An apparatus is provided herein for dilating bodily tissue and for monitoring neural activity in the distracted bodily tissue. In one aspect of the invention, the apparatus includes a first dilator having a tubular body with a distal end, a proximal end, and at least one electrode mounted about a circumference thereof; and, a second dilator having a tubular body of electrically-insulative material, the tubular body having a distal end, a proximal end, and a lumen extending therebetween sized to permit the second dilator to subsequently telescopically slide over the first dilator and come into overlapping coaxial alignment with the first dilator. A discrete window is formed through the tubular body, at or near the distal end, in communication with the lumen. With the second dilator being in overlapping coaxial alignment with the first dilator, the window is located to come into registration with at least one electrode such that, upon rotation of the second dilator relative to the first dilator, the window is positionally adjustable about the circumference of the first dilator. Advantageously, in addition to detecting the proximity of a nerve to the first dilator, the apparatus permits determination of the direction of the nerve from the first dilator. This facilitates more efficient re-positioning of the apparatus for avoidance of nerves, if a new path is necessary.

A medical instrument includes a shaft, a distal-end assembly and a puller-wire. The shaft is configured for insertion into a body of a patient. The distal-end assembly, which is coupled to the shaft, includes a telescopic assembly, configured to elongate so as to collapse the distal-end assembly, and to compress so as to expand the distal-end assembly. The distal-end assembly further includes an elastic element, coupled to self-elongate and thus elongate the telescopic assembly. The distal-end assembly also includes an inflatable balloon, which is coupled to the telescopic assembly and is configured to collapse by the telescopic assembly elongating, and to expand by the telescopic assembly compressing. The puller-wire runs through the shaft and is connected to a distal end of the telescopic assembly, and is configured, when pulled, to compress the telescopic assembly.

A medical device having a catheter and a fluid delivery conduit entirely disclosed within a portion of the catheter. The catheter may have a thermally transmissive region in fluid communication with the fluid delivery conduit and a rod disposed within at least a portion of the fluid delivery conduit. The medical device may control variable fluid flow with the ability to modify the effective cross-sectional area of the fluid delivery conduit available for fluid flow. Additional configurations provided herein may allow for the selective manipulation of a footprint or therapeutic pattern achievable with the medical device during a single procedure, negating the need for the removal and insertion of multiple devices to achieve the same variations in treatment geometry or characteristics.

The present disclosure describes devices, systems, and methods for intravascularly delivering an implantable device at the mitral annulus. A delivery system includes a delivery member coupled to a handle assembly and extending distally from the handle assembly. The intravascular device is attached at the distal end of the delivery member, and is housed within a distal piece of an outer sheath. A steering catheter is nested within the outer sheath to bend the delivery member into position. A delivery catheter is configured to advance the intravascular device relative to the outer sheath, and a suture catheter includes sutures/tethers which may be coupled to the intravascular device prior to deployment.

An intermittent urinary catheterisation aid 2 and an assembly is provided. The aid allows a user to manipulate an intermittent urinary catheter 3 in one direction and insert it into the urethra in another direction.

A flexible, polymer sleeve is provided that is everted into a body passageway in such a manner as to exert minimal rubbing friction on the internal walls of such passageway. The sleeve is housed within a tube assembly comprising a posterior tube that telescopingly slides into an insertion tube. The sleeve everts over the insertion tube, upon forward pressure applied thereon, as it extends forward into a body passageway, and consequently, causes the posterior tube to retract into the insertion tube. Multiple tubes can be telescoped to support the polymer sleeve and to keep a passageway open for the expelling of urine or body fluids, the insertion of tools, sanitation/antibacterial substances, or for the flow of liquids through the sleeve. The insertion tube can be locked in reference to the sleeve to prevent unintended removal of catheter assembly. Sleeve and tubing are removed by reversing the insertion and eversion movements.

A transseptal catheter delivery system includes an elongate first tubular member and an elongate second tubular member receivable within the first tubular member. The first tubular member includes an adjustable portion adjacent a distal end. The second tubular member is adapted to receive an instrument to be placed in the left ventricle, and includes a curved portion adjacent its distal end in a relaxed state. The adjustable portion is deflectable toward the atrial septum to guide a puncturing tool and/or guide insertion of the second tubular member through a septal puncture into the left atrium. Within the left atrium, the curved portion is oriented toward the left ventricle to guide insertion of a guide wire, and subsequently the second tubular member, into the left ventricle. Methods of transvenously accessing a left ventricle are also provided.

An intravascular device delivery system has an elongated member with a flexible hypotube. The hypotube can be rotationally keyed to a steerable catheter. The flexible hypotube includes one or more cuts to allow bending of the flexible hypotube within a first plane. The steerable catheter is steerable to bend the flexible hypotube within the first plane, and longitudinally movable relative to the flexible hypotube to allow distal movement of the steerable catheter relative to a distal end of the flexible hypotube.

A urinary catheter assembly comprises a urinary catheter having a proximal part with an insertion tip, a distal part and a tubular shaft extending there between. A package having at least a first compartment with an opening is provided to enclose the proximal part and at least a part of the tubular shaft therein in a curved or curled state during storage. A protective sleeve arrangement is arranged around the distal part of the urinary catheter, a distal end of the protective sleeve arrangement being connected to the urinary catheter, at or in the vicinity of a distal end thereof. The protective sleeve arrangement comprises at least two sleeves being telescopically displaceable in relation to each other, wherein the protective sleeve arrangement is transformable between a retracted position and an extended position.

Everting balloon systems and methods for using the same are disclosed herein. The systems can be configured to access and dilate body lumen and cavities. For example, the systems can be used to dilate the cervix and access the uterine cavity. The systems can also be used to occlude the cervix. The systems can also be used to occlude the urethra.