Described here are devices, systems, and methods for improving blood flow in a vessel. Generally, the method may comprise advancing a catheter into a first vessel proximal to an occlusion in the first vessel and forming a fistula between the first vessel and a second vessel. This may deliver blood flow around an occlusion to ischemic tissues located in the peripheral vasculature.

A device includes a first end portion, a second end portion, an intermediate portion, and a graft material. The first end portion has a first end diameter. The second end portion has a second end diameter smaller than the first end diameter. The first end portion comprises a first material. The second end portion comprises a second material different than the first material. The intermediate portion is between the first end portion and the second end portion. The intermediate portion tapers between the first end portion and the second end portion. The graft material is coupled to at least the intermediate portion.

A retrieval catheter and methods of use are described for removing a heart valve therapy such as a leaflet clip or artificial leaflet cord. The retrieval catheter can include a cutting element and a basket, piercing element, clamping mechanism, or similar grasping device. The method includes delivering a catheter to the region of the heart valve therapy and then manipulating the catheter and associated instruments to cut tissue as necessary and then remove the heart valve therapy and withdraw the catheter.

Procedures may be performed on the heart after the installation of a mitral valve fixation device. In order to prepare the heart for such procedures, the fixation device may be removed or disabled in minimally invasive ways (e.g., through an endovascular procedure), without requiring open access to the heart. The fixation device may be partitioned so that one portion may remain attached to each leaflet of the mitral valve. In another example, the leaflets may be cut along the edges of the distal element(s) of the fixation device, so as to cut the fixation device from the leaflet(s). Systems and devices for performing such procedures endovascularly are disclosed. Fixation devices with improved access to a release harness are also disclosed.

A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

This transcatheter device for the ablation of calcified tissue at the flaps of an aortic valve, is characterised in that it comprises a flexible body (1) acting as a catheter and having a soft and flexible end piece (2) that engages with a previously inserted wire guide (g) suitable for passing through the flaps of the valve above the part where the calcified tissue needs to be removed, said end piece (2) having at least one cutting system (3) comprising two motorised rotating cutting heads (3a) and (3b) disposed coaxially one above the other, the head (3a) located at the end of the end piece and acting first to remove the calcified tissue, has arrangements suitable for making a rough cut by grinding, while the other head (3b) has arrangements suitable for making a fine cut by grinding, said cutting system being mounted in combination with a vacuum suction means (4), said end piece (2) being provided with an adjustable guide means (5) suitable for engaging with the calcified tissue over the course of the ablation operation performed by the cutting system (3) in combination with a spiral path effect applied to the end piece.

Devices, systems, and methods for valve removal. In an embodiment of an umbrella device for removing a valve of the present disclosure, the umbrella device comprises an elongated shaft having a distal end, a first umbrella comprising a first mesh, the first umbrella coupled to the shaft at or near the distal end of the shaft, a second umbrella comprising a second mesh, the second umbrella coupled to the shaft proximal to the first umbrella, and a mechanical drill rotatably coupled to the shaft and positioned between the first umbrella and the second umbrella.

Methods and devices for treating a vessel for use in a medical procedure are disclosed. A vein or other vessel can be modified in situ, prior to harvesting. Subsequently, at least a portion of the vessel is removed, and subsequently implanted to treat a patient, typically in a bypass procedure in which the vessel portion fluidly connects a source of oxygenated blood to an occluded artery.

Procedures may be performed on the heart after the installation of a mitral valve fixation device. In order to prepare the heart for such procedures, the fixation device may be removed or disabled in minimally invasive ways (e.g., through an endovascular procedure), without requiring open access to the heart. The fixation device may be partitioned so that one portion may remain attached to each leaflet of the mitral valve. In another example, the leaflets may be cut along the edges of the distal element(s) of the fixation device, so as to cut the fixation device from the leaflet(s). Systems and devices for performing such procedures endovascularly are disclosed. Fixation devices with improved access to a release harness are also disclosed.

A cardiac valve cutter of the present disclosure has a flexible housing with a central lumen for receiving a guide wire. A high-speed cutting blade is disposed within the housing near an edge of the housing. A trough cut into a side of the housing exposes a portion of the cutting blade so that the cutting blade can cut valve tissue. Two pusher wires are disposed on an opposite side of the housing from the cutting blade. Troughs cut into the side of the housing form openings from which the pusher wires can extend. The pusher wires are staggered with respect to one another in the longitudinal direction. When the pusher wires are advanced, they extend outwardly from the troughs and can be used to stabilize the cutter at the cardiac valve and push the cutting blade against the valve on the opposite side.