Abstract: A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

Abstract: A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

Abstract: A combination flush catheter and selective catheter as one convertible catheter and methods of using the same. The selective catheter may be a reverse curve or guide catheter. The additional steps of removal of the flush catheter and re-insertion of the selective catheter may be eliminated, reducing the possibility of errors and making the procedure smoother and shorter.

Abstract: A variable flow stent is described for use with AV fistulas, TIPS procedures or dialysis grafts. The flow may be varied by adjusting the diameter of the stent. Embodiments include: a covered stent having a secondary chamber that functions as an air or fluid bladder; an expandable chamber within an interior stent covering; a retractable jack device with hooks that engage (snag) opposing walls of the stent; and, a stent with a hollow chamber or pocket in the interior stent covering into which an expandable balloon can be inserted. A self-healing valve is described for inflating or deflating expandable elements within the stent and may be implemented using a self-healing membrane. A radiopaque collar may be used to provide a marker surrounding the self-healing valve. If under-shunting or over-shunting occurs over time, the variable diameter stent may be adjusted using a second procedure.

Abstract: Tortuosity of vessels at or leading to the site of minimally invasive procedures is a problem for conducting such procedures as they increase the difficulty to guide the procedural catheters through tortuous vessels. Methods and apparatus for stabilization of the sheaths and catheters during access, procedures, and withdrawal in these tortuous vessels are disclosed. The apparatus and method for improving access include application of a pull component to the stabilized procedural catheter using a stabilization catheter/wire in addition to a push component from the percutaneous access to make the access easier while enabling use of more flexible catheters and softer wires. These methods and devices address the problems of trauma to the vessels during access, procedure and removal of catheters and wires, improve pushability of softer catheters and wires, and also substantially reduce substantially the procedure time.

Abstract: A combination flush catheter and selective catheter as one convertible catheter and methods of using the same. The selective catheter may be a reverse curve or guide catheter. The additional steps of removal of the flush catheter and re-insertion of the selective catheter may be eliminated, reducing the possibility of errors and making the procedure smoother and shorter.

Abstract: An arterial embolus retrieval system that includes an outer sheath configured as a tubular structure and that is able to move independent of a vessel wall. The arterial embolus retrieval system includes a retriever within the outer sheath, and configured to move independent of the outer sheath. The arterial embolus retrieval system also includes a handle configured to deploy the retriever, and a guidewire opposite of the handle and surrounded by the vessel wall. The outer sheath and the retriever can be configured to be guided to a location of an embolus using the guidewire. The guidewire can be configured to be retrieved once the outer sheath and the retriever are proximal to the embolus.

Abstract: A guide sheath device with an integrated stabilization wire is provided. The guide sheath device includes an elongate member having a proximal and distal end and a lumen there between and a stabilization wire integrated to the elongate member.

Abstract: Systems and methods to provide end to end stabilization support to the operational catheter and reduce the need to stabilize or push from the lateral wall of the aorta during coronary interventions. This reduces the potential for stroke from plaque breaking off the wall of the aorta during intervention procedures. A support and stabilization wire having one end at the femoral percutaneous access and the second end at a radial percutaneous access is established for end to end stabilization. A bifurcated catheter having a wide lumen for procedural catheters and a narrow lumen for the support wire or catheter is advanced over the support wire to the aortic arch. A procedural catheter and a variety of different shaped guide wires may be deployed from the wide lumen of the bifurcated catheter into the right or left coronary artery to accommodate a range of aortic anatomical considerations during the coronary interventions.

Abstract: A guide sheath device with an integrated stabilization wire is provided. The guide sheath device includes an elongate member having a proximal and distal end and a lumen there between and a stabilization wire integrated to the elongate member. The guide sheath is configured to access the lower vasculature via a contralateral percutaneous access. The stabilization wire is configured to exit the vasculature at an ipsilateral percutaneous access and be locked in place at the exit. The proximal end of the guide sheath and the distal end of the stabilization wire being accessible outside the vasculature enable stabilization of the stabilization wire and the guide sheath. The stabilization enables stabilization of procedural catheters and instruments as they access the site of a procedure within the lower vasculature.

Abstract: A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

Abstract: The use of bifurcated catheter is disclosed for stabilizing working catheters for carotid percutaneous intervention of vessels originating from a tortuous aortic arch, which uses guide wires that used to enable the catheters accessing the left or right carotid arteries (CA). Also disclosed is the use of two independent catheters or a catheter and snare wire within a single sheath, as well as the implementations, associated problems and corrective solutions to the identified problems. Further additional uses of the bifurcated catheter/dual catheter, for access to and treatment of other exemplary tortuous locations where stability of the procedural catheter would make a difference are also disclosed in the current application.

Abstract: A bifurcated catheter and methods of use are disclosed herein. The bifurcated catheter can include a fixed flat wire that is configurable as a stabilization wire. The bifurcated catheter can be configured to improve the initial access and directability by application of a pull force to the stabilization wire, in addition to a push force from the proximal end of the bifurcated catheter. The stabilization wire is anchored once the bifurcated catheter is positioned. The anchored, bifurcated catheter provides stability and pushability to assist the procedural catheter in traversing the tortuous peripheral vasculature.

Abstract: For percutaneous minimally-invasive intervention in vessels originating from other tortuous vessels, such as the tortuous aortic arch, guide wires/catheters are used to enable procedural catheters to access the vessels where an interventional procedure is needed. Two new methods for fixing a stabilization wire/catheter and providing the needed tension and stabilization without a second percutaneous access are disclosed (1) using a micro-anchor and pin and (2) using a modified Fogarty Balloon. These methods are also usable for access to and treatment of peripheral embolisms in tortuous vessels as well as renal and other visceral interventions.

Abstract: A variable flow stent is described for use with AV fistulas, TIPS procedures or dialysis grafts. The flow may be varied by adjusting the diameter of the stent. Embodiments include: a covered stent having a secondary chamber that functions as an air or fluid bladder; an expandable chamber within an interior stent covering; a retractable jack device with hooks that engage (snag) opposing walls of the stent; and, a stent with a hollow chamber or pocket in the interior stent covering into which an expandable balloon can be inserted. A self-healing valve is described for inflating or deflating expandable elements within the stent and may be implemented using a self-healing membrane. A radiopaque collar may be used to provide a marker surrounding the self-healing valve. If under-shunting or over-shunting occurs over time, the variable diameter stent may be adjusted using a second procedure.

Abstract: A system for the intravascular placement of a medical device including a guidewire having a first end and a second end, the first end having a microwhisk positional between a feeding state and a deployed state, a guidewire sheath surrounding the guidewire; and an anchoring device for cooperatively fixing the microwhisk relative to a patient. Also, the method of the intravascular placement of the medical device by inserting the medical device through the body with the guidewire and the microwhisk contained within the guidewire sheath, driving the microwhisk out of the guidewire sheath to position the microwhisk to its deployed state, and engaging the anchoring device from the outside of the body through a body surface into the microwhisk, and further into a stabilizing body component.

Abstract: A steerable intravascular anchor comprises an anchor portion that is steerable to a position and then pinned thereto by an external device protruding through the superficial temporal artery. The pin is steered through the skin into the anchor under, for example, by fluoroscopic guidance. The anchor portion, in one embodiment, may have a figure-eight shape, and that comprises two wires, each wire forming a ring. The rings may be located in the same plane or at an angle with respect to one other. Alternatively, the anchor portion comprises a plurality of wires, each wire forming a ring, each ring being connected to at least one other ring. It will be appreciated that other wire shapes may be used, including loops, triangles, squares, pentagons, hexagons, and the like, and combinations thereof.

Abstract: Tortuosity of vessels at or leading to the site of minimally invasive procedures is a problem for conducting such procedures as they increase the difficulty to guide the procedural catheters through tortuous vessels. Methods and apparatus for stabilization of the sheaths and catheters during access, procedures, and withdrawal in these tortuous vessels are disclosed. The apparatus and method for improving access include application of a pull component to the stabilized procedural catheter using a stabilization catheter/wire in addition to a push component from the percutaneous access to make the access easier while enabling use of more flexible catheters and softer wires. These methods and devices address the problems of trauma to the vessels during access, procedure and removal of catheters and wires, improve pushability of softer catheters and wires, and also substantially reduce substantially the procedure time.

Abstract: Tortuosity of vessels at or leading to the site of minimally invasive procedures is a problem for conducting such procedures as they increase the difficulty to guide the procedural catheters through tortuous vessels. Methods and apparatus for stabilization of the sheaths and catheters during access, procedures, and withdrawal in these tortuous vessels are disclosed. The apparatus and method for improving access include application of a pull component to the stabilized procedural catheter using a stabilization catheter/wire in addition to a push component from the percutaneous access to make the access easier while enabling use of more flexible catheters and softer wires. These methods and devices address the problems of trauma to the vessels during access, procedure and removal of catheters and wires, improve pushability of softer catheters and wires, and also substantially reduce substantially the procedure time.

Abstract: An arterial embolus retrieval system is disclosed. The arterial embolus retrieval system can include an outer sheath configured as a tubular structure and that's able to move independent of a vessel wall. The arterial embolus retrieval system includes a retriever within the outer sheath, and configured to move independent of the outer sheath. The arterial embolus retrieval system also includes a handle configured to deploy the retriever, and a guidewire opposite of the handle and surrounded by the vessel wall. The outer sheath and the retriever can be configured to be guided to a location of an embolus using the guidewire. The guidewire can be configured to be retrieved once the outer sheath and the retriever are proximal to the embolus.