Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating one or more abrasive elements within the vessel. The abrasive elements are attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, the handle assembly encapsulates an electric motor assembly, a pump assembly, and a controller assembly.

A thrombosis macerating and aspiration device for macerating and aspirating blood clots and blockages in a blood vessel is disclosed. In some embodiments, the macerating element of the device rotates and creates a partial vacuum to assist in the aspiration of the blood clot of blockage. The macerating element may have a variety of different designs and shapes and in some embodiments, the macerating element is expandable.

Medical systems and methods for making and using medical systems are disclosed. Example medical systems may include an atherectomy system configured to engage and remove plaque from walls in vessels of a vascular system. The atherectomy system may include a drive shaft, a rotational tip coupled to an end of the drive shaft, a motor coupled to the drive shaft to rotate the rotational tip, and a controller configured to control a motor state of the motor. The controller may adjust a range of possible load outputs from the motor and/or a maximum load output from the motor to account for external loads acting on the drive shaft and/or rotational tip rotated by the motor and facilitate passing an occlusion in a vasculature of a patient.

A thrombectomy system is provided that, in various embodiments, a rotating impeller that may be translated within limits along a guidewire and within a catheter. The rotating impeller is, during operation, either located entirely inside or outside of the distal end of the catheter's lumen or at least partially outside of the distal end of the catheter's lumen. In some cases, the impeller may be prevented from rotating if at least partially inside the catheter's lumen. The rotating impeller may achieve a working diameter that is greater than its resting diameter.

Rotational atherectomy devices and systems can remove or reduce stenotic lesions in implanted grafts by rotating one or more abrasive elements within the graft. The abrasive elements can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, individual abrasive elements are attached to the drive shaft at differing radial angles in comparison to each other (e.g., configured in a helical array). The centers of mass of the abrasive elements can define a path that fully or partially spirals around the drive shaft.

A device for intrabody surgery comprises a cutting arrangement rotatable by a hollow driveshaft, which is formed by a hollow front cutting region and a rear region. The front region includes multiple longitudinal drilling sections interconnected by transversely oriented cutting blade sections. The drilling sections are positioned at an angle to each other defining in combination with the cutting blades a conically shaped grid formation having a hollow internal cavity. The grid formation defines a plurality of ports between the drilling sections and the blades. A low-pressure zone is formed within the hollow internal cavity, wherein cut occlusion materials are aspired by the low-pressure zone through the plurality of ports into the hollow internal cavity for further evacuation from the cutting arrangement.

A catheter for centrally crossing an occluded blood vessel includes a catheter body having a distal end, a proximal end, and a central passage. A rotatable drive shaft extending through the central passage and has a distal end, a proximal end, and a central lumen. A cutting tip is mounted on the distal end of the rotatable drive shaft and configured to cut through occlusive material when rotated. A plurality of spiral or other flat springs is disposed circumferentially about a distal portion of the catheter body to maintain centering of the catheter and form a passage as the catheter is advanced through a chronic total occlusion.

A medical device has a rotatable drive shaft, a rotary body whose distal end includes a cutting edge for applying a cutting force to a stenosed site, and that is disposed on a distal side of the drive shaft so as to be rotated in conjunction with rotation of the drive shaft, and a distal member disposed in the rotary body. The distal member has a support portion extending to a distal side beyond a distal end of the rotary body, and configured to be capable of supporting the rotary body with respect to a blood vessel. The support portion is configured so that a distance from the rotary body is variable in a first direction (height direction) in which the rotary body is moved close to the stenosed site.

Medical systems and methods for making and using medical systems are disclosed. Example medical systems may include an atherectomy system configured to engage and remove plaque from walls in vessels of a vascular system. The atherectomy system may include a drive shaft, a rotational tip coupled to an end of the drive shaft, a drive mechanism coupled to the drive shaft to rotate the rotational tip, and control configurations to control settings of operational modules of the atherectomy system. The control configurations may be configured to change settings of multiple operational modules of the atherectomy system in response to a single actuation of an actuator to facilitate use of the atherectomy system in a vasculature of a patient.

Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating an abrasive element within the vessel. The abrasive element can be attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly.