Abstract: Off-axis visualization systems are described herein which facilitate the deployment, visualization, and retraction of an imaging element from a catheter. Such a system may include a deployment catheter and an attached imaging hood deployable into an expanded configuration as well as an imaging element, such as a CCD or CMOS imager, which may be deployed from a low profile configuration into a position which is off-axis relative to a longitudinal axis of the deployment catheter and/or imaging hood.

Abstract: Devices and methods for treating rhinitis are provided. An integrated therapy and imaging device is provided for single handheld use. The device may have a hollow elongated cannula, a therapeutic element coupled to a distal portion of the cannula, an imaging assembly coupled to the cannula to provide visualization of the therapeutic element, and an articulating region operably coupled to the imaging assembly to articulate the imaging assembly. The imaging assembly may be articulated so as to translate vertically, laterally, axially, and/or rotationally.

Abstract: A direct vision cryosurgical and methods of use are described herein where the device may generally comprise an elongated rigid structure with a distal end, a proximal end, and a central lumen. The distal end may comprise a non-coring optically transparent needle tip with at least one lateral fenestration in communication with the central lumen. The distal end may also house at least one imaging device configured for distal imaging. A proximal end of the device may comprise a handle with a means for connecting the imaging device(s) to an imaging display(s), and a means for accessing bodily tissue in the vicinity of the distal end with a cryo-ablation probe through the central lumen and the lateral fenestration(s) for diagnostic or therapeutic purposes.

Abstract: A system for visualizing a tissue region of interest comprises a deployment catheter defining a lumen and a hood coupled to and extending distally from the deployment catheter. The hood has a low-profile configuration within a delivery sheath and a deployed configuration when extended distally of the delivery sheath. The hood in the deployed configuration defines an open area in fluid communication with the lumen. A distal portion of the deployment catheter extends into the open area. An imaging element is coupled to an imager support member. When in the deployed configuration, the imaging element is configured to extend distally of the distal portion while the imager support member extends within the deployment catheter. The imaging element comprises a tapered surface and the deployment catheter comprises a complementary tapered surface. Retraction of the imaging element causes the imaging element to shift radially outward from a longitudinal axis.

Abstract: A system may comprise a first catheter having a first steerable segment and a second catheter disposed within the first catheter. The second catheter may have a second steerable segment. The system may also comprise an imaging element supported at a distal end of the second catheter, a coil reference sensor supported at a distal portion of the second catheter, and a processor in electrical communication with the coil reference sensor. The processor may be configured to determine a position of a distal portion of the first catheter with reference to the coil reference sensor.

Abstract: Described herein are methods and apparatuses for detecting an obstructive material within a lumen of an aspiration catheter using one or more sensors with the lumen of the suction catheter to prevent excess blood loss and improve operation of the apparatus.

Abstract: Described here are methods and apparatuses for tracking a clot material within a lumen of a suction catheter. For example, an apparatus as described herein may include a flexible elongate body having a suction lumen, a first pair of electrodes within the suction lumen, a second pair of electrodes proximal to the first pair of electrodes, and a controller configured to track a clot material within the suction lumen based on signals from the first pair of electrodes and the second pair of electrodes.

Abstract: Apparatuses and methods for distinguishing a blood clot from a vessel wall. These methods and apparatuses may include an aspiration opening into a suction lumen, an aspiration opening sensor(s) positioned at a rim of the aspiration opening, and a controller that interprets signals from the aspiration opening sensor(s) to determine when the aspiration opening is contacting a clot material or a vessel when a force is applied.

Abstract: A manipulation assembly comprises: a delivery catheter having a lumen extending therethrough; and a deployment catheter positioned within the lumen of the delivery catheter. The delivery catheter is manipulatable within multiple planes. The deployment catheter is independently manipulatable with respect to the delivery catheter and includes a first lumen and a second lumen. The assembly further comprises an elongate, flexible visualization element positioned within the first lumen of the deployment catheter and extendable distally beyond the delivery catheter. The visualization element is articulatable with respect to the delivery catheter. The assembly further comprises an ablation probe positioned within the second lumen of the deployment catheter and comprises an illumination tool routed through the deployment catheter. The ablation probe is extendable distally beyond the deployment catheter and is positionable off-axis with respect to a longitudinal axis of the delivery catheter.

Abstract: Electrophysiology mapping and visualization systems are described herein where such devices may be used to visualize tissue regions as well as map the electrophysiological activity of the tissue. Such a system may include a deployment catheter and an attached hood deployable into an expanded configuration. In use, the imaging hood is placed against or adjacent to a region of tissue to be imaged in a body lumen that is normally filled with an opaque bodily fluid such as blood. A translucent or transparent fluid, such as saline, can be pumped into the imaging hood until the fluid displaces any blood, thereby leaving a clear region of tissue to be imaged via an imaging element in the deployment catheter. A position of the catheter and/or hood may be tracked and the hood may also be used to detect the electrophysiological activity of the visualized tissue for mapping.

Abstract: A medical manipulation assembly includes a catheter and distal and proximal steering mechanisms. The catheter includes distal and proximal steerable portions with working channels configured to receive an instrument. The distal steering mechanism is operable to bend the distal steerable portion in a first plane relative to the proximal steerable portion in response to movement of a first portion of the distal steering mechanism about a first axis of rotation and to bend the distal steerable portion in a second plane relative to the proximal steerable portion in response to movement of a second portion of the distal steering mechanism about a second axis of rotation. The proximal steering mechanism is operable to bend the proximal steerable portion by rotational movement of the proximal steering mechanism. Distal pullwires extend between the distal steerable portion and steering mechanism and proximal pullwires extend between the proximal steerable portion and steering mechanism.

Abstract: Devices and methods for treating conditions such as rhinitis are disclosed herein where a distal end of a probe shaft is introduced through the nasal cavity where the distal end has an end effector with a first configuration having a low-profile which is shaped to manipulate tissue within the nasal cavity. The distal end may be positioned into proximity of a nasal tissue region having at least one nasal nerve. Once suitably positioned, the distal end may be reconfigured from the first configuration to a second configuration which is shaped to contact and follow the nasal tissue region and the at least one nasal nerve may then be ablated via the distal end. Ablation may be performed using various mechanisms, such as cryotherapy, and optionally under direct visualization.

Abstract: A manipulation assembly includes a delivery catheter having a lumen extending therethrough and a deployment catheter positioned within the delivery catheter. The deployment catheter is independently manipulatable with respect to the delivery catheter. The assembly further includes a visualization element extendable distally beyond the deployment catheter and an ablation probe comprising an energy transmitting surface positionable to ablate tissue adjacent to a distal end of the ablation probe. The ablation probe is extendable distally beyond the deployment catheter.

Abstract: In an example, a method for delivering an anesthetic agent to a target tissue in a nasal cavity of a patient includes inserting a cryotherapy device into the nasal cavity of the patient. The cryotherapy device includes a cryotherapy delivery feature and one or more protrusions. The method also includes positioning the cryotherapy delivery feature in contact with the target tissue, and delivering, using the cryotherapy delivery feature, a cryotherapy treatment to the target tissue. After inserting the cryotherapy device into the nasal cavity, the method includes actuating the one or more protrusions from a retracted state to an extended state. After actuating the one or more protrusions to the extended state, the method includes penetrating the target tissue with the one or more protrusions. After penetrating the target tissue, the method includes delivering, via the one or more protrusions, an anesthetic agent into the target tissue.

Abstract: Described herein are devices, systems and methods for treating target tissue in a patient's spine. In general, the methods include the steps of advancing a wire into the patient from a first location, through a neural foramen, and out of the patient from a second location; connecting a tissue modification device to the wire; positioning the tissue modification device through the neural foramen using the wire; modifying target tissue in the spine by moving the tissue modification device against the target tissue; and delivering an agent to modified target tissue, wherein the agent is configured to inhibit blood flow from the modified target tissue. In some embodiments, the step of modifying target tissue comprises removing target tissue located ventral to the superior articular process while avoiding non-target tissue located lateral to the superior articular process.

Abstract: According to some embodiments, the present technology includes a device for the disruption and/or removal of obstructive material in a blood vessel. The device can comprise an elongated shaft having a proximal portion, a distal portion, and a lumen extending therebetween. The device can further comprise a capture structure carried by the distal portion of the elongated shaft and having a greater cross-sectional dimension than a cross-sectional dimension of the elongated shaft. The capture structure can comprise an opening at a first end portion that is fluidly coupled to the lumen of the elongated shaft, a fluid impermeable sidewall enclosing an interior region, and an opening extending through a thickness of the sidewall. A portion of the sidewall surrounding the opening can be configured to deform towards or away from the interior region such that a cross-sectional dimension of the opening increases to receive the obstructive material therethrough.

Abstract: An apparatus for inhibiting tissue migration during a procedure comprises a deployment catheter defining at least one lumen therethrough and a non-inflatable hood projecting distally from the deployment catheter and defining an open area. The open area is in fluid communication with the at least one lumen. The apparatus also comprises a visualization element disposed within or along the non-inflatable hood for visualizing tissue adjacent to the open area. The apparatus also comprises a tissue grasping end effector positioned within the open area and configured to temporarily engage the tissue adjacent to the open area such that distal migration of the tissue relative to the barrier or membrane is inhibited.

Abstract: A medical manipulation assembly comprises a catheter including distal and proximal steerable portions with working channels. The assembly further comprises a steerable sheath through which the steerable portions extend. A distal steering mechanism, including a first lumen extending along a longitudinal axis of the catheter, bends the distal steerable portion. A proximal steering mechanism, including a second lumen extending along the axis and defined by a wall, bends the proximal steerable portion by rotational movement of the proximal steering mechanism independently of the distal steerable portion. The wall is rotatable about the axis. Distal pullwires extend between the distal steerable portion and the distal steering mechanism. Proximal pullwires extend between the proximal steerable portion and the proximal steering mechanism.

Abstract: A method of cannulating a coronary sinus within a heart chamber includes deploying, from a catheter, an imaging hood to a deployed configuration by extending the imaging hood from a distal end of the catheter and radially expanding the imaging hood to define a constant deployed volume within an open area of the imaging hood. The method further includes positioning a contact edge of the imaging hood and the open area of the imaging hood in the deployed configuration over or upon an ostium of the coronary sinus, displacing an opaque fluid with a transparent fluid from the open area defined by the imaging hood and tissue surrounding the ostium, visualizing the ostium through the transparent fluid by viewing the ostium via an imaging element attached to an inner surface of the imaging hood, and introducing a guidewire through the imaging hood and into the ostium while under visual guidance.