Methods and apparatuses for removing material (e.g., clot) from within a body, including inverting thrombectomy apparatuses. These methods and apparatuses may include methods and apparatuses for reusing portion of the devices, method and apparatuses for loading and reloading the inverting thrombectomy apparatuses, and methods and apparatuses for improving and enhancing the ability of the inverting thrombectomy apparatuses to remove clot. In particular, described herein are expandable scraper devices that may be used in conjunction with the inverting thrombectomy apparatuses descried herein, or on their own.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.

A device suitable for removing material from a living being is provided, featuring at least an aspiration pump, powered by a motor. The aspiration pump and any optional infusate pump preferably feature a helical pumping mechanism, and operate at a high rate of rotation, thereby ensuring adequate pumping performance and flexibility. The helical pumping mechanism may be a helical coiled wire about a central core tube. The helical coil wire, whether together with, or independent of, the core tube, may be rotated to cause a pumping action. Additionally, a narrow crossing profile is maintained, ensuring that the device may reach more tortuous regions of the vasculature. In one embodiment, the system comprises a wire-guided mono-rail catheter with a working head mounted on a flexible portion of the catheter that can laterally displace away from the guide wire to facilitate thrombus removal. The working head may be operated to separate and move away from the guide wire to come within a closer proximity of the obstructive material to more effectively remove it from the vessel.

An endoscopic tissue separator surgical device and method. The device has a multi-lumen shaft having proximal and distal ends, a central lumen for accepting an endoscope, and at least two fluid lumens, with a head coupled to the distal end of the shaft and a handle coupled to the proximal end. The head has an endoscope port and at least two fluid ports whose centers are all disposed along an arcuate line of curvature, while the handle has at least two fluid supply ports. Gas and fluid may be conveyed through the shaft from the handle to the head in the at least two fluid lumens separate from the lumen for accepting an endoscope. At least one lumen of the multi-lumen shaft may house a stainless steel tube with an inside diameter of sufficient size to accept an endoscope.

The present disclosure provides a tissue-removing catheter for removing tissue in a body lumen that includes an elongate body, a handle, tissue-removing element, liner assembly, and coupling assembly. The elongate body is sized and shaped to be received in the body lumen. The tissue-removing element is mounted on a distal end portion of the elongate body and removes tissue as rotated by the elongate body. The liner assembly defines a guidewire lumen. The coupling assembly is coupled to the liner assembly with a first orientation and a second orientation relative to the coupling assembly. The first orientation permits distal movement of the liner assembly relative to the coupling assembly prior to rotation of the elongate body to rotate the tissue-removing element. The second orientation is relative to the coupling assembly after rotation of the elongate body to prevent distal movement of the liner assembly relative to the coupling assembly.

Rotational atherectomy devices and systems can remove or reduce stenotic lesions in blood vessels by rotating one or more abrasive elements within the vessel. The abrasive elements are attached to a distal portion of an elongate flexible drive shaft that extends from a handle assembly that includes a driver for rotating the drive shaft. In particular implementations, the handle assembly encapsulates an electric motor assembly, a pump assembly, and a controller assembly.

A method of removing tissue in a body lumen includes advancing a tissue-removing catheter over a guidewire in the body lumen to position a distal end of the catheter adjacent the tissue and a proximal end portion of the catheter outside of the body lumen. The catheter includes an elongate body, a tissue removing element mounted on a distal end portion of the elongate body, and an inner liner disposed within the elongate body. The inner liner defines a guidewire lumen in which the guidewire is disposed during the advancement of the catheter. The method further includes rotating the elongate body and tissue-removing element of the catheter to remove the tissue. Detecting wear of the inner liner caused by the elongate body contacting the inner liner during use.

An endarterectomy device configured to remove plaque from an occluded artery is disclosed. The endarterectomy device uses an adjustable wire loop end effector to establish and advance a dissection plane in the subadventitial space of the artery. The endarterectomy device is passed down the length of an artery in the subadventitial plane, adjusting the size of the wire loop end effector as needed to navigate the artery and dissect a plaque column, until the end of the plaque is reached. The wire loop end effector is then used as a plaque cutter to transect the distal end of the plaque column. The endarterectomy device is further configured along its length with support arms that facilitate removal of the plaque column as the device is removed from the artery.

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.

Devices and methods for the treatment of chronic total occlusions are provided. One disclosed embodiment comprises a method of facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The method includes inserting an intramural crossing device into the vascular lumen, positioning at least the distal tip of the crossing device in the vascular wall, advancing an orienting device over the crossing device such that an orienting element of the orienting device resides in the vascular wall, inserting a reentry device, and re-entering the true vascular lumen.