A thrombectomy catheter includes a catheter body having a catheter lumen. An outflow orifice is positioned along a catheter perimeter. A fluid jet emanator communicates with a high pressure tube. The fluid jet emanator includes at least one jet orifice for directing a fluid jet from the fluid jet emanator through the catheter lumen toward the outflow orifice. The fluid jet emanator provides a jet stream from the catheter body through the outflow orifice. The jet stream includes first and second stream portions. An entrainment fluid flow circuit includes at least the first stream portion, and the entrainment fluid flow circuit entrains particulate and macerates the particulate therein. An exhaust fluid flow path includes the second stream portion, and the exhaust fluid flow path draws entrained particulate from the entrainment fluid flow circuit at a location exterior to the catheter body and directs it toward the catheter proximal portion.

A method for treating a patient having thrombus includes providing a manipulation device including a housing configured to be supported by the hand of a user and having a distal and proximal end, a drive system disposed within the housing, and configured to rotate a rotation member, an engagement member coupled to the rotation member and configured to be removably coupled to an elongate medical device, an activation member carried by the housing such that it can be operated by at least a portion of the hand of the user when the housing is supported by the hand of the user, the drive system configured to apply motive force to the engagement member, securing an elongate member to the engagement member, introducing at least the distal end of the elongate member into a blood vessel adjacent a thrombus, operating the activation member to cause at least some rotation of the rotation member, which in turn causes at least some rotation of the distal end of the elongate member at or near the thrombus, and aspirating at least some of the thrombus with an aspiration catheter.

The invention provides a filter assembly including a string or wire such that a lasso type cincture is effected, said filter being openable and closeable while in deployed within a bodily vessel. A string lengthen or shorting adjustment mechanism, such as a ratchet or reel allows more length of string into the device or alternatively to shorten the length of available string in the system. The described invention, when used to ameliorate venous clots and most arterio-venous dialysis grafts, a filter-tipped aspirator is used downstream from the clot to capture and remove dislocated emboli. A method of using same is disclosed.

Methods for removing blockages and preventing thromboembolic injuries, by advancing to a blockage a first tubular, endovascular device receiving irrigating fluid through a proximal opening, having a circumferential wall, lumen, at least one distal side hole oriented angularly to a distal opening; ejecting fluid from the side hole(s) to irrigate a blockage; introducing a second catheter for aspiration, comprising a circumferential wall having a proximal and distal opening, a flared, semi-permeable filter at the distal end for removal of emboli through the second lumen; advancing the second device to a blood vessel receiving blood from the blocked vessel, aspirating the blockage, axially rotating the first endovascular device having at least one half-loop to macerate an obstruction, capturing and removing emboli from the blockage through the second endovascular device which prevents emboli from causing further blockage of blood vessels. Variants of said method including a third rotatable device.

A thrombectomy catheter deployment for operation of a thrombectomy catheter may include a stand alone drive unit and a disposable pump/catheter assembly which is manually placed into a carriage assembly in the drive unit. The pump/catheter assembly may have a plurality of preconnected components including a tubular structure and a thrombectomy catheter connected thereto. A barcode reader may sense specific operational data pertaining to an individual pump and may provide an interface for operation of the reciprocating linear actuator.

A thrombectomy system incorporates analytical instrumentation to determine the aspirate characteristic (the fluid contents of the thrombectomy catheter) and subsequently selects a thrombectomy operating mode appropriate to the current aspirate characteristic. Aspirate characteristics include: (1) blood, which is slowly aspirated, (2) thrombus which is rapidly aspirated to waste, (3) clot, which is systematically aspirated and (4) clog, which is systematically cleared. A differential viscometer is disclosed for a broad array of applications including thrombectomy, as well as industrial, automotive, environmental and scientific. A variable aperture catheter is disclosed which permits selective aspiration and infusion in either the axial or radial directions.

A device and method for establishing retrograde blood flow during recanalization of a vessel having a targeted blockage. While in a collapsed state an occluding component is introduced distally intravascularly traversing the targeted blockage to its distal side. Then, the occluding component transitions to an expanded state having an enlarged diameter forming a seal with an internal wall of the vessel prohibiting anterograde blood flow beyond the expanded occluding component. Retrograde blood flow is thereby established in a region of the vessel bound at one end by the occluding component and at an opposite end by the targeted blockage by dispensing a flushing fluid into the region of the vessel.

A system for aspirating thrombus and delivering an agent includes an aspiration catheter having a supply lumen having a proximal end, a distal end, and a wall, and an aspiration lumen having a proximal end, an open distal end, and an interior wall surface adjacent the open distal end, and at least one orifice at or adjacent the distal end of the supply lumen, in fluid communication with the aspiration lumen and located proximally of the open distal end of the aspiration lumen, wherein the at least one orifice is configured to create a spray pattern that is caused to impinge on the interior wall surface of the aspiration lumen such that the spray pattern upon impinging on the interior wall surface is caused to transform into at least a substantially distally-oriented flow capable of exiting the open distal end of the aspiration lumen.

Method and surgical instrument for treating prostate tissue including a surgical instrument having a main body, a needle deployment port, a needle, first and second handles and a lockout release mechanism to limit needle extension. Additionally, a kit includes the surgical instrument, together with a cystoscope, and optionally a syringe and reservoir of ethanol. The method includes needle-less injection and visualizing the ethanol injection by delivering both an echogenic agent and ethanol either by needle or needle-less injection or by providing an ultrasonically visible marker near the tip of the ethanol delivery cannula. The method also includes extending the needle transversely of the instrument housing using a link assembly.

A catheter mounted arterial surgical tool has a body with a fluid jet prong extending from a distal end of the body along a prong axis that is parallel to and laterally offset from a body axis. A fluid passage extends through the fluid jet prong to an outlet that points laterally relative to the prong axis. A deflector anvil extends from the distal end of the body along a deflector axis that is parallel to and offset from the body axis. The deflector anvil has a face that faces toward the fluid jet prong and is impinged by a fluid jet discharged from the outlet. A pair of guide wire holes extend from the proximal to the distal end of the body parallel to the body axis for receiving guide wires to enable the body to slide along the guide wires.