Apparatus and methods are provided for delivering fluid into a body lumen during a medical procedure. A distal end of an apparatus may be introduced into a body lumen, and a valve on the distal end may be opened to deliver fluid through a first lumen into the body lumen, e.g., contrast and/or other diagnostic or therapeutic agents. The valve may be closed, and a procedure may be performed within the body lumen, e.g., using a treatment element carried on the distal end. For example, the treatment element may include a balloon that may be inflated when fluid is delivered through the first lumen with the valve closed. Optionally, a prosthesis, energy source, drug platform, and the like may be carried by the balloon for treating the body lumen. In various embodiments, the valve may be located proximal or distal to the treatment element.

Provided are products of manufacture and methods for the removal and/or destruction of a biofilm in situ, e.g., a gastro-luminal biofilm, and for the treatment or amelioration of biofilm-associated diseases, infections and conditions, including and GI luminal infections. Provided are devices and apparatus, and methods for using them, for the removal, disruption and/or destruction of a biofilm in situ, e.g., a gastro-luminal biofilm. In alternative embodiments, provided are devices and apparatus, and methods, for enhancing biofilm dissolving or disrupting agents, or for administering biofilm dissolving or disrupting agents, where in alternative embodiments the biofilm comprises a gastro-luminal ‘unstirred layer’, adherent layer or gastro-luminal mucus layer; or the biofilm comprises a matrix or a DNA-containing layer, or alternatively the biofilm comprises a polysaccharide gastro-luminal peripheral layer.

Catheter based systems for isolated stenting of an intravascular lesion can include two expandable occlusion devices with a balloon expandable stent or self-expanding stent therebetween. Expandable occlusion devices can be expanded in a distal direction and a proximal direction in relation to the lesion to occlude vasculature. A treatment agent can be injected into a cavity formed between the expandable occlusion device. A coating can be applied to one or both occlusion devices to prevent adherence to the treatment agent. The stent can be deployed across the lesion while the occlusion devices are in place. Fragments dislodged during stenting can be aspirated.

A method is provided for treating a gland or duct of a patient. In a particular embodiment, an obstruction in a gland or duct and the orifice thereof can be alleviated; in another, a substance can be injected thereinto; in yet another, the gland can be aspirated. The method includes the step of inserting an elongated6 probe into a gland or duct via an orifice thereinto. In some embodiments the probe can have a longitudinal lumen therethrough, with at least one distal hole through the probe wall in fluid communication with the lumen. The lumen can be used in concert with a source of suction for removing debris from the gland or duct, and/or with a source of a fluid and pumping means, for injecting a substance into the gland or duct.

An apparatus, device and method are provided for executing a clot or plaque removal procedure. In one embodiment, a clot removal device may include a clot holding element for penetrating a target clot and stabilizing the clot in its position; a controllable distal filter that can be extended to cover the target clot; a distal filter, openable downstream from the clot, designed to substantially prevent flow through of clot elements, and further designed to drag the clot out of a vessel, for retrieving by the clot removal device.

Clot removal from a patient's vessel, such as an artery, are described using aspiration and hydraulic forces supporting the removal process. Hydraulic forces can be generated by occluding the vessel distal to the clot and delivering liquid between the clot and the occlusive device. The aspiration catheter is positioned proximal to the clot. Catheters designed to facilitate the delivery of hydraulic forces can be based on single lumen designs or dual lumen designs. The catheters may have a fixed internal wire, or in some embodiments the catheters can ride over a wire with a valve/seal positioned to restrict flow into or out from the guide lumen such that the guide lumen can further function for balloon inflation and/or for infusion of liquid.

Systems, devices and methods for removing a blood clot (10) from a blood vessel (12). Various uses of suction pressure and positive pressure, proximal and/or distal to the blood clot (10) assist with clot dislodgement and removal. The pressure(s) may be constant and/or cycled/pulsed to assist with clot dislodgement and/or removal. Various further devices assist with separating the clot (10) from the vessel (12).

A neurovascular catheter having an elongate flexible tubular body. The body can have a catheter distal face residing on a first plane being at a first nonorthogonal angle relative to the longitudinal axis. The body can have a radiopaque marker being positioned in a distal zone of the tubular body and being proximal to the catheter distal face. The marker can have a marker distal face at least partially residing on a second plane being at a second nonorthogonal angle relative to the longitudinal axis. The first plane can be approximately parallel to the second plane.

The present disclosure provides a method, system, and apparatus that adds rotational functionality to a conventional clot maceration device. The rotational functionality can be imparted by a wide variety of mechanical devices, such as by a hand operated rack and pinion type gear system or an electrically driven motor. An outer member (such as a catheter) of a declotting apparatus may be rotated while an inner member remains substantially fixed in position. The degree of rotation of the inner member may be between 60 and 180 degrees in a clockwise and counterclockwise rotation. In one embodiment, the rotating mechanism is coupled to a sliding and/or lateral mechanism to impart both lateral and rotational movement to the declotting apparatus. The deformable members of a basket or jacket of the declotting apparatus may form a helical structure and/or each comprise a bundled wire.

An endovascular system includes inner and outer catheters, a handle system operably coupled one end of the catheters, and a microvalve coupled to the other end of the catheters. The microvalve is constrained in a radially-collapsed closed configuration for advancement within a vessel to a treatment site. The handle system is operable to displace the inner and outer catheters portions relative to each other to move the microvalve between closed and open configurations. An indicator is provided to visually indicate the extent by which the microvalve is opened within the vessel.