A tool has an outer assembly, which includes a deployment tube, extending around, and moveable with respect to an inner assembly of the tool; the inner assembly includes a single pull wire and a distal member configured to engage an end of an implantable medical device. The deployment tube includes an articulating segment located just proximal to an enlarged distal-most portion, which contains the device and the distal member. Relatively soft and stiff sections of a composite sidewall define the articulating segment and extend alongside one another, such that, when the pull wire is actuated, the composite sidewall causes bending of the segment in two directions. A handle assembly of the tool includes a control member for the pull wire, and may further include a flushing subassembly that has a connector port located at an end of the handle assembly that is opposite a proximal port of the handle.

A catheter including a catheter shaft that has a proximal shaft and a distal shaft. The proximal shaft and the distal shaft are joined to one another in the axial direction. The proximal and distal shafts are integrally connected to one another by the distal end of the proximal shaft being inserted into a hollow interior of the proximal end of the distal shaft or by the proximal end of the distal shaft being inserted into a hollow interior of the distal end of the proximal shaft. The proximal shaft includes a penetrating portion which penetrates from the inner surface through to the outer surface at the distal end of the proximal shaft. The distal shaft includes a projecting portion that includes a tip portion which extends through the penetrating portion past the inner or outer surface of the proximal shaft so that the tip portion is exposed.

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.

An endoscope includes a handle connected to a flexible, steerable, kink-resistant insertion tube. An endoscope insertion tube may include a shaft, a lower durometer section proximate to a distal end of the shaft, and a higher durometer section positioned between the lower durometer section and a medium durometer section. The endoscope insertion tube may further include a fourth thermoplastic laminate section proximate to a proximal end of the shaft and having a higher durometer. A method of making an endoscope insertion tube may include inserting a mandrel with one, two, or more lateral slots and a liner into a shaft, wherein the liner is positioned between the mandrel and the shaft, bonding a bonded portion of the liner to an inner surface of the shaft, separating other portion(s) of the liner from the shaft, and inserting a first deflection wire in a gap between the shaft and the unbonded portion(s) of the liner.

A delivery system and method for delivering a prosthetic heart valve to the aortic valve. The system includes a delivery catheter having a steering mechanism thereon for delivering a balloon-expandable prosthetic heart valve to the aortic valve through an introducer passing into the left ventricle through its apex. The introducer may have a more floppy distal section than a proximal section to reduce trauma to the heart wall while preserving good operating field stability. The delivery catheter includes a deflecting segment just proximal to a distal balloon to facilitate positioning of the prosthetic heart valve in the proper orientation. A trigger in a catheter handle may be coupled to a deflection wire that actuates the deflecting segment, while a slider in the handle controls retraction of a valve pusher. The prosthetic heart valve may be installed over the existing calcified leaflets, and a pre-dilation valvuloplasty procedure may also be utilized.

Apparatus, systems, and methods for achieving thermally-induced renal neuromodulation by intravascular access are disclosed herein. One aspect of the present application, for example, is directed to apparatuses, systems, and methods that incorporate a treatment device comprising an elongated shaft. The elongated shaft is sized and configured to deliver a thermal element to a renal artery via an intravascular path. Thermally-induced renal neuromodulation may be achieved via direct and/or via indirect application of thermal energy to heat or cool neural fibers that contribute to renal function, or of vascular structures that feed or perfuse the neural fibers.

A system and method used to deliver a percutaneous ventricular assist device (pVAD) or other cardiac therapeutic device to a site within the heart, such as a site at the aortic valve. A flexible device is percutaneously introduced into a vasculature of a patient and positioned to run from a femoral vein, through the heart via a transseptal puncture, and to a femoral artery. The venous-side end of the flexible device is withdrawn out the venous vasculature superior to the heart, and a pVAD is secured to the flexible device. The pVAD is pushed in a distal direction while the arterial-side end of the flexible device is pulled in the proximal direction to advance the pVAD to the target site. A left ventricle redirector aids in orienting the pVAD and preventing migration of the flexible member towards delicate structures of the heart during advancement of the pVAD.

A medical device includes an inner element and an outer element positioned at least in part around the inner element. At least one of the inner element and the outer element comprises compression-stiffening particles. The compression-stiffening particles are transitionable from a first state to a second state in response to application of pressure. The compression-stiffening particles have a higher rigidity in the second state than in the first state. The medical device also includes a pressure source operably coupled to one or both of the inner element and the outer element to apply pressure sufficient to transition the compression-stiffening particles from the first state to the second state.

A catheter shaft is produced by forming a first polymeric layer onto a flexible inner core while maintaining the inner core in a solid state, and solidifying the first polymeric layer, wherein the solidified first polymeric layer fails to bond with the inner core and is slidable thereon upon flexion of the shaft. A second polymeric layer may be formed over the first polymeric layer, and is slidable thereon when the shaft bends.

A medical delivery device for delivering a medical device includes a navigable elongated member, a deployment bay, and a compression mechanism. The deployment bay may be configured to house the medical device as the medical device is navigated to the target site. The deployment bay may be at a distal end of the delivery device and may include a distal opening through which the medical device may be deployed. The compression mechanism is configured to longitudinally compress in response to a predetermined force such that the elongated member and deployment bay are relatively closer together along a longitudinal axis of the delivery device.