An elongate endovascular element for crossing through an obstruction in a blood vessel comprises: a proximal section; a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections; wherein the tapered intermediate section has a length that is substantially λ/2 or a multiple of λ/2, where λ is a wavelength of a driving frequency that will produce longitudinal resonance in the element.

A medical device for removing an object in a body cavity, includes a rotatable drive shaft having a lumen, a cutter disposed at a distal portion of the drive shaft and by which the object is cut, a drive shaft driving source configured to rotate the drive shaft, a fluid driving source configured to move a fluid from a distal side to a proximal side of the lumen, a switch, and a controller configured to, in response to the switch being turned on, control the fluid driving source to begin moving the fluid, and control the drive shaft driving source to begin rotating the drive shaft a first predetermined period after the switch is turned on.

A medical device for removing an object in a body cavity includes a rotatable drive shaft having a lumen, a cutter disposed at a distal portion of the drive shaft and by which the object is cut, a handle disposed at a proximal portion of the drive shaft and including a first motor configured to rotate the drive shaft, a fluid flow path having an inlet and an outlet, the inlet communicating with the lumen, a rotatable portion in the fluid flow path, and a second motor configured to rotate the rotatable portion such that a fluid that has flowed into the fluid flow path from the inlet moves toward the outlet.

A medical device for removing an object in a body cavity includes a rotatable drive shaft having a lumen, a cutter at a distal portion of the shaft and by which the object is cut, a first rotation connection portion at a proximal portion of the shaft and by which a rotational force is transmitted to the shaft, a first fluid connection portion at the proximal portion and through which the object is removed with a fluid, and a handle including a second rotation connection portion connectable to the first rotation connection portion, a second fluid connection portion connectable to the first fluid connection portion, a rotation driving source connected to the second rotation connection portion and generating the rotational force, and a fluid driving source moving the fluid from the distal to proximal portions of the shaft via the first and second fluid connection portions.

The invention provides devices with integrated intravascular imaging and methods for crossing a CTO within the true lumen of a vessel. An interventional catheter with intravascular imaging capabilities can be guided into an affected vessel and to a CTO. An included intravascular imaging device captures a 3D image of the environment. The catheter includes a crossing member that can be extended out from a distal tip of the catheter, causing the crossing member to directly cross through the CTO creating a new channel through the CTO.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises an elongate endovascular element such as a wire. The element has a proximal section, a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections. The apparatus comprises an ultrasonic transducer, mechanically coupled to the proximal section of the element for ultrasonically activating the element, hence exciting the distal tip section to facilitate crossing through the obstruction. A catheter surrounds the element, leaving at least part of the distal tip section of the element protruding distally beyond a distal end of the catheter.

An endovascular apparatus for crossing through an obstruction in a blood vessel comprises: an elongate endovascular element such as a wire; an ultrasonic transducer, mechanically coupled to the endovascular element for ultrasonically exciting a distal tip portion thereof to facilitate the crossing through the obstruction, and one or more damping features, mechanically coupled to the endovascular element to attenuate lateral displacement of the endovascular element at positions away from the distal tip portion.

A device for introduction into a body vessel includes a shaft (105), a balloon (115) positioned at the distal end of the shaft (105), and at least one longitudinal scoring wire (135) to score a vascular lesion attached to the distal end of the shaft (105), disposed over the balloon (115). The shaft (105) includes a support (119), such as a wire or tube having one or more spirally cut portions (119A, 119B), which improves pushability and trackability, thereby allowing for use with an external guidewire in a “short rapid exchange” (SRX) format. The balloon (115) expands when fluid is delivered to the balloon (115) through the inflation lumen. This expansion pushes the scoring wire and guidewire against the vascular lesion.

A catheter (10) for introduction into a body vessel includes a shaft, a balloon (12) positioned at the distal end of the shaft, and at least one scoring wire (30) to score a vascular lesion. A distal end portion of the scoring wire is detachably connected to the catheter, such as by way of magnetic coupling (30a), thereby allowing for selective use of the catheter in a scoring or non-scoring configuration. The balloon expands when fluid is delivered to the balloon through an inflation lumen. This expansion pushes the scoring wire against the vascular lesion.

An elongate endovascular element for crossing through an obstruction in a blood vessel comprises: a proximal section; a distal tip section of smaller diameter than the proximal section; and a distally-tapering intermediate section extending between the proximal and distal tip sections; wherein the tapered intermediate section has a length that is substantially λ/2 or a multiple of λ/2 , where λ is a wavelength of a driving frequency that will produce longitudinal resonance in the element.