Abstract: Systems for less invasive medical procedures comprise a filter device mounted on an integrated guiding structure and an aspiration catheter. These components can be used together or separately, and the system can be used with other medical devices that are designed for less invasive procedures, such as procedures in a patient's vasculature. The filter device can involve improved torque coupling with a torque coupler associated with a resilient member that correspondingly also provides increased flexibility relative to an overtube that forms a tube for the remaining portions of the device. An actuation tool for the filter device used a systematic loading procedure for proper loading of the corewire and overtube into the actuation tool. A fiber cartridge comprises fibers loaded as a bundle into the cartridge for delivery with the ends of the fibers respectively bonded to radiopaque markers that can be visualized to come together when the filter is properly deployed.

Abstract: In general, aspiration catheters have a suction device, a proximal portion and a shaft with a proximal end and a distal end. Improvements in the aspiration catheter design provide for improved tracking and/or reduced chance of snagging during delivery of the aspiration catheter. In some embodiments, the tip of the shaft has a curve relative to the neutral orientation of the remaining portions of the shaft. In other embodiments, the aspiration catheter further comprises a tracking portion that has a guide lumen. A guide structure can extend through the guide lumen to limit the motion of the tip of the catheter relative to the guide structure during delivery of the aspiration catheter within a patient's vessel. In further embodiments, the aspiration catheter comprises a deflection structure having a tether and a bumper. Improved methods for using the aspiration catheter to recover an embolism protection device are described.

Abstract: An integrated guiding device has a tube and a corewire within the tube and a torque coupler. The torque coupler can couple the rotational motion of the tube with the rotational motion of the corewire. The wire can be moved longitudinally at least some amount relative to the tube. The device can further comprise a functional medical structure, such as an embolism protection structure. The device can be used in medical procedures, such as less invasive procedures within the cardiovascular system. Improved fiber based embolism protection devices comprise fiber bundles that are twisted prior to delivery.

Abstract: A biocompatible medical device having a segmented element including a first segment having a first shaped interface and a second segment having a second shaped interface configured to operably couple the first shaped interface. When the first shaped interface is engaging the second shaped interface to form a joined segmented element, the first segment and the second segment cannot be decoupled by movement along an axis through the element. The medical device further includes a locking element configured to engage the joined segmented element with a sliding motion to prevent decoupling of the first segment with respect to the second segment by preventing significant relative movement of the segments with a component of the movement perpendicular to the axis.

Abstract: Thrombectomy catheters are presented that have curved tip portions. A suction lumen extends from at or near the proximal end of the catheter to a suction port at or near the tip portion of the catheter. The curves of the thrombectomy catheter can be selected to place a suction port at or near a vessel wall for the more effective removal of thrombus resulting from directing the suction in the direction of the thrombus. In some embodiments, the tip portion of the catheter can be transitioned from a first configuration for delivery of the catheter into the vessel to a second more curved configuration with a desired design for application of suction. The catheter can be moved in a circumferential and/or lateral direction to cover selected portions of the inner vessel wall. In some embodiments, a partially occlusive structure can be used to reduce and/or redirect flow within the vessel to improve performance of the thrombectomy.

Abstract: Improved embolism protection devices comprises fibers that can have one configuration for delivery of the device and a second configuration in which the device is deployed for filtering of flow within a vessel. In some embodiments, the fibers can be connected to a fiber support, which is connected to an actuating element. The actuating element controls the transition from the delivery configuration to the deployed configuration. The embolism protection device can comprise a guidewire. The fibers can be attached at one end to a fiber support structure and at another end to the guidewire. A hypotube can be attached to the proximal end of the fibers while the guidewire is attached at the distal end of the fibers with the guidewire extending within a central channel of the hypotube. The hypotube can be used to guide the delivery of treatment structures, such as a balloon and/or a stent.

Abstract: Improved embolism protection devices comprises fibers that can have one configuration for delivery of the device and a second configuration in which the device is deployed for filtering of flow within a vessel. In some embodiments, the fibers can be connected to a fiber support, which is connected to an actuating element. The actuating element controls the transition from the delivery configuration to the deployed configuration. The embolism protection device can comprise a guidewire. The fibers can be attached at one end to a fiber support structure and at another end to the guidewire. A hypotube can be attached to the proximal end of the fibers while the guidewire is attached at the distal end of the fibers with the guidewire extending within a central channel of the hypotube. The hypotube can be used to guide the delivery of treatment structures, such as a balloon and/or a stent.

Abstract: A deflection and support catheter provided for improved manipulation of elongated medical devices used during percutaneous procedures in difficult to reach situations. In particular, the deflection and support catheters can facilitate placement of guidewires, guide catheters, and intervention devices such as angioplasty balloons and stent delivery devices.

Abstract: A guiding catheter for use in coronary angioplasty and other cardiovascular interventions which incorporates a plurality of segment of selected flexural modulus in the shaft of the device. The segments which have a different flexibility than the sections immediately proximal and distal to them, creating zones in the catheter shaft which are either more or less flexible than other zones of the shaft. The flexibility and length of the shaft in a given zone is then matched to its clinical function and role. A mid-shaft zone is significantly softer than a proximal shaft or distal secondary curve to better traverse the aortic arch shape without storing too much energy. A secondary zone section is designed to have maximum stiffness to provide optimum backup support and stability.

Abstract: Systems for less invasive medical procedures comprise a filter device mounted on an integrated guiding structure and an aspiration catheter. These components can be used together or separately, and the system can be used with other medical devices that are designed for less invasive procedures, such as procedures in a patient's vasculature. The filter device can involve improved torque coupling with a torque coupler associated with a resilient member that correspondingly also provides increased flexibility relative to an overtube that forms a tube for the remaining portions of the device. An actuation tool for the filter device used a systematic loading procedure for proper loading of the corewire and overtube into the actuation tool. A fiber cartridge comprises fibers loaded as a bundle into the cartridge for delivery with the ends of the fibers respectively bonded to radiopaque markers that can be visualized to come together when the filter is properly deployed.

Abstract: Various devices are described to provide filtering of flow from the aorta to the left carotid artery and the right carotid artery. The filters can be brought into a desired position through one or more peripheral arteries. A single filter device can provide the desired filtering or a plurality of devices can be used. In particular a single filter device can span between the brachiocephalic artery and the left carotid artery. These filter devices can be used effectively to capture emboli generated during procedures on the heart so that emboli do not travel to the patient's brain where the emboli can cause a stroke or other adverse event. In particular, these filters can be used during percutaneous procedures on the heart, such as endovascular heart valve replacement.

Abstract: Embolectomy procedures can be performed under conditions to effectively remove thrombus/emboli with little risk of injuring the vessel wall and while effectively capturing and removing emboli. Desired embolectomy devices present a polymer matrix against the vessel wall. Suction can be used to facilitate the embolectomy process and to remove emboli loosened in the procedure. Some devices combine features to present a polymer matrix against the vessel wall while corresponding providing sufficient support to effectively loosen thrombus. Combinations of embolectomy and/or filter elements can be used.

Abstract: Improved embolism protection devices comprises fibers that can have one configuration for delivery of the device and a second configuration in which the device is deployed for filtering of flow within a vessel. In some embodiments, the fibers can be connected to a fiber support, which is connected to an actuating element. The actuating element controls the transition from the delivery configuration to the deployed configuration. The embolism protection device can comprise a guidewire. The fibers can be attached at one end to a fiber support structure and at another end to the guidewire. A hypotube can be attached to the proximal end of the fibers while the guidewire is attached at the distal end of the fibers with the guidewire extending within a central channel of the hypotube. The hypotube can be used to guide the delivery of treatment structures, such as a balloon and/or a stent.

Abstract: Aspiration catheters generally comprise a tube or shaft with an aspiration opening at or near its distal end and a suction device that is at or near the proximal end of the catheter. An aspiration lumen extends from the suction device to the aspiration opening. The aspiration catheter can be associated with an extendable device such that their functions can be combined advantageously. The extendable device can function as a treatment structure and/or as a flow modifier. A treatment structure can be used to expand a constriction in a vessel or to deliver a treatment element into the vessel. A flow modifier generally controls the flow to decrease flow in the vicinity of the aspiration opening to improve the efficiency of the aspiration. Various relationships between the extendable structure and the aspiration catheter are described.

Abstract: A tubing assembly for manufacture for a catheter of the type having an inner tubular member defining a lumen, an outer tubular member surrounding said inner member, and a support member mounted between the tubular members to provide rigidity to the flexible catheter. The support member comprises a high tensile strength wire braid, and in the preferred embodiment comprises a stainless steel wire braid which has been tempered or hardened. This higher tensile strength affords significantly greater kink resistance to the flexible catheter. One wire braid has a tensile strength in the range of 300 to 425 kpsi and a braid density of approximately 40 pic. The high tensile strength wire braid has the disadvantage of tending to flare out at its free ends. Therefore, means are provided for preventing the flaring of the wire braid during manufacture of the tubing assembly. One means includes adhesive applied over the free ends. Another means includes a restraining sleeve applied over the free ends.

Abstract: A deflection and support catheter provided for improved manipulation of elongated medical devices used during percutaneous procedures in difficult to reach situations. In particular, the deflection and support catheters can facilitate placement of guidewires, guide catheters, and intervention devices such as angioplasty balloons and stent delivery devices.

Abstract: Medical devices with radiopaque three dimensional filtration matrices provide for improved visualization of the device within a vessel. In some embodiments, the three dimensional filtration matrix comprises fibers, such as surface capillary fibers. Visualization of the three dimensional filtration matrix provides for an evaluation of the proper deployment of the three dimensional filtration matrix. Radiopaque surface capillary fibers can be advantageously incorporated into other medical devices. Radiopaque surface capillary fibers can be formed by extrusion of a radiopaque polymer or polymer composite.

Abstract: Thrombectomy catheters are presented that have curved tip portions. A suction lumen extends from at or near the proximal end of the catheter to a suction port at or near the tip portion of the catheter. The curves of the thrombectomy catheter can be selected to place a suction port at or near a vessel wall for the more effective removal of thrombus resulting from directing the suction in the direction of the thrombus. In some embodiments, the tip portion of the catheter can be transitioned from a first configuration for delivery of the catheter into the vessel to a second more curved configuration with a desired design for application of suction. The catheter can be moved in a circumferential and/or lateral direction to cover selected portions of the inner vessel wall. In some embodiments, a partially occlusive structure can be used to reduce and/or redirect flow within the vessel to improve performance of the thrombectomy.

Abstract: In general, aspiration catheters have a suction device, a proximal portion and a shaft with a proximal end and a distal end. The shaft is operably connected at its proximal end to the proximal portion. The suction device is attached or attachable to the proximal portion to form a continuous lumen from the suction device to an aspiration opening at the distal end of the shaft. Improvements in the aspiration catheter design provide for improved tracking and/or a reduced chance of snagging during delivery of the aspiration catheter. In some embodiments, the tip of the shaft has a natural curve relative to the neutral orientation of the remaining portions of the shaft. In other embodiments, the aspiration catheter further comprises a tracking portion that has a guide lumen. A guide structure can extend through the guide lumen to limit the relative motion of the tip of the catheter relative to the guide structure during delivery of the aspiration catheter within a patient's vessel.

Abstract: Thrombectomy catheters are presented that have curved tip portions. A suction lumen extends from at or near the proximal end of the catheter to a suction port at or near the tip portion of the catheter. The curves of the thrombectomy catheter can be selected to place a suction port at or near a vessel wall for the more effective removal of thrombus resulting from directing the suction in the direction of the thrombus. In some embodiments, the tip portion of the catheter can be transitioned from a first configuration for delivery of the catheter into the vessel to a second more curved configuration with a desired design for application of suction. The catheter can be moved in a circumferential and/or lateral direction to cover selected portions of the inner vessel wall. In some embodiments, a partially occlusive structure can be used to reduce and/or redirect flow within the vessel to improve performance of the thrombectomy.