The invention provides devices with integrated intravascular imaging and methods for crossing a CTO within the true lumen of a vessel. An interventional catheter with intravascular imaging capabilities can be guided into an affected vessel and to a CTO. An included intravascular imaging device captures a 3D image of the environment. The catheter includes a crossing member that can be extended out from a distal tip of the catheter, causing the crossing member to directly cross through the CTO creating a new channel through the CTO.

Thrombectomy systems and devices and methods of using the same. In an exemplary embodiment of a thrombectomy system of the present disclosure, the thrombectomy system comprises a thrombectomy sheath, comprising a circumferential outer wall reinforced with a reinforcement, configured as an elongated tube having a lumen therethrough; and a sonovisible element positioned at or near a distal end of the circumferential outer wall; wherein the thrombectomy sheath is sized and shaped to be at least partially positioned within a vein proximal to a thrombus or other item within the vein and further configured to expand to contact the vein to secure the thrombectomy sheath within the vein; and wherein the lumen is sized and shaped to receive a device selected from the group consisting of a balloon catheter and a snare having a loop.

Systems and methods can remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.

A catheter for intraluminal lithotripsy including a first lumen, an energy delivery member supported by the catheter body. The energy delivery member includes a passageway, a valve positioned in the passageway and an energy emitter configured to communicate energy to target tissue. A method for performing intraluminal lithotripsy is also disclosed.

A surgical apparatus for treating a blood clot in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the blood clot. An energy emitter emits energy to the blood clot or hardenings and a connector connects the energy emitter to an external energy source, wherein blood flows into the second hole positioned proximal of the blood clot and exits the first hole distal of the blood clot during activation of the energy emitter. In some instances when the apparatus is introduced from a retrograde ‘upstream” approach blood may flow through the device in the opposite direction.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

In some examples, a capture assembly configured to remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system, includes a body configured to receive the material of interest. The body can be configured to axially lengthen and shorten.

An intravascular thrombus retraction device includes: wires that are compressible into a compact cylindrical form within a catheter and are self-expandable into a wire mesh web with at least some parallel wires forming openings in the wire mesh sufficient to allow fluid passage and small enough to filter particles of at least 0.001 mm, a base of the wire mesh web connected to radial ring-shaped structure supporting and maintaining an opening in the base of the wire mesh and forming a thrombus capture volume, and the radial ring-shaped structure being compressible into the catheter and being self-expandable or expandable by struts when free of compressive forces within the catheter to open up into an open, expanded, radial ring-shaped structure which maintains the opening in the opening in the base of the wire mesh.

A catheter that fits within a blood vessel wall includes electrodes aligned along a longitudinal axis of the catheter that produce unfocused shock waves that propagate radially toward the blood vessel wall for treatment.

Mechanical thrombectomy apparatuses including an inverting, rolling conveyor region (“tractor”) at the distal end that are configured to grab and remove thrombus material. In particular, described herein are mechanical thrombectomy apparatuses that are adapted to prevent premature deployment of the tractor, e.g., by including a tractor hold (e.g., a housing, a lock, a clamp, etc.) or the like to secure the outer end of the tractor against and/or relative to the elongate inversion support.