Abstract: A resilient tubular graft is delivered into place within a body passage by elongating the graft to reduce its diameter and then directing the graft to the desired position while in the elongated condition. The graft is carried into position by a pair of elongate members mounted for longitudinal movement relative to one other. Flexible lines secure opposite ends of the graft to the respective elongate members whereby relative longitudinal movement of the members functions to elongate the graft and reduce its diameter. The lines extend around the graft to impart radial compression thereto simultaneously with elongation of the graft. Upon placement of the graft at the desired location within a body passage, the lines are released to permit the graft to expand into engagement with the passage. Barbs on the graft provide for secure engagement of the graft with a body passage.

Abstract: An adjustable sensor retainer and method for adjustably securing and retaining a sensor (e.g. a piezoelectric pulse sensor) against a skin region of a person includes the use of a primary retainer tape and an adjustable secondary retainer tape. The primary retainer tape is an adhesive tape to which the sensor can be attached. The adhesive primary retainer tape has strips of protective film with blind pull tabs attached thereto. This allows simplified one-handed application of the primary retainer tape while initially positioning and holding the sensor in place with the other hand. The secondary retainer tape is a tape strip removably attached to the top of the primary retainer tape and disposed over the sensor. After the initial positioning of the sensor with the primary retainer tape, the sensor can be finally positioned and the secondary retainer tape re-attached to the top of the primary retainer tape, thereby securing the sensor in the final desired location.

Abstract: An adjustable surgical valve has a sealing body with an axial passage extending through it, a toroidal body axially aligned with the sealing body, and a device that selectively changes the relative axial positions of the sealing body and the toroidal body. The sealing body and the toroidal body have mating surfaces which radially compress the axial passage of the sealing body when the relative axial positions of the sealing body and the toroidal body are changed. This causes the axial passage to seal with an instrument inserted into it, or to seal with itself if no instrument is inserted. Alternatively, or additionally, the sealing body may include a braided sleeve coaxial with the axial passage and extending from the sealing body, and a device that selectively changes the relative axial positions of the sealing body and the extended part of the braided sleeve to elongate the braided sleeve. This causes the braided sleeve to contract radially, which compresses the axial passage of the sealing body radially.

Abstract: A tubular sheath capable of assuming a reduced diameter state for insertion into a body passage and of expanding once in place within the passage. The sheath is fabricated of a composite elastomeric material and axially stretched to assume the reduced diameter state. Selective axial stretching is achieved by an elongate stylet which extends slidably through the sheath for compression imparting engagement with a distal portion thereof.

Abstract: A self-sealing valve to accommodate the passage of elongate elements. The valve comprises an elastomeric body having a passage extending therethrough which is held in compression by an elastomeric sleeve disposed around the body. The passage includes an enlarged chamber intermediate its ends and at least a portion of the passage takes the form of a puncture. In use, the passage functions to seal around an elongate element extended therethrough and the chamber reduces friction on the element and provides a void into which the material of the elastomeric body may be displaced without disturbing the seal. A method of forming the valve with a bulbous-ended mandrel is also disclosed.

Abstract: Intrapericardial access is provided by clamping the wall of the pericardium between elongate jaw elements carrying axially aligned tubular guides and passing a guide wire through the guides and the pericardial tissue therebetween. In the preferred embodiment the jaw elements include interengageable ratchets for holding the elements in clamping engagement with the wall of the pericardium and aligned pointed extensions for piercing the pericardial tissue clamped between the elements. Further intrapericardial access is provided by an additional tubular guide carried by the jaw element intended to be disposed in the pericardium during placement of the guide wire.

Abstract: Intrapericardial access is provided by clamping the wall of the pericardium between elongate jaw elements carrying axially aligned tubular guides and passing a guide wire through the guides and the pericardial tissue therebetween. In the preferred embodiment the jaw elements include interengageable ratchets for holding the elements in clamping engagement with the wall of the pericardium and aligned pointed extensions for piercing the pericardial tissue clamped between the elements. Further intrapericardial access is provided by an additional tubular guide carried by the jaw element intended to be disposed in the pericardium during placement of the guide wire.

Abstract: An angioscopy imaging system which operates under the control of a computer system includes an optical scanning system which is inserted into a vessel, such as an artery, for generation of an image. An irrigation system provides pulsatile introduction of flush solution to the vessel to create clear a viewing field within the vessel for the optical scanning system. The computer system controls both the optical scanning system and the irrigation system such that the generation of the image is synchronized with the pulsatile introduction of the flush solution.

Abstract: In a dilatation catheter and constant pressure syringe, a pressurized compressible medium is used to maintain pressure on a non-compressible medium. Pressure is applied to a compressible medium in a first chamber, in turn applying pressure to a non-compressible medium in a second chamber. The use of appropriate quantities of each medium produces a nearly constant pressure as the incompressible medium is ejected from the syringe.

Abstract: Radially expansible, helically configured wire loops are employed to grip and shear arteriosclerotic deposits from the lumen of an artery wall. Shearing action is achieved by pulling the loops through the artery by means of a handle which is freely rotatable to avoid the application of torsional forces to the loops. A shear force gauge may be provided to measure and limit the pulling force applied to the loops.

Abstract: The present invention provides an angioscope catheter for visualizing the interior of a vessel, such as an artery. The angioscope catheter includes an angioscope having a distal viewing end, an irrigating catheter that includes structure for introducing flush solution to the interior of the vessel at the distal end of the angioscope, and a deflector shield mounted at the distal end of the angiscope such that flush solution introduced by the catheter impacts on the deflector shield.

Abstract: A method and apparatus for implanting an automatic implantable defibrillator without the need for major surgery is disclosed. Preconfigured electrodes are straightened by the use of a stylet or by the surrounding catheter and inserted into the intrapericardial space through catheters. The catheters may be removed or may be left in place and attached to the pericardium or surrounding tissue to hold the electrodes in place.

Abstract: The subject invention relates to a method and apparatus particularly suitable for use in dilating occluded blood vessels. The apparatus includes a tubular catheter having a balloon member connected to the distal end thereof. The balloon is initially located in an inverted manner with the free end thereof being connected to a reinversion member. A tubular sheath is telescopically mounted within the catheter surrounding said balloon member. In operation, the balloon member is everted by sliding the sheath beyond the distal end of the catheter. Fluid pressure can be utilized to facilitate eversion and to laterally expand the balloon member after it has been extruded through the occlusion. The sheath also aids in reinverting the balloon member.

Abstract: An implantable defibrillation electrode of a shape requiring minimal incision in the body is disclosed. The electrode has a flexible insulated guide and terminates in a preconfigured flexible distal portion with an exposed conductive element. The electrode may be straightened, as for example by insertion of a stylet into the body of the electrode, for ease of insertion into the body.

Abstract: Elongate flexible elements are guided into place within a tortuous body passage by providing the elements with annular guides adjacent their distal ends and sliding the elements over a guide wire extended through the passage. Column strength to move the elements through the body passage may be provided by a tubular pusher slidably received on the guide wire. The annular guides are localized at the distal ends of the members so that a plurality of members may be sequentially or simultaneously guided into place over a single guide wire.

Abstract: Apparatus and method for hemostatically clipping an incision edge with clips having jaws normally biased together. A plurality of the clips are contained in a magazine and selectively discharged from the magazine through a tunnel which spreads the jaws of the clips prior to discharge. In operation the spread jaws of the clips are engaged around the incision edge and, upon being discharged from the apparatus, retract to grip the edge.

Abstract: An open ended tubular sheath is provided with an annular guide element to facilitate placement of the sheath within a body passage. In use a guide wire is directed into the passage and the guide element is then slid over the wire to direct the sheath into the passage. Once in place, the sheath may be used to direct instruments into the passage without significant abrasion or trauma. The guide element may take the form of a loop or tube. Column strength may be provided to the sheath either by the guide element or a stiffener engaged with the element or the sheath.

Abstract: A cutter for the in-situ cutting of valves within a vein. The cutter comprises a catheter having cutter fingers extending from its open distal end in an annular pattern. A sheath is selectively extensible over the fingers to shield them from inadvertent contact with the vein being treated. A fiberoptic viewer extends through the catheter to view through its open distal end.

Abstract: A helical balloon is attached to the distal end of a catheter to serve when inflated as a therapeutic tool for the removal of blood clots and as a diagnostic tool for physical measurements and the application of treatment and other materials.

Abstract: In a refillable injection device for use with a dilation catheter, a large bore syringe is used to refill a small bore syringe without disconnecting the syringe assembly from the catheter. A one-way valve prevents fluid from moving in the opposite direction. Movement of the small bore syringe plunger produces a high pressure, low volume flow and can be repeated if necessary after the small bore syringe is refilled. Subsequent movement of the large bore syringe plunger produces a low pressure, high volume flow.