Systems and methods can involve wedge dissectors attached to strips in turn attached to medical balloons, for forming serrations within vascular wall tissue for angioplasty as well as drug delivery.

A device and method for intravascular treatment of atherosclerotic plaque prior to balloon angioplasty which microperforates the plaque with small sharp spikes acting as serrations for forming cleavage lines or planes in the plaque. The spikes may also be used to transport medication into the plaque. The plaque preparation treatment enables subsequent angioplasty to be performed at low balloon pressures of about 4 atmospheres or less, reduces dissections, and avoids injury to the arterial wall. The subsequent angioplasty may be performed with a drug-eluting balloon (DEB) or drug-coated balloon (DCB). The pre-angioplasty perforation procedure enables more drug to be absorbed during DEB or DCB angioplasty, and makes the need for a stent less likely. Alternatively, any local incidence of plaque dissection after balloon angioplasty may be treated by applying a thin, ring-shaped tack at the dissection site only, rather than applying a stent over the overall plaque site.

A device and method for intravascular treatment of atherosclerotic plaque prior to balloon angioplasty which microperforates the plaque with small sharp spikes acting as serrations for forming cleavage lines or planes in the plaque. The spikes may also be used to transport medication into the plaque. The plaque preparation treatment enables subsequent angioplasty to be performed at low balloon pressures of about 4 atmospheres or less, reduces dissections, and avoids injury to the arterial wall. The subsequent angioplasty may be performed with a drug-eluting balloon (DEB) or drug-coated balloon (DCB). The pre-angioplasty perforation procedure enables more drug to be absorbed during DEB or DCB angioplasty, and makes the need for a stent less likely. Alternatively, any local incidence of plaque dissection after balloon angioplasty may be treated by applying a thin, ring-shaped tack at the dissection site only, rather than applying a stent over the overall plaque site.

A cutting balloon catheter including a balloon mounted on a distal portion of a catheter shaft. An expandable frame may be disposed over the balloon. The expandable frame may include a plurality of struts extending from a proximal end region to a distal end region. One or more cutting members may be secured to the expandable frame.

The disclosure provides for an adjustable catheter system with isovolumetric suction and restoration of fluid for the removal of a thrombus and a method of use thereof. The catheter system includes an inner catheter and an outer sheath surrounding at least a portion of the inner catheter. The inner catheter may include at least three lumina extending from the proximal end to the distal end of the inner catheter, at least one infusion fenestration along the infusion segment, and a distal encapsulation balloon at the distal end. The outer sheath may include at least three lumina extending from the proximal end to the distal end of the outer sheath and a proximal encapsulation balloon at the distal end. The catheter system may further include an agitator for mechanical morcellation of the thrombus.

An intravascular device can comprise a carrier and an expansion apparatus. The device can be used for intravascular treatment of atherosclerotic plaque. The carrier can be reversibly expandable and collapsible within a vessel and can have ribbon strips extending between opposite ends in a longitudinal direction of the carrier. The ribbon strips can each be formed with a plurality of elongated protrusions thereon. The expansion apparatus can be used to actuate the ribbon strips each with the plurality elongated protrusions to pierce a luminal surface of the plaque with lines or patterns of microperforations which act as serrations for forming cleavage lines or planes in the plaque.

A drug-delivery device for vessels comprising a catheter body, an elongate ultrasound transmission member, an inflatable balloon, and a plurality of support wires. The catheter body has at least one lumen extending longitudinally therethrough. The elongate ultrasound transmission member extends longitudinally through the lumen. The elongate ultrasound transmission member has a distal portion and a proximal end configured to be coupled to an ultrasound transducer. The inflatable balloon, having an exterior surface, is coupled to the distal portion. The plurality of support wires are connected to the elongate ultrasound transmission member at two locations. A coating of at least one drug is on the exterior surface of the inflatable balloon. The elongate ultrasound transmission member is configured to transmit longitudinal vibrations to the inflatable balloon such that the inflatable balloon is longitudinally vibrated. The coating is removed by mechanical vibration of the inflatable balloon.

Retrieval of material from vessel lumens can be improved by electrically enhancing attachment of the material to the thrombectomy system. The system can include a catheter having a distal portion configured to be positioned adjacent to a thrombus in a blood vessel, an electrode disposed at the distal portion of the catheter, and an interventional element configured to be delivered through a lumen of the catheter. The electrode and the interventional element are each configured to be electrically coupled to an extracorporeal power supply.

A catheter is provided for both crossing a lesion, such as a chronic total occlusion, in a vessel and performing percutaneous transluminal angioplasty thereupon. The catheter includes a shaft having a tapered tip adapted for being pushed into the lesion to advance through the lesion. An inflatable balloon is mounted on the shaft, which may be braided to provide enhanced pushability and kink-resistance. The inflatable balloon includes a proximal portion and a distal tapered portion connected to the tapered tip, and having a shallow taper. The taper of the distal tapered portion and the tapered tip may together create a continuous sloping transition from a distal end of the distal tapered portion to an adjacent portion of the tapered tip to facilitate crossing a lesion. The balloon may also be selectively inflated or deflated during crossing of the lesion, and ultimately used to compact the lesion when inflated.

A medical instrument may include a tube, a sheath provided around and coaxial with the tube, and an inflatable balloon at a distal end of the sheath. The balloon may receive a fluid from a lumen of the sheath, and may have a central opening along a longitudinal axis thereof, and into which the tube extends, a proximal portion, a middle portion adjacent to and distal of the proximal portion, and a distal portion adjacent to and proximal of the middle portion. When the balloon is inflated with the fluid, a maximum diameter of the middle portion may be less than a maximum diameter of the proximal portion, and less than a maximum diameter of the distal portion. The medical instrument may also include an extraction member provided at a distal end of the tube, distal to the balloon, and movable axially relative to the balloon.