A septostomy device 10 with a cutting structure or means 140 and tissue capture mechanisms 240, 250 is disclosed, along with a medical procedure for using the device. The system 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

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.

The present disclosure is directed to a medical instrument. The medical instrument may include a delivery device and a retraction mechanism including a target tissue anchor and a first stabilizing anchor, wherein the target tissue anchor attaches to target tissue and connects to the delivery device.

An integrated guidewire includes a wire and a flexible tube. The wire is sized and shaped to move in an anatomical material transportation system of a patient. The flexible tube is sized and shaped to move in the anatomical material transportation system, having proximal and distal ends, the proximal-end is coupled to a device external to the patient, the flexible tube is configured to transfer fluids between the distal-end and the device, and the wire and the flexible tube are intertwined with respect to one another.

A treatment device and a treatment method are capable of improving permeability of a physiologically active substance into a blood vessel wall while maintaining a blood flow. A treatment device for treating a lesion in a blood vessel includes: a shaft portion including at least one lumen; a balloon disposed at a distal side of the shaft portion and configured to inflate; and at least one anchor member that can be inserted into the lumen and to radially expand at a state in which a distal portion protrudes from the lumen. The balloon has an outer diameter when inflated that is smaller than an outer diameter of the anchor member when radially expanded. When the anchor member radially expands in a blood vessel to come into contact with a blood vessel wall, the balloon is held away from the blood vessel wall.

Example embodiments relate to endoscopic systems. The system includes first and second main bodies. First main body includes first end section, which includes a first anchor assembly and first proximal portion. First anchor assembly includes first and second expandable members and first negative pressure opening. First and second expandable members are each configured to transition between a non-expanded configuration and an expanded configuration. First negative pressure opening is configured to apply negative pressure. First proximal portion is secured to the first anchor assembly. First proximal portion includes a bendable portion configured to selectively move the first anchor assembly in a plurality of directions. Second main body includes first and second end sections and main cavity. First end section of second main body includes a second anchor assembly, which includes third and fourth expandable members and second negative pressure opening. Second negative pressure opening is configured to apply a negative pressure.

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.

Devices, systems, and methods for treating a heart of a patient may make use of one or more implant structures which limit a size of a chamber of the heart, such as by deploying a tensile member to bring a wall of the heart toward (optionally into contact with) a septum of the heart.

A sheath includes a sheath body, an inflow port at a proximal end of the sheath body, an outflow port at the proximal end of the sheath body, and a plurality of radially expandable flexible members which extend along a length of the sheath body. The plurality of radially expandable flexible members are attached to the sheath body at a plurality of anchor points along the length of the sheath body. The plurality of radially expandable flexible members expand during active fluid inflow. The radially expandable flexible members are spaced apart along the sheath body to define one or more isolated spaces that extend between adjacent radially expandable flexible members when the radially expandable flexible members are inflated within a body passage.

Rotational atherectomy devices and systems can remove or reduce stenotic lesions in implanted grafts by rotating one or more abrasive elements within the graft. The abrasive elements can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, individual abrasive elements are attached to the drive shaft at differing radial angles in comparison to each other (e.g., configured in a helical array). The centers of mass of the abrasive elements can define a path that fully or partially spirals around the drive shaft.