A method of operating a catheter assembly including monitoring a gap feedback signal indicative of a distance between a first tissue contact surface and a second tissue contact surface. Producing, via a user interface of the catheter assembly, a graphical depiction of the first tissue contact surface and the second tissue contact surface spaced apart from the first tissue contact surface by the distance. Producing, via the user interface of the catheter assembly, a gap distance warning when the gap feedback signal indicates that the distance is outside of a target gap range.

Disclosed herein are catheter assemblies and methods thereof that address various aspects of at least the retrograde tunneling technique. The catheter assemblies include, but are not limited to, catheter assemblies configured for vascular access, catheter assemblies configured for priming, catheter assemblies configured for tunneling, and mechanisms for connecting catheter tubes to their respective catheter assemblies. The methods include, but are not limited to, priming, tunneling, and connecting catheter tubes to their respective catheter assemblies.

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.

Tips for use on a tunneling tool provide the ability to pull an implantable medical lead extension or catheter body through a subcutaneous tunnel. The tips may include a pin with a barb, where the barb is inserted within a compliant portion of a connector body of the lead extension or a catheter body to create an interference fit that allows the connector body or catheter body to be pulled through the tunnel. The tips may include a carrier that has a cavity for the connector body, where the tunneling is performed with the carrier present on the tunneling tool. A body is positioned within the cavity of the carrier to prevent tissue from snagging on and collecting within the carrier. The body may include a tip portion that performs the tunneling function. The carrier may also provide tunneling and/or may be attached to the tunneling tool during tunneling.

An occlusion bypassing apparatus is disclosed for re-entering the true lumen of a vessel after subintimally bypassing an occlusion in a vessel. The apparatus includes an outer shaft component, an inner shaft component disposed within the outer shaft component, and a needle component slidably disposed within the inner shaft component. The inner shaft component includes a body portion and a needle housing, which is distal to the body portion. The needle housing is less flexible than the body portion. In order to smooth the transition between the body portion and the needle housing, the needle housing includes a transition portion that has a variable flexibility along its length that decreases in a distal direction. A curved distal end of the needle component is distally advanced relative to the inner shaft component to pierce through the intima of the vessel and thereafter enter the true lumen.

A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

A reentry catheter having a catheter body having a lumen extending axially through a length of the catheter body, a distal port in communication with the lumen, and a flexible distal tip positioned at a distal end of the catheter body. The distal tip can have a first planar surface and a second planar surface that are angled to form a tapered portion in the distal tip. A thickness of the tapered portion in a first direction can decrease along the length of the tapered portion and can be less than a width of the tapered portion in a second direction at every point along the length of the tapered portion such that the tapered portion of the tip is more flexible when bent in the first direction than in the second direction, the second direction being normal to the first direction.

A system for facilitating fluid connection between cannulae and a blood pump. The system includes a cannula having proximal and distal ends. The distal end of the cannula adapted to be in fluid communication with the circulatory system. The proximal end of the cannula configured to couple to an inlet of the blood pump. The system further includes a tunneling device configured to be inserted into a body of a patient to direct the proximal end of the cannula adjacent to the inlet for connection thereto. The cannula further includes a first connecting structure. The tunneling device further includes a second connecting structure. The first and second connecting structures are selectively engageable to allow connection and disconnection between the cannula and tunneling device.

Devices and implantation methods utilizing subcutaneous placement into a patient are disclosed for the insertion, advancement and positioning of a subcutaneous implantable medical device (SIMD) such as a medical electrical lead. The SIMD is releasably-engaged with a device in accordance with embodiments of this disclosure, and advanced from an incision of the patient to an implant location. The implantation device may be disengaged from the SIMD without moving the SIMD from the implant location.

A method of positioning a tip of a pacemaker lead, which has passed through a coronary sinus, into an interventricular septum, in order to effectively transmit electrical stimulus, includes: inserting into a intervention wire through a superior vena cava and a coronary sinus to pass through the interventricular septum and then guiding the intervention wire to an inferior vena cava; and positioning the tip of the lead into the interventricular septum by inserting the pacemaker lead along the intervention wire. An apparatus for positioning a tip of a pacemaker lead, which has passed through a coronary sinus, into an interventricular septum where a conduction system of a heart is positioned, in order to effectively transmit electrical stimulus, includes: a intervention wire connected through a inferior vena cava, a coronary sinus, an interventricular sinus, a right ventricle, and an inferior vena cava; a surgical catheter passing through the inferior vena cava and a safe zone to capture the intervention wire positioned in the right ventricle; and a pacemaker lead inserted along the intervention wire such that the tip is positioned in interventricular septum tissues.