A treatment method involves introducing a catheter into a blood vessel in an arm of the patient and is advanced to position the distal end of the catheter in a blood vessel in a lower limb on one side of the patient's body. A treatment device is inserted into the catheter and advanced to a treatment target in the lower limb on the one side of the patient's body. The catheter is then moved to shift the distal end of the catheter from the blood vessel in the lower limb on the one side of the patient's body to a blood vessel in the lower limb on the other side of the patient's body. A treatment instrument can then be introduced into the catheter and advanced to carry out treatment on a treatment target in the lower limb on the other side of the patient's body.

Described herein is a shock wave device for the treatment of vascular occlusions. The shock wave device includes an outer covering and an inner member inner connected at a distal end of the device. First and second conductive wires extend along the length of the device within the volume between the outer covering and the inner member. A conductive emitter band circumscribes the ends of the first and second wires to form a first spark gap between the end of the first wire and the emitter band and a second spark gap between the end of the second wire and the emitter band. When the volume is filled with conductive fluid and a high voltage pulse is applied across the first and second wires, first and second shock waves can be initiated from the first and second spark gaps.

A method of removing embolic material from a vessel with mechanical and aspiration assistance. The method comprises the steps of providing an aspiration catheter having a central lumen and a distal end, advancing the distal end of the aspiration catheter to obstructive material in a vessel, applying vacuum to the central lumen to draw clot into the central lumen, introducing a thrombus engagement tool into the central lumen, and manually manipulating the tip to engage clot between the tip and an inside wall of the central lumen.

An intravascular access system for facilitation of intraluminal medical procedures within the neurovasculature through an access sheath. The system includes an aspiration or support catheter having a flexible, distal luminal portion having an inner diameter defining a lumen extending between a proximal opening at a proximal end of the luminal portion and a distal opening at a distal end of the luminal portion. The catheter has a rigid spine coupled to at least the proximal end of the luminal portion and extending proximally therefrom. The system includes a dilator having a flexible, distal dilator portion sized to be received within the lumen of the luminal portion. Associated systems, devices, and methods of use are also described.

An injection system is described that receives, from one or more sensors, a first group of one or more signals indicating a current volume of injection fluid dispensed from a fluid reservoir at a first time. The injection system determines, based on the first group of one or more signals, that a difference between a dispensed volume limit and the current volume of the injection fluid dispensed from the fluid reservoir at the first time is less than a necessary volume of fluid required to complete both a systolic injection phase and a diastolic injection phase. The injection system further, responsive to determining that the difference is less than the necessary volume of fluid required to complete both the systolic injection phase and the diastolic injection phase, controls the injection system to refrain from performing each of the systolic injection phase and the diastolic injection phase.

A thrombus engagement tool having a flexible shaft, a clot engagement tip, and a handle. The engagement tip may include one or more radially outwardly extending structures such as a helical thread. The helical thread can be advanced through a catheter to engage a clot. The handle may be configured to be rotated by hand. When the handle is rotated, the helical thread of the engagement tip can rotate in the same direction thereby allowing the helical threat to engage the clot. The helical thread can wrap around the flexible shaft at least about one, two, or four or more full revolutions, but in some cases no more than about ten or no more than about six revolutions.

Systems and methods for the intravascular treatment of clot material within a blood vessel of a human patient are disclosed herein. A method in accordance with embodiments of the present technology can include, for example, positioning a distal portion of a catheter proximate to the clot material within the blood vessel. The method can further include coupling a pressure source to the catheter via a tubing subsystem including a valve or other fluid control device and, while the valve is closed, activating the pressure source to charge a vacuum. The valve can then be opened to apply the vacuum to the catheter to thereby aspirate at least a portion of the clot material from the blood vessel and into the catheter.

An apparatus (1a) for extracorporeal blood treatment, comprising an infusion control arrangement (8) arranged for infusing a pre-dilution flow rate upstream a blood treatment unit (4) and a post-dilution flow rate downstream the blood treatment unit (4), an ultrafiltration, UF, arrangement (40) arranged for ultrafiltration of a liquid through a semipermeable membrane (7) of the blood treatment unit (4) and a control unit (31). The control unit (31) is configured to configure the infusion control arrangement (8) to obtain a plurality of different configurations of the pre-dilution flow rate and/or post-dilution flow rate. For each of the plurality of different configurations, the control unit (31) is configured to change an operating situation of the UF arrangement (40), to detect a plurality of ultrafiltration flow rate values through the membrane (7) as a function of TMP, on changing said operating situation, and to evaluate an optimal ultrafiltration flow rate value from a comparison of the detected ultrafiltration flow rates. The apparatus (1a) is also configured to estimate a clearance value for a certain solute at the optimal ultrafiltration flow rate value and to evaluate a preferred configuration of the pre-dilution flow rate and/or post-dilution flow rate from a comparison of the corresponding estimated clearance values.

A system for traversing an arterial occlusion in an artery includes a housing sized to fit in a palm of a user, an elongate drive tube configured to be rotated by the housing, the drive tube including an axially extending passage, a cylindrical member, configured to be rotationally coupled to the drive tube, such that a distal tip of the cylindrical member may be delivered to a location adjacent the arterial occlusion when the cylindrical member is coupled to the drive tube, and wherein grasping and activating the housing such that the drive tube is rotated, thereby causes the distal tip of the cylindrical member to be rotated, the rotation of the distal tip including at least a component of linear oscillation.

A catheter and tissue cutting system percutaneously permits the creation of an anastomosis between a first and second anatomical structure, such as a vein and an artery. The system comprises a catheter having a main body with a lumen and tapered distal tip, configured to be moved distally into the first anatomical structure over a primary guidewire. A cutting electrode is nested in the main body, with a lumen which tracks over a secondary guidewire, and is insertable into the secondary anatomical structure. An energy supply is operative to energize the cutting electrode in order to cut a tissue wall defining the first anatomical structure.