Abstract: A vascular interventional device may be introduced over a guidewire into a vessel of the cardiovascular system of a patient. This device includes a hollow, flexible tube having a proximal end and a distal end that is adapted to selectively engage a target vessel of the cardiovascular system of the patient. This tube also includes a lumen that is continuous from the proximal to the distal end, and has an end hole in the distal end that is in fluid communication with the lumen. The device also includes a hollow vessel dilator that is adapted for insertion into and through the tube and over the guidewire. The dilator has an inside diameter that is slightly larger than the guidewire and an outside diameter that is slightly smaller than the diameter of the lumen of the tube. The distal end of the dilator is adapted to accommodate vascular entry over the guidewire, and the dilator is adapted to dilate the vessel to accept the tube. The device also includes a hub at the proximal end of the tube.

Abstract: A percutaneous tissue removal apparatus having a flexible drill shaft, a cutting tip mounted on the shaft a power source for transmitting motion to the shaft to move the cutting tip against tissue and a suction source for removing tissue fragments along the shaft to a location outside the tissue mass while cutting. The apparatus may include a container for collecting one or more selected components of the harvested tissue fragments for implantation of the fragments preferably into the body of the patient from whom they were removed. Where the tissue to be cut is bone, a cutting tip is preferably made of a polymeric material which is softer than the cortical portion of the bone, although the cutting tip may be made of a ceramic or a composite material. A second flexible shaft may be provided either within or about the flexible drill shaft.

Abstract: The invention is directed to a device and method for minimally invasive access to the pericardial space of a human or animal patient. The disclosed pericardial access device includes a penetrating body axially mobile within the lumen of a guide tube. The distal end of the guide tube includes a shoulder to buttress pericardial tissue drawn into the guide tube by a suction force applied to the guide tube lumen. The penetrating body is subsequently distally advanced within the guide tube to access the pericardium.

Abstract: An endovascular device (1,100,200,300) having a distal end (2), a proximal end (4) and a body portion (3) therebetween. The body portion is made of a multiple filament helically wound row (A) of wires (5), provided with a sealing coating (14) on the inside surface or the outside surface or both. The device may be a catheter (1), a sheath, an introducer, a delivery device, a pusher (100), an embolization coil delivery device (300), or a receptacle (208) for an expandable prosthesis (220) used with a delivery device(200). From 2 to 12, and preferably from 4 to 8, wires (5) are used in the row, and fewer wires may be used proceeding toward the distal end (2) for greater flexibility. The helically wound row of wires transmits torque and provides pushability to the device while resisting kinking, and enables a small outside diameter for reaching very small vessels and extending through very tortuous vessels.

Abstract: Methods and devices relating to guidewires. In one embodiment, a distal tip portion of a guidewire comprises a first tip member and a second tip member. The first tip member has a first end, and a second end. The second tip member has a distal portion and a proximal portion. The first and second tip members are coupled together, preferably in an arrangement that can effect the flexibility of the guidewire at certain points along its length.

Abstract: The present invention provides a deflectable needle system for use in performing diagnostic or therapeutic medical procedures. The needle assembly of the invention provides access to physiological sites which may be inaccessible by prior art needle systems due to an obstruction. The deflectable needle assembly includes a telescoping cannula, catheter and stylet. The catheter component of the assembly is curved at its distal end and axially rotatable within the lumen of the cannula providing simple maneuverability for accurate placement of the catheter at a chosen physiological site.

Abstract: A catheter for delivery or retrieval of a medical device such as a filter 10 or a stent 16 has an outer shaft 1 with a pod 2 providing a medical device reception space at the distal end. An inner shaft 3 comprises a solid pod with a longitudinally extending surface pathway 4 for a guidewire 7. The inner shaft 3 defines an abutment surface 9 at its distal end for deployment of the device 10, 16. The outer shaft 1 has an exit port 8 at which the guidewire 7 exits the catheter in a rapid exchange manner.

Abstract: For creating a hole in body tissue and then enlarging the hole, a guidewire has a continuous diameter guidewire body having a proximal end and a distal end, a distal portion including an electrically conductive exposed tip for creating a perforation when RF current is applied and for preventing the creation of a perforation when RF current is not applied. For expanding the hole, a dilator region is provided between the distal end of the guidewire body and the distal portion for expanding the hole, and has a tapered profile. Also for expanding the hole, an inflatable balloon is located circumferentially on the guidewire body, and a catheter located on the guidewire body and in communication with the balloon for delivery of fluid to the balloon for its inflation.

Abstract: A single operator exchange biliary catheter having a common distal lumen. The biliary catheter includes an elongate shaft having a proximal portion defining an ancillary lumen and a distal portion defining a common guidewire and ancillary lumen. The common distal lumen reduces the profile of the distal portion of the shaft. The elongate shaft also includes a proximal guidewire port disposed between the proximal end of the shaft and the distal end of the shaft to facilitate single operator use. A seal may be disposed adjacent the proximal guidewire port to thereby seal the port. Preferably, the shaft includes a single lumen distal portion and a bitumen proximal portion. The single lumen distal portion of the shaft may be curved and may include a tapered or spherically shaped distal tip.

Abstract: A guidewire handle having a first substantially cylindrical portion and a second substantially cylindrical portion. The guidewire handle has a first aperture to receive a guidewire. A second aperture is located in the first cylindrical portion and the second cylindrical portion. The second aperture is configured to allow fluid to flow therethrough.

Abstract: A tubing assembly for manufacture for a catheter of the type having an inner tubular member defining a lumen, an outer tubular member surrounding said inner member, and a support member mounted between the tubular members to provide rigidity to the flexible catheter. The support member comprises a high tensile strength wire braid, and in the preferred embodiment comprises a stainless steel wire braid which has been tempered or hardened. This higher tensile strength affords significantly greater kink resistance to the flexible catheter. One wire braid has a tensile strength in the range of 300 to 425 kpsi and a braid density of approximately 40 pic. The high tensile strength wire braid has the disadvantage of tending to flare out at its free ends. Therefore, means are provided for preventing the flaring of the wire braid during manufacture of the tubing assembly. One means includes adhesive applied over the free ends. Another means includes a restraining sleeve applied over the free ends.

Abstract: A guide wire having an elongated core wire provided with a tabular distal end portion, and a coiled wire provided on an outer circumference of the core wire, wherein the distal end portion of the core wire is provided with a cutout section or a rased section so that a diametrical cross-sectional area of the distal end portion of the core wire gradually decreases toward a distal end thereof.

Abstract: An advancer for advancing a guide wire includes a distal portion having a passageway extending longitudinally therethrough. The distal portion is capable of straightening the guide wire. The advancer further includes a proximal portion having a passageway extending longitudinally therethrough and a central portion having first and second curved surface members which extend between the distal portion and the proximal portion. The curved surface members define an opening therebetween to provide access for a user's thumb and finger to advance a guide wire through the advancer. Also disclosed is a guide wire advancer assembly which includes the advancer and a guide wire storage tube. The tube has an outer diameter which is substantially the same as an inner diameter of the proximal portion and which has the guide wire enclosed within the storage tube.

Abstract: A catheter insertion device is provided that includes an insertion needle that is retractable into the device after use to prevent exposure to the contaminated needle. The needle retainer releasably retains the needle in an extended position against the bias of the biasing element. When the catheter is removed from the insertion device, the needle retainer automatically releases the needle, which is propelled rearwardly into the device. A device for inserting a guide wire into a patient is also provided. The device includes an insertion needle that is retractable into the housing of the device after use. A needle retainer releasably retains the needle in an extended position against the bias of the biasing element. The needle retainer engages the guide wire so that when the guide wire is removed from the insertion device, the needle retainer automatically releases the needle, which is propelled into the device.

Abstract: A medical apparatus assembly (10) comprises a medical device (11) that includes a side port assembly 13 adapted to combine a first pathway (37) for infusion of fluids with a second pathway (38) for wire guide (12) into a first passageway (26) while the second passageway (27) includes the third pathway (39), which comprises a control member (24), such as an electrical wire. The side port assembly is configured such that the first passageway communicates with both a first port (16), such as a fitting for connecting to a syringe, and a second port (15) which includes a sealing mechanism (32), such as a Tuohy-Borst fitting, thereby allowing the wire guide to be preloaded, instead of requiring it to be removed prior to infusing fluids. Optionally, a third port (43) may be included when external communication with the second passageway, is desired, such as balloons or baskets.

Abstract: A catheter (200) includes a spear shaped tip (130). In one embodiment, the spear shaped tip (130) is part of a spear shaped tip assembly (100) that includes a swivel assembly. The swivel assembly provides for improved trackability of the catheter (200) over a guide wire. The spear shaped tip catheter of the present invention can be designed in numerous configurations including over-the-wire and rapid exchange versions.

Abstract: A redirectional catheter apparatus 10 for inserting a conventional catheter 80 into a desired vascular access 201 wherein the redirectional catheter apparatus 10 includes a redirectional catheter member 20 having an elongated hollow stem 21 which includes a slightly tapered distal end 24, an enlarged proximal end 23, and a deflection flap 26 disposed proximate to, but spaced from, the distal end of the hollow stem 21 wherein the deflection flap 26 forms an aperture 25 in the sidewall 27 of the hollow stem 21 for directing a secondary guide wire 101 into the desired vascular access 201 so that the secondary guide wire 101 will eventually guide the conventional catheter 80 into the desired vascular access 201 and the method employed to accomplish that result.

Abstract: This invention relates to medical devices comprising melt-processible PTFE and methods of making same.

Abstract: A single operator exchange biliary catheter having a common distal lumen. The biliary catheter includes an elongate shaft having a proximal portion defining an ancillary lumen and a distal portion defining a common guidewire and ancillary lumen. The common distal lumen reduces the profile of the distal portion of the shaft. The elongate shaft also includes a proximal guidewire port disposed between the proximal end of the shaft and the distal end of the shaft to facilitate single operator use. A seal may be disposed adjacent the proximal guidewire port to thereby seal the port. Preferably, the shaft includes a single lumen distal portion and a bitumen proximal portion. The single lumen distal portion of the shaft may be curved and may include a tapered or spherically shaped distal tip.

Abstract: A catheter for the introduction into blood vessels having a lumen and guide means arranged therein wherein the guide means include a pre-bent wire (26) displaceable in the longitudinal direction of the catheter (10) and the catheter (10) has at its distal end an exit lock means (38) such that the pre-bent wire (26) can issue from the catheter (10) through the exit lock means (38) at the distal end.

Abstract: Total occlusions are crossed by passing a guidewire or other penetrating wire from a point proximal to the occlusion into a subintimal space between the intimal layer and adventitial layer of the blood vessel wall. The wire is advanced to a point distal to the occlusion and thereafter deflected back into the blood vessel lumen, typically using a deflecting catheter which is advanced over the guidewire after it has been positioned within the subintimal space. After the guidewire is returned to the blood vessel lumen, the deflecting catheter may be withdrawn and the guidewire is available for introduction of other interventional and diagnostic catheters.

Abstract: A medical guidewire comprised of an NiTi-based alloy having a high elasticity over a wide range of strain, excellent straightness, and preferable shape and characteristics of a stress-strain curve in a tensile test. The wire is obtained by applying a predetermined tension to a cold drawn NiTi-based alloy wire and mechanical straightening it under conditions of a predetermined torsional shear strain and temperature and shows superior pushability, torque transmission, and reinsertability as a medical guidewire, so is preferable for a catheter guidewire, endoscope guidewire, etc.

Abstract: A method and apparatus for treating Alzheimer's disease is disclosed. The method comprises delivering indomethacin or nonsteroidal anti-inflammatory agents having cyclooxygenase inhibitor action directly to the hippocampus or the lateral ventricle through an implanted catheter. The catheter has a flexible distal end that is implanted directly in the hippocampus or lateral ventricle as the preferred embodiment. The distal end has either a porous tip or a closed end. Where the distal end is closed, or a plurality of elution holes are present indomethacin is delivered to the hippocampus or lateral ventricle through either the porous tip or the elution holes.

Abstract: An apparatus for treating a patient. The apparatus includes a catheter having a distal end and a proximal end. The distal end has an orifice through which a fluid can flow. The distal end has a port through which the fluid can flow. The port is adjacent to but apart from the orifice. The apparatus includes a mechanism for controlling the size of the port that is open. The controlling mechanism is disposed over the port and able to close the port. An apparatus for treating a patient. The apparatus includes a catheter having a proximal end and a distal end having an orifice through which a fluid can flow. The distal end has an end marker disposed about the orifice which appears in an image of an imaging device. An apparatus for treating a patient. The apparatus includes a catheter having a proximal end and a distal end having an orifice through which fluid can flow. The catheter has an axis.

Abstract: A handle apparatus includes a handle body, a trolley member that may be secured to a steering wire, and a steering member operably connected to the trolley member. Rotation of the trolley member is prevented and rotation of the steering member axially repositions the trolley member and steering wire.

Abstract: A thrombolysis catheter system having a fixed length infusion zone is disclosed. The invention contemplates apparatus, method and kit aspects. The apparatus, which has the capability to track a guidewire, uses a multilumen catheter to deliver radially thrombolytic agent to an infusion zone defined by one or more balloon means. In one aspect, with an occluder means, a primary lumen of the catheter is used both for catheter placement and delivery of fluid. The method discloses utilization of radiopaque indicia to place the catheter in proximity to the occlusion or diseased tissue to be treated. The kit includes a catheter of the invention in conjunction with a steerable guidewire and a tip occluder wire, either or both of the tip occluder wire and the guidewire having an enlargement on their distal tip which cooperates with a reduced diameter portion of the catheter lumen.

Abstract: Various methods and apparatus are provided for aspirating emboli and other particles from the vasculature of a patient, particularly within saphenous vein grafts, coronary arteries, carotid arteries and similar vessels. One embodiment of an aspiration catheter is particularly well suited for delivery over a guidewire. Preferably, the guidewire is hollow and carries a distal occlusive device, and has a low profile to facilitate passage into small vessels. The aspiration catheter comprises an elongate body having a guidewire lumen positioned within an aspiration lumen, thereby providing a low profile catheter having a round cross-sectional shape. The aspiration lumen has an angled aspiration mouth which improves evacuation efficiency, and facilitates aspiration of larger particles within vessels. The angle of the aspiration mouth prevents suction between the mouth and the occlusive device, thereby reducing forced movement of the occlusive device while it is deployed during aspiration procedures.

Abstract: An apparatus for steering a guidewire and for connecting the guidewire to an extension guidewire. The apparatus includes a steering device for gripping an exterior of the guidewire, the steering device defining a passageway therein through which the guidewire may pass; and a connecting device for connecting the guidewire to the extension guidewire. The connecting device is configured for mating with the steering device to form an integral unit. The invention further includes a method of inserting a guidewire in a body and connecting the guidewire to an extension guidewire.

Abstract: The present invention is directed toward an improved catheter introducer needle capable of introducing a catheter into a body at a deflection angle in the range of 40-75° from the axis of the needle. This invention provides for a continuous perineural placement of a catheter. The present invention is also directed toward an introducer needle/catheter system comprising the needle of the present invention and a catheter extending through the needle such that it extends out beyond the tip of the needle at an angle of deflection in the range of 30-75° from the axis defined by the catheter within the main channel of the needle. This invention is useful in delivering pharmacological agents, such as local anesthetics, to nerves in various regions of the body including, but not limited to, the arms and shoulders.

Abstract: An apparatus for extracting an obstruction located in a patient's vessel by fragmenting the obstruction and conveying fragments of the obstruction through the apparatus and out of the patient's body, comprising a flexible-tube, having an open distal end, and connectable to a negative pressure. A motor-rotated, flexible, spiral conveyor-shaft disposed in the flexible tube conveys the obstruction fragments, cooperatively with the negative pressure, through the flexible tube. An offset agitator is connected to and is rotated by the flexible conveyor-shaft to fragment the obstruction. The offset-agitator can be moved in and out of the flexible tube, through the open distal end, to adjust its effective diameter.

Abstract: An emboli filtration apparatus is provided comprising a guide wire having a filter element captured thereon, so that the guide wire is free to rotate or translate while the filter element remains stationary. The apparatus allows for movement and rotation of the guide wire as devices are advanced over it to treat occlusive disease, substantially without dislodging the filter element.

Abstract: Methods and apparatuses for sterlizng a catheter. In one exemplary embodiment, the apparatus comprises a UV radiation source, a catheter having a lumen which is surrounded by the catheter's wall, and a fiber optic cable that is coupled to a UV radiation source. The fiber optic cable is disposed within the catheter's lumen and is capable of emitting UV radiation through the fiber optic cable's wall. In another exemplary embodiment, the apparatus described above further comprises an insertion tube having two separate paths, one path for a fluid source, and one path for a fiber optic cable. The fiber optic cable in one embodiment can easily be inserted when sterilization is needed and simply removed when completed without modification to existing catheter connections and components.

Abstract: A catheter guidewire includes an elongate solid body about which a catheter may be threaded for guidance to a target location in a vasculature passageway of a body. The elongate body includes a proximal end and a distal end, with the distal end being curved. Cuts are formed either by saw-cutting, laser cutting or etching at spaced-apart locations along the length of the body to increase its lateral flexibility. Integral beams are also formed within the body to maintain its torsional strength. The relative location and size of cuts and beams may be selectively adjusted so as to control the direction and degree of flexure, and the change in torsional stiffness relative to flexibility.

Abstract: A catheter system and corresponding methods are provided for accessing a blood vessel true lumen from a sub-intimal plane of the vessel. The catheter system includes visualization elements for determining the orientation of the true lumen with respect to the sub-intimal plane at an identified entry site from a position in the sub-intimal plane. The entry site is distal to a chronic total occlusion (CTO). The catheter system also includes a system for physically securing tissue of the sub-intimal plane at the entry site to the catheter system. The attaching system reduces or eliminates catheter float within the sub-intimal space. The catheter system further includes re-entry devices to establish and maintain a path from the sub-intimal plane back into the vessel true lumen.

Abstract: A peritoneal dialysis catheter for insertion into the abdominal cavity of a patient for delivering and withdrawing fluid from a patient comprising a catheter body having a proximal portion, a distal tip portion and a first longitudinally extending lumen configured to deliver fluid into the abdominal cavity. First and second side openings are formed in an outer wall of the catheter body adjacent the distal tip portion and are in fluid communication with the first lumen and configured for passage of fluid therethrough. A stiffening insert is positioned in the distal tip portion and has a first stiffness greater than a second stiffness of the distal tip portion to facilitate entry into the abdominal cavity. The stiffening insert has a lumen therethrough communicating with the first lumen. A method for insertion of the dialysis catheter is also disclosed.

Abstract: The present invention provides for a catheter assembly for implanting cellular pellets into diseased or damaged heart muscle tissue. A guiding catheter is accurately positioned within either the left or right ventricle by means of an anchor wire so that a seeding catheter can distribute a pattern of cellular pellets into the diseased heart muscle tissue to stimulate heart muscle growth or angiogenesis.

Abstract: Apparatus, systems, methods, and kits are provided for isolating a target lung segment and treating that segment, usually by drug delivery or lavage. The systems include at least a lobar or sub-lobar isolation catheter which is introduced beyond a second lung bifurcation (i.e., beyond the first bifurcation in a lobe of the lung) and which can occlude a bronchial passage at that point. An inner catheter is usually introduced through the isolation catheter and used in cooperation with the isolation catheter for delivering and/or removing drugs or washing liquids from the isolated lung region. Optionally, the inner catheter will also have an occluding member near its distal end for further isolation of a target region within the lung.

Abstract: The present invention is directed to an active handle assembly for use in a bidirectional steerable surgical instrument having a deflectable distal end. Typically, the surgical instrument includes a handle component which the user manipulates to cause a distal end of the instrument to deflect. The distal end comprises an end tip portion of a shaft which extends outwardly from the handle. A control mechanism is disposed within the handle and extends through the shaft for selectively controlling the direction and degree of deflection at the distal end. For example, one exemplary control mechanism uses control or steering wires to deflect the distal end. The active counterforce mechanism according to the present invention is designed to be used in combination with the control mechanism and provides a force which counters the return to center force generated by the deflection of the shaft at the distal end thereof.

Abstract: This invention comprises a guidewire with a tenacious lubricious coating on its surface comprising a finely divided lubricious particulate. The coatings of this invention have a thickness of not more than about 0.00002 inch, a coefficient of friction of not more than about 0.030 and a hardness not less than about 1.0 Mohs. Preferably, the surface coating comprises a monomolecular layer of particulate tungsten disulfide. The guidewire of this invention incorporates an improved distal tip configuration comprising a flexible elongate core member which has at least one tapered section at its distal extremity and a flattened distal portion. The distal portion has two or more flattened regions having cross-sectional areas which decrease in the distal direction. A flexible helical coil is attached to the core member and comprises three or more distinct regions, each having increasing coil spacing in the distal direction.

Abstract: The catheter of the present invention includes a tube-shaped catheter main body, a shaping member provided at least at the front end portion of the catheter main body such that the shaping member can impart a winding shape to the front end portion of the catheter, and a cavity portion formed at the inner side of the shaping member.

Abstract: The non-surgical method of installing a subcutaneously tunneled semipermanent catheter through the skin and into a central vein which utilizes an introducer catheter which has a pair of proximal ports, distal port, and an intermediate port located between the proximal ports and the distal port. The distal section of the introducer catheter is to be positioned within the central vein and the intermediate port is positioned exterior of but directly adjacent the vein and under the skin. A guide wire redirecting catheter is inserted into the introducer catheter and engages with the intermediate port. A sharp tipped guide wire is inserted through the guide wire redirecting catheter and is discharged from the redirecting catheter and travels subcutaneously some distance before penetrating the skin. The portion of the sharp tipped guide wire within the introducer catheter is then prolapsed into the distal portion of the introducer catheter.

Abstract: Disclosed is a medical apparatus assembly (10) comprising a medical device (11) that includes a side port assembly 13 adapted to combine a first pathway (37) for infusion of fluids with a second pathway (38) for wire guide (12) into a first passageway (26) while the second passageway (27) includes the third pathway (39), which comprises a control member (24), such as an electrical wire. The side port assembly is configured such that the first passageway communicates with both a first port (16), such as a fitting for connecting to a syringe, and a second port (15) which includes a sealing mechanism (32), such as a Tuohy-Borst fitting, thereby allowing the wire guide to be preloaded, instead of requiring it to be removed prior to infusing fluids. Optionally, a third port (43) may be included when external communication with the second passageway, is desired, such as balloons or baskets.

Abstract: A mechanical rapid exchange device is provided which plastically deforms a guidewire and constrains the guidewire in a non-linear configuration such that a catheter may be moved relatively proximally or distally over the guidewire to facilitate catheter exchange. The device generally includes a housing having a channel along a length of one side of the housing, a central first punch movable between a first position in which the first punch is located substantially to one side of the channel and a second position in which it extends at least partially into the channel, lateral second and third punches movable between a respective first position in which they are located to the other side of the channel and a respective second position in which they extend at least partially into the channel. The device also includes a handle attached via levers to the second and third punches such that when the handle is actuated, the second and third punches are moved into the second position.

Abstract: The present invention is a device for insertion into a human or animal body, in a preferred embodiment a perfusion guidewire capable of delivering perfusion fluids to a vascular site while at the same time exhibiting handling characteristics associated with existing non-perfusion guidewires. Preferred embodiments include a perfusion guidewire which closely matches the dimensions and physical characteristics of standard guidewires. Preferred embodiments also permit high pressure perfusion of oxygen-supersaturated solutions, and include a diffuser segment which divides the flow and reduces fluid velocity, thereby providing an a traumatic, non-cavitating, bubble-free delivery to the patient. The invention also encompasses the attachment of a core wire within a tubular housing to provide superior characteristics to such guidewires, balloon catheters and similar devices.

Abstract: An over-the-wire balloon dilatation catheter has a stainless steel hypotube catheter shaft, an intermediate sleeve section bonded to the shaft and a distal balloon section connected to the sleeve section. The sleeve section is forced from relatively flexible polymer materials and includes an inner core tube which defines a guide wire lumen extending only through a distal portion of the catheter (including its sleeve and balloon sections) to facilitate fast balloon catheter exchanges. A distal end of the hypotube shaft is crimped laterally and the core tube is nested and bonded within the crimp to provide a proximal outlet for the guide wire lumen. The hypotube shaft provides an inflation lumen for the balloon, with the inflation lumen being continued as an annular inflation lumen through the sleeve section where an outer sleeve is bonded about the core tube and extends from the distal end of the hypotube shaft to the balloon section.

Abstract: A device is disclosed for withdrawing a catheter or a probe from a body cavity or a body vessel with a drive which preferably is a friction drive and engages the axially movable part of the catheter. The drive is formed by at least one roller which is mounted for rotation around a shaft extending transversely to the direction of pull, which roller cooperates with at least one spring-loaded counter-roller, the rollers enclosing the catheter or the probe, with at least one roller being connected to a driving motor.

Abstract: A transvascular system for delivering a drug to a tissue region from a blood vessel, such as a coronary vein, includes a catheter having a distal portion with puncturing, orientation, drug delivery, and imaging elements. The puncturing element is deployable for penetrating the vessel wall to access the tissue region. The orientation element, e.g. a “cage” including a plurality of struts and/or a radiopaque marker, has a predetermined relationship with the puncturing element, the imaging element detecting the location of the orientation element with respect to the tissue region to orient the puncturing element. The catheter is percutaneously introducing into the vessel, the puncturing element is oriented towards the tissue region, the puncturing element is deployed to access the tissue region, and the drug is delivered to the tissue region.

Abstract: An apparatus for steering a guidewire and for connecting the guidewire to an extension guidewire. The apparatus includes a steering device for gripping an exterior of the guidewire, the steering device defining a passageway therein through which the guidewire may pass; and a connecting device for connecting the guidewire to the extension guidewire. The connecting device is configured for mating with the steering device to form an integral unit. The invention further includes a method of inserting a guidewire in a body and connecting the guidewire to an extension guidewire.

Abstract: The filter device captures embolic material in a blood vessel and is placed in the blood vessel via a guide wire. The guide wire has a proximal end, a distal end and a stop near its distal end. The filter device includes an expandable frame of frame struts having a closed, radially compact form and an open, radially expanded form. The frame, in the radially expanded form, has frame struts forming a pair of facing frustoconical frame structures. Filter material is attached to one of the pair of frustoconical frame structures. In one embodiment, the filter material is a perforated membrane. The guide wire extends through the expandable frame and the expandable frame is freely movable over the guide wire (likewise, the guide wire is freely movable within the frame), both rotatably and longitudinally, except distally beyond the stop near the distal end of the guide wire.

Abstract: A cannula has a distal portion which is angled relative to a proximal portion. The distal portion is straightened during introduction with a stiffening element. After introduction, the stiffening element is removed so that the distal portion angulates relative to the proximal portion so that the cannula can be moved out of the surgical field. The cannula preferably includes a stabilizing ring having suture holders. The stabilizing ring is also preferably angled relative to the cannula.