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.

Described is a method and device for dilating a tubular anatomical structure. The device and method can be useful for extracting a blood clot in an artery of a mammal by concentrically irradiating an inner wall of the occluded artery using an ultraviolet (UV) laser beam delivered by an optical fiber having an external or inverted conical tip. Dilation results from photophysical production and release of nitric oxide from the cells lining the arterial wall when UV laser light is projected as a ring beam onto the inner arterial wall. This “minimal contact persistent dilation system” prepares the artery for safer mechanical extraction by thrombectomy, owing to decrease in friction and dissolution of chemical bonding.

An apparatus for treating vascular thrombosis with ultrasound, includes a therapeutic ultrasonic transducer, suitable for generating focused ultrasonic waves that propagate along an emission axis; an imaging ultrasonic transducer associated with the therapeutic transducer; a means for moving the focal spot of the therapeutic ultrasonic transducer along the emission axis with respect to the imaging transducer; a motorized mechanical system for translating the transducers along at least a first axis parallel to the emission axis and a second axis perpendicular to the first; and an electronic control system for driving the motorized mechanical system and the means for moving the focal spot of the therapeutic transducer.

A platform device for material excision or removal from vascular structures for either handheld or stereotactic table or robotics platform use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated as well as single or multiple arrays of image guidance elements, directional elements, ablation elements and other interventional assistance elements. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulas and provisions for simultaneous or differential beak or scoopula closing under their differential rotation may be incorporated.

A surgical apparatus for treating a vessel blockage in a vessel of a patient having an elongated member having an outer wall, a first hole at a distal portion and a second hole spaced proximally from the first hole positioned in a side wall. A first lumen is provided within the elongated member for blood flow through the second hole, through the lumen and exiting the first hole to maintain blood flow during treatment of the vessel blockage. A motor driven impeller is rotatable during blood flow through the first lumen to enhance blood flow as blood flows into the second hole positioned proximal of the vessel blockage and exits the first hole distal of the vessel blockage during injection of fluid through one or more openings to treat the vessel blockage.

Devices, systems, and methods for removing obstructions from body lumens are disclosed herein. In some embodiments, a system for removing a thrombus includes an interventional element configured to be disposed proximate to or adjacent to a thrombus within a blood vessel. The system can include a signal generator in electrical communication with the interventional element. The signal generator can be configured to deliver an electrical signal to the interventional element. The electrical signal can include a waveform having a positive phase having a peak positive current and a first duration, and a negative phase having a peak negative current and a second duration. A magnitude of the peak positive current can be greater than a magnitude of the peak negative current, and the first duration can be greater than the second duration.

A method for inhibiting device thrombosis for a patient may include circulating blood through an extracorporeal circuit coupled to the patient, infusing nitrite into the flow of blood such that the nitrite is bioactivated by red blood cells to form nitric oxide, and illuminating the flow of blood with far-red light to increase bioactivation of the nitrite by the red blood cells. A system for inhibiting device thrombosis for a patient may include an extracorporeal circuit configured to circulate a flow of blood, a nitrite infusion device coupled to the extracorporeal circuit and configured to infuse nitrite into the flow of blood, and one or more light sources disposed along the extracorporeal circuit and configured to illuminate the flow of blood with far-red light.

An ultrasound catheter system and a method for operating an ultrasonic catheter at a treatment site within a patient's vasculature or tissue are disclosed. The ultrasound catheter system comprises a catheter having at least one ultrasonic element and a control system configured to generate power parameters that drive the at least one ultrasonic element to generate ultrasonic energy. The control system is configured to vary at least one of the power parameters and at least one physiological parameter by repeatedly cycling the power parameter and the physiological parameter through two set of values.

A system for assessing occlusion of a region to blood flow includes a catheter with an inflatable member, a first electrode configured for placement upstream of the inflatable member and the second electrodes configured for placement downstream of the inflatable member, the inflatable member configured for inflation to occlude the blood flow through the region. The system further includes a current/voltage source, a resistor and a voltmeter, wherein these components along with the first and second electrodes are configured to form an impedance measuring circuit configured to detect a change in impedance for indicating occlusion of the region to the blood flow.

An obstruction removal device is described having a retrieval component used to engage an obstruction within the vasculature and a sheath component that is capable of inverting to fold over the obstruction and the retrieval component. The sheath component helps contain the obstruction and minimizes trauma to the blood vessel during the removal process.