Described herein are atherectomy catheters, systems and methods that include a distal tip region that may be moved laterally so that its long axis is parallel with the long axis of the main catheter body axis. Displacing the distal tip region laterally out of the main catheter body axis exposes an annular blade and opens a passageway for cut tissue to enter a storage region within the catheter. The annular blade may be internally coupled to a drive shaft that rotates the blade, and thus the exposed blade edge may have the same crossing profile (OD) as the rest of the distal end region of the catheter. Also described herein are gear-driven atherectomy devices that may use a cable drive shaft to actuate the annular blade. Both push-to-cut and pull-to-cut variations are described, as are methods for cutting tissue and systems including these atherectomy catheters.

A catheter with a distal end that rotates through the conversion of linear motion to rotational motion, thus the distal end may be rotated without longitudinally advancing or retracting the distal end. The catheter includes a tube with a single helix or a dual chirality helix cut into the tube, a distal end segment, means for linear displacement of the helix, and means for coupling the junction point of the helix to the distal segment.

In various examples, a system includes a steerable medical device including a handle including a longitudinal axis. An elongate shaft extends distally from the handle. The elongate shaft includes a distal tip and a lumen through the elongate shaft. At least four pullwires are disposed within the handle and extending to and anchored proximate the distal tip of the elongate shaft. At least two actuators are associated with the handle. The at least two actuators are operably coupled to the at least four pullwires with actuation of the first actuator causing tension in the first or second pullwire to deflect the distal tip in a first or second tip direction, respectively, and actuation of the second actuator causing tension in the third or fourth pullwire to deflect the distal tip in a third or fourth tip direction, respectively.

Catheter exchange systems and methods may use a cutting tool to sever an encrusted catheter. The cutting tool may include a flexible cannula to encompass and move along the encrusted catheter. A sheath may selectively cover the cutting tool. The cutting tool may selectively transition between a first position in which the cutter is within the sheath and a second position in which the cutting tool is extended beyond the sheath to sever a suture of the catheter. A locking stylet may be used to secure the position of the encrusted catheter and remove the encrusted catheter.

A system of needles having rudders or keels is provided having perforations, such as kerfs, to allow the needles to be bent by the manipulations of wires imbedded within the needle body. The pulling or pushing of the embedded wires, or stylets, causes the needle tip to be bent, while within the body, to allow the needle to be steered past impediments towards the target necessitating treatment. Wires can be pulled or pushed and in some instances both a push and pull wire are provided to give the needle precision steerability. The needles are provided with a keel or rudder, or can be shaped such as with a teardrop cross-section, to give a degree of stabilization to the course the needle, and attendant tubing, takes within the patient. The kerf cut section of the needle, which can be on one side, two sides or all about the circumference of the needle, allows the needle to be bent one way and then, as needed, another way to allow the needle to be steered within the body.

The present disclosure generally relates to medical devices and methods for navigating a catheter shaft into the body of a subject during an intracoronary or other medical procedure and controlling the distal end of the catheter shaft. The present disclosure includes the use of an introducer positioning device that may be used in combination with an introducer. The introducer positioning device when used in combination with an introducer allows a catheter shaft to be inserted therethrough and into the introducer shaft located in the introducer where a distal end of the catheter shaft is aligned with the distal end of the introducer shaft.

A control unit that includes a braking system for fixing the position of an endoscope tip is provided. The control system includes an up-down control knob and a right-left control knob. The brakes are engaged by rotating the control knob itself counter-clockwise from a free wheeling position. After the brakes have been engaged, a sufficient amount of force applied to the control knobs will move the endoscope tip slightly in the corresponding direction, allowing for fine tuning of tip position after braking.

An intervertebral fusion device comprising inferior and superior fusion cage devices that provide an ability to correct spondylolisthesis via in-situ adjustment.

Systems and methods for extending a guidewire from an insertion tool are disclosed. A guidewire assembly includes a slider configured to engage a guidewire carrier. The guidewire carrier defines a lumen configured to receive a guidewire therein. The guidewire carrier is biased to a non-linear, coiled resting state and can elastically transition to a linear extended state. As the guidewire assembly and slider are urged distally, the slider transitions the guidewire carrier from the non-linear state to the linear extended state. A distance travelled by the slider is less than a distance travelled by a tip of the guidewire as the guidewire carrier transitions from the coiled state to the linear state.

Various systems, devices and methods associated with the placement of a dock or anchor for a prosthetic valve. The anchor can take the form of an anchor having multiple coils. The distal end portion of the anchor can be spaced radially outwardly from the next adjacent coil to help direct the anchor around native leaflets of a native valve. Various methods include different procedures for delivering the anchor and prosthetic valve.