Disclosed are methods and devices for restoring patency across a vascular or non-vascular occlusion. A first catheter having a first side port is configured to advance in a first direction through a vessel from a vascular access site on a first side of the occlusion. A second catheter having a second side port is configured to advance in a second direction through the vessel from a vascular access site on a second side of the occlusion. The catheters may have complementary surface configurations to facilitate alignment of the first and second side ports, so that a wire may be passed through the catheters, out of one of the side ports and into the other side port, to bypass the occlusion.

The present disclosure relates to medical devices. More particularly, this disclosure describes a vascular device allowing large bore transseptal access with subsequent atrial re-access by preplacing closures/tissue approximating sutures prior to creating a septostomy. Generally, the device may include a delivery catheter for puncturing and cutting the interatrial septum. An anchor of the delivery catheter may secure the suture in an atrium to a septum wall, for example, the left atrium. Incisions may be made by an expandable cutting implement which may use mechanical or radio frequency (RF) energy without interfering with the suture. A therapeutic instrument may be advanced through the tissue plane after the incisions are made by the cutting implement. Closure of the incision may be performed with the previously placed sutures.

A medical device for removal of an occlusion from a vessel in a patient’s body. The retrieval device having a retriever sub-system and an aspiration sub-system. The retriever sub-system having a delivery catheter and an elongated delivery member that includes proximal and distal expandable elements, the proximal element being removably engaged to the elongated delivery member and the distal element being fixed to the elongated delivery member. The proximal element adapted to move axially along the elongated delivery member in a distal direction toward the distal element when the proximal element is released from the elongated delivery member, whereby, when the proximal element is disposed on a distal side of the vessel occlusion and the distal element is disposed on a proximal side of the occlusion, the proximal and distal elements surround, isolate and contain the occlusion between the proximal and distal elements at the vessel occlusion site. The medical device also includes means for delivering a pharmacological agent composition to the vessel occlusion site during and after the occlusion extraction, the pharmacological agent composition adapted to at least partially lyse and/or disassociate the occlusion from the vessel wall or ameliorate and/or facilitate amelioration of tissue damage to an endothelial luminal wall of an obstructed vessel in vivo and/or enhance the flow rate of blood through the vessel. The aspiration sub-system being in communication with the retriever sub-system and adapted to remove at least a portion of the occlusion from the vessel.

A valve annulus repair system joins anchors at one or both of their proximal and distal ends to construct an implant to reshape the annulus. A removable frame may be used to position the anchors proximate to the annulus and to adjust the shape of the annulus. The frame may support the anchors during deployment of the system, release the anchors during construction of the implant, adjust the shape of the implant (and concomitantly the shape of the reconstructed valve) during an adjustment/cinching process, retain the adjusted shape of the valve annulus while relative anchor positions are secured, and release the anchors to enable the frame to be removed from the deployment site following implant construction. With such a system, a low-profile, flexile annular valve implant with reduced the risks of migration, fracture, embolism and thrombus may be provided.

Vascular access devices, systems, and methods of their use are provided. In one embodiment, a vascular access device includes a catheter, a balloon, and an inflation lumen. The catheter includes an elongate flexible shaft having a proximal end and a distal end with a primary lumen therethrough. The balloon is disposed about the distal end of the catheter. The inflation lumen is in fluid communication with the balloon and extends toward the proximal end of the shaft of the catheter. The balloon is inflatable into a shape having a first open end, a second open end, a sidewall between the first and second open ends, and a passageway therethrough, which, when the balloon is deployed and inflated within a vessel, permits blood flowing in the vessel to flow through the passageway. The balloon further includes a balloon lumen which is coupled at its first end to the primary lumen of the catheter and which extends to an aperture in the sidewall of the balloon, thereby providing a hemostatic connection and luminal access to a wall of the vessel via the primary lumen of the catheter.

Disclosed are methods and devices for bidirectional crossing of a vascular obstruction in a patient. The method includes the steps of advancing a first catheter transvascularly in a first (e.g., retrograde) direction towards a vascular obstruction, the first catheter having a first central lumen in communication with a first side port. A second catheter is advanced transvascularly in a second, opposite (e.g., antegrade) direction towards the obstruction, the second catheter having a second central lumen in communication with a second side port. The first and second side ports are aligned to place the first central lumen in communication with the second central lumen; and a wire is advanced through the first and second side ports such that a first end of the wire is on a first side of the obstruction and a second end of the wire is on a second side of the obstruction.

A needleless transseptal device assembly, and associated methods, for accessing the left atrium of a human heart includes a tubular body sized to navigate vasculature, and a dilator having a proximal end and a distal end. The dilator is substantially housed and axially movable within the tubular body. The assembly further includes a guidewire that is substantially housed and axially movable within the dilator. The guidewire includes a flexible proximal section and a flexible distal section, and the flexible distal section has a distal end with rotatable, septal tissue cutting elements. The distal end may be configured with a blunt shape. Further, the tubular body and the dilator may be arranged in a steerable configuration. A torquing member may also be coupled to the proximal section of the guidewire to assist in the rotational movement of the septal tissue cutting elements.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular wire and a coupling. The coupling when in use transmits ultrasonic energy along the wire from an ultrasonic energy source to an active tip at a distal end of the wire. The coupling is arranged to couple the source to the wire at any of a plurality of discrete operational positions along the length of the wire for said transmission of ultrasonic energy to the active tip.

Disclosed herein are vascular access systems with dilator locking mechanisms, and associated devices and methods. In some embodiments, the dilator locking mechanisms include a first cap coupled to a dilator component and a second cap coupled to the vascular access system. The first cap can include one or more locking members. The second cap can include one or more locking features, each configured to be releasably coupled to one of the locking members. In operation, the dilator component can be inserted into the vascular access system, and at least a portion of one or more of the locking members can be aligned with and inserted into the corresponding locking feature to, e.g., couple the first cap and the second cap. The interaction between first and second caps when coupled can at least partially prevent the dilator from moving relative to the vascular access system.

Described herein is a neuroaspiration catheter for removing a blood clot in a blood vessel. The neuroaspiration catheter includes a first tube, a second tube and a wire for guiding the navigation of the catheter. The wire can be navigated to the site of the blood clot, aid the navigation of the catheter, and left in the blood vessel during and after the aspiration. If the aspiration fails, the catheter can be quickly navigated back to the site of the blood clot using the wire as a guide. Also described herein is a method of removing a blood clot using the neuroaspiration catheter.