Clot engagement element comprising bundle of unwoven fibers can be assembled to form an acute stroke treatment device. The device has the capability of forming a three dimensional filtration matrix comprising effective pores with a distribution of sizes. The bundle of fiber design allows the device to be effectively delivered into circuitous cerebral arteries to remove clot that causes stroke. The fiber bundle based filtration matrix offers the advantages of conforming to the changing inner perimeter of a blood vessel during a clot removal process and thus the capability to effectively retain and remove a clot in the vessel. The filtration matrix offers the additional advantage to trap any break-off of the clot during the removal process. A plurality of fiber bundles can be combined to form an effective clot engagement element. Supplemental engagement structure as well as mechanical treatment structure can be integrated into the stroke treatment device. The deployment of the fiber based elements can be facilitated by actuation tool. Aspiration can be employed during the clot removal process.

A method of reducing blood flow within an aneurysm includes: injecting a contrast agent into a blood vessel including an aneurysm; expanding a stent, from a delivery device, across the aneurysm; and confirming that a stagnated area forms in the aneurysm. The stagnated area can form a crescent shape, a mushroom shape, a hemispherical shape, and/or a flat side. Upon confirming that the stagnated area forms in the aneurysm, the delivery device can be withdrawn from the blood vessel. The stagnated area can include the contrast agent. If the stagnated area does not form in the aneurysm, a second occluding device may be deployed. After withdrawing the delivery device, substantially all of the aneurysm progressively thromboses.

A catheter for intraluminal lithotripsy including an outer wall, at least one balloon extending from the outer wall, the balloon having a first portion, a second portion proximal of the first portion and an intermediate portion between the first and second portions such that a transverse dimension of the intermediate portion is less than a transverse dimension of the first and second portions. The catheter includes a first lumen, at least one energy emitter mounted on the balloon for emitting energy to break down or soften calcium and a connector connecting the at least one energy emitter to an external energy source, the connector extending through the catheter.

An aspiration thrombectomy system is described with an aspiration catheter assembly having fittings interfaced with conduit and a pump. The aspiration catheter assembly can include a guide catheter and an aspiration catheter. The aspiration catheter can be positioned into an artery with a distal opening positioned proximal to a clot. The fittings can include a filter for removing thrombus from the aspiration flow. The fittings can include a flow meter for measuring flow to the pump. The fittings can include a pressure sensor for measuring pressure in the fittings. The aspiration catheter can be manipulated based on pressure and flow measurements. The fittings can include a docking manifold that can dock the connection suction of the suction extension to allow removal of the suction extension from hemostatic isolation and clearing of clots from the suction extension without further fittings such that the cleared suction extension can be efficiently reinserted for additional use.

An intravascular device is provided having an expandable portion including a plurality of struts capable of being moved between an open and a closed position. A grating tool is provided on at least one of the struts. The grating tool is configured to remove atherosclerotic material or other substances located within the blood vessel when the expandable portion is in the opened position and moved axially through the blood vessel.

A method and apparatus for treating a clot in the blood vessel of a patient, and particularly the treatment of a pulmonary embolism is disclosed. The treatment includes restoring flow through the clot followed by clot removal, either partially or substantially completely. The clot treatment device is expandable into the blood vessel and may contain radial extensions that assist in restoring flow as well as in removing clot material.

An atherectomy device for removing deposits such as plaque from an interior of a vessel including an outer member and a rotatable shaft positioned for rotational movement within the outer member and fixed axially within the outer member. A tip is mounted to the distal region of the rotatable shaft and is positioned distally of the distal end of the outer member to create a gap between the proximal end of the rotatable tip and the distalmost edge of the outer member. The rotatable tip has a longitudinal axis mounted to the rotatable shaft for rotation about its longitudinal axis upon rotation of the shaft, the shaft including a guidewire lumen for receiving a guidewire to enable over the wire insertion of the device.

A medical device and a treatment method are disclosed that can be applied to body lumina with a wide range of inside diameters and can enhance a property for suction of a substance from the inside of a body lumen by restricting flow within the body lumen. The medical device includes an elongated shaft section; an expanding section that is an elastically deformable tubular body provided with a plurality of openings; a flexibly deformable tubular cover section that is coupled to an end portion on a proximal side of the expanding section, surrounds an outer periphery of the expanding section on the proximal side, but does not surround, and externally exposes, an outer periphery of the expanding section on a distal side; and a sheath capable of accommodating the expanding section and the cover section in a diameter-reduced state.

To provide a catheter having a simple structure capable of excising an atheroma in a blood vessel and capable of obtaining ultrasonic images of a blood vessel. [Solution] A catheter 10 has a shaft 11 having an opening 20 in a part of the side wall on the distal end side, a cutter 12 which is located in the vicinity of the opening 20 in the internal space of the shaft 11 and which can move in the axial direction 101 of the shaft 11, a balloon 23 which is disposed on the side opposite to the opening 20 with respect to the axis of the shaft 11 and which outwardly expands from the side wall of the shaft 11, and a phased array ultrasound probe 17 disposed along the circumferential direction 102 of the outer peripheral surface of the side wall in the vicinity of the opening 20 at least on the same side as the side where the opening 20 is provided with respect to the axis of the shaft 11.

A method and device for perforating an aortic valve to remove excessive calcium deposits on aortic valve leaflets improves the implantation of TAVI replacement valves in patients. By removing excessive calcium deposits, the radial pressure exerted by implanted TAVI replacement valves is reduced, such that there is less blood leakage around the valve and less stress on the cardiac conductive system. A device with a collapsible punch is inserted into the aortic valve. The punch is separable such that the aortic valve leaflets are positioned between at least two elements of the punch. The two elements then compress together with the leaflets between them, causing the aortic valve to be perforated. A circumferential ring of the remaining aortic valve and calcium deposits are left to provide stability for the TAVI replacement valve.