A large bore catheter has a guiding rail extending therethrough and an advance segment of the rail extends at least about 10 cm beyond the distal end of the catheter. The advance segment is advanced from the vena cava through the tricuspid and pulmonary valves of the heart into the central pulmonary artery while the distal end of the large bore catheter remains in the vena cava. The large bore catheter is thereafter distally advanced over the rail until the large bore catheter distal end is at least as far as the central pulmonary artery. The rail is thereafter proximally removed from the large bore catheter, and at least a portion of a clot is drawn from a pulmonary artery into the large bore catheter.

An inserter for guiding a device through a hemostasis valve. The inserter comprises an elongate tubular body, a concave landing zone, and an axially extending slit. The elongate body tubular body of the inserter partially defines a central lumen. A method a of passing a device through a valve comprises the steps of providing an inserter having a tubular body with a split sidewall, advancing the tubular body through a valve, advancing a device through the tubular body and beyond the valve and retracting the tubular body so that the device escapes laterally from the tubular body through the split sidewall, leaving the device in place across the valve.

A septostomy device 10 with a cutting structure or means 140 and tissue capture mechanisms 240, 250 is disclosed, along with a medical procedure for using the device. The system 10 is configured in such a way as to create a permanent interatrial aperture in the heart, including creating a permanent interatrial hole and/or removing tissue.

Provided is a dilator capable of increasing the diameter of a hole formed on the wall of a digestive tract and the like while ensuring distal-end flexibility and maintaining pushability and torquability even when a shaft is longer and curved. A dilator includes a hollow shaft having an outer diameter that is smaller at a distal end than at a proximal end, and a grip portion connected to the proximal end of the shaft. A spirally-arranged protruding portion protruding outwardly is provided on an outer peripheral surface of the shaft. The spirally-arranged protruding portion has gaps between adjacent portions along a longitudinal axis of the shaft.

Systems and methods for accessing an interior space of a joint such as a hip joint in preparation for arthroscopic surgery are provided. In general, the described techniques utilize a joint access device having a handle and a dilator shaft and/or sheath coupled to a distal end of the handle. The device can be advanced over a guidewire inserted into a joint to a first position and the guidewire can be reversibly locked to the handle. The handle can be associated with an actuator configured to be actuated to cause the dilator shaft and/or sheath to advance distally toward a second position within the joint while simultaneously retracting the guidewire coupled to the handle.

Provided is a dilator capable of increasing the diameter of a hole formed on the wall of a digestive tract and the like while ensuring distal-end flexibility and maintaining pushability and torquability even when a shaft is longer and curved. A dilator includes a hollow shaft having an outer diameter that is smaller at a distal end than at a proximal end, and a grip portion connected to the proximal end of the shaft. A spirally-arranged protruding portion protruding outwardly is provided on an outer peripheral surface of the shaft. The spirally-arranged protruding portion has gaps between adjacent portions along a longitudinal axis of the shaft.

Exemplary systems and methods encompass suture knot tools and suture knot tools pre-loaded with sutures for use in tendon repair and other surgical procedures. Related methods may include forming a nail knot between a suture and a tissue of a patient during a surgical procedure by drawing tissue into a port sleeve of an arthroscopic system, moving the port sleeve relative to a free end portion of the tissue and a nail knot cinch of a suture, to allow the nail knot cinch of the suture to contact the free end portion of the tissue; and tightening the nail knot cinch of the suture about the free end portion of the tissue, so as to form the nail knot with the suture and the tissue.

Device for accessing a pericardial space of a subject in need thereof, the device including a tubular member having an atraumatic distal end and a thread formed on, and at least partially around, the outer surface of the tubular member, proximally to the distal end; wherein the thread is configured to cut, puncture and/or penetrate a pericardium.

Systems and methods for accessing an interior space of a joint such as a hip joint in preparation for arthroscopic surgery are provided. In general, the described techniques utilize a joint access device having a handle and a dilator shaft and/or sheath coupled to a distal end of the handle. The device can be advanced over a guidewire inserted into a joint to a first position and the guidewire can be reversibly locked to the handle. The handle can be associated with an actuator configured to be actuated to cause the dilator shaft and/or sheath to advance distally toward a second position within the joint while simultaneously retracting the guidewire coupled to the handle.

Disclosed is a dilating incision device, which relates to a surgical tool and includes an outer shell, a dilating element and an incision assembly. The dilating element that is arranged at one end of the outer shell and communicated with the inside of the outer shell is used to drill into and expand a stenosis segment of the pancreatic or biliary duct or a puncture path between lumens of the digestive tract. A sliding groove is formed in a side wall of the outer shell, by which the inner cavity of the outer shell is communicated with the outside. The incision assembly includes an incision knife arranged in the outer shell and a sliding handle housing the outer shell. An intercommunicating hole is formed in one end of the dilating element, by which the inner cavity of the dilating element is communicated. with the outside.