A catheter has a body including a proximal region, a neck region, and a distal region. A shaping wire is disposed within the distal region to predispose it into at least a partial loop, which may have a fixed or variable radius of curvature. The shaping wire includes a distal portion having a circular transverse cross-sectional shape and a proximal portion having a non-circular (e.g., rectangular) transverse cross-sectional shape. The proximal portion of the shaping wire can have a width-to-thickness ratio of at least about 4, such as about 4.67. A transition portion can promote a gradual transition from the circular to the non-circular transverse cross-sectional shape, for example by increasing a width of the shaping wire by about 0.001″ and/or by decreasing a thickness of the shaping wire by about 0.001″ for every about 0.004″ in length through the transition portion.

Disclosed herein is a catheter tip sized and configured to fit onto a distal end of a catheter shaft, the catheter shaft having a shaft outer diameter. The catheter tip includes a base, a tip having an arcuate shape, an outer surface extending from the base to the tip along a longitudinal axis, the outer surface having a diameter at the base that is substantially equal to the shaft outer diameter, and an inner surface extending from the base, wherein the inner surface defines a first region having a first diameter and a second region having a second diameter, wherein the second diameter is less than the first diameter, and wherein the second region is distal of the first region and configured to receive at least one component extending beyond the distal end of the catheter shaft.

A catheter for radial artery access to the contralateral subclavian artery and internal mammary artery is disclosed. The catheter includes a preformed tubular hook element configured for aligning coaxially within the subclavian artery from a radial access. The tubular hook element includes a first arm connected to a second arm via a curved element, and a second arm connected, via a second curved element, to an elongated tubular body. Each curved element has an angle between approximately 90-130 degrees. The catheter can receive a second catheter and guide it to further advance the subclavian artery. The second catheter then extends past distal end of the catheter and advances into the internal mammary arteries for selective angiography and intervention. The two-catheter system allows angiography and intervention of the entire right and left upper extremities to be performed depending on the access from the left or right radial artery, respectively.

A guiding device is provided. An implantable apparatus includes a member to be anchored. A position-limiting wire is detachably connected to the implantable apparatus. A proximal end of the position-limiting wire is connected to the control handle. A distal end of the guiding catheter is provided with a guiding member. A distal end portion of the guiding catheter is bendable. A proximal end of the delivery catheter and a proximal end of the guiding catheter are respectively connected to the control handle. When the control handle is manipulated to make the guiding member on the guiding catheter move along the position-limiting wire toward the distal end, the distal end portion of the guiding catheter is bent and deformed, such that the distal end of the guiding catheter abuts against the member to be anchored of the implantable apparatus.

A delivery apparatus for an expandable, implantable medical device comprises a handle portion, a shaft extending from the handle portion, a delivery capsule configured to house the medical device in a radially compressed state, and a rotatable component disposed in the handle portion and operatively coupled to the delivery capsule to produce axial movement of the delivery capsule upon rotation of the rotatable component. The delivery apparatus further comprises a motor disposed in the handle portion that is operatively coupled to the rotatable component so as to produce rotation of the rotatable component and corresponding axial movement of the delivery capsule. Further, the delivery apparatus comprises a manual deployment tool that is also configured to produce rotation of the rotatable component and corresponding axial movement of the delivery capsule when a manual pulling force is applied to the pull cord to pull the pull cord relative to the rotatable component.

Three groups of guidewire embodiments are described with particularly suitable structures for navigating circuitous vessels, especially blood vessels of the brain. Some of the guidewires have a hyperbolic taper that provides desired flexibility. In some embodiments, an integrated guide structure provides for extension in the blood vessel of a corewire to provide for extended reach of the guidewire. In further embodiments, the guidewire has a flexible tip that can be guided directly by the flow in the vessel.

A steering assembly of a medical device may comprise a handle having a recess and first and second wire guides disposed within the recess. At least one of the first or second wire guides may be keyed to the recess to prevent rotation of the first or second wire guide within the recess. First and second wire segments may be configured to steer a sheath coupled to the steering assembly in first and second directions. The first wire segment may pass through a first gap between the first wire guide and the second wire guide. The second wire segment may pass through a second gap between the first wire guide and the second wire guide. Neither of the first nor the second gap may occupy any overlapping space.

Introducer sheaths are described. In one embodiment, an introducer sheath comprises a sheath hub, a fixed housing coupled to the sheath hub, a rotating element rotatably coupled to the fixed housing, a sheath tube fixedly coupled to the rotating element, and a lock coupled to the rotating element. The lock is capable of preventing the rotating element and the sheath tube from rotating with respect to the sheath hub.

Methods, systems, and devices for accessing tissue outside a bronchus and marking the location of a biopsy are provided. The method includes loading a navigation plan into a navigation system with the navigation plan including a CT volume generated from a plurality of CT images, inserting an extended working channel (EWC) including a location sensor into a patient's airways, registering a sensed location of the EWC with the CT volume of the navigation plan, and selecting a target in the navigation plan located outside the periphery of a patient's airways. The method further includes navigating the EWC and location sensor proximate the target, inserting a piercing catheter into the EWC, piercing through an airway wall to reach the target, storing a position of the location sensor in the navigation system as a biopsy location, and performing a biopsy at the stored biopsy location.

A steerable medical device includes a handle having a handle body and a first control assembly that is movable with respect to the handle body. A first cam is housed within the handle body and is coupled to the control assembly. Movement of the control assembly with respect to the handle body drives rotation of the cam with respect to the handle body. A first slider is housed within the handle body and is coupled to the cam. Rotation of the cam drives translation of the slider within the handle body. An elongate tool extends from the handle. A first control wire is coupled between the first slider and the tool. Translation of the first slider causes tensioning of the control wire, and tensioning of the control wire causes deflection of the tool.