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.

A thrombus treatment device includes a support wire, a body frame portion that is disposed about an axis defined by the support wire, one or more tethers that each have a first end and a second end, and a filter element extending from the body frame portion. Each of the one or more tethers is attached at its first end to the body frame portion, and at its second end to a collar that couples the second end of each of the multiple tethers to the support wire. When the collar is positioned substantially within a region interior of the body frame portion, a rotational actuation of the support wire causes a swiveling motion of the one or more tethers.

A device for fracturing calcifications in heart valves including an expandable stabilizer and expandable impactor arms assembled on and deployed by a delivery system, wherein the delivery system is operable to move the impactor arms, while in an expanded position, with respect to the stabilizer with sufficient energy so as to fracture a calcification located in tissue which is sandwiched between the stabilizer and the impactor arms.

An apparatus, device and method are provided for executing a clot or plaque removal procedure. In one embodiment, a clot removal device may include a clot holding element for penetrating a target clot and stabilizing the clot in its position; a controllable distal filter that can be extended to cover the target clot; a distal filter, openable downstream from the clot, designed to substantially prevent flow through of clot elements, and further designed to drag the clot out of a vessel, for retrieving by the clot removal device.

A balloon catheter is disclosed for endovascular procedures. In one embodiment, among others, the balloon catheter includes an elongated catheter body. At a distal end, the catheter body also includes an angled tip and a balloon adjacent to the angled tip. The balloon is inflatable to form an oblong shape.

Retrieval of material from vessel lumens can be improved by use of a distal element comprising an expandable mesh. a treatment device includes an elongated member having a proximal portion and a distal portion configured to be positioned within a blood vessel at a treatment site at or near a thrombus. A distal element comprising an expandable mesh is coupled to the distal portion of the elongated member via a connection assembly. In an expanded state, at least a portion of the mesh is configured to be in apposition with the blood vessel wall at the treatment site to anchor or stabilize the elongated member with respect to the blood vessel. The distal element can be electrically coupled to an extracorporeal current generator.

The invention provides methods and devices for treating liver cirrhosis or portal hypertension by creating an intrahepatic shunt, or new passage, from a portal vein of a patient to a hepatic vein using a device with intravascular imaging capabilities and pressure sensing capabilities or positioning mechanisms. The integration of intravascular imaging aids in the precise placement of the shunt and pressure measurement may verify successful shunt creation. An apparatus may include a catheter with an extended body for insertion into a hepatic vein of a patient, an intravascular imaging device and a needle exit port on the distal portion of the extended body, and a needle disposed within a lumen in the catheter and configured to be pushed out of the exit port and extend away from a side of the extended body, in which the needle includes a pressure sensor.