A wall (39) of a catheter (38) (a) includes a braided portion (41) having an outer surface (45), an inner surface (47), and a braided interior (53) between the outer and inner surfaces (45, 47), and (b) is shaped to define first and second longitudinally-running channels (27a, 27b) therethrough. A distal portion of the catheter (38) is shaped to define first and second lateral openings (26a, 26b). An angle between (a) a first line (76) running between the first and second lateral openings (26a, 26b), and (b) a second line (78) that is parallel to a central longitudinal axis of the catheter (38) when the catheter (38) is straight, is between 30 and 150 degrees. A flexible longitudinal member (14) passes from a proximal portion of the catheter (38) to the distal portion via the first channel (27a), out of the first channel (27a) via the first lateral opening (26a), into the second channel (27b) via the second lateral opening (26b), and from the distal portion to the proximal portion via the second channel (27b).

The present invention relates to a method for positioning a tip of a pacemaker lead that has passed through coronary sinus into an interventricular septum. More particularly, it relates to a method for positioning a tip of a pacemaker lead that has passed through a coronary sinus into an interventricular septum in order to more effectively transmit an electrical stimulus in a treatment using a pacemaker for patients with arrhythmia. A method of positioning a tip of a pacemaker lead, which has passed through a coronary sinus, into an interventricular septum, in order to effectively transmit electrical stimulus, includes: inserting into an intervention wire through a superior vena cava and a coronary sinus to pass through the interventricular septum and then guiding the intervention wire to an inferior vena cava; and positioning the tip of the lead into the interventricular septum by inserting the pacemaker lead along the intervention wire.

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 device and method for establishing retrograde blood flow during recanalization of a vessel having a targeted blockage. While in a collapsed state an occluding component is introduced distally intravascularly traversing the targeted blockage to its distal side. Then, the occluding component transitions to an expanded state having an enlarged diameter forming a seal with an internal wall of the vessel prohibiting anterograde blood flow beyond the expanded occluding component. Retrograde blood flow is thereby established in a region of the vessel bound at one end by the occluding component and at an opposite end by the targeted blockage by dispensing a flushing fluid into the region of the vessel.

A system for aspirating thrombus and delivering an agent includes an aspiration catheter having a supply lumen having a proximal end, a distal end, and a wall, and an aspiration lumen having a proximal end, an open distal end, and an interior wall surface adjacent the open distal end, and at least one orifice at or adjacent the distal end of the supply lumen, in fluid communication with the aspiration lumen and located proximally of the open distal end of the aspiration lumen, wherein the at least one orifice is configured to create a spray pattern that is caused to impinge on the interior wall surface of the aspiration lumen such that the spray pattern upon impinging on the interior wall surface is caused to transform into at least a substantially distally-oriented flow capable of exiting the open distal end of the aspiration lumen.

In some examples, a catheter may include a catheter body, a first expandable member, and a second expandable member. The catheter body may define a first lumen, a second lumen, a delivery port, and a surface extending from the delivery port into the first lumen. The first lumen may define a first central longitudinal axis. The second lumen may define a second central longitudinal axis spaced from the first central longitudinal axis in a direction orthogonal to the second central longitudinal axis. The delivery port may be in fluid communication with the first lumen. The surface extending from the delivery port into the first surface may be oriented at an obtuse or acute angle relative to the first central longitudinal axis.

A suction catheter for fragmenting and removing obstructive material and thrombus from the body or other body cavities that comprises a tube-like body with a proximal and distal end and a pressure lumen and discharge lumen formed in the catheter body. At the distal end of the catheter is a suction opening adjacent to the opening of the nozzle injector formation. At the proximal end of the catheter the lumens are connected to an inlet port and a discharge outlet. A hub structure is coupled to the proximal end of the catheter tubular body and includes a pressure lumen for connecting a fluid source to the pressure inlet. At the proximal end of the tubular catheter a discharge lumen is connected at the proximal hub to a discharge reservoir. The suction port at the distal end of the catheter may be formed into a separate lumen within the catheter body and may include a guidewire lumen.

The disclosure provides for an adjustable catheter system with isovolumetric suction and restoration of fluid for the removal of a thrombus and a method of use thereof. The catheter system includes an inner catheter and an outer sheath surrounding at least a portion of the inner catheter. The inner catheter may include at least three lumina extending from the proximal end to the distal end of the inner catheter, at least one infusion fenestration along the infusion segment, and a distal encapsulation balloon at the distal end. The outer sheath may include at least three lumina extending from the proximal end to the distal end of the outer sheath and a proximal encapsulation balloon at the distal end. The catheter system may further include an agitator for mechanical morcellation of the thrombus.

Methods for cerebral cooling are described. Cooling assemblies include elongate tubular members, a reservoir containing a pressurized fluid, and a manifold connecting the reservoir and elongate tubular members. After insertion of the elongate tubular members into the patient's nostrils, a pressurized fluid is delivered onto a surface of the patient's nasal cavity through a plurality of ports in the elongate tubular members. The delivery of the fluid causes cooling by direct heat transfer through the nasopharynx and hematogenous cooling through the carotids and the Circle of Willis.

Apparatus for use in dialyzing a patient, the apparatus comprising: a hemodialysis catheter comprising: an elongated body having a proximal end and a distal end, wherein the distal end terminates in a substantially planar distal end surface; first and second lumens extending from the proximal end of the elongated body to the distal end of the elongated body, wherein the first and second lumens terminate on the substantially planar distal end surface in first and second mouths, respectively, arranged in side-by-side configuration, and further wherein the first and second lumens are separated by a septum; and first and second longitudinal slots formed in the distal end of the elongated body and communicating with the interiors of the first and second lumens, respectively, the first and second longitudinal slots opening on the substantially planar distal end surface; wherein the first and second longitudinal slots each has a length and a width, relative to the dimensions of the first and second lumens and the rate of blood flow to be passed through the hemodialysis catheter, such that (i) when a given lumen is to be used for a return function, the primary blood flow will exit the mouth of that lumen, and (ii) when a given lumen is to be used for a suction function, the primary blood flow will enter the proximal end of the longitudinal slot associated with that lumen, whereby to minimize undesirable recirculation of dialyzed blood.