A system 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 first and second electrodes within the balloon arranged to carry a voltage there-across including an initial high electrical voltage at an initial low current. The initial high electrical voltage causes an electrical arc to form across the first and second electrodes within the balloon. The electrical arc causes a gas bubble within the liquid, a high current to flow through the first and second electrodes, a decrease in the initial high electrical voltage, and a mechanical shock wave within the balloon. The system further includes a power source that provides the first and second electrodes with a drive voltage that creates the initial high electrical voltage at the initial current and that terminates the drive voltage in response to the decrease in the initial high electrical voltage.

A method and a medical elongate body are configured to prevent stagnation or turbulence of blood flow in a recess of a rugged pattern formed in a blood vessel due to bulging of a blood vessel wall at a lesion part of the blood vessel. The method involves partitioning an inside of the blood vessel into upstream and downstream sides of the recess, and introducing gel into the recess to at least partially fill the recess. A blood vessel lumen forming method and medical elongate body to form such a lumen are other aspects of the disclosure and involve introducing gel into the recess to at least partially fill the recess with the gel, and drilling the gel to remove at least some of the gel to form a passage and secure blood flow in the blood vessel.

A method and apparatus for treating a clot in the blood vessel of a patient, and particularly the treatment of a pulmonary embolism is disclosed. The treatment includes restoring flow through the clot followed by clot removal, either partially or substantially completely. The clot treatment device is expandable into the blood vessel and may contain radial extensions that assist in restoring flow as well as in removing clot material.

A multi-lumen catheter having a guidewire for each lumen, the catheter having a proximal-end assembly and an elongate tube including a multi-lumen medial portion and a distal-end portion. Each guidewire extends from the proximal end assembly through the medial portion to a lumen convergence portion which merges the lumens into a single output lumen. The distal-end portion includes (a) the lumen convergence portion, (b) an intermediate section surrounding the output lumen, and (c) a tapered tip surrounding the output lumen, with the diameter of each lumen of the multiple lumens other than the output lumen being sized to match the guidewire therein such that the guidewire is able to move therealong while being constrained laterally and remaining substantially coaxial with its lumen, and the diameter of the single output lumen being equal to the diameter of the largest diameter lumen of the multiple lumens.

A medical guide wire device includes a base wire, a first accessory wire, and a guiding device configured to be removably coupled to the base and first accessory wires. The base wire has a first proximal end, a first distal end, a longitudinal length extending therebetween, and a flexible portion near the first distal end. The first accessory wire has a second proximal end, a second distal end, a longitudinal length extending therebetween, and a flexible portion near the second distal end. The second distal end of the first accessory wire is coupled to the base wire at a distance spaced apart from the first distal end. Upon actuating the guiding device, the flexible portion of the base wire and the flexible portion of the first accessory wire form a curve at the first distal end of the base wire and the second distal end of the first accessory wire.

Systems and methods can remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.

A method and systems for treating chronic total occlusions, particularly those that are difficult to treat, is disclosed. In this approach, recanalizing the CTO is achieved using a combined antegrade and retrograde approach. The proximal end of the occlusion is penetrated using an antegrade wire, using a traditional approach. Using collateral vessels, the distal end of the occlusion is crossed in a retrograde fashion and by appropriately maneuvering each member, a continuous channel is created. Additional elements such as capture devices, dilators and injection catheters are also disclosed.

A vascular guide wire device comprising: a guide wire comprising a guide wire head and a laser-acoustic head sensor configured to navigate in a patient's blood vessel, said laser-acoustic head sensor connected via an optic fiber threaded through said guide wire device with a laser-acoustic diode controlled by a laser-acoustic diode controller; a computerized system electronically communicating with said laser-acoustic head sensor, said computerized system comprising a computer, image processing means and display means and configured to provide images and measurements 2-centimeters ahead inside a patient's arteries occlusions therein purposing to move and navigate safely into the right artery lumen; first steering means connected with said guide wire head and configured to navigate said laser-acoustic head sensor according to said image processing results; and opening means connected with said guide wire head for opening total occlusion of said artery.

A system 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 first and second electrodes within the balloon arranged to carry a voltage there-across including an initial high electrical voltage at an initial low current. The initial high electrical voltage causes an electrical arc to form across the first and second electrodes within the balloon. The electrical arc causes a gas bubble within the liquid, a high current to flow through the first and second electrodes, a decrease in the initial high electrical voltage, and a mechanical shock wave within the balloon. The system further includes a power source that provides the first and second electrodes with a drive voltage that creates the initial high electrical voltage at the initial current and that terminates the drive voltage in response to the decrease in the initial high electrical voltage.

In a multiple-lumen catheter having multiple guidewires for treatment of vascular blockages, the catheter comprising a proximal-end assembly, a distal-end portion and a multi-lumen medial portion therebetween, the improvement wherein: (1) the multiple guidewires are preloaded in the catheter, each guidewire in its own single-guidewire lumen extending from its own guidewire entry port in the proximal-end assembly to a lumen convergence portion; and (2) the distal-end portion includes: (a) the lumen convergence portion along which the multiple lumens merge into a single output lumen sized to match the largest-diameter lumen of the multiple lumens, (b) an intermediate distal-end section connected to the lumen convergence portion and surrounding the single output lumen continuing therethrough, and (c) a tapered tip surrounding the single output lumen continuing therethrough.