Abstract: The present invention contemplates the use of a grafted stent having predetermined and sized lateral openings for the treatment of arterial disease at or around the intersection of multiple arteries, thereby ensuring blood flow through such arteries to collateral organs. In particular, the point of intersection of the arteries to be treated is determined and the lateral openings are interposed within the stent and appended graft and the stented graft is positioned precisely at a premeasured point whereby the intersection of the arteries coincides with the lateral openings of the stented graft. The method and apparatus of the present invention further includes securing the lateral openings of the stented graft against a portion of the walls of the intersection point to guard against leaking or improper fit.

Abstract: A method for predicting the presence of deep venous thrombosis in a patient comprises measuring the concentration of soluble tumor necrosis factor receptor-1 (p55) in the patient's urine and comparing the measured concentration to an established baseline concentration. A concentration in the patient's urine greater than the established baseline concentration is predictive of the presence of deep venous thrombosis.

Abstract: The present invention comprises an apparatus and a method for harvesting veins. The apparatus includes an elongate member, a set of prongs disposed at the end of the member, a light carrying system for positioning the apparatus, and a triggering mechanism for opening and closing the prongs such that a vein can be dissected from surrounding tissue with minimal intrusiveness and minimal chance of damaging the surrounding tissue. Once the vein has been separated from the surrounding tissue by the apparatus, a vein dissector having an inflatable cover at the end is placed around the vein from the posterior and inflated and deflated to gently dissect the vein.

Abstract: The present invention relates to an apparatus for removal of a clot from a blood vessel comprising, an embolectomy catheter, one or more sheath introducers disposed within the embolectomy catheter, two removal devices moveably engaged within the sheath introducers, and a balloon catheter with an inflatable/deflatable balloon. Each removal device has a flexible rod and a racquet shaped head integral therewith. Each head has an attached basket for retaining the clot. Each head also has a wire extending from its distal end to the proximal end of the flexible rod for manipulation of the head during capture of the clot.

Abstract: An apparatus for engrafting a blood vessel comprising: a plurality of strings, a tubular graft having a central lumen, wherein the plurality of strings are removably attached to the tubular graft, the graft is removably positioned at least partially within a restraining means, such as a sheath introducer, a guide wire with an attachment means for attachment of the plurality of strings, one or more stents for deployment within the graft, and a means for deploying the stents within the graft.

Abstract: A method and apparatus for percutaneous arterial closure with staples. The apparatus comprises a triple lumen catheter, two j-shaped guide wires, a vascular stapler, and a tubular member. The method and apparatus provide for closure of arterial punctures that are typically created during catheterization. The method and apparatus provide a percutaneous method that reduces the likelihood of bleeding and the formation of false aneurysms. The method comprises inserting the triple lumen catheter in the arterial opening to deploy a pair of guide wires having projections at the end. The catheter is removed and the projections on the end of the guide wires are engaged with the arterial wall around the opening. The guide wires are then twisted to close the opening. Next, a stapler is moved down the guide wires to the site of the opening where staples are inserted to close the opening. Then, the tubular member slides over the guide wires and straightens the projections for removal from inside the artery.

Abstract: A method for predicting the presence of deep vein thrombosis in a patient comprises measuring the concentration of soluble tumor necrosis factor receptor-1 in the venous blood of the patient and comparing it to an established baseline concentration. A concentration in the patients venous blood higher than the established baseline concentration is predictive of the presence of deep vein thrombosis.

Abstract: A bag apparatus for warming the splanchnic blood supply of a patient both during and after surgery to prevent the onset of hypothermia. A bag apparatus for selectively warming an internal organ. A method to prevent hypothermia in a patient during and after surgical procedures. A heating pad apparatus for warming the splanchnic blood supply in a patient during and after surgery, and methodology for accomplishing same.

Abstract: The present invention is comprised of an apparatus for stapling graft material to a vessel wall comprising a stapling device, a balloon catheter, a sheath, and an inflation means.

Abstract: Transfemoral aortic valve replacement with the simultaneous insertion of an aortic arch graft, referred to as "TAVAG", is effected with a device comprising the following components: a U-shaped collapsible nitinol ring which is attached to a bioprosthetic valve, a thin walled predetermined graft with branches, a perforated self-expandable carrier capsule having a large slit therein, diamond shaped guide wires, and a ring to control opening and closing of the carrier capsule. The graft and valve are pulled up from the left femoral artery toward the aortic arch by pulling on the guide wires which are threaded through catheters inserted in each of the bilateral carotid and subclavian arteries toward the left femoral artery. Cerebral circulation is also maintained from the right femoral artery through a novel balloon catheter placed inside the carotid artery.

Abstract: An apparatus and method for engrafting a blood vessel are disclosed. The apparatus includes a tubular graft having radially compressible annular spring portions for biasing proximal and distal ends of the graft into conforming fixed engagement with an interior surface of the vessel, with bifurcated and adjustable length embodiments being disclosed. Apparatus for deploying the graft includes an insertion catheter having a nitinol core wire, a controllable tip balloon at a remote end thereof for dilation and occlusion of the vessel, and a controllable graft balloon in the vicinity of the tip balloon for fixedly seating the spring portions into conformance with the interior surface of the vessel. A spool apparatus for adjusting or removing an improperly placed graft, and a micro-emboli filter tube, are usable with the deployment apparatus. A method of percutaneously implanting a graft, including a single-entry method for percutaneously implanting a bifurcated graft, are also disclosed.

Abstract: This invention relates to a method for the dissection of blood vessels, lymph nodes and other body organs from the surrounding tissue and to a novel balloon dissection instrument for use in the method. The dissection instrument comprises an elongated tube having at least one inflatable balloon attached around the outer wall of a distal portion of the tube. The method of dissecting a vein, such as the saphenous vein, involves severing of the vein at two sites, defining the length of vein to be dissected. The vein is then accessed by securing the severed end, for example by a thread attached thereto and passed through the lumen of the dissection instrument to serve as a controllable anchor. The distal end of the dissection instrument, with the balloon deflated, is placed over the free end of the vein so that the vein enters the lumen of the instrument and the distal end of the instrument is pressed between the outer layer of the vein, i.e., the adventitia, and the connected fascia.

Abstract: A method of treating arterial disease at the intersection of two arteries using both a graft and stent. The graft is placed at the intersection of two arteries by the use of a balloon catheter. A device is used to make an opening in the graft at a point corresponding to the intersection of the two arteries. A stent is inserted into the graft and through the graft opening; the stent having an attachment mechanism to attach one end of the stent to the opening in the graft whereby the flow of blood at the intersection of the arteries is ensured.

Abstract: A device for effecting myocardial perfusion is described. The described device comprises a plunger or catheter disposed within a capsule having bulbous members having appended thereto slit needles which are capable of perforating myocardium. The plunger is spring loaded and, when activated, causes the slit needles to emerge from the capsule and excise portions of the myocardium, so permitting perfusion at such sites. Perforation of the myocardium may also be affected by means of a laser beam directed through the luminia of the needle. Use of the described device eliminates long post open heart recovery, and permits patients to return to a productive life shortly after surgery.

Abstract: A method and apparatus for engrafting a blood vessel is disclosed. The apparatus includes a hollow tubular graft of a preselected cross section having a proximal and distal end containing compressable and expandable nitinol springs, and connecting bars to facilitate physical communication between both springs. Furthermore, the apparatus contains a transport and deployment member for delivering said hollow tublar graft to an engrafting site within a blood vessel. The transport and deployment apparatus is comprised of an insertion catheter having a graft balloon and a tip balloon, as well as multiple inner tracks for injection of fluid into said balloons and the blood vessel interior. The method includes transport and deployment of said graft, as well as non surgical movement and removal of said graft in the event of misplacement.

Abstract: An autogenous heart having a physiology similar to a native heart is formed from two muscle segments which are wrapped about a mold and divided to form four chambers. To form this heart, two segments of muscle are formed to surround a silastic balloon reinforced mold which permits gross formation of the heart. The silastic balloon is then deflated and withdrawn. The interior of the heart is subdivided; the four chambers are formed; and valves are emplaced in much the manner as in the native heart. A cardiac assist device formed from a single chamber is made in much the same manner. The cardiac assist device has a single exit vessel which is bifurcated so as to allow blood flow into the chamber as the muscle is relaxed and blood flow out of the chamber as the muscle is contracted. A further improvement over current cardiac assist devices is the use of a compression ring to occlude blood flow within the native vessel when the muscle is contracted.

Abstract: Cardiomyoplasty can be performed without significant incisions by using muscle segments as patches to reinforce the defective myocardium. This method involves the use of a dilator to form an opening within the diaphragm to provide an opening through which to pass the greater omentum. The greater omentum is partitioned and brought to the myocardium via the opening in the diaphragm to serve as an extra blood supply. Muscle segments are then used as patches on the defective myocardium by implacing them between the greater omentum and the myocardium. This method is accomplished through the use of a needle shaped myoplasty instrument for obtaining the muscle segments and a specially constructed dilator for forming an opening in the diaphragm.

Abstract: An improved intravascular device (20) is adapted for use in treating hypothermia in a patient. The improved device includes an elongated flexible catheter (21) having a distal end piece (26) arranged in spaced relation to a catheter main body portion (32). The distal end piece and catheter main body portions are joined by a wire stylet (33) and by a flexible wall portion (43). The stylet is adapted to be rotated relative to the catheter main body portion to selectively furl and unfurl the flexible wall portion. Once inserted into a patient blood vessel, a pump (25) is arranged to circulate heated fluid (e.g., heated saline solution) through communicating chambers (45,44) in heat exchange relation to blood flowing past the catheter. The pressure of fluid supplied by pump 25 may be caused to pulsate to prevent blood from clotting on the catheter.

Abstract: An inflatable balloon-type catheter (20) for use in performing an embolectomy, includes an elongated catheter (21) having a distal end (22) adapted to be inserted through an incision into a patient's blood vessel (V). A plurality of fingers (24) having first ends (25) are mounted on the distal marginal end portion of the catheter in circumferentially-spaced relation to one another. Each of the fingers has a second end (26) arranged farther from the catheter distal end than the finger first ends. Each of the fingers is configured as a leaf-spring and has an unbiased radius of curvature such that the finger second ends are normally spaced farther radially outwardly than the finger first ends. A balloon (28) surrounds the fingers and is operatively secured to the catheter so that the fingers are arranged with an inflatable chamber (29) defined between the catheter and the balloon.

Abstract: An improved valvulectome (10) is adapted for use in selectively excising the leaflets of a venous valve. The apparatus includes an elongated probe (11) having one tip end portion (12) adapted to be inserted generally longitudinally into a vein. An actuating rod (55) may be moved relative to the probe to selectively move a pair of blade members (45,46) between their respective fully-retracted positions, at which the blade cutting edges (51,51') will be concealed within the transverse profile or outline of the probe, and their outwardly-extending ready-to-cut positions. The probe has a lumen (38) for sensing the fluid pressure proximate the probe tip. The probe also has a piezoelectric sensor (29) for sensing and measuring the velocity of blood proximate the probe tip. In use, the probe is inserted into a vein, and pushed through a valve with the blades retracted. The blades are then extended radially, and the probe is pulled rearwardly to excise portions of the valve leaflets.