Guide wires, systems and methods can improve advancement through the vasculature, particularly when the catheter tip encounters resistance or an obstruction and cannot advance. The guide wire can include an enlargement spaced proximally from a distal tip of the elongated member alone or in combination with a configured portion of the wire. The configured guide wire can be positioned in the vasculature and a medical device such as a catheter can track over the guide wire. The catheter can get caught-up in the vasculature or on implanted devices during advancement. When that occurs, the configured guide wire can be retracted back to the catheter tip and the guide wire configuration can cause the catheter distal tip to move and/or deflect away from the obstruction or resistance allowing the system to advance. The guide wire can be returned to its distal position and the procedure can continue.

A transseptal guidewire and methods for perforating the intra-atrial septum of the heart are disclosed. The transseptal guidewire has an elongated body, an end section biased in a curved configuration to define a proximal curve, and a distal section biased in a curved configuration to define a distal curve, the distal curve being oriented in a direction generally opposite that of the proximal curve.

An introducer set includes an introducer and dilator along with an extension in a sealed sterile peal open package. The extension is available for use during procedures where the puncture access site to the patient is close enough to the site to be treated in the patient that the physician's hands and/or head may be positioned in the fluroscopic area while the physician is attempting to maneuver a wire guide to a desired location. When the extension is attached to the introducer, the physician may perform a procedure, such as an antigrade stick in the lower leg of a patient, while maintaining their hands and head outside of the fluroscopic area while direct radiation is being supplied and the wire guide is being maneuvered to a desired treatment location. After the wire guide has been properly positioned and the radiation has been terminated, the extension may be disconnected from the introducer and the remaining portions of the procedure (guide catheter insertion, balloon catheter insertion and dilation, etc.) may proceed in a known manner. The extension need only be in the range of ten to thirty centimeters to allow the physician to work a safe distance from the fluroscopic area undergoing direct radiation.

A medical device capable of improving handling properties and maintaining excellent insulation properties of conductive wires for supplying electricity to electrodes for performing treatment includes: an elongated shaft part having a guide wire lumen formed therein, the guide wire lumen being open at a distal part; a plurality of electrodes which are disposed on the distal side of the shaft part, extend in the longitudinal direction of the shaft part, and are deformable in the radial direction of the shaft part; and a plurality of conductive wires which extend from the proximal side of the shaft part to the distal side thereof and transfer electricity to an electrode layer. The conductive wires extend inside the electrodes and outside the guide wire lumen, and are electrically connected to the electrodes at the distal side of the electrodes.

A device is configured for closing an aperture in a wall of a blood vessel. An embodiment of the device includes a body and at least one suture element held within the body. A suture capture rod is positioned within the body and is operatively associated with the suture element and arranged to pass the suture element through a vessel wall such that opposed portions of the suture element extend from the vessel wall. A removable guidewire segment is removably attached to a distal end of the body.

A guidewire introducable into a bodily lumen having an obstruction therein is provided. An introducer needle is advanced through tissue and into the bodily lumen. A guidewire is advanced through the introducer and into the lumen. The guidewire is advanced further through the lumen until an atraumatic distal tip of the guidewire encounters an obstruction the distal tip cannot pass in a straight forward manner. The distal tip is pressed against the obstruction such that a flexible segment proximal of the distal tip forms a loop distal of the distal tip. The guidewire is advanced further through the lumen such that the loop of the flexible segment is pushed past the obstruction and the distal tip is pulled distally past the obstruction. A greater diameter guidewire extension can be coupled to the back end of the guidewire, providing function as a larger diameter guidewire.

Disclosed are a catheter-based kissing balloon systems and methods of connecting blood vessels or creating an access path between blood vessels. The system includes a first delivery or passing catheter in a first vessel and a second receiving catheter in a second vessel that cooperate to create a path between the vessels. A passing catheter balloon is arranged to mate with or kiss a receiving catheter balloon to align the vessels before a piercing element is extended to puncture both vessels and optionally puncture a balloon. A guidewire is delivered through a lumen of the piercing element, and a distal end of the guidewire is trapped in a cage of the receiving catheter. The guidewire can then be used to deliver additional implanted devices while the passing catheter, receiving catheter, or both are removed.

The invention relates to a low profile lumen free balloon catheter and a system for advancing the lumen free balloon from a build wire to a wire guide. The low profile balloon lacks an internal wire guide cannula between the catheter shaft and the soft tip. A releasable engagement is provided to connect/disconnect the build wire to/from the wire guide. A soft tip seals around the wire guide following advancement of the balloon catheter over the wire guide.

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.

An extension system for connecting or coupling a guidewire, primary or initial wire to an extension or secondary wire, a method of coupling elongate devices (40,41,42,43) and a method of using an extension system. The extension system is formed by the connection of devices to extension tubes or wires. In this way, connecting or coupling a guidewire, primary or initial wire to an extension or secondary wire may be done during or before a medical procedure. The resulting coupling from the extension system allows independent relative movement between inner and outer components of an endoluminal device such as a guiding catheter, endoscope, medical instrument or guidewire. In an assembled state, multiple concentric wires and tubular components can be locked and secured by a simple single movement, followed by a relative rotation, translation or both in order to create a mechanical strength between them that resembles such strength as if there was no connection at all. The extension system may also be used for procedures other than medical procedures.