Abstract: The invention provides a medical device having a catheter and one or more expandable constricting/occluding members. The catheter has a lumen communicating with a port at its distal end. The lumen and port are adapted for introduction of therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter, into a vertebral or basilar artery. The constrictor/occluder is mounted proximal to the port of the catheter. Manometers may be mounted distal to one or more constrictors for measuring pressure distal to the constrictor(s). Methods of using the devices for preventing distal embolization during vertebral and/or basilar procedures by reversing blood flow in the vertebral artery toward the subclavian artery are disclosed.

Abstract: Methods of using a medical device having catheter with one or more expandable constricting/occluding members for preventing distal embolization during extracranial or intracranial carotid procedures or vertebral artery procedures by augmenting collateral cerebral circulation by coarctation of the aorta to enhance reversal of blood flow in an internal carotid artery, an external carotid artery, and/or a common carotid artery toward the subclavian artery are disclosed. An interventional catheter can also be advanced into a left cerebral artery and a procedure performed on a lesion in the left cerebral artery.

Abstract: The invention provides a medical device having a catheter and one or more expandable constricting/occluding members. The catheter is adapted for use with therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter. The constrictor/occluder is mounted at the distal end of the catheter. Manometers may be mounted distal to one or more constrictors for measuring pressure distal to the constrictor(s). Methods of using the devices for preventing distal embolization during extracranial or intracranial carotid procedures or vertebral artery procedures by reversing blood flow in an internal carotid artery, an external carotid artery, and/or a common carotid artery toward the subclavian artery are disclosed.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. The descending aorta is accessed. A device is then located downstream from the takeoff of the brachiocephalic artery. The device is operated to at least partially obstruct blood flow in the aorta during systole and diastole. A physiologic parameter can be measured. The device can then be adjusted to modify the degree of obstruction based on the measured physiologic parameter.

Abstract: A method for mechanically assisting the pumping action of the heart. A catheter is provided comprising an elongate member having a proximal end, a distal region, an expandable member attached in the distal region, and an inflatable member in the distal region and attached distal the expandable member. The catheter is advanced into the aorta. The expandable member is expanded to at least partially obstruct the aorta. The inflatable member is inflated during diastole. The inflatable member is then deflated during the ejection phase of the left ventricle while expansion of the expandable member is maintained. The pumping action of the heart is thereby mechanically assisted. Cerebral perfusion augmentation may also be achieved by use of combined coarctation-counterpulsation devices and methods. Devices for practicing methods with increased volume-displacement efficiency are also described.

Abstract: Methods are provided for partial aortic obstruction for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially obstruct aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. Partial obstruction of a vessel can be accomplished by a device comprising an elongate catheter and a distally mounted expandable member. The expandable member may comprise one or two balloons. Other medical devices, such as an angioplasty, stent, or atherectomy catheter, can be inserted distal the expandable member to provide therapeutic intervention.

Abstract: A medical device having a catheter and one or more expandable constricting/occluding members. The catheter is adapted for use with therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter. A first constrictor/occluder mounted at the distal end of the catheter is adapted for placement in a brachiocephalic or subclavian artery. A second constrictor mounted proximal to the first constrictor/occluder is adapted for placement in the descending aorta. Pressure measuring devices may be included, and filters may be used to capture embolic debris. Methods of using the devices for preventing distal embolization during extracranial or intracranial carotid procedures or vertebral artery procedures by augmenting collateral cerebral circulation by coarctation of the aorta to enhance reversal of blood flow in an internal carotid artery, an external carotid artery, and/or a common carotid artery toward the subclavian artery are disclosed.

Abstract: Methods are provided for partial aortic obstruction for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially obstruct aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. Partial obstruction of a vessel can be accomplished by a device comprising an elongate catheter and a distally mounted expandable member. The expandable member may comprise one or two balloons. Other medical devices, such as an angioplasty, stent, or atherectomy catheter, can be inserted distal the expandable member to provide therapeutic intervention.

Abstract: The invention provides a medical device having a catheter and one or more expandable constricting/occluding members. The catheter is adapted for use with therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter. The constrictor/occluder is mounted at the distal end of the catheter. Manometers may be mounted distal to one or more constrictors for measuring pressure distal to the constrictor(s). Methods of using the devices are disclosed for preventing distal embolization during extracranial or intracranial carotid artery, vertebral artery, or coronary artery procedures, or procedures involving any vessel having collateral flow by reversing flow in the diseased vessel.

Abstract: The invention provides a medical device having a catheter and one or more expandable constricting/occluding members. The catheter has a lumen communicating with a port at its distal end. The lumen and port are adapted for introduction of therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter, into a vertebral or basilar artery. The constrictor/occluder is mounted proximal to the port of the catheter. Manometers may be mounted distal to one or more constrictors for measuring pressure distal to the constrictor(s). Methods of using the devices for preventing distal embolization during vertebral and/or basilar procedures by reversing blood flow in the vertebral artery toward the subclavian artery are disclosed.

Abstract: The invention provides a medical device having a catheter and first and second expandable members. The device may be used for protection against stroke by inserting the catheter into a carotid artery, locating the first expandable member within a common carotid artery, locating the second expandable member within an external carotid artery, expanding the first expandable member to occlude the common carotid artery, and expanding the second expandable member to at least partially obstruct the external carotid artery. By this method antegrade blood flow in the internal carotid artery stops.

Abstract: A method for increasing cerebral blood flow in a patient. A electrical stimulating device is provided. The electrical stimulating device is applied to the patient at a region adjacent the cervical sympathetic chain, the brain stem, the head, or the sympathetic nervous system. The electrical stimulating device is applied by any route selected from transcutaneous, subcutaneous, and subarachnoid. The electrical stimulating device is activated to stimulate or inhibit nerve impulses of the cervical sympathetic chain, thereby producing vasodilation in the cerebral vasculature, thereby increasing cerebral blood flow. Devices for increasing cerebral blood flow in a patient are also described.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. The descending aorta is accessed. A device is then located downstream from the takeoff of the brachiocephalic artery. The device is operated to at least partially obstruct blood flow in the aorta during systole and diastole. A physiologic parameter can be measured. The device can then be adjusted to modify the degree of obstruction based on the measured physiologic parameter.

Abstract: Methods are provided for partial aortic obstruction for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially obstruct aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. Partial obstruction of a vessel can be accomplished by a device comprising an elongate catheter and a distally mounted expandable member. The expandable member may comprise one or two balloons. Other medical devices, such as an angioplasty, stent, or atherectomy catheter, can be inserted distal the expandable member to provide therapeutic intervention.

Abstract: A method for enhancing cerebral blood flow in a patient. The patient's baseline cerebral blood flow is measured. An artery of the patient is cooled or warmed to produce vasodilatation of the artery. The artery is typically one or more of the left or right common carotid artery, left or right internal carotid artery, left or right middle cerebral artery, anterior cerebral artery, left or right vertebral artery, or basilar artery. Vasodilatation enhances cerebral blood flow. The enhanced cerebral blood flow is measured after cooling or warming the artery. The enhanced cerebral blood flow is compared to the baseline cerebral blood flow. Cooling or warming is then adjusted as needed to achieve a desired enhancement in cerebral blood flow. Devices for cooling and warming are also described.

Abstract: A medical device for providing retrograde venous perfusion to the cerebral vasculature for treatment of global or focal cerebral ischemia is disclosed. The device includes a catheter having an infusion port at its distal end, venous drainage port(s), and an expandable occluder disposed between the infusion port and drainage port(s). The catheter can be inserted into the superior vena cava or the internal jugular vein. The catheter is attached proximally to a pump and an oxygenator with or without a cooling system. Alternatively, the device includes two catheters, each having a lumen communicating with a distal infusion port and an occluder mounted proximal to the port. The catheters can be inserted into the internal jugular veins distal to jugular venous valves. Methods of using the devices to provide retrograde venous perfusion and isolated cerebral hypothermia are disclosed.

Abstract: The invention provides a medical device having a catheter and one or more expandable constricting/occluding members. The catheter has a lumen communicating with a port at its distal end. The lumen and port are adapted for introduction of therapeutic or diagnostic devices, including an angioplasty/stent catheter and an atherectomy catheter, into a vertebral or basilar artery. The constrictor/occluder is mounted proximal to the port of the catheter. Manometers may be mounted distal to one or more constrictors for measuring pressure distal to the constrictor(s). Methods of using the devices for preventing distal embolization during vertebral and/or basilar procedures by reversing blood flow in the vertebral artery toward the subclavian artery are disclosed.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. The descending aorta is accessed. A device is then located downstream from the takeoff of the brachiocephalic artery. The device is operated to at least partially obstruct blood flow in the aorta during systole and diastole. A physiologic parameter can be measured. The device can then be adjusted to modify the degree of obstruction based on the measured physiologic parameter.

Abstract: The invention provides a method for augmenting circulation in a patient having carotid stenosis. An elongate tubular member is provided having a lumen communicating with a port at a distal end. The tubular member is inserted into a peripheral artery and the distal port is advanced into a first carotid artery substantially free of a lesion where the patient possesses a second carotid artery substantially occluded by a lesion. Blood is perfused into the first carotid artery through the tubular member. Contralateral flow is augmented to improve perfusion to an ischemic region distal to the carotid stenosis. Angioplasty and stenting can be used to open the lesion in the second carotid artery.

Abstract: Cooled and oxygenated blood is shunted from the proximal aorta into the open ends of intercostal arteries severed during thoracoabdominal aortic surgery to prevent or minimize the effects of spinal ischemia. This cooled perfusion can be accomplished with a variety of perfusion assemblies. For instance, a single vessel perfusion assembly can be employed to shunt the oxygenated blood from the aorta to the lumen of a single intercostal artery. Cooled perfusion can also be performed with a branched multiple vessel perfusion assembly, which includes a branched conduit comprising a common portion and branch portions. In operation, oxygenated blood flows from the aorta into the inflow cannula, through the blood flow conduit, out of the one or more outflow cannula, and into the intercostal arteries.