Abstract: Devices, systems, and computer-implemented and surgical methods for providing and/or using optical, visual, and/or audio feedback when using a surgical instrument, such as to position and orient an implant are disclosed. A device includes a frame and a C-ring. The frame includes a fixation component optionally located at a first end and a tracking array optionally located at an opposing second end. The fixation component can be positioned at or near a center axis of the C-ring and is configured to releasably engage a surgical instrument. The tracking array may include tracking elements, such as reflective surfaces. The C-ring may include a plurality of light sources optionally arranged in a radial pattern. The light sources may be selectively illuminated based on a determined realignment to provide optical feedback with respect to at least a direction in which the surgical instrument should be moved to achieve a planned alignment.

Abstract: A method and apparatus of automatically locating in an image of a blood vessel the lumen boundary at a position in the vessel and from that measuring the diameter of the vessel. From the diameter of the vessel and estimate blood flow rate, a number of clinically significant physiological parameters are then determine and various user displays of interest generated. One use of these images and parameters is to aid the clinician in the placement of a stent. The system, in one embodiment, uses these measurements to allow the clinician to simulate the placement of a stent and to determine the effect of the placement. In addition, from these patient parameters various patient treatments are then performed.

Abstract: A guide sheath includes ports at a handle portion through which flexible endoscopic tools may be advanced until they emerge from corresponding ports at a distal tip of the guide sheath. The guide sheath includes a position sensor at its distal tip that is compatible with an image guided surgery (IGS) system, such that a virtual view of the distal tip's position relative to a surgical site may be presented by the IGS system. The virtual view may assist a surgeon in precisely positioning the distal tip at the surgical site, and then one or more flexible endoscopic tools may be advanced the length of the guide sheath for use at the surgical site. The guide sheath may also include an articulating portion at the distal tip that may be deflected in one or more directions in order to provide additional control over placement within the surgical site.

Abstract: Provided is a robot for vascular intervention. The robot for vascular intervention comprises: a catheter driving unit for rotating and translating a catheter extending in a longitudinal direction while having the longitudinal direction as an axis; a guide wire driving unit provided at a side of the catheter driving unit, drawing a guide wire into the catheter by translating the guide wire, and rotating the guide wire coaxially with the catheter; a micro-catheter driving unit provided at a rear of the catheter driving unit and translating the micro-catheter in a path coaxial with the catheter that is different from draw-in and draw-out paths of the guide wire when the guide wire is drawn out from an inside of the catheter; and a micro-guide wire driving unit provided at a rear of the micro-catheter driving unit, and drawing a micro-guide wire into the micro-catheter by translating the micro-guide wire, and rotating the micro-guide wire coaxially with the micro-catheter.

Abstract: The disclosure provides a system and method for a programmable medical wire that can be preprogrammed, and controlled and reshaped upon command. The system can include a power supply, a controller, and a multilayered wire assembly. The wire assembly includes a core conductor, actuator conductors coupled to the core conductor, selective conductors formed adjacent the core conductor and the actuator conductors, and a protective biocompatible shield around the layers. The selective conductors can be energized to activate the actuator conductors and cause the actuator conductors to bend or twist in a preprogrammed manner. By selectively controlling the direction of movement of the actuator conductors, the wire assembly can be remotely guided through body passageways to the target. Auxiliary equipment such as sensors, micro cameras, detectors, cutters, and other equipment can also be coupled to the wire assembly, and controlled and communicated with through one or more of the selective conductors.

Abstract: A system for imaging a robotically moved medical object has a movement device for robotic movement of the medical object, a medical imaging device, and a processing unit. The processing unit is configured to receive a data set that maps a vessel structure of an examination object and is registered with the medical imaging device, and to determine an object path along the vessel structure toward a target region in the data set. The movement device is configured to move the medical object along the object path and provide an object parameter relating to a movement state of the medical object. The processing unit is further configured to control a positioning of the medical imaging device relative to the examination object as a function of object parameter and object path such that a predefined section of the medical object is mapped in image data acquired by the medical imaging device.

Abstract: Methods for correlating intraluminal data with x-ray image data involve providing x-ray image data of a tubular organ, providing intraluminal data of the tubular organ, synchronizing the x-ray image data with the intraluminal data based on a cardiac cycle extracted from an available input signal and/or the x-ray image data and/or the intraluminal data to match x-ray image data with intraluminal data in a specific cardiac phase, and co-registering x-ray image data with intraluminal data by creating a cumulative image at the specific cardiac phase which reconstructs the path followed by an intraluminal wire used for acquiring the intraluminal data to link the intraluminal data to spatial locations of the path followed by the wire within the x-ray image. A corresponding system and computer program are also disclosed. The method and systems can be controlled by one or more computer systems configured with specific executable instructions.

Abstract: Embodiments relate to surgical systems and methods. The system includes a main assembly having an IMU subsystem, camera, scope head assembly, and processor. Processor processes images and IMU information, including determining whether images include a distal end of the scope head assembly and a cannulation target. Responsive to a determination that images include the distal end of the scope head assembly, the processor generates 3-dimensional position of distal end of the scope head assembly. When images are determined to include the cannulation target, the processor generates 3-dimensional positions of the cannulation target. Processor also generates predictions of one or more real-time trajectory paths for the distal end of the scope head assembly to cannulate the cannulation target.

Abstract: A local coil includes a coil element in the form of a loop. The coil element includes a first conductor, a second conductor, and a third conductor. The coil element includes a first dielectric and a second dielectric. The first dielectric is arranged between the first conductor and the second conductor, and the second dielectric is arranged between the second conductor and the third conductor. The coil element includes a receive unit that includes the first conductor and the second conductor, and a detuning unit that includes the third conductor. In a first operating state of the coil element, the receive unit has a first resonant frequency. In a second operating state of the coil element, the detuning unit is configured to detune the resonant frequency of the receive unit so that the receive unit has a second resonant frequency different than the first resonant frequency.

Abstract: Various embodiments of a system and associated method for determining a volume of surgical freedom using a plurality of three-dimensional extrema points along a surgical corridor in relation to a structure of interest are disclosed herein.

Abstract: A medical instrument assembly including a handle assembly having a first handle portion and a second handle portion proximate the second end, wherein the second handle portion is slidably engaged with the first handle portion. A first localization element is attached to the first handle portion and a second localization element is attached to the second handle portion. A medical instrument is mechanically coupled to the second handle portion and a translation of the second handle portion with respect to the first handle portion causes a coincident and coextensive translation of the medical instrument. The amount of translation of the medical instrument is adapted to be determined by calculating the distance between the first localization element and the second localization element. The first and second localization elements may be electromagnetic sensors which positions may be determined by a navigation system.

Abstract: A method and apparatus for marking a target with a radiopaque marker is disclosed. The method may include providing a radiopaque filament and inserting at least portion of the radiopaque filament into tissue. The filament may extend continuously and at last partially around a perimeter of the target so that the filament is disposed in a plurality of surgical planes to demarcate the target with the radiopaque maker.

Abstract: A device includes a catheter section comprising a flexible joint region disposed between a distal end and a proximal end. The device includes a laser fiber disposed within the catheter section. The laser fiber emits laser light at a fiber distal end. The device includes a wire comprising a distal end coupled to the catheter section. The wire is configured to move the distal end of the catheter section from a first position to a second position about the flexible joint region.

Abstract: The present invention relates to a medical device. In particular, the present invention concerns a medical device which can be detected by means of magnetic resonance imaging (MRI).

Abstract: A method and system for determining a target location for a medical device having complex geometry relative to an anatomical feature, and for navigating and positioning the medical device at the target location. The system may include a medical device including a treatment element having a centroid, one or more navigation electrodes, and a longitudinal axis and a navigation system in communication with the one or more navigation electrodes, the navigation system including a processing unit. The processing unit may be programmed to define a plane that approximates a surface of the anatomical feature, define a centroid of the anatomical feature, define a vector that is normal to the plane and extends away from the centroid of the anatomical feature, and determine a target location for the treatment element of the medical device based on the vector to assist the user in placing the device for treatment.

Abstract: A probe, such as a spectroscopic probe, for enabling a fluid or tissue sample to be tested in situ. The probe includes a conduit, such as a hypodermic needle, that can be inserted into a test subject and a wave coupling arranged to direct electromagnetic radiation, such as light, from an energy source to the sample and/or from the sample to a receiver for analysis. The receiver may comprise a Raman spectroscope. The probe may include a carriage that can be used to move at least some of the optical coupling towards and away from the insertion tip of the conduit. The probe may include a pressure modifier that can be used to draw fluid into or expel fluid from the conduit.

Abstract: One preferred embodiment includes a guidewire manipulation device for manipulating a guidewire during a procedure. Preferably, the guidewire manipulation device includes a powered motor that drives a tandem roller assembly. The guidewire is passed through a hole positioned lengthwise through the device where the roller assembly engages the guidewire's outer surface. The interface of the manipulation device includes a power button that directs the internal roller assembly to roll the guidewire in a desired rotational direction. Additional interface controls are also preferable to provide a different roll patterns, depending upon surgeon preference and guidewire placement efficiency.

Abstract: According to one aspect of the invention, a system for medical object tracking is provided. The system includes a plurality of radio frequency transceivers where each of the plurality of radio frequency transceivers are configured to emit a radio frequency signal at a respective frequency. The system includes a radio frequency beacon removably attachable to a medical object where the radio frequency beacon configured to: reflect the radio frequency signals from the plurality of radio frequency transceivers, and emit vibration-based signals. The system includes a control device in communication with the plurality of radio frequency transceivers where the control device includes processing circuitry configured to determine a location of the medical object in three-dimensional space based at least in part on the reflected radio frequency signals and vibration-based signals.

Abstract: A seeker device for facilitating access to a desired location within an ear, nose, throat or other location in a body may include a proximal shaft, an elastic distal portion, and an atraumatic distal tip. The elastic distal portion has a default shape with at least one curve to facilitate advancement of a distal end of the elastic distal portion through various anatomical passageways, toward the desired location. In some embodiments, the seeker device may be paired with a dilator device, to perform a dilation procedure on an anatomical structure in the ear, nose, throat or other part of the body. In other embodiments, the seeker device may be paired with a flexible endoscope, to facilitate visualization of an anatomical structure or area.

Abstract: A set of pre-operative images may be captured of an anatomical structure using an endoscopic camera. Each captured image is associated with a position and orientation of the camera at the moment of capture using image guided surgery (IGS) techniques. This image data and position data may be used to create a navigation map of captured images. During a surgical procedure on the anatomical structure, a real-time endoscopic view may be captured and displayed to a surgeon. The IGS navigation system may determine the position and orientation of the real-time image; and select an appropriate pre-operative image from the navigation map to display to the surgeon in addition to the real-time image.

Abstract: A photoacoustic image generation apparatus includes: a puncture needle that generates photoacoustic waves; an ultrasound probe that detects the photoacoustic waves and reflected ultrasonic waves reflected by the transmission of ultrasonic waves; a processor that generates a color Doppler signal of a region of interest as a color Doppler measurement target, generates a photoacoustic image on the basis of the photoacoustic waves, and detects the position of a tip portion of the puncture needle on the basis of the photoacoustic image; and a controller that sets the region of interest such that the position of the tip portion of the puncture needle and a center position of the region of interest are separated from each other by a predetermined distance and sets the region of interest, following the movement of the tip portion of the puncture needle, in a state in which the distance is maintained.

Abstract: A catheter and guide wire assembly for measurement of blood pressure in a living body, including a tubular shaft, which is connected to a tubular extension, which is connected to a permeable helical coil, which has a distal end that is secured in a distal tip, and a core member, which is attached in a distal portion of the tubular shaft and extends through the tubular extension and the helical coil, and is secured in the distal tip. The catheter and guide wire assembly has an outer diameter of about 0.35 mm and an open, inner lumen, which includes the tubular shaft, the tubular extension, the helical coil, and the core member. The catheter and guide wire assembly has a total flow-resistance index less than about 1.2×106 mm?3, and more preferably less than about 1.0×106 mm?3, and even more preferably less than about 0.7×106 mm?3.

Abstract: A locking mechanism for a medical device to selective lock a first elongate member from longitudinal movement relative to a second elongate member of the medical device. The locking mechanism includes a flexible tubular member disposed in a bore of a handle assembly of the medical device, and an actuator, such as a cam member having a cam or eccentric surface. Pivotable movement of the actuator from a first position to a second position compresses or deforms the flexible tubular member against the first elongate member to lock the first elongate member from longitudinal movement relative to the handle assembly.

Abstract: A catheter includes a handle with torqueing and steering mechanisms. The torqueing mechanism includes a rotatable nosecone and a bearing coupled to the nosecone to be rotatable therewith. The bearing is concentrically disposed over a shaft of the catheter. The steering mechanism includes a rack coupled to the bearing to be slideable therewith and a pull wire having a proximal end attached to the bearing and a distal end attached to a distal portion of the shaft. Rotation of the nosecone causes an entire length of the shaft to rotate and axial movement of the rack tensions the pull wire to bend the distal portion of the shaft. A valve relief component is slidingly disposed over the shaft and is configured to dock onto the handle when not in use.

Abstract: Provided is a photoacoustic measurement device including: an ultrasound image generation unit that generates an ultrasound image on the basis of a detection signal of reflected ultrasonic waves generated by the transmission of ultrasonic waves; a puncture needle detection unit that detects a length direction of a puncture needle on the basis of the ultrasound image; and a controller that controls a steering direction of a sample gate which is a Doppler measurement target on the basis of the length direction of the puncture needle such that an angle ? formed between a straight line extending in the length direction of the puncture needle and a straight line extending in the steering direction of the sample gate satisfies 0°??<90°.

Abstract: A medical probe for traversing a tract in the body of a human or animal. One medical probe includes an elongate elastically deformable member including a helically wound element, and a sheath having an inner surface which contacts an outer surface of the elastically deformable member. The probe is elastically deformable, for traversing the tract, by virtue of the elastically deformable member. The probe may include a treatment element, which can be used to perform a procedure in the body of a patient. An assembly includes a probe and a treatment element. The medical probe has a particular use in the treatment of a fistula, in which the probe takes the form of a fistula probe adapted to traverse a fistula tract.

Abstract: Provided is a photoacoustic measurement device including: an ultrasound image generation unit that generates an ultrasound image on the basis of a detection signal of reflected ultrasonic waves generated by the transmission of ultrasonic waves; a puncture needle detection unit that detects a length direction of a puncture needle on the basis of the ultrasound image; and a controller that controls a steering direction of a region of interest which is a color Doppler measurement target on the basis of the length direction of the puncture needle such that an angle ? formed between a straight line extending in the length direction of the puncture needle and a straight line extending in the steering direction of the region of interest satisfies 0°??<90°.

Abstract: A system for guiding implantation of an energy delivery component of a cardiac pacing device at a fixation location within a heart of a patient is provided. During a procedure to implant an energy pulse delivery component, the system receives a patient cardiogram collected during pacing of the energy pulse delivery component while the energy pulse delivery component is positioned at a current location within the heart. The system then determines based on the patient cardiogram the current location of the energy pulse delivery component. The system then outputs an indication of the current location to guide affixing of the energy pulse delivery component at the intended fixation location. This process is repeated until the energy pulse delivery component is at the fixation location. The system also evaluates the effectiveness of pacing at intermediate location to optimize the final location based upon simulated electro-mechanics of the system in near-real time.

Abstract: The present disclosure provides a device and methods for acquiring tissue within a lumen or for closure of bodily openings.

Abstract: An apparatus for treating a treatment area in the vasculature using a catheter having a balloon. The apparatus comprises a guidewire for guiding the balloon to the treatment area, said guidewire including one or more radiopaque markings arranged for corresponding to the treatment area. Related aspects and methods are also disclosed.

Abstract: The endovenous treatment device has a delivery system (1; 2) for delivering of at least one treatment dose, which delivery system (1; 2) includes a wire element (1) for delivery of a treatment dose, which has a distal end part (10) able to be inserted, over at least part of its length, longitudinally into a vein, and which allows at least one treatment dose to be delivered into a vein in the region of the end of said distal end part (10). It additionally includes a drive system (4) by which the wire element (1) for dose delivery can be driven in at least a first given drive direction (R), and a guide (3) which is flexible along all or part of its length. The device includes a holding system (5) by which the distal end part (30) of the guide (3) can be temporarily held with respect to the body of a patient, near the insertion zone (7) of the wire element (1).

Abstract: A flexible tube insertion apparatus includes: a flexible tube to be inserted into an insertion target body; a state detector to detect state information of the flexible tube relating to a shape of the flexible tube; and a bent formation determining section to determine whether first and second bent portions bent in different directions are formed on the flexible tube based on the state information. The flexible tube insertion apparatus further includes a shape changing section, arranged in the flexible tube, to actively change the shape of the flexible tube so that an angle at which a first virtual flat plane on which the first bent portion is formed and a second virtual flat plane on which the second bent portion is formed intersect becomes smaller, when the bent formation determining section determines that the first and second bent portions are formed on the flexible tube.

Abstract: An expandable sheath is disclosed herein, which has a first polymeric layer and a braided layer positioned radially outward of the first polymeric layer. The braided layer includes a plurality of filaments braided together. The expandable sheaths further include a resilient elastic layer positioned radially outward of the braided layer. The elastic layer is configured to apply radial force to the braided layer and the first polymeric layer. The expandable sheath further includes a second polymeric layer positioned radially outward of the elastic layer and bonded to the first polymeric layer such that the braided layer and the elastic layer are encapsulated between the first and second polymeric layers. Methods of making and using the devices disclosed herein are also disclosed, as are crimping devices that may be used in methods of making the devices disclosed herein.

Abstract: In some embodiments, a method includes identifying a nerve extending across a transection path; administering a cooling therapy to the identified nerve at a location proximal to the transection path so as to degenerate the identified nerve across the transection path prior to or during surgical transection along the transection path, wherein cooling the identified nerve prevents or reduces neuroma formation at a transected end of the nerve after transection of the nerve. In some embodiments, a method includes degenerating a portion of a nerve while preserving a connective tissue framework of the nerve. During or after the degeneration, the preserved connective tissue framework may be transected at a transection location distal to the treatment location. The regeneration of the nerve may be repeatedly disrupted for a period of time to reduce a regenerative rate of the nerve and delay neuroma formation.

Abstract: A guide wire including a flexible first core wire which has a first plate-shaped portion having a plate shape and a first linear portion having a linear shape that is continuous to the first-plate shaped portion. The width of the first plate-shaped is larger than the width of the first linear portion. The guide wire includes a flexible second core wire which has a second plate-shaped portion having a plate shape and a second linear portion having a linear shape that is continuous to the second-plate shaped portion. The width of the second plate-shaped portion is larger than the width of the second linear portion. The second plate-shaped portion axially overlaps the first linear portion, and the second linear portion axially overlaps the first plate-shaped portion.

Abstract: A corrugated radiofrequency ablation catheter and an apparatus thereof. The radiofrequency ablation catheter is provided with a strip-shaped connecting catheter (10). An electrode frame is provided at the front extremity of the connecting catheter (10). A control handle (20) is provided at the rear extremity of the connecting catheter (10). The electrode frame is a corrugated electrode frame consisting of one or more corrugations. One or more electrodes (2) respectively are distributed on the corrugations. Slidable, supporting, wall-attaching adjustment wires (6) are provided within one lumen of the connecting catheter (10) and the electrode frame. The supporting, wall-attaching adjustment wires (6) are divided into a flexible segment (61) away from the control handle and a rigid segment (62) in proximity to the control handle.

Abstract: A catheter and a surgical medical device. The catheter includes at least; a first elastic member positioned at an end portion of the catheter: a second elastic member connected with the first elastic member, the second elastic member being curved with a first radius of curvature to protrude toward a first direction; a first wire connected with a first surface of the first elastic member, and configured to pull the catheter to bend the catheter in the first direction; a second wire connected with a second surface of the first elastic member, which is opposite to the first surface, and configured to pull the catheter to bend the catheter in a second direction; and a tube containing the first elastic member, the second elastic member, the first wire, and the second wire.

Abstract: The present disclosure is directed to intravascular devices, systems, and methods having a core wire with multiple flattened sections. In one aspect, a sensing guide wire is provided. The guide wire includes a first flexible elongate member; a sensing element positioned at a distal portion of the first flexible elongate member; and a second flexible elongate member coupled to the first flexible elongate member such that the second flexible elongate member extends distally from the first flexible elongate member; and wherein a distal portion of the first flexible elongate member includes at least two flattened sections, and wherein the first and second flexible elongate members are coupled along a portion of one of the at least two flattened sections. In other aspects, methods of forming a sensing guide wire are provided.

Abstract: A guidewire has a distal-most end portion that retains its desired shape. The guidewire includes a first brazing member joining a distal end of a core shaft to a distal end of an outer coil, and a second brazing member provided adjacent to and on a proximal side of the first brazing member. The guidewire also includes an outer coil surrounding an outer periphery of the core shaft, and an inner coil provided between the outer coil and the core shaft. The second brazing member is provided between the outer coil and the inner coil, but is not provided between the inner coil and the core shaft. The melting point of the first brazing member is higher than the melting point of the second brazing member.

Abstract: This guide catheter includes a resin tube having an inner lumen through which a guide wire is insertable; a metal pipe attached to an inside of the tube to be coaxial with the tube; and a metal wire having a distal end portion welded to a region more distal than a proximal end of the pipe on an outer circumferential surface of the pipe. The pipe has a most proximal portion formed in a proximal end surface of the pipe, the most proximal portion is more proximal than other portions of the proximal end surface in a central axis direction of the pipe. A welding region of the wire welded to the pipe is formed on the outer circumferential surface of the pipe and a proximal end of the welding region is positioned apart from the most proximal portion of the pipe in the central axis direction of the pipe.

Abstract: A method and system of traversing a device through an accommodating conduit to reach a target area within the accommodating conduit can include varying an amount of elasticity of the device or an amount of torsion moment of the device applied to the accommodating conduit or varying both to minimize bending forces as the device traverses the accommodating conduit. The method or system upon reaching the target area within the accommodating conduit, can further include varying the elasticity or the torsion moment of the device or varying both to cause the device to stiffen. Other embodiments are disclosed.

Abstract: An elongate body extending from a proximal end to a distal end includes a core comprising an amorphous metal alloy and includes a sheath that comprises a crystalline metallic material. The sheath surrounds the core.

Abstract: Torque devices for use with intravascular devices and associated systems and methods are disclosed. In some embodiments, a torque device for use with an intravascular device includes a first component having a body defining a tapered opening for receiving a proximal portion of the intravascular device, a first arm extending from the body, and a second arm extending from the body; and a second component movably coupled to the first component, wherein the second component is movable relative to the first component between an open position where the torque device is configured to slidably receive the proximal portion of the flexible elongate member between the first and second arms of the first component and a closed position where the torque device fixedly engages the proximal portion of the flexible elongate member between first and second arms of the first component.

Abstract: A catheter having a head with a head orifice and a head channel connected to the head orifice, a primary lumen wall that defines an internal primary lumen volume, an adjustable neck that connects the head channel to the internal primary lumen volume, an adjustment system partially enclosed in the primary lumen wall that provides an articulation of the adjustable neck between an extended position to a contracted positon, wherein the articulation from the extended position to the contracted position provides a flexible tip catheter while the articulation from the contracted position to the extended position provides an ability to angulate toward a target.

Abstract: A set is provided for applying a flat, flexible two-dimensional thin-film strip into living tissue, particularly into brain tissue. The set includes the thin-film strip itself to be applied and an application tool, which is removable and mechanically connectable to the thin-film strip by a coupling device. After application of the thin-film strip in situ the application tool is removable from the tissue without residue by mechanically disengaging the coupling device itself, while leaving the thin-film strip behind.

Abstract: The present invention relates to a safety puncturing system comprising a cannula and a guidewire.

Abstract: A rapid exchange type medical elongated body is disclosed in which an outer diameter of a distal portion of a tubular member is set smaller than an outer diameter of a proximal portion of the tubular member, which prevents an occurrence of a kink in a physical property change region of the medical elongated body which has a relatively large change in physical property. A tubular member forming a second region of a distal member of a medical elongated body is integrally formed with a shaft portion. The distal member has a reinforcement layer containing a metallic material and formed between an inner layer and an outer layer from a first region to the second region. The reinforcement layer is disposed inside the tubular member in the second region. An outer diameter of the first region is set smaller than an outer diameter of the second region.

Abstract: A guide wire deployment system that can be utilized as a pre-surgical procedure without the need for radiology imaging. The clip marker would include light and sonic sensors to determine angular orientation and distance from the needle. Wireless communication between the handheld insertion device and the clip marker would provide information to guide the needle to the clip marker location. The guide wire would then be pushed from the needle and laid in a path to outside the patient.

Abstract: A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.

Abstract: The present disclosure provides a catheter including a first tubular structure defining a first lumen, the first tubular structure having a first end and a second end. The catheter may also include a second tubular structure defining a second lumen, the second tubular structure having a first end and a second end. The catheter may also include an aperture between the first tubular structure and the second tubular structure. The aperture is located at the first end of the second tubular structure. A first portion of the first tubular structure extends beyond the aperture, and the second tubular structure is positioned adjacent to a second portion of the first tubular structure.