An atherectomy catheter device includes an elongate body, a drive shaft extending proximally to distally within the elongate body, and a cutter attached to the drive shaft. The cutter includes a serrated annular cutting edge formed on a distal edge of the cutter and a recessed bowl extending radially inwards from the annular cutting edge to a center of the cutter. The recessed bowl has a first curvature. The cutter further includes a plurality of grinding segments extending inwardly from the distal edge within the bowl. Each of the plurality of segments has a second curvature that is different from the first curvature.

Devices and methods are provided for percutaneously treating atherosclerotic plaques within blood vessels. Atherosclerotic plaques cause significant morbidity and mortality by narrowing the arteries, which adversely affects blood flow, and by acting as a source for thrombi and emboli thus causing acute organ ischemia. Current treatments include open surgery with its inherent drawbacks, and stenting, which is less invasive but leaves the plaque material in the artery, which promotes restenosis. The present invention combines the advantages of both approaches. In general, the invention provides tools that enable percutaneously dissecting the plaque from the arterial wall and removing it from the body.

A subintimal entry catheter can be used for crossing an occlusion in a blood vessel of a patient. The catheter can include a distal end portion and a lumen extending longitudinally within the catheter and radially to an opening in a first radial side at the distal end portion of the catheter. The catheter can be used to cross at least a portion of an occlusion through a subintimal space. A wire can be provided through the lumen and to the opening to reenter the true lumen of the blood vessel.

A method for treating tissue of at least one of an internal carotid artery, an ophthalmic artery, or an ostium between the internal carotid artery and the ophthalmic artery of a subject may include expanding a first expandable device of a first device in the internal carotid artery. The method also may include delivering a second device in the ophthalmic artery via the first device and expanding a second expandable device of the second device in the ophthalmic artery. Further, the method may include adjusting a radial position of the second expandable device relative to the first expandable device.

A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

An arterial closure device includes an elongated catheter having a proximal end, an opposing flexible distal end, and a lumen extending between the proximal end and the distal end. An externalization needle and an internal catheter are disposed within the lumen. The externalization needle is in communication with a first plunger. A first threading needle and a second threading needle are positioned in separate threading channels and in communication with a second plunger. A suture has a first end attached to the second end of the first threading needle and a second end attached to the second end of the second threading needle. A primary aperture extends through a wall of the elongated catheter. A first threading aperture and a second threading aperture extend through the wall of the elongated catheter at opposing sides of the primary aperture.

A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

A gastrectomy device includes an elongated member defining a centerline that extends through proximal and distal ends thereof. A shape modification member coupled to the elongated member is movable relative to the centerline of the elongated member. The shape modification member is movable between a first state, adjacent to the elongated member, and a second state, spaced from the elongated member. The shape modification member conforms to a portion of a patient's stomach in the second state.

A rotational atherectomy device for abrading a stenotic lesion from a vessel of a patient comprises a flexible drive shaft which extends towards a distal end of the device, a distal fluid inflatable support element located at a distal end of the drive shaft and an abrasive element mounted to the drive shaft proximal to and spaced away from the distal fluid inflatable support element. Both the abrasive element and the distal fluid inflatable support element are rotatable together with the drive shaft and the drive shaft comprises a torque transmitting coil which defines a long lumen of the drive shaft.