Abstract: System and methods are provided for treating a patient that include a delivery device sized for introduction into a target site within a patient's body, a source of one or more therapeutic and/or diagnostic agents coupled to the delivery device, and a tubular member sized for introduction into the patient's vasculature to isolate the thoracic duct. Once the thoracic duct is isolated, fluid may be removed from the thoracic duct, e.g., to prevent the agents that transit from the target site into the thoracic duct from entering the patient's vasculature, and/or to modulate flow through the thoracic duct to modulate concentration and/or resident time of the agents at the target site. The one or more agents may include particles sized for preferential transit into the lymphatic system.

Abstract: System and methods are provided for harvesting one or more organs, e.g., a lung from a donor body. In one embodiment, a distal end of a tubular member is introduced into the donor body's vasculature via a percutaneous access site, and the tubular member is manipulated until the distal end of the tubular member is disposed within the thoracic duct. Fluid is removed from the thoracic duct through the tubular member to a location exterior to the patient's body, and one or more organs are removed from the donor body. Optionally, one or more parameters within the thoracic duct or other parameters of the donor body may be monitored and fluid removal may be adjusted to reduce fluid accumulation within the one or more organs.

Abstract: Apparatus and methods are provided for making catheters having intermediate layers that minimize or eliminate gaps during layup.

Abstract: Catheters, sheaths, or other tubular devices are provided that include a proximal end, a distal end sized for introduction into a patient's body, and a steerable distal portion. The tubular device includes a primary lumen extending between the proximal and distal ends; an auxiliary lumen adjacent the primary lumen; and one or more reinforcement members including windings extending helically along at least the distal portion, at least some of the windings passing between the primary and steering element lumens and at least some of the windings surrounding both the primary and steering element lumens. In one embodiment, a steering element is slidably disposed within the auxiliary lumen. Apparatus and methods for making such tubular devices are also provided.

Abstract: Apparatus, systems, and methods are provided for optically sensing position within body lumens within a patient's body, e.g., in blood-filled vessels and chambers. In one embodiment, the apparatus includes a tubular member including a proximal end, a distal end sized for introduction into a patient's body, and one or more lumens extending between the proximal and distal ends; a distal tip on the distal end for contacting tissue; and one or more optical elements on the distal tip configured to transmit illumination beyond the distal tip and capture optical signals from tissue or fluids adjacent the distal tip. The distal tip may be positioned within a body lumen, and the optical elements may be used to detect the proximity of the distal tip relative to tissue adjacent the body lumen.

Abstract: Systems and methods are provided for performing a medical procedure within a patient's body that involves a thoracic duct including an ostium communicating with the patient's venous system. A distal end of a catheter is introduced through the patient's venous system into a body lumen adjacent the ostium of the thoracic duct. An expandable member on the distal end of the tubular member may be expanded adjacent the ostium, e.g., within the body lumen or the thoracic duct itself, and used to isolate the thoracic duct from the body lumen, whereupon a medical procedure may be performed via the thoracic duct. For example, lymphatic fluid may be removed from the thoracic duct through a lumen of the tubular member and/or one or more agents may be introduced into the thoracic duct through the tubular member.

Abstract: A stent compression and crimping system includes a sheath having a proximal end, a distal end comprising a removable funnel, and a lumen extending between the proximal and distal ends. The system further includes a guidewire extending through the sheath's lumen. The system also includes a plurality of elongate wires. Each wire has a proximal end attached to a collar, a distal free end, and a wire body extending between the proximal end and the distal end. The plurality of elongate wires is collectively disposed about the guidewire in an operative configuration.

Abstract: Devices and methods are provided for inhibiting mouth breathing and/or improving nasal breathing, e.g., for PAP users or users with other sleeping problems. In an exemplary embodiment, an adhesive device is provided that includes an elongate membrane comprising first and second ends and side edges extending between the first and second ends, a first surface comprising an adhesive layer. The adhesive layer may be a low tack adhesive that is adherent to skin, yet is also easily removable without leaving significant residue. Optionally, the device may include one or more valves to provide one-way flow across the membrane, one or more weakened regions in the membrane, and/or one or more tabs to facilitate removal of the membrane from over a user's mouth.

Abstract: Systems and methods are provided for performing a medical procedure within a patient's body that involves a thoracic duct including an ostium communicating with the patient's venous system. An apparatus is provided that includes a catheter including proximal and distal ends and a lumen extending therebetween. An expandable sealing member is carried beyond the distal end that is expandable from a delivery condition to a deployed condition in which the sealing member defines a concave contact surface shaped for engaging a vessel wall surrounding the outlet of the thoracic duct. The sealing member includes an aspiration port in the contact surface communicating with the catheter lumen for removing fluid from the thoracic duct.

Abstract: Apparatus and methods are provided for making one or more tubular components of medical catheters or other tubular bodies using a strip of polymer material including a length, a width, and a first surface including a lubricious or other coating or surface modification. The strip is directed adjacent an elongate mandrel, such as beading, such that the length of the strip extends along the mandrel and the coating is disposed towards the mandrel. The strip is rolled at least partially around the mandrel such that the coating or surface modification is disposed inwardly towards the mandrel, and one or more strip-constrainment members are wrapped around the rolled strip. The directing, rolling, and wrapping steps may be substantially continuous to create one or more strip-mandrel-constrainment member subassemblies.

Abstract: Apparatus and methods are provided for making one or more tubular components of medical catheters or other tubular bodies using a strip of polymer material including a length, a width, and a first surface including a lubricious or other coating or surface modification. The strip is directed adjacent an elongate mandrel, such as beading, such that the length of the strip extends along the mandrel and the coating is disposed towards the mandrel. The strip is rolled at least partially around the mandrel such that the coating or surface modification is disposed inwardly towards the mandrel, and one or more strip-constrainment members are wrapped around the rolled strip. The directing, rolling, and wrapping steps may be substantially continuous to create one or more strip-mandrel-constrainment member subassemblies.

Abstract: Apparatus are provided for performing a procedure within a patient's body that include a tubular member including proximal and distal ends, a central axis or region extending therebetween, and a distal portion extending distally from an intermediate portion to the distal end. One or more accessory lumens and a steering element lumen extend between the proximal and distal ends, the steering element lumen offset from the central region within the distal portion such that a steering plane intersects the steering element lumen and the central axis. The distal portion includes a core member extending between the intermediate portion and the distal end, and stabilization elements embedded in the core member adjacent the accessory lumen and defining a stabilization plane that intersects the steering plane at a location offset from the central region, e.g., closer to the accessory lumen than the steering element lumen.

Abstract: Material transport catheters and methods for their use rely on rotation of an impeller within a catheter body and a clearing element for preventing buildup of materials at the opening of the catheter body. The impeller preferably comprises an inner tube or shaft having a helical rotor fainted over an outer surface thereof. The clearing element may comprise a free end of a structure near the distal end of the catheter body for disrupting clot, wherein the free end of the structure extends into the distal opening of the catheter body to break up materials as the impeller is rotated. Alternatively, the clearing element may comprise a cutting member disposed at the distal opening of the catheter body.

Abstract: Systems and methods are provided for performing a medical procedure within a patient's body that involves a thoracic duct including an ostium communicating with the patient's venous system. A distal end of a catheter is introduced through the patient's venous system into a body lumen adjacent the ostium of the thoracic duct. An expandable member on the distal end of the tubular may be expanded adjacent the ostium, e.g., within the body lumen or the thoracic duct itself, and used to isolate the thoracic duct from the body lumen, whereupon a medical procedure may be performed via the thoracic duct. For example, lymphatic fluid may be removed from the thoracic duct through a lumen of the tubular member and/or one or more agents may be introduced into the thoracic duct through the tubular member.

Abstract: A hub for a sheath, catheter, or other tubular device includes a tubular hub body including first and second ends, and a lumen extending therebetween and surrounding a central longitudinal axis, the lumen having a first cross-sectional area sized for receiving a medical device therethrough. A valve is secured within the lumen that includes an elastomeric valve body including a passage extending therethrough between front and rear surfaces thereof and offset from the central axis. The valve body defines a second cross-sectional area larger than the first cross-sectional area in a relaxed state in which the passage defines an oval shape, and is secured within the lumen in a compressed state in which the passage is compressed to a closed configuration for sealing the passage from fluid flow. The passage is resiliently expandable to accommodate receiving an instrument therethrough while providing a seal around the instrument.

Abstract: Apparatus and methods are provided for delivering a guidewire, agents, and the like through an occlusion in a body vessel or other body lumen. The apparatus includes a flexible catheter or other elongate member including a proximal end, a distal end sized for insertion into a body lumen, and a first lumen extending from the proximal end to a distal region of the tubular member. An expandable sheath is provided on the distal region of the catheter that is expandable from a contracted condition to minimize a profile of the sheath to allow insertion along with the tubular member into a body lumen, to an enlarged condition wherein the sheath at least partially defines a lumen communicating with and extending distally from the first lumen of the tubular member.

Abstract: Apparatus are provided for performing a procedure within a patient's body that include a tubular member including proximal and distal ends, a central axis or region extending therebetween, and a distal portion extending distally from an intermediate portion to the distal end. One or more accessory lumens and a steering element lumen extend between the proximal and distal ends, the steering element lumen offset from the central region within the distal portion such that a steering plane intersects the steering element lumen and the central axis. The distal portion includes a core member extending between the intermediate portion and the distal end, and stabilization elements embedded in the core member adjacent the accessory lumen and defining a stabilization plane that intersects the steering plane at a location offset from the central region, e.g., closer to the accessory lumen than the steering element lumen.

Abstract: Material transport catheters and methods for their use rely on rotation of an impeller within a catheter body and a clearing element for preventing buildup of materials at the opening of the catheter body. The impeller preferably comprises an inner tube or shaft having a helical rotor fainted over an outer surface thereof. The clearing element may comprise a free end of a structure near the distal end of the catheter body for disrupting clot, wherein the free end of the structure extends into the distal opening of the catheter body to break up materials as the impeller is rotated. Alternatively, the clearing element may comprise a cutting member disposed at the distal opening of the catheter body.

Abstract: A hub for a sheath, catheter, or other tubular device includes a first hub portion including a first hub lumen sized for receiving a medical device therethrough, and a second hub portion including a second hub lumen, the second hub portion coupled to the first hub portion such that the first and second hub lumens are aligned with one another and the first and second hub portions are spaced apart from one another to define a gap. A valve is secured within the gap between the first and second hub portions that includes a valve passage therethrough, e.g., for accommodating receiving a medical device through the first and second hub lumens into the tubular device, while providing a substantially fluid tight seal.

Abstract: Airway devices are provided for introducing an endoscope into a patient's gastrointestinal system that include a tubular proximal portion sized for placement in an oral cavity and including a passage for receiving an endoscope therethrough, and a curved distal portion. The distal portion may have a “C” shaped wall defining a channel extending from the passage to a distal tip of the distal portion. The proximal portion may include a flange for placement adjacent the patient's teeth when the airway device is inserted into the oral cavity, and the airway device may include sampling and fluid delivery lumens including ports on the face of the flange. The sampling lumen may include an inlet port within the passage, and the fluid delivery lumen may include an outlet port communicating with the channel such that the outlet port is offset distally relative to the inlet port.