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.

A delivery sheath and a medical device. The delivery sheath includes an outer canal and a traction structure. The outer canal includes a connecting canal, a canal body, and a distal canal. The canal body is located between the connecting canal and the distal canal. The canal body includes a first flexible canal, a spacer canal, and a second flexible canal. The spacer canal is provided between a distal end of the first flexible canal and a proximal end of the second flexible canal. The hardness of the connecting canal is greater than that of the first and second flexible canals, and the hardness of the spacer canal is greater than that of the first and second flexible canals. The traction structure includes a first traction fiber and a second traction fiber.

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.

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.

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.

A stent with a selectively curved region. The stent includes a radially expandable tubular framework and a covering surrounding the tubular framework. A stent also includes a drawstring having a first end attached to the tubular framework at a first attachment location proximate the distal end of the tubular framework. The second end of the first drawstring is manipulatable proximate the proximal end of the tubular framework to deflect the tubular framework into a curved configuration.

Steerable, elongated medical devices that are inserted into a patient's body are disclosed. The devices include first and second wires slidably extending longitudinally through a wall of a tube and attached adjacent a distal end of the tube. The devices also include a tension control member configured to selectively apply a tension force to the wires to bend the tube.

In some examples, a device includes a catheter insert elongated body defining a body lumen, the catheter insert elongated body being configured to be at least partially inserted to a catheter lumen defined by a catheter without covering a first fluid opening of the catheter and to form a fluidically tight coupling with the catheter, and one or more sensors positioned on the elongated body. At least one of the one or more sensors are configured to sense a substance of interest. The catheter insert elongated body includes a material that is a substantially non-permeable to the substance of interest.