An articulated arm for support of an extended flexible medical instrument includes: a segment rotationally mobile around an axis of rotation, where the mobile segment can either be rotationally locked or unlocked, a handgrip including: a distal holding part to be hand held, a proximal support part connecting the distal holding part to the remainder of the structure, and an actuator on the distal holding part locking and unlocking mobility of the segment in rotation around the axis. The locking and unlocking actuator extends over the main part of the length of the distal holding part such that: pressure of the user's hand griping the distal holding part directly creates contact with the actuator, sufficient for automatically unlocking mobility of the segment in rotation and release of the distal holding part terminates contact with the locking and unlocking actuator, sufficient for automatically locking mobility of the segment in rotation.

The present disclosure provides a catheter assembly including a catheter tube and an expandable unit attached to the catheter tube. The expandable unit is configurable in a collapsed configuration for facilitating delivery of the catheter assembly through a body lumen and a fully expanded configuration for contacting an interior wall of the body lumen to cover a perforation. The expandable unit defines a longitudinal channel extending from a proximal end to a distal end of the expandable unit when in the fully expanded configuration, permitting blood flow past the expandable unit. The disclosure further provides a method of treating a perforation by delivering a catheter assembly with an expandable unit to a perforation site, expanding the expandable unit to contact an interior wall of a body lumen to cover the perforation, and permitting blood flow past the expandable unit while in contact with the interior wall covering the perforation.

Disclosed is an articulated support arm for an elongated flexible medical instrument, including: a segment rotating about an axis of rotation, a radial brake for preventing rotation of the segment about the axis of rotation, including: a supply of hydraulic fluid, a piston whose stroke along the direction of the axis of rotation, due to the pressure of the hydraulic fluid, prevents rotation of the segment about the axis of rotation, the piston being an annular piston having a hollow center about the axis of rotation, the supply of hydraulic fluid passing through the hollow center.

A tissue treatment catheter and system include a catheter shaft sized and shaped for delivery through a radial artery to a blood vessel of a patient. The catheter shaft has several lumens, including a guidewire lumen, a cable lumen, and one or more fluid lumens. A stiffening web extends from the guidewire lumen and is thicker than an outer wall of the catheter shaft. The tissue treatment catheter and system include an ultrasound transducer, a balloon surrounding the ultrasound transducer, and a single electrical cable electrically connected to the ultrasound transducer to deliver sufficient electrical energy during sonication to the transducer such that the transducer thermally induces modulation of neural fibers surrounding the blood vessel sufficient to improve a measurable physiological parameter corresponding to a diagnosed condition of the patient. Other embodiments are described and claimed.

Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.) into the paranasal sinuses or other structures in the ear, nose or throat, Specific devices (e.g., tubular guides, guidewires, balloon catheters, tubular sheaths) are provided as are methods for manufacturing and using such devices to treat disorders of the ear, nose or throat.

An implantation and/or retrieval device for a leadless cardiac pacing device may include a first elongate shaft including a lumen; a second elongate shaft slidably disposed within the lumen of the first elongate shaft; an end cap assembly fixedly attached to a distal end of the first elongate shaft; and a plurality of wires attached to the second elongate shaft and extending distally from the end cap assembly, the plurality of wires being movable relative to the end cap assembly. The plurality of wires is configured to engage a proximal hub of the leadless cardiac pacing device. The plurality of wires forms a plurality of wire loops extending distally from the end cap assembly.

An endoscopy instrument is configured to be adjustable between a retracted position and an extended position. The endoscopy instrument includes a snare forming a loop extending from a proximate end to a distal end and a plurality of basket wires. Each of the basket wires includes a proximate end coupled to the proximate end of the snare and a distal end coupled to the distal end of the snare. The snare and the plurality of the basket wires cooperate to form a basket portion configured to contract when the endoscopy instrument is adjusted from the extended position towards the retracted position during entry of the basket portion into a tubular member. The contracting of the basket portion aids in grasping an object in need of retrieval from a patient.

A system for reshaping a valve annulus includes an elongate template having a length along a longitudinal axis and at least one concavity in a generally lateral direction along said length. The pre-shaped template is positioned against at least a region of an inner peripheral wall of the valve annulus, and at least one anchor on the template is advanced into a lateral wall of the valve annulus to reposition at least one segment of the region of the inner peripheral wall of the valve annulus into said concavity. In this way, a peripheral length of the valve annulus can be foreshortened and/or reshaped to improve coaptation of the valve leaflets and/or to eliminate or decrease regurgitation of a valve.

Apparatus is described that includes a kit. The kit includes a flexible catheter (22) and a support (40). The catheter is transfemorally advanceable to a heart of a subject and the support is dimensioned for percutaneous access to the heart. The support has a proximal end, an elongate portion, and a distal portion (41) having a catheter-engaging element (38). The catheter-engaging element is configured to reversibly engage the catheter in a manner that does not inhibit longitudinal advancement of the catheter. Other embodiments are also described.

The disclosed apparatus, systems and methods relate to an anterior mitral valve leaflet laceration catheter. The catheter has a plurality of lumens so as to allow for the introduction of the device via a guide wire, the inflation of a balloon and the manipulation of an introducer having a curved distal end cutting portion that can be rotated into a charged position for the laceration of the anterior mitral valve leaflet.