Disclosed are access systems, devices, and methods for internal access to a patient's body. For example, an access device for placing an acute dialysis catheter can include a frame; a housing, a pair of guidewire clamps, and a needle disposed on the frame; a dilator coupled to the frame, and an access guidewire in a ready-to-deploy state of the access device. The pair of guidewire clamps can be disposed on the frame between an end portion of the frame and a distal end of the housing for clamping the access guidewire. A needle hub of the needle can be disposed on the frame between the pair of guidewire clamps. The dilator can distally extend from the end portion of frame. A needle shaft of the needle can distally extend beyond a distal end of the dilator allowing the needle to establish an insertion site for the acute dialysis catheter.

A method and device handle having a slide assembly for controlling rotational speed of a catheter assembly under various rotational loads. The method includes setting a first current limit in a processor, activating the catheter assembly to rotate, calculating a current value in rotational period of a first current limit, updating a second current limit from the first current limit, and wherein the second current limit is lower than the first current limit.

An instrument advancement device may include a housing and an extension tube extending through the housing. A wedge may be disposed within the housing. The wedge may include an arc-shaped channel. A pair of opposing pinch members configured to pinch the extension tube may be disposed within the housing and configured to move along the extension tube. An instrument may extend through the arc-shaped channel. A first end of the instrument may be fixed. In response to moving the housing distally along the extension tube, the pair of opposing pinch members may push the wedge distally. In response to movement of the wedge distally a first distance, a second end of the instrument may be configured to advance distally a second distance. A support element or compressible element may be disposed within a lumen of the extension tube to support the instrument.

An endoscopic system includes an elongate shaft, a pull wire that runs a length of the elongate shaft, a handle coupled to a proximal portion of the elongate shaft, the handle housing a proximal portion of the pull wire, the handle being couplable to a robotic driver configured to tension the pull wire to cause articulation of the elongate shaft, and one or more conductors that run the length of the elongate shaft, the one or more conductors being electrically coupled to the pull wire at a distal portion of the elongate shaft and configured to form part of a closed electrical circuit with the pull wire.

Various exemplary drive apparatuses and associated methods are disclosed for driving an elongated member, e.g., a catheter, sheath, or guidewire. An exemplary drive apparatus may include a first component and a moveable component, each configured to selectively grip the elongated member. In some examples, the first and moveable components may each include a gripping device. The moveable component may be configured to selectively move axially and rotationally with respect to a support surface to effect axial movement and rotation movement, respectively, of the elongated member with respect to the support surface within a range of motion of the moveable component. The moveable component may be configured to move the elongated member across a predetermined movement having a magnitude greater than the range of motion.

A catheter insertion device is provided for positioning and inserting a catheter, particularly a midline catheter into a patient. The insertion device includes an actuator assembly movable with respect to a housing for deploying the catheter over a needle. A step-wise movement of the actuator advances a catheter assembly, including the catheter, in stages over the introducer needle. An indexing finger of the catheter assembly engages the actuator body during distal advancement of the actuator, and deflects as the actuator is moved proximally. The device further includes a lockout device such as a button, collar, slider, or tab, which allows movement of the catheter relative to the needle but prevents advancement of the catheter to the first stage of the step-wise movement.

A method for performing an intravascular procedure includes inserting a guide catheter into a blood vessel, and passing a device guide through the guide catheter so that a distal portion of the device guide, having a semi-tubular shape, protrudes from a distal end of the guide catheter into the blood vessel. An intravascular device is inserted through the guide catheter via the distal portion of the device guide to a target site in the blood vessel.

A drive assembly for a catheter procedure includes a body configured to receive a percutaneous device where the body has a first end and a second end. A distal pinch is configured to releasably engage the percutaneous device. A proximal pinch is positioned on the first end of the body and is configured to releasably engage the percutaneous device. A linear drive mechanism is coupled to the body and configured to move the body to cause linear movement of the percutaneous device in a first direction while the proximal pinch is disengaged from the percutaneous device and the distal pinch is engaged with the percutaneous device.

A vascular device insertion system includes a support catheter having a hub, a flexible elongate member that extends distally from the hub, and a catheter lumen that extends through the hub and the flexible elongate member. An insertion module housing is configured to contain a motor having a hollow motor shaft. The hollow motor shaft has a proximal end, a distal end, a distal end portion, and an elongate opening that extends from the proximal end to the distal end. The distal end portion of the hollow motor shaft is configured to couple to the hub of the support catheter. The elongate opening of the hollow motor shaft and the catheter lumen of the support catheter together define a continuous passage. A motor controller is electrically coupled to the motor, and is configured to rotationally oscillate the hollow motor shaft to in turn rotationally oscillate the support catheter.

A deep vein intravenous introducer has a wheel located toward the front end of the device that can be rotated by the index finger of the user. After placement of the needle in the lumen of the vessel, the user rotates the wheel, which turns a drive wheel. The drive wheel has an outer surface that advances the guide wire through the center of the needle and into the patient. Once the guide wire is advanced into the vessel lumen the catheter can be advanced over the guide wire with a hub or finger tab on the catheter close to the index finger. The operation can be performed by one hand without moving the hand from its initial position.