardium, the guidewire is anchored using barbs, balloons or other actuatable members to secure the guidewire to the myocardium. Subsequently, using a push-pull mechanism, stents and other medical devices can be advanced over the guidewire into the myocardium.

Catheter deployment device

An apparatus for deploying a needle within a lumen is provided. The apparatus includes a housing having a threaded bushing radially disposed therein. The bushing rigidly couples with a nose cone having a guide tip disposed at an end opposite the bushing for penetrating an arterial wall of a lumen. During operation, a user incrementally advances the bushing within the housing, thereby incrementally advancing the guide tip into the lumen. The nose cone also includes a flex guide having a slot configuration which couples with the guide tip which deploys into the lumen along with the guide tip.

Air-flow portable type guide device of endotracheal tube

气流携带式气管插管引导器，属于医疗器械技术领域，包括气球和引导索，所述引导索包括充气袋和充气管；所述气球的直径为0.3cm，气球的一端与充气袋的前端连接；所述充气袋充气后为圆柱形气袋，圆柱形气袋的长度为70cm、外直径为0.3cm，充气袋的前端内壁设置有放射性物质粉尘，充气袋的末端与充气管连接；所述充气管的长为10cm、外直径为0.2cm，充气管的末端设置有充气阀门；所述充气阀门为弹性橡胶柱，弹性橡胶柱长为0.5cm、外直径为0.3cm。本发明置入安全、有效、快速，且操作简单，费用低。

Method and device for lymphedema treatment

Catheter systems for crossing total occlusions in vasculature

描述了包括用于脉管系统的导管系统的医疗装置和方法。导管系统包括用于与许多导线一起使用的再进入式导管，在导线已经进入内膜下间隙后，所述的导管系统指导导线从腔外或内膜下间隙再进入真腔中。再进入式导管的实例是被构造成用于方便导线和导管进入并定位于脉管系统中的单个管腔导管。一个实施方案将导线和导管放置和定位于周围脉管系统中。更具体地说，再进入式导管使得导线从内膜下间隙再进入周围脉管系统的真腔中。

Systems, apparatus and methods for treating blood vessels

A system and method for treating a blood vessel that is at least partially obstructed by an occlusion which divides the lumen into a proximal lumen segment and a distal lumen segment. The system includes an orienting catheter having an orientation element positionable in an intrawall space of the vessel and an occlusion catheter having an occlusion balloon inflatable in the proximal lumen segment so as to isolate a target volume including the intrawall space. The pressure inside the target volume is reduced to a pressure below the pressure of the distal lumen segment so that the intima presses against the orienting element of the orienting catheter. A distal end of a reentry device may be advanced from the orienting catheter through the intima and into the distal lumen segment.

Reentry catheter

Quick-insertable central catheter insertion system and insertion assembly

本申请涉及可快速插入的中心导管插入系统和插入组件。例如，可快速插入的中心导管(“RICC”)系统可以包括导引器和RICC插入组件，该RICC插入组件包括布置在RICC插入装置中的RICC组件。RICC组件可以包括RICC，进入导丝，以及在RICC的导管管材和进入导丝上方的可分离外壳，形成纵向复合物。RICC插入装置可以包括框架和前端盖，以形成分离通道，该分离通道远离框架前端的贯穿通道进行分离。RICC插入装置可配置用于通过使纵向复合物在布置在框架中的滚轮上滚动来推进RICC组件。贯穿通道可配置用于推进导管管材穿过其中，而分离通道可配置用于分离可分离外壳并使其穿过分离通道。

Systems and methods for percutaneous occlusion crossing

本发明提供用于对血管的全闭塞或接近全闭塞进行穿通或旁通的方法和装置，其借助使用细长构件和特定导管，这些特定导管包括穿刺导管、再进入导管、多腔再进入导管、及其组合。穿刺导管包括用来在穿通程序中刺穿闭塞的远侧末端，且可构造成对闭塞进行微解剖或为细长构件提供支承。再进入导管包括远侧侧端口和斜坡以有利于再进入血管壁或对血管壁进行穿孔。多腔再进入导管包括可撕裂的内腔分隔件以及远侧侧端口和斜坡。

Method and device for lymphedema treatment

Materials and methods are provided to direct the formation of new lymphatics and to reconnect the disrupted lymphatic network. These materials and methods enable to improve survival of lymph nodes and lymph node fragments and their integration into a lymphatic network, following lymph node and lymph node fragments transplantation. The treatment or prevention of lymphedema is also addressed. In certain embodiments, a bundle of fibers or fibrils presented in the composition is effective to stimulate and direct the formation of new lymphatic and blood vessels. The bundle of fibers or fibrils presented in the composition is effective to promote survival of the lymph node or lymph node fragments and integration of the lymph node or lymph node fragments into a lymphatic network in the mammalian subject, at the site of transfer or transplantation.

Vascular re-entry catheter

A catheter device having a distal tube portion having a longitudinal axis and a tube wall comprising at least one side port; and a guide tip mounted on the distal tube portion, the guide tip defining: a unitary body having an outer wall, and a plurality of indentations in the outer wall, wherein the indentations are oriented substantially parallel to the longitudinal axis, and wherein each indentation extends from a distal-most end of the guide tip to a proximal region of the guide tip.

Expandable cardiac shunt

Disclosed are cardiac shunts and method of delivery, and in particular, to a shunt to reduce elevated left atrial pressure (LAP). The methods include forming a puncture hole between the left atrium and the coronary sinus, widening the puncture hole, and placing an expandable shunt within the widened puncture hole. A first catheter having a side-extending needle may be used to form a puncture into the left atrium. A second catheter extends along a guidewire and an expandable shunt with distal and proximal flanges is expelled therefrom into the puncture. The shunt defines a blood flow passage therethrough that permits shunting of blood from the left atrium to the coronary sinus when the LAP is elevated. The shunt is desirable formed of a super-elastic material and manipulated with control rods. The shunt defines a tilted flow tube that facilitates collapse into the catheter.

Reentry catheters for traversing chronic total occlusions

A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.

Methods and devices for crossing chronic total occlusions

The present disclosure is directed to a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method may include providing an intravascular device having a distal portion and a longitudinal axis and inserting the intravascular device into the vascular lumen. The method may further include positioning the distal portion in the vascular wall, rotating the intravascular device about the longitudinal axis, and advancing the intravascular device within the vascular wall.

System for treating blood vessels

本公开涉及一种用于处理血管的系统。所述系统可包括轴组件（202），该轴组件（202）包括定向元件（204）。所述系统还可包括延伸入轴管腔中的重入装置（100）。所述重入装置可包括芯线（104），所述芯线（104）配置为使得在绕设计弯曲半径进行弯曲期间在所述芯线中产生的弯曲应力小于所述芯线的弹性极限，从而使所述芯线在释放时将从弯曲状态弹性恢复。