A bending neck comprising a plurality of pivotally connected hollow links is formed by machining a tube to form individual, pivotally connected links. A second tube may be located inside the first tube and simultaneously machined with the first tube. Grooves are formed on opposite sides of the outer surface of the second tube to provide a passageway for control cables which control the articulation of the links. In a second implementation indentations are formed in the side of the single tube to form ring-like projections into the inner lumen of each link, through which the control cables may pass.

An enhanced flexibility catheter is provided, such as for distal neurovascular access or aspiration. The catheter includes an elongate flexible body, having a proximal end, a distal end, and a side wall defining a central lumen. The side wall is formed from a plurality of adjacent tubular segments. At least one segment has a first end face inclined at a non normal angle to a longitudinal axis of the catheter. An adjacent segment has a second end face inclined at a complementary angle to form an inclined junction at the transition between the two segments. The transition serves to provide superior bending characteristics along the length of the catheter shaft.

A medical device may comprise a handle, a first shaft extending from a distal end of the handle, and a second shaft extending a lumen of the first shaft. The handle may further include a first actuator and a second actuator. The first shaft may include (1) a plurality of lumens extending therethrough, (2) a distal face, and (3) a longitudinal axis. Actuation of the first actuator may articulate a distal portion of the first shaft. The second shaft may be axially movable relative to the first shaft such that the second shaft extends out of a distal opening of the first lumen and distally of the distal face. Actuation of the second actuator may articulate a distal portion of the second shaft.

A delivery system for prosthetic heart valves are provided. The delivery system includes a flexible shaft, a distal sheath capsule configured to contain the prosthetic heart valve, an inner steerable catheter including an inner distal flex component, and an outer steerable catheter including an outer distal flex component. The inner distal flex component includes a first cut pattern and a second cut pattern distal to the first cut pattern. The outer distal flex component includes a third cut pattern. The inner steerable catheter is rotatable at least 90 degrees relative to the outer steerable catheter when the third cut pattern of the outer distal flex component is disposed over at least a portion of the first cut pattern of the inner distal flex component and each of the inner steerable catheter and the outer steerable catheter is in the flexed configuration.

A deflection system for deflecting a body lumen that includes a deflection mechanism, wherein the deflection mechanism includes: a beam having a proximal end and a distal end, wherein the beam includes a neutral position and a deflected position, a pull wire coupled to the distal end of the beam, wherein the beam is configured to be placed in the deflected position when a tension force is applied to the pull wire, and wherein at least a portion of the pull wire is configured to move to a displacement distance away from the beam when the tension force is applied to the pull wire, and one or more constraint members operatively coupled to the beam, wherein each one of the one or more constraint members is configured to limit the displacement distance of the pull wire from the beam when the tension force is applied to the pull wire.

A steerable instrument for endoscopic and/or invasive type of applications includes an elongated tubular body and at least one actuation means at a proximal side of the steerable instrument and at least one bendable zone at a distal side of the steerable instrument, the at least one actuation means being arranged to control bending of the at least one bendable zone by means of longitudinal elements. The instrument further includes first, second and third cylindrical elements; at least one tangential spacer; and at least one lip shaped portion formed on at least one of the first cylindrical element or the third cylindrical element.

A steerable instrument for endoscopic and/or invasive type of applications, such as in surgery, which has an elongated tubular body having a proximal end part with a first actuation flexible zone having a first diameter and a distal end part having a first distal flexible zone having a second diameter that is different from the first diameter. A cylindrical diameter adaptation section is arranged to connect the proximal end part to the distal end part such that a flexion in a radial direction relative to a longitudinal center axis of the longitudinal tubular body of the first actuation flexible zone results in an amplified or attenuated flexion of the first distal flexible zone.

An elongate medical device shaft may comprise an elongate body and an annular electrode disposed on the elongate body. The annular electrode may define a longitudinal axis and have an outer diameter. The outer diameter may be greater at an axial center of the electrode than at an axial end of the electrode. Additionally or alternatively, the elongate body may comprise three longitudinal sections having three wall thicknesses. The middle wall thickness may be less than the proximal and distal wall thicknesses and the distal wall thickness may be less than the proximal wall thickness. Additionally or alternatively, the shaft may comprise an inner cylindrical structure and an outer tube. The outer tube may comprise a first radial layer and a second radial layer that is radially-outward of the first radial layer, the first radial layer, second radial layer, and inner structure having different stiffnesses.

Apparatus for passing a blocked vein, including: (a) an intravascular catheter body defining at least one lumen; (b) a radially expandable anchor at a distal end of said catheter; and (c) a penetration tool sized and shaped to be delivered by the lumen to a point distal of the expandable anchor, the penetration tool including a tip and configured for being pushed through venous blockage more than one week old and present with a young's modulus greater than 1 MPa. Optionally, the penetration tool tip comprises a sharpened tip. Optionally or additionally, the penetration tool tip is controllably bendable.

A movable shaft includes a tubular member. The tubular member has a proximal end and a distal end in a longitudinal direction of the tubular member. The tubular member has a bent portion extending along the longitudinal direction and allowed to be bent. Flexibility of the bent portion increases from a side of the proximal end to a side of the distal end.