An everting catheter with an expandable inner lumen for the passage of instruments or other devices is described. The catheter can have an inflatable everting balloon. When inflated, the everting balloon can define a channel or passageway, via an inner balloon lumen, into a target site. Instruments can be delivered to the target site through the channel defined by the inflated everting balloon.

Apparatus for controlling motion of an invasive probe relative to a sheath enclosing the probe. The apparatus includes an outer casing, configured for connection to the sheath. The apparatus further includes a drive mechanism, fixedly connected to the outer casing. The drive mechanism has a first set of components, configured to translate the probe along a direction parallel to an axis of the probe, in order to advance and retract the probe with respect to the sheath in a translational stepwise manner. The drive mechanism also includes a second set of components, configured to rotate the probe around the axis of the probe, in order to rotate the probe clockwise and counter-clockwise, with respect to the sheath, in a rotational stepwise manner.

A tubular structure having variable support includes a tubular member and a structural support member with a flexible tubular member over the structural support member, such that the flexible tubular member can engage and disengage or squeeze and release the structural support member. The structural support member can be a tubular mesh, stent, framework, skeleton, braid or other flexible framework. A fluid passage can be used to inflate and deflate the flexible tubular member. Methods of assembly and methods of use are also described.

Disclosed herein are a range of stiffening mechanisms or systems that assist or enable holding a pose or shape of a flexible body (1010, 216, 410, 420, 801). These stiffening mechanisms may be part of the steering mechanism (500, 800), may be separately actuated and/or may themselves also enable steering of the flexible elongate device (400). Further, the stiffening mechanisms may use information from sensor (826) systems, such as a shape sensor (222, 314, 426) in the form of an optical fiber, a plurality of EM sensors (426, 826) distributed along the length of a flexible device, and/or navigation systems, such as a sensor system (108) that computes the approximate location of medical instruments (such as a flexible body) within the anatomy of the patient and/or medical tools that are delivered through a main lumen (411, 811) of the flexible body (1010, 216, 410, 420, 801), to inform a control system (112, 116) which then controls formation and holding of a shape of the flexible body (1010, 216, 410, 420, 801).

Medical devices and methods for delivering fluid. The medical devices include one or more needles for delivering fluid. The methods may include expanding an expandable member such as an inflatable member to expand an expandable scaffold outward toward a lumen wall.

A method for determining a shape of a bendable instrument can include placing the bendable instrument in a neutral position; moving a first control element a first amount until slack is removed from the first control element; moving a second control element a second amount until slack is removed from the second control element; sensing a position of the first control element after moving the first control element the first amount, the sensed position of the first control element being defined as a first control element calibration position; sensing a position of the second control element after moving the second control element the second amount, the sensed position of the second control element being defined as a second control element calibration position. The method can further include bending the instrument by moving one or both of the first control element and the second control element from the respective first control element calibration position and the second control element calibration position; and determining a resulting shape of the bendable instrument based on a distance one or both of the first control element and the second control element respectively moved from the first control element calibration position and second control element calibration.

A catheter for positioning a guidewire across an occluded portion of a vessel includes an elongate catheter body, an integrated rotatable distal tip, a proximal handle region, and a catheter lumen extending through the elongate catheter body. The elongate body has a distal region configured to be bent to a set angle. The integrated rotatable distal tip includes one or more channeled flutes extending around the distal tip that are configured to be rotated in a first direction to dissect tissue and a second direction for bluntly contacting tissue. A proximal handle region includes a control for rotating the distal tip in either the first or second directions. The catheter lumen is configured to pass a guidewire.

A deflectable, flexible device includes an elongate body, a convoluted tip portion at a distal end of the elongate body, and a lumen to receive one or more wires. The convoluted tip portion includes an electroformed pleated region which is formed by electrodepositing a metal on a mandrel having a pleated region. The convoluted tip portion may be hermetically sealed to permit repeated sterilization. The electroformed pleated region may include one or more fluid emission orifices. The convoluted tip portion extends or bends in response to fluid pressure manipulation, contact with tissue, manipulation with an internal spring or wire, or by a user pushing, pulling, or twisting the catheter directly or via an introducer sheath or the like. The convoluted tip portion may further include an RF ablation element or other energy-driven technique to create continuous linear lesions or a sensing element.

A tubular structure having variable support includes a tubular member and a structural support member with a flexible tubular member over the structural support member, such that the flexible tubular member can engage and disengage or squeeze and release the structural support member. The structural support member can be a tubular mesh, stent, framework, skeleton, braid or other flexible framework. A fluid passage can be used to inflate and deflate the flexible tubular member. Methods of assembly and methods of use are also described.

Medical devices and methods for delivering fluid. The medical devices include one or more needles for delivering fluid. The methods may include expanding an expandable member such as an inflatable member to expand an expandable scaffold outward toward a lumen wall.