A medical kit, including a split-tip catheter, a first intra-catheter stiffener element, a second intra-catheter stiffener element, a first guidewire, and a second guidewire. The split-tip catheter includes a first lumen in fluid communication with a first distal opening and a second lumen in fluid communication with a second distal opening with the first distal opening proximal to the second distal opening. The first intra-catheter stiffener element is designed for disposition in the first lumen, and the second intra-catheter stiffener element is designed for disposition in the second lumen. The first intra-catheter stiffener element includes a first guidewire lumen, and the second intra-catheter stiffener element includes a second guidewire lumen.

A re-entry device (1) for recanalization procedures of an arterial vessel by an intraluminal or subintimal technique includes a catheter (10) having a distal end (12) with a curved tip (13) by an angle () of between 30 and 90, and an angled-tip stylet (2) insertable into the inner lumen of the catheter (10) to exit from a distal opening (14) thereof. The angled-tip stylet (2) is metal and has a distal end (22) with a curved tip (23) ending in a sharped apex (24). The distal end (22) of the an angled-tip stylet (2) is tapered and has a length of 3-5 cm, and the curved tip (23) is bent by an angle () of between 30 and 50. The structure makes the apex (24) adjustable outside the two-dimensional plane defined by the curved tip (13) of the catheter (10) to facilitate penetration of the arterial wall.

The invention generally relates to method and apparatus for crossing an obstruction in a tubular member, and more particularly to a medical device method for crossing of a chronic occlusion in a subintimal or interstitial space of an artery.

An occlusion bypassing apparatus for re-entering the true lumen of a vessel after subintimally bypassing an occlusion in a vessel. The apparatus includes an outer shaft component having a needle lumen there-through. A proximal end of the outer shaft component is fixed within a handle of the apparatus at a first attachment point. A stabilization tube of the apparatus is disposed within the needle lumen. A proximal end of the stabilization tube is fixed within the handle at a second attachment point that is spaced apart from the first attachment point and an elongated body and a distal end of the stabilization tube are not attached to the outer shaft component. A needle component of the apparatus is configured to be slidably disposed within the stabilization tube and removable therefrom, and the stabilization tube minimizes resistive forces exerted onto the needle component by the outer shaft component.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.

A system for facilitating fluid connection between cannulae and a blood pump. The system includes a cannula having a distal end adapted to be in fluid communication with the circulatory system and a proximal end configured to couple to an inlet of the blood pump. Further included is 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 and including a second connecting structure. Further included is a plug which has a first plug part and a second plug part. The first plug part includes a second connecting structure, the first and second connecting structures being selectively engageable. The second plug part is configured to be inserted in the proximal end of the cannula. The first and second plug parts are selectively disengageable to allow in situ disconnection between the cannula and tunneling device.

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.

Methods and devices for treating occlusive peripheral vascular diseases are described. The devices can include an access catheter having a guidewire lumen and stylet lumen, a guide tube having a curved distal end, a stylet, and an actuator handle. The methods describe techniques for using the described devices for performing vascular procedures, such as subintimal angioplasty.

Devices for loading intravascular treatment devices into a sheath and associated systems and methods are disclosed herein. A sheathing tool may include, for example, a first channel extending to a first opening, the first channel configured to receive a treatment device in a constrained state therethrough. The treatment device may include an elongated member and a first element and a second element at a distal region of the elongated member. The second channel may extend to a second opening, the second opening surrounded by a sidewall and configured to receive the treatment device in the constrained state therethrough, wherein the second opening is spaced apart from the first opening by a gap, and wherein a length of the gap is great enough to allow the first element to self-expand over the sidewall while the second element generally maintains its diameter in the constrained state while crossing the gap.

A catheter for recanalizing a blood vessel having an occlusion therein via a subintimal pathway. The catheter includes a catheter shaft having an inflatable balloon mounted to the distal end portion of the catheter shaft. A flexible tubular member extends from the catheter shaft and along an exterior of the inflatable balloon. Inflation of the inflatable balloon deflects the flexible tubular member into a deflected configuration away from a longitudinal axis of the catheter shaft to effect re-entry into the true lumen distal of the occlusion.