A device and method for treating a patient with total or near total occlusion is provided. The device can be positioned in a blood vessel at a treatment site. An occlusion at the treatment site is enlarged by a catheter. The catheter can be advanced over a guidewire into the occlusion. One or more of [a] compression or torsion applied to the guidewire or [b] compression or torsion applied to the catheter body expands or creates a path through the occlusion. The expansions or creation of the access path can be by cutting or abrading the occlusion or by a shoe-horn effect.

An intravascular catheter device and methods for using the same are provided. An expandable portion is provided at a distal end of a flexible catheter tube and includes struts operable between a first position and a second position where the struts are moved outward from the first position. An incising member is provided at, and extends along a lengthwise dimension of, and outward from, at least one of the struts. An embolic protection device is provided which is configured for movement between a first position and a second position where the embolic protection device is enlarged relative to said first position.

In some examples, a capture assembly configured to remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system, includes a body configured to receive the material of interest. The body can be configured to axially lengthen and shorten.

Devices and methods for increasing or restoring a flow in a body lumen. The devices and the methods may treat conditions like stroke by removing a clot from a blood vessel and/or reopen the vessel. The device may include a plurality of engaging elements, a central wire, and proximal control element. The device may include a linking structure between engaging elements. The linking structure may include segments configured to respond differently upon the application of longitudinal loads. The positions of the engaging elements and the distance therebetween can be adjusted simultaneously or sequentially to promote the engagement of the clot or occlusion. The device may include be configured to inhibit or prevent the proximal engaging element from being pulled back into a microcatheter when pulling the central wire to pull the distal engaging element proximally and/or during retraction of the device holding a clot.

An improved plaque extractor for shaving, scooping, cutting, and emulsifying accumulated plaque from blood vessels into fine particles, and removing the particles from blood vessel walls without cutting or permanently stretching the walls, and without substantially blocking the blood flow through the vessel during plaque removal operation. The plaque extractor includes an extractor guide and an internal auger, in which both are rotating and moving axially inside the vessel to engage the occlusive material. The operation of the device does not substantially disrupt blood pressure within the blood vessel.

A matter elimination catheter includes a catheter body extending from a catheter proximal portion to a catheter distal portion. The catheter body includes an infusion lumen, an aspiration lumen fluidly isolated from the infusion lumen, and a septum interposed between the infusion and aspiration lumens. A drive shaft is within the infusion lumen and is configured to provide rotation near the catheter distal portion. A guide wire lumen is within the drive shaft, and the infusion lumen, the drive shaft and the guide wire lumen are fluidly separated from the aspiration lumen with the septum. In one example, fluid bearings are formed between one or more of the catheter body and drive shaft or the drive shaft and a guide wire or guide wire liner when supplied with infusion fluid through the infusion lumen.

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.

In some examples, a catheter includes an elongated body defining an inner lumen and comprising an expandable member disposed at a distal portion of the elongated body, and a rotatable cutting tool located within an inner lumen of the elongated body, the rotatable cutting tool configured to segment a thrombus into smaller pieces while an aspiration force pulls the thrombus proximally into the inner lumen. In some examples, the catheter further comprises an intermediate structure oriented radially between the rotatable cutting tool and an interior surface of the elongated body, the intermediate structure configured to prevent the cutting tool from contacting the interior surface of the elongated body. In some examples, a stopper is configured to limit movement of the cutting tool distally past a distal end of the expandable member.

A matter elimination catheter includes a catheter body extending from a catheter proximal portion to a catheter distal portion. The catheter body includes an infusion lumen, an aspiration lumen fluidly isolated from the infusion lumen, and a septum interposed between the infusion and aspiration lumens. A drive shaft is within the infusion lumen and is configured to provide rotation near the catheter distal portion. A guide wire lumen is within the drive shaft, and the infusion lumen, the drive shaft and the guide wire lumen are fluidly separated from the aspiration lumen with the septum. In one example, fluid bearings are formed between one or more of the catheter body and drive shaft or the drive shaft and a guide wire or guide wire liner when supplied with infusion fluid through the infusion lumen.

Systems and methods can remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.