Subcutaneous implantation tools and methods of implanting a subcutaneous device using the same. The tool may include a tool body having a longitudinally extending recess having a distal opening and having a tunneler at a distal end of the tool body extending from the distal opening of the recess. The tool may include a plunger slidably fitting within at least a portion of the tool body recess. The recess may be configured to receive an implantable device and the tunneler preferably extends distally from the recess at a position laterally displaced from the device when the device is so located in the recess. Movement of the plunger distally within the recess advances the device distally out of the recess and alongside of and exterior to the tunneler.

A deployment system and method of use thereof is provided for an interior driveline that mitigates the risk of infections for a variety of implanted medical appliances with a percutaneous conduit. The interior driveline and driveline deployment system allow for the deployment of a driveline and an optional corresponding percutaneous access device (PAD) from within the tissue layers below the dermis, prior to exiting the body of a patient. The interior introduction of the driveline and corresponding PAD precludes entrainment introduction of exogeneous pathogens associated with the traditional approach for insertion of a driveline with an exterior to interior directionality relative to the subject corpus.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing an intravascular device having a distal portion with a side port, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall, directing the distal portion within the vascular wall such that the distal portion moves at least partially laterally, and directing the side port towards the vascular lumen.

This disclosure provides tools and implant techniques utilizing such tools to gain access to and implant a medical device, such as a medical electrical lead, within extravascular spaces. In one example, this disclosure provides a tool for creating a sub-sternal tunnel in a patient. The tool comprises a relatively straight guide member extending from a first end thereof to a second end thereof, a tunneling member extending from a first end thereof to a tip thereof, the tunneling member extending alongside and coplanar with the guide member, the first end of the tunneling member and the first end of the guide member being joined together, and a handle coupled to the guide member.

Electrode leads for providing neuromuscular stimulation of the spinal muscles, and methods of implantation of electrode leads, are provided that reduce injury to target muscles, and avoid extended recuperation period, by enabling a clinician to visualize and confirm the implantation site of the electrode leads during an implantation procedure.

A method for implanting a medical lead. The method includes advancing a tunneling tool posteriorly proximate the caudal end of the sternum toward a first location. The tunneling tool is advanced superiorly underneath the sternum through the anterior mediastinum from the first location to a second location cranial to the first location. A guidewire is advanced from the first location to the second location. A medical lead is slid along at least a portion of the guidewire, the medical lead at least substantially spanning the distance between the first location and the second location.

Devices and implantation methods utilizing subcutaneous placement into a patient are disclosed for the insertion, advancement and positioning of a subcutaneous implantable medical device (SIMD) such as a medical electrical lead. The device for implanting the SIMD is configured having a pre-biased distal curve for creating a pathway to an implant location within a substernal space.

A glaucoma treatment system includes a glaucoma drainage device having a flexible tube with distal and proximal ends, and an inserter with a filament that extends beyond the distal end of a rigid elongate member (e.g., rod or inserter tube). The filament is configured to detachably couple a distal portion of the drainage device tube to the elongate member of the inserter. The filament may extend through a wall of the distal portion of the drainage device tube. The filament and elongate member of the inserter can be configured for relative movement to detach the drainage device tube from the inserter. The elongate member can define an internal channel, and the filament can be configured for axial movement in this channel so that the filament may move toward the proximal end of the elongate member to detach the drainage device tube from the inserter. Other tools are described and claimed.

A hydrodissector for hydrodissecting a vascular target, the hydrodissector comprising: a handle; a shaft extending from the handle at an angle and including a tip at a distal end thereof; at least one port provided at the tip and configured to be coupled to a fluid supply and to eject fluid from the at least one port into the space between the vascular target and surrounding tissues to dissect the vascular target from the surrounding tissues, the at least one port being sized to provide sufficient pressure and velocity to dissect the vascular target from the surrounding tissues, wherein the length of the shaft is configured for insertion into an incision to atraumatically hydrodissect the vascular target from the surrounding tissues, and wherein the shaft is configured to releasably couple with one or more hook-shaped attachments configured to lift the vascular target after the vascular target is dissected from the surrounding tissues.

A catheter device for crossing occlusions includes an elongate catheter shaft, a rotatable tip configured to rotate relative to the elongate catheter shaft, a drive shaft, and an OCT imaging sensor. The rotatable tip includes a housing coupled with the elongate catheter shaft and cutting wedges extendable from the housing. The drive shaft has a central lumen extending therethrough and extends within the elongate catheter shaft. The drive shaft is coupled with the wedges and is configured to rotate the rotatable tip. The OCT sensor includes an optical fiber coupled with the rotatable tip and configured to rotate therewith. The elongate catheter shaft is configured to move axially over the drive shaft to extend and retract the wedges from the housing while maintaining a fixed position of the imaging sensor relative to the cutting wedges.