Abstract: Apparatuses, including systems, for performing a valve replacement or repair. Apparatuses may include an outer catheter, 2024/148366 one or more interchangeable inner catheters, a guidewire and an expandable chordae tendinae deflector. The outer catheter and inner catheter may be configured to engage with to prevent gaps. The inner catheter may include a chordae tendinae deflector. The outer catheter may be configured as a rapid pacing sheath that may be used with any of these apparatuses.

Abstract: Systems for positioning an interventional device within the vasculature may include an outer delivery sheath that may couple both centrally and distally to an inner tubular shaft to present a distal sealed interface between the two so that the outer delivery sheath may be advanced distally into position with the vasculature by transferring force from the inner tubular shaft to a middle region of the outer delivery sheath. The outer delivery sheath may have a middle junction and a stretchable distal tip that engages with an interface region of the inner tubular shaft when the middle region of the inner tubular shaft is connected to the outer delivery sheath. The tapered distal tip of the outer delivery sheath and the outer delivery sheath and inner tubular shaft are sized and configured so that the outer surface of the tapered distal tip are substantially flush with each other.

Abstract: Apparatuses for positioning a catheter may include an outer delivery sheath that may couple both centrally and distally to an inner tubular shaft to allow enhanced pushability of the outer delivery sheath. The system may include an outer delivery sheath having a middle junction, wherein the middle junction comprises a releasable lock, as well as an inner tubular shaft having a proximal end region, a distal end region, and an engagement protrusion extending radially from an outer surface of the inner tubular shaft, wherein the engagement protrusion is configured to engage the releasable lock when a distal end region of the inner tubular shaft extends distally out of a distal end of the outer delivery sheath. The engagement protrusion comprises a contact surface configured to drive advancement of the outer delivery sheath by pushing from the middle junction region of the outer delivery sheath.

Abstract: Apparatuses and methods for performing transseptal extracorporeal membrane oxygenation are disclosed. The method may include puncturing a septum between the right atrium and the left atrium and advancing a catheter system through the puncture and into the aorta. The catheter system may include coaxially arranged and independently moveable venous and arterial sheaths having independently positionable openings for removing blood from the patient and for returning oxygenated blood to the patient, e.g., within the aorta.

Abstract: A catheter for facilitating re-entry of a re-entry wire into a true lumen or into any desired region of a blood vessel may have an elongate shaft with a first lumen. A distal port and a first proximal port are fluidly coupled with the first lumen. A wire re-entry port is adjacent the distal end of the elongate shaft. The wire re-entry port has a re-entry axis. An ultrasound transducer on the catheter is configured to produce an image the blood vessel, and has a central axis that allows visualization of the re-entry wire as it exits the re-entry port and re-enters the true lumen. This allows the operator to ensure that the re-entry wire re-enters the true lumen in a desired location and does not damage the vessel.

Abstract: Methods, apparatuses, and systems for performing a valve replacement or repair. Apparatuses may include systems and may include an outer catheter, one or more interchangeable inner catheters, a guidewire and an expandable chordae tendinae deflector. Also described herein are rapid pacing sheaths that may be used with any of these apparatuses and methods.

Abstract: A method and system for performing transseptal extracorporeal membrane oxygenation is disclosed. The method may include puncturing a septum between the right atrium and the left atrium and advancing a catheter system through the puncture and into the aorta. A first portion of the catheter system can remove blood from the patient, in some examples near the inferior vena cava. A second portion can return oxygenated blood to the patient, through the transseptal puncture and into the aorta.

Abstract: An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes near the distal ends of the needles allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered from the needles in or near the adventitia to ablate nerves outside of the media while sparing nerves within the media.

Abstract: An intravascular catheter for peri-vascular nerve activity sensing or measurement includes multiple needles advanced through supported guide tubes (needle guiding elements) which expand with open ends around a central axis to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the perivascular space. The system also may include means to limit and/or adjust the depth of penetration of the needles. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall.

Abstract: Apparatuses and methods for performing transseptal extracorporeal membrane oxygenation are disclosed. The method may include puncturing a septum between the right atrium and the left atrium and advancing a catheter system through the puncture and into the aorta. The catheter system may include coaxially arranged and independently moveable venous and arterial sheaths having independently positionable openings for removing blood from the patient and for returning oxygenated blood to the patient, e.g., within the aorta.

Abstract: A therapeutic apparatus for treating damaged tissue on a limb or body of a subject includes a wearable adapted to cover and be secured to the limb or body of a subject over damaged tissue. The wearable being configured to reduce pressure on the damaged tissue and adapted to deliver one or more treatments selected from the group consisting of heat, oxygen, electrical current, and light to the damaged tissue.

Abstract: A rapid exchange guide wire system for rapid delivery of a guide wire to a blood vessel. The system has a main guide wire and rapid a rapid exchange tube attached to the main guide wire near a distal end of the main guide wire. The rapid exchange tube has a lumen which extends in a longitudinal direction and is configured to permit the rapid exchange tube to be reversibly displaceable in the longitudinal direction over a medical device having a cylindrical portion The medical device may be a guide wire, balloon angioplasty catheter, stent delivery catheter, atherectomy catheter, intravascular ultrasound catheter, blood flow measurement wire, optical coherence tomography catheter, or a stent-on-wire catheter.

Abstract: Intravascular delivery system is designed for a safe and efficient access to secondary and tertiary vascular structures, such as the branches of the coronary sinus, to enhance the delivery and deployment of various catheters, such as, for example, pacemaker electrical leads. The over-the-wire system features a straight, or alternatively shaped, micro-catheter distal tip of an inner catheter that seamlessly cooperates with a peel-away reinforced outer catheter. The inner catheter and the peel-away reinforced outer catheter are advanced in their engaged mode of operation towards (or beyond) the target site. Subsequently, the inner and outer catheters are disengaged, and the inner catheter is removed from the outer catheter. A pacemaker lead may be advanced over the wire inside the outer catheter to the target site for deployment. Subsequently, the outer catheter is easily split and may be rapidly removed from the blood vessel.

Abstract: Methods, apparatuses, and systems for performing a valve replacement or repair. Apparatuses may include systems and may include an outer catheter, one or more interchangeable inner catheters, a guidewire and an expandable chordae tendinae deflector. Also described herein are rapid pacing sheaths that may be used with any of these apparatuses and methods.

Abstract: A method and system for performing transseptal extracorporeal membrane oxygenation is disclosed. The method may include puncturing a septum between the right atrium and the left atrium and advancing a catheter system through the puncture and into the aorta. A first portion of the catheter system can remove blood from the patient, in some examples near the inferior vena cava. A second portion can return oxygenated blood to the patient, through the transseptal puncture and into the aorta.

Abstract: An intravascular catheter for nerve activity ablation and/or sensing includes one or more needles advanced through supported guide tubes (needle guiding elements) which expand to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the extra-luminal tissue including the media, adventitia and periadvential space. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall. Electrodes near the distal ends of the needles allow sensing of nerve activity before and after attempted renal denervation. In a combination embodiment ablative energy or fluid is delivered from the needles in or near the adventitia to ablate nerves outside of the media while sparing nerves within the media.

Abstract: An intravascular catheter for peri-vascular nerve activity sensing or measurement includes multiple needles advanced through supported guide tubes (needle guiding elements) which expand with open ends around a central axis to contact the interior surface of the wall of the renal artery or other vessel of a human body allowing the needles to be advanced though the vessel wall into the perivascular space. The system also may include means to limit and/or adjust the depth of penetration of the needles. The catheter also includes structures which provide radial and lateral support to the guide tubes so that the guide tubes open uniformly and maintain their position against the interior surface of the vessel wall as the sharpened needles are advanced to penetrate into the vessel wall.

Abstract: Apparatuses and methods for performing transseptal extracorporeal membrane oxygenation are disclosed. The method may include puncturing a septum between the right atrium and the left atrium and advancing a catheter system through the puncture and into the aorta. The catheter system may include coaxially arranged and independently moveable venus and arterial sheaths having independently positionable openings for removing blood from the patient and for returning oxygenated blood to the patient, e.g., within the aorta.

Abstract: Methods, apparatuses, and systems for performing a valve replacement or repair. Apparatuses may include systems and may include an outer catheter, one or more interchangeable inner catheters, a guidewire and an expandable chordae tendinae deflector. Also described herein are rapid pacing sheaths that may be used with any of these apparatuses and methods.

Abstract: The subject guide catheter extension system with a micro-catheter delivery catheter includes an outer sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. Several mechanisms of engagement/disengagement between the inner and outer members are provided including a friction mechanism, threaded mechanism, pull away sheath, and engagement/disengagement mechanism for pusher's handles. The sheath and the inner member are modified for different engagement/disengagement mechanisms operation. A micro-catheter delivery system provides for an improved atraumatic crossability to the treatment site in an expedited and simplified fashion. During a procedure, a guidewire along with a guide catheter are advanced to the vicinity of the treatment site within a blood vessel.