A tissue cutting device includes a sizing element which detects the diameter of the vessel in which the cutting device is positioned. The sizing element is coupled to the cutting element so that the amount of the cutting element that is exposed varies in response to movement of the sizing element.

A dilator assembly comprising an elongated body having a proximal end and a distal end, a first lumen extending along the body, a second lumen extending along the body so that it is a parallel to the first lumen, and a joint lumen disposed adjacent the distal end of the body, wherein both the first lumen and second lumen are in fluid communication with the joint lumen. A guidewire has a first end and a second end, and the first end of the guidewire is slidably received in the first lumen and the second end of the guidewire is slidably received in the second lumen.

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 catheter system for accessing the central venous system through an occlusion in the neck region.

In one aspect, a system for endovascular treatment of a blood vessel includes a control unit, an ultrasound device, an actuator, and a catheter having a treatment portion. The ultrasound device is communicatively coupled to the control unit. The ultrasound device includes an ultrasound probe having a subject contact surface. The actuator is coupled to the ultrasound probe and is operable to move the subject contact surface of the ultrasound prove relative to a treatment zone of a subject. The control unit is configured to determine a position of the treatment portion of the catheter as the catheter is advanced through the blood vessel, and move the subject contact surface of the ultrasound probe relative to the treatment zone of the subject with the actuator to follow the position of the catheter as the catheter is advanced through the blood vessel.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing an intravascular device having a distal portion, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall to at least partially surround the occlusion, and removing at least a portion of the surrounded occlusion from the lumen.

A device for manipulating tissue at a vessel includes an elongated member having a proximal end and a distal end, a guide member at the distal end of the elongated member, the guide member having a blunt distal tip for engagement against an interior wall of the vessel, and a tissue cutting device at the distal end of the elongated member, wherein the tissue cutting device has a sharp tip that is proximal to the blunt distal tip of the guide member.

Methods of performing procedures within an intervertebral disc are disclosed. The methods include performing procedures such as implant delivery, tissue manipulation, tissue diagnostics, and therapeutic and diagnostic agent delivery at selected locations within intervertebral discs. In one embodiment, a method includes delivering an anchor and an implant within a functional spinal unit using a surgical device having at least one depth stop.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes providing an intravascular device having a distal portion, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall to at least partially surround the occlusion, and removing at least a portion of the surrounded occlusion from the lumen.

An apparatus for treating a total occlusion in a blood vessel may include a self-orienting device including an elongate shaft and an inflatable orienting element. The shaft includes an inflation lumen having a first noncircular shape and a working lumen having a second noncircular shape. The inflatable orienting element includes first and second inflatable members extending laterally from the shaft. An outer diameter of the shaft is 0.045 inches or less, a cross-sectional area of the first noncircular cross-sectional shape is at least 0.00013 square inches, and a cross-sectional area of the second noncircular cross-sectional shape is at least 0.00056 square inches. The shaft may include a distal tail extending distally from the inflatable orienting element, the distal tail being at least 15 millimeters long. The shaft may include a plurality of first apertures communicating with the working lumen and disposed in the distal tail.