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.

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 medical device includes a catheter shaft extending along a longitudinal axis and having a shaft lumen. A balloon includes a proximal balloon end coupled to the catheter shaft, an interior in fluid communication with the shaft lumen, and a distal balloon end. A lead wire extends from a proximal wire end through the shaft lumen and the interior to a distal wire end. The lead wire includes a stepped portion between a proximal wire surface and a distal wire surface. The distal balloon end is axially fixed to the proximal wire surface. The proximal wire surface is narrower than the distal wire surface. Other embodiments are described and claimed.

A method may include accessing a terminal branch of an ophthalmic artery through a face of a subject. Additionally, the method may include positioning a device within the ophthalmic artery of the subject and treating at least one of a blockage, a stenosis, a lesion, plaque or other physiology in at least one of the ophthalmic artery or a junction between an internal carotid artery and the ophthalmic artery.

A supportive balloon catheter which may be used to assist a wire guide in advancing across a lesion which partially or totally occludes an intraluminal passage. The supportive balloon catheter is advanced over the wire guide, close to the location of the lesion. The supportive balloon catheter is then inflated, securing the position of the wire guide in the intraluminal passage. A braid on the catheter may provide additional structural support. The secured catheter restricts the movement of the wire guide advancing across the lesion, preventing kinking or deflection off the surface of the lesion. Once the wire guide has advanced across the lesion, the supportive balloon catheter or a different angioplasty may be used to clear the lesion from the intraluminal passage.

Catheter devices, assemblies and related methods for percutaneous crossing of an occlusion in a blood vessel are disclosed. A catheter device can include a central catheter, two side tubes, and a distally-protruding, curved subintimal guidewire. The central catheter can define a central lumen that extends from a proximal end to a distal end of the central catheter. The lumen can be configured to receive a primary guidewire. The central catheter can also define at least one reentry aperture oriented transverse to the central lumen. The first and second side tubes can be coupled with the central catheter, extending along a longitudinal axis thereof, with the first side tube flanking an opposite side of the central catheter relative to the second side tube. The subintimal guidewire can extend from the first side tube, distally beyond the distal end of the central catheter, to the second side tube.

A guidewire system may include a guidewire having a relatively stiff proximal section and a relatively flexible distal section joined by a transition region, and a TAVI device slidably disposed on the guidewire. The guidewire may include an expandable element disposed about the transition region. The expandable element may be configured to expand from a collapsed configuration to an expanded configuration. The guidewire may include an expandable element disposed at the distal end. The distal section may be pre-configured to form more than one distal loop. A method of protecting an apex of a left ventricle during a TAVI procedure may include inserting a guidewire into the left ventricle, positioning a transition region adjacent the apex, expanding an expandable element such that the expandable element spans the apex, advancing a TAVI device distally over the guidewire to an aortic valve, and performing a TAVI procedure at the aortic valve.

Provided is a treatment method and a medical device that can intentionally and locally administer a drug to a lesion area appearing in a narrow blood vessel such as a retinal blood vessel and a spinal blood vessel. The treatment method has an introduction step of introducing a medical elongated body having a drug holder for holding a drug into a living body, an arrangement step of arranging the drug holder at a treatment target inside the living body, and a discharge step of discharging the drug to the treatment target by releasing the drug held by the drug holder.

A method and device for positioning an expandable support in a blood vessel is disclosed herein. The device may include a handle, a catheter assembly, a core wire, and an expandable support. The expandable support may be used to position the device relative to the arteriotomy, as well as to provide temporary hemostasis. The expandable support may be attached to the catheter assembly at a first end, and to the core wire at a second end to optimize the width of the expandable support based on the function being performed by the expandable support at a given time. The catheter assembly may be able to move relative to the handle and the core wire, thereby moving the first end of the expandable support relative to the handle and the core wire.

The present invention relates to a method of delivering drugs having e.g., anti-proliferative activity in the vascular, preferably, the cardiovascular, system locally or systematically using an at least partially drug-coated guidewire. The drug-coated guidewire, particularly an expansion member or portion thereof, is brought into contact with the target tissue or in circulation and the drugs are quickly released into the area surrounding the device in a short time after the contact step. Once the therapeutic drugs are released, they are quickly and effectively absorbed by the surrounding cells or circulation.