Abstract: Percutaneous devices and methods for releasably engaging a guidewire against an inner surface of a tubular member are disclosed. A percutaneous device can include a tube member, a push member, and a fixation mechanism such as a fixation balloon. The tube member can define a lumen sized and shaped to receive one or more interventional medical devices therethrough and can have an outer diameter smaller than a lumen of a guide catheter. The push member can be attached at least to a proximal end portion of the tube member for slidably positioning a distal end portion of the tube member within and beyond a distal end of the guide catheter. The push member can include a lumen in fluid communication with an interior of the fixation balloon for delivering inflation fluid to, or removing fluid from, the balloon. The fixation balloon can be positioned on a portion of the push member and can be configured to engage a guidewire against the inner surface of the guide catheter or the tube member when inflated.

Abstract: Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member, a push member, and a removable support member. The push member can be eccentrically coupled directly or indirectly to the elongate tube member and can extend proximally therefrom for slidably positioning the elongate tube member within and partially beyond a distal end of a guide catheter. The removable support member can comprise a structure that surrounds at least a portion of the push member. The removable support member alone, or when placed over the push member, can be more rigid along its longitudinal axis than the elongate tube member and can have a cross-sectional dimension that is greater than a maximal cross-sectional dimension of the push member.

Abstract: This patent document discloses guide extension catheters for use with a predefined length guide catheter and related methods for treating blood vessel lesions and abnormalities. A guide extension catheter can include a push member, an elongate tube member, and a balloon radially surrounding a portion of the elongate tube member. The balloon can include an inflatable tube coupled to an elongate shaft having a lumen for receiving inflation fluid, and the inflatable tube can be coiled in a helical manner around the elongate tube member. A bioactive layer can coat an outer surface portion of the balloon and, when the balloon is inflated, one or more drugs of the bioactive layer can be received by the blood vessel. Inflation of the balloon can engage the elongate tube member with an inner surface of the blood vessel and/or an inner surface of the guide catheter.

Abstract: Perfusion catheters and related methods for treating complications related to CTO interventions or dilating a vessel occlusion while maintaining a passage through the treated vessel segment are disclosed. A perfusion catheter can include a balloon formed of an inflatable tube and an elongate shaft having a lumen for providing inflation fluid to, or withdrawing inflation fluid from, the balloon. The inflatable tube can be coiled in a helical manner around a central axis into a series of windings. Adjacent windings can be stacked against and bonded to each other, and an inner surface of the series of windings, when inflated, can define the passage. The elongate shaft can be eccentrically attached to the balloon and the shaft's lumen can be in fluid communication with the interior of the balloon, specifically the inflatable tube. The inflatable tube can include two different polymer tubes, one slightly smaller than the other.

Abstract: This patent document discloses guide extension catheters for use with a predefined length guide catheter and related methods for treating blood vessel lesions and abnormalities. A guide extension catheter can include a push member, an elongate tube member, and a balloon radially surrounding a portion of the elongate tube member. The balloon can include an inflatable tube coupled to an elongate shaft having a lumen for receiving inflation fluid, and the inflatable tube can be coiled in a helical manner around the elongate tube member. A bioactive layer can coat an outer surface portion of the balloon and, when the balloon is inflated, one or more drugs of the bioactive layer can be received by the blood vessel. Inflation of the balloon can engage the elongate tube member with an inner surface of the blood vessel and/or an inner surface of the guide catheter.

Abstract: Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member, a push member, and an external manipulation member. The push member can be eccentrically coupled relative to the tube member and extend proximally therefrom for slidably positioning the tube member within and partially beyond a distal end of a guide catheter. The manipulation member can be coupled to a proximal end of the push member, where the manipulation member can be configured to secure the guide extension catheter in place during use by attaching to an external object such that the tube member and push member remain stationary without user engagement.

Abstract: Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member, a push member, and a removable support member. The push member can be eccentrically coupled directly or indirectly to the elongate tube member and can extend proximally therefrom for slidably positioning the elongate tube member within and partially beyond a distal end of a guide catheter. The removable support member can comprise a structure that surrounds at least a portion of the push member.

Abstract: Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes.

Abstract: This patent document discloses perfusion catheters and related methods for treating complications related to CTO interventions or dilating a vessel occlusion while maintaining a passage through the treated vessel segment. A perfusion catheter can include a balloon formed of an inflatable tube and an elongate shaft having a lumen for providing inflation fluid to, or withdrawing inflation fluid from, the balloon. The inflatable tube can be coiled in a helical manner around a central axis into a series of windings. Adjacent windings can be stacked against and bonded to each other, and an inner surface of the series of windings, when inflated, can define the passage. The elongate shaft can be eccentrically attached to a proximal portion of the balloon and the shaft's lumen can be in fluid communication with the interior of the balloon, specifically the inflatable tube. The inflatable tube can include two different polymer tubes, one slightly smaller than the other.

Abstract: Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes.

Abstract: Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member and a lumenless push member. The push member can be eccentrically coupled to the tube member for slidably positioning the tube member within and partially beyond a distal end of a guide catheter. At least a proximal end portion of the push member can include a cross-section defined by an arcuate first surface and an opposing second surface. The first surface can engage an inner wall surface of the guide catheter along an arc length, and the second surface can be spaced furthest from the first surface at its center point. The first surface can have the same or substantially the same radius of curvature as the guide catheter's inner wall surface, and the second surface can be flat or substantially flat. This configuration of the push member can provide an advantageous blend of stiffness and flexibility, as well as space conservation through the guide catheter.

Abstract: Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes.

Abstract: Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member and a lumenless push member. The push member can be eccentrically coupled to the tube member for slidably positioning the tube member within and partially beyond a distal end of a guide catheter. At least a proximal end portion of the push member can include a cross-section defined by an arcuate first surface and an opposing second surface. The first surface can engage an inner wall surface of the guide catheter along an arc length, and the second surface can be spaced furthest from the first surface at its center point. The first surface can have the same or substantially the same radius of curvature as the guide catheter's inner wall surface, and the second surface can be flat or substantially flat. This configuration of the push member can provide an advantageous blend of stiffness and flexibility, as well as space conservation through the guide catheter.

Abstract: Assemblies and methods for capturing a guidewire advanced through a blood vessel in a retrograde direction are disclosed. An assembly can include a constraining catheter and a capture catheter. The constraining catheter can include a first longitudinal member and a tubular member; the tubular member can be eccentrically coupled with a distal end portion of the first longitudinal member. The capture catheter can include a second longitudinal member and a funnel member; the funnel member can be eccentrically coupled with a distal end portion of the second longitudinal member. The funnel member can be moved between a collapsed configuration and an expanded configuration through relative movement between the first and second longitudinal members. In the collapsed configuration, at least a portion of the funnel member is disposed within a lumen of the tubular member. In the expanded configuration, the portion of the funnel member projects from an end of the tubular member.

Abstract: Catheter devices, assemblies and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A catheter device can include a central catheter, two side tubes, and a distally-protruding, curved subintimal guidewire. The central catheter can define a central lumen that extends from a proximal end to a distal end of the central catheter. The lumen can be configured to receive a primary guidewire. The central catheter can also define at least one reentry aperture oriented transverse to the central lumen. The first and second side tubes can be coupled with the central catheter, extending along a longitudinal axis thereof, with the first side tube flanking an opposite side of the central catheter relative to the second side tube. The subintimal guidewire can extend from the first side tube, distally beyond the distal end of the central catheter, to the second side tube.

Abstract: This patent document discloses perfusion catheters and related methods for treating blood vessel lesions and abnormalities. A perfusion catheter can include an inflatable balloon, an elongate shaft operably attached to the balloon, and an optional containment structure surrounding at least a portion of the balloon. The balloon can be inflated until its outer surface contacts a wall of a blood vessel. When inflated, the balloon's inner surface defines a passage for blood to flow. The balloon can be configured to release one or more substances formulated to treat a tissue at or near the wall of a blood vessel. In an example, the balloon can include a bioactive layer, which comprises the one or more substances, overlaying an optional base layer. In an example, the balloon can include multiple filars, at least one of which is configured to elute the one or more substances through a perforation or hole in the filar.

Abstract: Balloon catheters for, and related methods of, preventing contrast-associated nephropathy are disclosed. A method for preventing contrast-associated nephropathy can include inserting a catheter into a patient's coronary sinus and blocking blood flow from the coronary sinus into the patient's right atrium. The blood may contain a contrast agent. The method can further include draining the blood from the coronary sinus through a first lumen defined by the catheter while the blood flow is blocked, filtering the contrast agent from the blood which passes through the catheter, and returning contrast-free or contrast-reduced blood to the right atrium through a second lumen defined by the catheter, which terminates in a port proximal to the coronary sinus. Another method can include selectively draining blood from the coronary sinus into the right atrium through a first lumen defined by a catheter that includes a switchable valve while the blood flow is blocked.

Abstract: Guide extension catheters and related methods are disclosed. A guide extension catheter can comprise an elongate tube member, a push member, and a concave track. The elongate tube member can define a lumen and three distinct portions of different diameter. A distal portion can define a first diameter, a proximal portion can define a second diameter which is larger than the first diameter but smaller than a lumen of a guide catheter with which the guide extension catheter is used, and a tapered portion, positioned between the distal portion and the proximal portion, can have a variable diameter. The push member can be eccentrically coupled relative to the tube member and extends proximally therefrom for slidably positioning the tube member within and partially beyond a distal end of the guide catheter. The concave track forms a transition between the tube member and the push member, and defines a partially cylindrical opening leading into the tube member.

Abstract: Catheter devices, assemblies and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A catheter device can include a central catheter, two side tubes, and a distally-protruding, curved subintimal guidewire. The central catheter can define a central lumen that extends from a proximal end to a distal end of the central catheter. The lumen can be configured to receive a primary guidewire. The central catheter can also define at least one reentry aperture oriented transverse to the central lumen. The first and second side tubes can be coupled with the central catheter, extending along a longitudinal axis thereof, with the first side tube flanking an opposite side of the central catheter relative to the second side tube. The subintimal guidewire can extend from the first side tube, distally beyond the distal end of the central catheter, to the second side tube.

Abstract: Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes.