Abstract: Methods and devices are disclosed that enable safe, rapid and relatively short and straight access to the cerebral arteries for the introduction of interventional devices to treat acute ischemic stroke. In addition, the disclosed methods and devices provide means to securely close the access site to the cerebral arteries to avoid the potentially devastating consequences of a transcervical hematoma.

Abstract: An intravascular access system for facilitation of intraluminal medical procedures within the neurovasculature through an access sheath. The system includes an aspiration or support catheter having a flexible, distal luminal portion having an inner diameter defining a lumen extending between a proximal opening at a proximal end of the luminal portion and a distal opening at a distal end of the luminal portion. The catheter has a rigid spine coupled to at least the proximal end of the luminal portion and extending proximally therefrom. The system includes a dilator having a flexible, distal dilator portion sized to be received within the lumen of the luminal portion. Associated systems, devices, and methods of use are also described.

Abstract: Methods, systems, and devices for facilitation of intraluminal medical procedures within the neurovasculature, the methods, systems and the devices including catheters and catheter advancement elements.

Abstract: Described are methods, systems, and devices for facilitation of intraluminal medical procedures within the neurovasculature including catheters and catheter advancement elements.

Abstract: Methods and a system for performing a medical procedure at a treatment site of an occlusion in a dural venous sinus of a brain of a patient including advancing a catheter and a flexible inner member retrograde to a target location distal to a sigmoid sinus relative to an access point of entry, positioning the catheter at the treatment site in the dural venous sinus, removing the inner member from the patient; and treating the occlusion through the catheter to restore outflow of blood from the brain through the dural venous sinus. Related devices, systems, and methods are provided.

Abstract: Described are methods and systems for transcervical access of the cerebral arterial vasculature and treatment of cerebral occlusions, including ischemic stroke. The methods and devices may include methods and devices which may provide aspiration and passive flow reversal, those which protect the cerebral penumbra during the procedure to minimize injury to brain, as well as distal catheters and devices to remove an occlusion. The methods and devices that provide passive flow reversal may also offer to the user a degree of flow control. Devices and methods which provide a way to securely close the access site in the carotid artery to avoid the potentially devastating consequences of a transcervical hematoma are also described.

Abstract: An intravascular access system for facilitation of intraluminal medical procedures within the neurovasculature through an access sheath. The system includes an aspiration or support catheter having a flexible, distal luminal portion having an inner diameter defining a lumen extending between a proximal opening at a proximal end of the luminal portion and a distal opening at a distal end of the luminal portion. The catheter has a rigid spine coupled to at least the proximal end of the luminal portion and extending proximally therefrom. The system includes a dilator having a flexible, distal dilator portion sized to be received within the lumen of the luminal portion. Associated systems, devices, and methods of use are also described.

Abstract: A robotic procedure system for treating neurovasculature of a patient including a guide sheath, catheter system having a support catheter and a navigation catheter, and robotic drive system configured to drive the catheter system within a patient's vessel. The robotic drive system includes a cassette with at least a first set of rollers and at least a second set of rollers and a controller operatively coupled to the cassette. The first set of rollers is configured to engage a proximal control element of the support catheter and the second set of rollers configured to engage a proximal extension of the navigation catheter. The controller is configured to control the first set and second set of rollers so as to determine a magnitude of linear translation of the support catheter and a magnitude of linear translation of the navigation catheter. Related devices, systems, and methods are provided.

Abstract: Methods of treating intracranial atherosclerotic disease carotid atherosclerosis, and intracranial and cerebral aneurysms by deploying implantable expandable devices. A catheter system is advanced through a base sheath towards an intracranial vessel having an atherosclerotic lesion. A tapered end region of an inner catheter is positioned distal to a distal end of an outer catheter, at least a portion of the tapered end region of the inner catheter crosses the lesion. The outer catheter is advanced over the inner catheter across the lesion. The inner catheter is withdrawn while the outer catheter is maintained in place. A stent delivery system is advanced through the catheter lumen. The outer catheter is withdrawn to unsleeve the stent and the stent delivery system maintained in place. The stent is deployed against the lesion. Related devices, systems, and methods are provided.

Abstract: A flow diverter including a self-expanding tubular member having a plurality of expandable cells, each of the expandable cells having interconnected struts and bridges. The tubular member has a constrained configuration having a first outer diameter of at least 1.0 mm sized for delivery using a flow diverter delivery system and an expanded configuration having a second outer diameter larger than the first outer diameter. The tubular member has a proximal end zone, a distal end zone, and a middle zone located between the proximal end zone and the distal end zone. At least the middle zone of the tubular member is laser-cut to have a material coverage of at least 25% when the tubular member is in the expanded configuration. Related devices, systems, and methods of treating disease, particularly intracranial and cerebral aneurysms by deploying implantable expandable devices, are provided.

Abstract: Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72 D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35 D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3 cm.

Abstract: An intravascular access system for facilitation of intraluminal medical procedures within the neurovasculature through an access sheath. The system includes an aspiration or support catheter having a flexible, distal luminal portion having an inner diameter defining a lumen extending between a proximal opening at a proximal end of the luminal portion and a distal opening at a distal end of the luminal portion. The catheter has a rigid spine coupled to at least the proximal end of the luminal portion and extending proximally therefrom. The system includes a dilator having a flexible, distal dilator portion sized to be received within the lumen of the luminal portion. Associated systems, devices, and methods of use are also described.

Abstract: Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3 cm.

Abstract: An intravascular access system for facilitation of intraluminal medical procedures within a vasculature including an outer catheter having a tubular distal portion having a lumen and a proximal extension without a lumen; an inner catheter having a flexible elongate body; and at least one coupler configured to be affixed to at least a portion of the proximal extension and at least a portion of the flexible elongate body to accommodate different relative positions between the outer catheter and the inner catheter during movement of the inner and outer catheters through the vasculature. The at least one coupler has a unitary elastic body with at least one slot configured to receive and retain the proximal extension and the flexible elongate body. Related devices, systems, and methods are provided.

Abstract: Described are methods, systems, and devices for facilitation of intraluminal medical procedures within the neurovasculature including catheters and catheter advancement elements.

Abstract: Described are methods, systems, and devices for facilitation of intraluminal medical procedures within the neurovasculature including catheters and catheter advancement elements.

Abstract: Systems and methods are described for removing an embolus in a cerebral vessel of a patient. The assembled system of devices includes a catheter having a catheter lumen and a distal end and a catheter advancement element extending through the catheter lumen. A tapered distal end region of the catheter advancement element extends distal to the distal end of the catheter. The assembled system of devices is advanced together towards an occlusion site in a cerebral vessel of a patient visible on angiogram. The occlusion site includes an angiographic limit of contrast and an embolus downstream of the angiographic limit of contrast. The catheter advancement element is advanced to a location past the angiographic limit of contrast without crossing the embolus. The catheter is advanced to position the distal end of the catheter at a treatment site located past the angiographic limit of contrast and aspiration applied.

Abstract: Method of endovascular intervention in neurovascular anatomy of a patient including deploying an anchor of a tethering device in an anchoring vessel of a neurovascular anatomy, the anchor coupled to a tether extending proximally from the anchor. Method includes advancing a guide-sheath over the tether of the tethering device anchored in the anchoring vessel and attached to the tether, the guide-sheath includes at least one lumen and a distal opening from the lumen. Method includes advancing a treatment device through the lumen of the guide-sheath and out the distal opening from the at least one lumen and through an entrance of a target intracranial vessel, and deploying the treatment device at a treatment site within the target intracranial vessel without a combined therapy of two or more anti-platelet therapeutic agents during a pen-procedural period. Related systems, devices, and methods are disclosed.

Abstract: A system of devices for treating an artery includes an arterial access sheath adapted to introduce an interventional catheter into an artery and an elongated dilator positionable within the internal lumen of the sheath body. The system also includes a catheter formed of an elongated catheter body sized and shaped to be introduced via a carotid artery access site into a common carotid artery through the internal lumen of the arterial access sheath. The catheter has an overall length and a distal most section length such that the distal most section can be positioned in an intracranial artery and at least a portion of the proximal most section is positioned in the common carotid artery during use.

Abstract: Described are methods, systems, and devices for facilitation of intraluminal medical procedures within the neurovasculature including catheters and catheter advancement elements.