Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

A catheter includes a tubular body comprised of inner and outer layers, and an embedded reinforcement body. The tubular body includes a substantially linear main body portion and a shaped portion that is bent so the shaped portion lies in substantially the same plane. The shaped portion includes a first bent portion defining a first angle distal of the main body portion, a second bent portion defining a second angle distal of the first bent portion and bent to the same side as the first bent portion, a third bent portion defining a third angle distal of the second bent portion and bent to a side opposite the second bent portion, and a most distal portion distal of the third bent portion. A physical property changing point exists between a proximal portion of the first bent portion and a distal portion of the second bent portion.

An MR compatible steerable sheath with elastomeric member is provided. The elastomeric member is configured to serve as a reservoir and receive contrast media therewithin. The elastomeric member is positioned on the distal end of the steerable sheath and may circumferentially surround the sheath shaft or be offset from a longitudinal axis thereof. In operation, the contrast media allows a user to view the distal tip of the steerable sheath by virtue of the contrast media contained within the elastomeric member.

An introducer assembly (10) includes a catheter (12) having a proximal end (14), a distal end (16) extending to a distal tip of the introducer assembly, and an outer catheter wall. The catheter (12) includes a medical device holding portion (34) proximate the distal end, a guide wire lumen (100) extending between the proximal and distal ends, and a side opening (50) extending through the outer wall to the guide wire lumen. The side opening (50) and the guide wire lumen (100) are simultaneously open and the guide wire lumen and side opening are able to receive a guide wire therethrough. The catheter (12) is flexible at least in the location of the side opening, such that a guide wire (28) fed from the distal end (16) can pass through to the proximal end (14) when the catheter is substantially straight and can pass from the distal end through the side opening (50) when the catheter is curved at the location of the side opening. The catheter (12) also includes a plurality of one stiffening mandrel lumens (104, 106) extending from the proximal end (14) and a plurality of stiffening mandrels sized to fit within the stiffening mandrel lumens and in some forms able to slide therewithin and in other forms enclosed within the stiffening mandrel lumens. The mandrels have different lengths disposed along the length of the catheter and can be of substantially uniform diameter.

Systems, devices, and methods for transvascular ablation of target tissue. The devices and methods may, in some examples, be used for splanchnic nerve ablation to increase splanchnic venous blood capacitance to treat at least one of heart failure and hypertension. For example, the devices disclosed herein may be advanced endovascularly to a target vessel in the region of a thoracic splanchnic nerve (TSN), such as a greater splanchnic nerve (GSN) or a TSN nerve root. Also disclosed are methods of treating heart failure, such as HFpEF, by endovascularly ablating a thoracic splanchnic nerve to increase venous capacitance and reduce pulmonary blood pressure.

A catheter apparatus comprises an elongated catheter body having a distal end, a proximal end, and at least one fluid lumen extending longitudinally therein; and a plurality of flexible electrode segments on a distal portion of the catheter body adjacent the distal end, each pair of neighboring flexible electrode segments being spaced from each other longitudinally by a corresponding electrically nonconductive segment. Each flexible electrode segment comprises a sidewall provided with one or more elongated stiffness reductions extending through the sidewall, the one or more elongated stiffness reductions providing flexibility in the sidewall for bending movement relative to a longitudinal axis of the catheter body. The electrically nonconductive segment is substantially smaller in length than each of the corresponding pair of neighboring flexible electrode segments.

An expandable introducer sheath for use in inserting a medical device into a body vessel of a patient includes a body which extends from a proximal end to a distal end along an axis. The body includes an inner layer, an outer layer, and an expandable reinforcement member which is disposed between said inner and outer layers. The expandable reinforcement member is configured to radially expand as the medical device is axially advanced or retracted through said introducer sheath. Once the medical device has exited the introducer sheath, the expandable reinforcement member facilitates a return of the introducer sheath to its original or unexpanded condition.

A catheter assembly including a tapered steering spine having a varying stiffness along an axial length. The tapered steering spine is tailored to provide increasing flexibility from proximal to distal in a way that makes the bend radius more uniform along the length of the steering section. In one embodiment, the tapered steering spine includes structures on adjacent rings that engage with each other when the steering section is flexed to limit the minimum bend radius to a predetermined minimum and which enhances the torsional rigidity of the steering section regardless of the degree of flexure of the steering section. The limited bend radius can prevent excessive bending of components such as fiber optics. The enhanced torsional rigidity can negate the need for torque braid in the section of the catheter shaft that surrounds the tapered steering spine.

The described invention provides an endovascular device comprising a tube comprising a first end comprising a bifurcation and a second end comprising an opening. The bifurcation at the first end comprises a first branch and a second branch. The opening at the second end comprises a primary opening and a secondary opening. The first branch and the primary opening form a working lumen. The second branch and the secondary opening form a support lumen. The described invention further provides an endovascular device comprising a tube comprising a side-hole, a first segment comprising a primary opening and a second segment. The side-hole and the first segment form a working lumen. The second segment forms a support lumen.

Balloon catheter includes an outer shaft having a hypotube and a monolithic single-layer distal outer member, a balloon in fluid communication with an inflation lumen, and a monolithic inner tubular member having a guidewire lumen defined therethrough. The outer shaft has the inflation lumen defined therethrough. The monolithic single-layer distal outer member is necked to a reduced diameter along an entire length thereof. A proximal end of the monolithic single-layer distal outer member is coupled to the hypotube. A distal section of the hypotube comprises a skive defined by a first angled cut, an axial cut, and a second angled cut. The balloon has a proximal balloon shaft coupled to a distal end of the monolithic single-layer distal outer member. The monolithic inner tubular member extends distally from a proximal port in the monolithic single-layer distal outer member through the balloon to form a tip.