A coaxial multilumen annulus plane catheter, including an outer pigtail catheter enclosing one or two additional lumens, each housing either a slidable shaped wire or a second pigtail catheter shaped to fit into a wide range of annulus diameters and/or depths. In embodiments, the device may include a catheter delivery handle with thumb/finger-actuated sliders that extend or retract the shaped wires and are sized to enable side-to-side or radial motion, imparting a torque to the pre-shaped wires which translates the length of the wires to enable individually controlled rotation or sweep of each wire to accommodate different annulus diameters. The delivery handle includes hemostasis controls and flush ports. In other embodiments, a handle is obviated by direct lumen axial and rotational control at a proximal end.

A pre-curved steerable catheter includes a catheter body (102) having a distal end portion. The distal end portion includes a permanently curved flexible end portion (110). A pull wire (108) is disposed in a pull wire lumen within the catheter body. The pull wire extends from the distal end portion to a proximal end portion of the catheter body wherein the pull wire, when tensioned, provides a change in an angle of the curved flexible end portion of the catheter body.

An assembly is provided for accessing a superior vena cava of a patient without visualization of a vasculature of the patient. A stylet has an elongated body including a core wire disposed within a tubular body, the core wire having a pre-formed shape in a first state and a straightened shape in a second state. A first portion of the core wire has a substantially straight shape in the first state. A second portion of the core wire has a first pre-formed bend in the first state. A third portion of the core wire has a substantially straight shape in the first state. A fourth portion of the core wire has a second pre-formed bend in the first state. A fifth portion of the core wire has a substantially straight shape in the first state and includes a narrow segment that increases deflection of the distal tip.

An endotracheal tube assembly with a plurality of curved portions is provided. A first curved portion in the endotracheal tube assembly is located adjacent to an insertion end thereof with a curvature that matches the curvature of a video laryngoscope (e.g., Glidescope®). A second curved portion in the endotracheal tube assembly is located in a central portion of the endotracheal tube assembly. The curvature of the first curved portion is greater than the curvature of the second curved portion. The first curved portion is bent at an angle of between about 120° and about 150° with respect to a straight portion of the endotracheal tube assembly. The second curved portion is bent at an angle of between about 30° and about 60° with respect to the straight portion of the endotracheal tube assembly.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

The described invention provides endovascular devices that share the following general features: a working segment, a support segment, a working lumen, a support lumen, a side hole, and an angled extension. A described endovascular device includes an outer support catheter and an inner catheter with a side hole optionally containing an angled extension disposed at least partially within the lumen defined by the outer support catheter. The inner catheter can be connected to sets of grips on the outer catheter and the inner catheter, which are used by the operator to rotate one catheter relative to the other so as to position the side hole or the angled extension of the inner catheter in the targeted vessel. A radiopaque marker or intravascular ultrasound can be used to identify the position of the distal side hole in vivo. In some devices, the distal segment beyond the side hole (the support segment) for each of the described devices is effective to provide stability to each endovascular device, to provide strength to the endovascular device, to provide support for the endovascular device, to facilitate placement of the endovascular device, to anchor the endovascular device within a blood vessel, to reduce kickback of the endovascular device, or a combination thereof. The endovascular devices described can include additional support elements, for example, a balloon, a stent, a wire, or a combination thereof. The described selectively inflatable balloon is of two dimensions, a diameter and a length, sized to fit within the diameter of a vessel, for positioning the endovascular device. It may be disposed in a circumferential array of selectively inflatable balloons, as a single distal inflatable balloon or both. The circumferential array of selectively inflatable balloons is effective to position the endovascular device within a target blood vessel. The single distal balloon is effective to anchor the endovascular device within a target blood vessel. Each inflatable balloon can be selectively filled with a fluid, e.g., sterile water and saline.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A catheter and a surgical medical device. The catheter includes at least; a first elastic member positioned at an end portion of the catheter: a second elastic member connected with the first elastic member, the second elastic member being curved with a first radius of curvature to protrude toward a first direction; a first wire connected with a first surface of the first elastic member, and configured to pull the catheter to bend the catheter in the first direction; a second wire connected with a second surface of the first elastic member, which is opposite to the first surface, and configured to pull the catheter to bend the catheter in a second direction; and a tube containing the first elastic member, the second elastic member, the first wire, and the second wire.

Described herein are bend-limited catheters (e.g., apparatuses, including devices and systems) and methods of using them. These apparatuses may include an elongate tubular body that has one or more cut-out kerfs forming a pattern of interlocking teeth that are arranged in rings (and/or one or more spiral patterns) around the perimeter of the elongate tubular body. The pattern of interlocking teeth is configured to provide the catheter with a high degree of flexibility in bending, while permitting the device to lock at a locking diameter when the catheter bends to a minimum locking angle, beyond which no further bending is permitted.

Medical devices, medical device systems, and methods for making and using the same are disclosed. An example medical device may include an inner shaft having a stent receiving region. A bumper shaft may be disposed about the inner shaft. A deployment sheath may be slidably disposed about the inner shaft. The deployment sheath may have a body region and a distal stent covering region. The distal stent covering region may have an outer diameter that is smaller than an outer diameter of the body region.