Atherectomy catheters and methods of using them are described herein. In particular, described herein are optical coherence tomography (OCT) catheters that may include a distal tip that can be deflected away from the long axis of the device using a multi-channel bushing. The bushing may include at a hinge point that is offset (e.g., located on a side of the elongate body near the distal end of the elongate body) and a rotatable cutter near an imaging assembly that can be driven against the wall with a high mechanical advantage.

The present invention provides an atherectomy catheter which has a cutting element that is able to cut both soft tissue and hard tissue, and methods of cutting material from a blood vessel lumen using a rotating cutting element. The cutting element has a sharp cutting edge that surrounds a cup-shaped surface and at least one surface of abrasive material. The cup-shaped surface directs the cut material into a tissue chamber. The cutting edge and the cup-shaped surface together are well suited to cut and remove relatively soft tissue from the blood vessel. The abrasive material surface in combination with the cutting element is well suited to abrade and remove hard material from the blood vessel.

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

Method and devices for cutting and removing a portion of a tissue composition which includes cancellous bone which is directly or indirectly impinging on a neural structure of the spine by creating channels through the tissue structure and then removing the detached tissue.

An atherectomy catheter includes an elongate flexible catheter body, a cutter near the distal end of the catheter body, a drive shaft connected to the cutter and extending within the catheter body, an imaging element near the distal end of the catheter body and an imaging shaft connected to the imaging element and extending within the catheter body. The cutter and the imaging element are mechanically isolated, and the drive shaft is configured to be axially translated relative to the imaging shaft and the catheter body.

The present disclosure is directed to a device. The device may include a distal shaft defining a central lumen and an orienting element comprising at least one inflatable member. Wherein a first portion of the orienting element extending from the shaft in a first direction and a second portion of the orienting element extending from the shaft in a second direction. Further, wherein the second direction is substantially opposite the first direction.

A deployment mechanism of a tissue-removing catheter includes a socket member received in a catheter body that is capable of moving longitudinally therein, and a ball member extending distally from the distal end portion of the cutting element and operatively connected to the socket member. The ball member is constrained axially relative to the socket member and is capable of pivoting relative to the socket member for allowing pivoting of the cutting element relative to the socket when the cutting element is moved from a retracted position to a cutting position.

A tissue removing catheter includes an apposition mechanism that selectively imparts an axially compressive load on the catheter body to bend the catheter and urge a tissue-removing element toward a blood vessel wall. The apposition mechanism can include one or more adjustment lines and an adjustment mechanism for selectively tensioning one of the adjustment lines to impart the compressive load on the catheter body. Two adjustment lines can have diametrically opposed positions and be wound onto a spool of the adjustment mechanism in opposite directions so that rotation of the spool simultaneously shortens one adjustment line and lengthens the other. The catheter body can have a more flexible bending segment adjacent the tissue-removing element to promote bending near the tissue-removing element operative to urge the tissue-removing element in apposition with the blood vessel.

A catheter for performing a procedure at a treatment site in the lumen of a blood vessel. The catheter includes an elongate tubular shaft having a proximal bend, a distal bend and a hinge element. A distal portion of the shaft includes a window extending through the sidewall of the shaft between the hinge element and the distal end of the elongate tubular shaft. A working element is disposed within the lumen of the elongate tubular shaft and is configured for performing the procedure through the window at the treatment site. The bends and hinge element are configured to urge the window against a wall of the vessel at the treatment site.

A tissue-removing catheter includes a tissue-removing element operatively connected to a drive shaft for rotation of the tissue-removing element about an axis of rotation in a cutting direction. In some embodiments, the tissue removing element has a cutting blade and cutting teeth positioned radially inward of the cutting blade with respect to the axis of rotation. The cutting blade and cutting teeth are fixed with respect to one another to form first and second cuts in tissue as the tissue-removing element rotates. In certain embodiments, the tissue-removing element includes a cutting blade and raised elements spaced apart inward of the cutting blade relative to the axis of rotation to define an annular tissue-receiving channel between the cutting blade and the raised elements. A bottom surface of the channel can define cutting teeth.