The embodiments presented herein relate to concepts designed to eliminate the gap between a catheter and guide wire that can otherwise contribute to a catheter getting stuck within the vasculature.

A steerable guidewire. The steerable guidewire is fabricated includes an outer tube, an inner tube, a hub, and a distal articulating region. The steerable guidewire hub can be removed to permit advancement of catheters over its proximal end followed by re-attachment of the hub to permit deflection of the distal end of the steerable guidewire.

The invention relates to evaluation of maturity of arteriovenous (AV) fistula using guidewires that measure intravascular blood flow and/or pressure. The invention provides methods of evaluating AV fistula maturation using an instrumented guidewire to measure intravascular flow and/or pressure. By using a small diameter guidewire that does not interfere substantially with the flow, an accurate measurement can be made that is useful for identifying when a fistula is mature and therefore ready to be used for hemodialysis. The flow of blood through the fistula is measured using the guidewire and the measured flow and/or pressure of blood is used to determine if the fistula is mature.

In one representative embodiment, a gripping and pushing device for a medical instrument comprises an elongated main body defining a lumen. The elongated main body comprises one or more deflectable portions that can be pressed radially inwardly toward a shaft of the medical instrument extending through the lumen. One or more elastomeric gripping layers can be secured to the inner surface of a respective deflectable portion at axially spaced apart attachment locations. The one or more gripping layers are axially deformable relative to the one or more deflectable portions between the attachment locations when manual pressure is applied to the one or more deflectable portions to press the one or more gripping layers against the shaft and move the shaft longitudinally into a patient's body.

A medical device system includes a medical device that is configured to be delivered to a lesion area in a body lumen, a guide wire that is configured to guide the medical device, a port member that is configured to introduce the guide wire and the medical device into a living body, a proximal-end fixing member that is configured to fix the guide wire and the port member and is provided with an operation unit that is configured to cause the guide wire to move in an insertion/pulling-out direction from the fixed state, an anchor device provided with an anchor portion in a distal portion thereof, and an anchor-device guide wire that is configured to guide the anchor device.

A stylet for placing a catheter in a vasculature of a patient is disclosed. The stylet can include an ECG sensor assembly having an electrode, a magnetic assembly producing a magnetic field, a core wire and a coil defining a lumen. A portion of the core wire can be disposed within the lumen of the coil. An intravascular catheter is disclosed that includes the stylet disposed within a lumen of the catheter. A method of placing a catheter within a superior vena cava of a patient is provided, including inserting the stylet within a lumen of the catheter, connecting the ECG sensor assembly to an ECG system, advancing the catheter along a patient vasculature, discontinuing advancement of the catheter upon an indication via an ECG signal that a tip of the stylet is disposed within the superior vena cava, and removing the stylet from the lumen of the catheter.

A torque device for selectively securing, engaging, or gripping an elongate medical device is disclosed. The torque device can be configured to permit torquing of the elongate medical device by manipulation of the torque device. A securement mechanism for selectively securing, engaging, or gripping an elongate medical device is also disclosed. The securement mechanism may be adapted for use with the disclosed torque device, or the securement mechanism may also be adapted for use with other medical devices. For example, the securement mechanism may be adapted for use with a suture securement apparatus.

A torque apparatus for facilitating manipulation of a guidewire includes a handle member dimensioned for engagement by a clinician and defining a longitudinal axis and a torque member mounted to the handle member. The torque member defines a lumen configured for reception and passage of a guidewire and is configured to rotate relative to the handle member to impart rotational movement to the guidewire. A gripper member associated with the torque member is adapted to releasably secure the guidewire relative to the torque member and a trigger member depending from the handle member is actuable to cause the gripper member to release the guidewire to thereby permit the guidewire to be moved within the lumen of the torque member. An actuator is operatively coupled to the torque member and is movable to impart rotational movement to the torque member to thereby cause corresponding rotational movement of the guidewire.

This invention is a transvascularly placed steerable guidewire, further including internal steerability and the ability to articulate in a direction at right angles to its longitudinal axis at or near its distal end. The steerable guidewire is generally fabricated from stainless steel and includes an outer tube, an inner tube, hub structures, and a distal articulating region. The steerable guidewire can be advanced through a body lumen in its straight configuration and then be selectively articulated or curved to permit negotiation of tortuous curvature. The steerable guidewire hub can be removed to permit advancement of catheters over its proximal end followed by re-attachment of the hub to permit deflection of the distal end of the steerable guidewire. Removal of the hub can result in a limp guidewire or maintenance of a forced curvature of the distal end of the guidewire.

A dilation catheter system includes a body, a guidewire, and a dilation catheter having an elongate shaft. The dilation catheter system may include a locking mechanism to prevent the guidewire from moving relative to the elongate shaft or to lock the guidewire to the dilation catheter to form a fixed wire unit. The dilation catheter system may include a stabilizing tube extending from an actuator, to provide rigidity to the guidewire. The dilation catheter may include a grip element having a plurality of grip features disposed thereon. The dilation catheter may include a cap biased toward a first longitudinal position and movable to a second longitudinal position. A guide catheter secured to the cap is prevented from changing angular orientation in the first longitudinal position and is free to change angular orientation in the second longitudinal position.