Abstract: Devices and methods are disclosed for widening a channel in a treatment site, the channel containing a guide-wire. The channel is widened by advancing an elongated dilation device, which is configured to fit tightly over the guide-wire at the distal tip of the dilation device and to provide a distal dilating surface, over the guide-wire and at least partially through the treatment site. The dilation device comprises a tubular metallic shaft, typically a metal inner tube, for providing sufficient stiffness and column strength for the dilator to be advanced at least partially through the channel, and a flexible sleeve providing a tapered distal tip. The distal end of the dilator defines a leading surface that is shaped to force away portions of a lesion surrounding the guide-wire away from the guide-wire as the distal end is advanced over the guide-wire through the lesion, whereby a channel through the lesion is at least partially dilated.

Abstract: Described herein is a method for creating a channel through a foreign material located in a body of a patient. The foreign material defines a material first surface and a substantially opposed material second surface and the channel extends through the foreign material between the material first and second surfaces. The method uses an apparatus including an electrode, and includes the steps of: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel. In some embodiments, the patient's body includes a heart defining a septum, the septum defines an aperture extending there-through and the foreign material extends across the aperture to cover the aperture.

Abstract: Described herein is a method for creating a channel through a foreign material located in a septum of a heart at the site of a septal defect. The foreign material defines a material first surface and a substantially opposed material second surface, and the channel extends through the foreign material at least partially between the material first and second surfaces. The method uses an apparatus including an electrode and includes the steps of: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel.

Abstract: A radiofrequency perforation apparatus for creating a channel at a target location in a body of a patient, the radiofrequency perforation apparatus comprising: a substantially tubular member defining a tubular member lumen; an end member partially positioned within the tubular member lumen at a distal end of the tubular member, the end member including an electrode; and an electrical insulator extending along the substantially tubular member.

Abstract: A method and apparatus are disclosed for a medical device, including a means for enhancing visibility under imaging which, while reducing the local mechanical strength, avoids compromising the overall device effectiveness or safety. Visibility under imaging is increased by a non-uniform distribution of visibility-enhancing features as a function of the local stresses expected during use. One embodiment is for a medical device comprising an elongate member having proximal and distal regions, wherein the distal region comprises: a first echogenic region including a plurality of circumferential first region cuts, each of the first region cuts having a first region cut volume; and a second echogenic region, distal of the first echogenic region, including a plurality of circumferential second region cuts, wherein each of the second region cuts has a second region cut volume greater than said first region cut volume.

Abstract: A method is disclosed for creating a channel through an occlusion located in a vein that drains the central nervous system of a patient. The method utilizes a channel creating apparatus, including an energy delivery component operatively coupled to a distal end portion of the channel creating apparatus, to create a channel through the occlusion by delivering energy using the energy delivery component, in order to substantially increase blood flow through said vein to treat chronic cerebrospinal venous insufficiency (CCSVI).

Abstract: A method for creating a channel through a foreign material located in a body of a patient, the foreign material defining a material first surface and a substantially opposed material second surface, the channel extending through the foreign material between the material first and second surfaces, the method using an apparatus including an electrode, the method comprising: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel, wherein the foreign material is included in a stent graft.

Abstract: A method of accessing a pericardial cavity of a heart is disclosed, comprising delivering electrical energy to a pericardium in a manner which creates a channel substantially through a parietal pericardium and does not substantially affect myocardial tissue.

Abstract: A radiofrequency perforation apparatus for creating a channel at a target location in a body of a patient, the radiofrequency perforation apparatus being usable by an intended user having a hand, the radiofrequency perforation apparatus comprising: a handle graspable by the hand; a distal portion, the distal portion defining a distal portion length, the distal portion including an electrode and an electrical insulator extending from the electrode; and a force transmitting portion extending between the distal portion and the handle, the force transmitting portion defining a force transmitting portion length, the force transmitting portion length being larger than the distal portion length, the force transmitting portion having a force transmitting portion flexural rigidity of at least about 0.

Abstract: An energy delivery apparatus for delivering electrical energy at a target location, the energy delivery apparatus being usable in combination with a magnetic field. The energy delivery apparatus includes an electrical conductor, the electrical conductor having a substantially elongated configuration; an electrode for delivering the electrical energy at the target location, the electrode being electrically coupled to the electrical conductor and located at a predetermined location therealong; and a guiding element mounted to the electrical conductor in a substantially spaced apart relationship relative to the electrode, the guiding element including a magnetically responsive material. The energy delivery apparatus is constructed such that a movement of the guiding element causes a corresponding movement of the electrode. The magnetic field is used to move the guiding element in order to position the electrode substantially adjacent to the target location.

Abstract: A method for creating a channel through a foreign material located in a body of a patient, the foreign material defining a material first surface and a substantially opposed material second surface, the channel extending through the foreign material between the material first and second surfaces, the method using an apparatus including a substantially elongated member defining a proximal end region and a substantially longitudinally opposed distal end region, the apparatus including an electrode located about the distal end region, the method comprising: introducing the distal end region into the body of the patient; positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel.

Abstract: A method of surgical perforation via the delivery of electrical, radiant or thermal energy comprising the steps of: introducing an apparatus comprising an energy delivery device into a patient's heart via the patient's superior vena cava; positioning the energy delivery device at a first location adjacent material to be perforated; and perforating the material by delivering energy via the energy delivery device; wherein the energy is selected from the group consisting of electrical energy, radiant energy and thermal energy.