Embodiments of an actuated cannula seal are disclosed In some embodiments, a cannula seal includes a base portion that engages with a cannula; and a seal portion integrally formed with the base portion, the sealing portion capable of engaging with an instrument shaft, the sealing portion capable of being actuated by an actuator so that the sealing portion is continually in motion relative to the instrument shaft. The actuation of the sealing portion can be accomplished by rotation or vibration of the sealing portion relative to the instrument shaft.

Needle assemblies and related methods having a needle hub with a needle, a catheter tube with a catheter hub and having the needle extending through the catheter tube in a ready to use position. A valve is positioned in an interior cavity of the catheter hub, the valve having sections that can deflect in a distal direction and sections that can deflect in a proximal direction to open a fluid flow path through the valve. The valve can be deflected by a multi-piece valve opener.

A catheter has a cannulated guiding rail extending therethrough, an advance segment of the rail extending at least about 10 cm beyond the distal end of the catheter. The catheter and rail are advanced over a guidewire until the distal end of the advance segment is at a target vascular site. The catheter is thereafter advanced along the rail to the target vascular site.

A novel hemostasis valve-equipped indwelling needle that is capable of discharging air in an internal flow path includes a cannula to be inserted percutaneously into a blood vessel on a distal end side thereof, a link connector on a proximal end side thereof, an internal flow path extending from the cannula to the link connector, and a hemostatic valve disposed inside the link connector. An air vent passage that allows the internal flow path to communicate with an external space is formed in the link connector further on the cannula side than the hemostatic valve, and a filter that allows gas to pass through but does not allow liquid to pass through is mounted in a compressed state on the air vent passage.

An extension set may include a tube having an outer surface. An instrument, such as a tubing or a probe, may be disposed within the tube and may include a proximal end and a distal end. A translation handle may be coupled to the outer surface of the tube and may move along the outer surface between a proximal position and a distal position to translate the distal end of the instrument between a retracted position and an advanced position. In the advanced position, the distal end of the instrument may extend beyond the distal end of the tube and into a catheter assembly and/or vasculature of a patient.

A catheter has a cannulated guiding rail extending therethrough, an advance segment of the rail extending at least about 10 cm beyond the distal end of the catheter. The catheter and rail are advanced over a guidewire until the distal end of the advance segment is at a target vascular site. The catheter is thereafter advanced along the rail to the target vascular site.

The distal tip of a sensing catheter is placed in proximity to a target intravascular foreign material. A signal is propagated from the sensing catheter, a return signal is received, and at least a portion of the foreign material is captured and removed when the return signal is indicative of a foreign material located within a capture zone.

A system for accessing a central pulmonary artery includes an elongate, flexible tubular catheter, having a proximal end, a distal end and a catheter hub on the proximal end. An elongate, flexible rail has a proximal end, a distal end and a rail hub on the proximal end. The rail has a distal advance segment which extends at least about 10 cm beyond the distal end of the catheter when the catheter hub is adjacent the rail hub.

A large bore catheter has a guiding rail extending therethrough and an advance segment of the rail extends at least about 10 cm beyond the distal end of the catheter. The advance segment is advanced from the vena cava through the tricuspid and pulmonary valves of the heart into the central pulmonary artery while the distal end of the large bore catheter remains in the vena cava. The large bore catheter is thereafter distally advanced over the rail until the large bore catheter distal end is at least as far as the central pulmonary artery. The rail is thereafter proximally removed from the large bore catheter, and at least a portion of a clot is drawn from a pulmonary artery into the large bore catheter.

Needle assemblies and related methods in which a valve opener is used to push into a valve to open one or more slits on the valve to open the valve. The needle assemblies each includes a needle hub with a needle, a catheter tube with a catheter hub and the valve and valve opener positioned in the interior cavity of the catheter hub. The valve can have a valve skirt and a nose section of the valve opener can locate therein. One or more reliefs can be provided with the valve opener so that an elbow or diagonal section on a needle guard can project from a holding space within the valve opener through the relief.