Intravascular catheters with fluoroscopically visible indicium of rotational orientation are described. The catheter includes an elongate flexible tubular body, having a proximal end, a distal end and a tubular side wall defining at least one lumen extending there through. At least first and second opposing pairs of radiopaque rings are embedded in the side wall, spaced axially apart from each other. A first transverse axis extending through the first pair of rings is rotationally offset from a second transverse axis extending through the second pair of rings. The rings may be supported by a subassembly integrated into the wall of the catheter. The subassembly may include a tubular body having a plurality of aperture portions connected by intervening hinge portions. In one implementation, the catheter is a reentry catheter.

A system and method for treating a blood vessel that is at least partially obstructed by an occlusion which divides the lumen into a proximal lumen segment and a distal lumen segment. The system includes an orienting catheter having an orientation element positionable in an intrawall space of the vessel and an occlusion catheter having an occlusion balloon inflatable in the proximal lumen segment so as to isolate a target volume including the intrawall space. The pressure inside the target volume is reduced to a pressure below the pressure of the distal lumen segment so that the intima presses against the orienting element of the orienting catheter. A distal end of a reentry device may be advanced from the orienting catheter through the intima and into the distal lumen segment.

Methods for treating a patient using intravascular devices, systems, and methods are disclosed herein. One aspect of the present technology is directed to an intravascular device having an elongated member coupled to and extending between a handle and an angled distal portion. The distal portion is moveable between a first configuration having a first shape configured for intravascular delivery and a second configuration having a second shape, different than the first shape, that is configured for intravascular delivery.

A re-entry device (1) for recanalization procedures of an arterial vessel by an intraluminal or subintimal technique includes a catheter (10) having a distal end (12) with a curved tip (13) by an angle () of between 30 and 90, and an angled-tip stylet (2) insertable into the inner lumen of the catheter (10) to exit from a distal opening (14) thereof. The angled-tip stylet (2) is metal and has a distal end (22) with a curved tip (23) ending in a sharped apex (24). The distal end (22) of the an angled-tip stylet (2) is tapered and has a length of 3-5 cm, and the curved tip (23) is bent by an angle () of between 30 and 50. The structure makes the apex (24) adjustable outside the two-dimensional plane defined by the curved tip (13) of the catheter (10) to facilitate penetration of the arterial wall.

A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. A method of crossing a chronic total occlusion includes the steps of advancing the reentry catheter across the occlusion via a channel formed in the subintimal space, and advancing a guidewire via a selected exit port into the native lumen distally of the occlusion. The catheter may be removed, leaving the guidewire across the occlusion to guide further interventional devices.

A medical device comprising an elongated tubular member having a proximal portion, a distal portion, an outer surface and a lumen and the distal portion of the elongated tubular member comprising an expandable occlusion tip, the expandable occlusion tip having a central lumen and comprising a plurality of lobes, the expandable occlusion tip having an unexpanded state and an expanded state, in the unexpanded state the lobes extend distally from the elongated tubular member, in the expanded state, the lobes radially expand and are adapted to restrict flow in a patient's vessel.

A catheter device for lumen re-entry is provided. The catheter device includes a catheter shaft having a lumen extending from a proximal end to a distal end and an expandable member positioned at the distal end of the catheter shaft. The catheter shaft having interior walls defining a central lumen extending from a proximal end to a distal end along a longitudinal axis of the lumen. The expandable member configured to receive a fluid that selectively expands the expandable member from a first volume to a second volume, the second volume being larger than the first volume to provide a deflection surface that is oriented at an angle with respect to the longitudinal axis of the lumen. The deflection member provides a surface to angle a guidewire out of the distal opening at the tip of the catheter shaft (i.e., not a separate side-facing hole].

A catheter, such as for use for total occlusion crossing and lumen reentry, incorporate a retractable long flexible nitinol curved needle at the catheter distal end. The needle is straight when withdrawn inside the catheter. When pushed forward, the needle is deployed by protruding axially out, directly from the distal tip, through a mechanism used to direct the curved needle into a specific radial direction. When pushed forward, the needle restores its curved shape and can penetrate the plaque or the media and intimal layers to reenter the true lumen.

A method for thermal bonding of an inverted balloon neck on a catheter, including placing an inverted balloon neck (84) on a shaft (86) of a catheter, and characterized by applying heat at an internal hollow (85) of the shaft (86) where the inverted balloon neck (84) is placed, while applying internal pressure to attach an external surface of the shaft (86) to the inverted balloon neck (84).

Devices and methods for draining excess lymph fluid are disclosed. The device can be fixed to the blood vessel adjacent to the thoracic duct. The device can have a port for withdrawing lymph fluid exiting the thoracic duct. The device can have a cannula and/or subcutaneous port to draw the lymph fluid away from the thoracic duct and reduce hemostatic pressure in the lymphatic system.