The invention relates to evaluation of maturity of arteriovenous (AV) fistula using guidewires that measure intravascular blood flow and/or pressure. The invention provides methods of evaluating AV fistula maturation using an instrumented guidewire to measure intravascular flow and/or pressure. By using a small diameter guidewire that does not interfere substantially with the flow, an accurate measurement can be made that is useful for identifying when a fistula is mature and therefore ready to be used for hemodialysis. The flow of blood through the fistula is measured using the guidewire and the measured flow and/or pressure of blood is used to determine if the fistula is mature.

Systems and methods for informing and evaluating neuromodulation therapy are disclosed herein. A system configured in accordance with embodiments of the present technology can include, for example, a guidewire having a proximal portion, a distal portion configured to be positioned at a target site in a blood vessel of a human patient, and a sensing element positioned along the distal portion. The sensing element can be a pressure sensing element, a flow sensing element, an impedance sensing element, and/or a temperature sensing element. The system can further include a controller configured to obtain one or more measurements related to a physiological parameter of the patient via the sensing element. Based on the measurements, the controller can determine the physiological parameter and compare the parameter to a predetermined threshold. Based on the comparison, the controller and/or the operator can assess the likelihood of the patient benefiting from neuromodulation therapy.

A sensing guidewire device used to measure physiological parameters within a living body. In one embodiment, the device is used to measure the fractional flow reserve (FFR) across a stenotic lesion in a patient's vasculature. The device includes a sensor that is adapted to be affixed near the distal end of a guidewire. The guidewire contains a corewire, processed to enclose electrical conductors in a sealed, off-centered interstice or channel, with an outer diameter approximate to the outer diameter of the device, running substantially the full length of the device, and has a homogenous outer surface. The enclosed eccentric channel provides space for electrical conductors to move freely. The corewire can have a tapered segment to create desirable flexibility. A solid connector comprised of alternating conductive and insulating elements for connecting the conductors to an external device is disclosed. The guidewire can be advanced through a patient's blood vessels, returning pressure measurements across vessel blockages that allow for accurate assessment of blockage severity and lead to better clinical outcomes.

A medical apparatus includes a shaft for insertion into an organ of a patient, an expandable frame, a plurality of diagnostic electrodes, a respective plurality of reference electrodes, and a processor. The expandable frame is coupled to a distal end of the shaft, extending along a longitudinal axis and including a plurality of expandable spines disposed about the longitudinal axis. The plurality of diagnostic electrodes, disposed on external surfaces of the expandable spines, are configured to sense diagnostic signals when in contact with tissue. The respective plurality of reference electrodes, disposed on internal surfaces of the expandable spines directly opposite the diagnostic electrodes, is electrically insulated from the tissue and is configured to sense interfering signals. The processor is configured to receive the diagnostic signals sensed by the diagnostic electrodes, receive the interfering signals sensed by the respective reference electrodes, and calculate corrected diagnostic signals by subtracting the interfering signals from the diagnostic signals.

A vessel locator apparatus (30) having a locator housing, and an elongated cavity defined in the locator housing, is described. The vessel locator apparatus include a superelastic wire (46) positioned at least partially in the elongated cavity, the superelastic having a proximal end and a distal end. The superelastic wire may have an elongated portion extending in a substantially longitudinal direction and a distal locator portion having an original shape configuration. The original shape configuration of distal locator portion may include a first curved segment, a second curved segment, an intermediate segment extending between the first curved segment and the second curved segment, and an end segment extending between the second curved segment and the distal end of the superelastic wire. A method of locating a vessel, such as a blood vessel, using a vessel locator apparatus is also described.

A system for automated navigation to a target neuron is disclosed. The system comprises a recording electrode including a pipette with a hollow glass tip and a headstage for detecting electrical resistance measurements at the glass tip. The system further comprises an actuator, a light source configured to emit light from the glass tip, an ultrasound transducer for detecting photoacoustic signals in response to the light, a light sensor for detecting optical signals in response to the light, and a processor. The processor iteratively receives the photoacoustic and optical feedback and moves the glass tip via the actuator based on a calculated distance of the target neuron. When the distance at or below a predetermined threshold, the processor maintains the position of the hollow glass tip with respect to the target neuron. Upon successful navigation, the recording electrode may be used to perform single-unit neural recording of the target neuron.

Methods for diagnosing and/or treating a multi-lesion intravascular region are disclosed. The methods may include advancing a pressure sensing device to a first position that is distal of a first lesion and that is distal of a second lesion, proximally retracting the pressure sensing device to a second position that is proximal of the first lesion and that is proximal of the second lesion, calculating a first estimated post-treatment fractional flow reserve based on treatment of the first lesion, calculating a second estimated post-treatment fractional flow reserve based on treatment of the second lesion, and treating the first lesion, the second lesion, or both based on the first estimated post-treatment fractional flow reserve and the second estimated post-treatment fractional flow reserve.

The present disclosure is directed to intravascular devices, systems, and methods having a core wire with multiple flattened sections. In one aspect, a sensing guide wire is provided. The guide wire includes a first flexible elongate member; a sensing element positioned at a distal portion of the first flexible elongate member; and a second flexible elongate member coupled to the first flexible elongate member such that the second flexible elongate member extends distally from the first flexible elongate member; and wherein a distal portion of the first flexible elongate member includes at least two flattened sections, and wherein the first and second flexible elongate members are coupled along a portion of one of the at least two flattened sections. In other aspects, methods of forming a sensing guide wire are provided.

Embodiments of the present disclosure are related to intravascular devices having improved rapid-exchange configurations and associated systems and methods. In some particular embodiments, the devices of the present disclosure include a reinforced rapid-exchange port, an offset rapid-exchange port, and/or combinations thereof. For example, in some implementations an intravascular imaging device is provided that includes a main catheter body; a rotational imaging element positioned within a lumen of the main catheter body; a distal portion extending from the main catheter body, the distal portion having a rapid-exchange port in communication with a guidewire lumen, the rapid-exchange port and the guidewire lumen sized and shaped to receive a guidewire; and at least one reinforcing element positioned adjacent to the rapid-exchange port.

Guidewires and methods for transmitting electrical stimuli to a heart and for guiding and supporting the delivery of elongate treatment devices within the heart are disclosed. A guidewire can comprise an elongate body, including first and second elongate conductors, and at least first and second electrodes. A distal end portion of the elongate body can include a preformed bias shape, such as a pigtail-shaped region, on which the first and second electrodes can be located. The preformed bias shape can optionally be non-coplanar relative to an intermediate portion of the elongate body. The first and second elongate conductors can be formed of a single structure or two or more electrically connected structures. The conductors can extend from proximal end portions to distal end portions that electrically connect to the first and second electrodes. A corewire can extend the length of the elongate body, can at least partially form the first conductor, and can be at least partially surrounded by the second conductor.