The present disclosure describes surgical dilators including a multi-faceted shaped tip and methods of use associated therewith.

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 inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A medical tool includes a rotation mechanism that further includes a warning feature. The warning feature provides an indication when the rotation mechanism has achieved a number of rotations.

A medical probe includes a shaft for navigation in a patient body, and first and second deflection mechanisms. The shaft ends with a flexible section and a spring, followed by a rigid distal tip having one or more medical devices coupled thereto. The first deflection mechanism is configured to deflect the flexible section relative to the shaft. The second deflection mechanism is configured to deflect the distal tip relative to the first flexible section by using the spring.

A transport system for delivery or retrieval of a biostimulator, such as a leadless cardiac pacemaker, is described. The biostimulator transport system includes a docking cap supported by a bearing within a bearing housing. The bearing allows relative rotation between a torque shaft connected to the docking cap and an outer catheter connected to the bearing housing. The bearing housing and the docking cap include respective bearing retainers that constrain the bearing within the bearing housing without a weld attachment. The weldless retainers of the biostimulator transport system provide a robust mechanical securement of the bearing that is not vulnerable to corrosion. Other embodiments are also described and claimed.

A decoupling delivery system may include a handle portion and a catheter portion. The handle portion may be removable coupled to the catheter potion. The catheter portion may include a cable extending from the handle portion to a distal end of the catheter portion and having an inner lumen. The system may include a wire extending through the inner lumen and the wire may be operable by actuation of the handle to advance or retract the wire within the inner lumen. The system may have a device engagement mechanism arranged at the distal end configured for engaging a medical device in response to longitudinal motion of the wire.

A catheter can include a catheter main body and a sheath that covers the catheter main body and can move along the longitudinal axis with respect to the catheter main body. An operating unit can be disposed at a proximal end portion of the sheath and can move the sheath and the catheter main body with respect to one another. The catheter main body can include a slit on an outer peripheral surface of a distal end portion and can extend along the longitudinal axis from a slit distal end to a slit proximal end side. An outside diameter of the distal end portion of the catheter main body is larger than an inside diameter of a distal end portion of the sheath when the distal end portion of the catheter main body is housed in the sheath.

A magnetically steerable screw-tip cannula can include a flexible cannula with a distal end to be inserted into biological tissue and an internal lumen extending to the distal end. A magnetically steerable screw-tip can be on the distal end of the cannula. The screw-tip can include a screw body with screw threads on an exterior surface thereof, the screw threads oriented to generate insertion or retraction force along a longitudinal axis of the screw body when the screw body rotates. The screw body can also include an internal lumen extending along the longitudinal axis of the screw body, where the internal lumen is connected to the internal lumen of the cannula. A magnet can be associated with the screw body having an average magnetization substantially parallel to the longitudinal axis of the screw body.

Systems, devices, and methods are provided for transseptal access of septa within a patient. The device can be advanced to a septum, e.g., towards a fossa ovalis. Instead of applying positive pressure to “tent” the septum, a negative pressure is applied to a lumen within a sheath, e.g., within an elongated member slidable within the sheath, via a negative pressure source such as a syringe on the proximal end of the sheath. This results in the septum pulling inward. The sheath employs a stationary needle-like central core component contained within the lumen of the sheath that punctures the septum when the same is pulled passed it by the negative pressure. The stationary needle-like central core component may be hollow and may form a portion of the elongated member or may be coupled to a distal end thereof.

A guiding sheath has a braided layer for improved deflection characteristics and ring electrodes for electrical sensing, mapping and visualization, wherein lead wires for the ring electrodes are passed through lumened tubing position under the braided layer in a proximal portion of the guiding sheath shaft and above the braided layer in a distal portion of the guiding sheath shaft. Moreover, the hemostatic valve includes an improved friction ring with air vents to reduce the risk of air being introduced into the valve.