The present invention provides delivery systems for positioning a gastrointestinal implant in a patient, for example, for treatment of a metabolic disease. Also provided are methods for assembling the delivery systems, methods of positioning a gastrointestinal implant, and methods of treatment of metabolic diseases, such as type 2 diabetes, non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), obesity, and related comorbidities thereof.

A hydrodynamic catheter includes a catheter body with a catheter lumen and an infusion tube extending within the catheter body, the infusion tube configured for coupling with a fluid source near the catheter proximal portion. An inflow orifice and an outflow orifice are positioned at locations along a catheter body perimeter. A fluid jet emanator is in fluid communication with the infusion tube, where the fluid jet emanator includes one or more jet orifices configured to direct one or more fluid jets through the catheter lumen from near the inflow orifice toward the outflow orifice. A pivot cylinder located along the catheter body perimeter is positioned distal relative to one or more of the fluid jet emanator, the inflow orifice, or the outflow orifice.

Described here are devices and components for use in performing an atherectomy. Generally, the atherectomy devices may have a handle, a cutter assembly, and a catheter or catheter assembly therebetween. The cutter assembly may include a housing and a cutter comprising a proximal cutter and a distal cutter, each of which may be rotated relative to the atherectomy device to cut occlusive material.

A medical manipulator is provided with: a drive unit provided with a motor; a removable portion that is removably attached to the drive unit and that is provided with a rotating body to be connected to a rotating shaft of the motor; an elongated insertion portion coupled to the removable portion; a distal-end movable part disposed at a distal end of the insertion portion; a wire connecting the rotating body and the distal-end movable part and transferring tension generated by power of the motor to the distal-end movable part to actuate the distal-end movable part; a pressing member that is formed of an elastic material and that presses a longitudinal intermediate position of the wire in the wire diameter direction; and a sensor that is attached to the pressing member and that detects an elastic deformation amount caused in the pressing member according to the tension of the wire.

An intravascular cutting device described herein uses high-pressure water, saline, or other fluid to cut tissue and other materials including but not limited to calcified tissue, stents, stent grafts, and other devices. In some embodiments, the cutting device includes a working end that has a nozzle with a hole to allow the release of a high-pressure fluid jet. Opposite of the nozzle is a catch plate or deflector anvil that prevents the fluid jet from cutting healthy tissue. The device user will place the item to be cut between the nozzle and catch plate and then advance the device along the item to be cut as the fluid jet is activated, thus cutting the object as it advances.

A vascular device is provided having a catheter body and a rotatable cutter assembly located at the distal end of the catheter body. The cutter assembly has at least one helical cutting surface within a housing that is coupled by a torque shaft to a drive mechanism. A conveyor mechanism helically wound about the torque shaft conveys occlusive material conveyed into the housing by the helical cutting blade further proximally along the catheter body for discharge without supplement of a vacuum pump. The catheter body is manipulated to insert the distal end of the catheter body within a body lumen and advance the distal end of the catheter body toward the occlusive material. The drive mechanism is operated to rotate the helical cutting surface to cut and convey the occlusive material from the body lumen proximally into the housing and to convey the occlusive material conveyed into the housing by the helical cutting surface further proximally along the catheter body by the conveyor mechanism for discharge without supplement of a vacuum pump. The distal end of the catheter body is deflected and rotated to sweep the cutter assembly in an arc about the center axis of the catheter body to cut occlusive material in a region larger than the outside diameter of the cutter assembly.

An intravascular treatment device is presented having an expandable frame made up of circular struts, straight struts, and bent struts forming a frame with circumference that varies over the length of the frame. Radiopaque markers can be positioned on the bent struts to indicate outer circumferences of the frame along the length of the frame. The device can be a stent or a clot retriever. If the device is a clot retriever, the proximal end of the expandable frame can be attached to a guide wire and the distal end of the expandable frame can be free to slide over the guide wire when the frame moves from a collapsed state to an expanded state and vice versa.

Devices, assemblies, systems, and techniques described herein may facilitate the delivery of medical fluid, such as an adhesive, to a patient. For example, a medical assembly may include a flexible catheter configured to be disposed within an anatomical structure of a patient, wherein the flexible catheter defines a lumen configured to contain a volume of medical adhesive. The medical assembly may also include a shaft defining a shaft cross-sectional dimension smaller than a lumen cross-sectional dimension of the lumen, wherein advancement of the shaft through at least a portion of the lumen forces at least a portion of the volume of medical adhesive out of the distal opening of the lumen of the flexible catheter.

In some examples, a medical aspiration system includes a vacuum source; a vacuum tube coupled to the vacuum source; a vent tube; and a device configured to convert a constant suction force from the vacuum source into a periodic suction force, the device including a housing configured to receive a portion of the vacuum tube and a portion of the vent tube; a first plunger; a second plunger; and a rotatable cam configured to cause the first plunger to periodically compress the vacuum tube and to cause the second plunger to periodically compress the vent tube.

The present invention provides delivery systems for positioning a gastrointestinal implant in a patient, for example, for treatment of a metabolic disease. Also provided are methods for assembling the delivery systems, methods of positioning a gastrointestinal implant, and methods of treatment of metabolic diseases, such as type 2 diabetes, non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver disease (NAFLD), obesity, and related comorbidities thereof.