A catheter system for creating an arteriovenous (AV) fistula includes a proximal base having a distal end surface. A distal tip is connected to the proximal base and is movable relative to the proximal base. The distal tip has a proximal end surface. The distal end surface and the proximal end surface are adapted to contact opposing sides of a tissue portion to create the fistula. A peripheral edge defines the distal end surface of the proximal base. A stop is formed in the peripheral edge and is configured to limit movement of the distal tip in a proximal direction.

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 providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.

The catheter device comprises a drive shaft connected to a motor, and a rotor mounted on the drive shaft at the distal end section. The rotor has a frame structure which is formed by a screw-like boundary frame and rotor struts extending radially inwards from the boundary frame. The rotor struts are fastened to the drive shaft by their ends opposite the boundary frame. Between the boundary frame and the drive shaft extends an elastic covering. The frame structure is made of an elastic material such that, after forced compression, the rotor unfolds automatically.

Disclosed herein is a catheter advancement device having an elongate shaft and a capsule attached to or integral with the shaft, and related methods for assisting with advancement of catheters such as cardiovascular guiding catheters while reducing damage to the inner wall of the blood vessel. Some capsules have a distal plug portion and a neck portion having a smaller diameter than the plug. Other capsules have a channel defined along the outer surface of the capsule. Some elongate shafts have an attachment tube disposed at or near the proximal end thereof.

A suction catheter system is described with a suction extension interfaced with a guide catheter to form a continuous suction lumen extending through a portion of the guide catheter and through the suction extension. The suction extension can be positioned by tracking the suction nozzle through a vessel while moving a proximal portion of the suction extension within the lumen of the guide catheter. The suction extension can comprise a connecting section with a non-circular cross section for interfacing with the inner lumen of an engagement section of the guide catheter. The tubular body of the guide catheter can have a reduced diameter distal section the can be useful to restrain the movement of the suction extension.

A catheter is provided for both crossing a lesion, such as a chronic total occlusion, in a vessel and performing percutaneous transluminal angioplasty thereupon. The catheter includes a shaft having a tapered tip adapted for being pushed into the lesion to advance through the lesion. An inflatable balloon is mounted on the shaft, which may be braided to provide enhanced pushability and kink-resistance. The inflatable balloon includes a proximal portion and a distal tapered portion connected to the tapered tip, and having a shallow taper. The taper of the distal tapered portion and the tapered tip may together create a continuous sloping transition from a distal end of the distal tapered portion to an adjacent portion of the tapered tip to facilitate crossing a lesion. The balloon may also be selectively inflated or deflated during crossing of the lesion, and ultimately used to compact the lesion when inflated.

Embodiments of a nosecone for a transcatheter delivery apparatus are disclosed. The nosecone can include a distal portion and a proximal portion. A longitudinal axis can extend from a distal end of the distal portion to a proximal end of the proximal portion. The proximal portion can have a shoulder region adjacent the distal portion of the nosecone and a body region proximal to the shoulder region. An outer surface of the nosecone can have a cross-sectional profile taken along the longitudinal axis of the nosecone. The cross-sectional profile of the body region can have a convex shape when viewed from a centroid of the body region.

A medical system includes an insertion device including a delivery shaft with an internal lumen, a coupling tube coupled to the delivery shaft and configured to receive a medical device, and a liner tube inserted through the internal lumen of the delivery shaft.

With smaller gauge catheters, forming distal tip structures, termed “tipping,” can be increasingly challenging. The thin wall-thicknesses of these small gauge catheters provide a reduced cross-sectional surface area with which to couple the distal tip structure to. This increases the risk of failure of the device either during manufacture or during use. To address the foregoing, embodiments include forming and placing a spiral plug within a lumen of a proximal section of the catheter. The spiral plug co-operates with the catheter to provide an increased wall thickness and an increased cross-sectional surface area with which to couple a distal tip structure thereto. Further the spiral plug can align the lumen of the catheter body with a lumen of the distal tip structure. The spiral plug can be sacrificial and provide increased material across the joint, mitigating joint failure.

A medical catheter assembly includes a catheter tip coupled to a distal end of an elongate catheter member and is symmetric about a plane defined by a septum of the elongate catheter member. The catheter tip defines first and second lumens, and the catheter tip defines first and second openings in the distal portion of the catheter tip. Each opening of the catheter tip is defined by a respective side surface of the catheter tip. Each opening is in fluid communication with a respective one of the first and second lumens of the catheter tip and with a respective one of a pair of lumens defined by the elongate catheter member. The distance between upper and lower surfaces of the catheter tip decreases from a distal end of the proximal portion toward a closed distal end of the catheter tip.