A tool, consisting of an enclosure and a rotatable knob retained by, and protruding from, the enclosure. The tool has a tube having a proximal end that is retained by the enclosure, and the tube has an axis of symmetry. A Geneva drive is retained within the enclosure, the Geneva drive consisting of a drive wheel fixedly attached to the rotatable knob and a driven wheel fixedly attached to the proximal end of the tube, so that an axis of rotation of the driven wheel coincides with the axis of symmetry of the tube. Thus, a continuous rotation of the rotatable knob causes the tube to rotate about the axis of symmetry in discrete angular steps.

A vascular access disassembling needle assembly is provided that enables rapid insertion of a guide wire into the needle and subsequent rapid removal of the access needle off the guide wire by facile disassembly of the needle. The disassembling needle assembly includes a needle portion wherein the needle breaks apart by splitting along at least one seam that extends from the proximal to the distal end to allow removal of the guide wire. Various mechanical features are described that can facilitate the separation of the needle body along at least one seam. Once one or more seams are separated, the needle body may be removed from the guide wire without the need to withdraw the needle along the length of the guide wire, which permits preloading of expanders and other medical devices onto the guidewire.

In one example, this disclosure is directed to a kit for intravascular implantation of an implantable medical device, the kit comprising an outer sheath, the outer sheath sized to traverse a vasculature of the patient, and an elongated inner sheath with a tapered distal end. The inner sheath is slidable within the inner lumen of the outer sheath and is selectably removable from the inner lumen of the outer sheath by sliding the inner sheath out of the proximal opening of the outer sheath. The kit includes an elongated deployment receptacle including a deployment bay slidable within the inner lumen of the outer sheath when the inner sheath is not within the inner lumen of the outer sheath. The deployment bay carries an implantable medical device through the inner lumen of the outer sheath and facilitates deployment of the implantable medical device from the distal end of the outer sheath.

A guidewire advancing device used in connection with medical devices for providing intravascular access for advancing substantial length of guidewire used to place such medical devices within the anatomical structure. A method of managing substantial length of guidewire for use with medical devices. The guidewire advancing device includes a longitudinally extending wire guide which is removably secured to the medical device and which includes a longitudinally extending channel. The guidewire extends the length of the channel to be advanced along the channel.

The subject guide catheter extension system with a micro-catheter delivery catheter includes an outer sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. Several mechanisms of engagement/disengagement between the inner and outer members are provided including a friction mechanism, threaded mechanism, pull away sheath, and engagement/disengagement mechanism for pusher's handles. The sheath and the inner member are modified for different engagement/disengagement mechanisms operation. A micro-catheter delivery system provides for an improved atraumatic crossability to the treatment site in an expedited and simplified fashion. During a procedure, a guidewire along with a guide catheter are advanced to the vicinity of the treatment site within a blood vessel. Subsequent thereto, the subject guide catheter extension system is manipulated to advance the micro-catheter along the guidewire inside the guide catheter towards and beyond the site of interest. Once the micro-catheter is in place, the outer sheath slides along the micro-catheter until reaching the lesion, and then the inner member is removed from the sheath, and the sheath then is ready for passing the treatment catheter (stent/balloon) towards the lesion to be treated.

Novel systems for and methods of delivering therapeutic agents to target tissues are disclosed. The method of delivering a therapeutic agent to a target tissue involves identifying a target tissue via an imaging modality and then using a guidewire capable of anchoring in tissue to advance a cannula to the target tissue. The guidewire and novel cannula configurations enable rapid and repeated treatments of the target tissue without the need for subsequent imaging. The cannula is coupled to a source of ultrasound, radiation, radiofrequency energy, or chemotherapeutic agents which can then be delivered to from the cannula the target tissue. The system and method can be used to treat tumors that are small or surgically inoperable. In addition, the system can be used to treat lymphatic tissue that may contain metastases from the tumors.

Medical devices and methods for making and using medical devices are disclosed. An example medical device may include an elongate shaft having a proximal end region and a distal end region. A first lumen may be defined in the shaft. A second lumen may be defined in the shaft. The distal end region may include a common lumen region in fluid communication with the first lumen and the second lumen. A deflectable member may be disposed within the shaft. The deflectable member may be designed to shift between a first configuration where the deflectable member directs a first medical device disposed within the common lumen region into the first lumen and a second configuration where the deflectable member allows a second medical device to move between the common lumen region and the second lumen.

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.

In the treatment method, a surgeon introduces a catheter assembly into a blood vessel in an arm, and delivers a distal portion of the catheter assembly to a predetermined position of a lower limb through the blood vessel in the body. Moreover, in the treatment method, the surgeon pulls an inner catheter out of an outer catheter, causes a treatment device to advance to the treatment target through the inside of the outer catheter, and treats the treatment target by the treatment device.

A supportive balloon catheter which may be used to assist a wire guide in advancing across a lesion which partially or totally occludes an intraluminal passage. The supportive balloon catheter is advanced over the wire guide, close to the location of the lesion. The supportive balloon catheter is then inflated, securing the position of the wire guide in the intraluminal passage. A braid on the catheter may provide additional structural support. The secured catheter restricts the movement of the wire guide advancing across the lesion, preventing kinking or deflection off the surface of the lesion. Once the wire guide has advanced across the lesion, the supportive balloon catheter or a different angioplasty may be used to clear the lesion from the intraluminal passage.