摘要:
A method of diverting fluid flow from a first vessel including an occlusion to a second vessel includes deploying a prosthesis at least partially in a fistula and making valves in the second vessel incompetent. Making the valves in the second vessel incompetent includes at least one of using a reverse valvulotome to cut the valves, inflating a balloon, expanding a stent, and lining the second vessel with a stent.
摘要:
The present disclosure discusses a devices, systems and methods for transvascular, transvenous and/or transdural access, to the brain parenchyma, subarachnoid or subdural spaces. In some embodiments, the disclosed systems and methods may be used for local drug delivery, tissue biopsy, nanofluidic or microelectronic device/component delivery/insertion/implantation, in situ imaging, ablation of abnormal brain tissue and the like. Embodiments of the present disclosure include an access catheter system for extravascular procedures in the brain having an elongate, flexible tubular body, with at least one lumen extending axially there through between a proximal end, and a distal end. The access catheter system may include a side exit port and a distal end port. Further, the access catheter system may include a selective deflector positioned within the lumen configured to deflect a procedure catheter and permit a guide catheter.
摘要:
Disclosed are steerable needles having a shaft that can be controllably buckled, a steering head positioned at a distal end of the shaft, a transmission for controlling the orientation of the steering head, and a base at the end of the shaft, the base optionally comprising a controller for controlling the transmission. Also disclosed are methods of using the disclosed steerable needles.
摘要:
The invention relates to a device for applying a needle array (1) to biological tissue (2), comprising a needle array holder (6) carrying the needle array (1), a pre-tensioning geometry (3) and an actuating element (4), wherein the actuating element (4) is so configured that, during its actuation, in a first step it transfers the pre-tensioning geometry (3) into a pre-tensioning position on the biological tissue (2) while pre-tensioning the biological tissue, and in a second step it transfers the needle array (1) into an application position on the biological tissue (2), while in this respect the pre-tensioning geometry (3) is held in the pre-tensioning position by the actuating element (4).
摘要:
Methods and kits for delivering pharmaceutical agents to the adventitia and other regions outside the external elastic lamina (EEL) surrounding a blood vessel utilize a catheter having a needle. The needle is positioned in up to 5 mm beyond the EEL and delivers an amount of pharmaceutical agent sufficient to circumferentially permeate around the blood vessel and, in many cases, extend longitudinally and radially along the blood vessel. Confirmation that a delivery aperture of the needle lies beyond the EEL may be required before delivering the pharmaceutical agent. In one example, the catheters are used to deliver dexamethasone and other anti-inflammatory agents to the peripheral and other vasculature to treat peripheral vascular disease and other conditions.
摘要:
A device and method for delivering a drug from inside a body lumen to tissue surrounding the body lumen. An endoluminal drug delivery device includes a dual-lumen catheter for housing a guidewire and a needle connectable to a drug source. The guidewire exits the catheter through an opening at the distal end, and the needle exits the catheter through an exit port in the outer wall of the catheter. A distal portion of the catheter has a single lumen and includes a taper, allowing the distal tip to act as a dilator. The device optionally includes a catheter lumen splitter and/or a handpiece assembly. A method of delivering fluid to tissue surrounding a body lumen includes inserting a guidewire into the body lumen, tracking the device over the guidewire, deploying the needle through the exit port to the tissue, delivering fluid, and retracting the needle into the catheter.
摘要:
A catheter for delivering an agent to an injection site in a wall of a patient's body lumen, with an elongated shaft having a needle-through lumen slidably containing a needle therein, and an expandable member on the distal shaft section which has a collapsed configuration and a radially expanded configuration. In the radially expanded configuration, the expandable member supports the shaft in a position spaced away from the body lumen wall, and the needle slidably exits the needle-through lumen in the extended configuration through the port spaced away from the body lumen wall as a portion of the expandable member maintains the position of the port section of the shaft in the body lumen. The expandable member typically has an open-walled, helical, or lobed configuration providing a perfusion path along the expandable member.
摘要:
Kits, apparatus, devices and methods for treating varicose veins caused by an incompetent venous junction (e.g., the saphenofemoral and/or saphenopopliteal junctions) are disclosed. The kits may include a sheath, a vein closure device, and an injection device. Alternatively, a vein closure device may include an integral injection channel and injection device. Methods may include injecting a vein with a sclerosing agent through a needle that extends in a direction that is not aligned with a longitudinal axis of a sheath or shaft.
摘要:
A catheter assembly comprises a catheter including a catheter wall and a lumen extending lengthwise of the wall. The wall has inner and outer surfaces. The wall includes plural openings that extend through the wall and communicate with the lumen. An elongated hollow needle includes a proximal end portion and a distal end portion. The needle is movable in the lumen to move the distal end portion between the openings. The distal end portion is directed radially outward so as to extend into an adjacent opening. The distal end portion has a configuration that stores potential energy when in the lumen. The potential energy is converted to kinetic energy to produce movement of the proximal end portion as the distal end portion moves from the inner surface of the catheter wall across an edge of an opening. The movement of the proximal end portion is haptically perceptible.
摘要:
A catheter system comprising a) an elongate flexible catheter; b) a lumen that extends from a proximal insertion port to a side outlet opening; c) a penetrating guidewire insertable into the proximal insertion port and thereafter advanceable through the lumen and out of the side outlet opening; and d) an orientation element useable to provide an indication of the trajectory on which the penetrating guidewire will advance from the catheter body. Also disclosed are methods for using such catheter to direct the penetrating guidewire out of the side opening and into the true lumen of a blood vessel when bypassing an obstruction in the blood vessel such as a chronic total occlusion (CTO) of an artery.