Abstract: A system and method enables delivery of an implantable medical lead to an implant location. A delivery tool of the system defines the delivery angle of the lead at the implant location. The delivery tool includes an elongate body having at least one lumen extending from a distal portion to a proximal portion. A suction cup is coupled to the distal portion of the elongate body. The suction cup may be configured to be collapsible in a first configuration, prior to deployment, and expandable in a second configuration. The system may include a suction source for drawing tissue at the implant location into the suction cup of the delivery tool that is disposed at the distal portion. The delivery angle of the lead tip is based on the interior cavity of the suction cup rather than the angle of insertion with the suctioned tissue.

Abstract: Embodiments of the claimed invention are directed to the treatment of glaucoma (or conditions of elevated intraocular pressure) using a novel ab interno trabeculotomy procedure that uses a flexible device. At least one advantage of the present method is that it does not require a conjunctival or scleral incision, which in turn improves patient recovery time and healing.

Abstract: To perform a tool exchange in a medical robotic system, tool is retracted back into an entry guide from a deployed position and pose so that an assistant in the operating room may replace it with a different tool. While the tool is being retracted back towards the entry guide by user action, its configuration is changed to an entry pose while avoiding collisions with other objects so that it may fit in the entry guide. After the tool exchange is completed, a new tool is inserted in the entry guide and extended out of the guide by user action to the original position of the old tool prior to its retraction into the entry guide while the tool's controller assists the user by reconfiguring the new tool so as to resemble the original deployed pose of the old tool prior to its retraction into the entry guide.

Abstract: An intravascular emboli capture and retrieval system for intravascular embolism protection and embolism removal or maceration. Guidewire mounted proximally and distally located multiple opening filters are deployed within the vasculature and used to part, divide and macerate embolic debris and to capture such embolic debris within the confines thereof. A deployable flexible preformed memory shaped capture sleeve is alternatively used to collapse one or more filters and embolic debris therein for subsequent proximal withdrawal from the vasculature.

Abstract: A delivery system deploys a prosthesis for open surgical repair of a body vessel. The system includes a sleeve to retain segments of a prosthesis in a compressed configuration and retraction members. The sleeve has outer segments associated with each end of the prosthesis. Retraction of the retraction members removes the outer segments of the sleeve from the prosthesis outer ends to allow for expansion of the outer ends of the prosthesis in an outside-in direction. The system can include a handle and an actuation member movably attached to the handle. The actuation member is coupled to the sleeve outer segments so that movement of the actuation member corresponds to removal of the sleeve. The system can include elements to retain the sleeve outer segments to the actuation member and to redirect the retraction members to a direction different from the axis of the prosthesis.

Abstract: An implant placement device includes a sheath; a long-axis member having an opening on a distal end side, movable along an axis, and a lumen communicating with the opening; a stylet movable in the axis and provided within the lumen to be turnable around the axis; an operating part on a proximal end side of the stylet to turn the stylet around the axis; a guide part on the proximal end side of the sheath to guide the operating part in a predetermined direction, thereby moving the sheath in the axis with respect to the stylet and turning a distal end portion of the stylet around the axis; and a coupling portion formed at the distal end of the stylet, detachably coupled with an implant, and moving in the axis and turning around the axis along with the stylet and the implant according to an operation of the operating part.

Abstract: Described here are angioplasty balloon devices for generating shock waves to break up calcified plaques along a length of a vessel and methods of making such devices. Generally, the devices may be used in angioplasty and/or valvuloplasty procedures, but may alternatively be used in other applications. In some variations, the device may include an elongate member, a plurality of electrode assemblies, and at least one tubular sleeve interposed between adjacent or neighboring electrode assemblies that form a continuous outer profile between the electrode assemblies. These devices may have a smooth, continuous outer profile without substantial profile transitions and/or may have stiffening sections between electrode assemblies.

Abstract: A surgical instrument includes an elongated shaft having a distal portion and a proximal portion coupled to a housing. An inner shaft member extends at least partially through the elongated shaft and is selectively movable in a longitudinal direction. An end effector is supported by the distal portion of the elongated shaft. The end effector includes upper and lower jaw members pivotally coupled to the distal portion of the elongated shaft about a pivot axis and including a pair of laterally spaced flanges. The pairs of flanges of the jaw members are arranged in an offset configuration such that one flange of the upper jaw member is positioned on a laterally exterior side of a corresponding flange of the lower jaw member, and the other flange of the upper jaw member is positioned on a laterally interior side of the other flange of the lower jaw member.

Abstract: Navigation and tissue capture systems and methods for navigation to and/or capture of selected tissue using the innate electrical activity of the selected tissue and/or other tissue are described. In the context of left atrial appendage closure, the systems and methods can be used to navigate to the left atrial appendage and capture/control the appendage while a closure instrument (suture, clip, ring) is placed over the appendage and tightened down or a closure method (ablation, cryogenic procedures, stapling, etc.) is performed to close the left atrial appendage. The use of innate electrical activity for navigating devices may be used in connection with other tissues and/or areas of the body.

Abstract: A robotic catheter system including a housing and a drive mechanism configured to engage and to impart motion to a catheter device is provided. The drive mechanism is supported by the housing. The robotic catheter system includes a guide catheter support coupled to the housing. The guide catheter support is located in front of the drive mechanism, and the guide catheter support has a longitudinal axis. The guide catheter support includes a first surface configured to engage a guide catheter and a rotation joint allowing the first surface to be rotated about the longitudinal axis such that the surface is able to engage the guide catheter at a plurality of angular positions relative to a patient.

Abstract: An intravascular emboli capture and retrieval system for intravascular embolism protection and embolism removal or maceration. Guidewire mounted proximally and distally located multiple opening filters are deployed within the vasculature and used to part, divide and macerate embolic debris and to capture such embolic debris within the confines thereof. A deployable flexible preformed memory shaped capture sleeve is alternatively used to collapse one or more filters and embolic debris therein for subsequent proximal withdrawal from the vasculature.

Abstract: A surgical instrument includes an elongated shaft having a distal portion and a proximal portion coupled to a housing. An inner shaft member extends at least partially through the elongated shaft and is selectively movable in a longitudinal direction. An end effector is supported by the distal portion of the elongated shaft. The end effector includes upper and lower jaw members pivotally coupled to the distal portion of the elongated shaft about a pivot axis and including a pair of laterally spaced flanges. The pairs of flanges of the jaw members are arranged in an offset configuration such that one flange of the upper jaw member is positioned on a laterally exterior side of a corresponding flange of the lower jaw member, and the other flange of the upper jaw member is positioned on a laterally interior side of the other flange of the lower jaw member.

Abstract: Various features are described that are adapted to improve performance of interference-relief type delivery systems. A delivery system provided herein comprises an implant comprising a socket at a proximal end of the implant; an elongate sleeve having (i) a proximal section, (ii) a distal section slidably disposed within the socket, and (iii) a window between the proximal section and the distal section, the window extending through a wall of the sleeve; and a core member having a proximal portion slidably received within the proximal section of the sleeve and a distal portion extending through the window to a space outside the sleeve and within the socket. The distal portion of the core member provides an interference fit with the distal section of the sleeve within the socket until the core member is withdrawn.

Abstract: Apparatus and methods are described, including apparatus for puncturing a fossa ovalis of a heart. The apparatus includes a catheter shaped to define a catheter lumen. A puncturing element is slidably disposed within the catheter lumen, and is deployed from a distal portion of the catheter and to puncture the fossa ovalis. A probing element is deployed from the distal portion of the catheter. Upon being deployed, the probing element probes tissue near the fossa ovalis, the probing element having a first configuration thereof upon probing the tissue near the fossa ovalis. Upon probing tissue of the fossa ovalis, the probing element facilitates positioning of the puncturing element, by automatically adopting a second configuration thereof that is different from the first configuration. Other applications are also described.

Abstract: An implantable and removable filter that may be implanted in and/or removed from a body lumen, such as the Vena Cava. The filter including tissue anchors on expandable anchoring legs, which can be selectively moved between a non-anchoring or pre-deployed configuration into an anchoring or deployed configuration by obturators that are movable inside the anchoring legs.

Abstract: A stone retrieval device includes a sheath and a stone retrieval basket that includes a distal region with a plurality of basket wires and a proximal region with one or more core wires. The stone retrieval basket is contained within the sheath and is movable out a distal opening of the sheath to cause the plurality of basket wires to open into a basket shape. The stone retrieval device further includes a lock mechanism that locks the position of the stone retrieval basket with respect to the position of the sheath and a basket force controller that includes a first control stage and a second control stage. The first control stage includes a sensor for measuring force on the stone retrieval basket when the lock mechanism is in an unlocked position, and the second control stage includes a sensor for measuring force on the stone retrieval basket when the lock mechanism is in a locked position.

Abstract: A stent-graft has a closed web configuration in which end stent crowns or apexes do not extend beyond an end of a tubular graft. In order to permit interaction of the endmost crowns with tip capture fingers or prongs of a delivery system, the graft covers the endmost crowns but the endmost crowns are not coupled to the graft material and thus free to interact with the delivery system. In order to prevent slippage of the graft material at the endmost crowns and secure the longitudinal position of the graft material, one of a pair of stoppers is coupled on each of the opposing struts between which the unattached endmost crown is formed. In an embodiment, the stoppers are cylindrical tubes of a radiopaque material having a longitudinally-extending slit in a wall thereof.

Abstract: An volume filling device for treatment of obesity is placed outside the stomach wall of the patient to reduce the inner volume of the stomach, thereby affecting the patient's appetite. By providing the volume filling device outside the stomach wall, contact with stomach acids is avoided, thereby increasing the life of the device. Furthermore including a stretching device to stretch a portion of the stomach wall to further affecting the patient's appetite.

Abstract: Embolic implants delivery systems and methods of manufacture and delivery are disclosed. The devices can be used for aneurysm and/or fistula treatment. The designs offer low profile compressibility for delivery to neurovasculature, while maintaining advantageous delivery and implant detachment control features.

Abstract: Methods and devices are disclosed for treating neurovascular venous outflow obstructions, with or without implantation of a prosthetic valve. The valve may be carried by a support, such as a stent, which may be self-expandable or balloon expandable. Both transvascular and direct surgical access is contemplated.