A method and device for perforating an aortic valve to remove excessive calcium deposits on aortic valve leaflets improves the implantation of TAVI replacement valves in patients. By removing excessive calcium deposits, the radial pressure exerted by implanted TAVI replacement valves is reduced, such that there is less blood leakage around the valve and less stress on the cardiac conductive system. A device with a collapsible punch is inserted into the aortic valve. The punch is separable such that the aortic valve leaflets are positioned between at least two elements of the punch. The two elements then compress together with the leaflets between them, causing the aortic valve to be perforated. A circumferential ring of the remaining aortic valve and calcium deposits are left to provide stability for the TAVI replacement valve.

Systems and methods for grasp adjustment based on grasp properties include a computer-assisted device. The device includes a two-jawed end effector located at a distal end of the device, a drive unit for operating the two-jawed end effector, and an image processing unit. The image processing unit is configured to receive imaging data of the end effector and recognize the end effector and a material grasped by the end effector in the received imaging data. The device is configured to adjust a force magnitude limit or a torque magnitude limit of the drive unit based on the received imaging data. In some embodiments, the image processing unit is further configured to determine one or more of a position, an orientation, a size, or a shape of the material based on the received imaging data. In some embodiments, at least one jaw of the end effector includes fiducial indicia.

Retrieval of material from vessel lumens can be improved by use of a distal element comprising an expandable mesh, a treatment device includes an elongated member having a proximal portion and a distal portion configured to be positioned within a blood vessel at a treatment site at or near a thrombus. A distal element comprising an expandable mesh is coupled to the distal portion of the elongated member via a connection assembly. In an expanded state, at least a portion of the mesh is configured to be in apposition with the blood vessel wall at the treatment site to anchor or stabilize the elongated member with respect to the blood vessel. The distal element can be electrically coupled to an extracorporeal current generator.

A system for treating a patient having thrombus including an aspiration catheter having an aspiration lumen configured to be coupled to a vacuum source and configured for aspirating thrombus therethrough, an elongate member having a straight distal portion configured to extend from the aspiration lumen into a thrombus within the blood vessel, and a manipulation device selectively coupled to the elongate member, the manipulation device being configured to apply motive force to the elongate member, wherein the motive force comprises a combination of motive force components comprising an alternating clockwise motion and counter-clockwise motion.

A system for treating a patient having thrombus including an aspiration catheter having an aspiration lumen configured to be coupled to a vacuum source and configured for aspirating thrombus therethrough, an elongate member having a straight distal portion configured to extend from the aspiration lumen into a thrombus within the blood vessel, and a manipulation device selectively coupled to the elongate member, the manipulation device being configured to apply motive force to the elongate member, wherein the motive force comprises a combination of motive force components comprising an alternating clockwise motion and counter-clockwise motion.

An ultrasonic probe assembly includes a handle configured to be handheld, and has a housing that defines a chamber. A carriage is slidably coupled to the housing. The carriage has an operator arm configured to be operable by a user to move the carriage between a first position and a second position. An ultrasonic catheter has a catheter sheath and an ultrasonic core wire. The ultrasonic catheter has a proximal end portion and a distal end portion. An ultrasonic transducer is positioned in the chamber of the housing. The ultrasonic transducer is connected to the proximal end portion of the ultrasonic catheter, and the ultrasonic transducer is connected to the carriage. The ultrasonic transducer is configured to longitudinally move in the chamber of the housing between a retracted position and an extended position coincident with a corresponding longitudinal movement of the carriage.

An ultrasonic probe assembly includes a handle configured to be handheld, and has a housing that defines a chamber. A carriage is slidably coupled to the housing. The carriage has an operator arm configured to be operable by a user to move the carriage between a first position and a second position. An ultrasonic catheter has a catheter sheath and an ultrasonic core wire. The ultrasonic catheter has a proximal end portion and a distal end portion. An ultrasonic transducer is positioned in the chamber of the housing. The ultrasonic transducer is connected to the proximal end portion of the ultrasonic catheter, and the ultrasonic transducer is connected to the carriage. The ultrasonic transducer is configured to longitudinally move in the chamber of the housing between a retracted position and an extended position coincident with a corresponding longitudinal movement of the carriage.

A medical treatment device is disclosed herein. In one example, the medical treatment device includes a core assembly which has a first conduct and a second conductor, the second conductor being formed from a first conductive material. An insulative material can surround the second conductor and define one or more uninsulated portions. A second conductive material can surround the first conductive material along at least a portion of the one or more uninsulated portions and can have a higher electrical conductivity than the first conductive material. The medical treatment device can include an interventional element formed from a third conductive material that electrical couples to the first conductor. A fourth conductive material can be disposed over the third conductive material and have a higher electrical conductivity than the third conductive material.

A medical treatment device is disclosed herein. In one example, the medical treatment device includes a core assembly which has a first conduct and a second conductor, the second conductor being formed from a first conductive material. An insulative material can surround the second conductor and define one or more uninsulated portions. A second conductive material can surround the first conductive material along at least a portion of the one or more uninsulated portions and can have a higher electrical conductivity than the first conductive material. The medical treatment device can include an interventional element formed from a third conductive material that electrical couples to the first conductor. A fourth conductive material can be disposed over the third conductive material and have a higher electrical conductivity than the third conductive material.

A clot removal device for removing a clot from a body vessel, the clot removal device including: an elongated member sized to traverse vasculature and having a proximal end and a distal end, the elongated member comprising a longitudinal axis; and an engagement structure connected to the distal end of the elongated member, the engagement structure comprising a plurality of pinching cells connected to each other, the at least one pinching cell being configured to engage clot in an expanded deployed configuration and to pinch the clot upon actuation to the clot pinching configuration, a first pinching cell of the plurality of pinching cells being connected to a second pinching cell of the plurality of pinching cells such that the second pinching cell is rotatable respective the first pinching cell substantially about the longitudinal axis.