Abstract: An example system is disclosed for generating a model of a tubular anatomical structure. The system includes an anatomical measurement wire (“AMW”), a tracking system and a computing device. The AMW is configured to be navigated through the anatomical structure of a patient, and the AMW includes at least one sensor. The tracking system is configured to provide tracking data representing multiple positions of the sensor in a spatial coordinate system. The computing device is configured to generate a data point cloud based on the tracking data, generate a parametric model corresponding to at least a portion of the vessel based on the data point cloud and store the parametric model in non-transitory memory.

Abstract: Medical devices, medical device systems, and methods for making and using the same are disclosed. An example medical device may include an inner shaft having a stent receiving region. A bumper shaft may be disposed about the inner shaft. A deployment sheath may be slidably disposed about the inner shaft. The deployment sheath may have a body region and a distal stent covering region. The distal stent covering region may have an outer diameter that is smaller than an outer diameter of the body region.

Abstract: Systems and methods for delivering a catheter to a location of interest in the vasculature, the method including selectively positioning a guidewire at the location, positioning a self-expanding sheath within a lumen of the catheter, advancing the catheter and the self-expanding sheath in tandem over the guidewire, and distally moving a distal end of the self-expanding sheath out from an inner lumen of the catheter thereby causing the self-expanding sheath to move from a collapsed state within the catheter to an expanded state outside the catheter.

Abstract: A balloon catheter includes an outer shaft, an inner shaft, and an inflatable balloon. The inner shaft is inserted inside the outer shaft. A part of the inner shaft extends beyond a leading end of the outer shaft. The inflatable balloon includes a base end side joint portion and a leading end side joint portion, the base end side joint portion is joined to the outer shaft and the leading end side joint portion is joined to the inner shaft. The inner shaft has an extension portion configured to extend in an axial line direction. The extension portion is located closer to the base end side of the outer shaft than to the leading end side joint portion of the inflatable balloon.

Abstract: A stent delivery system can include a core member, an introducer sheath, and a microcatheter. The core member can have a first section and a second section distal to the first section. The second section can have a bending stiffness per unit length that is less than a bending stiffness per unit length of the first section. The introducer sheath can have a lumen configured to receive the core member therethrough. The introducer sheath can have a length of at least about 80 cm. The microcatheter can have a lumen and a proximal end configured to interface with a distal end of the introducer sheath for delivering the core member into the microcatheter lumen.

Abstract: A balloon catheter having a distal-end tip which, even if caught in a stenosis, will not break apart from a distal end of an inner shaft of the balloon catheter when the balloon catheter is forcibly rotated or pulled by an operator. The distal-end tip of the balloon catheter is fixed to the distal end of the inner shaft, and a connecting tube covers an outer surface of the distal end of the inner shaft and a proximal end of the distal-end tip. An inwardly protruding portion of the connecting tube is embedded into the distal-end tip. This creates an anchoring effect and increases a welding area between an outer surface of the distal-end tip and an inner surface of the connecting tube, thereby reducing a risk that the distal-end tip will break apart from the distal end of the inner shaft.

Abstract: Intravascular devices, systems, and methods are provided. In some embodiments, the intravascular devices are catheters with a plurality of openings in a distal portion to facilitate taking pressure measurements from within a lumen of the catheter. The intravascular device includes a tubular member that has a proximal portion and a distal portion; a lumen extending from the proximal portion to the distal portion along a longitudinal axis of the tubular member, the lumen sized and shaped to receive a pressure sensing device; and openings spaced along the distal portion of the tubular member, the openings sized and shaped to provide fluidic communication between the lumen and a region surrounding the tubular member to allow the pressure sensing device to measure an ambient pressure of the region surrounding the tubular member from within the lumen. An intravascular system and a method for obtaining pressure measurements are also provided.

Abstract: In some examples, a system includes an implantable medical device configured for implantation in a chamber of the heart, an extension attached to the implantable medical device, the extension comprising a housing comprising at least one electrode, the housing defining a hole, and a tether comprising a first tether portion and a second tether portion and configured to be threaded through the hole. When the tether is threaded through the hole, the first tether portion and the second tether portion are on opposite sides of the hole. The tether may be used to implant the extension in a different chamber of the heart of the patient than the implantable medical device.

Abstract: An ultrasonic surgical instrument is disclosed, and includes a handle assembly, an elongate tubular member, and an end effector. The elongate tubular member extends from the handle assembly and defines a channel therethrough. The end effector is coupled with a distal end of the elongate tubular member and includes a first jaw member pivotably attached to the tubular member, and a second jaw member longitudinally movable within the channel of the elongate tubular member. One of the first jaw member and the second jaw member includes at least one ultrasonic transducer.

Abstract: Guide extension catheters and methods of manufacturing and using guide extension catheters are disclosed. An example guide extension catheter may include a distal sheath having a proximal opening, a distal opening, and a central lumen extending therebetween. The guide extension catheter may also include a proximal shaft having an outer diameter smaller than an outer diameter of the distal sheath, the proximal shaft including a distal opening. The guide extension catheter may also include a coupling member for securing the distal sheath to the proximal shaft. The coupling member may include a distal portion attached to the distal sheath and a proximal portion disposed within the distal opening of the proximal shaft.

Abstract: Catheters including those having guidewire lumens that can convert from an Over-the-Wire mode to a Rapid Exchange mode are useful and effective when this conversion happens without adjusting the position of the guidewire in a body lumen.

Abstract: A vascular closure device includes a catheter, a balloon, an introducer, and a guidewire lumen. The catheter includes an inflation lumen. The balloon is positioned at a distal end portion of the catheter. The introducer is positioned distal of the balloon. The guidewire lumen extends along at least a portion of the introducer and terminates at a rapid exchange port positioned distal of the balloon. The guidewire lumen is receptive of a guidewire to guide the catheter through a vessel puncture in a vessel to position the balloon within the vessel.

Abstract: A method of selective catheterism of in a network of conduits of an anatomical structure including inserting a flexible distal end of a guide for catheterism through the network of conduits. An appendage is attached on the distal end of the guide, the appendage includes a channel extending along a longitudinal axis of the guide. A catheter is slid along the catheter until a distal face of the catheter surrounding the guide engages a proximal surface of the appendage. A force oriented in a distal direction is exerted with the catheter on the appendage, which disengages the appendage from the distal end of the guide within the network of conduits. Navigation through the network of conduits is continued with the flexible distal end of the guide once the appendage is removed.

Abstract: Devices for palliating gastrointestinal strictures using rapid exchange type enteral stent placement catheters. The catheter may include an inner member and an outer member, with the two members being slidable with respect to one another. In various device embodiments, a ramp for directing a guidewire out from within the catheter is provided using portions of the outer member or a shaped mandrel. The inner member may take a number of forms, including a tubular distal portion, a skived or integrally attached elongate midsection, and a proximal portion. A mandrel can be used in a portion proximal of the guidewire ramp, with the mandrel taking one of several disclosed forms.

Abstract: A balloon catheter having a distal-end tip which, even if caught in a stenosis, will not break apart from a distal end of an inner shaft of the balloon catheter when the balloon catheter is forcibly rotated or pulled by an operator. The distal-end tip of the balloon catheter is fixed to the distal end of the inner shaft, and a connecting tube covers an outer surface of the distal end of the inner shaft and a proximal end of the distal-end tip. An inwardly protruding portion of the connecting tube is embedded into the distal-end tip. This creates an anchoring effect and increases a welding area between an outer surface of the distal-end tip and an inner surface of the connecting tube, thereby reducing a risk that the distal-end tip will break apart from the distal end of the inner shaft.

Abstract: A dilation apparatus comprises an elongate member and a dilation assembly that is slidable along the elongate member. The dilation assembly comprises a platform and an inflatable dilator. The platform and the elongate member cooperate to absorb inflation forces from the dilator directed toward the longitudinal axis of the elongate member, such that the dilation forces are exerted against tissue asymmetrically relative to the longitudinal axis of the elongate member. The dilation apparatus may be used to dilate the ethmoid infundibulum in a human patient. Various devices may be used to maintain the dilated state of an ethmoid infundibulum, including a wedge, a mesh, and a tether. An illuminator may be configured to reach around an uncinate process, retract the uncinate process, and then illuminate the ethmoid infundibulum to provide improved visualization of the ethmoid infundibulum.

Abstract: A balloon catheter includes a proximal shaft, a distal shaft, an intermediate shaft positioned between the proximal shaft and the distal shaft, lumens that penetrate through the proximal shaft, the intermediate shaft, and the distal shaft and introduce and discharge a dilation fluid for a balloon, an inner tube shaft having a guide wire opening arranged at a boundary between the intermediate shaft and the distal shaft and through which the lumen extends, and a reinforcement member arranged in the lumen so as to suppress an occurrence of a kink. The reinforcement member has a tapered proximal portion fixed to the proximal shaft and arranged inside the lumen positioned in the intermediate shaft, a tapered distal portion arranged inside the lumen positioned in the distal shaft, and a straight transition portion positioned between the proximal portion and the distal portion. The transition portion is aligned with the guide wire opening.

Abstract: Described is a method for treating a bronchial tissue. A guide wire is inserted through a bronchial passage to a desired location relative to a target portion of tissue to be treated. A catheter is slid along the guide wire with the guide wire received in a first lumen of the catheter until the guide wire exits a proximal port of the first lumen. A stiffening member is inserted into a second lumen of the catheter. A fluid is injected through the second lumen to a distal port of the catheter, so that the fluid is supplied to the bronchial tissue.

Abstract: A rapid exchange balloon catheter including: an outer conduit having a lumen and a wall surrounding the lumen, the wall including a lateral opening formed therein; an inner conduit having a proximal end and a distal end; a sealing sleeve for sealing the lateral opening of the outer conduit; a balloon whose proximal margin is attached to the outer surface of the distal end of the outer conduit, and whose distal margin is attached to the outer surface of the portion of the inner conduit that extends beyond the distal end of the outer conduit; a pushing-pulling mechanism disposed in the outer conduit; and a fluid port for the introduction of an expansion fluid and for the removal of the expansion fluid.

Abstract: Devices, systems, and methods for lead delivery. In at least one exemplary embodiment of a catheter for delivering a lead within a mammalian body of the present disclosure, the catheter comprises an elongated tube comprising a wall extending from a proximal end to a distal end, a lead delivery channel within the elongated tube, the lead delivery channel defining an outlet for delivering a lead, a balloon chamber positioned at or near the distal end of the elongated tube, and at least one balloon positioned within the balloon chamber, the at least one balloon capable of inflation to reversibly anchor the elongated tube within a mammalian body when at least a portion of the elongated tube is positioned therein.

Abstract: Medical devices for delivering stents, prosthetic valve devices, and other implantable articles inside a patient's body are provided. The devices have an elongate inner compression member having a proximal end and a distal mating end with a tapered portion and outer engaging surface, a first portion proximal to the distal mating end, and the tapered portion having a smaller cross sectional area than the first portion and being more flexible than the first portion. The devices further have an inner guide channel member with a first end and a second end defining a channel of substantially uniform inner diameter, the second end having an outer diameter, and the first end having a taper extending from the second end outer diameter to a smaller second outer diameter. A joint is configured for melt bonding or implanting the inner compression member distal mating end and the inner guide channel member second end.

Abstract: A containing catheter for facilitating sequential treatment operations therethrough, is provided. The containing catheter comprises a median portion comprising an elongated, substantially tubular member, and a distal portion, comprising a distal stiff member. A catheterization apparatus is provided, comprising the containing catheter and an elongated inner catheter insertable into the containing catheter. A method of catheterization is provided, comprising providing the containing catheter, stiffening a portion of the containing catheter and inserting the stiffened containing catheter into a body conduit of a patient.

Abstract: Methods and devices incorporating a guidewire entry port subassembly for use in rapid exchange catheters. The use of a subassembly allows for stronger quality control and simpler fabrication of a rapid exchange device. In several embodiments, methods of making a molded guidewire entry port using a mold, often in conjunction with one or more mandrels, are disclosed. Several device embodiments include a separate molded guidewire port as well as molded guidewire ports which are attached, during a molding step, to segments of a catheter.

Abstract: The present invention is primarily directed to a rapid exchange catheter that permits axial movement of an inner conduit within an outer conduit comprising: • an outer conduit; • an inner conduit, suitable for total or partial passage over a guide wire, wherein said inner conduit is movably disposed within the lumen of said outer conduit, wherein the proximal end of said inner conduit is angled such that it pierces the wall of said outer conduit; • means for permitting axial movement of said inner conduit within said outer conduit, such that said movement is not hindered by the passage of the angled proximal part of the inner conduit through said outer conduit; and • means, situated at the proximal end of the outer conduit, for causing axial pushing-pulling movements of said inner conduit.

Abstract: The invention relates to a low profile lumen free balloon catheter and a system for advancing the lumen free balloon from a build wire to a wire guide. The low profile balloon lacks an internal wire guide cannula between the catheter shaft and the soft tip. A releasable engagement is provided to connect/disconnect the build wire to/from the wire guide. A soft tip seals around the wire guide following advancement of the balloon catheter over the wire guide.

Abstract: Catheters, assemblies, and methods for delivering and recovering embolic protection devices. Catheters are provided that can be advanced over single length guide wires and which can be retracted over single length wire shafts of distal embolic protection devices. One catheter is a two-port catheter having two sidewall ports, a distal end port, and a proximal end port. The two-port catheter can be advanced over a guide wire threaded between the distal end port and the distal sidewall port. An embolic protection device wire shaft can be back loaded into the distal end port and out the proximal sidewall port. A three-port catheter includes a distal end port, and distal, intermediate, and proximal sidewall ports.

Abstract: An introducer sheath. The introducer sheath includes a tubular body. The tubular body extends from a distal end toward a proximal end. The tubular body includes a lumen. The lumen is defined at least partially by a wall. The tubular body includes a secondary channel. The secondary channel is disposed within the wall. The secondary channel is configured to receive a guidewire.

Abstract: A rapid exchange catheter comprises a guide wire lumen including a substantially sealed portion in which a lumen wall extends around an entire periphery thereof and a channel portion including a channel opening the lumen to an exterior of the catheter, wherein a width of the channel is less than a maximum width of the channel portion. A guide wire ramp extends into the channel portion, with the ramp extending further into the lumen of the channel portion as a distal end of the ramp is approached.

Abstract: Medical devices and methods for making and using the same. An example medical device may include an elongate tubular member, an endosurgery stent disposed on the outer surface of the tubular member, a push tube slidably disposed along the outer surface of the tubular member, and a push member slidably disposed in a lumen formed in the tubular member. The push member may be coupled to the push tube.

Abstract: A pre-assembled kit for administering ischemic postconditioning comprising a catheter and a handle having a fluid circuit to control and modulate flow of inflation fluid to and from a balloon wherein the catheter is free from additional assembly and preparation procedures such that it is ready-to-use within a variety of vessel sizes.

Abstract: Balloon catheter comprises an elongated shaft having a proximal end and a distal end, the elongated shaft including a biaxially oriented nonporous thermoplastic polymer tubular member having a Shore durometer hardness of less than about 75 D with an inflation lumen defined therein. The balloon catheter also comprises a balloon sealing secured proximate the distal end of the shaft and having an interior in fluid communication with the inflation lumen.

Abstract: The present invention relates to balloon catheters for treating a luminal system of a patient. Specifically, the invention relates to catheters having a flexible membrane positioned at a distal portion of the catheter, the flexible membrane retained in a substantially unexposed conformation prior to deployment. Preferably the flexible membrane is capable of delivering a therapeutic agent to a localized environment when deployed to an exposed conformation.

Abstract: The present disclosure relates to a catheter having a longitudinal guidewire lumen defined by a first tube configured for an over-the-wire or rapid-exchange mode of operation, the wall of the first tube provided with an expansion member that is a sub-region of the wall of the first tube provided with an expandable material. An inflation lumen extending from the proximal end towards the distal end of the shaft is in fluidic contact with the expansion member, the member being configured to expand or contract responsive to pressure in the inflation lumen. The wall of the first tube may be formed from a helically coiled wire or helically braided wire having a helix angle of 60 degrees or more which tubing is resistive to radial pressure applied in the inflation lumen.

Abstract: Joint assemblies for joining sheaths for use in medical devices are provided, as are methods of manufacturing the joint assemblies. An elongate first sheath has a distal end portion having melt bonding material. A second sheath has first and second end portions, the second end portion having melt bonding material. An outer sleeve body includes proximal and distal engaging portions that have melt bonding materials. The proximal engaging portion is disposed about and melt bonded to the first sheath distal end portion. The distal engaging portion is disposed about and melt bonded to the second sheath proximal end portion. In one embodiment, one or both sheaths have an inner layer, a coiled middle layer optionally stopping short of the joint assembly, and an outer layer that has said melt bonding materials. In one embodiment, the sheaths are used in a rapid insertion catheter delivery system.

Abstract: An elongate shaft of a medical catheter including a thermoset polymeric tubular member including a skived distal portion. The skived distal portion includes a distally extending trough having a convex surface and a concave surface. A thermoplastic tubular sleeve may be positioned over at least a portion of the skived distal portion of the thermoset polymeric tubular member. In some instances, the thermoplastic tubular sleeve includes a crescent-shaped tubular portion defining a crescent-shaped lumen. The trough of the skived distal portion may extend through the crescent-shaped lumen. The thermoplastic tubular sleeve is thermally bonded to the inner and outer tubular members of a distal section of the elongate shaft at a guidewire port joint.

Abstract: Catheter comprising an inner tubular member defining a fluid lumen and inflation lumen therein. An exterior surface of the inner tubular member defines a fluid flow port in fluid communication with the fluid lumen and located along a region of the inner tubular member. Catheter further includes an outer member having a distal section movable relative to the inner tubular member and having an interior surface. A piston balloon is coupled to the inner tubular member distal to the fluid flow port and is in fluid communication with the inflation lumen. A pressure chamber is in fluid communication with the fluid flow port. Fluid introduced through the inflation lumen inflates the piston balloon to seal against the interior surface and fluid introduced through the fluid flow port and into the pressure chamber applies a force to urge at least the distal section of the outer member in a proximal direction.

Abstract: An elongate shaft of a medical catheter including a thermoset polymeric tubular member including a skived distal portion. The skived distal portion includes a distally extending trough having a convex surface and a concave surface. A thermoplastic tubular sleeve may be positioned over at least a portion of the skived distal portion of the thermoset polymeric tubular member. In some instances, the thermoplastic tubular sleeve includes a crescent-shaped tubular portion defining a crescent-shaped lumen. The trough of the skived distal portion may extend through the crescent-shaped lumen. The thermoplastic tubular sleeve is thermally bonded to the inner and outer tubular members of a distal section of the elongate shaft at a guidewire port joint.

Abstract: A method and apparatus for introducing a first elongate medical device and short wire guide that are coupled together into a work site and remotely disconnecting them within the work site such that a secondary device comprising a catheter member can be introduced over the wire guide to the work site, and/or a second wire guide can be introduced to the work site via a passageway of the primary access device. A separating member may be provided to remotely separate the wire guide from the elongate medical device.

Abstract: Coaxial balloon catheters are described herein. The balloon catheter can include outer and inner tubes in a coaxial relationship, with a balloon attached to an end thereof. A support sleeve can be disposed around the inner tubular member proximate the proximal end of the balloon. The support sleeve can have a channel formed therein to communicate with an inflation lumen and a balloon interior. The channel may be formed by separation of two longitudinal edges extending through the support sleeve. The support sleeve can include an outward extending portion that is sized to engage the distal end of the outer tube in order to limit relative movement between the inner and outer tubes. The support sleeve can be configured to orient the inner tube eccentrically or concentrically relative to the outer tube. The support sleeve can have an elongate body that can be extended in proximal or distal direction.

Abstract: An intravascular aspirating assembly comprising an elongate guidewire having a proximally facing filter disposed on a distal portion thereof, a single operator exchange aspiration catheter disposed on the guidewire, the aspiration catheter having a proximal end, a distal end and an aspiration lumen extending therebetween, an extension catheter slidably disposed in the aspiration lumen and having a length greater than that of the aspiration catheter.

Abstract: Devices for palliating gastrointestinal strictures using rapid exchange type enteral stent placement catheters. The catheter may include an inner member and an outer member, with the two members being slidable with respect to one another. In various device embodiments, a ramp for directing a guidewire out from within the catheter is provided using portions of the outer member or a shaped mandrel. The inner member may take a number of forms, including a tubular distal portion, a skived or integrally attached elongate midsection, and a proximal portion. A mandrel can be used in a portion proximal of the guidewire ramp, with the mandrel taking one of several disclosed forms.

Abstract: Intravascular devices and a method of delivering at least one therapeutic agent. The device includes an elongate element with proximal and distal portions and at least first and second lumens provided therein. The first lumen is adapted for delivering at least one therapeutic agent. The second lumen is adapted for allowing fluid therethrough. An expandable member is disposed adjacent to the distal portion of the elongate element. At least one tip cut is provided in a distal tip portion of the elongate element. The at least one tip cut is adapted for providing flexibility to the elongate element. The method includes providing an elongate element. Spacing of at least one tip cut is varied during positioning of the elongate element within a vessel. The vessel is occluded with the elongate element. The at least one therapeutic agent is delivered to tissue adjacent the occluded vessel.

Abstract: Some embodiments relate to a catheter system having a changeable or adjustable working length. The catheter system can comprise a proximal end, a distal end, and a first axial lumen configured to receive a guidewire formed through at least a portion of the catheter body. A first opening can be formed through a portion of the catheter body and be in communication with the first lumen. The sheath can be rotatable, axially movable, or otherwise changeable from at least a first position to a second position, wherein the sheath can substantially cover the first opening in the catheter body in the first position, and can substantially expose the first opening in the catheter body in the second position.

Abstract: A system and method of treating urinary incontinence including a catheter and injection guide operatively disposed together. At least one needle is operatively disposed within at least one lumen and at least one channel extending through the catheter and injection guide respectively. The injection guide is transformable from a pre-injection configuration for placement in the bladder to an injection configuration for injection of a pharmaceutical such as botulinum toxin into the bladder tissue. Upon introduction of the pharmaceutical to the bladder tissue, symptoms of incontinence are alleviated.

Abstract: A single operator exchange biliary catheter having a tubular member extending proximally from the proximal guidewire port. The tubular member defines a guidewire lumen extension adapted to permit the guidewire to be retracted from guidewire lumen and re-inserted therein. By retracting the guidewire from the guidewire lumen and into the guidewire lumen extension, fluid may be readily injected via the guidewire lumen without encountering resistance to fluid flow from the guidewire. The guidewire lumen extension also maintains guidewire lumen access such that the guidewire may be easily re-inserted into the guidewire lumen.

Abstract: A predilation device may comprise a shaft portion and a distal tip having helical threadings. The predilation device may further include a rapid exchange element rotatably coupled to the shaft portion. A guidewire may slidably engage the rapid exchange element and may guide the predilation device to a lesion site. The predilation device may be positioned with the distal tip abutting the lesion. The shaft portion may be rotated, thereby rotating the tip and causing the tip to pass through the lesion and predilate the lesion. In some embodiments, the tip may remove lesion material.

Abstract: Methods and devices for preventing fluid flow through the relatively short guidewire lumen of a rapid exchange catheter. The guidewire lumen for a rapid exchange catheter is provided with a narrowed or sealed section allowing for passage of a guidewire therethrough while preventing fluid flow while a guidewire is disposed therethrough. The narrowed or sealed section extends for a relatively short length of the guidewire lumen to avoid creating excessive friction between the guidewire and the guidewire lumen. In several embodiments the narrowed or sealed section is placed proximal of the distal end of the guidewire lumen.

Abstract: A catheter including an outer conduit and an inner conduit movably disposed therein. The inner conduit includes at least one movable part. The proximal end of the inner conduit is angled piercing the wall of the outer conduit. The catheter includes an inflatable intussusceptable balloon having a proximal margin attached to the distal tip of the outer conduit and a distal margin attached to a portion of the inner conduit extending beyond the distal tip of the outer conduit. The diameter of a first portion of the balloon is larger than the diameter of other portions thereof. The catheter includes means for axially moving the inner conduit within the outer conduit, means for introducing expansion fluid into the balloon and means for permitting axial movement of the inner conduit within the outer conduit, unhindered by the passage of the angled proximal part of the inner conduit through the outer conduit.

Abstract: A coaxial guide catheter to be passed through guide catheter having a first lumen, for use with interventional cardiology devices that are insertable into a branch artery that branches off from a main artery. The coaxial guide catheter is extended through the lumen of the guide catheter and beyond the distal end of the guide catheter and inserted into the branch artery. The device assists in resisting axial and shear forces exerted by an interventional cardiology device passed through the second lumen and beyond the flexible distal tip portion that would otherwise tend to dislodge the guide catheter from the branch artery.

Abstract: A coaxial guide catheter to be passed through guide catheter having a first lumen, for use with interventional cardiology devices that are insertable into a branch artery that branches off from a main artery. The coaxial guide catheter is extended through the lumen of the guide catheter and beyond the distal end of the guide catheter and inserted into the branch artery. The device assists in resisting axial and shear forces exerted by an interventional cardiology device passed through the second lumen and beyond the flexible distal tip portion that would otherwise tend to dislodge the guide catheter from the branch artery.