A system for traversing an arterial occlusion in an artery includes a housing sized to fit in a palm of a user, an elongate drive tube configured to be rotated by the housing, the drive tube including an axially extending passage, a cylindrical member, configured to be rotationally coupled to the drive tube, such that a distal tip of the cylindrical member may be delivered to a location adjacent the arterial occlusion when the cylindrical member is coupled to the drive tube, and wherein grasping and activating the housing such that the drive tube is rotated, thereby causes the distal tip of the cylindrical member to be rotated, the rotation of the distal tip including at least a component of linear oscillation.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

A neurovascular access catheter can comprise an elongate, flexible tubular body. The tubular body can comprise a proximal end, a distal end, and a side wall at least partially defining a central lumen. The central lumen can extend axially through the side wall. The tubular body can include a distal microcatheter segment that extends proximally from the distal end. The tubular body can include a proximal shaft that extends distally from the proximal end. The tubular body can include a tapered dilator segment being positioned in between the distal microcatheter segment and the proximal shaft segment.

An over-the-wire retrieval system having at least one expandable filter basket deployable and retrievable over a positioning guidewire that remains in place throughout the thrombectomy procedure. The filter catheter can slidably receive the positioning guidewire allowing the positioning guidewire to navigate a collapsed filter basket past a clot before the filter basket is expanded and pulled through the clot to engage or capture clot material. The filter basket can be re-collapsed and navigated past the clot over the positioning guidewire for multiple passes through the clot. The filter catheter can be paired with a flexible capture sleeve or an aspiration sheath for collection and removal of the clot material gathered by the filter basket on each pass. The flexible capture sleeve includes, in an example, a thrombus conveyor configured to transition between everted and inverted configurations.

An access needle is provided. The access needle includes a needle housing and a needle shaft having a portion disposed within the needle housing. The access needle also includes a lumen within the needle shaft, an entry port at a proximal end of the needle shaft, and a needle tip at a distal end of the needle shaft. The access needle also includes an exit port on a sidewall of the needle shaft, wherein the exit port is disposed nearer the distal end of the needle shaft than the proximal end, and wherein the lumen extends from the entry port to the exit port. The exit port a reduced diameter from the needle shaft. Guide surfaces in the vicinity of the exit port help to reduce snagging or drag of the guide wire. The access needle tip can be formed from nitinol and the guide surfaces can be formed from UV or AB glue. A system and a method for using the access needle are also provided.

A tissue-removing catheter for removing tissue in a body lumen includes an elongate catheter body. A tissue-removing element is operatively coupled to a distal end portion of the elongate catheter body. The tissue-removing element has a central axis. The tissue-removing element is configured to be rotated about its central axis to remove tissue from the body lumen. A distal end portion of the tissue-removing element includes a distal end face at a distal-most end of the tissue-removing element. The distal end face has a perimeter and a diameter extending through the central axis. Diametrically opposite points on the perimeter lie in a plane that is oblique to the central axis of the tissue-removing element.

Retrieval of material from vessel lumens can be improved by use of a distal element comprising an expandable mesh. a treatment device includes an elongated member having a proximal portion and a distal portion configured to be positioned within a blood vessel at a treatment site at or near a thrombus. A distal element comprising an expandable mesh is coupled to the distal portion of the elongated member via a connection assembly. In an expanded state, at least a portion of the mesh is configured to be in apposition with the blood vessel wall at the treatment site to anchor or stabilize the elongated member with respect to the blood vessel. The distal element can be electrically coupled to an extracorporeal current generator.

A medical device for removing a material from a hollow anatomical structure is provided. The device may include a shaft member. The device may include an expandable centering element near the distal end of the device. The device may include a macerator element either attached to the shaft or independent and freely moveable from the shaft. Alternatively, the device may include a rotating wire attached to the macerator element. The device may include an aspiration lumen in for removal of material. The device may include a drive shaft attached to a motor and used to rotate the macerator element. The device may be used in combination with a distal occlusion element, which may be either a radially expandable filter or balloon member.

An apparatus for neurovascular endoluminal intervention, in particular for the treatment of ischemic stroke, is provided. The apparatus comprises a catheter (2) for insertion into the circulatory system (CS) of a patient, in order to aspirate one or several clots (C) present in the circulatory system (CS). A distal outer section (22) of the catheter (2) comprises an unexpanded state, in which the diameter (D2) of the distal outer section (22) is smaller than the diameter (D1) of a proximal outer section (21) of the catheter (2), in order to facilitate navigation of the catheter through the circulatory system, and a radially expanded state, in order to facilitate aspiration of the one or several clots (C) through the catheter (2). Furthermore, a method for applying such an apparatus is provided.

A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.