A catheter system including a wire, a translatable catheter, and first and second tethers is introduced into a body of a subject. The translatable catheter has a curved portion proximate a distal end of the translatable catheter. The first tether is coupled to the wire, and passes proximally through the translatable catheter. The second tether is attached to the curved portion. The catheter system is positioned such that the wire is disposed at a first location in the body. While the wire remains at the first location, the translatable catheter is translated away from the wire by manipulating the first tether and the second tether. Other embodiments are also described.

An obturator comprising a hollow distal end portion, the distal end portion comprising a distal end and a side hole located proximally of the distal end, the side hole being for receipt of a guidewire and to direct the guidewire laterally from the obturator.

Devices for palliating gastrointestinal strictures using rapid exchange type enteral stent placement catheters. The catheter may include an inner member and an outer member, with the two members being slidable with respect to one another. In various device embodiments, a ramp for directing a guidewire out from within the catheter is provided using portions of the outer member or a shaped mandrel. The inner member may take a number of forms, including a tubular distal portion, a skived or integrally attached elongate midsection, and a proximal portion. A mandrel can be used in a portion proximal of the guidewire ramp, with the mandrel taking one of several disclosed forms.

The present invention discloses control catheters and methods for pulmonary suffusion and related therapies. The control catheter may comprise a control end, working end having a first balloon, a minor lumen, and a first and second major lumen. One method of the present invention involves introducing the working end of the catheter into a circulator system of the mammal, positioning the catheter into a desired first lobe pulmonary artery, inflating the minor balloon using the corresponding lumen, positioning the major balloon in the main pulmonary artery, and inflating the major balloon using the corresponding lumen. The method may comprise the additional step of infusing a chemical agent through the distal tip after the inflation of the minor balloon and the major balloon.

Methods and devices are disclosed for passing Chronic Total Occlusion (CTO) from subintimal location and re-entry into a true-lumen of the patient using transient fenestration approach. The transient fenestration is induced by balloon dilatation within the CTO, and a guidewire quickly trails into a true lumen.

Catheter devices, assemblies and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A catheter device can include a central catheter, two side tubes, and a distally-protruding, curved subintimal guidewire. The central catheter can define a central lumen that extends from a proximal end to a distal end of the central catheter. The lumen can be configured to receive a primary guidewire. The central catheter can also define at least one reentry aperture oriented transverse to the central lumen. The first and second side tubes can be coupled with the central catheter, extending along a longitudinal axis thereof, with the first side tube flanking an opposite side of the central catheter relative to the second side tube. The subintimal guidewire can extend from the first side tube, distally beyond the distal end of the central catheter, to the second side tube.

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.

Disclosed herein is a lifting surgical instrument having a branch point, which is used to insert a thread without a cog and a barb into the skin. The lifting surgical instrument includes a sheath, including: a probe part formed in the tubular shape in which a through hole penetrating in a longitudinal direction is formed, and configured such that the front end thereof may be inserted into the skin; and a body configured to extend from the rear end of the probe part, to have a diameter larger than that of the through hole, to communicate with the through hole, and to include a sheath hole. In this case, a direction guidance portion is provided on the inner surface of the probe part, and the angle at which the needle travels is changed via the direction guidance portion when the needle passes through the through hole.

The present teachings generally relate to translation catheter systems and method of using thereof in treating defective mitral valves. Specifically, a translation catheter system includes a catheter configured to move substantially laterally along the mitral annulus and the lateral movement of the catheter is substantially continuous and substantially adjustable. Accordingly, a method of using such a translation catheter includes advancing a first wire across the mitral annulus at a first treatment location, delivering a catheter at or near the first treatment location, moving the catheter substantially laterally to a second treatment location, and advancing a second wire across the mitral annulus, where the distance between the first and second treatment locations is substantially adjustable and optionally visualized.

Methods and devices are disclosed for passing Chronic Total Occlusion (CTO) from subintimal location and re-entry into a true-lumen of the patient using transient fenestration approach. The transient fenestration is induced by balloon dilatation within the CTO, and a guidewire quickly trails into a true lumen.