The various embodiments herein relate 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 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.

The present invention relates to a method for positioning a tip of a pacemaker lead that has passed through coronary sinus into an interventricular septum. More particularly, it relates to a method for positioning a tip of a pacemaker lead that has passed through a coronary sinus into an interventricular septum in order to more effectively transmit an electrical stimulus in a treatment using a pacemaker for patients with arrhythmia. A method of positioning a tip of a pacemaker lead, which has passed through a coronary sinus, into an interventricular septum, in order to effectively transmit electrical stimulus, includes: inserting into an intervention wire through a superior vena cava and a coronary sinus to pass through the interventricular septum and then guiding the intervention wire to an inferior vena cava; and positioning the tip of the lead into the interventricular septum by inserting the pacemaker lead along the intervention wire.

A distal protection device for use in a body lumen includes a functional element, which may be a filter or an occlusive element. The device includes a first elongate member, a second elongate member carried by the first elongate member, and the functional element carried by the second elongate member. Motion of the first elongate member can be independent of the motion of the functional element.

A steerable endoluminal device adapted for delivery into a patient's vasculature. The device includes a tubular member having a distal deflection portion that extends to the distal end and a main body portion that extends from the deflectable portion to the proximal end, the tubular member further including a stiff portion extending along the distal deflection portion, and being formed of polymeric material, which is disposed circumferentially adjacent to the stiff portion. The stiff portion is made of a material that has an elastic modulus greater than the elastic modulus of the polymeric material. A pull wire extends between the proximal end and the distal end of the tubular member and is attached to the distal deflection portion to control deflection of the distal deflection portion of the tubular member.

A vascular access device to passively open a fluid path within a vasculature. The vascular access device may include a catheter and an obturator slidably positioned within the lumen of the catheter. The catheter may have a proximal end, a distal tip comprising an opening having an inner diameter, a sidewall defining a lumen between the proximal end and distal tip. The obturator may have a distal end with an outer diameter configured to form an interference fit with the inner diameter of the distal tip. The obturator may be positioned within the lumen to open various fluid pathways. The obturator may be repositioned to move the catheter tip.

A neurovascular catheter extension segment is provided, such as for distal neurovascular access or aspiration. The neurovascular catheter extension segment includes 1) an elongate flexible control wire having a proximal end and a distal end and 2) a tubular extension segment having a side wall defining a central lumen carried by the distal end of the control wire. The side wall of the tubular extension segment includes a tubular inner liner, a tie layer separated from the lumen by the inner liner, a helical coil surrounding the tie layer, and an outer jacket surrounding the helical coil. The extension segment may be introduced into the proximal end of a neurovascular catheter and advanced distally to extend beyond the catheter and thereby extend the reach of the catheter.

Devices and methods for providing an internal balloon sheath are disclosed. One device includes a sheath for insertion through an arteriotomy of a patient. The sheath comprises a tubular sheath body having a longitudinal axis, an open proximal end, an open distal end, an outer surface and an inner surface, the inner surface defining a lumen between the proximal and distal ends for passage of a catheter device. The sheath also comprises an inflatable balloon disposed within the lumen. The inflatable balloon is configured to occupy a longitudinal space in the lumen between the inner surface of the sheath body and the catheter device when the catheter device is disposed within the sheath and the balloon is inflated, and fluidically seal the lumen.

One embodiment provides a balloon catheter which has an inner tube having a main lumen and an outer tube which forms an expansion lumen. A part of the inner tube is connected to the outer tube at a position closer to the proximal end than a balloon, a side hole is open at the connection section, and a weak section is provided to the inner tube a position closer to the distal end than the side hole. The weak section has lower rigidity than the remaining portion of the inner tube. When the balloon is expanded by fluid supplied to the expansion lumen, the weak section is pressed by the fluid pressure to thereby close the main lumen of the inner tube.

Embodiments of the invention are directed towards a rapid exchange catheter configured for insertion into a subintimal space and crossing an occlusion in a subintimal space. The catheter includes a proximal end, a distal end, a first lumen configured to receive a first wire, the first lumen extending longitudinally through a least a lateral port of the catheter, and a second lumen having at least a portion distal of the lateral port and extending through at least the distal end of the catheter. The catheter also includes an exchange port arranged on a exterior portion of the catheter configured to the receive a second wire and second rapid exchange port in communication with the second lumen. Moreover, other embodiments of the invention are directed towards methods for using the rapid exchange catheter to cross an obstruction in a vessel, e.g., a total or partial occlusion, in a subintimal space.

The apparatus includes a catheter having a combined infusion/aspiration lumen, a three lumen proximal portion and a two lumen distal portion. An infusion/aspiration valve located at the distal end of the catheter facilitates performing infusion and aspiration through the same lumen, which in turn reduces the number of lumens, and enables the combined infusion/aspiration lumen to be made larger without the need to increase the diameter of the catheter. Differing material properties in the proximal and distal portions of the catheter enable the proximal portion to be made stiffer for pushability, while the distal portion is more flexible to navigate tortuous vasculature and enable a greater amplitude agitator to be received within the catheter.