A balloon suction catheter may be used to remove clots and increase blood flow to obstructed vessels such as a cerebral artery in a stroke patient. The catheter may be used to apply suction on the clot while providing flow arrest, embolic protection, and optionally flow reversal. The same catheter may also be used to provide for a flow modulation procedure known as post-conditioning to potentially reduce any damage from the sudden reintroduction of blood flow reperfusion injury.

A bioadhesive mixing assembly includes first and second syringes and an adapter. The first syringe includes first and second chambers holding a first sealant component and an activator, respectively. The second syringe includes third and fourth chambers holding a second sealant component and one of an activator or a third sealant component, respectively. The adapter is mounted to the first syringe and includes first and second channels in flow communication with the first and second chambers, a first seal member providing sealed access to the first and second channels, first and second needles connected in flow communication with the third and fourth chambers, and a second seal member enclosing the first and second needles. Connecting the adapter to the second syringe punctures the first and second seal members with the first and second syringes to create flow communication between the first and third chambers and the second and fourth chambers.

The apparatus includes a catheter having a combined infusion/aspiration lumen, a three lumen proximal portion and a two lumen distal portion. An infusion/aspiration valve located at the distal end of the catheter facilitates performing infusion and aspiration through the same lumen, which in turn reduces the number of lumens, and enables the combined infusion/aspiration lumen to be made larger without the need to increase the diameter of the catheter. Differing material properties in the proximal and distal portions of the catheter enable the proximal portion to be made stiffer for pushability, while the distal portion is more flexible to navigate tortuous vasculature and enable a greater amplitude agitator to be received within the catheter.

Described herein are methods and devices for selectively applying either fluids (e.g., anesthetics, nerve-blockers, etc.) or energy, such as radiofrequency or ultrasound energy, to a target tissue from within a blood vessel while minimizing the amount of fluid or energy applied to non-target tissue. The catheters described herein may include an elongate body, a directional injector, and one or more holdfasts for securing the catheter. In addition, catheters can include energy applying features for delivering energy to the target tissue.

A rotational atherectomy device for removing a stenotic tissue from the iliac artery of a patient. The device comprises a flexible, rotatable drive shaft having an elongated proximal portion, an elongated distal portion, and an abrasive element mounted to the drive shaft between the elongated proximal and distal portions of the drive shaft and configured for rapid rotation together with the drive shaft.

An apparatus for sealing a puncture through a vessel wall including a positioning assembly, a sheath releasably engaged with the positioning assembly, and a support member axially advanceable through the sheath. The positioning assembly includes a positioning element positioned at a distal portion of the positioning assembly and a sealant disposed at a distal portion of the positioning assembly. The sheath guides the sealant and positioning assembly to the puncture in the vessel wall.

A clot capture catheter comprises an elongate tubular shaft having a proximal end, a distal end and an inflatable expansile member at the distal end. The expansile member is inflatable from a collapsed delivery configuration to an expanded configuration. In the expanded configuration, the expansile member extends to define a funnel shape having an enlarged distal clot entry mouth at the distal-most end of the catheter. In the expanded configuration, the expansile member may extend distally beyond the distalmost tip of the shaft. The expansile member may be integral with the distal tip of the catheter shaft.

A sealant is provided for sealing a puncture through tissue that includes an elongate first section including a proximal end, a distal end, and a cross-section sized for delivery into a puncture through tissue, and a second section fused to and extending from the distal end of the first section. The first section may be formed from a freeze-dried hydrogel that expands when exposed to physiological fluid within a puncture. The second section may be formed from a solid mass of non-freeze-dried, non-crosslinked hydrogel precursors, the precursors remaining in an unreactive state until exposed to an aqueous physiological, whereupon the precursors undergo in-situ crosslinking with one another to provide an adhesive layer bonded to the first section. Apparatus and methods for delivering the sealant into a puncture through tissue are also provided.

A system can include an elongated member that includes a proximal portion and a distal portion that includes an agitator. The elongated member can extend through a working channel of an endoscope placed within a patient such that the agitator extends past a distal end of the endoscope into a target region within the patient. The agitator can include a plurality of disruption elements that can be in a low-profile state when within the working channel of the endoscope and can transition to an expanded state when advanced past the distal end of the endoscope. The plurality of disruption elements can define an empty cage configuration when in the expanded state. The system can include a driver coupled to the proximal portion of the elongated member. The driver can rotate the elongated member about a longitudinal axis of the elongated member.

Catheter based systems for isolated stenting of an intravascular lesion can include two expandable occlusion devices with a balloon expandable stent or self-expanding stent therebetween. Expandable occlusion devices can be expanded in a distal direction and a proximal direction in relation to the lesion to occlude vasculature. A treatment agent can be injected into a cavity formed between the expandable occlusion device. A coating can be applied to one or both occlusion devices to prevent adherence to the treatment agent. The stent can be deployed across the lesion while the occlusion devices are in place. Fragments dislodged during stenting can be aspirated.