A constraining structure for use with a balloon catheter can include multiple longitudinal struts and multiple, sinusoidal shaped radial rings. The constraining structure can expand to form a pattern of channels including substantially square windows. The constraining structure can modify, restrict, and control a shape and/or size of the balloon when inflated. Inflating the balloon catheter within the constraining structure can provide nonuniform pressure on a vessel wall adjacent the 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.

A controllable stiffness endoscope overtube includes an overtube shaft including an inner sheath defining an access lumen and an outer sheath surrounding the inner sheath from proximal to distal end of inner sheath to define an annulus therebetween having a proximal portion with a vacuum connection. The sheath distal ends are longitudinally fixed to one another and sized to receive an endoscope. The outer sheath has a constant outer diameter over at least a distal portion of the annulus proximate to the distal ends of the sheaths. A vacuum device is fluidically connected to the vacuum connection and applies vacuum to the annulus. Responsive thereto, annulus pressure is lowered, the sheaths are drawn together, and the overtube shaft is stiffened over at least the distal portion to stiffen and maintain a current shape of the overtube shaft over at least the distal portion of the annulus.

A device for introduction into a body vessel includes a main elongated element, a balloon positioned at the main elongated element distal end, a distal connecting element positioned at the distal end of the balloon to receive a guidewire during use, and a longitudinally movable sheath positioned external to the main elongated element, a position of the sheath distal end with respect to the balloon defining an exposed portion of the balloon that expands when fluid is delivered to the balloon through the inflation lumen.

Catheters with weeping balloons can be used for various medical purposes. For example, in some embodiments provided herein weeping balloons are used for catheter visualization devices. In some embodiments, weeping balloons are used to deliver therapeutic agents. Weeping balloons can include openings of a selected size and shape through which a fluid gradually flows or “weeps.” The design of the openings can affect performance characteristics such as, but not limited to, fluid flow rate, tear resistance, and mitigation of counter-flow.

A drive assembly for a catheter procedure includes a body configured to receive a percutaneous device where the body has a first end and a second end. A distal pinch is configured to releasably engage the percutaneous device. A proximal pinch is positioned on the first end of the body and is configured to releasably engage the percutaneous device. A linear drive mechanism is coupled to the body and configured to move the body and the proximal pinch between a first position and a second position to cause linear movement of the percutaneous device along a longitudinal axis of the percutaneous device. A rotational drive mechanism is coupled to the second end of the body and is configured to rotate the body and the proximal pinch to cause the percutaneous device to rotate about the longitudinal axis of the percutaneous device.

Disclosed is a system and method for the placement of elongate medical members within a patients body using coaptive ultrasound. In a particularly preferred embodiment, a flexible tube includes a first balloon at a distal end of the tube, and a second balloon at the distal end of the tube and positioned within the first balloon. The first and second balloons are inflatable to form one or more echogenic windows between them, which echogenic window may be detected from within a patient's body by an ultrasound probe that is external to the patient's body. Detection of such echogenic window is used to identify an acceptable location on the patient's body at which to insert a guidewire configured to receive an elongate medical member without damage to surrounding patient tissues or organs.

Treating a treatment area in the vasculature includes a first catheter adapted for positioning at the treatment area, said first catheter including a first balloon having a transient radiopaque material corresponding to the treatment area. A second catheter adapted for positioning at a treatment area includes a treatment that substantially matches the transient radiopaque material, preferably so that the length and/or position of the treatment corresponds to the length and/or position of the transient radiopaque material. Related kits, assemblies, and methods are also described.

The subject guide catheter extension system with a micro-catheter delivery catheter includes an outer sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. Several mechanisms of engagement/disengagement between the inner and outer members are provided including a friction mechanism, threaded mechanism, pull away sheath, and engagement/disengagement mechanism for pusher's handles. The sheath and the inner member are modified for different engagement/disengagement mechanisms operation. A micro-catheter delivery system provides for an improved atraumatic crossability to the treatment site in an expedited and simplified fashion. During a procedure, a guidewire along with a guide catheter are advanced to the vicinity of the treatment site within a blood vessel. Subsequent thereto, the subject guide catheter extension system is manipulated to advance the micro-catheter along the guidewire inside the guide catheter towards and beyond the site of interest. Once the micro-catheter is in place, the outer sheath slides along the micro-catheter until reaching the lesion, and then the inner member is removed from the sheath, and the sheath then is ready for passing the treatment catheter (stent/balloon) towards the lesion to be treated.

An angioplasty balloon including a non-deployable stent to prevent or reduce the potential for slippage of the inflated balloon with respect to the vessel wall being treated. The balloon includes a non-deployable stent that is adapted to be secured to the balloon or angioplasty balloon catheter. The stent has a proximal end, a distal end, and at least three radially-spaced struts, each, each strut connecting the proximal end to the distal end and having one or more bends that allow expansion of the strut to accommodate the inflation of the balloon. The stem is made or a material so that the stent collapses upon deflation of the balloon.