A self-expandable occluding device can both cover the neck of an outpouching and serve as a permanent embolic plug thereby immediately stabilizing the outpouching. The self-expandable device effectively covers the neck of an outpouching with, for example, a mesh, or other at least partially occluding component, in a desired orientation across the neck of the outpouching without projecting into the parent vessel. The device incorporates elements which immediately stabilize the device in the outpouching, in effect, functioning as a permanent embolic plug. An embolic disc is combined with retention arms of flexible material, which deploy within the outpouching and provide immediate stabilization thereby retaining the occluding component or mesh across the neck of the outpouching. In illustrative embodiments, the arms are in the form of coils configured to deploy into three dimensional structures.

An apparatus and method are provided for accessing and/or removing material from a body lumen. The apparatus includes a tubular sheath including a shaft having a proximal end and an expandable distal end that is expandable between a collapsed configuration and an expanded, tapered configuration. A treatment member can be introduced into the body lumen through the tubular sheath. The treatment member includes one or more expandable members to interact with the material to be removed from the body lumen.

Methods and system are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

Medical methods and devices for treating aortic dissections. A catheter-based cutting device permits cutting a septum of acute or chronic aortic dissections, in a retrograde manner. The catheter includes a base section having a central lumen therethrough and two flexible arms extending from a distal end thereof. The flexible arms can each have a guide wire channel therethrough. With distal ends of the two flexible arms separated, the two arms form a Y-shape with the base section. In one embodiment, with distal ends of the two flexible arms together, the two arms have a longitudinal profile, about a periphery thereof, identical to a longitudinal profile of the base section. A cutting component resides between the two arms. The cutting component can face distally outward between the two arms with the distal ends of the two flexible arms separated.

Methods and system are provided for thermally-induced renal neuromodulation. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers. In some embodiments, parameters of the neural fibers, of non-target tissue, or of the thermal energy delivery element, may be monitored via one or more sensors for controlling the thermally-induced neuromodulation. In some embodiments, protective elements may be provided to reduce a degree of thermal damage induced in the non-target tissues. In some embodiments, thermally-induced renal neuromodulation is achieved via delivery of a pulsed thermal therapy.

An atherectomy device comprising a rotatably motor-driven flexible hollow shaft that is coaxial with a longitudinal axis of the guidewire; an annular distal end of the hollow shaft having a diameter that is only slightly larger than the diameter of the guidewire and configured with cutting surfaces for piercing hardened atherosclerotic plaque! a tubular sleeve secured to a first peripheral surface of the hollow shaft and configured with cutting surfaces for enlarging an opening formed in the plaque; and an asymmetric cutting unit extending between the sleeve and a second peripheral surface of the hollow shaft, to enable eccentric rotation of the hollow shaft for cutting and removing additional occlusive material from the blood vessel to open a chronic total occlusion. In one embodiment, the cutting unit is a helical strand unit having a polygonal cross section with a first side that atraumatically contacts a blood vessel wall.

A system and a method for disrupting an occlusion within a blood vessel is provided The system includes an elongated catheter body having a proximal portion, a distal portion, and a first lumen. The system further includes an ultrasound transmitter extending longitudinally through the first lumen of the catheter body and having a proximal end and a distal end. The system further includes a positioning mechanism located at a distal end of the catheter body. The positioning mechanism has a first retracted position and a second deployed position, and the positioning mechanism is radially expandable from the first retracted position to the second deployed position to position the catheter in the blood vessel.

A medical device for removing a material from a hollow anatomical structure is provided. The device may include a shaft member. The device may include an expandable centering element near the distal end of the device. The device may include a macerator element either attached to the shaft or independent and freely moveable from the shaft. Alternatively, the device may include a rotating wire attached to the macerator element. The device may include an aspiration lumen in for removal of material. The device may include a drive shaft attached to a motor and used to rotate the macerator element. The device may be used in combination with a distal occlusion element, which may be either a radially expandable filter or balloon member.

A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

A device for removing an obstruction from a lumen in a human or animal subject may include an inflatable balloon. The inflatable balloon may include a proximal tapered portion having a proximal taper angle, a central portion, and a distal tapered portion having a distal taper angle that is greater than the proximal taper angle. The balloon may also include at least one eversion feature on the proximal tapered portion and/or the distal tapered portion. The eversion feature may facilitate preferential eversion of the distal tapered portion into an inside of the balloon without the proximal tapered portion collapsing. Preferential eversion of the distal tapered portion may be provided by the differences in the distal and proximal taper angles and by one or more of a number of different types of eversion features.