A catheterization system for treatment of patients can include a peripherally inserted central catheter comprising a catheter tube joined to an extension leg with a junction and a securement device that fits around a portion of the junction to inhibit movement. The catheter tube can include a taper proximate the junction, the taper transitioning the catheter tube from a larger outer diameter and a larger wall thickness to a smaller outer diameter and a smaller wall thickness. The taper and thicker wall thickness near the junction can help prevent damage to the catheter tube near the junction when bent (e.g., to secure a proximal region of the catheter to a patient's arm). The securement device can configured to fit around an outer diameter of the junction to inhibit movement of the junction when the junction is held in the securement device.

Methods for removing blockages and preventing thromboembolic injuries, by advancing to a blockage a first tubular, endovascular device receiving irrigating fluid through a proximal opening, having a circumferential wall, lumen, at least one distal side hole oriented angularly to a distal opening; ejecting fluid from the side hole(s) to irrigate a blockage; introducing a second catheter for aspiration, comprising a circumferential wall having a proximal and distal opening, a flared, semi-permeable filter at the distal end for removal of emboli through the second lumen; advancing the second device to a blood vessel receiving blood from the blocked vessel, aspirating the blockage, axially rotating the first endovascular device having at least one half-loop to macerate an obstruction, capturing and removing emboli from the blockage through the second endovascular device which prevents emboli from causing further blockage of blood vessels. Variants of said method including a third rotatable device.

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.

A medical fluid suspension generating apparatus includes a Venturi-agitating tip assembly, a source of pressurized chemical solution, a source of a medical solution, and a dual lumen catheter connecting the Venturi-agitating tip assembly to the source of pressurized chemical solution and the source of the medical solution.

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.

The present invention discloses a steering device for use in a body lumen of a patient. The steering device comprises a flexible tube; a plurality of spaced-apart elements positioned along at least a portion of the tube; wherein the plurality of spaced-apart elements and the tube form a single integrated unit; and at least two steering wires having at least a portion passing through the spaced-apart elements and at least a portion passing within the tube. According to another broad aspect of the present invention, there is provided a steering device for use in a body lumen of a patient, comprising: a flexible tube; at least two steering wires having at least a portion passing within the flexible tube; at least two spring-like sleeves; each spring-like sleeve at least partially enclosing a steering wire respectively; wherein the spring-like sleeve has a variable pitch along its length; such that the flexible tube comprises at least two portions having different bending properties.

A method of inserting a stent includes inserting a unitary, monolithic catheter assembly into a cardiac artery. The catheter assembly includes a body having a proximal end and a distal end, a distal balloon mounted on the distal end, and a proximal balloon mounted on the body, proximally of the distal balloon. A balloon expandable stent is mounted on the distal balloon. The method further includes the steps of advancing the catheter assembly to a blockage in the artery until the distal balloon and the stent both extend across the blockage; inflating the distal balloon and expanding the stent; deflating the distal balloon; advancing the catheter body distally until the proximal balloon extends within the stent; expanding the proximal balloon to post-dilate the stent; deflating the proximal balloon; and withdrawing the catheter body from the artery.

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.

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.