An epidural space is cleared of fat and scar tissue in preparation for implantation of a medical lead by utilizing a clearing tool. The clearing tool has a flexible body that allows the clearing tool to deflect when entering the epidural space through a window in the vertebral bone and ligaments. The clearing tool is guided into the epidural space and to a target site by a guidewire present in the epidural space. Upon removal of the guidewire and clearing tool, the medical lead is inserted through the window and cleared epidural space until reaching the target site. The clearing tool may include a distal tip with a shape and size that aids in the clearing of the epidural space. The distal tip may be integral to the clearing tool or may be removable so as to allow for different sizes of the distal tip to be installed as needed.

Described are methods and systems for transcervical access of the cerebral arterial vasculature and treatment of cerebral occlusions, including ischemic stroke. The methods and devices may include methods and devices which may provide aspiration and passive flow reversal, those which protect the cerebral penumbra during the procedure to minimize injury to brain, as well as distal catheters and devices to remove an occlusion. The methods and devices that provide passive flow reversal may also offer to the user a degree of flow control. Devices and methods which provide a way to securely close the access site in the carotid artery to avoid the potentially devastating consequences of a transcervical hematoma are also described.

A modular medical device system comprises a parent module with a proximal end configured to remain outside the body of a patient and a distal end configured to go inside the body of a patient, the distal end comprising an inner lumen; and an adapter module comprising a proximal portion and a distal portion, an attachment mechanism positioned at the proximal portion and comprising an interfacing element and an elongated element, wherein at least a portion of the interfacing element compresses to engage the inner lumen of the parent module, and wherein the elongated element connects the attachment mechanism to the distal portion of the adapter module.

A method for replacing a first sheath, whose distal end is positioned inside a vessel and whose proximal end is positioned outside the skin of a patient, with a second sheath may involve inserting a dilator over a guidewire and into the first sheath until a distal end of the dilator and a distal end of the guidewire are positioned inside the vessel. The dilator may be hubless or include a removable hub, and may define an external channel configured to receive a second guidewire. The method may further involve removing the first sheath, thereby leaving the dilator and the guidewire in place. After removing the first sheath, a second sheath may be passed over the dilator and the guidewire until the distal end of the second sheath is positioned inside the vessel. The method may further involve removing the dilator and the guidewire, leaving the second sheath in place.

Described are methods and systems for transcervical access of the cerebral arterial vasculature and treatment of cerebral occlusions, including ischemic stroke. The methods and devices may include methods and devices which may provide aspiration and passive flow reversal, those which protect the cerebral penumbra during the procedure to minimize injury to brain, as well as distal catheters and devices to remove an occlusion. The methods and devices that provide passive flow reversal may also offer to the user a degree of flow control. Devices and methods which provide a way to securely close the access site in the carotid artery to avoid the potentially devastating consequences of a transcervical hematoma are also described.

A method of controlling intravascular sheaths including the steps of: a) obtaining a guide assembly having a body with a tubular wall bounding a passageway, the body having a length between axially spaced ends and an outer surface that tapers towards each of the spaced ends, the body flexible at each of the spaced ends to allow the spaced ends to bend transversely to the length of the body; b) directing the guide assembly into an operative state within a human body vessel; c) obtaining a first sheath having a tubular body extending around a passageway; and d) relatively moving the guide assembly body and first sheath to thereby direct the guide assembly body into the passageway on the first sheath and thereafter guidingly sliding the first sheath lengthwise against the outer surface of the guide assembly body to: a) advance the first sheath into the human body vessel; or b) withdraw the first sheath.

Described are methods for performing a medical procedure at a treatment site in a cerebral vessel of a patient. The methods include positioning a system of devices into an advancement configuration, the system including a catheter and an inner member sized and shaped to slide within the catheter lumen. The inner member defines a single lumen and has a distal portion, the distal portion having a first outer diameter that tapers distally to a second outer diameter that is smaller than the first outer diameter. When positioned in the advancement configuration, the inner member extends coaxially through the catheter lumen and the distal portion of the inner member is positioned distal to the distal end of the catheter. The method further includes advancing the system of devices distal to a petrous portion of an internal carotid artery while the system of devices is positioned in the advancement configuration.

The disclosed technology is directed to a catheter comprises a catheter main body. A sheath covers the catheter main body and is movable along the longitudinal axis with respect to the catheter main body. An operating unit is disposed at a proximal end portion of the sheath and is used to move the sheath and the catheter main body with respect to one another. The catheter main body includes a slit that is formed in an outer peripheral surface of a distal end portion and extends 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 in a state in which the distal end portion of the catheter main body is housed in the sheath.

Methods and devices for preventing fluid flow through the relatively short guidewire lumen of a rapid exchange catheter. The guidewire lumen for a rapid exchange catheter is provided with a narrowed or sealed section allowing for passage of a guidewire therethrough while preventing fluid flow while a guidewire is disposed therethrough. The narrowed or sealed section extends for a relatively short length of the guidewire lumen to avoid creating excessive friction between the guidewire and the guidewire lumen. In several embodiments the narrowed or sealed section is placed proximal of the distal end of the guidewire lumen.

Trapping catheter and kit and method for preparing a trapping catheter A trapping catheter (10) for insertion into a guide catheter assembly (3) comprises a balloon (22) and a trapping catheter body (23) bounding an inflation lumen (24) extending longitudinally within the trapping balloon catheter. The inflation lumen has a distal end opening (25) into an internal space bounded by the balloon. The trapping catheter body is provided with a stopper (26) for abutting against an abutment (27) at a proximal end (27) of the guide catheter assembly so as to determine a maximum insertion depth of the trapping catheter into the guide catheter. A kit and method for preparing a trapping catheter prior to insertion into a guide catheter is also described.