A cutting balloon catheter including a balloon mounted on a distal portion of a catheter shaft. An expandable frame may be disposed over the balloon. The expandable frame may include a plurality of struts extending from a proximal end region to a distal end region. One or more cutting members may be secured to the expandable frame.

The current document is directed to improved PTA methodologies that significantly decrease the risks of persistent blood-vessel-wall distention and subsequent restenosis and the risks of PTA-induced dissection, hematoma, and pseudoaneurysm when used to treat blood vessels. Similar improved percutaneous-transluminal-interventional methods are used to treat non-vascular vessels. The improved methods include initial selection of balloon length and inflation pressure for initial treatment of primary lesions to minimize the risks of over-inflation and generation of undesirable localized forces during balloon inflation. The improved methods further include higher-pressure treatment of remaining secondary lesions that also minimizes the risks of over-inflation and generation of undesirable localized forces. The improved methods can be practiced using differently sized balloons and conventional instrumentation, but may be facilitated by use of balloon-length-adjustable catheters.

A method may include inflating a first balloon within an internal carotid artery so as to block antegrade flow of blood into an ophthalmic artery. Additionally, the method may include maintaining antegrade flow of blood in the internal carotid artery via a perfusion lumen in the first balloon. Further, the method may include inserting a device into the ophthalmic artery via a lumen extending through a portion of the first balloon to a side opening in the first balloon.

A medical device with an expandable element and expandable tubular sleeve surrounding at least a portion of the expandable element which influences the rate, shape and/or force required to expand the expandable element and methods for use in a body lumen are provided.

A system for breaking obstructions in body lumens includes a catheter including an elongated carrier, a balloon about the carrier in sealed relation thereto, the balloon being arranged to receive a fluid therein that inflates the balloon, and an arc generator including at least one electrode within the balloon that forms a mechanical shock wave within the balloon. The system further includes a power source that provides electrical energy to the arc generator.

The invention provides a device for generating shock waves. The device may comprise an elongated tube and a conductive sheath circumferentially mounted around the elongated tube. The device may further comprise first and second insulated wires extending along the outer surface of the elongated tube. A portion of the first insulated wire is removed to form a first inner electrode, which is adjacent to a first side edge of the conductive sheath. A portion of the second insulated wire is removed to form a second inner electrode, which is adjacent to a second side edge of the conductive sheath. Responsive to a high voltage being applied across the first inner electrode and the second inner electrode, a first shock wave is created across the first side edge and the first inner electrode, and a second shock wave is created across the second side edge and the second inner electrode.

A clot removal device can include a caged portion which can include a distal end; a proximal end; an inner cage having a network of inner struts; and an outer cage having a network of outer struts. The inner cage and the outer cage can include a delivery configuration within a microcatheter and a deployed configuration distal of the microcatheter operable to retrieve at least a portion of the clot. The device can include a distal pinching portion located proximate the distal end of the caged portion, and a proximal pinching portion located proximate the proximal end of the caged portion, each pinching portion can include at least one pinching cell can include a collapsed state and an expanded state distal of the microcatheter operable to tweeze at least a portion of the clot.

Methods and devices are disclosed for passing Chronic Total Occlusion (CTO) from subintimal location and re-entry into a true-lumen of the patient using transient fenestration approach. The transient fenestration is induced by balloon dilatation within the CTO, and a guidewire quickly trails into a true lumen.

A method is disclosed for removing a vascular occlusion, such as a clot, from a blood vessel. A tubular sheath is inserted into the vessel and a self-expanding Nitinol mesh filter is deployed from a distal end of the tubular sheath at a location proximal to a clot. An inner catheter is advanced through the tubular sheath and through the mesh filter for contacting the clot. An expandable agitation element is provided along a distal end portion of the inner catheter for cutting or chopping the clot, thereby facilitating removal of the clot and improving blood flow through the vessel. Resulting clot particles are captured by the mesh filter. Negative pressure may be applied along a proximal end portion of the sheath for aspirating remaining particles. Certain embodiments of the method are well-suited for treating deep vein thrombosis and do not require the use of thrombolytic drugs.

An obstruction removal device is described, having one or more engaging members which can engage portions of the clot. The one or more engaging members have a collapsed, delivery state, and an expanded, deployed state.