The present disclosure relates generally to the field of tissue removal and more particularly to methods and devices for use in medical applications involving selective tissue removal. One exemplary method includes the steps of providing a tissue cutting instrument capable of distinguishing between target tissue to be removed and non-target tissue, urging the instrument against the target tissue and the non-target tissue, and allowing the instrument to cut the target tissue while automatically avoiding cutting of non-target tissue. Various tools for carrying out this method are also described.

A tissue resecting instrument includes a housing, a shaft rotatable relative to the housing and defining a proximal end portion disposed within the housing and a distal end portion distally-spaced from the housing, a cutting member operably associated with the distal end portion of the shaft, a turbine disposed within the housing and operably associated with the proximal end portion of the shaft, and a fluid outflow tube operably associated with the housing. The fluid outflow tube is adapted to connect to a suction source to enable the suctioning of fluid and resected tissue proximally through a lumen of the shaft, an interior of the housing, and into the fluid outflow tube. The turbine is configured such that proximal fluid flow across the plurality of fins of the turbine urges the turbine to rotate, thereby rotating the shaft relative to the housing to enable tissue resection with the cutting member.

Medical devices and method for making and using medical devices are disclosed. An example method for treating a blood vessel may include disposing a medical device within the blood vessel at a position adjacent to a lesion. The medical device may include an elongate shaft having a distal end region, a balloon coupled to the distal end region, and a cavitation member disposed within the balloon. The method may also include inflating the balloon to a first pressure, activating the cavitation member, and inflating the balloon to a second pressure greater than the first pressure.

A medical device and method are disclosed which can cause a filter included in a cylinder to capture a capturing target by causing a fluid including a circulating flow to flow inside and around the cylinder introduced into a living body. The medical device has a filter, a cylinder, and an impeller. The filter captures a capturing target present inside a living body. The cylinder includes a lumen having the filter arranged therein, an aspiration section, which is open on the distal side of the lumen, and a discharge section which is open on a side surface on a proximal side of the lumen. The impeller is arranged on a proximal side of the filter in the lumen, and causes the lumen to aspirate the capturing target together with a fluid by causing the fluid to flow from the aspiration section toward the discharge section inside the living body.

An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.

A tissue resecting instrument includes a housing, a shaft rotatable relative to the housing and defining a proximal end portion disposed within the housing and a distal end portion distally-spaced from the housing, a cutting member operably associated with the distal end portion of the shaft, a turbine disposed within the housing and operably associated with the proximal end portion of the shaft, and a fluid outflow tube operably associated with the housing. The fluid outflow tube is adapted to connect to a suction source to enable the suctioning of fluid and resected tissue proximally through a lumen of the shaft, an interior of the housing, and into the fluid outflow tube. The turbine is configured such that proximal fluid flow across the plurality of fins of the turbine urges the turbine to rotate, thereby rotating the shaft relative to the housing to enable tissue resection with the cutting member.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis and proximal and distal end portions spaced apart from one another along the axis. A turbine is fixed to the elongate body and is disposed at an intermediate position between the proximal and distal end portions of the elongate body. A rotatable tissue-removing element is at the distal end portion of the elongate body and is operatively coupled to the turbine such that the turbine imparts rotation of the tissue-removing element. The tissue-removing element removes the tissue from the body lumen as the tissue-removing element is rotated by the turbine.

An atherectomy system includes a handle having a handle housing, with a drive member extending through the handle housing and operably coupled to an atherectomy burr. A drive mechanism is disposed within the handle housing and is adapted to rotatably engage the drive member. The drive mechanism may include an electric drive motor, a drive gear that is rotatably engaged with the electric drive motor and a driven gear that is coupled with the drive member and is engaged with the drive gear such that rotation of the driven gear causes rotation of the drive member. The drive mechanism may be configured to enable a rotation speed of the atherectomy burr of up to at least about 200,000 revolutions per minute (rpm).

Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating an abrasive element within the vessel. The abrasive element can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly. In particular embodiments, the handle assembly includes a compressed gas driven turbine member that drives rotation of the drive shaft. The turbine member can be rotatably attached to a carriage that is longitudinally translatable in relation to a housing of the handle assembly. The handle assembly can include a latch mechanism that when actuated allows the carriage to translate to a proximal-most position. While the carriage is in the proximal-most position, an open pathway is created so that a guidewire can be slidably passed through the handle assembly and a lumen of the drive shaft.