Apparatus and methods are provided for removing obstructive material within a body lumen. The apparatus includes a macerator device deployable from a sheath that includes an expandable cage carried by a shaft and within a constraint tube. The shaft is movable relative to the constraint tube for deploying and expanding the cage within a body lumen such that an open end of the cage is oriented towards obstructive material. The cage is advanced to capture the material or the material is directed into the cage using an expandable member expanded beyond the material and retracted to direct the material into the cage. The cage is withdrawn into the constraint tube to compress the cage radially inwardly. Materials extending through apertures in the cage are sheared off by a sharpened edge of the constraint tube. The smaller, sheared off particles are then aspirated from the body lumen through the sheath.

A method includes inserting into a patient body a catheter, which includes an insertion tube and at least an expandable distal-end device coupled to a distal end of the insertion tube. The distal-end device is expanded in a blood vessel, thereby forming an annular guiding trench between the distal-end device and a circumference of the blood vessel, the annular trench shaped to receive and guide a distal tip of a medical instrument. The distal tip of the medical instrument is guided in the annular guiding trench formed by the expanded distal-end device of the catheter, so as to approach multiple points on the circumference of the blood vessel.

An intracorporeal pressure shock wave includes an expandable pressure shock wave reflector at the distal end of an intracorporeal catheter to direct shock waves from a shock wave generator within a human or animal blood vessel or body lumen.

A device and method for establishing retrograde blood flow during recanalization of a vessel having a targeted blockage. While in a collapsed state an occluding component is introduced distally intravascularly traversing the targeted blockage to its distal side. Then, the occluding component transitions to an expanded state having an enlarged diameter forming a seal with an internal wall of the vessel prohibiting anterograde blood flow beyond the expanded occluding component. Retrograde blood flow is thereby established in a region of the vessel bound at one end by the occluding component and at an opposite end by the targeted blockage by dispensing a flushing fluid into the region of the vessel.

A sealant for sealing a puncture through tissue includes a first section, e.g., formed from freeze-dried hydrogel, and a second section extending from the distal end. The second section may be formed from PEG-precursors including PEG-ester and PEG-amine, e.g., in an equivalent ratio of active group sites of PEG-ester/PEG-amine greater than one-to-one, e.g., such that excess esters may provide faster activation upon contact with physiological fluids and enhance adhesion of the sealant within a puncture. At least some of the precursors remain in an unreactive state until exposed to an aqueous physiological environment, e.g., within a puncture, whereupon the precursors undergo in-situ cross-linking to provide adhesion to tissue adjacent the puncture. For example, the PEG-amine precursors may include the free amine form and the salt form. The free amine form at least partially cross-links with the PEG-ester and the salt form remains in the unreactive state in the sealant before introduction into the puncture.

Methods for collapsing a tubular organ, such as the esophagus, involve inserting a device into the tubular organ, at least partially sealing off a section of the tubular organ, and drawing in the wall of the tubular organ by application of suction. The devices may be used to move the wall of the tubular organ away from an area undergoing treatment or therapy, such as to minimize damage to the tubular organ by application of radiofrequency energy or to limit temperature increase of the tubular organ.

A method and a medical elongate body are configured to prevent stagnation or turbulence of blood flow in a recess of a rugged pattern formed in a blood vessel due to bulging of a blood vessel wall at a lesion part of the blood vessel. The method involves partitioning an inside of the blood vessel into upstream and downstream sides of the recess, and introducing gel into the recess to at least partially fill the recess. A blood vessel lumen forming method and medical elongate body to form such a lumen are other aspects of the disclosure and involve introducing gel into the recess to at least partially fill the recess with the gel, and drilling the gel to remove at least some of the gel to form a passage and secure blood flow in the blood vessel.

A catheter for removable insertion into a body vasculature has at least one inflatable member. The catheter has at least in part an expandable body that forms an internal axially extending lumen in at least the expanded state of the body. The inflatable member is adjacent a distal axial end of the body and is configured to at least partially obstruct the lumen.

One aspect of the present invention provides a method for the treatment of lithiasis, which mitigates the risk of damage to surrounding body tissue when removing a calculi (e.g., biological concretions, such as urinary, biliary, and pancreatic stones) that obstructs or may otherwise be present within a body's anatomical lumen. In one embodiment, the instant invention provides a method of using a polymer plug to occlude a lumen distal to a calculi, whereby calculi fragments resulting from lithotripsy are prevented from traveling up the lumen. In certain embodiments, a dual lumen catheter is utilized to inject two solutions proximal to the calculi, the mixing of said solutions causing a polymer plug to form.

A neurovascular catheter extension segment is provided, such as for distal neurovascular access or aspiration. The neurovascular catheter extension segment includes 1) an elongate flexible control wire having a proximal end and a distal end and 2) a tubular extension segment having a side wall defining a central lumen carried by the distal end of the control wire. The side wall of the tubular extension segment includes a tubular inner liner, a tie layer separated from the lumen by the inner liner, a helical coil surrounding the tie layer, and an outer jacket surrounding the helical coil. The extension segment may be introduced into the proximal end of a neurovascular catheter and advanced distally to extend beyond the catheter and thereby extend the reach of the catheter.