A micropuncture kit for direct access of a surgically exposed vessel using direct visual guidance includes a micropuncture access needle having a proximal hub coupled to an elongate shaft defining an inner lumen and a visible depth indicator positioned on the elongate shaft a distance away from a distal tip of the elongate shaft. The kit includes an access guidewire sized to be received through the inner lumen of the micropuncture access needle and a microaccess cannula having an elongate body defining an inner lumen and a plurality of visible depth indicators formed on the elongate body. The guidewire includes a distal tip and at least one visible depth indicator positioned on the access guidewire a distance away from the distal tip of the guidewire. Each of the plurality of visible depth indicators identifies a distance from a distal tip of the cannula. Related systems, devices and methods are provided.

A portable vein viewer apparatus may be battery powered and hand-held to reveal patient vasculature information to aid in venipuncture processes. The apparatus comprises a first laser diode emitting infrared light, and a second laser diode emitting only visible wavelengths, wherein vasculature absorbs a portion of the infrared light causing reflection of a contrasted infrared image. A pair of silicon PIN photodiodes, responsive to the contrasted infrared image, causes transmission of a corresponding signal. The signal is processed through circuitry to amplify, sum, and filter the outputted signals, and with the use of an image processing algorithm, the contrasted image is projected onto the patient's skin surface using the second laser diode. Revealed information may comprise vein location, depth, diameter, and degree of certainty of vein locations. Projection of vein images may be a positive or a negative image. Venipuncture needles may be coated to provide visibility in projected images.

In some examples, a catheter includes a catheter body including an outer jacket and an inner liner. The inner liner may include a proximal section including a proximal end of the inner liner and a distal section including a distal end of the inner liner. The distal section may include an inner liner defining a plurality of cuts. Each cut may extend at least partially through the liner wall. The one or more cuts defined in the liner wall of the distal section of the inner liner may increase a bending flexibility of the distal section relative to the proximal section of the inner liner, while maintaining a suitable tensile strength of the distal section.

A robotic catheter system including a first drive mechanism configured to interact with an elongated medical device to cause the elongated medical device to move along its longitudinal axis. A wiper assembly includes a first wiping surface moving toward and away from the longitudinal axis. A controller provides a signal to a motor to move the first wiping surface toward the longitudinal axis when the elongated device is being withdrawn from a patient.

A method and a medical elongate body are configured to prevent stagnation or turbulence of blood flow in a recess of a rugged pattern formed in a blood vessel due to bulging of a blood vessel wall at a lesion part of the blood vessel. The method involves partitioning an inside of the blood vessel into upstream and downstream sides of the recess, and introducing gel into the recess to at least partially fill the recess. A blood vessel lumen forming method and medical elongate body to form such a lumen are other aspects of the disclosure and involve introducing gel into the recess to at least partially fill the recess with the gel, and drilling the gel to remove at least some of the gel to form a passage and secure blood flow in the blood vessel.

A neurovascular catheter extension segment is provided, such as for distal neurovascular access or aspiration. The neurovascular catheter extension segment includes 1) an elongate flexible control wire having a proximal end and a distal end and 2) a tubular extension segment having a side wall defining a central lumen carried by the distal end of the control wire. The side wall of the tubular extension segment includes a tubular inner liner, a tie layer separated from the lumen by the inner liner, a helical coil surrounding the tie layer, and an outer jacket surrounding the helical coil. The extension segment may be introduced into the proximal end of a neurovascular catheter and advanced distally to extend beyond the catheter and thereby extend the reach of the catheter.

Methods and devices for performing transjugular carotid flow reversal are provided. A flow reversal sheath is advanced through a transjugular carotid fistula. An occlusion balloon is inflated, causing carotid inflow to be diverted through the sheath and through a flow reversal region positioned in the jugular vein. After reversal of blood flow, a carotid intervention is performed.

A guide wire, for use, for example, in guiding an elongated catheter through an artery or vein of a mammalian body having a stenosis and/or an occlusion therein, includes an elongated conductor having a longitudinal dimension, a proximal end and a distal end. The guide wire further includes an insulator overlying the elongated conductor. The insulator exposes a portion of the longitudinal dimension of the elongated conductor to form an electrode. The elongated conductor is arranged to be connected to a source of high voltage pulses to cause electrical arcs at the electrode that in turn form steam bubbles and shock waves to break the stenosis and/or open the occlusion and permit the guide wire to pass there through. Other embodiments are directed to a system including the guide wire and a method of using the guide wire.

Endovascular assemblies may include a catheter, a shunt, and a wire. The shunt includes a frame and a liner secured about the frame. The wire extends through the catheter and is coupled to the shunt. The shunt is configured to move between a collapsed configuration and a radially expanded configuration in response to movement of the wire. Endovascular assemblies may be used to shunt a vessel.

Various methods for optimizing coating of medical devices, such as balloon catheters are disclosed. One method configures catheter balloon folds based on balloon diameter and volume. Other methods include using a specifically-sized protective sheath, using a vacuum, using pressure, pulling the balloon through a coating solution, using at least one spacer or a wick between at least one fold for metering a therapeutic coating into the folds of the balloon, placing an intermediate layer between the balloon and the therapeutic coating, placing a soluble film having a therapeutic agent around the catheter balloon or inside the folds, and any combination thereof. Balloon catheters and catheter balloons having a specific folding configuration, a specifically-sized protective sheath, an intermediate layer, or a soluble film are also disclosed.