The disclosure provides various embodiments of catheters having articulable ends that can be used for various procedures. Embodiments of methods are also provided that can be performed with catheters in accordance with the present disclosure.

Apparatus and methods for replacing a mitral valve are provided. The apparatus comprises controller, a cutting section movable between a collapsed position for delivering the apparatus to a mitral valve and an expanded position for incising a mitral valve leaflet, and a guidewire. The apparatus is sized and dimensioned to enter a subject through a first access site, traverse through a subject's circulatory system, and exit the subject through a second access site so that a distal end of the guidewire and the controller are external to the subject's circulatory system when the apparatus is situated intravascularly. The method comprises inserting the apparatus percutaneously through the first access site, advancing the apparatus through the subject's circulatory system, advancing the apparatus through the second access site, incising a mitral valve leaflet, and delivering a prosthetic valve intravascularly over the guidewire to the incised mitral valve leaflet from the second access site.

A medical system includes a shaft, an inflatable balloon, a radial array of ultrasound transducers and a processor. The shaft is configured for insertion into a body of a patient. The inflatable balloon is coupled to a distal end of the shaft and configured to perform a treatment to surrounding anatomy. The ultrasound transducers are distributed circumferentially around the distal end of the shaft inside the balloon, and configured to transmit ultrasound waves at respective radial directions and receive respective ultrasound reflections. The processor is configured to estimate and output to a user, based on the ultrasound reflections received from the ultrasound transducers, an extent of mechanical contact between the balloon and the surrounding anatomy.

An assembly for placement of a cardiac, aortic or arterial implant. The assembly includes an insertion sheath of an introducer or of a delivery catheter, which is of a size smaller than that of an introducer, intended to be introduced into an artery of a human body. The metal support of an electrode of the external cardiac stimulator being integrated into the insertion sheath of a peripheral venous or arterial accessory catheter, or a sleeve around the accessory catheter, which is introduced into the peripheral vein or artery of a patient. The sheath of the accessory catheter or the sleeve is therefore directly in contact with a peripheral vein or artery of the patient.

The present technology is directed generally to devices, systems, and methods for capturing and cutting fibrous and trabeculated structures (such as synechiae) in vessel lumens. In one embodiment, the present technology includes an intraluminal tissue modifying system configured to capture the fibrous structures, put the fibrous structures in tension, and controllably cut through the fibrous structures without applying appreciable additional force to the vessel wall. The system may include an expandable capture device and a cutting device.

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.

The present invention provides devices and methods for percutaneously retrieving an embolized or malpositioned heart valve or foreign bodies from a patient's body. Several of these devices may include a catheter system with expandable and retractable baskets attached to a catheter and guidewire system. The guidewire may be inserted through the lumen of the embolized or malpositioned heart valve, capturing the valve in the baskets, and deploying a mechanism to crush the valve within the baskets. Then the crushed baskets and valve may be retrieved either from the body or to a safer location such as but not limited to the descending aorta. This system is advantageous because it does not require open surgery to retrieve the valve or embolized material.

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.

A venous valve incising cutter includes a cutting teeth head, a guide, a wire and a coupling rod that couples the guide and a cutting teeth head, all aligned in a rotation axis thereof. More than four pieces of cutting blades are formed on the outer surrounding surface of the cutting teeth head. Each cutting blade has a roughly triangular pyramid shape such that the three ridge lines are composed of the outer surrounding surface of the cutting teeth head and the two planes formed in the reverse side of the outer surrounding surface and the apex is a knife-point of the cutting blade.

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.