The subject guide catheter extension system with a micro-catheter delivery catheter includes an outer sheath, an inner member extending within the sheath, and a mechanism for engagement/disengagement of the inner member to/from the sheath. Several mechanisms of engagement/disengagement between the inner and outer members are provided including a friction mechanism, threaded mechanism, pull away sheath, and engagement/disengagement mechanism for pusher's handles. The sheath and the inner member are modified for different engagement/disengagement mechanisms operation. A micro-catheter delivery system provides for an improved atraumatic crossability to the treatment site in an expedited and simplified fashion. During a procedure, a guidewire along with a guide catheter are advanced to the vicinity of the treatment site within a blood vessel. Subsequent thereto, the subject guide catheter extension system is manipulated to advance the micro-catheter along the guidewire inside the guide catheter towards and beyond the site of interest. Once the micro-catheter is in place, the outer sheath slides along the micro-catheter until reaching the lesion, and then the inner member is removed from the sheath, and the sheath then is ready for passing the treatment catheter (stent/balloon) towards the lesion to be treated.

A guide extension catheter with improved stability includes an elongated pushing portion connected to an extension portion with a balloon disposed near its distal end. An inflation lumen extends along a length of the pushing portion and the extension portion to feed fluid into an interior of the balloon. Introduction of fluid into the balloon expands it radially outward from the extension to apply pressure against an inner wall of the vessel to anchor the distal end of the extension within the vessel.

Sheath assembly for the insertion of a cord-shaped element, comprising an introducer sheath, and an auxiliary sheath for insertion into the introducer sheath together with the cord-shaped element. In some examples, the auxiliary sheath has a housing configured to detachably couple to the introducer sheath housing, and to detachably fasten the cord-shaped element with respect to the auxiliary sheath housing.

The disclosure provides various embodiments of prostheses and delivery systems to permit an interventional cardiologist to create shunts between various blood vessels. Moreover, the disclosed shunts can be used to shunt between various hollow organs, as set forth in the present disclosure.

An insertable robot for minimally invasive surgery includes a tube array having a guide tube housed within a straightening tube. The guide tube includes a curved working end. The guide tube may be axially translated and rotated relative to the straightening tube such that the curved working end is constrained inside the straightening tube, causing the curved working end to achieve a smaller dimension. The tube array is inserted into a working channel on an endoscope, resectoscope or trocar. Once the tube array is inserted, the curved working end of the guide tube is translated forward beyond the distal end of the working channel, allowing the curved working end to return to its pre-formed shape. A surgical tool is inserted through the guide tube for an operation. The straightening tube allows the guide tube curved working end to be temporarily straightened during insertion and removal of the tube array.

Urinary tract infections UTI may be over-diagnosed in very young children because of contamination of a urine specimen by external bacteria when using a conventional catheter. The subject matter disclosed herein relates to a coaxial catheter system and methods for its use, comprising an outer catheter that shields the distal collection opening of an inner catheter during insertion of the system through the meatus. Once the system has been deployed, the distal opening of the inner catheter is exposed in order to collect uncontaminated urine. The system may include a variety of mechanisms to advance the inner catheter relative to the outer, or to retract the outer catheter relative to the inner, a halting mechanism to limit distal movement of the outer catheter, a stopping mechanism to limit distal movement of the inner catheter, and a stabilization mechanism to hold the deployed system in place in male patients.

An extension cannula for use with a conventional ECMO return cannula is provided. The extension cannula includes a flexible conduit transitionable between a collapsed insertion state and an expanded deployed state when in communication with blood flow from an ECMO machine via the ECMO return cannula. The extension cannula may be positioned through a conventional ECMO return cannula such that the proximal end of the flexible conduit is disposed within and proximal to the end of the ECMO return cannula, while the distal end of the flexible conduit is disposed in a patient's thoracic aorta to deliver oxygenated blood directly to the patient's thoracic aorta via one or more pores at the distal region of the flexible conduit to improve cerebral oxygenation, maintain systemic arterial pulsatility, and reduce the potential for end-organ injury.

An aspiration catheter is provided including a proximal section and a distal section extendable through the proximal section. A vacuum transfer tool may be coupled to a proximal end of the proximal section. The vacuum transfer tool may include a proximal transfer tube and a distal transfer tube, each having an aspiration port in communication with a vacuum source. The proximal transfer tube may be removably received within a proximal end of the distal transfer tube. The distal section of the catheter may be inserted into the proximal section through the proximal transfer tube. The proximal transfer tube may maintain a vacuum around the proximal end of the distal section of the catheter such that when the distal section is removed by decoupling the proximal and distal transfer tubes, the vacuum within the distal transfer tube and proximal section of the catheter is maintained, preventing the escape of any clots.

A direct stream hydrodynamic catheter system is provided for the removal of thrombus, lesions and the like including provisions for the infusion of drugs, lysing fluids and the like into a blood vessel. Physician controlled powered direct fluid jet streams emanate from a fluid jet emanatory in the form of robust radially directed fluid jet streams to impinge upon and ablate difficult and strong thrombus and lesions within a blood vessel. Effluent aspiration is controlled by an exhaust regulator in the form of a roller pump, but effluent removal can be assistingly influenced by the fluid pressure associated with the radially directed fluid jet streams.

A method and system for creating a tract in retrograde fashion for nephrostomy tube creation comprising the steps of providing a puncture wire having a tissue penetrating tip shielded in a sheath, inserting the puncture wire and sheath through a channel in an ureteroscope, advancing the puncture wire from the sheath while visualizing under direct vision a position of the puncture wire, advancing the puncture wire through the flank, and inserting a catheter over the puncture wire. In some methods and systems, two catheters are utilized.