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 inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A catheter including a cutting element and an insertion tube, wherein the springy resilient cutting element (1) consists of a sleeve (1a) and profiled longitudinal arms (1b) with sharp endings (1c), protruding from it and directed towards an atraumatic tip (7), wherein the element (1) is mounted on an assembly (2) of an inner tube.

A method of treating a lesion in a body lumen to enlarge a passageway in the lumen including providing a cutting member, connecting a tracking member to the cutting member to form an assembly, inserting the connected cutting member and tracking member through a first lumen of a catheter, withdrawing the catheter from the cutting member and tracking member, inserting the catheter over the tracking member and leaving the cutting member outside the catheter, and expanding a portion of the catheter to move the cutting member into cutting contact with the lesion. A device for treating a lesion in a body lumen including a cutting member having a coupler to connect a tracking member is also provided.

A medical device and a treatment method are disclosed, which can improve safety by reducing damage to a biological tissue while an object inside a biological lumen can be cut. A medical device is disclosed for cutting an object inside a biological lumen includes a rotatable drive shaft, and a rotary structure that interlocks with a distal side of the drive shaft so as to be rotated by the drive shaft. The rotary structure has a cutting portion for cutting the object, and a non-cutting portion capable of smoothly coming into contact with a biological tissue. The non-cutting portion is located in a maximum outer diameter portion of the rotary structure.

A clot retrieval system includes a delivery catheter defining a lumen and having proximal and distal ends. An elongate shaft has proximal and distal ends and is configured for receipt within the delivery catheter. An inverted sleeve has a closed end attached to a distal segment of the elongate shaft and an open end. An outer section of the inverted sleeve that includes the open end is folded over onto an inner section of the inverted sleeve that includes the closed end at a rolling fold. An expansion device is supported on the elongate shaft at an axial location proximally spaced from the closed end and aligned with or distally spaced from the open end. The expansion device is configured for radially expanding the open end of the inverted sleeve.

A device suitable for removing material from a living being is provided, featuring at least an aspiration pump, powered by a motor. The aspiration pump and any optional infusate pump preferably feature a helical pumping mechanism, and operate at a high rate of rotation, thereby ensuring adequate pumping performance and flexibility. The helical pumping mechanism may be a helical coiled wire about a central core tube. The helical coil wire, whether together with, or independent of, the core tube, may be rotated to cause a pumping action. Additionally, a narrow crossing profile is maintained, ensuring that the device may reach more tortuous regions of the vasculature. In one embodiment, the system comprises a wire-guided mono-rail catheter with a working head mounted on a flexible portion of the catheter that can laterally displace away from the guide wire to facilitate thrombus removal. The working head may be operated to separate and move away from the guide wire to come within a closer proximity of the obstructive material to more effectively remove it from the vessel.

A method for detaching an object from a patient includes providing a tool having a sheath, and a separating assembly operably coupled to a distal end of the sheath. The separating assembly includes a separator moveably coupled to a tip via a threadable connection. The separating assembly is placed near patient tissue that is attached to the object, the sheath is rotated to move the separator distal to the tip, and the separator is applied to the patient tissue that is attached to the object, so as to separate the tissue. A separating system includes a sheath, and a separator threadably coupled with a distal end of the sheath. The separator is adapted to switch between a first configuration where a separating mechanism is deployed, and a second configuration where the separating mechanism is undeployed.

A medical device is disclosed for cutting substances inside a body lumen. The medical device includes: a drive shaft that is rotatable; at least one strut that is rotatably connected to a distal side of the drive shaft, the at least one strut extending along a rotation axis, and wherein a central portion of the at least one strut is bent so as to be expandable radially outwardly; and a support portion that is rotatably connected to the distal side of the drive shaft, and wherein the support portion is formed in a mesh shape and a tubular shape while including multiple gaps, at least a portion of which is positioned on a radially inside of the at least one strut, and which is expandable radially outwardly by a central portion in a direction extending along the rotation axis being bent.

A vascular device is provided having a catheter body and a rotatable cutter assembly located at the distal end of the catheter body. The cutter assembly has at least one helical cutting surface within a housing that is coupled by a torque shaft to a drive mechanism. A conveyor mechanism helically wound about the torque shaft conveys occlusive material conveyed into the housing by the helical cutting blade further proximally along the catheter body for discharge without supplement of a vacuum pump. The catheter body is manipulated to insert the distal end of the catheter body within a body lumen and advance the distal end of the catheter body toward the occlusive material. The drive mechanism is operated to rotate the helical cutting surface to cut and convey the occlusive material from the body lumen proximally into the housing and to convey the occlusive material conveyed into the housing by the helical cutting surface further proximally along the catheter body by the conveyor mechanism for discharge without supplement of a vacuum pump. The distal end of the catheter body is deflected and rotated to sweep the cutter assembly in an arc about the center axis of the catheter body to cut occlusive material in a region larger than the outside diameter of the cutter assembly.

A catheter used for percutaneous endovascular procedures is described. The catheter is configured to be used for engagement and treatment of obstructive lesions in a patient's vasculature. The catheter includes a tube having a leading edge that is configured to score or cut a lesion in a vasculature. The tube may be an expandable outer tube, and placed around an inflatable inner tube, such that inflation of the inner tube expands the outer tube. Expansion of the inner tube may connect or laterally lock the inner tube to the outer tube, allowing both tubes to move in unison through the vasculature. The leading edge can score or cut lesions as it moves in the vasculature.