Abstract: An intravascular device comprising an intra-aortic and extra-aortic component for perfusing the spinal arteries during thoracoabdominal surgeries. The intra-aortic component comprises a catheter having a shunt releasably mounted on a distal end of the catheter. An expandable occluder is disposed about the shunt for occluding the aortic lumen. The extra-aortic component comprises a tubular member having a lumen communicating with a first end and a second end. The first end is adapted for attachment to the shunt. The second end of the second tubular member is attached to a plurality of tubular branches. A cooler may be attached to the second tubular member for providing hypothermic perfusion. When the intra-aortic component is attached to the extra-aortic component, blood flows from the proximal aorta to the spinal arteries through the lumens of the tubular branches. Methods of using the device for spinal perfusion during thoracoabdominal surgeries herein are also disclosed.

Abstract: Methods are provided for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Methods include partial or complete obstruction of the femoral or iliac arteries or the inferior vena cava, external compression of the iliac, femoral, or brachial arteries, placing the patient in a trendelenberg position, applying one or more compression members to the extremities, or removing portion(s) of cerebral spinal fluid. 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 additional 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 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: 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: The invention provides a medical device having a catheter with two lumens and a cooling system. The first lumen has a proximal end and communicates with a port at the distal end. The second lumen has a proximal end and communicates with a side port. The proximal ends of the lumens are connected to the cooling system. The cerebral spinal fluid can be drained from the side port of the first lumen. Methods for cooling the brain to prevent neurologic damage during head trauma or inadequate perfusion are also disclosed.

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.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. A catheter is advanced into the descending aorta, the catheter having a proximal region, a distal region, and an expandable member mounted on the distal region. The expandable member is located downstream from the takeoff of a carotid artery. The expandable member is expanded to at least partially obstruct blood flow in the aorta. A physiologic parameter is measured that indicates adequacy of cerebral perfusion. The expansion of the expandable member is adjusted based on the measured physiologic parameter. Other medical devices, such as an atherectomy catheter, can be inserted distal the occluder to provide therapeutic intervention.

Abstract: A method for increasing renal and/or coronary blood flow. A catheter is inserted into the descending aorta. An expandable member on a distal region of the catheter is positioned in the aorta downstream from the takeoff of a renal artery or downstream from a coronary ostium. The expandable member is expanded to partially occlude blood flow in the aorta. Blood pressure in the proximal aorta increases, blood pressure in the distal aorta decreases, and renal and/or coronary blood flow increases by this technique. Blood pressure in the proximal aorta may be measured to monitor the effects of the procedure. The expansion of the expandable member may be adjusted based on the measured blood pressure.

Abstract: The invention provides a medical device having two elongate catheters, a pump, and a refrigeration system. Each catheter has a proximal end, a distal end, a lumen therebetween and communicating with a distal port. The proximal ends of the catheters are connected to the pump and the refrigeration system. The distal ends are adapted for insertion into the subarachnoid space. The cerebral spinal fluid is aspirated from the first catheter to the pump, cooled to below body temperature, and returned to the second catheter. The flow rate of the cerebral spinal fluid is adjusted according the CSF pressure and temperature. Also described are methods of using the devices in treating patients suffering from neurologic complications that arise as a result of inadequate cerebral perfusion, such as cardiac arrest, cardiac failure, low cardiac output states, stroke, head injury, cerebral aneurysm surgery, open and closed cardiac surgery and aortic surgery.

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: 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 increasing cerebral blood flow is described. A catheter is inserted into the descending aorta, the catheter having a proximal region, a distal region, and at least one expandable member mounted on the distal region. The expandable member is positioned downstream from the takeoff of the brachiocephalic artery. The expandable member is expanded to at least partially obstruct blood flow in the aorta. The expandable member is then cycled between greater and lesser obstruction of blood flow. In this manner, renal ischemia and lower limb ischemia is avoided.

Abstract: An aortic shunt comprising a second tubular member nested within a lumen of a first tubular member, wherein aortic blood flows through the lumen of the first tubular member and oxygenated and/or cooled blood is infused through a lumen and distal port(s) of the second tubular member to perfuse the cerebral vasculature. Alternatively, a cooling cylinder is nested within the first member, such that aortic blood is cooled through the cylinder before being delivered to the brain. A venous return catheter comprising an elongate tubular member is also provided to remove and isolate the cooled blood entering through jugular veins from the blood entering through the subclavian veins, when the cannula is positioned in the superior vena cava. Methods of using the aortic shunt and/or venous return cannula in providing selective cerebral perfusion in patients suffering from stroke and cardiac arrest are also disclosed.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. Alternatively, the methods can be used to partially occlude aortic blood flow to condition the spinal cord to secrete neuroprotective agents prior to abdominal aortic aneurysm repair. The methods can also be used to partially occlude the renal arteries to reduce renin secretion in hypertensive patients. Partial occlusion of a vessel can be accomplished by a device comprising an elongate catheter, a distally mounted expandable occluder, a variable flow mechanism, and a manometer. The occluder may comprise two conical shells or an inflatable ring-shaped balloon disposed about a cylindrical sleeve. Other medical devices, such as an atherectomy catheter, can be inserted distal the occluder to provide therapeutic intervention.

Abstract: Methods are provided for partial aortic occlusion for cerebral perfusion augmentation in patients suffering from global or focal cerebral ischemia. A catheter is advanced into the descending aorta, the catheter having a proximal region, a distal region, and an expandable member mounted on the distal region. The expandable member is located downstream from the takeoff of a carotid artery. The expandable member is expanded to at least partially obstruct blood flow in the aorta. A physiologic parameter is measured that indicates adequacy of cerebral perfusion. The expansion of the expandable member is adjusted based on the measured physiologic parameter. Other medical devices, such as an atherectomy catheter, can be inserted distal the occluder to provide therapeutic intervention.

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: The invention provides a medical device having a catheter, an expandable occluding member and a constricting member. 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, an atherectomy catheter, and a blood filter, into the carotid artery. The occluder is mounted proximal to the port of the catheter, and the constrictor is mounted distal to the port. Manometers may be mounted distal to the occluder and/or the constrictor for measuring pressure proximal and distal to the constrictor. A pump, operably associated with a shunt mounted through a second occluder, may be used instead of the constrictor to facilitate passage of blood through the second occluder. Methods of using the devices for preventing distal embolization during carotid procedures by reversing blood flow in the internal carotid artery toward the external carotid artery are disclosed.

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: An intravascular device comprising an intra-aortic and extra-aortic component for perfusing the spinal arteries during thoracoabdominal surgeries. The intra-aortic component comprises a catheter having a shunt releasably mounted on a distal end of the catheter. An expandable occluder is disposed about the shunt for occluding the aortic lumen. The extra-aortic component comprises a tubular member having a lumen communicating with a first end and a second end. The first end is adapted for attachment to the shunt. The second end of the second tubular member is attached to a plurality of tubular branches. A cooler may be attached to the second tubular member for providing hypothermic perfusion. When the intra-aortic component is attached to the extra-aortic component, blood flows from the proximal aorta to the spinal arteries through the lumens of the tubular branches. Methods of using the device for spinal perfusion during thoracoabdominal surgeries herein are also disclosed.