An apparatus for performing a medical procedure and, in particular, an aortic valvuloplasty, in a vessel for transmitting a flow of fluid includes a first inflatable balloon, such a perfusion balloon with a plurality of cells in a single cross-section of the balloon for permitting the fluid flow in the vessel. An inflatable valve, which may take the form of a second inflatable balloon, may be provided for controlling the fluid, flow through the first balloon when inflated. Through selective movement of the second balloon when inflated via the flow rhythms created by the beating heart, a one way valve results that can be used to mimic the natural flow created by the valve under treatment.

An aortic occlusion and perfusion device includes an expandable member configured to expand within the aorta. A catheter extends proximally from the expandable member in fluid communication with the expandable member. The catheter defines openings through which blood can pass with one or more of the openings located proximal to the expandable member and one or more of the openings located within the expandable member. The catheter defines a lumen in fluid communication with the one or more openings located within the expandable member, the lumen terminating at a terminus such that the lumen is not in fluid communication with a distal end portion of the catheter. A flow control sheath is disposed around the catheter proximal to the expandable member such that axial movement of the flow control sheath relative to the catheter selectively occludes or uncovers the one or more openings located proximal to the expandable member.

Disclosed herein are designs for improved inflatable structures for use during minimally invasive cardiovascular procedures. These inflatable structures facilitate the perfusion of blood through an anatomical structure, such as a heart valve, during the cardiovascular procedure. The inflatable structures are formed of a plurality of balloons arranged radially around a central location. The plurality of balloons form a lumen through which blood flows. Each balloon of the plurality is shaped or configured to stabilize the adjacent balloons, limiting their movement relative to each other. For example, some embodiments can feature balloons with a keystone shape that limits movement of the balloons inward toward the lumen. Some implementations can also include a support coil running through the lumen. The support coil holds enables the lumen to be open to perfusion even in the early stages of balloon inflation.

This patent document discloses perfusion catheters and related methods for treating blood vessel lesions and abnormalities. A perfusion catheter can include an inflatable balloon, an elongate shaft operably attached to the balloon, and an optional containment structure surrounding at least a portion of the balloon. The balloon can be inflated until its outer surface contacts a wall of a blood vessel. When inflated, the balloon's inner surface defines a passage for blood to flow. The balloon can be configured to release one or more substances formulated to treat a tissue at or near the wall of a blood vessel. In an example, the balloon can include a bioactive layer, which comprises the one or more substances, overlaying an optional base layer. In an example, the balloon can include multiple filars, at least one of which is configured to elute the one or more substances through a perforation or hole in the filar.

The disclosure relates to devices and methods for the treatment of edema, which devices use a restrictor for flow compensation. Devices and methods of the invention further use a flow-restrictor in the circulatory system, upstream of an intravascular pump, to balance pressure changes induced by the pump and to compensate for downstream flow. The device may be provided as an indwelling, intravascular catheter with a mechanical pump such as an impeller and a selectively deployable restrictor such as an inflatable balloon. Congestive heart failure or edema is treated by\operating the pump in an innominate vein and using the restrictor for flow compensation, to restrict the upstream flow and thus amplify or maintain pressure reduction at the lymphatic outlet.

The disclosure relates to devices and methods for the treatment of edema using a purge-free system. The invention provides devices and methods useful for treating edema by means of an indwelling catheter that is placed in a blood vessel of a patient and used to pump blood to cause a decrease in pressure at an outlet of a lymphatic duct. The catheter pumps blood by means of an impeller but is purge-free in that the catheter does not include a system for purging or flushing catheter components with a purge fluid. The purge-free catheter avoids blood-related mechanical complications such as clotting or thrombosis by means of an impermeable sleeve or shroud that protects moving parts of the impeller drive system.

This document describes rotational atherectomy devices and systems for removing or reducing stenotic lesions in blood vessels by rotating an abrasive element within the vessel to partially or completely remove the stenotic lesion material.

An example system for creating a lumen according to the present disclosure includes, among other possible things a balloon wound in a generally helical shape having an inner surface and an outer surface, and a support attached to at least one of the inner surface and the outer surface of the generally helical shape and constraining the tubular balloon in the generally helical shape. The balloon has a first diameter in a low-profile operating mode and the generally helical shape has a second diameter in a high-profile operating mode, and the second diameter is larger than the first diameter. Other example systems for creating a lumen and methods for creating a lumen in an artery are also disclosed.

Systems for imparting pulsatile energy to cardiovascular tissue are provided. Aspects of the systems include a console assembly comprising a potential source, a manifold assembly operably connected to an output of the console assembly, wherein the manifold assembly comprises an oscillator configured to generate pulse energy from energy transmitted from the potential source and a catheter assembly operably connected to an output of the manifold assembly. Catheter assemblies of the present invention include a connector operably connecting the catheter assembly to the manifold assembly and configured to transduce a first pulse energy generated by the manifold assembly to a second pulse energy, a catheter comprising a fluidic passage operably connected to the output of the connector and configured to transmit the second pulse energy and a heart-tissue-conforming element configured to receive the second pulse energy transmitted through the fluidic passage of the catheter to apply pulsatile energy to cardiovascular tissue. Also provided are methods for imparting pulsatile energy to cardiovascular tissue, e.g., deploying a system so that a heart-tissue-conforming element of the system is adjacent to cardiovascular tissue and engaging the system in a manner that the heart-tissue-conforming element imparts energy to the cardiovascular tissue. In addition, standalone catheter assemblies as well as kits comprising components of the systems described herein are provided. The systems, assemblies, methods and kits find use in a variety of different applications, including balloon angioplasty applications or other catheter-based therapies or treatments.

In vivo positionable filtration devices are provided that filter one or more therapeutic agents in blood flowing in a blood vessel. The filtration devices include an elongated member and a filtering component coupled to the elongated member. The elongated member and the filtering component are dimensioned for positioning within a blood vessel of a human or non-human animal. Further, the filtering component includes a filtration material to filter the one or more therapeutic agents from blood. Methods of in vivo filtration of one or more therapeutic agents are also provided. The methods include positioning a filtration device in a blood vessel of a body of a human or non-human animal, and administering a therapeutic agent upstream from the target tissue site to direct flow of the therapeutic agent to the target tissue site and then to the filtration device. The filtration device is positioned downstream from a target tissue site.