A platform device for material excision or removal from vascular structures for either handheld or stereotactic table or robotics platform use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated as well as single or multiple arrays of image guidance elements, directional elements, ablation elements and other interventional assistance elements. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous or differential beak or scoopula closing under their differential rotation may be incorporated.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

An atherectomy catheter for use in a vessel includes a catheter and a rotatable cutter. The rotatable cutter can be translatable within the catheter to extend the cutter through a window of the catheter or retracted the cutter within the catheter. The catheter can have fixed bend and/or have a shapeable portion configured to facilitate positioning and movement of the cutter. In some cases, the cutter is configured to tilt and/or move radially with respect to the catheter upon translation.

A tissue-removing catheter includes a drive assembly. The drive assembly includes a gear rotatable about an axis, a gear extension coupled to the gear and extending axially outward from the gear, and a lock received in and coupled to the gear extension. The gear extension is rotatably driven by the gear, and the lock is rotatably driven by the gear extension. An elongate drive member is received in and coupled to the lock. The drive member is driven by the lock, whereby rotation of the gear imparts rotation to the drive coil.

A catheter for use in a subject's vasculature includes a rotating and axially movable instrument. The instrument includes a rounded element at its distal end connected to a body having a spiral shape. The instrument is at least partially disposed in a lumen of the catheter and is configured for axial and rotational motion within the lumen between a proximal-most position and a distal-most position, where the body includes at least one edge configured to promote removal of a target substance from the body passageway upon contact with the target substance.

An atherectomy catheter device includes an elongate body, a drive shaft extending proximally to distally within the elongate body, and a cutter attached to the drive shaft. The cutter includes a serrated annular cutting edge formed on a distal edge of the cutter and a recessed bowl extending radially inwards from the annular cutting edge to a center of the cutter. The recessed bowl has a first curvature. The cutter further includes a plurality of grinding segments extending inwardly from the distal edge within the bowl. Each of the plurality of segments has a second curvature that is different from the first curvature.

An interventional device for cutting tissue at a targeted cardiac valve, such as a mitral valve. The interventional device includes a catheter having a proximal end and a distal end. A cutting mechanism is positionable at the distal end, such as by routing the cutting mechanism through the catheter to position it at the distal end. The cutting mechanism includes one or more cutting elements configured for cutting valve tissue when engaged against the tissue. A handle is coupled to the proximal end of the catheter and includes one or more controls for actuating the cutting mechanism.

Methods and tools for implanting prosthetic heart valves and modifying leaflets of an existing valvular structure in a subject are disclosed herein. Prior to or during implantation of the prosthetic heart valve within the existing valvular structure, each tool can be provided in the ascending aorta (or equivalent thereof) of a subject and can be used to pierce, lacerate, slice, tear, cut or otherwise modify a leaflet or commissure of the existing valvular structure. The existing valvular structure can be a native aortic valve or other native heart valve, or a previously-implanted prosthetic heart valve. The modification can avoid, or at least reduce the likelihood of, issues that leaflets of the existing valvular structure might otherwise cause once the prosthetic heart valve has been fully installed, for example, obstruction of blood flow to the coronary arteries and/or improper valve mounting due to a non-circular cross-section.

A surgical instrument configured to cut tissue includes an outer member and an inner member at least partially received within the outer member. The outer member includes a cutting window near a distal end thereof. A driving assembly is coupled to the inner member and configured to cause the inner member to rotate around and move along a longitudinal axis of the outer member. A controller is configured to control the driving assembly to control at least one of an angular position, an angular velocity, or an angular acceleration of the inner member according a plurality of piecewise continuous profiles. The initial and final angular velocities of the inner member are zero, and the inner member cuts tissue extending into the cutting window.

According to one aspect, a medical device may be configured for use with an endoscope and may include a tool. The tool may include an actuator, at least one extension at a distal portion of the actuator, and a distal end. The at least one extension may extend radially outward from the actuator and may have an edge configured to fragment debris within a body. The medical device may also include a cap configured for coupling to a distal end of the endoscope, and the cap may include a body defining an opening and a cavity. The opening may be configured to align with optics of the endoscope, and the at least one extension may be positioned within the cavity of the body.