Clot aspiration systems intended for removing clot from a blood vessel include an aspiration assembly which will have two or more of the following components: an aspiration catheter, an inner catheter, an intermediate catheter, and an outer catheter, the latter typically being a guiding or other sheath. A transition structure is coupled to a distal end of the aspiration assembly to cover or fill an open distal end of one or more of the components of the aspiration assembly. The transition structure may be configured to facilitate introduction of the aspiration catheter into the patient's vasculature and/or advancement of the aspiration catheter through the vasculature to a target site, such as a cerebral target site which may be occluded with clot, thrombus, or other occlusive material.

Described here are devices and methods for forming shock waves. The devices may comprise an axially extending elongate member. A first electrode pair may comprise a first electrode and a second electrode. The first electrode pair may be provided on the elongate member and positioned within a conductive fluid. A controller may be coupled to the first electrode pair. The controller may be configured to deliver a series of individual pulses to the first electrode pair, where each pulse creates a shock wave. The controller may cause current to flow through the electrode pair in a first direction for some of the pulses in the series and in a second direction opposite the first direction for the remaining pulses in the series.

A device and system are described that are capable of isolating at least one targeted tissue and forming an anastomosis between two internal body structures though a completely endoscopic procedure. Further, the device and system described generally comprise two tubular members that are capable of moving in a telescopic fashion relative to one another. Additionally, a method is described for using the device and/or system to bypass the duodenum from digestion.

An intracorporeal space filling device and a delivery system and method for using the device is disclosed. The space filling device is preferably configured for percutaneous delivery from a peripheral conduit of a patient. The space filling device has an elongated tubular or interconnected bead structure which may have a transmutable material disposed within it. The transmutable material can be altered from a non-rigid state to a rigid state by the application of various types of energy or by other suitable means. The space filling device can be positioned by a delivery system and detached from the delivery system after desired positioning is achieved.

A system for endoscopic surgery within a body lumen of a patient including a flexible catheter having an expandable balloon at a distal portion and an access opening. The expandable balloon is expandable from a collapsed insertion configuration to an expanded configuration to provide an expanded chamber on a first side of the catheter. The access opening provides a window to access target tissue. The catheter includes a lumen dimensioned to receive an endoscopic instrument therethrough such that a distal end of the endoscopic instrument is positionable within the expanded chamber and angled laterally within the expanded chamber to access the target tissue through the window.

A device for removing a urinary tract stone from a ureter may include an outer shaft, an inner shaft extending coaxially within the outer shaft, a self-expanding wire basket attached to a basket shaft extending coaxially within the inner shaft, an inflatable balloon and a handle. The balloon main include a rounded distal tip. The handle may include an inversion slider coupled to the inner shaft and configured to actuate the inner shaft, thereby inverting the distal tip of the inflatable balloon to form a pocket adapted to receive a urinary tract stone. The handle may also include a basket slider coupled to the basket shaft and configured to actuate the basket shaft to move the wire basket in and out of the inner shaft.

The present disclosure is directed, in one embodiment, to a wire centering sheath system in which wires outwardly extend from a sheath to brace against a vessel wall. The wire centering sheath system may be used to center endovascular devices.

A rotational atherectomy device for removing a stenotic tissue from the iliac artery of a patient. The device comprises a flexible, rotatable drive shaft having an elongated proximal portion, an elongated distal portion, and an abrasive element mounted to the drive shaft between the elongated proximal and distal portions of the drive shaft and configured for rapid rotation together with the drive shaft.

An example medical device is disclosed. The device includes a tubular member having a lumen defined therein and a distal end portion, the distal end portion defining a guidewire port. The medical device also includes an expandable frame disposed along the distal end portion of the tubular member, the expandable frame being designed to shift between a first configuration and an expanded configuration. The frame includes a base, an end region and a plurality of struts extending between the base and the end region, the struts defining a plurality of apertures along the frame. The medical device also includes a cover attached to a portion of the frame and the cover is configured to cover one or more of the plurality of apertures such that the frame will align the guidewire port with an opening in a heart valve when the frame is positioned within a body lumen.

A radiopaque frame is transluminally advanced to an atrium of a heart of a subject. The frame is expanded within a valve adjacent the atrium such that part of the frame remains disposed in the atrium. While the frame remains expanded within the valve, progressive portions of an annuloplasty structure are progressively positioned and anchored around the annulus using multiple anchors by, for each of the anchors sequentially (i) while fluoroscopically imaging the frame and a distal end of a delivery tool, and facilitated by mechanical guidance from the frame, positioning the distal end of the delivery tool between the frame and a wall of the atrium; and (ii) driving the anchor into the annulus laterally from the frame. Subsequently, the frame is contracted and withdrawn from the subject while leaving the annuloplasty structure anchored around the annulus. Other embodiments are also described.