An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular wire and a coupling. The coupling when in use transmits ultrasonic energy along the wire from an ultrasonic energy source to an active tip at a distal end of the wire. The coupling is arranged to couple the source to the wire at any of a plurality of discrete operational positions along the length of the wire for said transmission of ultrasonic energy to the active tip.

A radiofrequency guidewire includes a core wire configured to be coupled to a radiofrequency generator. The core wire includes a proximal end and a distal end with respect to the radiofrequency generator. A tip structure is coupled to the core wire proximate the distal end. The tip structure includes one or more edge surfaces. The one or more edge surfaces provide an area of reduced curvature radius on the tip structure. The area of reduced curvature radius generates a higher electric field than other areas of the tip structure during a delivery of radiofrequency energy on the tip structure. A method of ablating an occlusion utilizing the radiofrequency guidewire is also disclosed.

A launching catheter for targeting a second vessel from a first vessel includes a catheter including a proximal portion and a distal portion including a needle aperture and a flat rectangular radiopaque marker. The flat rectangular radiopaque marker disappears under fluoroscopy upon rotation to provide information about rotational alignment of the launching catheter. The launching catheter includes a needle configured to extend through the needle aperture. A method of aligning the catheter includes rotating the catheter in a first blood vessel until the marker has a thickness (e.g., minimal thickness) under fluoroscopy. The thickness indicates rotational alignment of the catheter.

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 system of devices for treating an artery includes an arterial access sheath adapted to introduce an interventional catheter into an artery and an elongated dilator positionable within the internal lumen of the sheath body. The system also includes a catheter formed of an elongated catheter body sized and shaped to be introduced via a carotid artery access site into a common carotid artery through the internal lumen of the arterial access sheath. The catheter has an overall length and a distal most section length such that the distal most section can be positioned in an intracranial artery and at least a portion of the proximal most section is positioned in the common carotid artery during use.

An atherectomy catheter includes a sheath and an elongate corewire. The sheath has a side wall configured to define, in a lumen and in a distal sheath portion, an entrapment boundary region having a drilling allowance region. The elongate corewire has a distal wire portion having an outer bulge portion that is proximal to an elongate drill tip portion. The elongate corewire is located in the lumen of the sheath with the outer bulge portion of the elongate corewire slidably disposed in the drilling allowance region of the sheath, and with the elongate drill tip portion of the elongate corewire distally protruding from the distal end of the sheath.

A catheter is provided comprising localized regions of modified flexibility. The regions of modified flexibility may comprise a softened inner liner, for example softened via stretching the inner liner or disposing a plurality of holes in the inner liner, to modify the bending stiffness and/or tensile stiffness of the catheter. The catheter may further include an axially extending filament that at least partially overlaps the softened portion of the inner liner. The axially extending filament may include an anchoring section to anchor the at least one axially extending filament in a section of the catheter that includes the helical coil.

The invention relates generally to methods and systems for capturing, filtering, or retrieving obstructions or other particulates from a patient's vasculature. In one aspect, device for retrieving an obstruction from a patient is provided that includes an outer delivery shaft and an expandable basket movable between a collapsed configuration and an expanded configuration. The basket is configured to be in the collapsed configuration during delivery and in the expanded configuration during engagement and retrieval of the obstruction. A proximal end of the basket is configured to be centrally and pivotally coupled to the outer delivery shaft. The proximal end and/or a distal end of the basket is movable relative to each other such that a proximal portion of the expandable basket is invertible toward a distal portion of the basket to form a proximally oriented cavity in the expanded configuration to engage and retrieve the obstruction.

A robotic catheter procedure system for performing a procedure to treat a vascular lesion including a bedside system and a remote workstation is provided. The bedside system includes a first percutaneous device including an end section, the end section structured to allow the first percutaneous device to create a bore through the vascular lesion. The bedside system includes a second percutaneous device. The bedside system also includes a first actuating mechanism configured to engage and to impart movement to the first percutaneous device and a second actuating mechanism configured to engage and to impart movement to the second percutaneous device. The remote workstation includes a user interface and a control system operatively coupled to the user interface and to the bedside system. The control system controlling the first actuating mechanism to cause movement of the first percutaneous device to create a bore through the lesion and the second actuating mechanism to cause movement of the second percutaneous device through the bore created by the first percutaneous device.

Systems and methods for removal of thrombus from a blood vessel in a body of a patient are disclosed herein. The method can include: providing a thrombus extraction device including a proximal self-expanding member formed of a unitary fenestrated structure, a distal substantially cylindrical portion formed of a net-like filament mesh structure, and an inner shaft member connected to a distal end of the net-like filament mesh structure; advancing a catheter constraining the thrombus extraction device through a vascular thrombus, deploying the thrombus extraction; retracting the thrombus extraction device to separate a portion of the thrombus from the vessel wall and to capture the portion of the thrombus within the net-like filament mesh structure; and withdrawing the thrombus extraction device from the body to remove thrombus from the patient.