Abstract: In some examples, a tissue compression device includes a base including a major surface configured to engage a dorsal surface of a hand of a patient, a flexible backing adjustably mechanically connected to the base and configured to engage a palmar surface of the hand when the dorsal surface of the hand is engaged with the base, and an expandable member mechanically connected to the flexible backing. The expandable member is configured to be positioned over an ulnar region of the patient when the palmar surface of the hand is engaged with the flexible backing and the dorsal surface of the hand is engaged with the base, such that inflation of the expandable member may apply pressure to tissue near the ulnar artery of the patient.

Abstract: Devices, assemblies, systems, and techniques described herein may deliver a pressure wave to structures of a heart, such an aortic valve. For example, a medical assembly may include an expandable member configured to expand from a collapsed configuration to an expanded configuration, the expandable member configured to at least partially define a channel through the expandable member in the expanded configuration and one or more electrodes carried by the expandable member. The one or more electrodes may be configured to transmit an electrical signal through a fluid to cause the fluid to undergo cavitation that generates a pressure wave within the fluid.

Abstract: Devices for, and methods of, compressing a stented prosthetic heart valve are disclosed. The method including inserting a stented prosthetic heart valve having a self-expandable stent frame into a container, initiating a cooling element in the container, transferring heat through a thermal conductor to cool an interior of the container, reducing a temperature of the self-expandable stent frame while located within the container to a critical temperature of not greater than 8° C., and compressing an outer diameter of the stented prosthetic heart valve while the stented prosthetic heart valve is at the critical temperature.

Abstract: Delivery devices for delivery of a stented prosthetic heart valve. Various delivery devices include an outer sheath assembly including an outer sheath connected to a capsule that is advanced proximally to retain the prosthetic valve, which is secured over an inner shaft assembly of the delivery device. The delivery device further includes a bumper to provide a smooth transition of the capsule over the prosthetic valve during loading and recapture procedures. The bumper is expandable from a first position to a second position in which a distal end of the bumper is expanded to increase its diameter. The bumper can be biased in the second, expanded position so that the bumper automatically transitions to the expanded position upon retraction of the outer sheath.

Abstract: The disclosure relates to transcatheter stented prosthesis delivery devices including a handle assembly connected to a shaft assembly on which a stented prosthesis is loaded and compressively retained with a plurality of elongate tension members. The delivery devices include a cutting assembly that can sever the elongate tension members after the stented prosthesis is expanded at a target site so that the delivery device can be withdrawn from the patient. Certain embodiments position the cutting assembly at least within the shaft assembly and others position the cutting assembly over the shaft assembly. Various disclosed cutting assemblies are actuated with the handle assembly or the like, which draw the tension members across the blade or vice versa.

Abstract: A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A handle is mounted to the proximal end portion of the elongate body and operable to cause rotation of the elongate body. A tissue-removing element is mounted on the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body and is coupled to the handle at a proximal end portion of the inner liner. The inner liner defines a guidewire lumen. A sensor is arranged with respect to the inner liner and is configured to produce a signal for indicating the presence of a guidewire within the inner liner.

Abstract: A “dry” packaging in which a prosthetic heart valve is packaged within a container with hydrogel that can be provided in many forms. Certain embodiments include hydrogel that is preloaded with glycerol or the like. The hydrogel regulates the humidity within the container through a diffusion-driven mechanism if a gradient of humidity between the inside and the outside of the hydrogel exists. Humidity regulation is important to prevent the tissue of the valve structure from drying out. When the partially-hydrated hydrogel is present within container, which is saturated with air of a predefined humidity, the water molecules from the air will be absorbed by the hydrogel if the air humidity is high (i.e. when the thermodynamics favor hydrogel hydration) or vice versa. Various embodiments are configured to also house at least a portion of a delivery device for delivering the prosthetic heart valve.

Abstract: Stented prosthetic heart valves including a stent frame having a plurality of stent frame support structures collectively defining an interior surface, an exterior surface and a plurality of cells. The stented prosthetic heart valve further including a valve structure including valve leaflets disposed within and secured to the stent frame and defining a margin of attachment. The stented prosthetic heart valve including one or both of an outer paravalvular leakage prevention wrap and an inner skirt for supporting the valve leaflets. In various embodiments, the outer wrap is positioned entirely on one side of the margin of attachment. In embodiments including an inner skirt, the outer wrap and the inner skirt are on opposite sides of the margin of attachment such that the inner skirt and the outer wrap do not overlap. In other embodiments, the outer wrap includes a plurality of zones having varying thickness.

Abstract: A variety of nanoparticles or microparticles may be used to treat diseases such as restenosis or blood clots. For example, a nanoparticle or microparticle may include a core having a biodegradable polymer, an exterior having hydrophilic moieties. and a therapeutic agent. The nanoparticles may include targeting moieties that target the nanoparticle or microparticle to an arterial lesion. The nanoparticle or microparticle may include an exterior shell around the core to increase stability of the nanoparticle or microparticle. The nanoparticle or microparticle may include a magnetic particle to allow targeted delivery of the nanoparticle or microparticle via a magnetic field. The nanoparticles or microparticles may be coated on a medical device, such as a catheter balloon or a stent, or may be delivered systemically or locally to patients in need thereof.

Abstract: Transcatheter guidewire delivery systems, catheter assemblies and associated methods for percutaneous guidewire delivery across heart valves are disclosed herein. A catheter assembly configured in accordance herewith includes an elongated tubular component and an alignment assembly at a distal portion of the tubular component and which is adapted to be located at a target location adjacent a heart valve of a patient. In one embodiment, the alignment assembly deploys to a shape set loop configuration with a side port in an open configuration positioned to allow advancement of a guidewire to exit the catheter in an aligned path with a leaflet coaptation region of the heart valve. In another embodiment, the alignment assembly has a plurality of spaced apart side ports that a guidewire may advance therethrough and toward the heart valve. In some embodiments, a wire guide is used to align the guidewire with a selected side port.

Abstract: The present disclosure relates to numerous devices and methods for transcatheter stented prosthetic heart valve loading and delivery. Such devices and methods reduce suture tangling and also provide the ability to adjust the stented prosthetic heart valve expansion and contraction prior to the final release of the stented prosthetic heart valve from the delivery device.

Abstract: A catheter used for percutaneous endovascular procedures is described. The catheter is configured to be used for engagement and treatment of obstructive lesions in a patient's vasculature. The catheter includes a tube having a leading edge that is configured to score or cut a lesion in a vasculature. The tube may be an expandable outer tube, and placed around an inflatable inner tube, such that inflation of the inner tube expands the outer tube. Expansion of the inner tube may connect or laterally lock the inner tube to the outer tube, allowing both tubes to move in unison through the vasculature. The leading edge can score or cut lesions as it moves in the vasculature.

Abstract: A guide extension catheter assembly including a guide extension catheter and a support device. The guide extension catheter includes a shaft and a tubular member. The support device includes a push member and a shuttle member. The guide extension catheter assembly is configured to selectively provide a delivery state in which at least a portion of the shuttle member is disposed within the lumen, a leading end of the shuttle member is distal a distal end of the tubular member, and the shuttle member is directly, physically connected to the tubular member. In the delivery state, a longitudinal distal force applied to the push member is transferred to the tubular member as a longitudinal distal force via the shuttle member. The guide extension catheter assemblies of the present disclosure can promote a two stage guide extension catheter deployment.

Abstract: Methods of compressing a stented prosthetic heart valve are disclosed. The method including inserting a stented prosthetic heart valve having a self-expandable stent frame into a container, initiating a cooling element in the container, transferring heat through a thermal conductor to cool an interior of the container, reducing a temperature of the self-expandable stent frame while located within the container to a critical temperature of not greater than 8° C., and compressing an outer diameter of the stented prosthetic heart valve while the stented prosthetic heart valve is at the critical temperature.

Abstract: A stent graft delivery system and method of operating the same are disclosed. The system includes a stent graft cover, a screw gear, and a handle assembly. The handle assembly includes an external slider configured to rotate about the screw gear, and a central hub configured to slide linearly along the screw gear as the external slider is rotated. The central hub defines a main lumen port extending therethrough and configured to receive the stent graft cover, and a branched lumen port configured to receive a branched lumen. The stent graft cover can be fixed to and within the main lumen port. Rotation of the handle causes the central hub to slide linearly, which simultaneously retracts the stent graft cover and the branched lumen.

Abstract: Devices, assemblies, systems, and techniques described herein may deliver a pressure wave to structures of a heart, such an aortic valve. For example, a medical assembly may include an expandable member configured to expand from a collapsed configuration to an expanded configuration, the expandable member configured to at least partially define a channel through the expandable member in the expanded configuration and one or more electrodes carried by the expandable member. The one or more electrodes may be configured to transmit an electrical signal through a fluid to cause the fluid to undergo cavitation that generates a pressure wave within the fluid.

Abstract: A catheter can restore the patency of a body lumen, for example, by removing tissue from a body lumen (e.g., a blood vessel). The catheter can be a rotational catheter having a rotatable drive shaft and a tissue-removing element secured to the drive shaft to be driven in rotation by the drive shaft. The catheter can have an abrasive burr configured to abrade tissue in a body lumen. The catheter can have an expandable tissue-removing element. The catheter can include a balloon and an inflation conduit. The catheter can also be configured to move over a guidewire through a body lumen. In one embodiment, the catheter comprises an over-the-wire, balloon-expandable, rotational, and abrasive tissue-removing catheter.

Abstract: A stent graft assembly with a sacrificial entry/exit port is disclosed. A first sacrificial port extends from a first branch stent graft and is configured to face a second branch stent graft when the stent graft assembly is in an expanded configuration. Likewise, a second sacrificial port can be provided, and can extend from the second branch stent graft and configured to face the first branch stent graft when the stent graft assembly is in the expanded configuration. The first and optional second sacrificial ports are configured to transition between (i) an open configuration to enable a guidewire or other surgical tool to pass from the first branch stent graft to the second branch stent graft while bypassing the main body, and (ii) a closed configuration to inhibit blood flow therethrough.

Abstract: A system for repairing a defective heart valve. The system includes a delivery device, a balloon and a prosthetic heart valve. The delivery device includes an inner shaft assembly and a delivery sheath assembly. The delivery sheath assembly provides a capsule terminating at a distal end. The prosthesis includes a stent carrying a prosthetic valve. In a delivery state, the capsule maintains the prosthesis in a collapsed condition over the inner shaft assembly, and the balloon is in a deflated arrangement radially between the prosthetic heart valve and the capsule. In a deployment state, at least a portion of the balloon and at least a portion of the prosthetic heart valve are distal the capsule. Further, the balloon is inflated and surrounds an exterior of at least a portion of the prosthetic heart valve. The balloon controls self-expansion of the prosthetic heart valve.

Abstract: The techniques of this disclosure generally relate to a stent-graft system including a bifurcated stent-graft, a first bifurcating branch device, and a first branch extension. The bifurcated stent-graft includes a body, a first branch limb, and a second branch limb. The first bifurcating branch device includes a body segment coupled to the first branch limb of the bifurcated stent-graft, a first branch limb, and a second branch limb. The first branch extension is within the first branch limb of the first bifurcating branch device and within an external iliac artery. The first bifurcating branch device has a wide patient applicability since the treatment can be extended proximal to the anatomical iliac bifurcation and is not limited by the common iliac artery length. The stent-graft system is suitable to treat a wide range of internal and external iliac artery diameters.