A coaxial multilumen annulus plane catheter, including an outer pigtail catheter enclosing one or two additional lumens, each housing either a slidable shaped wire or a second pigtail catheter shaped to fit into a wide range of annulus diameters and/or depths. In embodiments, the device may include a catheter delivery handle with thumb/finger-actuated sliders that extend or retract the shaped wires and are sized to enable side-to-side or radial motion, imparting a torque to the pre-shaped wires which translates the length of the wires to enable individually controlled rotation or sweep of each wire to accommodate different annulus diameters. The delivery handle includes hemostasis controls and flush ports. In other embodiments, a handle is obviated by direct lumen axial and rotational control at a proximal end.

The present disclosure relates to novel and advantageous systems and methods for deploying a surgical tool or guidewire. Particularly, the present disclosure relates to novel and advantageous systems and methods for deploying a surgical tool for use in changing the shape of portions of luminal systems. More particularly, the present disclosure relates to novel and advantageous systems and methods including an access catheter to direct an implement, such as a guide wire, off axis into a wall of a vessel or a wall of a tissue structure.

Ablation systems and methods of the present disclosure include a catheter including one or more image sensors. The one or more image sensors can facilitate, for example, positioning an ablation electrode at a treatment site of an anatomic structure and, additionally or alternatively, can facilitate controlling delivery of therapeutic energy to a treatment site of an anatomic structure.

Antiseptic caps that can be used to disinfect and/or protect medical connectors are disclosed herein. In some embodiments, the antiseptic cap can include a first chamber configured to be removably attached to the medical connector. Delivery systems for use with medical articles are also disclosed herein. In some embodiments, the delivery system comprises various dispensing systems for antiseptic caps and/or antiseptic cap holder assemblies. In some embodiments, the delivery system can be configured to permit the medical articles to be individually removable from the delivery system.

Systems and methods for dynamically modulating aspiration in response to sensed conditions. An aspiration system can include a catheter configured to be inserted within a vasculature of the subject, a canister coupled to the catheter, a pressure source that generates a vacuum pressure through the catheter for aspirating the fluid, a sensor configured to sense a parameter associated with at least one of the catheter, the canister, or the pressure source, and a computer system coupled to the sensor. The computer can cause the pressure source to initiate the vacuum pressure throughout the catheter, receive a measurement of the parameter from the sensor, determine whether the measurement violates a threshold associated with the parameter, and modulate the vacuum pressure at the catheter tip in response to a determination that the measurement violates the threshold.

An endoluminal punch and introducer sheath are described wherein the endoluminal punch comprises a guidewire lumen through which a user is capable of placing a guidewire. The endoluminal punch system further comprises a mechanism affixed to the hub which is capable of controlling the axial positioning of the guidewire relative to the endoluminal punch distal end. The control mechanism can be released so that the endoluminal punch can be removed from a patient while retaining the guidewire in place within the patient. The endoluminal punch introducer, including a sheath and dilator, can comprise energy emitting electrodes or transducers for cutting larger size holes in stubborn (friable, scarred, or fibrotic) tissue. In other embodiments, the endoluminal punch can comprise a guidewire or stylet, wherein the guidewire or stylet is capable of emitting energy to cut through tissue.

A multi-headed catheter for fluid delivery and a method of placing a multi-headed catheter for fluid delivery are provided. The multi-headed catheter includes a first tube extending along an axis, wherein the first tube has at least one exit hole provided at a distal end of the first tube to define a perfusion section of the first tube; and a second tube extending along the axis, wherein at least a portion of the second tube is disposed within the first tube, wherein the second tube has at least one exit hole provided at a distal end of the second tube to define a perfusion section of the second tube. The distal end of the second tube is configured to exit said first tube at an opening provided along a wall of the first tube. The perfusion sections of the first tube and the second tube can be independently placed to deliver fluid to distinct anatomical areas within a surgical wound site.

A system for assisting in the retrieval of a clot from a vessel. The system can include an outer catheter and an inner catheter disposed in a lumen of the outer catheter. The inner catheter can include a distal end, a proximal end, a distal segment, a proximal segment, and a lumen extending proximal of the distal end and terminating at a transfer port at the proximal end of the distal segment. A seal is located on the outer surface of the inner catheter distal of the transfer port, the seal capable of sealing against the lumen of the outer catheter so that aspiration applied through the outer catheter is configured to be transferred to the inner catheter.

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.