In some embodiments, a method includes a shaft having a side catheter guide attached thereto via a guide coupler into an inferior vena cava and a superior vena cava such that the guide coupler is disposed in a right atrium, and applying a distal force to a proximal portion of the side catheter guide such that a distal end of the side catheter guide deflects laterally about the guide coupler towards a septum. The method further includes extending a side catheter that is disposed within the side catheter guide distally from the side catheter guide towards and into contact with the septum. The method further includes, with the side catheter in contact with the septum, extending a septum penetrator that is slidably disposed within the side catheter distally from the side catheter such that the septum penetrator pierces the septum.

Apparatus for puncturing a fossa ovalis includes a catheter shaped so as to define a central catheter lumen open through a catheter distal end opening. An angle between (i) a first line running between first and second lateral openings defined by the catheter and (ii) a second line that is parallel to a central longitudinal axis of the catheter when the catheter is straight, is between 30 and 150 degrees. A flexible longitudinal member passes (a) from a proximal portion of the catheter to a distal portion of the catheter, (b) out of the first lateral opening, and (c) into the second lateral opening, so as to form a loop outside the catheter. The flexible longitudinal member is configured to assume a deployment configuration in which a distal-most portion of the loop is curved and is distal to the catheter distal end opening. Other embodiments are also described.

The presently disclosed subject matter relates generally to a device for cutting soft tissue, such as transverse carpal ligaments and annular ligaments of the finger, and methods of using the soft tissue cutting device. A soft tissue cutting device includes an inner tubular member extending between a distal end and a proximal end of the inner tube, an outer tubular member disposed over at least a portion of the inner tubular member and movable between an initial position and an extended position, an outer tubular member movement controller that controls movement of the outer tubular member between the initial position and the extended position, and an attachment mechanism for removably coupling the proximal end of the inner tubular member to a dispensing member. A distal end of the outer tubular member includes a cutting member.

The present technology relates generally to devices and methods for intravascular evaluation of blood vessels. Many embodiments of the technology relate to the intravascular evaluation of blood vessels before, during and after creation of autologous valves. In one embodiment, for example, the present technology is directed to a method comprising intravascularly delivering a delivery catheter to a target location adjacent a vessel wall and engaging the vessel wall along a portion of the delivery catheter. The method can further include determining the location of a first circumferential periphery of a dissection pouch formed within the vessel wall, determining the location of a second circumferential periphery of the dissection pouch, and determining an angular width of the dissection pouch based on the location of the first circumferential periphery and the second circumferential periphery.

The present disclosure is directed to a device. The device may include a distal shaft defining a central lumen and an orienting element comprising at least one inflatable member. Wherein a first portion of the orienting element extending from the shaft in a first direction and a second portion of the orienting element extending from the shaft in a second direction. Further, wherein the second direction is substantially opposite the first direction.

Telescoping, self-driving, and laterally-pushing atherectomy devices are provided, each having a flexible sheath, a cutter with helical flutes, and a drive assembly. The drive assembly can have a flexible driveshaft that is rotatably translational with the lumen of the flexible sheath, a positive displacement pump that begins pumping at the distal end of the drive shaft adjacent to the helical flutes at the proximal end of the cutter, and the flexible drive shaft can be longer than the flexible sheath to enable a reversible telescoping of the drive assembly from the lumen of the flexible sheath. The positive displacement pump can be a screw pump having a drive screw portion extending beyond the flexible sheath, exposed for contact with a vascular lumen for the self-driving. And, the devices can have a reversibly-expandable, lateral pushing member at the distal end of the flexible sheath for the lateral pushing.

Vascular access devices and methods of their use are provided. In one embodiment, a vascular access device includes a catheter and at least one deployable wire. The catheter includes a primary lumen extending from a proximal end to a distal end of the catheter. The at least one deployable wire is secured to the catheter and configured to move relative to the catheter between a delivery configuration and a deployed configuration.

A reentry catheter for crossing a vascular occlusion includes an elongate flexible tubular body, having a proximal end, a distal end and at least one lumen extending there through. A reentry zone on the tubular body includes at least two and preferably three sets of opposing pairs of axially spaced exit apertures in communication with the lumen. The apertures are rotationally offset from each other and aligned in a spiral pattern around the tubular body. Each aperture may be defined within a radiopaque reinforcing ring embedded within the tubular body. A first set of opposing pairs of reinforcing rings may be separated axially from a second set of opposing pairs of reinforcing rings and may be connected by a flexible hinge section.

An atherectomy catheter includes an elongate flexible catheter body, a cutter near the distal end of the catheter body, a drive shaft connected to the cutter and extending within the catheter body, an imaging element near the distal end of the catheter body.

The present disclosure is directed to a device. The device may include a distal shaft defining a central lumen and an orienting element comprising at least one inflatable member. Wherein a first portion of the orienting element extending from the shaft in a first direction and a second portion of the orienting element extending from the shaft in a second direction. Further, wherein the second direction is substantially opposite the first direction.