A medical probe includes a guidewire, a guidewire advancement mechanism (GAM), and a middle inflatable balloon. The guidewire is configured for insertion into a lumen of an organ of a patient. The GAM is disposed at a distal end of the guidewire, with the GAM including: (i) a proximal inflatable balloon, (ii) a distal inflatable balloon, and (iii) a middle inflatable balloon that is coupled between the proximal and distal balloons. The proximal, distal and middle balloons are configured to move the guidewire in the lumen by inflating and deflating in a predefined sequence.

A catheter system for imparting pressure to induce fractures at a treatment site within or adjacent a blood vessel wall includes a catheter, a fortified balloon inflation fluid and a first light guide. The catheter includes an elongate shaft and a balloon that is coupled to the elongate shaft. The balloon has a balloon wall and can expand to a first expanded configuration to anchor the catheter in position relative. The fortified balloon inflation fluid can expand the balloon to the first expanded configuration. The fortified balloon inflation fluid includes a base inflation fluid and a fortification component. The fortification component reduces a threshold for inducing plasma formation in the fortified balloon inflation fluid compared to the base inflation fluid. The fortification component can include at least one of carbon and iron. The first light guide is disposed along the elongate shaft and is positioned at least partially within the balloon. The first light guide is in optical communication with a light source and the fortified balloon inflation fluid. The light source provides sub-millisecond pulses of a light to the first light guide so that plasma formation and rapid bubble formation occur in the fortified balloon inflation fluid, thereby imparting pressure waves upon the treatment site.

A catheter system includes a catheter having an elongate shaft, a balloon and a light guide. The balloon expands from a collapsed configuration to a first expanded configuration. The light guide is disposed along the elongate shaft and is in optical communication with a light source and a balloon fluid. A first portion of the light guide extends into a recess defined by the elongate shaft. A protection structure is disposed within the recess and is in contact with the first portion of the light guide. The light source provides pulses of light to the balloon fluid, thereby initiating plasma formation and rapid bubble formation within the balloon, thereby imparting pressure waves upon a treatment site. The protection structure can provide structural protection from the pressure waves to the first portion of the light guide.

A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption at a treatment site includes a catheter including an elongate shaft and balloon coupled to the elongate shaft. The catheter system includes a light guide disposed along the elongate shaft and at least partially within the balloon, where the light guide is in optical communication with a light source and a balloon fluid. The catheter can include a first focusing element located at a distal portion of the light guide and in optical communication with the light source. The first focusing element can direct light from within the light guide to a first location at a first distance away from the distal portion of the light guide to initiate plasma formation in the balloon fluid away from the distal portion and to cause rapid bubble formation, thereby imparting pressure waves at the treatment site.

A catheter system for pressure wave and inertial impulse generation for intravascular lesion disruption includes a balloon coupled to an elongate shaft, and a first and second light guide disposed along the elongate shaft. The first and second light guides each include a diverting feature in optical communication with at least one light window to direct light to exit each light guide toward a side surface portion thereof and toward the balloon. A method includes expanding the balloon from a collapsed configuration to a first expanded configuration, and activating a light source in optical communication with each light guide to provide sub-millisecond pulses of light to the diverting features, thereby inducing plasma formation in a balloon fluid, causing rapid bubble formation, and imparting pressure waves upon the treatment site.

Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to the thrombectomy system. The system can include a catheter having a distal portion configured to be positioned adjacent to a thrombus in a blood vessel, an electrode disposed at the distal portion of the catheter, and an interventional element configured to be delivered through a lumen of the catheter. The electrode and the interventional element are each configured to be electrically coupled to an extracorporeal power supply.

A catheter includes a handle with torquing and steering mechanisms. The torquing mechanism includes a rotatable nosecone and a bearing coupled to the nosecone to be rotatable therewith. The bearing is concentrically disposed over a shaft of the catheter and is configured to transmit a torque from the nosecone to the shaft when the nosecone is rotated. The steering mechanism includes a rack coupled to the bearing to be slideable therewith and a pull wire having a proximal end attached to the bearing and a distal end attached to a distal portion of the shaft. Rotation of the nosecone causes an entire length of the shaft to rotate and axial movement of the rack tensions the pull wire to bend the distal portion of the shaft. A valve relief component is slidingly disposed over the shaft and is configured to dock onto the handle when not in use.

Apparatuses, systems, and methods for crossing a tissue region may include a catheter and a tip section arranged therewith. The tip section may be configured to puncture the tissue region and create an opening therein, dilate the opening in the tissue region, and pass through the opening.

An atraumatic vessel occlusive system includes a flexible tubular member with an infusion lumen, a vessel occluder mounted at the distal end of the tubular member, and a pressure sensor located within a chamber defined by the occluder. The occluder has a braided construct provided with a fluid impermeable membrane over its proximal portion and a fluid permeable covering over its distal portion. The pressure sensor is adapted to sense pressure within the vessel through the fluid permeable membrane without being subject to the effects of turbulent flow at the exit of the infusion lumen. The accurately sensed pressure can be used to determine a dwell time for the occluder.

A dilation apparatus includes a handle assembly, a dilator, a guidewire, and a steering assembly. The dilator is connected to the handle assembly and is configured to transition between an unexpanded state and an expanded state. The guidewire is longitudinally fixed relative to the dilator. The steering assembly is configured to laterally deflect at least a portion of the guidewire relative to the handle assembly. The steering assembly includes an actuator coupled with the handle assembly and a pull wire extending between the actuator and guidewire. A portion of the pull wire is attached to the guidewire. The actuator is configured to move the pull wire relative to the handle assembly in order to laterally deflect the at least a portion of the guidewire.