Assemblies and delivery apparatus for delivering a medical device into a patient's vasculature are disclosed. In some examples, an assembly includes a delivery apparatus and a radially compressible and expandable prosthetic heart valve. The delivery apparatus includes a handle, a first shaft and a second shaft extending from the handle, and a locking mechanism to prevent axial movement of the second shaft relative to first shaft. The second shaft extends coaxially through the first shaft and includes, at a distal end portion thereof, a balloon, one or more radiopaque markers, and the prosthetic valve radially compressed over the balloon. A flared end piece extending from the first shaft covers a proximal portion of the balloon during advancing of the delivery apparatus through a patient's vasculature. The first shaft is retractable relative to the second shaft to expose the balloon from the flared end piece.

A respiratory access assembly may include a manifold having a first mating surface defining a first port opening. The respiratory access assembly may include a rotatable adapter having a second mating surface defining a second port opening and a seal assembly disposed between the manifold and the rotatable adapter that includes a first seal ring, a second seal ring, and an outer seal ring disposed proximate an outer perimeter of at least one of the manifold or the rotatable adapter. The rotatable adapter may be rotatable relative to the manifold between an open configuration and a closed configuration. The seal assembly may include a connection portion connected between the first seal ring and the second seal ring. The connection portion may form a seal between the first mating surface and the second mating surface between the first seal ring and the second seal ring.

A tightening port for use with a hub of an introducer sheath includes a cartridge for reversible engagement with a proximal end of the hub, the cartridge having a proximal end and a distal end and a lumen extending therebetween, a seal positioned within the lumen of the cartridge, a lock nut having an inner portion positioned within the lumen of the cartridge and an outer portion configured for engagement with the proximal end of the cartridge, such that the inner portion of the lock nut is configured to push the seal to reduce a size of an opening of the seal.

A tightening port for use with a hemostasis valve of an introducer sheath includes a gripper configured for engagement with the hemostasis valve hub, the gripper having a proximal end, a distal end, a cylindrical body defining a lumen, and a plurality of protrusions extending from the proximal end, a base having a cylindrical body and a lumen defined therethrough for receiving a portion of the gripper, and a plurality of engagement features configured for engaging with the plurality of protrusions of the gripper, and wherein the lumen of the gripper has an initial diameter prior to engagement with the base, and the lumen of the gripper has a compressed diameter after engagement with the base, wherein the compressed diameter is less than the initial diameter.

Disclosed herein is a system for treatment including a compound valve system that can be integral to, or attached to a sheath introducer. The compound valve system includes a secondary valve that can be positioned in a proximal direction from a primary valve of the sheath introducer. The secondary valve can move longitudinally in response to a pressure differential. The compound valve system can include an aspiration port between the primary valve and secondary valve. The secondary valve can be integral to a secondary valve accessory device that can be assembled onto a catheter shaft of an intralumenal treatment device, and the secondary valve accessory device can further function as an introducer tool for the intralumenal treatment device.

A catheter system may include one or more of the following: a catheter adapter, a catheter, a housing, an introducer needle, a tube, a guidewire advancement feature, a pinch member, and a guidewire. A proximal end of the introducer needle may be secured within the housing. The tube may be disposed within the housing and in fluid communication with the proximal end of the introducer needle. The guidewire advancement feature may extend through a slot in the housing and may be movable along the slot. The pinch member may be disposed within the guidewire advancement feature and configured to move along an exterior of the tube with the guidewire advancement feature. The guidewire may be disposed within the tube. In response to moving the guidewire advancement feature distally along the slot, the pinch member may move the hub distally and the guidewire may be advanced distally.

Deflectable catheters, hemostasis valves, and materials for the same are disclosed. The deflectable catheters and hemostasis valves can be made at least partially, if not entirely, from a fluoroelastomer and ePTFE combination. A deflectable region of the catheters can be articulated to form simple and/or complex curves.

Devices, systems, and methods for sealing medical devices, particularly during intravascular access, are disclosed herein. Some aspects relate to a hemostatic valve for sealing a wide range of medical devices, such as catheters, wires, embolectomy systems. The valve can include an elongate member having a first end, a second end, and a central lumen extending therebetween. A reinforcement structure extends along at least a portion of the elongate member and is coupled to the elongate member. A shell defining a first aperture and a second aperture may be included, which first and second apertures can be fluidly coupled by the elongate member. A tensioning mechanism is coupled to the shell and to the elongate member, the tensioning mechanism can be moveable between a first configuration wherein the tensioning mechanism is collapsed and the central lumen is sealed and a second configuration wherein the central lumen is open.

A vacuum aspiration system may be used to treat thromboembolic disease, such as deep vein thrombosis or pulmonary embolism. The system includes a housing, and a fluid flow path extending through the housing. A first catheter is in fluid communication with the flow path, and a connector is configured to place a source of aspiration in communication with the flow path. A clot container is carried by the housing. A hemostasis valve is provided in the housing, and configured to receive a second catheter and direct the second catheter through the first catheter.

Embodiments of the present disclosure provide a delivery apparatus for a prosthetic heart valve. Disclosed steerable catheters can include a handle, a steerable shaft extending from the handle, and a pull wire. The shaft can include a main lumen, an inner polymeric layer surrounding the main lumen, a braided layer surrounding the inner polymeric layer, and an outer polymeric layer surrounding the braided layer, the outer polymeric layer defining a pull wire lumen. The pull wire can extend from the handle and through the pull wire lumen and can have a distal end portion coupled to a distal end portion of the shaft.