A device includes a first end portion, a second end portion, an intermediate portion, and a graft material. The first end portion has a first end diameter. The second end portion has a second end diameter smaller than the first end diameter. The first end portion comprises a first material. The second end portion comprises a second material different than the first material. The intermediate portion is between the first end portion and the second end portion. The intermediate portion tapers between the first end portion and the second end portion. The graft material is coupled to at least the intermediate portion.

Described is a method and device for dilating a tubular anatomical structure. The device and method can be useful for extracting a blood clot in an artery of a mammal by concentrically irradiating an inner wall of the occluded artery using an ultraviolet (UV) laser beam delivered by an optical fiber having an external or inverted conical tip. Dilation results from photophysical production and release of nitric oxide from the cells lining the arterial wall when UV laser light is projected as a ring beam onto the inner arterial wall. This “minimal contact persistent dilation system” prepares the artery for safer mechanical extraction by thrombectomy, owing to decrease in friction and dissolution of chemical bonding.

Methods and systems for separating an object, such as a lead, from formed tissue are provided. Specifically, a tissue slitting device is configured to engage patient formed tissue at a slitting engagement point. While the object is subjected to a first traction force, the tissue slitting device is caused to move further into the engaged tissue and slit the tissue past the point of engagement. The slitting device causes the tissue to separate along an axial direction of the length of the formed tissue and releases at least some of the force containing the object. The methods and systems are well suited for use in cardiac pacing or defibrillator lead explant procedures.

A platform device for material excision or removal from vascular structures for either handheld or stereotactic table or robotics platform use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated as well as single or multiple arrays of image guidance elements, directional elements, ablation elements and other interventional assistance elements. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous or differential beak or scoopula closing under their differential rotation may be incorporated.

A medical device may include an elongated body, a balloon positioned at a distal portion of the elongated body, and one or more pressure-wave emitters positioned along a central longitudinal axis of the elongated body within the balloon. The one or more pressure-wave emitters may be configured to propagate pressure waves radially outward through the fluid to fragment a calcified lesion at the target treatment site. The at least one of the one or more pressure-wave emitters may include an electronic emitter comprising a first electrode and a second electrode. The first electrode and the second electrode may be arranged to define a spark gap between the first electrode and the second electrode, and the second electrode may comprise a portion of a hypotube.

A catheter system for imparting pressure to induce fractures in a vascular lesion within or adjacent a vessel wall, includes a catheter and a superheating system. The catheter can advance to the vascular lesion. The catheter includes an elongate shaft and a balloon coupled to the elongate shaft. The balloon includes a balloon wall. The balloon moves between a collapsed configuration and a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site. The superheating system can heat a balloon fluid within the balloon rapidly enough to achieve spontaneous vaporization of the balloon fluid and to generate inertial bubbles and acoustic pressure waves. The superheating system can include a first light guide extending along the elongate shaft. The first light guide is in optical communication with a light source at a proximal portion of the first light guide.

A light output monitoring apparatus includes a light receiving unit, an attachment unit, an adapter, and a protective cap, and monitors a power of light output from a light emitting end of a catheter incorporating an optical fiber. The protective cap includes an insertion opening into which a part of the catheter of a predetermined range on the light emitting end side is removably inserted, includes a window portion for transmitting the light output from the light emitting end of the catheter, and is fixed in position by being inserted into a through-hole of the adapter. The adapter is fixed in position by being attached to the attachment unit.

A catheter system (100) for treating a treatment site (106) within or adjacent to a vessel wall (108A) or a heart valve includes a light source (124), a first light guide (122A), a second light guide (122A), and a guide bundle (152). The light source (124) generates light energy. The first light guide (122A) receives the light energy from the light source (124) and has a guide proximal end (122P). The second light guide (122A) receives the light energy from the light source (124) and has a guide proximal end (122P). A guide bundle (152) is in optical communication with the light source (124). The guide bundle (152) bundles the first light guide (122A) and the second light guide (122A). The guide bundle (152) includes a first ferrule (778) that engages the guide proximal end (122P) of the first light guide (122A) and a second ferrule (778) that engages the guide proximal end (122P) of the second light guide (122A). At least one of the ferrules (778) can be formed at least partially from a ceramic material or a metallic material.

A catheter that fits within a blood vessel wall includes electrodes aligned along a longitudinal axis of the catheter that produce unfocused shock waves that propagate radially toward the blood vessel wall for treatment.

Various embodiments of the present disclosure encompass an endoluminal therapy system employing an endoluminal therapy device (21) and an endoluminal therapy monitoring controller (10). In support an endoluminal procedure, the endoluminal therapy device (21) is controlled to treat a site to be treated within a lumen. The controller (10) is operated to synchronize an activated dwell timing of the endoluminal therapy device (21) within the lumen to a tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen. The controller (10) is further operated to monitor the site to be treated within the lumen induced by the endoluminal therapy device (21) during the synchronization by the controller (10) of the activated dwell timing of the endoluminal therapy device (21) within the lumen to the tracked positioning of the endoluminal therapy device (21) contiguous with the site to be treated within the lumen.