The present disclosure provides a catheter system and methods for use that includes (a) a first catheter having a first end and a second end, where the first catheter has a first diameter, (b) a second catheter having a first end and a second end, where the second catheter has a second diameter that is less than the first diameter of the first catheter, and where the second catheter is positioned at least partially within a lumen of the first catheter and is moveable relative to the first catheter, and (c) a wire having a first end and a second end, where the first end of the wire is coupled to the second catheter.

A catheter system to reduce a risk of transfixing a blood vessel. The catheter system may include a catheter adapter, which may include a proximal end, a distal end, and a lumen extending therebetween. The catheter system may include a catheter extending distally from the distal end of the catheter adapter. The catheter system may include an introducer needle extending through the catheter. The introducer needle may include a sharp distal tip and a primary bevel extending from an outer edge of the introducer needle to the sharp distal tip. The outer edge may be parallel to a central axis of the introducer needle and aligned with the sharp distal tip. The primary bevel may include a primary bevel angle with respect to the central axis. The primary bevel angle may be between 20° and 33°.

A transseptal puncture system that includes a needle member that includes a distal end, a proximal end and defines a first lumen therethrough, a dilator that includes a distal end, a proximal end and defines a second lumen therethrough, a sheath that includes a distal end, a proximal end and defines a third lumen therethrough, a needle control device that is configured to move the needle member a predetermined distance from a stowed position to a deployed position and a guidewire that includes a distal end and a proximal end and is movable within the first lumen. The needle member is movable within the second lumen and the distal end of the needle member is configured to puncture the septum. The dilator is movable within the third lumen.

An expandable medical sheath can include a sheath body having a lumen that extends between proximal and distal ends of the sheath. The sheath can have first and second members where the first member has a different elastic modulus than the second member such that one provides elasticity to the sheath and the other provides column strength. The first and second members can be coupled together in alternating sections to form the tubular sheath or the stiffer members can be embedded in the elastic member along all or a portion of the longitudinal length of the sheath. The sheath can automatically move to an expanded state to allow a larger diameter medical device to pass through the lumen, and once through the sheath can automatically return to its initial diameter.

A method of using an integrated catheter assembly includes a housing member, an outer lumen member extending from the housing member, and a needle member slidably or movably coupled to the housing member, wherein the needle member can be extended beyond a first port of the outer lumen member in a first position and concealed in the outer lumen member in a second position. The outer lumen member has a side port between its first and second ports such that when the needle is extended in the first position and inserted into an arteriovenous fistula, blood from the arteriovenous fistula flashes into the needle member, is diverted through a relief port of the needle member out the side port of the outer lumen member for delivery to a dialysis machine. The assembly further includes an inner lumen member that is disposable through the housing member to extend out from the same the outer lumen member to provide dialyzed blood from the machine. The assembly therefore receives and delivers blood through a single injection site.

A lumenal element configured to transit a body lumen comprising a lumenal member (102) and an outer member (200) disposed over at least part of the lumenal member with a structural support (350), e.g. a mesh or stent, having a facing surface facing a surface of the lumenal member and wherein the facing surface includes at least one non-smooth surface portion, discontinuity, or non-uniformity, wherein the structural support is between the lumenal member and the outer member wherein the outermember is at least partly sealed to adjacent surfaces of the lumenal member sufficient to withstand fluid pressure within a space about the structural support, wherein the lumenal member has a first flexibility in the area of the structural support, and increasing the flexibility of the area of the structural support by moving at least a part of the outer member out of contact with the structural support. The flexibility of a lumenal element can be changed. Also disclosed a method of assembly of the lumenal element.

A method of securing tissue is provided. The method includes obtaining a section of tubing, sizing the section of tubing to a desired length, securing the section of tubing to a connector member, securing the connector member to an end effector of a surgical instrument, guiding the end effector to a target location using the section of tubing, and performing a surgical procedure with the end effector.

A catheter system that is actuatable to a deployed state and includes a catheter body and a dilator positioned at least partially within the lumen of the catheter. A distal end of the dilator can be releasably connected to a distal tip of the catheter body. The dilator can be retractable to expand and invert the distal tip and form a funnel shape in the deployed state.

An expandable medical sheath can include a sheath body having a lumen that extends between proximal and distal ends of the sheath. The sheath can have first and second members where the first member has a different elastic modulus than the second member such that one provides elasticity to the sheath and the other provides column strength. The first and second members can be coupled together in alternating sections to form the tubular sheath or the stiffer members can be embedded in the elastic member along all or a portion of the longitudinal length of the sheath. The sheath can automatically move to an expanded state to allow a larger diameter medical device to pass through the lumen, and once through the sheath can automatically return to its initial diameter.

A method of using an integrated catheter assembly includes a housing member, an outer lumen member extending from the housing member, and a needle member slidably or movably coupled to the housing member, wherein the needle member can be extended beyond a first port of the outer lumen member in a first position and concealed in the outer lumen member in a second position. The outer lumen member has a side port between its first and second ports such that when the needle is extended in the first position and inserted into an arteriovenous fistula, blood from the arteriovenous fistula flashes into the needle member, is diverted through a relief port of the needle member out the side port of the outer lumen member for delivery to a dialysis machine. The assembly further includes an inner lumen member that is disposable through the housing member to extend out from the same the outer lumen member to provide dialyzed blood from the machine. The assembly therefore receives and delivers blood through a single injection site.