In a method for diagnosing and treating a patient having lesions in both arteries of left and right lower limbs. By determining that a larger lesion curvature to be treated first, catheters and an operation time can be reduced is to be treated first on a priority basis based on diagnostic data, deciding that a smaller lesion curvature is to be treated next, then treating the lesions substantially continuously.

A vascular access disassembling needle assembly 20 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 20 includes a needle portion 30 wherein the needle breaks apart by splitting along at least one seam 40 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.

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.

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.

A catheter assembly includes an outer catheter that includes a tubular outer catheter body and an outer catheter hub, and an inner catheter that includes an inner catheter body and an inner catheter hub. The inner catheter body is positionable in the outer catheter body, and the outer catheter hub is connectable to the inner catheter hub. The inner catheter body includes a shaft extending from the inner catheter hub, and a tubular body disposed at the distal end of the shaft and possessing an inner catheter lumen. When the outer catheter hub is connected to the inner catheter hub, a portion of the tubular body is distal of the distal-most end of the outer catheter body, a portion of the tubular body is distal of the proximal-most end of the outer catheter body, and a proximal end portion of the tubular body is in the outer catheter lumen.

Embodiments of the present disclosure are directed to apparatuses, systems, and methods for merging a balloon catheter onto a locked guidewire. In one implementation, a balloon catheter may include an inflatable balloon affixed thereto and a slit extending from a distal end of a guidewire lumen to a position proximal of the balloon. The slit may be widened by a working member of an adapter to allow passage of the locked guidewire into the guidewire lumen of the balloon catheter. The balloon catheter may be merged onto the guidewire via the slit and delivered to the desired treatment device without requiring the guidewire to be unlocked. Advantageously, access to at least one desired treatment site may be maintained with the guidewire during merging of the balloon catheter.

Embodiments of the present disclosure are directed to apparatuses, systems, and methods for merging an endoscopic basket delivery catheter onto a fixed guidewire. In one implementation, a catheter may include a sheath having a saddle secured to a distal portion thereof. The sheath may constrain an endoscopic tool such as a basket therein, while the saddle may receive a portion of a guidewire. The saddle may include a slit extending along its longitudinal length. The slit may be widened by a working member of an adapter to allow passage of a locked guidewire into the guidewire lumen of the saddle. The catheter may be merged onto the guidewire via the slit and delivered to the desired treatment device without unlocking of the guidewire. Advantageously, access to at least one desired treatment site may be maintained with the guidewire during merging of the catheter.

Embodiments of the present disclosure are directed to cannulating devices and methods for exchanging cannulating devices in an endoscopic procedure. In one implementation, an apparatus for endoscopic operations is described. The apparatus includes a cannulating device to be introduced through an internal lumen of an endoscope via a biopsy port. The cannulating device has an elongated body. The elongated body includes a guidewire lumen configured to receive a guidewire therein, and a slit extending over at least a portion of the length of the elongated body from a distal tip to a proximal position of the elongated body.

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. The method may further involve removing the first sheath, thereby leaving only 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 only the second sheath in place.

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.