Sinusitis and other disorders of the ear, nose and throat are diagnosed and/or treated using minimally invasive approaches with flexible or rigid instruments. Various methods and devices are used for remodeling or changing the shape, size or configuration of a sinus ostium or duct or other anatomical structure in the ear, nose or throat; implanting a device, cells or tissues; removing matter from the ear, nose or throat; delivering diagnostic or therapeutic substances or performing other diagnostic or therapeutic procedures. Introducing devices (e.g., guide catheters, tubes, guidewires, elongate probes, other elongate members) may be used to facilitate insertion of working devices (e.g. catheters e.g. balloon catheters, guidewires, tissue cutting or remodeling devices, devices for implanting elements like stents, electrosurgical devices, energy emitting devices, devices for delivering diagnostic or therapeutic agents, substance delivery implants, scopes etc.) into the paranasal sinuses or other structures in the ear, nose or throat. Specific devices (e.g., tubular guides, guidewires, balloon catheters, tubular sheaths) are provided as are methods for manufacturing and using such devices to treat disorders of the ear, nose or throat.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A device suitable for removing material from a living being is provided, featuring at least an aspiration pump, powered by a motor. The aspiration pump and any optional infusate pump preferably feature a helical pumping mechanism, and operate at a high rate of rotation, thereby ensuring adequate pumping performance and flexibility. The helical pumping mechanism may be a helical coiled wire about a central core tube. The helical coil wire, whether together with, or independent of, the core tube, may be rotated to cause a pumping action. Additionally, a narrow crossing profile is maintained, ensuring that the device may reach more tortuous regions of the vasculature. In one embodiment, the system comprises a wire-guided mono-rail catheter with a working head mounted on a flexible portion of the catheter that can laterally displace away from the guide wire to facilitate thrombus removal. The working head may be operated to separate and move away from the guide wire to come within a closer proximity of the obstructive material to more effectively remove it from the vessel.

An endoscopic tissue separator surgical device and method. The device has a multi-lumen shaft having proximal and distal ends, a central lumen for accepting an endoscope, and at least two fluid lumens, with a head coupled to the distal end of the shaft and a handle coupled to the proximal end. The head has an endoscope port and at least two fluid ports whose centers are all disposed along an arcuate line of curvature, while the handle has at least two fluid supply ports. Gas and fluid may be conveyed through the shaft from the handle to the head in the at least two fluid lumens separate from the lumen for accepting an endoscope. At least one lumen of the multi-lumen shaft may house a stainless steel tube with an inside diameter of sufficient size to accept an endoscope.

An endoscopic tissue separator surgical device and method. The device has a multi-lumen shaft having proximal and distal ends, a central lumen for accepting an endoscope, and at least two fluid lumens, with a head coupled to the distal end of the shaft and a handle coupled to the proximal end. The head has an endoscope port and at least two fluid ports whose centers are all disposed along an arcuate line of curvature, while the handle has at least two fluid supply ports. Gas and fluid may be conveyed through the shaft from the handle to the head in the at least two fluid lumens separate from the lumen for accepting an endoscope. At least one lumen of the multi-lumen shaft may house a stainless steel tube with an inside diameter of sufficient size to accept an endoscope.

The invention refers to a catheter (51) for aspiration, fragmentation and removal of removable material from blood vessels. The catheter (51) comprises a flexible tube (52), a flexible helical transport screw (62) inside of the flexible tube (52), a stopper element (82) for providing an abutment for the distal end (64) of the flexible helical transport screw (62). The stopper element (82) is provided spaced from the distal end of the catheter (51), thereby defining a distal region (56) of the catheter (51) extending from the stopper element (82) in direction to the distal end of the catheter (51) which is free of rotational elements inside. A suction opening (74) for aspiration of the removable material into the inside of the flexible tube (52) is provided in the distal region (56) of the catheter (51).

The invention refers to a catheter (51) for aspiration, fragmentation and removal of removable material from blood vessels. The catheter (51) comprises a flexible tube (52), a flexible helical transport screw (62) inside of the flexible tube (52), a stopper element (82) for providing an abutment for the distal end (64) of the flexible helical transport screw (62). The stopper element (82) is provided spaced from the distal end of the catheter (51), thereby defining a distal region (56) of the catheter (51) extending from the stopper element (82) in direction to the distal end of the catheter (51) which is free of rotational elements inside. A suction opening (74) for aspiration of the removable material into the inside of the flexible tube (52) is provided in the distal region (56) of the catheter (51).

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

An endoscope for removing tissue at a surgical site includes an elongated tubular body insertable within a mammalian cavity of a patient. An instrument channel extends between a first opening at a distal end and a second opening at a proximal end of the tubular body and is sized and configured to receive a surgical cutting assembly that includes an aspiration channel configured to remove material entering the endoscope via a distal end of the surgical cutting assembly. A torque generation component configured to generate torque is positioned within the distal end and configured to provide the generated torque to a coupling component. The coupling component is positioned at the distal end of the elongated tubular member and configured to actuate a cutting component of the surgical cutting assembly responsive to actuation of the torque generation component.

A surgical device includes an outer member, an inner member, and at least one locking element. The inner member is at least partially supported within the outer member. The at least one locking element is configured in a first arrangement of the surgical device to lock the inner member in a first position and configured in a second arrangement of the surgical device to unlock the inner member from the first position. The at least one locking element is configured to change from the first arrangement to the second arrangement upon coupling the inner member in an operational arrangement to a hand piece.