Abstract: A recanalization catheter for facilitating re-entry into a lumen of a blood vessel from a subintimal space. The recanalization catheter includes first and second mechanically actuatable wings positioned at a distal region of the elongate shaft of the catheter that are actuatable between a retracted position and an expanded position. In the retracted position the mechanically actuatable wings are positioned in first and second elongate channels defined in the elongate shaft, and in the expanded position the mechanically actuatable wings extend outward from the first and second elongate channels. The actuatable wings extend in an arcuate path away from the elongate shaft in the expanded position to be positionable in a circumferential orientation within a subintimal space formed in a vessel wall to automatically orient a lateral port of the elongate shaft toward the true lumen.

Abstract: Guide extension catheters and methods of manufacturing and using guide extension catheters are disclosed. An example guide extension catheter may include a distal sheath having a proximal opening, a distal opening, and a central lumen extending therebetween. The guide extension catheter may also include a proximal shaft having an outer diameter smaller than an outer diameter of the distal sheath, the proximal shaft including a distal opening. The guide extension catheter may also include a coupling member for securing the distal sheath to the proximal shaft. The coupling member may include a distal portion attached to the distal sheath and a proximal portion disposed within the distal opening of the proximal shaft.

Abstract: A delivery system for delivering a collapsible prosthetic heart valve includes a valve support structure for supporting a collapsible prosthetic heart valve, and a distal sheath movable in a longitudinal direction relative to the valve support structure between a first position in which the distal sheath is adapted to surround a collapsible prosthetic heart valve supported on the valve support structure, and a second position in which the distal sheath is adapted to expose the collapsible prosthetic heart valve for deployment. The distal sheath is at least partially formed of an inner polymer layer, an outer polymer layer, and a tubular supporting member sandwiched between the inner polymer layer and the outer polymer layer.

Abstract: An assembly for collapsing a prosthetic heart valve includes a compression member and a pusher member. The compression member has a first open end with a first diameter, a second open end with a second diameter less than the first diameter, and a tapered wall between the first open end and the second open end. The pusher member has a base adapted to engage an end of the valve. The pusher member and the compression member are movable relative to one another between an initial position in which the base of the pusher member is relatively far from the first open end of the compression member and an operative position in which the base of the pusher member is relatively close to the first open end of the compression member. Movement of the pusher and compression members from the initial position to the operative position radially compresses the valve.

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: A delivery system for delivering and deploying a medical implant, such as a prosthetic heart valve, includes an elongated support member, a sheath, and a tip. The sheath is movable relative to the elongated support member between a distal position overlying the medical implant and a proximal position exposing the medical implant for release from the delivery system. The tip is attached to the elongated support member and is positioned at a distal end of the sheath when the sheath is in the distal position. The tip has a compressed condition and an expanded condition, and a maximum diameter in the expanded condition that is larger than the outer diameter of the sheath.

Abstract: A forceps including a gripping assembly. The gripping assembly includes an upper jaw and a lower jaw. The upper jaw includes a proximal end and a distal end. The upper jaw includes an upper tooth having an upper proximally facing canted tooth surface and an upper distally facing canted tooth surface. The lower jaw includes a proximal end and a distal end. The lower jaw includes a socket having a lower distally facing canted socket surface and a lower proximally facing socket surface. The upper jaw, the lower jaw or both are moveable so that the gripping assembly moves between an open position and a gripping position. In the gripping position, a gap is defined between the upper distally facing canted tooth surface and the lower proximally facing socket surface.

Abstract: A recanalization catheter assembly for recanalization of an occluded blood vessel is disclosed. The recanalization catheter assembly includes an elongate shaft having a tubular portion, a guide member, and a rotary ablation tool. The tubular portion includes a distal opening, from where the rotary ablation tool extends distally. The guide member extends distal of the distal opening and includes a guidewire lumen to receive a guidewire therethrough. The guide member is configured to advance over the guidewire in a subintimal space between a first tissue layer and a second tissue layer of a wall of the blood vessel, while the rotary ablation tool is advanced in a true lumen of the blood vessel.

Abstract: A recanalization catheter for facilitating re-entry into a lumen of a blood vessel from a subintimal space. The recanalization catheter includes first and second mechanically actuatable wings positioned at a distal region of the elongate shaft of the catheter that are actuatable between a retracted position and an expanded position. In the retracted position the mechanically actuatable wings are positioned in first and second elongate channels defined in the elongate shaft, and in the expanded position the mechanically actuatable wings extend outward from the first and second elongate channels. The actuatable wings extend in an arcuate path away from the elongate shaft in the expanded position to be positionable in a circumferential orientation within a subintimal space formed in a vessel wall to automatically orient a lateral port of the elongate shaft toward the true lumen.

Abstract: A delivery device for a collapsible prosthetic heart valve includes a support shaft around which a compartment for the valve is defined, a distal sheath adapted to selectively cover and uncover the compartment and the valve, and a marker cage having a collapsed condition when the distal sheath covers the compartment and an expanded condition when the compartment is uncovered. The marker cage includes at least one rib having a radiopaque marker for determining the positioning of the valve as it is deployed. The valve may be assembled around the marker cage so that the marker cage does not interfere with the radial expansion of the valve during deployment.

Abstract: A delivery device 10 for a collapsible prosthetic heart valve includes a catheter assembly 16 including a shaft 26 around which a compartment 23 is defined, the compartment 23 being adapted to receive the valve in an assembled condition, and a retainer 30 including a pusher 32 and a holder 34 adapted to retain a stent portion 106 of the valve. The catheter assembly 16 also includes a distal sheath 24 adapted to selectively cover and uncover the compartment 23 and the valve, the distal sheath 24 extending around the shaft 26 at least when the distal sheath 24 covers the compartment 23. The pusher 32 includes one or more recesses 40 in a retention edge 33 thereof, each recess 40 being adapted to receive a junction 107 at an end of the stent portion 106 of the valve. The holder 34 includes one or more elongated ribs 50, each rib 50 being adapted to fit into a cell opening 108 of the stent portion 106 of the valve.

Abstract: A delivery system for an implantable medical device having at least one retention member at an end thereof includes a shaft extending in a longitudinal direction. An elongated sheath surrounds the shaft. The sheath is slidable relative to the shaft in the longitudinal direction. A space is defined inside of the sheath and is adapted to receive the medical device in an assembled or collapsed condition. A retainer is positioned at a first end of the space. At least one recess is provided in the retainer and is adapted to receive the retention member of the medical device in the assembled condition. A selectively activable member is disposed in the compartment between the longitudinal shaft and the medical device. When in an activated state, the member expands radially relative to the shaft, thereby urging the retention member to disengage from the recess.

Abstract: A delivery device for a collapsible prosthetic heart valve includes a support shaft around which a compartment is defined, an inner shaft extending through the support shaft and adapted to slide relative to the support shaft along a longitudinal axis thereof, the inner shaft having a lumen therethrough, and a distal sheath operatively connected at a distal end to the inner shaft and slidable therewith. The compartment may receive the valve in an assembled condition, and may be selectively covered and uncovered by the distal sheath. A first flow path may provide flow communication between the lumen of the inner shaft and the compartment.

Abstract: A delivery system for delivering and deploying a medical implant, such as a prosthetic heart valve, includes an elongated support member, a sheath, and a tip. The sheath is movable relative to the elongated support member between a distal position overlying the medical implant and a proximal position exposing the medical implant for release from the delivery system. The tip is attached to the elongated support member and is positioned at a distal end of the sheath when the sheath is in the distal position. The tip has a compressed condition and an expanded condition, and a maximum diameter in the expanded condition that is larger than the outer diameter of the sheath.

Abstract: A delivery device for a collapsible prosthetic heart valve includes a support shaft around which a compartment for the valve is defined, a distal sheath adapted to selectively cover and uncover the compartment and the valve, and a marker cage having a collapsed condition when the distal sheath covers the compartment and an expanded condition when the compartment is uncovered. The marker cage includes at least one rib having a radiopaque marker for determining the positioning of the valve as it is deployed. The valve may be assembled around the marker cage so that the marker cage does not interfere with the radial expansion of the valve during deployment.

Abstract: A delivery system for an implantable medical device having at least one retention member at an end thereof includes a shaft extending in a longitudinal direction. An elongated sheath surrounds the shaft. The sheath is slidable relative to the shaft in the longitudinal direction. A space is defined inside of the sheath and is adapted to receive the medical device in an assembled or collapsed condition. A retainer is positioned at a first end of the space. At least one recess is provided in the retainer and is adapted to receive the retention member of the medical device in the assembled condition. A selectively activable member is disposed in the compartment between the longitudinal shaft and the medical device. When in an activated state, the member expands radially relative to the shaft, thereby urging the retention member to disengage from the recess.

Abstract: A heart valve delivery system includes a low-profile catheter having an outer sheath, the outer sheath having therein a stent and a replacement heart valve. In an unemployed configuration, the stent is located distally to the replacement heart valve. Upon deployment, however, the stent and replacement heart valve are expanded and the replacement heart valve is situated within the stent.

Abstract: A delivery device for a collapsible prosthetic heart valve includes a support shaft around which a compartment is defined, an inner shaft extending through the support shaft and adapted to slide relative to the support shaft along a longitudinal axis thereof, the inner shaft having a lumen therethrough, and a distal sheath operatively connected at a distal end to the inner shaft and slidable therewith. The compartment may receive the valve in an assembled condition, and may be selectively covered and uncovered by the distal sheath. A first flow path may provide flow communication between the lumen of the inner shaft and the compartment.

Abstract: Described is a guide catheter for guiding other medical devices into or through a body lumen, comprising: a polymeric, tubular inner liner having a textured inner surface; and, a polymeric jacket bonded to an exterior of the inner liner; wherein the texture of the inner surface of the inner liner reduces the coefficient of friction between the inner liner and the other medical devices.

Abstract: A subintimal recanalization catheter system for recanalizing a blood vessel. The system includes a support catheter and a balloon catheter configured to extend through the support catheter. The support catheter includes a tubular portion and an extension segment extending distal of the distal opening of the tubular portion. The balloon catheter, having a balloon secured to a distal portion thereof, is positionable through the tubular portion of the support catheter to position the balloon alongside the extension segment. The system is configured to be advanced into a subintimal space between a first tissue layer and a second tissue layer of a blood vessel wall where the balloon may be inflated against the extension segment to cause a distal portion of the catheter shaft of the balloon catheter to deflect toward the vessel lumen within the subintimal space to facilitate reentry into the vessel lumen.