A coil wire and method of using the coil wire to navigate blood vessels are provided. The coil wire is configured to facilitate coaxial catheter advancement over at least a part of the length of the coil wire. Existing catheters utilize the distal tip of a guidewire to select the vessel origins by shaping it (either during fabrication or by the operating physician) in such a way that the tip will point into the desired vessel as the wire is advanced. The coil wire of the present disclosure functions in a unique manner: its distal tip resumes a pre-formed three-dimensional coil configuration as it is expressed from the catheter. This shape catches the flow of moving blood and propels the coil wire forward while unfurling the coil. As the coil wire is advanced, the small outer diameter of the unfurled coil allows it to pass deep into the selected vessel.

Medical guidewire assembly is movable through guidewire introducer positionable proximate to a biological wall located within the body of a patient. Medical guidewire assembly has flexible distal shaft section configured to extend along the guidewire introducer. Medical guidewire assembly has a predetermined spatial geometry once the flexible distal shaft section is removed from guidewire introducer. Medical guidewire assembly also has a piercing stylet device configured to puncture the biological wall in response to placement of guidewire introducer (in use) proximate to the biological wall, and movement of the flexible distal shaft section through the guidewire introducer. The predetermined spatial geometry is configured to prevent physical contact between the piercing stylet device and adjacently positioned tissue of the patient in response to formation of the predetermined spatial geometry.

A medical guidewire assembly is movable through an exit portal of a guidewire introducer. The guidewire introducer and the medical guidewire assembly are each insertable, at least in part, into a patient. The medical guidewire assembly is configured to reduce, at least in part, the hoop stress surrounding a puncture hole extending through the tissue of the patient. This is done in response to movement, at least in part, of the medical guidewire assembly relative to the puncture hole (after the puncture hole has been initially formed).

Disclosed are introducer components, assemblies, and methods. For example, an introducer assembly can include a fluidly connected syringe and needle. The needle can include a needle shaft and a needle hub over a proximal portion of the needle shaft. The needle hub can include a port and a valve disposed in the port. The port can be in a side of the needle hub proximal of a proximal end of the needle shaft. The valve can be configured to form a fluid-tight seal around an elongate medical device such as an access guidewire when passed through the port and into a needle-hub lumen of the needle hub. Such an access guidewire can be disposed in the introducer assembly just proximal of a needle tip of the needle. In this way, the access guidewire can be immediately advanced into a blood-vessel lumen upon establishing a needle tract thereto with the needle.

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.

An aspiration clot retrieval catheter to have profiled guidewire for deliverability that transitions at a proximal joint to a distal tubular section with a lumen for directing aspiration and facilitating the smooth passage of other products in performing mechanical thrombectomy procedures. The joint can have a low-profile proximal strut formed integrally with the distal tubular section and configured to interlock with a distal portion of the guidewire so that there is a smooth transition of stiffness between the guidewire and the tubular portion of the catheter to improve trackability and decrease the likelihood of kinking. The distal tubular section of the proximal joint can also have features to tailor flexibility. The distal tubular section can be configured to push radially outward to form a seal with an outer catheter to optimize aspiration transmission to the distal mouth of the aspiration clot retrieval catheter.

Apparatuses, systems, and methods for controlling the sampling of tissue using a guidewire. In an illustrative embodiment, an apparatus includes a handle, a flexible dual lumen catheter couplable to the handle, and a guidewire guide disposed at a distal end of the flexible dual lumen catheter.

An elongated catheter assembly defines a catheter lumen configured to receive the distal guidewire section of the guidewire, and also defines an axial portal and a radial portal. A guidewire deflector is mounted to the elongated catheter assembly. The guidewire deflector is configured to selectively deflect urged axial movement of the distal guidewire section of the guidewire away from the axial portal and radially toward the radial portal.

A guidewire introducible into a bodily lumen having an obstruction therein is provided. An introducer needle is advanced through tissue and into the bodily lumen. A guidewire is advanced through the introducer and into the lumen. The guidewire is advanced further through the lumen until an atraumatic distal tip of the guidewire encounters an obstruction the distal tip cannot pass in a straight forward manner. The distal tip is pressed against the obstruction such that a flexible segment proximal of the distal tip forms a loop distal of the distal tip. The guidewire is advanced further through the lumen such that the loop of the flexible segment is pushed past the obstruction and the distal tip is pulled distally past the obstruction. A greater diameter guidewire extension can be coupled to the back end of the guidewire, providing function as a larger diameter guidewire.

A guide wire of the present disclosure includes a core shaft having a distal end portion decreasing in cross-sectional area, a coil body wound to cover the distal end portion, and a distal end fixing portion fixing the core shaft and the coil body to each other. The distal end portion includes a small cross-sectional area portion, a large cross-sectional area portion, and a tapered portion between the small cross-sectional area portion and the large cross-sectional area portion. The core shaft and the coil body are fixed at a portion excluding the tapered portion. A first bending rigidity FR1 of the large cross-sectional area portion, a second bending rigidity FR2 of the small cross-sectional area portion, and a length L of the tapered portion satisfy the following expressions (1) and (2). In the following expressions (1) and (2), the unit of L is mm (millimeter).
(FR1/FR2).sup.0.25/L≥0.83  (1)
1≤L≤3  (2)