Abstract: The invention relates to a method for manufacturing an endoscope insertion tube (2). The insertion tube (2) has a proximal passive flexible section (20) and a distal angled section (A). The passive flexible section (20) and the angled section (A) are integrally formed. Individual cuts (201, 202) are made in the flexible section (20), provided as a tube-like element, in such a way that adjacent individual cuts (201, 202) are equidistant from one another.

Abstract: A root canal irrigant needle for use with a dental syringe for use in a dental procedure such as a root canal is provided. The root canal irrigant needle has a non-circular shape and has multiple irrigant outlets located along the length of the root canal irrigant needle. The location and angular orientation of the multiple irrigant outlets allow for an efficient removal of debris from the root canal.

Abstract: A tube element for a device for introduction into a body passage comprises a first tube element end and a second tube element end, wherein a longitudinal dimension is formed between the first and second tube element end. The tube element has a sheath comprising an outer wall and an inner wall. A cross-sectional element is arranged between the first and second tube element ends. The cross-sectional element contains a plurality of opening arrangements. Each opening arrangement comprises a first opening containing an insert element and a second opening, the internal pressure of which can be changed by a pressure changing means.

Abstract: A catheter may include an inner liner, at least one support structure over the inner liner, and an outer jacket over the at least one support structure. In some examples, the catheter includes a tip jacket positioned over a distal portion of the outer jacket and extend beyond a distal-most part of the inner liner and a distal-most part of the outer jacket to define a single-layer catheter tip. In some examples, the at least one support structure may include a braid and a coil. The catheter may include a marker band over a distal portion of one of the braid or the coil. The other of the braid or the coil ends proximally of a proximal end of the marker band, such that the catheter includes a location with lower radial and/or flexural stiffness proximal of the marker band.

Abstract: Distal tips for use with delivery catheters are disclosed that are configured to facilitate deflection of the catheters as they are advanced through the vasculature to a desired treatment site. Distal tips so configured realize one or more of the objectives of safer, more accurate steering of the catheter through the vasculature.

Abstract: Medical devices and methods for making and using medical devices are disclosed. An example medical device may include a guide extension catheter. The guide extension catheter may include a proximal member having a proximal end, a distal end, and a proximal diameter. The guide extension catheter may additionally include a collar member attached to an extension portion of the proximal member, where the extension portion may be located at the distal end of the proximal member. The extension portion may allow a delivery device to be inserted through the guide extension catheter to extend along a surface of the extension portion and align with a lumen of a distal sheath of the guide extension catheter.

Abstract: An implantable medical device deployment system is disclosed that employs both a sheath element and a constraint member to protect implantable medical devices during delivery in a body while providing simple, accurate, and reliable device deployment. The delivery system is configured so that loading and deployment forces are not directly related to device diameter, length, or design, thus allowing a more universal delivery system across various delivered device configurations and product lines. The deployment system can provide numerous benefits, include better protection for drug-coated implantable devices.

Abstract: An implant delivery system is provided for deploying an expandable implant in a patient lumen. An outer sheath has an outer sheath lumen that extends between an outer sheath proximal opening and an outer sheath open tip. At least one outer sheath side wall opening selectively places an outer sheath outer surface in fluid communication with the outer sheath lumen. At least one outer sheath open slit extends at least partially between the outer sheath open tip and a respective outer sheath side wall opening. A shaft has at least one shaft side wall opening that selectively places a shaft outer surface in fluid communication with at least one shaft lumen. When the shaft is operably joined to the outer sheath, at least a portion of the at least one shaft side wall opening is selectively aligned with a respective outer sheath side wall opening.

Abstract: The present invention relates to a shaft for a catheter which may be usable having a tubular core which may be usable with a minimally invasive procedure such as intravascular medical treatment system. It also relates to a method of fabricating such shaft.

Abstract: In some aspects, catheter devices can include: a reinforcing member having a proximal and distal ends, the reinforcing member comprising: discrete longitudinally arranged structural regions between the proximal and distal ends comprising: a first, proximal, structural region defining a first series of wall perforations that generate structural properties within the first structural region, the first series of wall perforations setting a first stiffness of the first structural region; and a second structural region, disposed distally relative to the first structural region, defining a second series of wall perforations that generate structural properties within the second structural region, the second series of wall perforations setting a second stiffness of the second structural region, which is less than the first stiffness, wherein the second series of wall perforations differs from the first series of wall perforations by at least one of: cut balance, cut frequency, or pitch.

Abstract: A multiple lumen central venous catheter with the lumens exit ports on the distal sides of the catheter; enclosed in a separate casing that has exit ports in the walls at its distal end; that allows the enclosed catheter to rotate in the casing, allowing the exit ports in the catheter to align or non-align to open and close the individual lumens at the distal end.

Abstract: The present embodiments provide strain relief members for a medical device delivery system, methods of use thereof, and methods of manufacturing. In one embodiment a strain relief member may include a support having a first end with a first outer diameter, a second end having a second outer diameter, an inner surface facing a support lumen that extends axially through the support along a longitudinal axis, and an outer surface opposite to the inner surface. An embodiment may also include an overlay coupled to a portion of the outer surface of the support, where the overlay comprises a first material and the support comprises a second material, and the first material is more flexible than the second material. A liner may be disposed in a portion of the support lumen and a first connector disposed over a portion of the support.

Abstract: A method of changing a catheter into a distal steering tool catheter includes adding to an existing catheter a tube assembly that passes through the catheter, the tube assembly including an internal tube and an external tube whose distal ends are coupled to each other and which are arranged for longitudinal axial movement relative to one another, and providing a tube manipulator coupled to the tube assembly, which is operative to cause relative axial movement of the internal and external tubes and bending of a distal portion of at least one of the internal and external tubes.

Abstract: An elastic percutaneous elastic introducer sheath is disclosed which can locally expand and reduce to accommodate a transcatheter medical device. The elastic introducer sheath includes a non-circumferentially continuous elastic frame, a liner, and a jacket.

Abstract: A method of manufacturing tubing suitable for use as a component of a medical device, such as a catheter body, and the real-time adjustment of characteristics of the tubing as it passes from one reel to another reel during manufacture. Thus, a length of tubing is manufactured that includes a plurality of segments of different flexibilities and the length of tubing is then cut into a plurality of sub-lengths of tubing that are suitable for use as a component of a medical device. In one embodiment, a method of manufacturing a length of catheter tubing comprises: extruding a base layer; overlaying a braided layer on the base layer; overlaying a sub-jacket layer over the braided layer; overlaying an outer jacket on the jacket sub-layer; and heating at least a portion the jacket sub-layer to change a characteristic of the length of catheter tubing.

Abstract: The present disclosure provides improved medical delivery devices for delivering a medical device into a subject. In one embodiment, the medical delivery device includes a non-porous composite inner layer constructed of a lubricious material having a plurality of pores and a thermoplastic elastomer reflowed into the plurality of pores. In other embodiments, the medical delivery device further includes a thermoplastic elastomer coated braided metallic member surrounding the nonporous composite inner layer to provide strength and structure to the device.

Abstract: Devices for moving blood within a patient, and methods of doing so. The devices can include a pump portion that includes an impeller and a housing around the impeller, as well as a fluid lumen. The impeller can be activated to cause rotation of the impeller and thereby move fluid within the fluid lumen.

Abstract: A microcatheter includes an inner polymeric tube defining an inner lumen. It includes a proximal section with an inner wire layer helically wound in a constricted state over the inner polymeric tube and includes an outer wire layer helically wound over the inner wire layer in a constricted state within the proximal section. It includes a distal section with a distal wire layer helically wound in a constricted state and having an outer diameter. The proximal and distal sections are joined. The outer diameter of the outer wire layer is substantially the same as the outer diameter of distal wire layer at the location where the proximal and distal sections are joined.

Abstract: A retrieval system for a biostimulator, such as a leadless cardiac pacemaker, is described. The biostimulator retrieval system includes a docking cap rotatably coupled to an outer catheter by a bearing. A torque shaft extends through the outer catheter and attaches to the docking cap to transmit torque to the docking cap to cause rotation of the docking cap relative to the outer catheter. The rotating docking cap can transmit torque to an attachment feature of a biostimulator received within the docking cap. The attachment feature can be captured by a snare that extends through the torque shaft. A cincher tube extends through the torque shaft around the snare, and advances over the snare independently from the torque shaft that is attached to the docking cap, to cinch the snare onto the attachment feature. Other embodiments are also described and claimed.

Abstract: Guidewires having conductive elements are described where in one variation, the guidewire may be formed by disposing an insulative layer upon a surface of the guidewire core, and printing one or more conductive traces directly upon a surface of the insulative layer.

Abstract: An interventional catheter for treating an artery includes an elongated body sized and shaped to be transcervically introduced into a common carotid artery at an access location in the neck. The elongated body has an overall 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: Devices, systems and methods are described herein to provide improved steerability for delivering a prosthesis to a body location, for example, for delivering a replacement mitral valve to a native mitral valve location. A delivery component can have a plurality of slots that provide for desired bending of the delivery component, particularly compound bending of the delivery component that can facilitate steering of the delivery component in three dimensions.

Abstract: A microcatheter is characterized as having a hardness-transition section along an entire or partial length an outer layer, hardness of the outer layer varying in the hardness-transition section so as to increase from the distal tip to the proximal tip along the lengthwise direction, due to arrangement of a second forming material in a stripe pattern extending in the lengthwise direction of the outer layer in the first forming material including a forming material formable into the outer layer so that a surface area ratio of the two forming materials in a circumferential direction of a cross section varies along the lengthwise direction for the first forming material and the second forming material.

Abstract: Catheters and methods for supporting a guidewire or delivering a radiopaque, diagnostic or therapeutic agent through a vessel stenosis or other tortuous anatomy are disclosed. A catheter can comprise an elongate shaft body and a tip member disposed at a distal end of the shaft body. The shaft body can extend from a proximal end to the distal end and can define an inner lumen. The shaft body can include a liner, a braid member surrounding the liner, a multi-layer coil surrounding the braid member, and a polymer cover surrounding the multi-layer coil. An outer surface portion of the polymer cover can include one or more helical threads, which can be enveloped in an outer wrapper. The tip member can be made from a metal or a polymer. Polymer tip members can include a hard or semi-hard distal tip.

Abstract: A device comprises a tubular member with a longitudinal axis having a proximal end and a distal end, at least one partial cut located at, along or near the distal end of the tubular member, the at least one partial cut comprising an orientation that is angled relative to both the longitudinal axis and an axis transverse to the longitudinal axis, a pusher member positioned within an interior of the tubular member and configured to selectively advance the distal end of the tubular member longitudinally, wherein the distal end of the tubular member is configured to at least partially rotate when the pusher member is advanced relative to the tubular member so at to facilitate placement of the distal end in a particular branch of a subject's intraluminal network, wherein the distal end of the tubular member is configured to longitudinally elongate along or near an area of the at least one partial cut.

Abstract: A method of manufacturing a catheter shaft includes the steps of forming an inner layer of a first polymeric material, forming a plait matrix layer including a second polymeric material about the inner layer, and forming an outer layer of a third polymeric material about the plait matrix layer. The plait matrix layer includes a braided wire mesh partially or fully embedded within the second polymeric material, which is different from at least one of the first polymeric material forming the inner layer and the third polymeric material forming the outer layer. The second polymeric material has a higher yield strain and/or a lower hardness than at least the first polymeric material, and preferably both the first and the third polymeric materials. The first polymeric material and the third polymeric material may be different or the same. The catheter shaft may be formed by stepwise extrusion, co-extrusion, and/or reflow processes.

Abstract: A catheter may include an inner liner, at least one support structure over the inner liner, and an outer jacket over the at least one support structure. In some examples, the catheter includes a tip jacket positioned over a distal portion of the outer jacket and extend beyond a distal-most part of the inner liner and a distal-most part of the outer jacket to define a single-layer catheter tip. In some examples, the at least one support structure may include a braid and a coil. The catheter may include a marker band over a distal portion of one of the braid or the coil. The other of the braid or the coil ends proximally of a proximal end of the marker band, such that the catheter includes a location with lower radial and/or flexural stiffness proximal of the marker band.

Abstract: A vascular access device is disclosed including a catheter, a catheter adapter having a distal end and a proximal end, an overall length extending from the distal end to the proximal end, an internal cavity, an upper portion, a lower portion and a tip having a distal opening having a circumference through which the catheter extends, an introducer needle extending through the catheter; and a needle hub connected to the proximal end of the introducer needle. The catheter adapter being connected to the proximal end of the catheter and at least a majority of the catheter adapter is made from a first material and at least a portion of the tip is made from a second material that is more flexible than the first material.

Abstract: A catheter comprises a heater control supplying power, a handle, a base catheter with lumen and comprising a proximal section and a distal segment, and a variable stiffness element. The element comprises a heater connected to the heater control, coiled at least at the distal segment, and comprising a shaft portion of a first metallic conductive material and a heater portion of a second metallic conductive material. A jacket is disposed about the heater portion. A variable flex sub-assembly between the catheter and jacket comprises a non-conducting braid and a binding material. Without power, the binding material is stiffened. Responsive to heating of the binding material, the binding material softens to increase flexibility of the variable flex sub-assembly at least at the distal segment. Responsive to removing power, the binding material cools and stiffens to decrease flexibility of the variable flex sub-assembly at least at the distal segment.

Abstract: In some examples, a catheter includes an elongated body including a structural support layer comprising at least two filaments of different materials wound longitudinally adjacent to each other to define a coil structure, and an outer jacket positioned over the structural support layer.

Abstract: A system of devices for treating an artery includes an arterial access sheath adapted tointroduce 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: A pre-curved steerable catheter includes a catheter body (102) having a distal end portion. The distal end portion includes a permanently curved flexible end portion (110). A pull wire (108) is disposed in a pull wire lumen within the catheter body. The pull wire extends from the distal end portion to a proximal end portion of the catheter body wherein the pull wire, when tensioned, provides a change in an angle of the curved flexible end portion of the catheter body.

Abstract: A medical device includes an elongate shaft including a multifilar coil comprising a first strand and a second strand wound in the same winding direction, the multifilar coil comprising a first section having a first end and a second end wherein the first strand and the second strand are wound with identical pitch patterns between the first end and the second end of the first section, the multifilar coil further comprising a second section having a first end and a second end, wherein the first strand and the second strand are wound with different pitch patterns from each other between the first end and second end of the second section, and a polymeric tubular member coextending with the multifilar coil.

Abstract: Methods and apparatuses for detecting tension on a tendon and/or mechanical deformation (e.g., breakage) of one or more steering tendon of a steerable and flexible articulating device. Theses apparatuses may have one or more tendons that are each electrically conductive and configured to steer the apparatus when tension is applied to the proximal end of the tendon. Tension and/or breakage (or other deformation) of one or more of these tendons may be detected by monitoring the electrical resistance of the tendons.

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: A catheter configured for use with a magnetic field-based localization system includes a distributed location sensor that includes a plurality of individual location sensing coils electrically connected in series. The distributed location sensor has an effective magnetic center based on the individual characteristics of each location sensing coil. The effective magnetic center can be located in a space occupied by another structure such as an irrigation fluid delivery tube. The plurality of individual location sensing coils are generally smaller, thereby easing placement, and collectively, when connected in series, output a relatively strong and noise-free signal.

Abstract: Medical devices such as catheters can include structure or provision that permit a physician or other health care professional to adjust the stiffness of at least a portion of the medical device. In some instances, the medical device may be adjusted prior to inserting the medical device into a patient. In some cases, the medical device may be adjusted while in use within the patient.

Abstract: An interventional catheter for treating an artery includes an elongated body sized and shaped to be transcervically introduced into a common carotid artery at an access location in the neck. The elongated body has an overall 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: A supportive balloon catheter which may be used to assist a wire guide in advancing across a lesion which partially or totally occludes an intraluminal passage. The supportive balloon catheter is advanced over the wire guide, close to the location of the lesion. The supportive balloon catheter is then inflated, securing the position of the wire guide in the intraluminal passage. A braid on the catheter may provide additional structural support. The secured catheter restricts the movement of the wire guide advancing across the lesion, preventing kinking or deflection off the surface of the lesion. Once the wire guide has advanced across the lesion, the supportive balloon catheter or a different angioplasty may be used to clear the lesion from the intraluminal passage.

Abstract: Described here are devices and methods for performing atherectomies. Generally, the atherectomy devices may comprise a handle, a cutter assembly, and a catheter or catheter assembly therebetween. The cutter assembly may include a cutter housing and a cutter comprising a first cutting element and a second cutting element, each of which may be rotated relative to the atherectomy device to cut occlusive material.

Abstract: A medical balloon is made radiographic, such as by incorporating a radiopaque foil or film layer. The radiopaque foil or film layer may be placed between an inner layer and an outer layer of a non-compliant balloon wall. The foil or film may provide the balloon with a radiographic quality from a first end to a second end in the absence of an inflation fluid. The balloon may be provided with the foil or film in a manner that provides a first section, such as the barrel, with a first radiographic quality, and a second section, such as the cone, with a second radiographic quality. The film may also be applied as a decal or appliqué to the external surface of a balloon-shaped body. Related methods are also disclosed.

Abstract: In some embodiments, an apparatus includes a first catheter movably disposed within a first lumen of a second catheter. The first catheter has a first occlusion member disposed at a distal end portion and the second catheter has a second occlusion member disposed at a distal end portion. A third catheter has a third occlusion member disposed at a distal end portion and is moveably disposable within a second lumen of the second catheter. The second catheter has a side port in fluid communication with the second lumen and the third catheter can be extended out of the second lumen through the side port. The first occlusion member, second occlusion member and third occlusion member can collectively isolate a target region including a portion of a first body lumen (e.g., a main vessel) and a portion of a second body lumen (e.g., a branch of the main vessel).

Abstract: A percuscopic access device is disclosed. The percuscopic access device has a hollow shaft with a proximal opening and a distal opening. The percuscopic access device also has one or more barrier ridges on the outside of the hollow shaft. The percuscopic access device also has one or more recesses on the inside of the hollow shaft and in communication with the distal opening. A cleaning obturator for use with the percuscopic access device is also disclosed. The cleaning obturator and percuscopic access device may be combined as a surgical apparatus. The cleaning obturator has a guide rod having a proximal end and a distal end. The cleaning obturator also has a plugging tip on the distal end. The cleaning obturator further has one or more swab guides proximal to the plugging tip.

Abstract: The present invention provides a lacrimal duct tube that can be preferably used for the treatment of lacrimal duct obstruction, in particular, sheath guided endoscopic probing having been frequently performed in recent years, the lacrimal duct tube being excellent in passage through a lesion in the lacrimal duct, operability in the lacrimal duct, and manipulation of the endoscope inserted into the lumen of the tube, and providing a sufficient viewing field of the endoscope. The present invention relates to a lacrimal duct tube, including: a pair of tubular members that each has an opening at one end and a hole in a side wall communicating with a lumen; and a connection member that connects other ends of the tubular members, wherein the tubular members each include a plurality of resin portions different in Shore hardness, at least one of the resin portions is positioned between the opening and the hole and forms a lumen wall of the tubular member, and the lumen wall has a Shore hardness of 57D or more.

Abstract: The present disclosure describes an occlusion device and methods of delivering the occlusion device. The occlusion device can include an expandable structure configured to move between an unexpanded configuration and an expanded configuration. The expandable structure can be configured to have an expansion ratio of at least about 5:1. Further, the occlusion device can be configured to prevent substantially all fluid from flowing past the occlusion device when the occlusion device is in the expanded configuration in the vessel.

Abstract: A turbulator for promoting mixing of fluids passing through a body lumen includes an elongate flow perturbing component and an elongate shape controlling component freely slidable within the flow perturbing component. The turbulator is adjustable from a low profile, lumen access configuration to a deployed configuration via sliding the shape controlling component within the flow perturbing component. Adjusting the turbulator within a body lumen of a patient induces turbulence within a flow of fluid passing through the body lumen to increase mixing of a treatment fluid with the body fluid by way of the induced turbulence.

Abstract: Single filter and multi-filter endolumenal methods and systems for filtering fluids within the body. In some embodiments a blood filtering system captures and removes particulates dislodged or generated during a surgical procedure and circulating in a patient's vasculature. In some embodiments a filter system protects the cerebral vasculature during a cardiac valve repair or replacement procedure.

Abstract: This invention is a multipolar or multi-conductor guidewire which can be navigated or steered through the vasculature from outside a patient's body to perform a medical procedure within the patient's vasculature. In one embodiment, a guidewire of this invention has at least 4, preferably at least 6, to as many as 10 or more distal-to-proximal conductive pathways, which are substantially longitudinally parallel to each other running linearly along substantially the majority if not the entire length of the guidewire body, preferably in a printed circuit format. In a further practice, the conductive pathways helically wound around the guidewire body.

Abstract: A medical device delivery catheter includes an elongate tubular body including proximal, intermediate, and distal longitudinal segments. The proximal segment extends between a proximal end of the body and a first transition between the proximal segment and the intermediate segment, has a first outer diameter, and includes at least one flexibility increasing cut through a wall of the body. The intermediate segment extends between the first transition and a second transition between the intermediate segment and the distal segment, has a second outer diameter that is less than the first outer diameter, and defines a medical device support region. The distal segment has an initial outer diameter that is greater than the second outer diameter and terminates in a distally tapered region. The body is free of joints and has a uniform tensile strength across the proximal, intermediate, and distal segments and the transitions.

Abstract: Medical devices, systems, and methods for treating patients with tissue ablation include catheter systems having bi-modal steering mechanisms, which are capable of both linear and loop ablation. In other words, the catheter system may have two different steering modes: two-dimensional and three-dimensional. In the first and second steering modes, the steering actuator may cause one or more portions of the catheter shaft to bend in different planes. A steerable ablation catheter may include treatment elements such as electrodes at its distal end and along the catheter shaft, each of which may map, pace, and ablate. Optional features include a series of thermocouples for monitoring local temperatures.