Medical methods and devices for treating aortic dissections. A catheter-based cutting device permits cutting a septum of acute or chronic aortic dissections, in a retrograde manner. The catheter includes a base section having a central lumen therethrough and two flexible arms extending from a distal end thereof. The flexible arms can each have a guide wire channel therethrough. With distal ends of the two flexible arms separated, the two arms form a Y-shape with the base section. In one embodiment, with distal ends of the two flexible arms together, the two arms have a longitudinal profile, about a periphery thereof, identical to a longitudinal profile of the base section. A cutting component resides between the two arms. The cutting component can face distally outward between the two arms with the distal ends of the two flexible arms separated.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

Assemblies and methods provide for implantation of multiple medical leads to a defined space within the body, such as the epidural space, through a single entry. A catheter having multiple lumens or alternatively a single oblong lumen may be used. A distal end of the catheter enters the defined space through the single entry such that the distal ends of the multiple lumens or the oblong lumen are present in the defined space. Medical leads are introduced through the multiple lumens or the oblong lumen into the defined space. In some cases, the distal end of the catheter may be deflectable to direct the medical leads within the defined space. In other cases, sheaths may be present within each lumen of the catheter where the sheaths may be extended into the defined space and deflect to direct the medical leads that are being passed through a lumen of the sheaths.

A surgical apparatus for treating a blood clot in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the blood clot. An energy emitter emits energy to the blood clot or hardenings and a connector connects the energy emitter to an external energy source, wherein blood flows into the second hole positioned proximal of the blood clot and exits the first hole distal of the blood clot during activation of the energy emitter. In some instances when the apparatus is introduced from a retrograde upstream approach blood may flow through the device in the opposite direction.

The invention provides a device for generating shock waves. The device may comprise an elongated tube and a conductive sheath circumferentially mounted around the elongated tube. The device may further comprise first and second insulated wires extending along the outer surface of the elongated tube. A portion of the first insulated wire is removed to form a first inner electrode, which is adjacent to a first side edge of the conductive sheath. A portion of the second insulated wire is removed to form a second inner electrode, which is adjacent to a second side edge of the conductive sheath. Responsive to a high voltage being applied across the first inner electrode and the second inner electrode, a first shock wave is created across the first side edge and the first inner electrode, and a second shock wave is created across the second side edge and the second inner electrode.

A method is disclosed for treating calcified lesions within a wall of a blood vessel. The first step includes breaking apart a calcified lesion using a plurality of shockwaves generated in an angioplasty balloon of an angioplasty catheter device. The angioplasty balloon is dilated via a fluid to a first extent to fit against at least a portion of the wall of the blood vessel. A plurality of electrical pulses are delivered to a pair of electrodes disposed within the fluid inside the balloon. The electrical pulses have an amplitude sufficient to create plasma arcs in the fluid to generate shockwaves that are conducted through the fluid and through the balloon to the blood vessel, to crack the calcified lesion. After breaking apart the calcified lesion, the angioplasty balloon is allowed to further expand to a second extent greater than the first extent, thereby expanding an opening in the blood vessel.

Catheter systems of the invention are directed to the removal of occlusions, such as thrombi and plaque, within blood vessels. In certain aspects, catheter systems of the invention include an elongate body defining a first lumen and comprising a distal portion, an inner member configured for insertion into the first lumen, the inner member comprising an energy source configured to deliver therapeutic energy to a treatment site; and a dissolution element coupled to the distal portion of the elongate body. The dissolution element may include a heating element, steam, and a balloon.

This disclosure disclosed an ultrasonic needle and apparatus used for removal of the vitreous body and other tissues. An ultrasonic vitrectomy needle, comprising: a connector, a connected inner needle, and an outer sheath. The length of the outer sheath at the distal end is slightly longer than that of the inner needle; the sheath distal end is of blind with smooth surface, but there is an open cut at the side of the distal end used for aspirating the vitreous body. The benefits of this disclosure: due to the difficulty if not impossible in the prior arts making a slim long center bore needle for ultrasonic surgical system, this disclosure clears the way to make the ultrasonic vitrectomy a practical reality; the ultrasonic vibration inherent advantages of the quietness, minuscule displacement, liquid repulsion and viscosity reduction improve safety of the surgery; the possibility of integrating ultrasonic vitrectomy and ultrasonic phaco emulsification procedures simplifies the complexity from prior arts, thus brings ease to the ophthalmic surgeries and reduces the cost.

Devices, assemblies, systems, and techniques described herein may deliver a pressure wave to structures of a heart, such an aortic valve. For example, a medical assembly may include an expandable member configured to expand from a collapsed configuration to an expanded configuration, the expandable member configured to at least partially define a channel through the expandable member in the expanded configuration and one or more electrodes carried by the expandable member. The one or more electrodes may be configured to transmit an electrical signal through a fluid to cause the fluid to undergo cavitation that generates a pressure wave within the fluid.

A system and method is provided for generating ultrasound at the tip of an intravascular catheter. This may be used for the treatment of vascular occlusions, including chronic total occlusions (CTOs) and thrombotic occlusions (e.g., deep vein thrombosis, stroke, myocardial infarction). For instance, the systems and methods may be used to induce cavitation to enhance the enzymatic degradation of a vascular occlusion. In some configurations, the approach employs a hollow cylindrical transducer, electrically stimulated in the radial direction at a frequency corresponding to the length mode excitation, thereby projecting ultrasound forwards past the catheter tip. This design overcomes electrical impedance issues for the generation of low frequencies with a smaller diameter transducer capable of negotiating a coronary artery. The hole within the transducer may accommodate a guidewire to facilitate its placement adjacent to the proximal portion of the occlusion.