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 medical device for removing an intravascular thrombus includes: a rotatable tubular driving shaft in which a spiral-shaped carrier is provided on an inner surface thereof; a cutting part that is provided on a distal side of the driving shaft and cuts the thrombus; and an elongated resistive body that is disposed in a lumen of the driving shaft and can be rotated relative to the driving shaft.

An improved flexible endoscopic instrument to precisely and efficiently obtains samples of flat polyps and multiple polyps from a patient by debriding one or more polyps and retrieving the debrided polyps without having to alternate between using a separate cutting tool and a separate sample retrieving tool and may be used with an endoscope. In one aspect, the cutting tool is coupled to a flexible torque coil or torque rope that is configured to transfer rotational energy from a powered actuator through the length of the endoscope onto the cutting tool.

An atherectomy system includes a drive mechanism that is adapted to rotatably actuate an atherectomy burr and a controller that is adapted to regulate operation of the drive mechanism. In some cases, the drive mechanism includes a drive cable that is coupled with the atherectomy burr and a drive motor that is adapted to rotate the drive cable. The controller is adapted to receive an indication of an increase in torque experienced at the atherectomy burr and is further adapted to, in response, regulate operation of the drive mechanism such that the increase in torque results in a noticeable reduction in speed of the drive mechanism such that a user of the atherectomy system notices the reduction in speed and is alerted to the increase in torque.

A drive shaft (1, 3) for use with a rotation device (10, 20) includes an outer layer (11, 31) and an inner layer (12, 32). The outer layer is a tubular structure, and the inner layer is accommodated in a space defined by the outer layer and defines a central lumen (13, 33) for receiving therein an external mechanism. The outer layer is rotatable about the central lumen, and the inner layer is rollable relative to both the outer layer and the external mechanism and thus allows rolling friction to occur between the drive shaft and the external mechanism. Such a structure of the drive shaft can reduce friction between the drive shaft and a guidewire as well as loss due to such friction, avoiding failure of the guidewire due to excessive friction between the guidewire and the drive shaft. Therefore, it is ensured that the drive shaft is suitable for use with guidewires commonly used in clinical practice, resulting in improved surgical operability and lower surgical cost. Also disclosed is a rotation device including an instrument (2, 4) and the drive shaft. The instrument is disposed at one end of the drive shaft and is coupled to the outer layer of the drive shaft so as to be able to be driven by the outer layer to rotate.

A method of removing embolic material from a vessel with mechanical and aspiration assistance. The method comprises the steps of providing an aspiration catheter having a central lumen and a distal end, advancing the distal end of the aspiration catheter to obstructive material in a vessel, applying vacuum to the central lumen to draw clot into the central lumen, introducing a thrombus engagement tool into the central lumen, and manually manipulating the tip to engage clot between the tip and an inside wall of the central lumen.

The invention provides devices with integrated intravascular imaging and methods for crossing a CTO within the true lumen of a vessel. An interventional catheter with intravascular imaging capabilities can be guided into an affected vessel and to a CTO. An included intravascular imaging device captures a 3D image of the environment. The catheter includes a crossing member that can be extended out from a distal tip of the catheter, causing the crossing member to directly cross through the CTO creating a new channel through the CTO.

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.

A catheter for intraluminal lithotripsy including a first lumen, an energy delivery member supported by the catheter body. The energy delivery member includes a passageway, a valve positioned in the passageway and an energy emitter configured to communicate energy to target tissue. A method for performing intraluminal lithotripsy is also disclosed.

Systems and methods are disclosed including apparatuses and methods for endoscopy such as an endoscope device operable to produce suction. An endoscope can include or use a cylinder for use at a distal end of an endoscope, and the cylinder can include a cylinder channel extending from a first end of the cylinder to a second end of the cylinder, and a rotor arranged within a working channel of the endoscope at the distal end of the endoscope. The rotor can be movable within the cylinder or the channel such as to help fragment or clear foreign bodies during a procedure.