Abstract: A method of filling an aneurysm space within the abdominal aorta is disclosed. The method involves placing a prosthesis in the abdominal aorta; delivering a fillable bladder in a deflated state into the aneurysm space using a catheter; placing a filler tube in fluid communication with an inflow port of the fillable bladder. The fillable bladder comprises a bladder seal surrounding the fillable bladder and the bladder seal has a first side, a second side, a third side, and a fourth side. The first side is symmetric with the second side with respect to a first axis of the fillable bladder and the third side is symmetric with the fourth side with respect to a second axis of the fillable bladder. The first axis is perpendicular to the second axis. The method further involves filling the fillable bladder with a filling agent and removing the filler tube.

Abstract: Two part laparoscopic tools and surgical methods using such tools are presented. The tools and methods enable use of multiple surgical tools each having wide tool heads to be used in a body cavity using a single wide trocar and one or more narrow incisions, thereby reducing surgical risk and enhancing patient comfort and shortening recovery time. Additional instruments for facilitating laparoscopic surgery are also presented.

Abstract: A guide wire, for use, for example, in guiding an elongated catheter through an artery or vein of a mammalian body having a stenosis and/or an occlusion therein, includes an elongated conductor having a longitudinal dimension, a proximal end and a distal end. The guide wire further includes an insulator overlying the elongated conductor. The insulator exposes a portion of the longitudinal dimension of the elongated conductor to form an electrode. The elongated conductor is arranged to be connected to a source of high voltage pulses to cause electrical arcs at the electrode that in turn form steam bubbles and shock waves to break the stenosis and/or open the occlusion and permit the guide wire to pass there through. Other embodiments are directed to a system including the guide wire and a method of using the guide wire.

Abstract: Spring clips are arranged end to end in a cavity of an inner shaft. Such shaft slides within an outer shaft, and a pusher member slides in the cavity behind the clips. The clips have jaws biased together, but which are wedged apart by an opener as the pusher is moved distally. An opened clip is ejected by relative movement of the inner and outer shafts to clamp body tissue at a desired site.

Abstract: A teat (1, 1?, 1?) comprising at least a shaft (4) and a nipple (2), wherein structured surface areas are provided at least in a partial region thereof, and the structured surface areas are formed by at least one rough surface zone (7) having a surface roughness of 100 ?m at the most, in particular of 50 ?m at the most.

Abstract: Medical devices robotically manipulated by a medical robotic system for performing a medical procedure on a patient are bundled together as a bundled unit and inserted into the patient through a single entry port. Bracing of the bundled unit at the surgical site so as to be constrained in one or more degrees of freedom of movement may be performed using an anchor secured to an anatomic structure at the surgical site and physically coupled to the bundled unit, or using a tool extending out of a distal end of the bundled unit that extends out to an anatomic structure at the surgical site.

Abstract: Apparatus for percutaneous access to a patient's body comprising a first steerable tube (12), shaped to define a first lumen, and a first coupling (152) at a longitudinal site of the first tube; and a second steerable tube (14), shaped to define a second lumen and a second coupling (154), the second coupling being intracorporeally couplable to the first coupling, the apparatus having (A) an unlocked state in which the second tube is rotatable within the first lumen, and (B) a locked state in which the second coupling is coupled to the first coupling, and rotation of the second tube is inhibited. The apparatus is configured such that when the second coupling becomes disposed at the longitudinal site in a given rotational orientation of the second tube, the apparatus moves into the locked state by the second coupling automatically coupling to the first coupling. Other embodiments are also described.

Abstract: A medical assembly is disclosed comprises a stent and a catheter having a balloon, wherein the coefficient of friction and/or the adhesion at the stent/balloon interface are reduced.

Abstract: Prosthesis delivery devices and methods are provided that enable precise control of prosthesis position during deployment. The catheter for delivering a prosthesis to a treatment site in a body lumen typically carries one or more self-expanding tubular prostheses within a sheath. A radially expandable control member is positionable within the prostheses and has an expanded shape which engages an inner surface of the prostheses to urge the prostheses outwardly against the sheath. The radially expandable control member therefore controls axial position of the prostheses during deployment. Thus one or more prostheses may be deployed at a treatment site precisely. When multiple prostheses are deployed, excessive spacing or overlap between adjacent prostheses is minimized. The prostheses of the present invention are often deployed in stenotic lesions in peripheral arteries as well as coronary arteries and other body lumens.

Abstract: An inflation device includes a syringe body containing a bore. The bore holds a fluid that is used to inflate a separate device such as a dilation balloon. A plunger assembly slides within the syringe bore and contains a sealing member that forms a fluid tight seal with the syringe body. A shut-off valve is disposed within the distal end of the syringe body. The distal end of the syringe body has a fluid bypass channel fluidically coupled to the aperture of a connector. The shut-off valve has a spring-biased moveable piston with a bypass lumen contained therein, wherein the bypass lumen forms a fluid path between the bore and the fluid bypass channel when the pressure of the fluid is below a threshold value. The fluid path between the bore and the fluid bypass channel is interrupted when the pressure of the fluid is above the threshold value.

Abstract: The present invention is directed to a device that permits a permanent aperture to be formed in a wall, or other partition, of an implantable medical device. The present invention maintains the continuity and fluid-retaining properties of the implantable medical device by providing a breachable barrier material fully covering an opening delimited by a deformable framework. The invention is accessed with conventional interventional surgical instruments that disrupt and displace the barrier material. Following disruption of the barrier material, the opening is enlarged with surgical instruments to form a permanent framed aperture in the wall of the implantable medical device. The permanent framed aperture provides fluid communication across the wall of the implantable medical device.

Abstract: An anastomosis device for facilitating sutureless side-to-side arteriovenous fistula creation and maintenance of patency thereof is presented. The device comprises two device halves each containing an anastomosis window which is in fluid connection with an interior lumen of the device. Further, the device comprises a pair of vessel joining portions in which the bounds of the fistula are created. The invention also has an embodiment wherein a method of joining a vein and an artery in order to create a fistula is presented.

Abstract: A device for brain stimulation includes a lead having a longitudinal surface, a proximal end and a distal end. A plurality of electrodes are disposed along the longitudinal surface of the lead near the distal end of the lead. At least one marker is disposed on the longitudinal surface of the lead. The at least one marker is configured and arranged to identify a relative position of the plurality of electrodes.

Abstract: Embodiments described herein address the need for improved catheter devices for delivery, repositioning and/or percutaneous retrieval of the percutaneously implanted heart valves. One embodiment employs a plurality of spring-loaded arms releasably engaged with a stent frame for controlling expansion for valve deployment. Another embodiment employs a plurality of filaments passing through a distal end of a pusher sleeve and apertures in a self-expandable stent frame to control its state of deployment. With additional features, lateral positioning of the stent frame may also be controlled. Yet another embodiment includes plurality of outwardly biased arms held to complimentary stent frame features by overlying sheath segments. Still another embodiment integrates a visualization system in the subject delivery system. Variations on hardware and methods associated with the use of these embodiments are contemplated in addition to those shown and described.

Abstract: A multi-section tubular member including a sleeve surrounding and bridging a joint between a first section and a second section of the tubular member, and a method of forming a multi-section tubular member are disclosed. A polymeric sleeve may extend over a portion of the first section and an adjoining portion of the second section. A length of heat shrink tubing may be placed over the sleeve and heated, thereby compressing the heat shrink tubing around the sleeve. The sleeve may then be thermally bonded to each of the first section and the second section. The heat shrink tubing may then be removed, leaving the sleeve securely joining the first section and the second section to form a multi-section tubular member.

Abstract: A thrombus removal apparatus (10) includes a catheter (12) having at its distal end (14) a solenoid coil section (16) within which there is disposed a piercing element (20) made of electromagnetic material. Within the solenoid coil section (16) there is provided a solenoid coil (26) which can be powered to generate an electromagnetic field which causes the piercing element (20) to reciprocate into and out of the coil section (16), in practice to pierce into and fragment a thrombus disposed in a patient's vessel. An aspiration unit may be provided for aspirating thrombus fragments into the assembly (10) for removal from the patient's vasculature. The apparatus (10) is able to remove dense thrombus material from within a patient, which cannot be otherwise removed by means of thrombolytic agents.

Abstract: A trans-endoscopic hydraulic balloon dilation apparatus includes a fluid reservoir containing a hydraulic fluid. A shaft has a lumen in fluid communication with a leading end of the fluid reservoir. A balloon is mounted on the shaft and an opening in the shaft enables hydraulic fluid to flow through the opening into or from the balloon. A piston secured to a leading end of a piston rod is slideably positioned within a lumen of the fluid reservoir. A hub secured to a trailing end of the fluid reservoir is centrally apertured to accommodate the piston rod so that a trailing end of the piston rod is external to the fluid reservoir. Displacement of the piston rod in a trailing-to-leading direction causes expansion of the balloon. Displacement of the piston rod in a leading-to-trailing direction causes deflation of the balloon. The piston can be locked into any position.

Abstract: A delivery device for deploying an expandable prosthesis and method of use thereof are described. The delivery device includes an outer sheath that is capable of retracting in a proximal direction and resheathing over the prosthesis in a distal direction. The device includes a drive pulley that can engage gears to retract or resheath the outer catheter in relation to the prosthesis. In some embodiments, the delivery device may include a reinforced outer sheath disposed over an inner elongate member, the reinforced outer sheath comprising a proximal section reinforced with a braid, a distal section reinforced with a coil and an overlapping section extending between the proximal section and the distal section. Additionally or alternatively, the delivery device may include a stabilizing element for releasably holding the stent to the inner catheter.

Abstract: The drug eluting folded stent and a stent delivery system, which includes a stent having a plurality of struts interconnected to form a tubular body. At least one of the struts includes a U-shaped strut having in cross-section a first leg, a second leg, and a closed end connecting the first leg and the second leg, wherein the first leg, the second leg, and the closed end define a recess having a drug release opening opposite the closed end; and a drug coating disposed on the first leg, the second leg, and the closed end within the recess. The drug release opening is sized to release a drug from the drug coating at a predetermined drug elution rate.

Abstract: A retrieval catheter operable by a single clinician that will neither displace a deployed stent nor cause undue trauma to the vascular lumen or lesion. The retrieval catheter may be sized to accommodate both a guidewire and a balloon wire. The retrieval catheter is easy to navigate through tortuous passageways and will cross a previously deployed stent or stent-graft easily with minimal risk of snagging on the deployed stent or stent graft. The sheath and dilator are adapted to allow a guidewire or balloon wire to pass through the walls of both and to allow the sheath and dilator to move axially with respect to each other.