The present invention relates to a dilator. The dilator includes a shaft, a lumen and a hub. The shaft has at least two stiffness sections with the stiffness sections becoming less rigid as they approach a distal end of the shaft. The varying stiffness sections allow the dilator to track along the guidewire through torturous vasculature so as the dilator is advanced and the stiffness is changed, the stiffer sheath can advance smoothly through a blood vessel. The dilator may also taper at the distal tip to stretch the initial skin puncture hole larger to accommodate the dilator shaft and ease the sheath tip insertion through to the vasculature. Or the shaft may taper from where it extends beyond the sheath distal tip to the distal end so that it can reach further distal in the vasculature. The dilator may also include an atraumatic tip for easier advancement of the dilator. The dilator distal end may also include one or more radiopaque markers and a shaped distal end.

Apparatuses and methods are disclosed for the perforation of a communication between the aorta and left atrium. The method includes introducing the apparatus, positioning the apparatus at a location along the aorta, and energizing the apparatus to create a perforation. For example, one method may include: introducing a flexible wire into the left atrium, advancing a dilator along the flexible wire to position the flexible wire adjacent a selected location along the aorta and energizing the flexible wire to create a perforation from the left atrium into the aorta.

Methods, apparatuses, and systems are described for stent delivery and positioning for transluminal application. The method may include positioning the stent in an undeployed configuration through an access site in a wall of a first body lumen. In some cases, the method may include retracting an outer sheath proximally and past an anchoring component disposed at a distal portion of an inner tubular member based on positioning the stent. A distal portion of the stent may be disposed between the anchoring component and the outer sheath while the stent is in the undeployed configuration. The method may further include deploying the distal portion of the stent from the outer sheath and within the first body lumen and expanding a proximal portion of the stent from within the outer sheath such that upon fully exiting the outer sheath, the proximal portion expands to a deployed configuration within a second body lumen.

Reinforced catheter tips, catheters including rapidly insertable central catheters (“RICCs”), and methods thereof reduce the number of steps and medical devices involved in introducing catheters into patients. In an example of a catheter, a RICC can include a catheter tube, a catheter hub coupled to a proximal portion of the catheter tube, and a plurality of extension legs extending from the catheter hub. The catheter tube can include a first section in a distal portion of the catheter tube and a second section proximal of the first section. The first section of the catheter tube can distally terminate with a catheter tip reinforced with a reinforcement band therein. The plurality of extension legs that extend from the catheter hub can be equal in number to a plurality of lumens extending through the RICC. In another example, a method can include a method of making the foregoing RICC.

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

A vascular occlusion device having an expandable frame that carries a membrane. The membrane can include a tubular portion configured to transition between an open configuration in which the tubular portion is configured to receive a guidewire and a closed configuration in which the tubular portion is configured to occlude blood flow.

A dilator releasably connected with an endoscope to dilate a stricture as the dilator that is releasably connected to a portion of a cylindrical body of the endoscope passes through the stricture. The endoscopic dilator is moveable between an open position and a closed position configured to enable the dilator to be secured to the endoscope. When the dilator is in the closed position, an inner surface or a component on the inner surface of the dilator frictionally secures dilator to the portion of the cylindrical body of the endoscope. When in the open position, the dilator is not frictionally secured to the portion of the cylindrical body of the endoscope.

A dilator releasably connected with an endoscope to dilate a stricture as the dilator that is releasably connected to a portion of a cylindrical body of the endoscope passes through the stricture. The endoscopic dilator is moveable between an open position and a closed position configured to enable the dilator to be secured to the endoscope. When the dilator is in the closed position, an inner surface or a component on the inner surface of the dilator frictionally secures dilator to the portion of the cylindrical body of the endoscope. When in the open position, the dilator is not frictionally secured to the portion of the cylindrical body of the endoscope.

An introducer may include a layered tubular member having an inner liner including at least one folded portion extending along a distal region of the inner liner in a delivery configuration; a reinforcing member disposed over at least a portion of the inner liner, the reinforcing member including a plurality of longitudinal spines defining a plurality of openings disposed between adjacent longitudinal spines, wherein each folded portion is circumferentially overlapped by one of the plurality of openings; and an outer sheath disposed over the reinforcing member, wherein the outer sheath includes at least one perforation circumferentially overlapping each folded portion; and a tip member fixedly attached to a tapered distal region of the layered tubular member. The inner liner may extend to a distal end of the layered tubular member. At least a portion of each folded portion may terminate proximal of the distal end of the layered tubular member.