Abstract: A catheter system for infusing a chilled fluid into a subject can include an input lumen, a return lumen, and a transition lumen that provides sufficient flow resistance to urge a first portion of fluid flowing out of the input lumen in the forward direction to flow into the return lumen in the reverse direction toward a cooling device, while a second portion of the fluid flowing out of the input lumen in the forward direction flows out of the distal end of the catheter and into the subject's blood vessel.

Abstract: An implantable frame comprises a plurality of corner structures configured to decrease pressure to the vessel wall and define pulsatility enhancing windows of the implantable frame. The corner structures may comprise plurality of neighboring longitudinal struts that extend in a longitudinal direction of the blood vessel when placed to form the vessel wall to a substantially polygonal cross-section and distribute pressure loading of the corner structure among the plurality of neighboring longitudinal struts to improve biocompatibility. The corner structures also allow increased forming of the vessel wall and can provide stretching of the vessel wall to enhance pulsatility of the vessel wall.

Abstract: An implantable frame comprises a plurality of corner structures configured to decrease pressure to the vessel wall and define pulsatility enhancing windows of the implantable frame. The corner structures may comprise plurality of neighboring longitudinal struts that extend in a longitudinal direction of the blood vessel when placed to form the vessel wall to a substantially polygonal cross-section and distribute pressure loading of the corner structure among the plurality of neighboring longitudinal struts to improve biocompatibility. The corner structures also allow increased forming of the vessel wall and can provide stretching of the vessel wall to enhance pulsatility of the vessel wall.

Abstract: Systems and methods for screening a subject for a therapy are described. A mechanical stimulation device positioned near at target location of a blood vessel to provide a mechanical stimulus to the blood vessel. The mechanical stimulus increases strain in one or more regions of the blood vessel, such as by modifying the cross-sectional geometry and/or area of the blood vessel to have different regions of different curvature A baroreflex or related physiological response in response to the mechanical stimulation is detected. In response to the detected response, it is determined whether the subject is appropriate for the therapy and/or which of a plurality of implants with different geometries and/or cross-sectional areas is most optimally suited for deployment in the subject.

Abstract: Systems and methods for screening a subject for a therapy are described. A mechanical stimulation device positioned near at target location of a blood vessel to provide a mechanical stimulus to the blood vessel. The mechanical stimulus increases strain in one or more regions of the blood vessel, such as by modifying the cross-sectional geometry and/or area of the blood vessel to have different regions of different curvature A baroreflex or related physiological response in response to the mechanical stimulation is detected. In response to the detected response, it is determined whether the subject is appropriate for the therapy and/or which of a plurality of implants with different geometries and/or cross-sectional areas is most optimally suited for deployment in the subject.

Abstract: An implantable frame comprises a plurality of corner structures configured to decrease pressure to the vessel wall and define pulsatility enhancing windows of the implantable frame. The corner structures may comprise plurality of neighboring longitudinal struts that extend in a longitudinal direction of the blood vessel when placed to form the vessel wall to a substantially polygonal cross-section and distribute pressure loading of the corner structure among the plurality of neighboring longitudinal struts to improve biocompatibility. The corner structures also allow increased forming of the vessel wall and can provide stretching of the vessel wall to enhance pulsatility of the vessel wall.

Abstract: An apparatus method for establishing a Transjugular Intrahepatic Portosystemic Shunt between the portal vein from a hepatic vein. The apparatus comprises an elongated hollow outer guide; an outer handle having an inner lumen and a first luer lock, the outer handle attached at a proximal end of the outer guide, the outer guide in flow communication with the inner lumen and the luer lock; an elongated hollow inner needle; and a hub having a second luer lock, the hub attached at a proximal end of the inner needle, the inner needle in flow communication with the second luer lock. The inner needle is slidingly received into the outer guide through the inner lumen. The inner needle is configured to rotate within the outer guide by manipulation of the hub; and a distal tip of the inner needle is deployed out of and beyond a distal tip of the outer guide.

Abstract: An apparatus method for establishing a Transjugular Intrahepatic Portosystemic Shunt between the portal vein from a hepatic vein. The apparatus comprises an elongated hollow outer guide; an outer handle having an inner lumen and a first luer lock, the outer handle attached at a proximal end of the outer guide, the outer guide in flow communication with the inner lumen and the first luer lock; an elongated hollow inner needle; and a hub having a second luer lock, the hub attached at a proximal end of the inner needle, the inner needle in flow communication with the second luer lock. The inner needle is slidingly received into the outer guide through the inner lumen. The inner needle rotates within the outer guide by manipulation of the hub; and a distal tip of the inner needle is deployed out of and beyond a distal tip of the outer guide.

Abstract: Stimulation of a stretch receptor response to the cardiac cycle is enhanced by constraining a region of a blood vessel wall upstream and/or downstream of a baroreceptor. The constraint may be external or internal and will typically be effected using a circumferential restraint placed over or within the blood vessel.

Abstract: An apparatus method for establishing a Transjugular Intrahepatic Portosystemic Shunt between the portal vein from a hepatic vein. The apparatus comprises an elongated hollow outer guide; an outer handle having an inner lumen and a first luer lock, the outer handle attached at a proximal end of the outer guide, the outer guide in flow communication with the inner lumen and the first luer lock; an elongated hollow inner needle; and a hub having a second luer lock, the hub attached at a proximal end of the inner needle, the inner needle in flow communication with the second luer lock. The inner needle is slidingly received into the outer guide through the inner lumen. The inner needle rotates within the outer guide by manipulation of the hub; and a distal tip of the inner needle is deployed out of and beyond a distal tip of the outer guide.

Abstract: An apparatus method for establishing a Transjugular Intrahepatic Portosystemic Shunt (“TIPS”) between the portal vein from a hepatic vein. The apparatus comprises a multi-needle TIPS device designed to facilitate safer and more rapid catheterization of the portal vein. The method utilizes the multi-needle TIPS device to access the portal vein from the hepatic vein approach. The multi-needle TIPS device and method provides numerous benefits over previous TIPS devices and procedures and results in shorter and safer procedures. Use of multiple needles increases the probability of finding the portal vein more quickly.

Abstract: A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter system includes visualization elements for determining the orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane. The entry site is distal to a chronic total occlusion (CTO). The catheter system also includes a system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system. The attaching system reduces or eliminates catheter float within the sub-intimal space. The catheter system further includes re-entry devices to establish and maintain a path from the sub-intimal plane back into the vessel true lumen.

Abstract: Apparatus and methods are provided for forming a gastrointestinal tissue fold by engaging tissue at a first tissue contact point, moving the first tissue contact point from a position initially distal to a second tissue contact point to a position proximal of the second contact point to form a tissue fold, and extending an anchor assembly through the tissue fold near the second tissue contact point.