A tissue cutting device that is especially suited for neurosurgical applications is disclosed and described. The device includes a handpiece and an outer cannula in which a reciprocating inner cannula is disposed. The inner cannula includes a hinge between a body section and a cutting section that allows the cutting section to pivot when the inner cannula reciprocates within the outer cannula. A tissue collector is also provided and is in fluid communication with the lumen of the inner cannula. A fluid supply sleeve is disposed about the outer cannula and is selectively positionable along the length of the outer cannula.

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 Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel.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.

Described here are devices, systems and methods for forming a fistula between two blood vessels. Generally, the systems may comprise a first catheter which may comprise a fistula-forming element. The fistula-forming element may comprise one or more electrodes, mechanical cutting elements, laser sources, or combinations thereof, and may be used to assist in fistula formation. In some instances, a system may comprise a second catheter, which may comprise a fistula-forming element. One or more of the catheters may comprise one or more markers, magnetic alignment elements, and/or one shape-changing elements.

Versatile tissue collection devices that can provide reduced crossing profiles, fluid pressure release, and/or easy cleaning or removal. In particular, devices having tissue collection devices with multiple configurations to facilitate navigation through narrow vessel cross-sections while also providing adequate tissue storage capacity. Additionally, the devices may include detachable components that allow easy removal, cleaning, and replacement during a procedure. Furthermore, venting elements and sections may be included to relieve fluid buildup in storage reservoirs.

A tissue-removing catheter includes a sensor configured to detect a parameter of the catheter during the cutting operation of the catheter when a tissue-removing element is in a tissue-removing position. A locking control circuit is in electrical communication with the sensor and a locking device. During an operational control function, the locking control circuit receives a signal from the sensor based at least in part on the parameter of the catheter detected during the cutting operation of the catheter. The locking control circuit determines whether the received signal is indicative of a tissue-removing element engaging a non-tissue obstruction. The locking control circuit configures the locking device in its locked configuration to inhibit movement of the tissue-removing element from its tissue-removing position to its neutral position if the received signal is indicative of the tissue-removing element engaging a non-tissue obstruction.

An atherectomy catheter includes a deflectable distal tip, a rotatable cutter proximal to the distal tip, a cutter drive shaft configured to rotate the rotatable cutter, and a pull shaft concentric with the drive shaft and coupled to the distal tip. The pull shaft is configured such that pulling the pull shaft deflects the distal tip, thereby exposing the rotatable cutter. Also disclosed herein is a magnetic drive system configured for non-contact actuation of a catheter.

Described herein are atherectomy catheters, systems and methods that include longitudinally displaceable drive shafts that drive actuation of one or more cutters at the distal end of the catheter. The catheters described herein may include one or more imaging sensors for imaging before, during or after cutting tissue. In some variations the imaging sensor may be rotated around the perimeter of the catheter independently of the rotation of the cutter. Also describe herein are imaging catheters that may be used without cutters.

An atherectomy catheter for use in a vessel includes an elongate catheter body and an annular cutter. The elongate catheter body includes a fixed jog section with a pre-set curvature and a flexible section that has a greater flexibility than a remainder of the elongate catheter body. The fixed jog section and flexible section are formed of a frame including a plurality of circumferential slits therein. Also described herein is an atherectomy catheter for use in a vessel includes an elongate catheter body, an annular cutter, and an s-shaped curved portion in the elongate catheter body. The curved portion includes a frame having a longitudinal proximal spine and a longitudinal distal spine. The longitudinal proximal spine is positioned approximately 180 degrees away from the longitudinal distal spine.

A tissue-removing catheter includes a tissue-removing element operably connected to a drive shaft for rotation of the tissue-removing element about an axis of rotation in a cutting direction. The tissue-removing element includes a cutting edge that extends around the axis of rotation and a depth stop that extends around the axis of rotation radially inward of the cutting edge relative to the axis of rotation. The depth stop defines an engagement surface adapted to engage a hard object and thereby limit the depth at which the cutting edge cuts into the hard object. In use, when the cutting edge cuts into a hard object, the depth stop engages the hard object to limit the cutting depth.

Described herein is a system and method for identifying elastic lamina during interventional procedures, such as atherectomy. Such identification can be used to avoid trauma to the external elastic lamina during the procedure.