Abstract: A direct visualization catheter includes a handle, a balloon, an elongate shaft, and a camera assembly. The elongate shaft has a proximal end and a distal end opposite the proximal end. The proximal end is coupled to the handle. The distal end is coupled to the balloon and defines a longitudinal axis. The camera assembly is coupled to the distal end of the elongate shaft and is disposed within the balloon. The camera assembly includes a camera and an adjustment mechanism for varying a configuration of the camera relative to the distal end of the elongate shaft between a delivery configuration and a deployed configuration. The camera faces primarily in a radial direction in the delivery configuration and the camera faces primarily in an axial direction in the deployed configuration.

Abstract: Tissue puncture devices, and systems and methods for accessing tissue (e.g., cardiovascular tissue) according to the present disclosure may include a tubular sheath extending along a longitudinal axis, the tubular sheath having a proximal end and a distal end, a needle disposed coaxially in the sheath, the needle having a proximal end and a distal end and being movable along the longitudinal axis of sheath, and a needle control mechanism disposed at the proximal end of the needle, the needle control mechanism being configured to lock the distal end of the needle in a first position retracted within the distal end of the sheath, and release the needle to an unlocked second position such that the distal end of the needle is extendable beyond the distal end of the sheath.

Abstract: Tissue puncture devices, and systems and methods for accessing tissue (e.g., cardiovascular tissue) according to the present disclosure may include a tubular sheath extending along a longitudinal axis, the tubular sheath having a proximal end and a distal end, a needle disposed coaxially in the sheath, the needle having a proximal end and a distal end and being movable along the longitudinal axis of sheath, and a needle control mechanism disposed at the proximal end of the needle, the needle control mechanism being configured to lock the distal end of the needle in a first position retracted within the distal end of the sheath, and release the needle to an unlocked second position such that the distal end of the needle is extendable beyond the distal end of the sheath.

Abstract: Apparatuses, systems, and methods for crossing a tissue region may include a catheter and a tip section arranged therewith. The tip section may be configured to puncture the tissue region and create an opening therein, dilate the opening in the tissue region, and pass through the opening.

Abstract: Tissue puncture devices, and systems and methods for accessing tissue (e.g., cardiovascular tissue) according to the present disclosure may include a tubular sheath extending along a longitudinal axis, the tubular sheath having a proximal end and a distal end, a needle disposed coaxially in the sheath, the needle having a proximal end and a distal end and being movable along the longitudinal axis of sheath, and a needle control mechanism disposed at the proximal end of the needle, the needle control mechanism being configured to lock the distal end of the needle in a first position retracted within the distal end of the sheath, and release the needle to an unlocked second position such that the distal end of the needle is extendable beyond the distal end of the sheath.

Abstract: A direct visualization catheter includes a handle, a balloon, an elongate shaft, and a camera assembly. The elongate shaft has a proximal end and a distal end opposite the proximal end. The proximal end is coupled to the handle. The distal end is coupled to the balloon and defines a longitudinal axis. The camera assembly is coupled to the distal end of the elongate shaft and is disposed within the balloon. The camera assembly includes a camera and an adjustment mechanism for varying a configuration of the camera relative to the distal end of the elongate shaft between a delivery configuration and a deployed configuration. The camera faces primarily in a radial direction in the delivery configuration and the camera faces primarily in an axial direction in the deployed configuration.

Abstract: A method of preparing an electrode for use with an implantable medical device, the electrode including a titanium surface, the method including: maintaining a nitrogen gas environment proximate to the titanium surface, delivering energy to a portion of the titanium surface, modifying the portion of the titanium surface with the energy delivered to the titanium surface, and forming titanium nitride by reacting titanium at the portion of the titanium surface with nitrogen from the nitrogen gas environment. Modifying includes increasing a surface area of the portion of the titanium surface, and removing titanium from the portion of the titanium surface. The titanium nitride is formed at the portion of the titanium surface where titanium has been removed.

Abstract: Various aspects of the present disclosure are directed toward apparatuses, systems, and methods for crossing a tissue region. The apparatuses, systems, and methods may include a catheter and a tip section arranged therewith. The tip section may be configured to puncture the tissue region and create an opening therein, dilate the opening in the tissue region, and pass through the opening.

Abstract: A method of preparing an electrode for use with an implantable medical device, the electrode including a titanium surface, the method including: maintaining a nitrogen gas environment proximate to the titanium surface, delivering energy to a portion of the titanium surface, modifying the portion of the titanium surface with the energy delivered to the titanium surface, and forming titanium nitride by reacting titanium at the portion of the titanium surface with nitrogen from the nitrogen gas environment. Modifying includes increasing a surface area of the portion of the titanium surface, and removing titanium from the portion of the titanium surface. The titanium nitride is formed at the portion of the titanium surface where titanium has been removed.

Abstract: Catheter systems and methods for determining blood flow rates based on light reflection measurements. The catheter may include a lumen extending between a proximal end of the catheter and a distal end of the catheter. The catheter may include fluid infusion openings at the distal end region of the catheter that are configured to permit the indicator fluid to exit the catheter from the lumen. The catheter system may include an optical fiber having one or more sensors thereon for sensing light reflected by blood particles in a body vessel lumen. A blood flow rate may be determined based on the sensed light reflected by blood particles in the body vessel lumen.

Abstract: An electrode for use with an implantable medical device includes a titanium surface, and a titanium nitride layer formed on at least a portion of the titanium surface. At least some titanium of the portion of the titanium surface is removed from the titanium surface prior to forming the titanium nitride layer. The textured titanium nitride layer is formed by reacting nitrogen proximate to the portion of the titanium surface with titanium at the portion of the titanium surface.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a guide extension catheter. The guide extension catheter may include an elongate tubular member having a proximal region, a distal region, and a slot formed in the tubular member between the proximal region and the distal region. The proximal region of the tubular member may be configured to shift between a first configuration and a collapsed configuration. The guide extension catheter may also include an elongate shaft for shifting the proximal region between the first configuration and the collapsed configuration.

Abstract: An electrode for use with an implantable medical device includes a titanium surface, and a titanium nitride layer formed on at least a portion of the titanium surface. At least some titanium of the portion of the titanium surface is removed from the titanium surface prior to forming the titanium nitride layer. The textured titanium nitride layer is formed by reacting nitrogen proximate to the portion of the titanium surface with titanium at the portion of the titanium surface.

Abstract: Various embodiments concern a lead having a proximal section and a curbed section. The lead can comprise an outer tubular portion having a bias such that the lead assumes a curved shape along the curved section. The lead can further include an inner tubular portion extending within the outer tubular portion, the inner tubular portion comprising an inner coil conductor and an inner polymer jacket over the inner coil conductor along the curved section, the inner tubular member stiffer along the proximal section than the curved section, the outer tubular portion stiffer along the curved section relative to the inner tubular portion along the curved section such that the inner tubular portion can rotate relative to the outer tubular portion while the curved shape is substantially maintained. Relative rotation can extend and rotate and active fixation element.

Abstract: Medical devices may include an electrode that has been processed to increase its surface area. In some cases, an electrode may be processed using an ultrafast laser to produce an electrode surface that includes macrostructures formed within the electrode surface and nanostructures formed on the macrostructures. The nanostructures may be formed of material that was removed from the electrode surface in forming the macrostructures.

Abstract: A medical device may include an elongate delivery sheath and a valve replacement implant disposed within a lumen of the delivery sheath, the implant including an anchor member reversibly actuatable between a delivery configuration and a deployed configuration. The implant may include at least one locking element configured to lock the anchor member in the deployed configuration, and at least one actuator element configured to engage the at least one locking element and actuate the anchor member between the delivery configuration and the deployed configuration. The at least one actuator element may include an unlocking member configured to compress a first locking portion of the at least one locking element to unlock the anchor member from the deployed configuration.

Abstract: A medical device for sympathetic nerve ablation may include an elongate shaft and an expandable member. A printed ablation electrode assembly may be disposed on an outer surface of the expandable member, the printed ablation electrode assembly including a positive electrical pathway and a ground electrical pathway printed directly on the outer surface of the expandable member. A temperature sensor may be printed directly on the outer surface of the expandable member. A method of manufacturing a medical device for sympathetic nerve ablation may include printing a conductive ink network directly on a surface of a polymeric balloon material in a flat configuration, printing at least one temperature sensor directly on the surface of the polymeric balloon material, forming the polymeric balloon material into an inflatable balloon, and attaching the inflatable balloon to an elongate catheter shaft.

Abstract: Catheter systems and methods for determining blood flow rates based on light reflection measurements. The catheter may include a lumen extending between a proximal end of the catheter and a distal end of the catheter. The catheter may include fluid infusion openings at the distal end region of the catheter that are configured to permit the indicator fluid to exit the catheter from the lumen. The catheter system may include an optical fiber having one or more sensors thereon for sensing light reflected by blood particles in a body vessel lumen. A blood flow rate may be determined based on the sensed light reflected by blood particles in the body vessel lumen.

Abstract: Various embodiments concern a lead having a proximal section and a curbed section. The lead can comprise an outer tubular portion having a bias such that the lead assumes a curved shape along the curved section. The lead can further include an inner tubular portion extending within the outer tubular portion, the inner tubular portion comprising an inner coil conductor and an inner polymer jacket over the inner coil conductor along the curved section, the inner tubular member stiffer along the proximal section than the curved section, the outer tubular portion stiffer along the curved section relative to the inner tubular portion along the curved section such that the inner tubular portion can rotate relative to the outer tubular portion while the curved shape is substantially maintained. Relative rotation can extend and rotate and active fixation element.

Abstract: Medical devices may include an electrode that has been processed to increase its surface area. In some cases, an electrode may be processed using an ultrafast laser to produce an electrode surface that includes macrostructures formed within the electrode surface and nanostructures formed on the macrostructures. The nanostructures may be formed of material that was removed from the electrode surface in forming the macrostructures.