An endoscopic system having a shaft, a sheath disposed at least partially inside the shaft having a distal end with a leading surface and an inner surface, the leading surface at the distal end of the sheath having rounded edges so as to be atraumatic, an instrument at least partially inside the sheath and movable relative to the sheath along a longitudinal direction of the sheath, the inner surface being sloped so as to deflect the instrument at a predetermined angle as it is moved into contact with the inner surface and out of the sheath, and the sheath being rotatable relative to the shaft so as to change the direction at which the instrument extends from the sheath.

A device and method for delivering a drug from inside a body lumen to tissue surrounding the body lumen. An endoluminal drug delivery device includes a dual-lumen catheter for housing a guidewire and a needle connectable to a drug source. The guidewire exits the catheter through an opening at the distal end, and the needle exits the catheter through an exit port in the outer wall of the catheter. A distal portion of the catheter has a single lumen and includes a taper, allowing the distal tip to act as a dilator. The device optionally includes a catheter lumen splitter and/or a handpiece assembly. A method of delivering fluid to tissue surrounding a body lumen includes inserting a guidewire into the body lumen, tracking the device over the guidewire, deploying the needle through the exit port to the tissue, delivering fluid, and retracting the needle into the catheter.

Devices and methods to perform elevation of the Schneiderian membrane in a safe, easy and minimally invasive manner are described. The devices include a cannula and a balloon. A liquid can be introduced through the cannula inside the maxillary sinus below the Schneiderian membrane to elevate the Schneiderian membrane. The balloon can be inflated through the cannula so the balloon will be expanded inside the maxillary sinus below the Schneiderian membrane while being surrounded by the liquid which was previously introduce inside the maxillary sinus. The expansion of the balloon is safely further elevating the Schneiderian membrane in a controlled amount and location.

A biologics delivery device and method of use for promoting angiogenesis in occluded vessels and ischemic tissue of a patient are provided, wherein the biologics delivery device includes a catheter having a proximal end, a distal region having a distal end, and a side wall defining a catheter lumen; an expandable member disposed in the distal region, the expandable member configured to support a subintimal space in an occluded blood vessel of a patient, and to transition between a collapsed state and an expanded state; and a hollow needle having a penetration tip deployable from inside the catheter lumen to outside the catheter lumen, and into tissue surrounding the occluded blood vessel, wherein the expandable member in the expanded state allows the flow of oxygenated blood to the occluded blood vessel. Methods of using the inventive biologics delivery device also are provided to deposit the biologic from a subintimal space to tissue surrounding the occluded blood vessel.

A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.

A launching catheter for targeting a second vessel from a first vessel includes a catheter including a proximal portion and a distal portion including a needle aperture and a flat rectangular radiopaque marker. The flat rectangular radiopaque marker disappears under fluoroscopy upon rotation to provide information about rotational alignment of the launching catheter. The launching catheter includes a needle configured to extend through the needle aperture. A method of aligning the catheter includes rotating the catheter in a first blood vessel until the marker has a thickness (e.g., minimal thickness) under fluoroscopy. The thickness indicates rotational alignment of the catheter.

A biologics delivery device and method of use for promoting angiogenesis in occluded vessels and ischemic tissue of a patient are provided, wherein the biologics delivery device includes a catheter having a proximal end, a distal region having a distal end, and a side wall defining a catheter lumen; an expandable member disposed in the distal region, the expandable member configured to support a subintimal space in an occluded blood vessel of a patient, and to transition between a collapsed state and an expanded state; and a hollow needle having a penetration tip deployable from inside the catheter lumen to outside the catheter lumen, and into tissue surrounding the occluded blood vessel, wherein the expandable member in the expanded state allows the flow of oxygenated blood to the occluded blood vessel. Methods of using the inventive biologics delivery device also are provided to deposit the biologic from a subintimal space to tissue surrounding the occluded blood vessel.

The present disclosure generally relates to devices for ophthalmic procedures, and more particularly, to a surgical instrument for performing subretinal injections and methods of use thereof. The surgical instrument may include a handpiece configured for grasping by a user for fluid injection. The handpiece may include a first lumen disposed therein and an actuatable toggle movably coupled with the handle. The surgical instrument may further include a cannula coupled to the handpiece and configured to be introduced into an eye. The cannula may include a second lumen extending therethrough and a needle movably disposed within the second lumen. The needle may be coupled with the actuatable toggle and configured to extend from and retract into the second lumen at a distal end of the cannula upon actuation of the toggle.

The present disclosure generally relates to devices for ophthalmic procedures, and more particularly, to apparatus for performing subretinal injections and methods of use thereof. In some embodiments, the apparatus includes an injection needle having a proximal end and a distal end, the distal end configured to be insertable into the subretinal space at a position on a surface of a retina. The apparatus may further include an inserter device removably coupled to the injection needle and a tubing having a distal end coupled to the proximal end of the injection needle and a proximal end coupled to a fluid source. The tubing may have a first lumen and a second lumen, wherein the tubing is disposed through the inserter device. The apparatus may further include a stabilizer configured to immobilize the injection needle at the position on the surface of the retina and a fluid source. The fluid source may include both a first fluid reservoir containing a non-treatment solution and a second fluid reservoir containing a treatment solution. The fluid source may be configured to provide the non-treatment solution from the first fluid reservoir to the subretinal space via the first lumen. The fluid source may be further configured to provide the treatment solution from the second fluid reservoir into the subretinal space via the second lumen.

An example catheter includes an elongated member configured to be navigated through vasculature of a patient to a target treatment site in a vessel of the patient, a needle positioned at a distal portion of the elongated member, the needle configured to be within the elongated member when in a delivery configuration and radially extended to puncture a vessel wall of the vessel at the target treatment site when in a deployed configuration, and an expandable balloon including a needle guide configured to position a distal end of the needle at a predetermined distance from a central axis of the elongated member when the balloon is in an expanded configuration and the needle is in the deployed configuration.