An adjustable loop ring stripper for stretching an arterial wall outwardly as plaque is excavated inwardly.

Devices and methods for exploiting intramural (e.g., subintimal) space of a vascular wall to facilitate the treatment of vascular disease, particularly total occlusions. For example, the devices and methods disclosed herein may be used to visually define the vessel wall boundary, protect the vessel wall boundary from perforation, bypass an occlusion, and/or remove an occlusion.

A tissue-removing catheter for removing tissue in a body lumen includes a tube extending axially along the catheter. A junction box housing is located at a distal end of the tube. An elongate body extends distally from the junction box housing. The elongate body is sized and shaped to be received in the body lumen. A gear assembly is disposed in the junction box housing. The gear assembly engages the elongate body for rotating the elongate body. A tissue-removing element is mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen.

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.

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 a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.

A method for collapsing a target vein in a patient. The method comprises providing an intravascular irritation element having a plurality of mechanical irritating objects, inserting the intravascular irritation element into a venous lumen of a target vein, and irritating the target vein by moving the plurality of mechanical irritating objects in contact with the inner surface thereof, thereby triggering a collapse of the target vein.

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 with a side port, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall, directing the distal portion within the vascular wall such that the distal portion moves at least partially laterally, and directing the side port towards the vascular lumen.

A catheter for actively scoring or slicing a lesion. A catheter body includes first and second lateral openings. A selectively deployable cutter is connected to the catheter body. The cutter has a retracted configuration in which it does not perform a slicing or scoring function, such as while tracking through the vasculature, and a deployed configuration for slicing or scoring an obstruction. The cutter may include a plurality of retractable blades, such that when deployed, each blade projects in a different direction, such as from one of the lateral openings. Related methods are also disclosed.

A tissue-removing catheter for removing tissue in a body lumen includes an elongate body and a handle mounted to a proximal end portion of the elongate body. The handle is operable to cause rotation of the elongate body. A tissue-removing element is mounted on a distal end portion of the elongate body. The tissue-removing element is configured to remove the tissue as the tissue-removing element is rotated by the elongate body within the body lumen. An inner liner is received within the elongate body and is coupled to the handle at a proximal end portion of the inner liner. The inner liner defines a guidewire lumen. The inner liner is coupled to the tissue-removing element at a distal end portion of the inner liner such that translational movement of the inner liner in the body lumen causes a corresponding translational movement of the tissue-removing element.

An atherectomy system includes a handle and a drive motor that is adapted to rotate a drive cable extending through the handle and operably coupled to an atherectomy burr. A control system is adapted to regulate operation of the drive motor, including providing the drive motor with a high frequency pulse width modulation (PWM) drive signal in order to operate the drive motor. The control system monitors a motor performance parameter such as motor speed or motor torque, and when the motor performance parameter approaches a limit of a performance range, the control system adds a low frequency PWM signal to the high frequency PWM drive signal, thereby causing the drive motor to produce a tactile signal that signals to the user that the motor performance parameter is approaching the limit of the performance range.