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.

The invention provides devices with integrated intravascular imaging and methods for crossing a CTO within the true lumen of a vessel. An interventional catheter with intravascular imaging capabilities can be guided into an affected vessel and to a CTO. An included intravascular imaging device captures a 3D image of the environment. The catheter includes a crossing member that can be extended out from a distal tip of the catheter, causing the crossing member to directly cross through the CTO creating a new channel through the CTO.

Instruments, systems and methods are provided for performing submucosal medical procedures in a desired area of the digestive tract using endoscopy. Instruments include a safe access needle injection instrument, a submucosal tunneling instrument, a submucosal dissection instrument, a mucosal resection device. Systems include a combination of one or more of such instruments with or without injectable agents. Embodiments of various methods for performing the procedures are also provided.

Disclosed herein are intraosseous access devices having various operating mechanisms, as well as methods of the intraosseous access devices. For example, an intraosseous access device includes, in some embodiments, a constant-torque spring assembly, a drive shaft, an intraosseous needle, and an interlock mechanism. The constant-torque spring assembly is disposed in a housing, and the drive shaft extends from the housing. The drive shaft is coupled to the constant-torque spring assembly. The intraosseous needle is coupled to the drive shaft. The intraosseous needle is configured for drilling through bone and providing intraosseous access to a medullary cavity of a patient. The interlock mechanism is configured to prevent rotation of the intraosseous needle and the drilling therewith until the interlock mechanism is disengaged.

An apparatus for loading an endovascular shunt into a delivery catheter includes a base, a boss rod connected to, and extending longitudinally across, the base, and a plurality of guide bosses slidably coupled to the boss rod. The guide bosses include a delivery catheter guide boss coupled to the delivery catheter, a malecot holding tube guide boss, wherein a malecot holding tube is connected to a first lateral side of the malecot guide boss extending towards the delivery catheter guide boss, a claw assembly guide boss, where a claw assembly is attached to a first lateral side of the claw guide boss extending towards the malecot holding tube guide boss, and a chase pin guide boss, wherein a chase pin is connected to a first lateral side of the chase pin guide boss extending towards the claw assembly guide boss.

In a method of forming an access route to the bile duct, a needle is introduced into a duodenum, and the introduced needle is pierced into an oral side projection of a duodenal papilla, which is located at an oral position than an opening of the duodenal papilla. The tip of the pierced needle is made to reach the inside of the bile duct to form a tunnel communicating the duodenum and the bile duct, and a treatment device is inserted into the formed tunnel.

An obesity treatment apparatus comprises at least one operable stretching device implantable in an obese patient and adapted to stretch a portion of the patient's stomach wall, and an operation device for operating the stretching device when implanted to stretch the stomach wall portion such that satiety is created.

A drug solution injection needle includes: a distal end member being a sharp member and made of metal; a connecting tube having electrical insulating properties connected to a base end side of the distal end member; a metal tube connected to a base end side of the connecting tube; and an insulating layer covering an outer circumferential surface of a base end portion of the metal tube. The connecting tube and/or the distal end member includes at least one hole communicating with a cavity of the drug solution injection needle and open to an outer surface of the connecting tube or the distal end member, and an electrode configured to measure electric potential is formed by a distal end portion of the metal tube not covered by the insulating layer.

An intravascular blood pump for percutaneous insertion into a patient's vasculature comprises a pumping device and a supply catheter. The pumping device comprises a pump section with a blood flow inlet, blood flow outlet, and impeller for conveying blood from the inlet to the outlet and further comprises a drive section connected to the pump section and adapted to drive the impeller. The supply line supplies the drive section with electric energy for driving the impeller. An anchoring structure is provided at a distal end region of the intravascular blood pump. A connecting catheter may be attached to the anchoring structure from distally in order to guide the intravascular blood pump through the patient's vasculature in a distal direction.

A magnet-assisted suture grasper for grasping a magnetic suture is provided. The magnet-assisted suture grasper includes a suture retrieval needle, a retriever body, a grasper arm, and a grasper magnet. Translation of the retriever body within a needle lumen of the suture retrieval needle in a first direction causes the grasper arm to move from a first position to a second position, thereby exposing the grasper magnet and allowing contact between the grasper magnet and a magnetic suture attracted thereto. Translation of the retriever body within the needle lumen in a second direction opposite the first direction causes the grasper arm to move from the second position to the first position, thereby sequestering the grasper magnet and grasping the magnetic suture within the needle lumen. Another magnet-assisted suture grasper including a handle, a stem, first and second grasper jaws, a grasper magnet, and an actuator body also is disclosed.