An apparatus for harvesting a subcutaneous blood vessel is disclosed. The apparatus comprises a guidewire with an angled tip, an intra-vascular catheter to receive the guidewire and having a lateral orifice to allow the angled tip thereof to perforate the subcutaneous blood vessel. The apparatus further comprises a flexible pulling device having a pair of circumferential grooves, one adjacent to each end thereof, to allow for securing the subcutaneous blood vessel thereat; and a flexible pushing device having a concave-cup shape at a distal end thereof to facilitate pushing of the subcutaneous blood vessel secured with one of the pair of circumferential grooves of the flexible pulling device. The flexible pulling device and the flexible pushing device are operable in conjunction to cause inversion and eversion and separation from the surrounding tissues of the subcutaneous blood vessel for removal and harvesting thereof.

The subject guide catheter extension system with a micro-catheter delivery catheter includes an outer sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. Several mechanisms of engagement/disengagement between the inner and outer members are provided including a friction mechanism, threaded mechanism, pull away sheath, and engagement/disengagement mechanism for pusher's handles. The sheath and the inner member are modified for different engagement/disengagement mechanisms operation. A micro-catheter delivery system provides for an improved atraumatic crossability to the treatment site in an expedited and simplified fashion. During a procedure, a guidewire along with a guide catheter are advanced to the vicinity of the treatment site within a blood vessel. Subsequent thereto, the subject guide catheter extension system is manipulated to advance the micro-catheter along the guidewire inside the guide catheter towards and beyond the site of interest. Once the micro-catheter is in place, the outer sheath slides along the micro-catheter until reaching the lesion, and then the inner member is removed from the sheath, and the sheath then is ready for passing the treatment catheter (stent/balloon) towards the lesion to be treated.

A delivery device to deliver a guidewire through an intravenous catheter assembly may include a housing, which may include a distal end, a proximal end, and a slot. The delivery device may include a guidewire, which may include a proximal end and a distal end. The delivery device may include a guidewire hub disposed within the housing. The guidewire may be secured to the guidewire hub, and the guidewire hub may be configured to move along the slot to advance the guidewire in a distal direction. The distal end of the guidewire may include a fluid permeable structure. For example, the fluid permeable structure may include an elongated core and a coil extending around the elongated core. In some embodiments, a space between the elongated core and the coil may be configured to receive blood in response to the guidewire being inserted into the vasculature.

A rigidizing device includes a plurality of layers and an inlet between the elongate flexible tube and the outer layer and configured to attach to a source of vacuum or pressure. The rigidizing device is configured to have a rigid configuration when vacuum or pressure is applied through the inlet and a flexible configuration when vacuum or pressure is not applied through the inlet.

Disclosed are introducer components, assemblies, and methods. For example, an introducer assembly can include an access guidewire loaded in a needle assembly fluidly connected to a syringe. The needle assembly can include a needle and a valve thereover. The needle can include a needle shaft including a needle lumen, a needle slot in a proximal portion of the needle shaft, and a needle hub over the proximal portion of the needle shaft but proximal of the needle slot. The valve can be over the needle slot with a valve port aligned with the needle slot. The access guidewire can be loaded in the needle lumen and sealed therein by way of the valve port in a ready-to-deploy state of the introducer assembly. In this way, the access guidewire can be immediately advanced into a blood-vessel lumen of a patient upon establishing a needle tract thereto with the needle assembly.

Disclosed are devices and methods for automated emergency arterial cannulation. The device comprises a hand-held automated emergency arterial sheath placement device having a body with a handle and an actuator, and an arterial sheath placement head at the distal end of the handle body configured for placement against the patient's skin. The arterial sheath placement head includes an arterial sheath insertion device configured to advance an arterial needle, guide wire, and arterial sheath into a patient's artery upon sequential operation of the actuator. The arterial sheath placement head also includes a non-invasive artery locator configured to locate an artery into which the arterial sheath is intended to be placed. The arterial sheath placement head also preferably includes a Doppler gel and antiseptic needle, a local anesthetic needle, and a scalpel, all of which are likewise configured to advance from the upper body portion upon sequential operation of the actuator.

Embodiments of catheter placement systems described herein include a temporary splittable sheath anchor, disposed on an outer surface of a needle. The splittable anchor moves with respect to the needle when accessing the vessel, allowing for a temporary anchor to be created as soon as venous access is confirmed via flashback. The clinician can advance the anchor over the needle once vessel access has been confirmed by flashback. The needle can then be removed without further insertion into the vessel, mitigating accidental trauma. The guidewire can then be introduced through the anchor and advanced to a target location within the vasculature. The anchor can then be removed by splitting and withdrawing the anchor proximally. Embodiments further include a splittable advancement sheath including a guidewire and configured to be drawn thorough a housing and split to allow the guidewire to separate from the advancement sheath and advance into the vasculature.

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.

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.

In general, implantation of neurostimulation systems or device includes subcutaneous or percutaneous placement of at least the electrodes. Preferred are minimally invasive implantation procedures, systems and devices that can reliably operate for extended periods, and systems and devices providing a high degree of comfort for the subject. The implantation specialist may need to address adequate placement of the electrodes with respect to the nerve tissue to be stimulated, and to choose between one or more convenient locations for the elements of the system or device. Methods are provided comprising forming a first 1250 and second 1260 incision on opposite sides of a target location, and introducing a first introducer sheath 3050a under the skin with a maximum internal transverse cross-section less than the further maximum transverse cross-section 710 of an implantable stimulator. Such a method is advantageous if the maximum transverse cross-section 710 of the further portion is at least 1.2 times greater than the maximum transverse cross-section 730 of the first portion—the dimensions of the implantation tools may be reduced. A further method is provided wherein the first portion 630 with at least two electrodes 200, 400 is introduced in the skin layers between the nerve tissue 2003 to be stimulated and above or in the aponeurosis layer 2009. By being implanted deeper and/or more accurately, comfort and/or reliability for the subject may be improved. In addition, the chance that the stimulator is implanted under the nerve tissue is greatly increased.