A catheter for positioning a guidewire across an occluded portion of a vessel includes an elongate catheter body, an integrated rotatable distal tip, a proximal handle region, and a catheter lumen extending through the elongate catheter body. The elongate body has a distal region configured to be bent to a set angle. The integrated rotatable distal tip includes one or more channeled flutes extending around the distal tip that are configured to be rotated in a first direction to dissect tissue and a second direction for bluntly contacting tissue. A proximal handle region includes a control for rotating the distal tip in either the first or second directions. The catheter lumen is configured to pass a guidewire.

An intravascular safety guidewire including an elongated main shaft, a distal terminus extending from the elongated main shaft, and an anchor rotatably connected to the distal terminus. In use, a needle is inserted into a patient's vein, then the intravascular safety guidewire is placed through the needle and into the vein, the needle is then removed over the intravascular safety guidewire, then a venous catheter is exchanged over the intravascular safety guidewire following serial dilatation using the Seldinger technique. Tubes such as dilators and catheters can then be placed over the intravascular safety guidewire and the intravascular safety guidewire ultimately removed. Currently complications can arise if a guidewire becomes retained inside a patient during an endovascular procedure, which is associated with high morbidity and mortality rates. The instant intravascular safety guidewire with its rotatable anchor reduces the likelihood of this complication.

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.

Disclosed is a device for facilitating placement of a central line in a patient, said device comprising: a housing having proximal and distal ends and a central portion therebetween, said housing having an upper portion and a lower portion; a handgrip provided on a proximal end of the housing, said handgrip having at least one of a channel and a through hole extending from the proximal end to the central portion, wherein the channel or through hole is sized to receive a guidewire; a feeder tip receiver provided on a proximal end of the handgrip in communication with the channel or through hole in said handgrip; a stabilizer provided on a lower portion of said housing; a Luer slip tip provided on a distal end of the housing, said Luer slip tip having a mounting portion for attachment to a needle hub, said Luer slip tip having a lumen aligned with the channel or through hole in said handgrip.

Catheters including those having guidewire lumens that can convert from an Over-the-Wire mode to a Rapid Exchange mode are useful and effective when this conversion happens without adjusting the position of the guidewire in a body lumen.

Loading tools for use with medical devices are disclosed. An example loading tool may include a tubular sleeve having a proximal end region, a distal end region, and a lumen. The distal end region may be designed to be engaged with a resilient seal member of a hemostasis valve so that a medical device disposed within the lumen can be passed through the resilient seal member. The tubular sleeve may include a tube wall. At least a portion of the tube wall may overlap to define an overlapping region.

Disclosed is an assembly of parts for an endourological procedure, including a tubular sheath and an introducer, the tubular sheath being removably mounted on the introducer. The introducer comprises a security channel that is openable to shift a guidewire from a position inside the security channel to a position outside and next to the tubular sheath. Disclosed are also access sheaths and a method of performing an endourological procedure.

A rapid exchange catheter comprises a guide wire lumen including a substantially sealed portion in which a lumen wall extends around an entire periphery thereof and a channel portion including a channel opening the lumen to an exterior of the catheter, wherein a width of the channel is less than a maximum width of the channel portion. A guide wire ramp extends into the channel portion, with the ramp extending further into the lumen of the channel portion as a distal end of the ramp is approached.

A catheter for positioning a guidewire across an occluded portion of a vessel includes an elongate catheter body, an integrated rotatable distal tip, a proximal handle region, and a catheter lumen extending through the elongate catheter body. The elongate body has a distal region configured to be bent to a set angle. The integrated rotatable distal tip includes one or more channeled flutes extending around the distal tip that are configured to be rotated in a first direction to dissect tissue and a second direction for bluntly contacting tissue. A proximal handle region includes a control for rotating the distal tip in either the first or second directions. The catheter lumen is configured to pass a guidewire.

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port, arranged on an exterior portion of the catheter configured to receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space.