Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.

Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.

Abstract: Intravascular catheters with fluoroscopically visible indicium of rotational orientation. The catheter includes an elongate flexible tubular body, having a proximal end, a distal end and a tubular side wall defining at least one lumen extending therethrough. At least first and second opposing pairs of radiopaque rings are embedded in the side wall, spaced axially apart from each other. A first transverse axis extending through the first pair of rings is rotationally offset from a second transverse axis extending through the second pair of rings. The rings may be supported by a subassembly integrated into the wall of the catheter. The subassembly may include a tubular body having a plurality of aperture portions connected by intervening hinge portions. In one implementation, the catheter is a reentry catheter.

Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. Each aperture may be defined within a radiopaque reinforcing ring embedded within the tubular body. A first set of opposing pairs of reinforcing rings may be separated axially from a second set of opposing pairs of reinforcing rings and may be connected by a flexible hinge section.

Abstract: A single pass, large bore transseptal crossing catheter system is disclosed. An elongate, flexible tubular body has a proximal end, a distal end and an electrically conductive sidewall defining a central lumen. An insulation layer surrounds the sidewall and leaves exposed a first distal electrode tip. An inner conductive wire is provided, having a second distal electrode tip. The inner wire is axially movably extendable through the central lumen. A tubular insulation layer is provided in between the wire and the electrically conductive sidewall.

Abstract: Disclosed is an electrically enabled introducer sheath, such as for crossing a septum into a left atrium and guiding a large bore catheter across the septum and into the left atrium. The sheath includes an elongate, flexible tubular body, having a proximal end, a distal end and an electrically conductive sidewall defining a central lumen. A tubular insulation layer surrounds the sidewall and leaves exposed an annular conductive surface at the distal end. The tubular body has a proximal hub, having at least one access port in communication with the central lumen and a connector in electrical communication with the conductive sidewall. The central lumen is configured to receive a radio frequency conducting wire, to facilitate crossing the septum.

Abstract: Disclosed are methods of transseptal crossing to permit introduction of large bore catheters into to the left atrium, such as to deploy left atrial appendage closure devices or to repair or replace a mitral valve. The method may include the steps of providing a single pass, large bore transseptal crossing system, having a tubular access cannula and an energy delivery wire movably extending through the tubular access cannula. A first electrode tip on the energy delivery wire is brought into contact with a fossa ovalis and energized. The energy delivery wire and cannula are advanced into the left atrium. A large bore sheath is advanced directly over the access cannula and into the left atrium. The cannula and energy delivery wire are removed, and a large bore index procedure catheter may be advanced through the large bore sheath and into the left atrium.

Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. Each aperture may be defined within a radiopaque reinforcing ring embedded within the tubular body. A first set of opposing pairs of reinforcing rings may be separated axially from a second set of opposing pairs of reinforcing rings and may be connected by a flexible hinge section.

Abstract: Systems and methods for locally engaging tissue using suction. In at least one catheter device embodiment, the catheter device comprises an engagement catheter having a proximal end, a distal end, and a vacuum lumen therethrough operably coupling the proximal and distal ends; an elongated tube of a shape memory material having a plurality of elongated strips removed from a length of the elongated tube to form elongated shape memory tines at a distal end of the tube, wherein the shape memory tines flare outward away from a central axis to form a fluted distal end; and an elastomeric coating disposed over the elongated shape memory material tines to form a suction cup shape.

Abstract: Intravascular catheters with fluoroscopically visible indicium of rotational orientation are described. The catheter includes an elongate flexible tubular body, having a proximal end, a distal end and a tubular side wall defining at least one lumen extending there through. At least first and second opposing pairs of radiopaque rings are embedded in the side wall, spaced axially apart from each other. A first transverse axis extending through the first pair of rings is rotationally offset from a second transverse axis extending through the second pair of rings. The rings may be supported by a subassembly integrated into the wall of the catheter. The subassembly may include a tubular body having a plurality of aperture portions connected by intervening hinge portions. In one implementation, the catheter is a reentry catheter.

Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. Each aperture may be defined within a radiopaque reinforcing ring embedded within the tubular body. A first set of opposing pairs of reinforcing rings may be separated axially from a second set of opposing pairs of reinforcing rings and may be connected by a flexible hinge section.

Abstract: A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.