A method can include engaging the pericardium of a patient at two engagement positions of the pericardium. The method can further include moving the two engagement positions of the pericardium away from each other to tension a portion of the pericardium. The method can further include advancing an access device through the tensioned portion of the pericardium to introduce the access device into the pericardial space of the patient. Other and further methods are also disclosed.

A pair of cooperating catheters are used together to provide rapid access to the Left heart for diagnostic or therapeutic interventions. The initial entry point for the catheter pair is the groin. The pair of catheters can be used to carry out an electrographic determination of the location of the Fossa Ovalis on the septum. Features on the Catheter system permit quick and reliable confirmation of the catheter location via echo or x-rays. Once across the septum the inner catheter is removed from the outer catheter and a standard intervention may be carried out through the lumen of the outer catheter.

A transseptal insertion device is provided including device housing, a pusher slidably disposed in the device housing and a guide element extending from the pusher. The device housing is configured to be inserted into the right atrium of a patient's heart and the guide element can then be advanced from the device housing and against the cardiac septum to facilitate stable puncturing of the cardiac septum by a needle carried by a catheter inserted through the device housing, to provide access to the left atrium. The guide element can be formed as a webbing or ring. The pusher and/or guide element can optionally be inflatable.

Systems and methods can be employed for trans-tympanic membrane access to the middle ear for delivery of a therapeutic agent, for example, to the round window niche adjacent to the cochlea under direct visualization. The systems and methods can also be used to improve accessibility and visualization for various otological surgical procedures, such as, but not limited to, cholesteatoma removal, tympanic membrane repair and ossicular chain repair.

Described here are delivery devices for delivering one or more implants to the body, and methods of using. The delivery devices may deliver implants to a variety of locations within the body, for a number of different uses. In some variations, the delivery devices have a cannula with one or more curved sections. In some variations, a pusher may be used to release one or more implants from the cannula. In some variations, one or more of the released implants may be a self-expanding device. Methods of delivering implants to one or more sinus cavities are also described here.

An access needle is provided. The access needle includes a needle housing and a needle shaft having a portion disposed within the needle housing. The access needle also includes a lumen within the needle shaft, an entry port at a proximal end of the needle shaft, and a needle tip at a distal end of the needle shaft. The access needle also includes an exit port on a sidewall of the needle shaft, wherein the exit port is disposed nearer the distal end of the needle shaft than the proximal end, and wherein the lumen extends from the entry port to the exit port. The exit port a reduced diameter from the needle shaft. Guide surfaces in the vicinity of the exit port help to reduce snagging or drag of the guide wire. The access needle tip can be formed from nitinol and the guide surfaces can be formed from UV or AB glue. A system and a method for using the access needle are also provided.

Devices and methods are described for a minimally invasive procedure offering immediate relief of brain compression and prevention of subdural hematoma re-accumulation. For example, this disclosure describes devices and methods for embolization of bleeding branch vessels of the middle meningeal artery and subdural hematoma drainage in a single endovascular intervention using multimodal catheter-based technology.

A method and system for creating a tract in retrograde fashion for nephrostomy tube creation comprising the steps of providing a puncture wire having a tissue penetrating tip shielded in a sheath, inserting the puncture wire and sheath through a channel in an ureteroscope, advancing the puncture wire from the sheath while visualizing under direct vision a position of the puncture wire, advancing the puncture wire through the flank, and inserting a catheter over the puncture wire. In some methods and systems, two catheters are utilized.

A medical device having an elongate body with a proximal portion, a distal portion, and defining a lumen therethrough. The medical device has an expandable element coupled to the distal portion of the elongate body, the expandable element defining a proximal portion, a distal portion opposite the proximal portion and an intermediate portion disposed between the proximal portion and the distal portion. The expandable element also has an inner surface and an outer surface opposite the inner surface. The medical device has a plurality of cutting members, each cutting member being coupled with the outer surface of the expandable element, each cutting member having a proximal end and a distal end opposite the proximal end, the proximal end being proximate the proximal portion of the expandable element and the distal end being proximate to the intermediate portion of the expandable element.

A movement transfer mechanism for a surgical scoping device, wherein a rotational proximal input force is transformed into a longitudinal force that is conveyed down the length of an instrument channel of the scoping device, where it is transformed again into an operational movement of a distal instrument. The operational movement can be rotational movement, but may be any movement that changes the orientation or configuration of the distal instrument. By conveying a linear force along the instrument channel rather than a twisting force, the problems of slipping and discontinuous operation of the distal instrument due to friction between the instrument and the instrument channel can be reduced or eliminated.