Abstract: Devices, systems, and methods can articulate catheters and other tools using fluid drive systems that provide robotically coordinated motion. The drive power will often be transmitted from a fluidic driver to the catheter through a series of pneumatic or hydraulic channels and the driver can be isolated from a sterile field by encasing the driver in a sterile housing and directing drive fluid through a sterile junction between the catheter and driver. Interventional physicians can retain tactile feedback by manually advancing the catheter over a wire or the like, and can subsequently bring an interface of the catheter down into engagement with a corresponding driver interface once a therapeutic tool approaches a target site. A sensor may provide signals during manual advancement of the driver and catheter along the catheter axis.

Abstract: Devices, systems, and methods for articulating elongate flexible structures such as catheters optionally include an array of fluid-expandable bodies such as balloons. The array can be formed using separate strings of balloons formed along single-lumen balloon tube material. The balloon strings can be twisted together to form a multi-channel bundle, or the balloon strings may be circumferentially separated, each extending axially. Regardless, the balloons along a common lumen may be aligned so as to bend the catheter in a desired lateral direction. The fluid-expandable bodies may include an elastomeric bladder with a fiber braid so that inflation of the bladder shortens the assembly and applies axial tension to articulate the catheter. The elongate flexible structures may be pre-biased so as to form a bend when in a relaxed configuration, with the structures being articulatable from the bend.

Abstract: Articulation devices, such as comprising pull rings, are provided having improved or increased visibility under conventional visualization techniques, such as fluoroscopy. Such improved visibility is achieved by the presence of at least one insert comprised of a material that is more visible or detectable under imaging techniques than the pull ring. The at least one insert is positionable within a cut-out in the articulation device and fixed into place by a suitable method such as adhesive, soldering, swaging, welding, laser welding, etc. The insert resides within the dimensions of the walls of the pull ring so as to not increase the outer diameter or decrease the inner diameter of the pull ring. This maintains the profile of the overall articulation device.

Abstract: Articulation devices, such as comprising pull rings, are provided having improved or increased visibility under conventional visualization techniques, such as fluoroscopy. Such improved visibility is achieved by the presence of at least one insert comprised of a material that is more visible or detectable under imaging techniques than the pull ring. The at least one insert is positionable within a cut-out in the articulation device and fixed into place by a suitable method such as adhesive, soldering, swaging, welding, laser welding, etc. The insert resides within the dimensions of the walls of the pull ring so as to not increase the outer diameter or decrease the inner diameter of the pull ring. This maintains the profile of the overall articulation device.

Abstract: An intraluminal grafting system having a delivery catheter comprising a flexible elongate tubular member having proximal and distal extremities and a capsule mounted on the distal extremity of the tubular member and including a graft disposed within the capsule. The graft is comprised of a tubular body configured to be secured to a blood vessel by a self expanding attachment system. The attachment system comprises a generally sinusoidal wire frame having apices which extend longitudinally outward from the end of the tubular body apices which are secured within the tubular body. Both the protruding apices and the base apices are formed with helices which bias the attachment system radially outward. The attachment system further includes a plurality of lumen piercing members that are oriented in a responsive relationship to the radially outward bias of the attachment system.

Abstract: An apparatus for repairing a vessel using a multicapsule catheter having first, second and third capsules for releasably retaining each terminal end of a bifurcated graft. The method for repairing the vessel includes the steps of performing a surgical technique to gain remote access to the vessel, advancing the multicapsule catheter within the vessel and releasing the bifurcated graft within the vessel to thereby repair the vessel.

Abstract: An intraluminal grafting system having a delivery catheter comprising a flexible elongate tubular member having proximal and distal extremities and a capsule mounted on the distal extremity of the tubular member and including a graft disposed within the capsule. The graft is comprised of a tubular body configured to be secured to a blood vessel by a self expanding attachment system. The attachment system comprises a generally sinusoidal wire frame having apices which extend longitudinally outward from the end of the tubular body apices which are secured within the tubular body. Both the protruding apices and the base apices are formed with helices which bias the attachment system radially outward. The attachment system further includes a plurality of lumen piercing members that are oriented in a responsive relationship to the radially outward bias of the attachment system.

Abstract: An intraluminal grafting system having a delivery catheter comprising a flexible elongate tubular member having proximal and distal extremities and a capsule mounted on the distal extremity of the tubular member and including a graft disposed within the capsule. The graft is comprised of a tubular body configured to be secured to a blood vessel by a self expanding attachment system. The attachment system comprises a generally sinusoidal wire frame having apices which extend longitudinally outward from the end of the tubular body apices which are secured within the tubular body. Both the protruding apices and the base apices are formed with helices which bias the attachment system radially outward. The attachment system further includes a plurality of lumen piercing members that are oriented in a responsive relationship to the radially outward bias of the attachment system.

Abstract: An apparatus for repairing a vessel using a multicapsule catheter having first, second and third capsules for releasably retaining each terminal end of a bifurcated graft. The method for repairing the vessel includes the steps of performing a surgical technique to gain remote access to the vessel, advancing the multicapsule catheter within the vessel and releasing the bifurcated graft within the vessel to thereby repair the vessel.

Abstract: A removable supplementary hitch pivots into operational position on a trailer tongue in concert with a primary trailer hitch of the dependent vehicle used in pulling the trailer. The secondary hitch includes at least one additional hitch between the trailing vehicle and the dependent vehicle. Another additional hitch is also commonly provided resulting in an additional hitch on either side of the primary hitch. To introduce a measure of tolerance to breaking the connection through unwanted turning of the power vehicle after the secondary hitch is attached between the vehicles, the connection between the bar and the channel may comprise a flexible spring connection that allows the bar to move off parallel to the channel in absorbing unwanted turning forces while biasing the bar to return to its parallel position.

Abstract: The present invention relates to a guidewire having a shaped three dimensional guide section. In the preferred embodiment the guide section is helical, and exerts an outward radial force on a lumen the guidewire is constrained in. The outward radial force can be measured or calculated according to methods of the present invention. Also described is a system comprising a guidewire and catheter where the force of the catheter exerts on a body lumen can also be calculated. Apparatus and methods of making the guidewire are also disclosed, as well as alternative embodiments of the guidewire.

Abstract: An integrated blood oxygenation and pump system suitable for use in a sterile field having a low priming volume is provided in which a blood oxygenator portion of the system includes an active element, separate from the pump, that disrupts the development of laminar flow and stagnation zones in the fiber bundle employed for gas exchange. The integrated system enables the pump and oxygenator to be used independently of one another or be rapidly reconfigured to provide both pumping action and blood oxygenation.

Abstract: An integrated blood oxygenation and pump system suitable for use in a sterile field having a low priming volume is provided in which a blood oxygenator portion of the system includes an active element, separate from the pump, that disrupts the development of laminar flow and stagnation zones in the fiber bundle employed for gas exchange. The integrated system enables the pump and oxygenator to be used independently of one another or be rapidly reconfigured to provide both pumping action and blood oxygenation.

Abstract: The present invention relates to a guidewire having a shaped three dimensional guide section. In the preferred embodiment the guide section is helical, and exerts an outward radial force on a lumen the guidewire is constrained in. The outward radial force can be measured or calculated according to methods of the present invention. Also described is a system comprising a guidewire and catheter where the force the catheter exerts on a body lumen can also be calculated. Apparatus and methods of making the guidewire are also disclosed, as well as alternative embodiments of the guidewire.

Abstract: The present invention comprises a guidewire having a compressible guide section capable of deflecting a catheter to abut a lumen wall. The compressible guide section exerts an outward radial force while it is at least partially compressed within a lumen. The guide section permits a physician to precisely locate a catheter within a body lumen and adjust a catheter tip orientation to be directed to a particular side of a body lumen. A method is disclosed for properly matching a guidewire and a catheter to operate together in the present invention, along with a force measuring instrument to assist in measuring a catheter's resistance force value. This method and systems of the present invention involve determining the exact force relationship between the compressible guide section and the resistance of the catheter in vitro.

Abstract: Apparatus and methods for treating in-stent restenosis are described for removing stenotic material from within previously stented regions of a patient's vasculature. The apparatus includes a catheter system having a stenotic material removal mechanism mounted on a distal portion of an elongated inner catheter. A sensing means, such as one or more sensing electrodes, are positioned on an outer surface of the apparatus. In addition, the apparatus optionally includes control means for diametrically expanding the stenotic material removal mechanism for effective recanalization of the stent. A coaxial outer catheter is provided for aspirating stenotic material which is removed from within the stent. In addition, embolic filter apparatus are described for collecting the stenotic material removed from within the stent.

Abstract: Apparatus and methods for treating in-stent restenosis are described for removing stenotic material from within previously stented regions of a patient's vasculature. The apparatus includes a catheter system having a stenotic material removal mechanism mounted on a distal portion of an elongated inner catheter. A sensing means, such as one or more sensing electrodes, are positioned on an outer surface of the apparatus. In addition, the apparatus optionally includes control means for diametrically expanding the stenotic material removal mechanism for effective recanalization of the stent. A coaxial outer catheter is provided for aspirating stenotic material which is removed from within the stent. In addition, embolic filter apparatus are described for collecting the stenotic material removed from within the stent.

Abstract: An apparatus and method for repairing a vessel at a bifurcation using a multicapsule catheter having first, second and third capsules for releasably retaining each terminal end of a bifurcated graft. The method for repairing the vessel includes the steps of performing a surgical technique to gain remote access to the vessel, advancing the multicapsule catheter within the vessel and releasing the bifurcated graft within the vessel to thereby repair the vessel.

Abstract: An intraluminal grafting system having a delivery catheter comprising a flexible elongate tubular member having proximal and distal extremities and a capsule mounted on the distal extremity of the tubular member and including a graft disposed within the capsule. The graft is comprised of a tubular body configured to be secured to a blood vessel by a self expanding attachment system. The attachment system comprises a generally sinusoidal wire frame having apices which extend longitudinally outward from the end of the tubular body apices which are secured within the tubular body. Both the protruding apices and the base apices are formed with helices which bias the attachment system radially outward. The attachment system further includes a plurality of lumen piercing members that are oriented in a responsive relationship to the radially outward bias of the attachment system.

Abstract: Apparatus and methods are provided for restoring and maintaining an open passage or lumen in a body conduit, such as a blood vessel, which has become stenosed or occluded. The apparatus includes a stent which is specially adapted for inhibiting restenosis within the stent after implantation in a body passage. In various embodiments, the apparatus also includes a catheter or other device for operating the stent to inhibit restenosis within the stented region of the body passage. The methods presented include implanting the stent within a body passage, typically a blood vessel such as a coronary artery, which has become stenosed or occluded, and operating the stent to inhibit ingrowth of stenotic material which would result in restenosis of the stented region.