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.

An embolic protection system may include a delivery catheter, a core wire slidably disposed within a lumen of the delivery catheter, an expandable support frame, and a filter element coupled to the expandable support frame. The filter element is a material configured to allow blood flow therethrough while blocking a passage of embolic debris. The embolic protection device may be positioned within the ascending aorta with a distal end located between the aortic valve and the coronary arteries.

An over-the-wire retrieval system having at least one expandable filter basket deployable and retrievable over a positioning guidewire that remains in place throughout the thrombectomy procedure. The filter catheter can slidably receive the positioning guidewire allowing the positioning guidewire to navigate a collapsed filter basket past a clot before the filter basket is expanded and pulled through the clot to engage or capture clot material. The filter basket can be re-collapsed and navigated past the clot over the positioning guidewire for multiple passes through the clot. The filter catheter can be paired with a flexible capture sleeve or an aspiration sheath for collection and removal of the clot material gathered by the filter basket on each pass. The flexible capture sleeve includes, in an example, a thrombus conveyor configured to transition between everted and inverted configurations.

Devices, systems and methods for filtering embolic particles that may be generated from a medical procedure including protection of the major branching vessels from the aorta, and catches and filters emboli that may be generated during the TAVR procedure. The filter devices disclosed herein form an improved seal against the vessel wall that is activated by flowing blood. Devices described herein also allow for the closing of the ends of the filter device after capture of emboli, providing further security against accidental loss of emboli post capture.

Methods of using a medical device having catheter with one or more expandable constricting/occluding members for preventing distal embolization during extracranial or intracranial carotid procedures or vertebral artery procedures by augmenting collateral cerebral circulation by coarctation of the aorta to enhance reversal of blood flow in an internal carotid artery, an external carotid artery, and/or a common carotid artery are disclosed. An interventional catheter can also be advanced into a right cerebral artery and a procedure performed on a lesion in the right cerebral artery.

A prosthetic heart valve delivery catheter includes an embolic filter to provide integrated embolic protection to inhibit the release of emboli into the aorta, the aortic arch or branch vessels, and other vasculature during transvascular heart valve replacement procedures. The embolic filter will usually be fixedly or movably attached to a shaft of the delivery catheter proximal of the prosthetic heart valve.

Vascular filters and deflectors and methods for filtering bodily fluids. A blood filtering assembly can capture embolic material dislodged or generated during an endovascular procedure to inhibit or prevent the material from entering the cerebral vasculature. A blood deflecting assembly can deflect embolic material dislodged or generated during an endovascular procedure to inhibit or prevent the material from entering the cerebral vasculature.

A method is provided for infusing a therapeutic. The method includes providing a microvalve device having an inner catheter longitudinally displaceable relative to an outer catheter, and a filter valve coupled to the inner catheter adjacent the distal ends of the inner and outer catheters such that longitudinal displacement of the inner catheter relative to the outer catheter permits the filter valve to be reconfigured from a first configuration to a second configuration. The filter valve is advanced to a target location in via a blood vessel in which the filter valve is configured under tension. Then in an embodiment, the tension is released and the filter valve is placed under compression. Then the therapeutic agent is infused through the inner catheter and out of the orifice of the inner catheter beyond the filter valve.

Methods, devices, and systems establish and facilitate retrograde or reverse flow blood circulation in the region of the carotid artery bifurcation in order to limit or prevent the release of emboli into the cerebral vasculature such as nto the internal carotid artery. The methods are particularly useful for interventional procedures, such as stenting and angioplasty, atherectomy performed through a transcarotid approach or transfemoral into the common carotid artery, either using an open surgical technique or using a percutaneous technique, such as a modified Seldinger technique or a micropuncture technique.

Apparatus and methods are described for capturing emboli during a medical procedure that is performed at a first location within a subjects body. An intravascular device (24) is configured to perform the medical procedure at the first location. An inner sheath (32) facilitates insertion of the intravascular device (24) into the subjects body, by the intravascular device being inserted via a lumen (31) of the inner sheath (32). A filter (34) extending from a distal-most portion (42) of the inner sheath (32) has a non-radially-constrained configuration in which the filter (34) is configured to prevent at least some emboli that are generated by the medical procedure from passing through the filter (34). Other applications are also described.