A system has an outer catheter and an inner aspirating clot retrieval catheter having an expansile distal tip for flow restriction, improved aspiration efficiency, and a large mouth into which a clot or other obstructions can be retrieved. The clot retrieval catheter can have a support tube proximal of the tip. The expansile tip can be a strut framework, and a flexible, low-modulus cover is disposed around at least a portion of the tip strut framework and the proximal support tube. The distal end of the tip can be encapsulated by a low-friction elastomeric lip for atraumatic contact with the walls of a blood vessel. The tip has a collapsed delivery configuration and expands radially into a deployed configuration. The tip strut framework, support tube, and cover can all have characteristics which enhance the deliverability of the clot retrieval catheter to the target.

An aspiration clot retrieval catheter to have profiled guidewire for deliverability that transitions at a proximal joint to a distal tubular section with a lumen for directing aspiration and facilitating the smooth passage of other products in performing mechanical thrombectomy procedures. The joint can have a low-profile proximal strut formed integrally with the distal tubular section and configured to interlock with a distal portion of the guidewire so that there is a smooth transition of stiffness between the guidewire and the tubular portion of the catheter to improve trackability and decrease the likelihood of kinking. The distal tubular section of the proximal joint can also have features to tailor flexibility. The tubular section can be configured to push radially outward to form a seal with an outer catheter to optimize aspiration transmission to the distal mouth of the aspiration clot retrieval catheter.

An ultrasonic device may include an ultrasonic system including a transducer coupled to an ultrasonic blade, A method of delivering energy to the device may include sensing a vessel contacting the blade, identifying that the vessel is calcified, and generating a warning. In some aspects, the method further includes disabling one or more activation functions of the blade. In another aspect, the method further includes generating a message to apply compression to the vessel for a predetermined period, disabling activation functions of the blade during compression, and enabling activation functions after the expiration of the compression period. In yet another aspect, the method includes applying a compressive clamp force to the calcified vessel by driving a clamp arm toward the blade, disabling activation functions of the blade during compression, and enabling the activation functions after adjusting the compressive force. An ultrasonic surgical instrument may effect the method.

A sheathed blade assembly for minimizing or preventing contact between the moving interior blade and the exterior sheath. The assembly includes an exterior sheath having a first portion and second portion with an inner lumen therebetween, an interior blade movable within the inner lumen of the exterior sheath, a first pocket within a first surface of the interior blade, and a first ball bearing within the first pocket. The first ball bearing creates a clearance amount between the first surface of the interior blade and the first portion of the exterior sheath. The assembly may also include a second pocket within a second surface of the interior blade for a second ball bearing. The second ball bearing creates a clearance amount between the second surface of the interior blade and the second portion of the exterior sheath. The second pocket is in a staggered configuration relative to the first pocket.

A device for transmitting mechanical waves, including a mechanical waveguide having an elongated shape and extending between a proximal end and a distal end for propagating the mechanical waves coupled at the proximal end up to the distal end, and a radiopaque marker secured to the mechanical waveguide adjacent to the distal end thereof.

An endovascular fixation device includes a first portion and a second portion connected to the first portion to define a central lumen extending longitudinally through the portions. The first portion includes a first radially expandable ring and at least one first connector, connected to the first ring, configured to cause at least one first flarable crown of the first ring to flare radially outwardly relative to other portions of the first ring when the first ring is expanded from a retracted position to an expanded position. The second portion includes a second radially expandable ring and at least one second connector, connected to the second ring, configured to cause at least one second flarable crown of the second ring to flare radially outwardly relative to other portions of the second ring when the second ring is expanded from a retracted position to an expanded position.

A treatment system includes an insert that is resiliently deflectable. The tip portion of the insert can be configured to be coupled to the trailing portion of an implant. A guide tube having an internal lumen is configured to permit passage of the tip portion and the body portion of the insert through a guide tube. The guide tube can have a length that is less than that of the insert. Treatment systems include a plurality of inserts, each insert differing from in at least one of length, diameter, and curvature. Treating a patient can include sizing a fistula using an insert.

A device for deploying a suture clip onto a suture can include a proximal handle portion that includes an actuation mechanism. The device can also include an outer shaft defining an inner lumen. A crimping assembly can be at least partially disposed within a distal end of the outer shaft. The crimping assembly can include a plurality of crimping members configured to receive and radially compress a suture clip. The actuating mechanism can be configured to move the plurality of crimping members radially inwardly from a first position, where the crimping members are configured to receive a suture clip, to a second position where the plurality of crimping members are configured to radially compress the suture clip, causing the suture clip to plastically deform and become secured around one or more sutures.

A surgical instrument includes a rotatable electrical coupling assembly having a first part and a second part that electrically couple and rotate relative to each other. The second part is carried by and rotates with a tube collar coupled to a transducer. A portion of the transducer is inserted through an aperture of the second part, but does not contact the second part. The first part of the assembly may electrically couple to the second part via pogo pins, brush contacts, or ball bearings. Alternatively, the first part may comprise conductive channels formed in the casing. The second part may comprise a rotatable drum with a conductive trace. In some versions, one or more components may comprise MID components. In another version, the rotatable electrical coupling assembly comprises a rotatable PC board and brush contact. Further still, a circuit board may be provided with the transducer inside a transducer casing.

A surgical instrument operable to sever tissue includes a body assembly and a selectively coupleable end effector assembly. The end effector assembly may include a transmission assembly, an end effector, and a rotational knob operable to rotate the transmission assembly and the end effector. The body assembly includes a trigger and a casing having a distal aperture configured to receive a portion of the end effector assembly. First and second coupling mechanism portions cooperatively couple the end effector assembly to the body assembly for use. The coupling may mechanically and/or electrically couple the end effector assembly to the body assembly via various coupling mechanisms. For instance, a threaded slip nut may couple to threads within the body assembly. In one configuration, the end effector assembly may have locking tabs that rotate into rotational recesses in the body assembly. The locking tabs may include electrical contacts and/or optically perceivable indicators.