Vascular access devices, assemblies, kits, and related methods are disclosed. A vascular access assembly may include a first tubular conduit, a second tubular conduit, and an expandable stent graft that is coupled adjacent to a peripheral end of the second tubular conduit. When implanted into the patient, vascular access assemblies may form a flow path that extends from an artery or an arteriovenous graft to a heart of a patient. The vascular access assembly, when implanted and assembled, may be a fully subcutaneous surgical implant.

A split-tip catheter and methods for deploying a split-tip catheter in a right atrium are provided. The catheter is configured with a distal portion including a first and a second distal end regions elastically divergable from alignment along a splitting plane to regain a relaxed configuration. The first distal end region terminates in a first tip having a first forward opening, and the second distal end region terminates in a second tip having a second forward opening. Catheter deployment may include directing the first forward opening generally towards an anterior right atrium wall portion and applying the first forward opening to withdraw blood from the right atrium.

A short length flexible catheter with hollow guide wire and flushing port for convection enhanced delivery may be provided. The short length CED catheter may include a catheter body made of silicone or plastic. The short length catheter may further include an attachment port connected to a first end of the flexible, hollow guide wire contained within the catheter body. The hollow catheter guide wire may extend beyond the catheter body on one end for both enhanced tunneling and simultaneous use of flushing.

A subcutaneous tunneling device includes a shaft having a bend, a catheter connector extending from a distal end of the shaft distal of the bend, and a sleeve. The catheter connector can include a body having a gripping portion, and a barbed extension distal of the body configured for insertion into a distal opening of a catheter. The sleeve is slidably mounted on the shaft and has a retracted position exposing the catheter connector for coupling the catheter to the catheter connector via the barbed extension, and an extended position covering the catheter connector and a distal end of the catheter.

A split-tip catheter and methods for deploying a split-tip catheter in a right atrium are provided. The catheter is configured with a distal portion including a first and a second distal end regions elastically divergable from alignment along a splitting plane to regain a relaxed configuration. The first distal end region terminates in a first tip having a first forward opening, and the second distal end region terminates in a second tip having a second forward opening. Catheter deployment may include directing the first forward opening generally towards an anterior right atrium wall portion and applying the first forward opening to withdraw blood from the right atrium.

A lumen re-entry system includes a helically wound coil having open proximal and distal ends, and defining a longitudinal movement axis. The helically wound coil includes a distal segment that is relaxed relative to a proximal segment. A tip deflection wire is attached to the relaxed distal segment and coaxially disposed relative to the helically wound coil. Movement of the tip deflection wire moves the lumen re-entry system from an advancement configuration in which the open distal end of the helically wound coil is substantially aligned with the longitudinal movement axis to a deflected configuration. The lumen re-entry system also includes a puncture wire slidably received within the helically wound coil and having a distal puncture tip.

Devices and methods obtain and use endovascular electrograms in a number of clinical applications and settings. In one embodiment, methods for triggering analysis of an endovascular ECG waveform are based on the detection of a peak in a skin-based ECG waveform in order to determine a location of an indwelling medical device, such as a catheter. In another embodiment, the position of a catheter or other medical device within the vasculature can be determined by analysis of the energy profile of a detected P-wave. In yet other embodiments, magnetic connecting devices are used for establishing an operable connection through a sterile field.

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.

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.

A system and method for treating a blood vessel that is at least partially obstructed by an occlusion which divides the lumen into a proximal lumen segment and a distal lumen segment. The system includes an orienting catheter having an orientation element positionable in an intrawall space of the vessel and an occlusion catheter having an occlusion balloon inflatable in the proximal lumen segment so as to isolate a target volume including the intrawall space. The pressure inside the target volume is reduced to a pressure below the pressure of the distal lumen segment so that the intima presses against the orienting element of the orienting catheter. A distal end of a reentry device may be advanced from the orienting catheter through the intima and into the distal lumen segment.