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.

An attachment configuration for a vascular filter assembly including a self-expanding filter member attached to a catheter body and constrained from expansion in a first configuration by a constraining sheath is presented. The attachment configuration includes an outer tube of material that is overlaid over an end of the filter member and bonded to the catheter body through cutouts disposed through the end of the filter member.

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 for implanting a replacement heart valve within a diseased valve includes accessing a patient's heart by piercing a myocardium, advancing a guidewire into the patient's heart, and installing an access device in a wall of the heart. The access device preferably has at least one valve mechanism. A valve delivery device is advanced over the guidewire and through the access device. The valve delivery device has a replacement heart valve disposed along a distal end portion thereof. The replacement heart valve preferably includes an outer support structure and a leaflet valve disposed within the outer support structure. The replacement heart valve is radially expanded within the diseased valve. During implantation, the outer support structure conforms to a diameter of the diseased valve and the leaflet valve expands to a fixed size having a diameter smaller than the diameter of the diseased 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 into 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.

Systems and methods are adapted for treating the carotid artery. The systems include interventional catheters and blood vessel access devices that are adapted for transcervical insertion into the carotid artery. Embodiments of the systems and methods can be used in combination with embolic protection systems including blood flow reversal mechanisms, arterial filters, and arterial occlusion devices.

A medical device for treating a vascular narrowing within a blood vessel including a catheter having a proximal end hole, a distal end hole positioned opposite the proximal end hole, a circumferential balloon located proximally of the distal end hole and an operational lumen extending through the catheter from the proximal end hole to the distal end hole. A first bend curves in a first direction and a second bend curves in a second generally opposite direction, the second bend being positioned distally of the first bend and proximally of the circumferential balloon, wherein the first bend and the second bend are configured to brace the catheter within the blood vessel against an arch defined by the blood vessel to inhibit recoil of the catheter. A supplemental medical device is configured for insertion into the blood vessel through the operational lumen of the catheter.

A method includes providing microvalve device having inner and outer catheters, and a filter valve attached to the distal end of the inner and outer catheters. Longitudinal displacement of the inner catheter relative to the outer catheter moves the filter valve from a non-deployed configuration to a deployed configuration. With the inner catheter longitudinally advanced a first amount relative to the outer catheter, the filter valve is in a reduced first diameter for advancement of a guidewire to a target location. Once the filter valve reaches the target location, the inner catheter is moved relative to the outer catheter such that the filter valve assumes a larger second diameter. A therapeutic agent is infused through the inner catheter and beyond the filter valve.

Various devices are described to provide filtering of flow from the aorta to the left carotid artery and the right carotid artery. The filters can be brought into a desired position through one or more peripheral arteries. A single filter device can provide the desired filtering or a plurality of devices can be used. In particular a single filter device can span between the brachiocephalic artery and the left carotid artery. These filter devices can be used effectively to capture emboli generated during procedures on the heart so that emboli do not travel to the patient's brain where the emboli can cause a stroke or other adverse event. In particular, these filters can be used during percutaneous procedures on the heart, such as endovascular heart valve replacement.

A filtering sheath includes an elongated tubular member defined by a circumferential wall and having a distal end, a proximal end, and a lumen extending therebetween. The distal end has a plurality of slits extending through the circumferential wall, the plurality of slits defining an expandable filter region. The plurality of slits are arranged in a pattern that allows the expandable filter region to move between a first, contracted configuration, and a second, expanded configuration.