Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating one or more abrasive elements within the vessel. The abrasive elements are attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, the handle assembly encapsulates an electric motor assembly, a pump assembly, and a controller assembly.

An atherectomy system is adapted for both anterograde ablation and retrograde ablation, and includes a drive coil and an atherectomy tool coupled to the drive coil, the atherectomy tool including a distal region adapted for anterograde ablation and a proximal region adapted for retrograde ablation. A proximal handle includes an actuation member adapted to be movable in a first direction to urge the atherectomy tool in an anterograde ablation direction and to be movable in a second direction to urge the atherectomy tool in a retrograde ablation direction. The atherectomy system is adapted such that the actuation member provides a similar feedback to a user regardless of whether the atherectomy tool is ablating in the anterograde ablation direction or in the retrograde ablation direction.

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.

A clot removal device for removal of an occlusion from a lumen in a patient's body is provided. The clot removal device has a lumen, an elongated member positioned within the lumen and extending axially from a proximal end to a distal end of the lumen, a handle attached to the proximal end of the lumen, a first expandable member positioned along a length of the elongated member, a second expandable member positioned along the length of the elongated member, wherein the second expandable member is distal to the first expandable member relative to the handle. The handle has at least one actuation mechanism and at least one of the following applies: a) the first expandable member is coupled to the at least one actuation mechanism and is configured to be moveable relative to the second expandable member upon manipulation of the at least one actuation mechanism; b) the first expandable member is configured to mechanically expand or contract by manipulating the at least one actuation mechanism; c) the second expandable member is coupled to the at least one actuation mechanism and is configured to be moveable relative to the first expandable member upon manipulation of the at least one actuation mechanism; or d) the second expandable member is configured to mechanically expand or contract by manipulating the at least one actuation mechanism.

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.

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.

An intravascular catheter device includes an expandable portion with a plurality of struts operable between a closed position where the expandable portion has a first diameter, and an opened position where the expandable portion has a second diameter that is larger than the first diameter. An incising element is provided on and extends from the outward facing surface of a particular one of the struts. A medication delivery tube is associated with the particular one of the struts and the incising element.

A thrombectomy system includes a frame having plurality of struts joined at an apex, a netting coupled to the plurality of struts, a pestle moveable relative to the frame and configured and arranged to macerate a clot within a vessel, adherent to its walls and against a portion of the apex of the frame.

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.

Methods and apparatuses for removing material (e.g., clot) from within a body, including inverting thrombectomy apparatuses. These methods and apparatuses may include methods and apparatuses for reusing portion of the devices, method and apparatuses for loading and reloading the inverting thrombectomy apparatuses, and methods and apparatuses for improving and enhancing the ability of the inverting thrombectomy apparatuses to remove clot. In particular, described herein are expandable scraper devices that may be used in conjunction with the inverting thrombectomy apparatuses descried herein, or on their own.