A catheter system can include a tubular body, and at least one of a targeting system coupled to the tubular body, an expandable member, or a fluid injection port. A method of identifying a bifurcation can include inserting a catheter system into a first vessel, positioning the catheter system at a first location, expanding an expandable member to occlude the first vessel, delivering contrast material so the contrast material pooling proximate to the expandable member, and reviewing a shape of the contrast material in the first vessel under fluoroscopy.

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 providing an intravascular device having a distal portion with a side port, inserting the device into the vascular lumen, positioning the distal portion in the vascular wall, directing the distal portion within the vascular wall such that the distal portion moves at least partially laterally, and directing the side port towards the vascular lumen.

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, and in particularly in a heart. The device may include a shunt being positioned between two or more lumens in a body, to enable fluids to flow between the lumens, and an adjustable flow regulation mechanism being configured to selectively cover an opening of the shunt, to regulate the flow of fluid through the shunt in relation to a pressure difference between the body lumens. In some embodiments a control mechanism coupled to the adjustable flow regulation mechanism may be provided, to remotely activate the adjustable flow regulation mechanism.

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 providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.

Methods and devices for performing transjugular carotid flow reversal are provided. A flow reversal sheath is advanced through a transjugular carotid fistula. An occlusion balloon is inflated, causing carotid inflow to be diverted through the sheath and through a flow reversal region positioned in the jugular vein. After reversal of blood flow, a carotid intervention is performed.

A device for vessel harvesting is disclosed. The device for vessel harvesting includes a distal housing, a dissector coupled to the distal housing, a drive element coupled to the dissector, and an actuator coupled to the drive element. The device for vessel harvesting may also include a rotatable dissector, a shaft coupled to the distal housing having a first articulation joint movable within a first plane, and a second articulation joint movable within a second plane, which is substantially perpendicular to the first plane, a barrel chain drive element coupled to the rotatable dissector, and an actuator coupled to the drive element. The device for vessel harvesting may also include a member slidably engaged to the distal tip.

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 providing a first intravascular device having a distal portion with a concave side, inserting the first device into the vascular lumen, positioning the distal portion in the vascular wall, and orienting the concave side of the distal portion toward the vascular lumen.

A cannula system for puncturing the heart is provided, comprising a cannula and a trocar. The cannula comprises a cannula shaft with a heart-side inlet and a pump-side outlet. The trocar has a trocar shaft which can be inserted into the lumen of the cannula and which comprises a puncturing tip, wherein the puncturing tip can completely cover the inlet opening of the cannula.

A coring device, for forming an opening in a tissue wall, includes a body having a proximal end, a distal end and an internal housing, a coring head having a transection blade and being movable between a rest position and an actuated position, an actuation mechanism for moving the head between the positions and having an actuation rod, at one end of which the head is placed, a lumen extending through at least the proximal end of the body, actuation rod and coring head in order to allow passage of a flexible guide element, and the distal end of the body forms a support for a surgical tool configured to receive a hollow surgical tool with a positive fit and to support this tool to permit linear guiding of the surgical tool during the movement of the latter toward the outside of the coring device.

A kit including a sheath having a tubular body with proximal and distal ends, an axis extending between the ends and a wall defining a bore extending along the axis to the distal end of the body. A delivery tube having proximal and distal ends and a lumen is adapted for disposition within the bore of the sheath in sealing engagement with the sheath, the delivery tube being slideable distally relative to the sheath. An elongated cannula having proximal and distal ends and a lumen is adapted for disposition inside the lumen of the delivery tube and an elongated dilator is adapted to fit within the lumen of the cannula with a proximal portion of the dilator extending proximally beyond the proximal ends of the cannula and delivery tube and in sealing engagement with the delivery tube proximal to the cannula.