An expandable sheath assembly includes a support body extending from a proximal end to a distal end. A guide rod is interconnected to the support body and extends between the ends along an axis. A dilator extends from the guide rod for insertion into a body vessel, and a hub is releasable connected to the distal end of the support body. A distal sheath overlays the dilator, and a hemostatic valve is slidably disposed along the axis. A proximal sheath extends from the hemostatic valve and is disposed in surrounding and coaxial relationship with the guide rod. The proximal sheath is concurrently slidable with the hemostatic valve along axis to advance the proximal sheath through the hub and interleave the proximal sheath between the dilator and the distal sheath for lifting the distal sheath from the dilator and effectuating an expansion of the body vessel.

In one aspect, a playback device includes a command-keyword engine having a local natural language unit (NLU). The playback device detects, via the command-keyword engine, a first command keyword in voice input of sound detected by one or more microphones of the playback device. The playback device determines whether the sound input data includes a keyword from a first predetermined library of keywords via a local natural language unit (NLU). The playback device transmits the input sound data to a second playback device over a local area network, the second playback device employing a second local NLU with a second predetermined library of keywords. The playback device receives a response from the second playback device and performs an action based on an intent determined by at least one of the first NLU or the second NLU according to the keywords in the voice input.

A valve bypass tool, and a biostimulator transport system having such a valve bypass tool, is described. The valve bypass tool includes an annular seal to seal against a protective sheath of the biostimulator transport system. The valve bypass tool is slidably mounted on the protective sheath and includes a bypass sheath to insert into an access introducer. The valve bypass tool can lock onto the access introducer by mating a locking tab of the valve bypass tool with a locking groove of the access introducer. The locking tab can have a detent that securely fastens the components to resist decoupling when the biostimulator transport system is advanced through the access introducer into a patient anatomy. Other embodiments are also described and claimed.

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 various embodiments herein relate a catheter advancement device having an elongate shaft and a capsule attached to or integral with the shaft, and related methods for assisting with advancement of catheters such as guiding catheters while reducing damage to the inner wall of the blood vessel. Some capsules have a distal plug portion and a neck portion having a smaller diameter than the plug. Other capsules have a channel defined along the outer surface of the capsule.

A micropuncture kit for direct access of a surgically exposed vessel using direct visual guidance includes a micropuncture access needle having a proximal hub coupled to an elongate shaft defining an inner lumen and a visible depth indicator positioned on the elongate shaft a distance away from a distal tip of the elongate shaft. The kit includes an access guidewire sized to be received through the inner lumen of the micropuncture access needle and a microaccess cannula having an elongate body defining an inner lumen and a plurality of visible depth indicators formed on the elongate body. The guidewire includes a distal tip and at least one visible depth indicator positioned on the access guidewire a distance away from the distal tip of the guidewire. Each of the plurality of visible depth indicators identifies a distance from a distal tip of the cannula. Related systems, devices and methods are provided.

A variable diameter tube for use in a vessel inserter for performing hemodynamics researches and related operations comprises two coupled different-characteristic materials which are coupled to one another to provide a single stretchable tube assembly.

A system for accessing a central pulmonary artery includes an elongate, flexible tubular catheter, having a proximal end, a distal end and a catheter hub on the proximal end. An elongate, flexible rail has a proximal end, a distal end and a rail hub on the proximal end. The rail has a distal advance segment which extends at least about 10 cm beyond the distal end of the catheter when the catheter hub is adjacent the rail hub.

Intravenous access is achieved by introducing a catheter over an access needle which is initially present in the catheter. A tapered dilating element is positioned over the needle and provides a transition between the needle and a larger catheter lumen. The access needle is hollow and has a port which allows blood to flash back through a lumen of the catheter so that flashback can be observed on a catheter hub or the catheter itself.

Embodiments herein include an insertion tool for inserting a medical device into another medical device, such as a hemostasis sealing valve, and related methods. In an embodiment, an insertion tool includes a guide sheath and a protection tube. The guide sheath can include a flared proximal end. The guide sheath can further include a central lumen. The guide sheath can further include a locking notch disposed on the inner surface between the proximal end and the distal end. The protection tube can include a flared proximal end. A portion of the protection tube can be situated within the central lumen of the guide sheath. The flared proximal end of the protection tube can be sized to fit within the locking notch and can have an outer diameter larger than portions of the inner surface immediately adjacent to the locking notch. Other embodiments are also included herein.