A steerable transseptal punch system and method of using the steerable transseptal punch system to access the left atrium.

A delivery guidewire for navigating a catheter in the heart to deliver a valve prosthesis. The delivery guidewire comprising an elongated core, an outer sleeve disposed on the elongated core, and a coil disposed on a distal portion of the elongated core. The delivery guidewire having a first section having a generally uniform diameter and a second section having a tapering section. A distal portion of the second section of the delivery guidewire comprises a pigtail shape atraumatic tip which can remain in the left ventricle.

Devices, systems, and methods for guidewire placement for a gastrostomy tube are described herein. A system can include an elongated tube, an inflatable member, and a guidewire assembly. The elongated tube can have a first end, a second end, and can define a lumen. The inflatable member can be coupled to the first end of the elongated tube and can be fluidically coupled to the lumen such that the inflatable member can receive fluid via the lumen. The guidewire assembly can include a guidewire having a first end and a second end. The first end of the guidewire assembly can include a coupling member, the coupling member configured to couple to the inflatable member such that translation of the elongated tube translates the guidewire assembly.

A guide wire of the present disclosure includes a core shaft having a distal end portion decreasing in cross-sectional area, a coil body wound to cover the distal end portion, and a distal end fixing portion fixing the core shaft and the coil body to each other. The distal end portion includes a small cross-sectional area portion, a large cross-sectional area portion, and a tapered portion between the small cross-sectional area portion and the large cross-sectional area portion. The core shaft and the coil body are fixed at a portion excluding the tapered portion. A first bending rigidity FR1 of the large cross-sectional area portion, a second bending rigidity FR2 of the small cross-sectional area portion, and a length L of the tapered portion satisfy the following expressions (1) and (2). In the following expressions (1) and (2), the unit of L is mm (millimeter).

(FR1/FR2).sup.0.25/L≥0.83   (1)

1≤L≤3   (2)

A guidewire for use in penetrating through complex and stenosed lesions. The distal tip of the guidewire has a roughened surface to increase frictional engagement with calcified and fibrous tissue to increase the penetration of the distal tip and the guidewire into and through the lesion and reduce the likelihood of deflection of the guidewire tip. The average surface roughness of the distal tip is in the range from 1 micron to 200 microns.

Disclosed are introducer adapters, introducer assemblies, and methods. In an example, an introducer assembly can include a syringe, a needle, and an introducer adapter fluidly coupled therebetween. The introducer adapter can include a primary conduit, a secondary conduit extending from a side of the primary conduit, and a valve including an elastomeric septum sealing a proximal portion of the primary conduit or the secondary conduit. An access guidewire is optionally loaded in the introducer adapter and sealed therein by the valve. In another example, a method can include a method for securing vascular access with the foregoing introducer assembly. Such a method can include obtaining the introducer assembly, establishing a needle tract from an area of skin to a blood-vessel lumen of a patient with the needle, and advancing at least a guidewire tip of the access guidewire into the blood-vessel lumen for the securing of the vascular access.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

The invention relates to an infusion catheter device. This catheter device 10 has an elongate, substantially tubular shape defining a longitudinal axis, a distal end (D) and a proximal end (P), configured to be introduced into a conduit (50) having an inner wall (54) and an outer wall (56) and comprising at least one partial or total obstruction (60) or occlusion to be treated, said device comprising, at its distal end (D), one or more infusion orifices (16, 18, 20, 22) for an infusion liquid (LI), and, upstream from the one or more infusion orifices, at the proximal side (P) of the infusion catheter (10), at least one obturating element (70) for temporary obturating, configured to treat said obstruction (60) or occlusion and to perform the infusion of the infusion liquid (LI) downstream from the obturating element (70) and in the obturating position. This device is suitable in particular for cardiac surgery and interventional cardiology.

A guide wire is disclosed, which is capable of reducing an unintended deviation in a guide wire position while preventing an occurrence of discomfort with respect to usability. The guide wire has a flexible core wire, and has a distal core portion, a main body portion, and a rigidity changing portion that gradually decreases in rigidity from the main body portion toward the distal core portion. The rigidity changing portion includes a first tapered portion continuous with a distal end of the main body portion, a second tapered portion continuous with a distal end of the first tapered portion, and a third tapered portion continuous with a proximal end of the distal core portion. A boundary portion between the first tapered portion and the second tapered portion is located in a range of 300 to 400 mm from a foremost distal end of the distal core portion.

An aspiration clot retrieval catheter to have profiled guidewire for deliverability that transitions at a proximal joint to a distal tubular section with a lumen for directing aspiration and facilitating the smooth passage of other products in performing mechanical thrombectomy procedures. The joint can have a low-profile proximal strut formed integrally with the distal tubular section and configured to interlock with a distal portion of the guidewire so that there is a smooth transition of stiffness between the guidewire and the tubular portion of the catheter to improve trackability and decrease the likelihood of kinking. The distal tubular section of the proximal joint can also have features to tailor flexibility. The tubular section can be configured to push radially outward to form a seal with an outer catheter to optimize aspiration transmission to the distal mouth of the aspiration clot retrieval catheter.