Cerebrovascular treatment at an intracranial location beyond the petrous segment of the carotid artery can be challenging due to blood vessel size and tortuosity. First pass cerebrovascular thrombectomy success rate under only fluoroscopic guidance can be low (e.g., 25.1%) but an angioscope can help improve efficacy. A sheath catheter can be advanced toward the cerebrovascular pathology. Its distal balloon can be inflated. An angioscope can be inserted via its working lumen for viewing. The sheath catheter can have a stepped-down lateral profile and can extend the working channel a distance beyond the balloon. A dual concentric lumen structure can include an inner body and an outer body, defining an inflation lumen therebetween, with one or more portions of one or more layers stretched or cut or both, such as to provide bending flexibility. Reflow techniques can be used to help bond layers together.

Medical systems, devices and methods for creation of autologous tissue valves within a mammalian body are disclosed. One example of a device for creating a valve flap from a vessel wall includes an elongate tubular structure having a proximal portion and a distal portion and a longitudinal axis; a first lumen having a first exit port located on the distal portion of the elongate tubular structure; a second lumen having a second exit port located on the distal portion of the elongate tubular structure; a recessed distal surface on the distal portion of the elongate tubular structure, wherein the recessed distal surface is located distally to the first exit port; and an open trough on the recessed distal surface extending longitudinally from the first exit port.

A catheter comprises an imaging core, an inner sheath enclosing the imaging core, an outer sheath surrounding the inner sheath, and a flexible membrane arranged on the outer sheath and configured to deflect in response to intravascular pressure. At least part of the inner sheath and part of the outer sheath are nested within each other. A chamber is defined by the membrane, and the parts of the inner and outer sheaths that are nested within each other. The chamber provides a space into which the membrane is deflected when surrounded by fluids. A processor controls the imaging core to acquire pressure data by scanning the membrane with light transmitted through the chamber, and to acquire image data by scanning a vessel wall with light transmitted through the inner sheath. If the membrane breaks, the chamber prevents fluids from entering the imaging core, and the catheter continues acquiring image data.

A system and method of assessing a depth of view of an image by analyzing an image data set to determine a diameter of a luminal network proximate a determined position of a tool and displaying an image, the image including an indicator of a relative position of the catheter and the tool and an indicator of a position of a distal portion of the tool relative to a luminal wall of the luminal network.

A direct visualization catheter includes an elongate shaft defining a lumen and having a distal end portion and a proximal end portion and a transparent balloon attached to the distal end portion of the shaft. The balloon includes a first layer comprising a thermoset polymer and a plurality of polymeric fibers at least partially embedded in the thermoset polymer and a second layer disposed on the first layer and comprising a hydrogel.

Components for an endoscopic vessel harvesting system suitable for harvesting target vessels such as the saphenous vein or radial artery for cardiac artery bypass graft surgery. The main components of such systems include a vessel dissector and a vessel harvester, both of which work in conjunction with a separately provided endoscope. The vessel dissector is an elongated cannula having a blunt tip for separating layers of facial around vessels. The tip may be movable, and is typically transparent to permit viewing forward of the tip using the endoscope. Internal features of the tip may reduce glare back to the endoscope. Several devices improve visibility through the tip by reducing interference from tissue or fluid on the tip. The vessel harvester also has an elongated cannula for receiving the endoscope. Several tools within the harvester permit manipulation, severing, and sealing of vessels forward of the distal end. The tool for manipulating vessels may have a low-profile for increased visibility of operation, and may be coupled to the cannula with a damping mechanism to reduce the possibility of avulsion of the vessels. Various vessel cutting and sealing devices are provided that may accommodate various sizes of vessels and improve cutting and sealing efficacy.

Visualization and ablation systems and catheters. The systems can capture a plurality of different 2D images of the patient's anatomy adjacent an expandable member, each of which visualizes at least one part of the patient that is in contact with the expandable membrane, tag each of the plurality of different 2D images with information indicative of the position and orientation of a locational element when each of the plurality of different 2D images was captured, create a patient map, wherein creating the patient map comprises placing each of the plurality of different 2D images at the corresponding tagged position and orientation into a 3D space, and display the patient map.

The invention is directed to a method of determining properties in a vessel or the heart (V) of a patient. It comprises the steps of placing an element in a vessel or the heart(V) and determining a propulsion force (2) acting on the element. Furthermore, at least one of acceleration (3) and velocity (4) of the element is determined. At least one property of a neighbouring medium of the element is determined based on the propulsion force and at least one of acceleration (3) and velocity (4) of the element.

Described herein are atherectomy catheters, systems and methods that include longitudinally displaceable drive shafts that drive actuation of one or more cutters at the distal end of the catheter. The catheters described herein may include one or more imaging sensors for imaging before, during or after cutting tissue. In some variations the imaging sensor may be rotated around the perimeter of the catheter independently of the rotation of the cutter. Also describe herein are imaging catheters that may be used without cutters.

An atherectomy catheter includes an elongate flexible catheter body, an elongate deflectable distal tip coupled to the catheter body at a hinge point, a rotatable cutter near the distal end of the catheter body, and a drive shaft extending within the catheter body and configured to rotate the cutter. The atherectomy catheter further includes an optical fiber extending through the drive shaft substantially on-axis with the catheter body and attached to the cutter. The optical fiber is configured to rotate with the drive shaft. The atherectomy catheter further includes a wedge configured to deflect the distal tip away from the catheter body at the hinge point upon axial movement of the drive shaft.