In one aspect, a system for endovascular treatment of a blood vessel includes a control unit, an ultrasound device, an actuator, and a catheter having a treatment portion. The ultrasound device is communicatively coupled to the control unit. The ultrasound device includes an ultrasound probe having a subject contact surface. The actuator is coupled to the ultrasound probe and is operable to move the subject contact surface of the ultrasound prove relative to a treatment zone of a subject. The control unit is configured to determine a position of the treatment portion of the catheter as the catheter is advanced through the blood vessel, and move the subject contact surface of the ultrasound probe relative to the treatment zone of the subject with the actuator to follow the position of the catheter as the catheter is advanced through the blood vessel.

A medical implant delivery system can comprise a puncture needle, a medical implant delivery catheter and the puncture needle being configured to be slidably advanced through a puncture needle lumen of the medical implant delivery catheter, a medical implant device positioned on the medical implant delivery catheter, and an outer delivery catheter comprising a medical implant delivery lumen, the medical implant delivery catheter being configured to slidably extend through the medical implant delivery lumen. A medical implant delivery system can comprise a puncture needle, a medical implant delivery catheter and the puncture needle being configured to slidably extend through the puncture needle lumen of the medical implant delivery catheter, a medical implant device positioned on the medical implant delivery catheter, an elongate housing adjacent to the medical implant delivery catheter, and an outer sheath around a portion of the medical implant delivery catheter and the elongate housing.

The invention discloses a novel vascular punch employing compressive normal force for tissue separation from a targeted vessel. This invention is particularly designed for making a large round hole without massive bleeding in vascular surgery. A clean, non-frayed hole-making guided by the normal force cutting principle is realized using a site-biting punch mechanism. The side-biting vascular punch comprises a U-shaped razor blade cutter, a backstop for receiving the cutter, and a linkage mechanism, forming an aligned line of contact for normal compression force generation and thereby severing tissue out of the targeted vessel.

A differential pressure regulating device is provided for controlling in-vivo pressure in a body, particular 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.

A system for deploying a stent-graft from the femoral artery into the femoral vein and back into the femoral artery in order to bypass a femoral occlusion comprises a penetration catheter and a guidewire capture and stabilization catheter. The penetration catheter may be advanced contralaterally to a location above the occlusion and the capture and stabilization catheter may be introduced upwardly through the femoral vein. The penetration tool on the penetration catheter is used in multiple steps to deploy guidewires which are then used to deploy the stent-graft in the desired location.

An implantable shunting device configured to shunt blood from the left atrium of the heart to the azygous vein through an aperture in the atrial septal wall is provided. The device comprises a flexible tube configured for radial adjustment between a contracted delivery configuration suitable for delivery in a delivery catheter and a deployed radially expanded configuration, the tube having a through lumen, a distal end configured to anchor within the azygous vein, and a proximal end configured to span an aperture in an atrial septal wall and anchor to the wall to provide fluid communication between the left atrium and the azygous vein. Methods of treating heart disease by implanting a shunting device of the invention are also disclosed.

A needle-tract assistants (100, 200) for establishing a needle tract of a predetermined length, including a needle thruster (110, 210) and a needle-in-catheter assembly (130, 230) removably loaded in the needle thruster (110, 210). The needle thruster (110, 210) can include a cradle (112, 212), a carriage(114, 214) within the cradle (112, 212), and a plunger (116, 216) coupled to the carriages (114, 214). The carriages (114, 214) can be configured to move between a proximal-end portion and a distal-end portion of the cradle(112, 212). The plungers (116, 216) can be configured to move the carriages (114, 214) within the cradle(112, 212). The plungers (116, 216) can also be configured to allow a user to set the predetermined length of the needle tract before establishing the needle tract. The needle-in-catheter assembly (130, 230) can include a hub (132, 232), a catheter tube (134, 234) extending from a distal-end portion of the hub (132, 232), and a needle (137, 237) disposed within the catheter tube (134, 234). Also described are components of the needle-tract assistants (100, 200) and methods of the needle-tract assistants (100, 200) or the components thereof.

A medical device is disclosed that can reduce variations in the degree of cauterization by an energy transfer element, and can suppress generation of thrombus formation, tissue damage, and the like due to the cauterization. The medical device can include an elongated shaft portion, and an expansion body that is provided in a distal portion of the shaft portion and can expand and contract in a radial direction, in which: the expansion body includes a plurality of wire portions that are linked with a shaft portion, and a clamping portion that is formed by at least one wire portion and clamps a biological tissue; the clamping portion includes an energy transfer element that outputs energy, and a back support portion; the back support portion includes a receiving surface that can face the energy transfer element when the expansion body expands; and the receiving surface can be inclined.

An endovascular stent-graft with an extravascular extension is presented including: a stent-graft having an aperture and a vascular graft having an and attached to the aperture and a free end. Methods of using the endovascular stent-graft with an extravascular extension include providing the endovascular stent-graft with an extravascular extension to a target vessel of the patient and using free end to either provide access for a circulatory medical procedure or attaching the free end to another point in the circulatory system to perform a bypass operation or to provide a graft for providing hemodialysis. The methods may be performed noninvasively through incisions in the back of the patient.

Several unique intra-cardiac pressure devices, placement catheters, methods of placement and methods of treating heart failure are presented. The intra-cardiac pressure devices presented allow sufficient flow from the left atrium to the right atrium to enable the relief of elevated left atrial pressure and resulting patient symptoms. The intra-cardiac pressure devices are made of a non-braided material.