Methods and apparatuses for mechanically removing objects from a body. In particular, described herein are thrombectomy methods and mechanical thrombectomy apparatuses for removal of blood clots from within a lumen of a blood vessel.

A system is transluminally advanced into the heart of a subject. A first portion of the system is positioned through a native valve of the heart, the system including wires disposed at the first portion. The first portion is stabilized at the native valve by positioning a distal portion of the system within a blood vessel of the subject. While the distal portion of the system remains within the blood vessel, the wires are induced to bow laterally such that the wires press against the native valve. While the wires remain pressed against the native valve, the shape of the wires is radiographically imaged. An anchor is transluminally anchored to tissue of the native valve, facilitated by the imaging. Other embodiments are also described.

Methods and devices are disclosed for passing Chronic Total Occlusion (CTO) from subintimal location and re-entry into a true-lumen of the patient using transient fenestration approach. The transient fenestration is induced by balloon dilatation within the CTO, and a guidewire quickly trails into a true lumen.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular element such as a wire. The element has a proximal section, a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections . The apparatus comprises an ultrasonic transducer, mechanically coupled to the proximal section of the element for ultrasonically activating the element, hence exciting the distal tip section to facilitate crossing through the obstruction. A catheter surrounds the element, leaving at least part of the distal tip section of the element protruding distally beyond a distal end of the catheter.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

Cerebrovascular treatment at an intracranial location beyond the petrous segment of the carotid artery can be challenging due to blood vessel size and tortuosity. First pass cerebrovascular thrombectomy success rate under only fluoroscopic guidance can be low (e.g., 25.1%) but an angioscope can help improve efficacy. A sheath catheter can be advanced toward the cerebrovascular pathology. Its distal balloon can be inflated. An angioscope can be inserted via its working lumen for viewing. The sheath catheter can have a stepped-down lateral profile and can extend the working channel a distance beyond the balloon. A dual concentric lumen structure can include an inner body and an outer body, defining an inflation lumen therebetween, with one or more portions of one or more layers stretched or cut or both, such as to provide bending flexibility. Reflow techniques can be used to help bond layers together.

A catheter system for accessing the central venous system through an occlusion in the neck region.

A system for treating a patient having thrombus including an aspiration catheter having an aspiration lumen configured to be coupled to a vacuum source and configured for aspirating thrombus therethrough, an elongate member having a straight distal portion configured to extend from the aspiration lumen into a thrombus within the blood vessel, and a manipulation device selectively coupled to the elongate member, the manipulation device being configured to apply motive force to the elongate member, wherein the motive force comprises a combination of motive force components comprising an alternating clockwise motion and counter-clockwise motion.

An actuated telescoping system for navigation within a vascular lumen and thrombectomy of a thrombus. The system includes a tubular catheter member having an open distal end defining a catheter lumen, a vacuum source, a rotational drive system, a flexible shaft having a channel coupled to the rotational drive system for rotational movement in response thereto, and an optional guidewire selectively inserted at least partially within the flexible shaft. The flexible shaft is at least partially disposed within the tubular catheter member configured for uncoupled rotational and translational motion therein and to optionally define a corkscrew motion in response to rotational driving force by the drive system that results in formation of hydrodynamic vortices within the catheter lumen. The telescoping system can be capable of reversibly transitioning between navigation and thrombectomy modes by differentially disposing and actuating the components and enable faster, more efficient and simpler removal of thromboembolic material.

An elongate endovascular element for crossing through an obstruction in a blood vessel comprises: a proximal section; a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections; wherein the tapered intermediate section has a length that is substantially λ/2 or a multiple of λ/2, where λ is a wavelength of a driving frequency that will produce longitudinal resonance in the element.