Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3 cm.

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.

The invention relates to a clot retrieval and thrombectomy device with adjustable orifice diameter and retrieval length to retrieve embolism from the vascular system, especially pulmonary arteries and venous system, which allows restoring the blood flow to pulmonary vasculature and relieve right heart strain and re-perfusion in occluded veins or arteries with organized thrombus formation. The main objective of the invention is to provide a device that can be used in different vessel dimensions, different types of vessels and situations. The present invention has an adjustable device orifice and retrieval length to overcome the limitations in retrieval of the clots in different vessel dimensions. According to the clot length and volume, the orifice of the braided mesh basket can be adjusted to the vessel diameter. Therefore, the device can be used in every type of vessel having different diameters and in every patient having different conditions.

A tissue-removing catheter for removing tissue in a body lumen includes an elongate body having an axis. A handle is mounted to a proximal end portion of the elongate body. A tissue-removing element is mounted on a distal end portion of the elongate body. An inner liner is received within the elongate body and defines a guidewire lumen. An advancer is mounted on the handle and is movable relative to the housing. The inner liner is coupled to the advancer at a proximal end portion of the inner liner such that movement of the advancer causes a corresponding movement of the inner liner to exert a push force on the tissue-removing element to advance the tissue-removing element and a pull force on the tissue-removing element to retract the tissue-removing element for moving the tissue-removing element relative to the handle.

Described herein are membrane puncturing devices used for endovascular surgery.

An obstruction removal device is described, having one or more engaging members which can engage portions of the clot. The one or more engaging members have a collapsed, delivery state, and an expanded, deployed state which in some embodiments can be locked to maintain its fixed configuration.

A medical device and a treatment method are disclosed for cutting substances inside a body lumen. The medical device includes a rotatable tubular drive shaft; an elongated tube extended through the drive shaft; a bearing placed at the proximal end of elongated tube; and a rotation transmitting member fixed on an outer surface of the elongated tube, wherein the rotation transmitting member is movable between a proximal end of the drive shaft and the bearing.

Described are methods, systems, devices for facilitation of intraluminal medical procedures within the neurovasculature. A catheter advancement device includes a flexible elongate body having a proximal end, a distal end, and a single lumen extending therebetween. The flexible elongate body has a proximal segment, an intermediate segment, and a tip segment. The proximal segment includes a hypotube coated with a polymer. The intermediate segment includes an unreinforced polymer having a durometer of no more than 72D. The tip segment is formed of a polymer different from the intermediate segment and has a durometer of no more than about 35D and a length of at least 5 cm. The tip segment has a tapered portion that tapers distally from a first outer diameter to a second outer diameter over a length of between 1 and 3

A method for treating a patient having thrombus includes providing a manipulation device including a housing configured to be supported by the hand of a user and having a distal and proximal end, a drive system disposed within the housing, and configured to rotate a rotation member, an engagement member coupled to the rotation member and configured to be removably coupled to an elongate medical device, an activation member carried by the housing such that it can be operated by at least a portion of the hand of the user when the housing is supported by the hand of the user, the drive system configured to apply motive force to the engagement member, securing an elongate member to the engagement member, introducing at least the distal end of the elongate member into a blood vessel adjacent a thrombus, operating the activation member to cause at least some rotation of the rotation member, which in turn causes at least some rotation of the distal end of the elongate member at or near the thrombus, and aspirating at least some of the thrombus with an aspiration catheter.