An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular element such as a wire. The element has a proximal section, a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections . The apparatus comprises an ultrasonic transducer, mechanically coupled to the proximal section of the element for ultrasonically activating the element, hence exciting the distal tip section to facilitate crossing through the obstruction. A catheter surrounds the element, leaving at least part of the distal tip section of the element protruding distally beyond a distal end of the catheter.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

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 medical device for removing an object in a body lumen includes a catheter and a drive device. The drive device includes a hub support portion with which a hub portion of the catheter is interlocked. The hub portion has first and second engagement portions interlocked with the hub support portion. The hub support portion includes a rotation blocking portion that is engaged with the first engagement portion to block the hub portion from rotating with respect to the hub support portion, a movement blocking portion that is engaged with the second engagement portion to block movement of the hub portion with respect to the hub support portion in an axial direction, and a releasing portion that releases a state in which a rotation of the hub portion is blocked while maintaining a state in which movement of the hub portion is blocked.

An elongate endovascular element for crossing through an obstruction in a blood vessel comprises: a proximal section; a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections; wherein the tapered intermediate section has a length that is substantially λ/2 or a multiple of λ/2, where λ is a wavelength of a driving frequency that will produce longitudinal resonance in the element.

A medical device that removes an object in a body lumen, includes a rotatable drive shaft, an outer tube that accommodates the drive shaft and is rotatable independent of the drive shaft, a cutter attached to a distal portion of the drive shaft for cutting the object, a first housing that accommodates a proximal portion of the drive shaft and has an outer surface including a first groove that extends around a rotation axis of the drive shaft, a second housing interlocked with a proximal portion of the outer tube and rotatable around the first housing, the second housing having an inner surface that faces the outer surface and includes a second groove that extends along the rotation axis, and a moving member that fits into the first and second grooves and is movable along the first and second grooves according to rotation of the second housing.

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 medical device has a rotatable drive shaft, a rotary body whose distal end includes a cutting edge for applying a cutting force to a stenosed site, and that is disposed on a distal side of the drive shaft so as to be rotated in conjunction with rotation of the drive shaft, and a distal member disposed in the rotary body. The distal member has a support portion extending to a distal side beyond a distal end of the rotary body, and configured to be capable of supporting the rotary body with respect to a blood vessel. The support portion is configured so that a distance from the rotary body is variable in a first direction (height direction) in which the rotary body is moved close to the stenosed site.

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.