Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

A vascular plug comprises a superstructure expandable from a collapsed percutaneous insertion configuration to an expanded deployment or use configuration. The superstructure is comprised of both primary and secondary three-dimensional shapes allowing for the occlusion of a wide range of vessel sizes from small to large through a disproportionately small delivery catheter. The plug includes a shape memory element for the generation of radial force and the creation of the larger secondary three-dimensional twisting or helical superstructure as is needed for target vessel occlusion.

An occluding catheter for preventing stroke by occluding blood flow to right and left carotid arteries is provided. The occluding catheter includes a shaft that has a proximal end and a distal end, and a proximal occluding balloon carried by the shaft. The proximal occluding balloon is inflated to occlude blood flow through one of the right carotid artery and the left carotid artery. A distal occluding balloon is carried by the shaft and is inflated to occlude blood flow through one of the right carotid artery and the left carotid artery that is not occluded by the proximal occluding balloon. The shaft has a segment that is located between the proximal occluding balloon and the distal occluding balloon. Also provided are alternative arrangements with a single or dual inflation and/or guidewire channel, single occluding balloon, and an associated method of diverting emboli from cerebral circulation.

A catheter-based system is provided having two occlusion elements and a perfusion lumen having a distal opening distal to the occlusion elements and a proximal opening proximal to the occlusion elements. The occlusion elements can be expanded to block blood flow both distal to an intravascular treatment site and to block blood flow proximal to the treatment site, thereby isolating the treatment site. The perfusion lumen can allow blood to flow between the distal and proximal openings, through the treatment site, while remaining isolated from fluids in the treatment site. The system can further include a treatment lumen having a proximal opening accessible by a user to provide aspiration, drug delivery, mechanical device delivery, or other treatment into the vasculature and a distal opening positioned between the two occlusion elements and in communication with fluids at the isolated treatment site.

Improved methods and devices for performing an endoscopic surgery are provided. Systems are taught for operatively treating gastrointestinal disorders endoscopically in a stable, yet dynamic operative environment, and in a minimally-invasive manner. Such systems include, for example, an endoscopic surgical suite. The surgical suite can have a reversibly-expandable retractor that expands to provide a stable, operative environment within a subject. The expansion can be asymmetric around a stabilizer subsystem to maximize space for a tool and an endoscope to each be maneuvered independently to visualize a target tissue and treat the target tissue from outside the patient in a minimally invasive manner.

The disclosure presents methods and systems for applying a suction force to a surface of a left atrial appendage (LAA) with a tube attached to an exterior surface of an inflatable balloon. The disclosure also presents methods and systems for inflating a first inflatable balloon within a cavity of a left atrial appendage (LAA). A method may include applying a suction force with at least one tube coupled to the first inflatable balloon to attract the first inflatable balloon to an interior surface of the LAA or to a second inflatable balloon. A method may include puncturing, using a tissue-penetrating tip, a target surface of the LAA.

The invention relates to medical technology, and more particularly to a device for the conservative treatment of nasal and paranasal sinus diseases. The present device comprises obturators for the posterior and anterior nasal openings, each obturator being in the form of an expandable sheath made of a resilient material and provided with a feed tube. The distal end of the tube is in communication with the cavity below the sheath, and the proximal end is provided with an adapter having a valve mechanism. The obturator sheath for the posterior nasal opening is hermetically fastened to the distal portion of its feed tube. The obturator sheath for the anterior nasal opening is hermetically fastened to a cuff. The cuff is provided with two channels, one of which holds the feed tube of the obturator sheath for the posterior nasal opening in such a way that the cuff can move along the entire length of the feed tube. The other channel holds a catheter for evacuating a pathological secretion from the paranasal sinuses and/or for introducing solutions of medicinal preparations into same for diagnostic or therapeutic purposes. The catheter is held in said channel in such a way that the distal portion thereof can be moved into the space between the obturator sheaths. The invention is intended to provide more effective treatment of nasal and paranasal sinus disorders.

The present disclosure is directed to embodiments and methods of reducing or eliminating erosion resulting from the use of an occluder. In particular, the present disclosure is directed to reducing or eliminating erosion resulting from the use of an occluder while maintaining the fundamental function and effectiveness of the occluder with an improved occluder braid pattern. The embodiments and methods disclosed herein reduce or eliminate erosion, for example, by reducing the friction and force of an occluder on cardiac tissue and/or by increasing occluder disc compliance to cardiac structures and movement.

Apparatus and methods are described including a blood pump that includes a catheter, a first impeller disposed on the catheter, and a second impeller disposed on the catheter, proximally to the first impeller. A motor drives the first and second impellers to pump blood of a subject, by driving the first and second impellers to rotate. The blood pumps is configured such that (a) the first and second impellers are shaped differently from each other when the first and second impellers are in non-radially-constrained configurations, (b) the first and second impellers are sized differently from each other when the first and second impellers are in non-radially-constrained configurations, and/or (c) the first and second impellers are driven by the motor to rotate under respective rotation conditions that are different from each other. Other applications are also described.

One disclosed embodiment comprises a method for treating lesions in the carotid artery of a mammalian body. The method comprises transcervical access and blocking of blood flow through the common carotid artery (with or without blocking of blood flow through the external carotid artery), shunting blood from the internal carotid artery and treating the lesion in the carotid artery.