A system for inserting a medical tube within the body using a tunneler device enables formation of a tunnel within the body and further enables concurrent insertion of the medical tube within the body as the tunnel is formed, eliminating extra steps required by current technologies for insertion of the medical tube within the body. The tunneler device provides an attachment element that captures the medical tube and further provides a handle slidably mounted along the tunneler device to aid practitioners when inserting the tunneler device into the body. The tunneler device further provides a bend angle to aid practitioners in forming the tunnel past the clavicle of the body. The tunneler device enables practitioners to place medical tubes within the body while reducing time and friction commonly associated with medical tube placement procedures.

A launching catheter for targeting a second vessel from a first vessel includes a catheter including a proximal portion and a distal portion including a needle aperture and a flat rectangular radiopaque marker. The flat rectangular radiopaque marker disappears under fluoroscopy upon rotation to provide information about rotational alignment of the launching catheter. The launching catheter includes a needle configured to extend through the needle aperture. A method of aligning the catheter includes rotating the catheter in a first blood vessel until the marker has a thickness (e.g., minimal thickness) under fluoroscopy. The thickness indicates rotational alignment of the catheter.

A recanalization catheter for facilitating reentry into a lumen of a vessel having an occlusion therein from a subintimal space in a wall of the vessel. The recanalization catheter includes a catheter shaft extending distally from a hub. The catheter shaft defines a guidewire lumen extending therethrough. First and second inflatable balloon members are disposed on a distal end region of the catheter shaft. The catheter shaft includes an inflation lumen in fluid communication with the first and second inflatable balloon members. A lateral opening which is in communication with the guidewire lumen opens to an exterior of the catheter shaft between the first and second inflatable balloon members on a first side of the catheter shaft. The catheter shaft also includes an imaging lumen extending through the catheter shaft configured to receive an IVUS imaging device therein.

Provided herein are systems, devices, and methods for facilitating the performance of peritoneal dialysis. A long-term use sheath with cuffs to secure to skin and the rectus muscle is provided. Through this long-term use sheath, a peritoneal dialysis catheter may be inserted into the peritoneum and used for dialysis, and when appropriate such as when catheter malfunction risk or injury risk is apparent, this catheter may be exchanged through the sheath for a new catheter.

A catheter for use with a subintimal reentry guidewire includes a proximal portion having a proximal guidewire lumen and a proximal inflation lumen, a distal portion having a distal guidewire lumen and a distal inflation lumen, and an intermediate portion disposed between the proximal portion and the distal portion and having an intermediate inflation lumen in fluid communication with the proximal and distal inflation lumens. The intermediate portion is devoid of a guidewire lumen. A blocking mechanism disposed in the distal portion of the catheter is transformable from a non-blocking configuration in which a guidewire is free to translate through the distal guidewire lumen and a blocking configuration in which a guidewire disposed in the distal guidewire lumen is prevented from translating through the distal guidewire lumen.

The disclosure provides apparatus and methods for reentering a true lumen. The reentry catheter includes a shaft that includes a proximal opening in a proximal end of the shaft, a J-shaped filler in a distal end of the shaft, and a distal side opening in a sidewall of the shaft. The distal side opening is adjacent to the J-shaped filler. A passageway extends between the proximal opening and the distal side opening. The proximal opening, the distal side opening, and the passageway each are configured for the passage of an elongate medical device there through. A movable cover is hingedly attached to the sidewall of the shaft biased in a closed position and configured to occlude the distal side opening when in the closed position. The elongate medical device is configured to open the movable cover, the movable cover is configured to facilitate reentry to a true lumen.

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.

Disclosed are cardiac shunts and method of delivery, and in particular, to a shunt to reduce elevated left atrial pressure (LAP). The methods include forming a puncture hole between the left atrium and the coronary sinus, widening the puncture hole, and placing an expandable shunt within the widened puncture hole. A first catheter having a side-extending needle may be used to form a puncture into the left atrium. A second catheter extends along a guidewire and an expandable shunt with distal and proximal flanges is expelled therefrom into the puncture. The shunt defines a blood flow passage therethrough that permits shunting of blood from the left atrium to the coronary sinus when the LAP is elevated. The shunt is desirable formed of a super-elastic material and manipulated with control rods. The shunt defines a tilted flow tube that facilitates collapse into the catheter.

Disclosed is an intraluminal catheter that includes a flexible elongate shaft configured to be positioned within a body lumen of a patient, and an intraluminal sensor disposed at the distal portion of the shaft that is configured to sense a characteristic within the body lumen. The shaft further comprises a plurality of wires disposed around a lumen, wherein the wires are helically twisted. The wires can be helically twisted in a single direction to form a cylindrical shape. This helical structure is configured to stiffen the flexible elongate shaft for movement into an obstruction within the body lumen without kinking.

A tunneling system for use with a catheter includes an elongate tunneling member defining a longitudinal axis along at least a portion of a longitudinal length thereof. The elongate member has a first end and a second end. The tunneling system further includes a connector configured for releasably engaging the second end of the elongate tunneling member to the catheter.