Abstract: A method of positioning a main stent at a vessel bifurcation includes positioning a main guidewire in the main vessel; and advancing a stent delivery system to a position proximate the bifurcation. The stent delivery system includes a catheter with a flexible side sheath attached thereto and a main stent positioned over the catheter. The flexible side sheath is positioned to pass through the side opening in the main stent. The method also includes advancing a branch guidewire through the flexible side sheath and into the branch vessel; and subsequently, advancing the catheter over the main guidewire while advancing the flexible side sheath over the branch guidewire while viewing relative movement of a marker positioned on the flexible side sheath with respect to at least one marker positioned on the catheter.

Abstract: A stent includes a central portion of helically wound undulations formed of struts, cylindrical end portions, and transition zones between the helical portion and the cylindrical portions. According to a first aspect of the invention, the torsional flexibility of the stent is maximized by having bridges connecting adjacent winding be interrupted by the maximum possible number of undulations. In one embodiment, each winding includes nineteen undulations around the circumference, bridges are provided every five undulations. According to a second aspect of the invention, uniform opening of the transition zone is achieved by altering the width, and thereby the flexibility, of a series of struts in accordance with their lengths. Specifically, the long transition zone struts are made wider.

Abstract: A prosthesis that mechanically couples with both cancellous bone and cortical bone of a glenoid includes a head portion comprising a rear surface and an articular surface, an anchor member, and a plurality of deformable fins extending radially outward from the anchor member. The anchor member includes a distal end and a proximal end connected to the rear surface of the head portion. The plurality of deformable fins extend radially outward from the anchor member and includes at least a first proximal fin adjacent to the rear surface of the head portion positioned to engage with the cortical bone. The anchor member may also include at least one distal fin located proximate the distal end of the anchor member positioned to engage with the cancellous bone.

Abstract: A syringe configured to deliver viscous compositions is described, in which the syringe may include an elongate chamber having side port(s) extending therefrom. Various viscous compositions may be inserted through the side port(s) and into the elongate chamber, which may further house a plunger for ejecting the composition. One portion of the plunger may interact with a restricted opening on the chamber to inhibit removal of the plunger from the chamber; and another portion of the plunger may have a locking structure, which cooperates with a locking structure on the chamber to selectively fix the plunger with respect to the chamber. The plunger may also be fully slidable within the chamber when the locking structures of the plunger and the elongate chamber are not engaged. Related methods of using the aforementioned syringe, as well as kits including further instruments that interact with the syringe, are also disclosed.

Abstract: Methods of preparing and using a stent assembly that includes a stent jacket formed from an expansible mesh structure having apertures and that includes a fiber having a diameter of about 7 micrometers and about 40 micrometers, and an expansible stent operatively associated with the stent jacket. The method further comprises administering to the subject an active pharmaceutical ingredient (API) eluted from the stent assembly.

Abstract: Medical apparatus (100) is provided for insertion into a mammalian body. The apparatus (100) includes structural stent elements (110), at least a portion of which are shaped so as to define (a) at least one generally circumferential band (112), and (b) a plurality of engagement members (114) that are joined to and extend radially inwardly from the band (112). The apparatus (100) further includes an elongated latch member (118) which is threaded through the engagement members (114), thereby physically latching the engagement members (114). The band (112) and the engagement members (114) are configured such that (a) when the latch member (118) is threaded through and thus physically latches the engagement members (114), the engagement members (114) retain the band (112) in a radially-compressed state, and (b) when the latch member (118) is removed from the engagement members (114), the band (112) assumes a radially-expanded state. Other embodiments are also described.

Abstract: Mechanical devices such as prosthetic knees, hips, shoulders, fingers, elbows, wrists, ankles, fingers and spinal elements when implanted in the body and used as articulating elements are subjected to wear and corrosion. These prosthetic implants are usually fabricated in modular form from combinations of metallic materials such as stainless steels, Co—Cr—Mo alloys, and Ti—Al—V alloys; plastics such as ultra high molecular weight polyethylene (UHMWPE); and ceramics such as alumina and zirconia. As the articulating surfaces of these materials wear and corrode, products including plastic wear debris, metallic wear particles, and metallic ions will be released into the body, transported to and absorbed by bone, blood, the lymphatic tissue, and other organ systems. The polyethylene wear particles have been shown to produce long term bone loss and loosening of the implant.

Abstract: A medical device and tension member for use in a subject enables fixation of tension members and transmission of force from tissues to energy converters or to natural or prosthetic bones or other prostheses. The medical device includes an anchor block having a knob extending from its surface, such knob configured to engage a looped tension member. The tension member includes a looped portion configured to engage the knob, an intermediate portion, and a tissue engaging portion configured to engage tissue in a subject. The looped portion is connected to the tissue engaging portion via the intermediate portion. A system is provided for use in a subject and includes at least one looped tension member, an operational device, and at least one medical device configured to couple the looped tension member and the operational device.

Abstract: A volar fixation system includes a plate intended to be positioned against the volar side of the radial bone. The plate includes threaded holes for receiving fasteners which lock relative to the plate.

Abstract: A prosthetic valve for implantation in a stenosed aortic valve. The prosthetic valve includes a metallic frame formed with intersecting bars having diameters in the range of 0.1 to 0.6 mm. The frame is radially collapsible for advancement into a native aortic valve using a catheterization technique. The frame is radially expandable for embedding the frame within the native aortic valve. The frame has sufficient radial strength to resist the recoil forces of the native aortic valve after implantation. The prosthetic valve includes a collapsible valvular structure made with pericardium. The prosthetic valve also includes an internal cover which forms a substantially impermeable tubular sleeve. The internal cover preferably extends between a lower extremity of the frame and the valvular structure. The internal cover is preferably sutured to the valvular structure. The valvular structure and internal cover are sutured to the bars of the frame.

Abstract: A volar fixation system includes a plate intended to be positioned against the volar side of the radial bone. The plate includes holes having a predefined axis along which fasteners can be received and locked relative to the plate. A guide is provided that seats on the plate to guide a drill in axial alignment with the holes in plate.

Abstract: A heart valve assembly includes a base including a multi-lobular annular shape within a plane, a valve member or other annular body including a multi-lobular shape complementary to the shape of the base, and cooperating connectors on the base and the annular body for connecting the annular body to the base. The base includes an anchoring ring, and a flexible cuff for attaching the base to a biological annulus. The base and the annular body include guides for aligning their multi-lobular shapes, e.g., visual, tactile, or other markers, or tethers that extend from the base that are slidable through the annular body. During use, the base is attached to a biological annulus, the annular body is directed adjacent the annulus, oriented such that the multi-lobular shape of the annular body valve member is aligned with the base, and the annular body is attached to the base.

Abstract: A method of shoulder replacement surgery is described in which an implant is placed on a surface of a glenohumeral joint while keeping the joint located. The method includes creating a first non-bony passage to the joint, inserting the implant through the passage into the joint, and replacing a surface of the joint with the implant without dislocation of the joint.

Abstract: The device (1) comprises a first snare (10) and a second snare (20), each of these snares comprising a contractable hollow elongated body (11, 21) which defines a longitudinal central axis (X10, X20) and which reduces its cross section when two opposed first (12, 22) and second (13, 23) ends thereof are axially moved away from each other. The first end (12) of the first snare (10) and the first end (22) of the second snare (20) are each open and adapted to be fitted and tightened around, respectively, two stumps (T1, T2) of a soft tissue (T) to be repaired. The second end (13) of the first snare (10) and the second end (23) of the second snare (20) are adapted to the axially pulled so that the second end of each of the two snares is passed alongside or through the body (11, 21) of the other snare.

Abstract: An anterior spinal plate has affixed to at least a portion of a surface thereof at least one preformed drug-eluting device fabricated from a drug-eluting matrix containing at least one elutable drug.

Abstract: A method for implanting a heart valve into a patient's heart can include inserting the heart valve prosthesis into a barrel of an implanter apparatus. An opening is created in muscle tissue of the patient's heart to provide a substantially direct path that extends from the opening to a desired implantation site in the heart. A length of the barrel is inserted through the opening in the tissue such that an end of the barrel and the opening are along the direct path to the implantation site. The heart valve prosthesis is advanced through the barrel to the implantation site. The heart valve prosthesis is positioned at the desired implantation site. The heart valve prosthesis can be expanded at the desired implantation site from the reduced cross-sectional dimension toward the expanded cross-sectional dimension.

Abstract: A method for endovascularly replacing a heart valve of a patient. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor in an unexpanded configuration within a catheter to a vicinity of the heart valve; deploying the anchor from the catheter; expanding the anchor to contact tissue at an anchor site; and retrieving the anchor into the catheter. The invention also includes an apparatus for endovascularly replacing a heart valve, including: a catheter; a replacement valve configured to be disposed within the catheter for delivery to a vicinity of the heart valve; and an expandable anchor configured to be disposed within the catheter for delivery to a vicinity of the heart valve, to be deployed from the catheter, to be expanded to contact tissue at an anchor site and to be retrieved back into the catheter after having been expanded.

Abstract: A delivery system for a self-expanding device for placement in a bodily lumen, the system comprising a sheath that confines the device to a radially compact delivery disposition until the device is to be released into the lumen, the system having an elongate pull element to be pulled proximally from its proximal end, which pull element is arranged radially inside the sheath for pulling preferentially on a pull zone on the circumference of the distal end of the sheath, thereby to tear the sheath progressively along a tear line running the length of the sheath, starting at the distal end of the sheath, to release the device from the confining effect of the sheath, progressively, beginning at the distal end of the device and wherein the sheath is of polyethylene-terephthalate, cold drawn along its long axis, and in that the distal end of the sheath tapers inwardly to provide an inwardly tapered distal end of the system.

Abstract: An interspinous implant is provided. The interspinous implant can include a first member having a first end and a second end. At least one of the first end and the second end can include a mating portion. The interspinous implant can also include a second member, which can have a first end, a second end and at least one receiving portion formed adjacent to at least one of the first end and the second end. The at least one receiving portion can receive the mating portion to couple the first member to the second member at a desired orientation. The interspinous implant can also include a first extension, which can be substantially opposite the mating portion, and adapted to engage a spinous process. The interspinous implant can comprise a second extension, which can be substantially opposite the at least one receiving portion, and adapted to engage a second process.

Abstract: A breast implant and process to optimize the treatment of breast cancer patients that offers more effective alternatives in breast reconstruction and simultaneously administers regional therapies in order to minimize the possibility of local recurrences. The breast implant comprises an inner porous core contained by an elastic holding layer with a system of tubes and conducts within it covered with biodegradable chemotherapeutic and attaching layers.