Abstract: A guidewire for placement within a blood vessel for penetrating an occlusion therein. The guidewire comprises a length of flexible wire having a lumen extending therethrough. The distal end of the guidewire is generally arcuate and has a diameter greater than that of the wire immediately proximal thereto. A flexible stylet substantially the same length as the flexible wire may be disposed within the lumen of the wire. In operation, the arcuate distal end of the guidewire is positioned in the blood vessel against an occlusion, and a dottering action is thereafter provided whereby the arcuate distal end of the guidewire repeatedly impinges on the occlusion until penetration of the occlusion occurs.

Abstract: An atherectomy catheter device includes an improved guidewire system including a guidewire port member secured to the distal tip portion of the outer tubular member of an atherectomy catheter of the coaxial type having large and small concentrically disposed elongated flexible tubular members with a rotating cutter member fixed to the distal end of the inner tubular member. The guidewire is spaced from the cutter head yet controls the cutter disposition relative to the vessel lumen of interest. The inner and outer tubular members are constructed to simultaneously provide flushing liquid and aspirate the cutting site. A method of using the improved catheter is also disclosed.

Abstract: An atherectomy catheter is provided with an improved high speed rotating cutting head is disclosed in which the cutting head has a generally oval-shaped nose portion which includes a plurality of radially disposed excising openings extending along and rearward from a point near the center of the nose. The openings are elongated but do not extend beyond the elliptical portion of reduced diameter, and, therefore, do not damage the lining of the vessel involved.

Abstract: A handle device for an endoscope incorporates controls for adjusting the degree of curvature of the distal tip portion of the endoscope as well as the degree of extension of the surgical instrument beyond the distal end of the endoscope's working lumen. The handle member comprises a generally hollow body which is dimensioned to be readily grasped by the surgeon and it incorporates a thumb-slide having a ratchet surface thereon, the thumb-slide being joined to a pull-wire extending the length of the endoscope and fastened at its distal end to the body of the endoscope. By depressing and longitudinally sliding the thumb-slide, the curvature of the distal end of the steerable endoscope is controlled. The degree of extension of the working instrument beyond the distal end of the working lumen is controlled by a rotatable threaded rod which is designed to produce only translational motion to the instrument without any twisting thereof.

Abstract: An improved endoscope having a flexible tip portion with both a selectable angle of deflection, and a selectable radius of curvature to provide a more maneuverable endoscope for use by a physician. It includes a body member receiving a rigid tube within a lumen thereof. The tube extends toward, but short of the distal end of the body member to define a deflectable tip portion. A pull-wire is positioned within the rigid tube and lumen and extends from the body member's proximal end to the body member's distal end. By selectively retracting the pull-wire in the proximal direction, the distal end of the flexible tip portion is deflected about the distal end of the rigid tube. In an alternative embodiment of the invention, a second rigid tube is telescopingly received within the first rigid tube. The second tube is selectively extendable beyond the distal end of the first rigid tube into the lumen of the body member.

Abstract: To facilitate certain surgical procedures, a flexible endoscope may more readily be passed through body vessels and tubular organs, especially when those organs assume a tortuous path. However, a difficulty arises in steering a flexible endoscope through internal body orifices. In accordance with the present invention, a rigid introducer is used in combination with the flexible endoscope to facilitate targeting of such an orifice and once the distal end of the introducer is made to enter the orifice, the flexible endoscope can be advanced through the introducer and there beyond to the point in the body where an item of interest is to be viewed.

Abstract: The guide catheter system for use in the treatment of coronary artery disease includes a first single-lumen catheter of a relatively large internal diameter to pass a second guide catheter therethrough. The first guide catheter comprises an elongated flexible tube having a stainless steel braid embedded in the wall thereof for imparting desired torqueability characteristics to it. The first guide catheter is intended to be inserted at an appropriate point in the vascular system and then advanced until its distal end reaches the coronary ostium. The second guide catheter is fabricated by extruding a plastic, such as polyurethane thermoplastic resin over a tubular Teflon.RTM. core and because it is to be used within the lumen of the first catheter, it need not include a braided structure within its walls to prevent it from kinking.

Abstract: A catheter assembly especially designed for the performance of atherectomy procedures which include an elongated flexible plastic tube which can be routed through the vascular system to the location of the atheroma to be removed and a working catheter insertable through the guide catheter in the form of an elongated flexible plastic tube having a series of fibers integrally formed with or otherwise attached to the distal end portion of the working catheter and normally laying flat against the wall of the catheter. The proximal end of the working catheter is adapted for connection to a high speed motor whereby the working catheter can be rotated relative to the surrounding guide catheter.

Abstract: An intravascular catheter designed to apply a liquid medicament or other substance to a stenotic lesion as the blood vessel is undergoing dilatation to facilitate the restoration and long-term maintenance of patency to the blood vessel. It comprises three concentrically arranged flexible plastic tubes and a pair of concentrically arranged expander members located at the distal end of the tubes. The space between the outer wall of the inner tube and the inner wall of the intermediate tube is in fluid communication with the interior of the first expander member while the space between the outer wall of the intermediate tube and the inner wall of the outer tube is in fluid communication with the interior of the second expander member.

Abstract: A catheter for facilitating the exchange of guidewires during the course of a transluminal angioplasty or related procedure which comprises an elongated, flexible, tubular member having at least one lumen running the full length thereof from its proximal end to its distal end and which at least three apertures or ports extending through the wall thereof at longitudinally spaced locations near the distal end of the tubular member. These ports communicate with the lumen of the tubular member and a longitudinal slit is also provided through the wall of the tubular member connecting the most proximal port to the next proximal port. The exchange catheter may also include a proximal hub connected to the proximal end of the elongated plastic tube.

Abstract: A catheter for facilitating the exchange of guidewires during the course of a transluminal angioplasty or related procedure which comprises an elongated, flexible, tubular member having at least one lumen running the full length thereof from its proximal end to its distal end and with at least three apertures or ports extending through the wall thereof at longitudinally spaced locations near the distal end of the tubular member. These ports communicate with the lumen of the tubular member and a longitudinal slit is also provided through the wall of the tubular member connecting the most proximal port to the next proximal port. The exchanger catheter may also include a proximal hub connected to the proximal end of the elongated plastic tube.

Abstract: A blood pressure monitoring catheter for use in a Monorail.TM. intravascular system for measuring the pressure gradient across a stenotic lesion. It comprises an elongated, flexible, plastic, extruded, tubular member having a guidewire port extending through the wall thereof a short distance proximal to the distal end of the tubular member to intersect with a lumen which extends to the distal end. The second lumen runs the entire length of the tubular member from its distal end to its proximal end. The proximal end of the blood pressure monitor catheter is fitted to a molded plastic hub to facilitate the attachment of the catheter to the blood pressure measuring apparatus with which the catheter is to be used.

Abstract: A hand-operated inflator device for inflating the expander on a balloon-type catheter. It comprises a molded plastic housing for retaining a syringe tube therein for containing an inflation fluid. The housing also includes an internally threaded surface. A syringe plunger having an internal longitudinal bore and a longitudinal slot formed through the wall thereof has a piston mounted on the distal end for insertion into the syringe body. Fitted into the longitudinal slot is an externally threaded member which can be raised and lowered in a radial direction by manipulation of a manuable actuable means positioned in the longitudinal bore of the plunger. When the externally threaded member is raised, its teeth mesh with the teeth on the internally threaded annular surface of the housing, but when lowered, the threaded surfaces are disengaged. When the two are engaged, the piston is advanced in the syringe tube by rotating the plunger.

Abstract: A method of attaching a plastic hub member to the proximal end of a Teflon-lined thermoplastic tubular catheter so as to prevent delamination of the Teflon lining at the site of the attachment. The thermoplastic outer layer of the tubular catheter is removed in a grinding operation for a predetermined distance from the proximal end of the tube to expose a short length of the Teflon lining. Next, a spinning forming tool is forced against the proximal end of the tubular catheter causing the exposed Teflon lining to be rolled back over the outer surface of the thermoplastic tube. Next, the proximal end of the catheter is inserted into the bore of the hub and because the Teflon layer has been rolled over the end portion of the tubular catheter, it is trapped against an internal flange formed in the catheter hub when the hub is adhesively bonded to the exterior of the thermoplastic layer and prevented from delaminating and possibly occluding the lumen of the catheter.