Abstract: Assemblies and methods for delivering an implant to a patient are disclosed. A delivery assembly can comprise an elongate tube, an outer magnetic member, and an inner magnetic member. The elongate tube extends from a proximal end portion to a distal end portion and defines a delivery lumen. The outer magnetic member can be movable along an outer surface of the tube; the inner magnetic member can be positioned within the delivery lumen and magnetically coupled to the outer magnetic member through a sidewall of the tube. The inner magnetic member can be movable through the delivery lumen when actuated by relative movement between the outer magnetic member and the tube. The delivery assembly can further comprise a syringe or an inflator/deflator couplable to a hub at the proximal end portion of the tube. The syringe or inflator/deflator can be used to urge fluid against a proximal end portion of the inner magnetic member.

Abstract: This patent document discloses methods for facilitating revascularization of an occlusion in a blood vessel. A method can include engaging a first guide within a vessel wall adjacent to a distal cap of the occlusion and advancing the first guide, in a retrograde direction, to a subintimal position near a proximal cap of the occlusion. A second guide can be engaged within the proximal cap or the vessel wall adjacent to the proximal cap and advanced, in an antegrade direction, until its distal end is near or axially overlaps a distal end of the first guide. A first vessel lumen, formed by advancement of the first guide, and a second vessel lumen, formed by advancement of the second guide, can be connected by inflating a balloon positioned at or near the distal end of the second guide.

Abstract: Catheters and related methods for supporting a guidewire or delivering an agent through a vessel stenosis or other tortuous anatomy are disclosed. A catheter can comprise an elongate shaft body and a polymer tip member disposed at a distal end of the shaft body. The shaft body and the tip member can include a liner, one or both of a braid member or a coil member surrounding the liner, and a polymer cover surrounding the braid member or the coil member. The tip member can further include one or more filaments extending from a position overlapping, underlapping, or abutting a distal end of the braid member or the coil member on their proximal ends to a position distal to the braid member or the coil member on their distal ends. The one or more filaments can include a plurality of filaments arranged in a series of contacting helical windings about the liner, the braid member, or the coil member.

Abstract: Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes.

Abstract: Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes.

Abstract: This patent document discloses assemblies, alignment devices and methods for creating a bi-directional path through an occlusion. An alignment device can include a positioning member and a tubular member. The tubular member can be coupled with a distal end portion of the positioning member and can include proximal and distal progressive size-changing shapes separated by a narrow neck passageway. An assembly can include the alignment device, a guide catheter having a lumen in which the alignment device is at least partially positioned, a guidewire, and a specialty catheter for supporting the guidewire. The alignment device and the guide catheter can be advanced in an antegrade direction to a proximal end of the occlusion, and the guidewire and the specialty catheter can be advanced in a retrograde direction to a distal end of the occlusion. The guidewire and the specialty catheter can be manipulated through the occlusion and into the distal end of the tubular member.

Abstract: This patent document discloses perfusion catheters and related methods for treating complications related to CTO interventions or dilating a vessel occlusion while maintaining a passage through the treated vessel segment. A perfusion catheter can include a balloon formed of an inflatable tube and an elongate shaft having a lumen for providing inflation fluid to, or withdrawing inflation fluid from, the balloon. The inflatable tube can be coiled in a helical manner around a central axis into a series of windings. Adjacent windings can be stacked against and bonded to each other, and an inner surface of the series of windings, when inflated, can define the passage. The elongate shaft can be eccentrically attached to a proximal portion of the balloon and the shaft's lumen can be in fluid communication with the interior of the balloon, specifically the inflatable tube. The inflatable tube can include two different polymer tubes, one slightly smaller than the other.

Abstract: Percutaneous devices and methods for releasably engaging a guidewire against an inner surface of a tubular member are disclosed. A percutaneous device can include a tube member, a push member, and a fixation mechanism such as a fixation balloon. The tube member can define a lumen sized and shaped to receive one or more interventional medical devices therethrough and can have an outer diameter smaller than a lumen of a guide catheter. The push member can be attached at least to a proximal end portion of the tube member for slidably positioning a distal end portion of the tube member within and beyond a distal end of the guide catheter. The push member can include a lumen in fluid communication with an interior of the fixation balloon for delivering inflation fluid to, or removing fluid from, the balloon. The fixation balloon can be positioned on a portion of the push member and can be configured to engage a guidewire against the inner surface of the guide catheter or the tube member when inflated.

Abstract: Assemblies and methods for delivering an implant to a patient are disclosed. A delivery assembly can comprise an elongate tube, an outer magnetic member, and an inner magnetic member. The elongate tube extends from a proximal end portion to a distal end portion and defines a delivery lumen. The outer magnetic member can be movable along an outer surface of the tube; the inner magnetic member can be positioned within the delivery lumen and magnetically coupled to the outer magnetic member through a sidewall of the tube. The inner magnetic member can be movable through the delivery lumen when actuated by relative movement between the outer magnetic member and the tube. The delivery assembly can further comprise a syringe or an inflator/deflator couplable to a hub at the proximal end portion of the tube. The syringe or inflator/deflator can be used to urge fluid against a proximal end portion of the inner magnetic member.

Abstract: This patent document discloses assemblies and methods for removing obstructive material from a body vessel or other cavity. An assembly can include an elongate inner member, an elongate outer member, an aspirator, one or more valves, or a waste collection reservoir. Each of the elongate members can extend from a proximal end portion to a distal end portion and can include a lumen therethrough. The elongate inner member can be partially disposed in the lumen of the elongate outer member and can be moveable along its longitudinal axis relative to the elongate outer member. The aspirator can be in flow communication with the proximal end portion of the elongate inner member for drawing the obstructive material into or through its lumen. The one or more valves can be configured and positioned to allow obstructive material removed from the body vessel or cavity to be urged toward the waste collection reservoir.

Abstract: Closure systems, kits and methods for sealing a percutaneous puncture or other opening in a blood vessel wall, body cavity or biopsy tract are disclosed. A closure system can comprise an implant assembly, a delivery assembly, and an introducer sheath. The closure system can further comprise a valve bypass and a dilator. The implant assembly can include an inner member, a sealing membrane, and an outer member, each of which can be delivered by the delivery assembly. The inner member can be extended through the puncture or opening and positioned adjacent an inner tissue surface. The outer member can be positioned adjacent an outer tissue surface. The sealing membrane can have a distal end attached to the inner member, a proximal end including an opening configured to receive the outer member, and a mid-region therebetween.

Abstract: This patent document discloses assemblies and methods for removing obstructive material from a body vessel or other cavity. An assembly can include an elongate inner member, an elongate outer member, an aspirator, one or more valves, and a waste collection reservoir. Each of the elongate members can extend from a proximal end portion to a distal end portion and can include a lumen therethrough. The elongate inner member can be partially disposed in the lumen of the elongate outer member and can be moveable along its longitudinal axis relative to the elongate outer member. The aspirator can be in flow communication with the proximal end portion of the elongate inner member for drawing the obstructive material into or through its lumen. The one or more valves can be configured and positioned to allow obstructive material removed from the body vessel or cavity to be urged toward the waste collection reservoir.

Abstract: Catheters and related methods for supporting a guidewire or delivering an agent through a vessel stenosis or other tortuous anatomy are disclosed. A catheter can comprise an elongate shaft body and a polymer tip member disposed at a distal end of the shaft body. The shaft body and the tip member can include a liner, one or both of a braid member or a coil member surrounding the liner, and a polymer cover surrounding the braid member or the coil member. The tip member can further include one or more filaments extending from a position overlapping, underlapping, or abutting a distal end of the braid member or the coil member on their proximal ends to a position distal to the braid member or the coil member on their distal ends. The one or more filaments can include a plurality of filaments arranged in a series of contacting helical windings about the liner, the braid member, or the coil member.

Abstract: This patent document discloses perfusion catheters and related methods for treating complications related to CTO interventions or dilating a vessel occlusion while maintaining a passage through the treated vessel segment. A perfusion catheter can include a balloon formed of an inflatable tube and an elongate shaft having a lumen for providing inflation fluid to, or withdrawing inflation fluid from, the balloon. The inflatable tube can be coiled in a helical manner around a central axis into a series of windings. Adjacent windings can be stacked against and bonded to each other, and an inner surface of the series of windings, when inflated, can define the passage. The elongate shaft can be eccentrically attached to a proximal portion of the balloon and the shaft's lumen can be in fluid communication with the interior of the balloon, specifically the inflatable tube. The inflatable tube can include two different polymer tubes, one slightly smaller than the other.

Abstract: This patent document discloses assemblies and methods for removing obstructive material from a body vessel or other cavity. An assembly can include an elongate inner member, an elongate outer member, an aspirator, one or more valves, and a waste collection reservoir. Each of the elongate members can extend from a proximal end portion to a distal end portion and can include a lumen therethrough. The elongate inner member can be partially disposed in the lumen of the elongate outer member and can be moveable along its longitudinal axis relative to the elongate outer member. The aspirator can be in flow communication with the proximal end portion of the elongate inner member for drawing the obstructive material into or through its lumen. The one or more valves can be configured and positioned to allow obstructive material removed from the body vessel or cavity to be urged toward the waste collection reservoir.

Abstract: 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, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall to at least partially surround the occlusion, and removing at least a portion of the surrounded occlusion from the lumen.

Abstract: 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 lumen extending therein; inserting the device into the vascular lumen; positioning the distal portion in the vascular wall; and directing the distal portion within the vascular wall.

Abstract: 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 inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a re-entry device, and re-entering the true vascular lumen.

Abstract: 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.

Abstract: 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.