Abstract: Disclosed herein are methods and devices for securing soft tissue to a rigid material such as bone. A bone anchor is described that comprises an anchor body with expandable tines and a spreader that expands the tines into bone. Also disclosed is a bone anchor that comprises a base and a top such that suture material may be attached to apertures in the anchor top or else compressed between surfaces on the base and top to secure the suture to the anchor. Also described is an inserter that can be used to insert the bone anchor into bone and move the spreader relative to the anchor body attach suture material. Also described is an inserter that can be used to insert the bone anchor into bone and move the anchor top relative to the anchor body or anchor base to attach to or clamp suture material there between.

Abstract: An occlusion device suitable for endovasculature treatment of an aneurysm in a blood vessel in a patient, including a substantially tubular structure having a proximal end region and a distal end region, having a first, expanded condition and a second, collapsed condition. The device has dimensions in the second, collapsed condition suitable for insertion through vasculature of the patient and through a neck of the aneurysm. The device further includes a control ring having a substantially annular body disposed on the proximal end region of the structure and at least substantially circumscribing the proximal end region to prevent radial expansion of the proximal end region and to provide an engagement feature during manipulation of the occlusion device.

Abstract: An ultrasonic surgical apparatus including a first signal generator outputting a drive signal at a predetermined voltage and frequency, a first oscillating structure receiving the drive signal and oscillating at the frequency of the drive signal, and a bridge circuit, detecting the mechanical motion of the first oscillating structure and outputting a signal representative of the mechanical motion.

Abstract: Apparatus and methods are described herein for repositioning a tether attached to a prosthetic heart valve. In some embodiments, a method includes inserting a distal end portion of a snare device through an incision at a first location in a ventricular wall of a heart and within the left ventricle of the heart. A tether extending from a prosthetic mitral valve, through the left ventricle and out an incision at a second location on the ventricular wall of the heart is snared with the snare device. The tether is pulled with the snare device such that a proximal end of the tether is moved back through the incision at the second location on the ventricular wall and into the left ventricle. The snare device is pulled proximally such that the tether is pulled proximally through the incision at the first location in the ventricular wall of the heart.

Abstract: A method of treatment for a body vessel is provided. The body vessel includes a dissection flap formed from a wall of the body vessel, which longitudinally separates a natural body vessel lumen into a true lumen and a false lumen. One or more cuts are formed in the dissection flap with a cutting device or system. An expandable device is inserted within the true lumen, and expanded to reappose the dissection flap against the wall of the body vessel where the dissection flap was detached from the wall such that the false lumen is closed. A variety of cut patterns are disclosed.

Abstract: Devices and methods are described for occluding the left atrial appendage (LAA). The device excludes the LAA from blood flow to prevent blood from clotting within the LAA and subsequently embolizing, particularly in patients with atrial fibrillation. The implantable device is delivered via transcatheter delivery into the LAA and secured within the LAA. The implant comprises an expandable and compliant frame and an expandable and conformable tubular foam body carried by the frame. The device may have a thromboresistant cover at a proximal end and a thromboresistant coating on the foam body. The frame may have recapture struts inclining radially outwardly in the distal direction from a central hub. The frame may have axially extending side wall struts, with adjacent pairs of side wall struts joined at one or more apexes. Anchors extend from the frame to engage tissue. The anchors can also be reversible to allow retraction of the anchors and repositioning or retrieval of the device.

Abstract: An occluder includes a first occluder disc, a second occluder disc, a waist portion connecting the first occluder disc and the second occluder disc, and at least one soft and fibrous strand bundle structure. The strand bundle structure is disposed on at least one of a disc surface of the first occluder disc and a disc surface of the second occluder disc, the two disc surfaces faces each other, and the strand bundle structure is disposed near the waist portion. By disposing the strand bundle structure to be immediately adjacent to the waist portion, a defect opening can be occluded after implantation, thereby effectively blocking blood from flowing from one side of the defect to the other side thereof, and preventing a shunt from being formed.

Abstract: Adjuncts for use with surgical instruments, such as staplers, are provided. In one embodiment, an adjunct can include a plurality of suction members configured to attach the adjunct to an end effector jaw of a surgical stapler using a suction force. The suction members can be configured to generate the suction force when compressed. The suction members can be further configured to release the suction force to decouple the adjunct from the end effector jaw, permitting deployment of the adjunct at a treatment site. In certain embodiments, the suction members can include a plurality of air pockets formed in the bulk of the adjunct or within protrusions extending outward from a surface of the adjunct. The air pockets can be in communication with corresponding openings allowing air to escape the air pockets when compressed.

Abstract: The present invention is directed to a hemostatic semi-solid paste material comprising a bioabsorbable carrier hemostatic material; and a supplemental hemostatic agent; wherein the paste material has an elongated form extending along a lengthwise axis with an aspect ratio of at least 3; wherein the paste is self-supporting and syringe extrudable; and wherein the supplemental hemostatic agent has a non-homogenous distribution profile across a cross-section taken across the lengthwise axis. In another aspect, the present invention relates to devices for forming and expressing the hemostatic material.

Abstract: Instruments and techniques to pass a suture are presented. The instruments and techniques are particularly useful where access to confined spaces and the ability to pass a suture through difficult to penetrate materials are needed. The instruments and techniques are particularly useful in surgery of the hands and feet.

Abstract: The invention provides methods, devices and systems for delivering, positioning and/or repositioning an expandable prosthetic heart valve in a patient's heart chamber. At least one non-looped wire and looped wire pair is operatively connected with an expanded prosthetic heart valve that is collapsed within a delivery catheter lumen having its distal end positioned in the subject heart chamber. The collapsed prosthetic heart valve is translated through the delivery catheter lumen to and out of its distal end where the prosthetic heart valve expands to a working configuration. The wire(s) of the non-looped and looped wire pair may be manipulated by pulling proximately or pushing distally to position or reposition the expanded prosthetic stent into position, then released from connection with the positioned stent and withdrawn from the patient.

Abstract: A platform device for material excision or removal from vascular structures for either handheld or stereotactic table use may comprise a work element or elements configured to selectively open and close at least one articulable beak or scoopula configured to penetrate and remove intra-vascular materials or obstructions, or follow a central lumen of another device or over a wire in a longitudinal direction. Flush and vacuum tissue transport mechanisms may be incorporated. A single tube or an inner sheath and an outer sheath which may be co-axially disposed relative to a work element may be configured to actuate a beak or beaks or scoopulae and provisions for simultaneous beak or scoopula closing under rotation may be incorporated.

Abstract: Devices for removing implanted objects from body vessels are provided. A device includes a sheath assembly having a cutting tip. The cutting tip includes a cutting surface that is adapted to cut tissue coupled to an implanted object as the cutting tip rotates. The sheath assembly further includes an outer shield carried outside of the cutting tip. The outer shield includes a distal opening, and the outer shield is translatable relative to the cutting tip from a first position to a second position and vice versa. In the first position the cutting surface of the cutting tip is disposed within the outer shield, and in the second position the cutting tip extends through the distal opening and the cutting surface is at least partially disposed outside of the outer shield.

Abstract: Embodiments of the present disclosure are directed to medical devices, methods, and systems for delivering a medical device to a target site. In one embodiment, a medical device includes a proximal lobe and a distal lobe, at least one of the proximal lobe or the distal lobe configured to receive a delivery device therethrough. The medical device also includes a central engagement member disposed between the proximal lobe and the distal lobe, the central engagement member configured to be engaged by a delivery device for facilitating deployment of the proximal and distal lobes at the target site.

Abstract: A positioning and retrieval device manipulated by carrying element coupled to an handle and driven by an actuator that allows for axial movement and rotational movement of a capturing portion on the carrying element.

Abstract: A device such as a medical device and a method for making same provides a surface modified by beam irradiation, such as a gas cluster ion beams or a neutral beam, to inhibit or delay attachment or activation or clotting of platelets.

Abstract: Systems, instruments, and methods for minimally invasive procedures including one or more of fractional resection, fractional lipectomy, fractional skin grafting, fractional scar revision, and/or fractional tattoo removal are described. Embodiments include instrumentation comprising a scalpet assembly coupled to a carrier, and the scalpet assembly includes a scalpet array. The scalpet array includes one or more scalpets configured for fractional resection, fractional lipectomy, fractional skin grafting, fractional scar revision, and/or fractional tattoo removal. The system includes a vacuum component coupled to the scalpet assembly and configured to evacuate tissue from the a site. The carrier is configured to control application of a rotational force and/or a vacuum force to the scalpet assembly.

Abstract: Configurations are described for assisting in the execution of a percutaneous procedure while protecting the vascular pathway to the operational theater, which may comprise diseased tissue. A railed sheath may be controllably expandable and collapsible, and may comprise two or more elongate rail structures configured to assist in the distribution of loads to associated diseased tissue structures, while also contributing to the deployment of percutaneous tools by maintaining alignment of such tools with the railed catheter and associated anatomy.

Abstract: Venous endoluminal devices, in particular for the treatment of defects of the veins, are provided with a substantially tubular body which defines an inner lumen and support modules oriented longitudinally and joined, in a distal direction, by distal bridges and in a proximal direction, by proximal bridges. Each support module includes a distal section, extending in a distal direction beyond the distal bridges, wherein the distal section is at least partially projecting in a radial direction, internally in relation to the inner lumen of the body. Methods of treatment using such devices are also provided.

Abstract: A catheter system with a proximal end and a distal end means at the proximal end to actuate a device at the distal end of the system, and an actuator element that runs the length of the system, from the actuator means to the device and actuates the device by transmitting a physical force from the proximal end to the distal end and characterized by a pre-tensioner near the distal end of the system, that can be set in a pre-tensioning disposition prior to actuation of the device, the pre-tensioner thereby reducing the magnitude of the said physical force that must be transmitted from the proximal end when actuation of the device is required.