Disclosed are methods, systems, and devices for the endovascular repair of cardiac valves, particularly the atrioventricular valves which inhibit back flow of blood from a heart ventricle during contraction. The procedures described herein can be performed with interventional tools, guides and supporting catheters and other equipment introduced to the heart chambers from the patient's arterial or venous vasculature remote from the heart. The interventional tools and other equipment may be introduced percutaneously or may be introduced via a surgical cut down, and then advanced from the remote access site through the vasculature until they reach the heart.

A guide wire for guiding a dilator to be inserted into a living body includes: a flexible elongated shaft portion; a puncture portion at a distal end portion of the shaft portion to form a hole in biological tissue; and an elastically deformable cover portion covering the puncture portion. The cover portion includes a sparse pitch portion that has a wire member wound in a spiral shape and axially contractible, and a distal end cover located on a distal end side of the sparse pitch portion and covering at least a part of the puncture portion. The puncture portion includes a first contact portion. The distal end cover includes a second contact portion configured to contact the first contact portion from a proximal end side, so that relative axial movement of the first and second contact portions is restricted by the first contact portion contacting the second contact portion.

An apparatus (100) includes: a expandable structure (140) formable into three dimensional shapes including a range of diameters (D) and corresponding lengths (L); a movable component (106) moveable between a range of positions (124, 126) effecting the range of diameters; and a mechanical linkage (110) disposed between the movable component and the expandable structure. The expandable structure is configured to fit inside a working channel (204) of an endoscope (202) when the expandable structure is collapsed. The mechanical linkage is configured to move the collapsed expandable structure through the working channel to a selected location (400) past a distal end (404) of the endoscope and to increase and decrease a diameter of the expandable structure in response to changes in the position of the movable component when the expandable structure is at the selected location.

Methods and devices for removing an obstruction from a vessel include an elongate flexible shaft with an expandable capture cage coupled to the distal end of the elongate flexible shaft. The expandable capture cage has an expanded configuration and a collapsed configuration. The collapsed configuration is adapted to be delivered through the vessel and the expanded configuration is adapted to be expanded in the vessel to enmesh the obstruction.

A dilator assembly comprising an elongated body having a proximal end and a distal end, a first lumen extending along the body, a second lumen extending along the body so that it is a parallel to the first lumen, and a joint lumen disposed adjacent the distal end of the body, wherein both the first lumen and second lumen are in fluid communication with the joint lumen. A guidewire has a first end and a second end, and the first end of the guidewire is slidably received in the first lumen and the second end of the guidewire is slidably received in the second lumen.

An apparatus includes: a expandable structure formable into three dimensional shapes including a range of diameters and corresponding lengths; a movable component moveable between a range of positions effecting the range of diameters; and a mechanical linkage disposed between the movable component and the expandable structure. The expandable structure is configured to fit inside a working channel of an endoscope when the expandable structure is collapsed. The mechanical linkage is configured to move the collapsed expandable structure through the working channel to a selected location past a distal end of the endoscope and to increase and decrease a diameter of the expandable structure in response to changes in the position of the movable component when the expandable structure is at the selected location.

The present disclosure is directed to a shuttle apparatus for detachably joining a catheter to a guidewire so that the joined catheter, extending alongside the guidewire, is in sliding engagement with the guidewire without extending around the guidewire. The apparatus comprises a collar member sized for mounting in sliding engagement around a length of the guidewire, the collar member having a longitudinal axis that approximately aligns along the length, when mounted thereabout, the length being defined between a proximal-most point of the guidewire and a distal point of the guidewire, the distal point being offset proximally from a distal-most point of the guidewire. The apparatus further comprises a plug member coupled to the collar member, the plug member having a longitudinal axis, and the plug member being sized to fit within an opening of the catheter for detachable engagement therewith.

The present invention pertains to a thrombectomy device comprising a cylindrical proximal portion, a dome-shaped distal portion, a transition portion, and a coil. The cylindrical proximal portion forms a stent frame having a first lattice network of a first plurality of interconnecting segments. The first plurality of interconnecting segments is configured to exert a first radial force against an inner wall of a blood vessel. The dome-shaped distal portion forms a protection cage having a second lattice network of a second plurality of interconnecting segments. The second plurality of interconnecting segments is configured to exert a second radial force against the inner wall of the blood vessel. The transition portion is arranged between the stent frame and the protection cage. The coil is formed at a distal end of the protection cage.

Devices and methods for occluding or promoting fluid flow through openings are disclosed. In one exemplary embodiment an occlusion device is provided having an expandable outer elongate tubular body, a guide member extending from a distal end of the outer body, and a slide tube disposed within the outer body, the proximal portions of the outer body and the slide tube being fixedly mated. The slide tube is configured to slide distally within the outer tubular body when the tubular body is expanded to form wings. A tether can be included as part of the device and it can be used to assist in positioning and locking a location of the device in an opening. Exemplary methods for delivering devices disclosed herein are also provided.

Disclosed are methods and systems for restoring patency across a vascular or non-vascular occlusion. The system may include a retrograde catheter, having a proximal end, a distal end, a first central lumen and a first side port spaced proximally apart from the distal end, the first central lumen extending at least as far as the first side port. An antegrade catheter is also provided, having a proximal end, a distal end, a second central lumen in communication with a second side port spaced proximally apart from the distal end. The catheters may have complementary surface configurations to facilitate alignment of the first and second side ports, so that a wire may be passed out of one of the side ports and into the other side port.