Abstract: Systems and methods for implanting an endovascular shunt in a patient is disclosed. The system having an expandable anchor configured for being deployed in a dural venous sinus of a patient at a location distal to a curved portion of a wall of an inferior petrosal sinus (IPS) of the patient; an elongate guide member coupled to, and extending proximally from, the anchor; a shunt delivery catheter having a first lumen configured to receive the guide member, and a second lumen extending between respective proximal and distal openings in the shunt delivery catheter, the shunt delivery catheter further having a penetrating element coupled to a distal end of the catheter; and the system further having a guard at least partially disposed over, and movable relative to, the penetrating element.

Abstract: An end effector for use by a surgeon to staple an anatomical structure of a patient during a surgical procedure includes an anvil and a cartridge. Each of the anvil and the cartridge has a face that is positionable on the anatomical structure. The anvil is coupled to the cartridge at first and second ends. The anvil is movable relative to the cartridge to define a first gap between the faces at the first ends that is different from a second gap between the faces at the second ends.

Abstract: Provided herein are methods and materials for improving arteriovenous fistula (AVF) maturation and/or maintaining AVF functionality. For example, methods and materials for using one or more senolytic agents to improve AVF maturation, to maintain AVF functionality, and/or to maintain the patency of an AVF are provided. Methods and materials for using one or more senolytic agents to maintain functionality and/or patency of a venous graft (e.g., a venous graft that bypasses an occluded artery) also are provided.

Abstract: An apparatus for delivering an implant to an eye using a ratchet drive. Some embodiments of an apparatus for delivering an implant to an eye may comprise a gear rack configured to be coupled to the implant, a forward gearwheel, an input gearwheel meshed with the forward gearwheel, an idler gearwheel meshed with the input gearwheel, and a reverse gearwheel meshed with the idler gearwheel. An actuation lever may be configured to rotate the input gearwheel. Some embodiments may additionally comprise a pivot arm that may be operable to selectively engage the forward gearwheel and the reverse gearwheel to the gear rack.

Abstract: Methods and devices that prevent stasis in the LAA by either increasing the flow through the LAA or by closing off or sealing the LAA. Increasing the flow is accomplished through shunts, flow diverters, agitators, or by increasing the size of the ostium. Closing off the LAA is accomplished using seals or by cinching the LAA.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to delivering a variable length stent within a patient. In one example, a stent may include a body comprising coils about a longitudinal axis of the stent and along the length of the stent between a proximal end and a distal end in a substantially helical pattern. The coils may define a lumen along the longitudinal axis through the center of the body. A distal tube may have a wall extending from the distal end of the body. A first aperture may extend through the wall of the distal tube into the lumen. A distal retention member may extend from the distal tube. A distal suture may have a mid-portion. The mid-portion may extend through the first aperture.

Abstract: Various exemplary methods, systems, and devices for joint to pump elevation level user interfaces, autocalibration for joint elevation, and joint pressure estimation are provided. In general, an arthroscopic pump can be configured to estimate fluid pressure at a surgical site, e.g., at a joint, to provide an accurate indication of fluid pressure to users. In an exemplary embodiment, the fluid pressure estimation is based on a fluid pressure measurement at the pump that is adjusted at the pump, e.g., by a processor at the pump that executes instructions stored in a memory at the pump, using one or more control algorithms that adjust for one or more factors, such as pressure loss in tubing and sheath through which fluid flows between the pump and the surgical site and elevation difference between the pump and the surgical site.

Abstract: Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device, tool, or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Some systems described here may be configured to cut or tear the trabecular meshwork with the body of an elongate member located within Schlemm's canal. Other tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.

Abstract: The present disclosure provides a fluidic device including (a) a first channel including a first inlet and a first outlet, (b) a second channel including a second inlet and a second outlet, wherein the second inlet of the second channel is in fluid communication with the first outlet of the first channel, and (c) a sensor positioned between the first outlet and the second inlet, wherein the sensor includes a sensor configured to deflect in response to a flow between the first channel and the second channel.

Abstract: A prosthetic heart valve and delivery system adapted to facilitate transapical or transfemoral implantation of a prosthetic heart valve, the delivery system comprising an elongated sheath or shaft have one or more loop stabilization wires adapted to circumscribe and crimp a metallic stent, the loop stabilization wires releasable with retraction of an engagement pin to expand the metallic stent and anchor the same in native tissue within the circulatory system of a patient.

Abstract: An apparatus for shunting blood includes a flow-indication chamber shaped to define an entry port and an exit port, and one or more moveable objects disposed within the flow-indication chamber and configured to move in response to a flowing of the blood from the entry port to the exit port. At least a portion of a wall of the flow-indication chamber is transparent so as to expose the moveable objects to sight. Other embodiments are also described.

Abstract: Implantable occlusion devices that include one or more flanges extending from a tubular body are disclosed. The flange or flanges may assist in retention of the device within a vessel, cavity, appendage, etc. At least one flange on the occlusion device may include a concave surface proximate one end of a body. Because of the shape of the flange, e.g., its concavity, the occlusion device may resist dislocation due to e.g., the forces generated within the left atrial appendage during atrial fibrillation.

Abstract: Described is a system for affecting intestinal microbial flora. The system includes an intestinal sleeve that is implanted in a patient and bypasses a section of the intestine; and probiotics, prebiotics or pharmacologic therapy used in combination with the intestinal sleeve. Also described are related methods.

Abstract: A mesh for repair/prevention of a parastomal hernia during ostomy treatment is disclosed. More specifically, a pre-molded mesh having a unique shape to provide support to the abdominal wall adjacent a stoma formed during an ostomy procedure to prevent/repair formation of a parastomal hernia is disclosed which also provides a clearance channel through which the bowel can pass in a manner that prevents collapse or obstruction of the exposed segment of the bowel.

Abstract: The present disclosure concerns embodiments of an implantable perfusion device that can be implanted in an injured blood vessel to control bleeding without occluding the vessel. In one specific implementation, the perfusion device can be implanted percutaneously into a patient's descending aorta to control bleeding at the site of a ruptured portion of the aorta (known as torso hemorrhage) while still allowing for the antegrade flow of blood from a location upstream of the ruptured portion of the aorta to a location downstream of the ruptured portion of the aorta. The perfusion device can be left inside the patient as the patient is transported to a medical facility where the injury can be repaired. Following repair of the vessel, the perfusion device can be withdrawn from the patient.

Abstract: Junction assemblies for joining intravenous (IV) devices to tubing are provided. A junction assembly includes a component connector and a shaped memory polymer (SMP) member formed of a shape changing material. The junction assembly allows movement of the tube along the component connector when the SMP member is in an expanded state and the junction assembly retains the tube securely against the component connector when the SMP member is in a contracted state. The shape changing material changes to one of the expanded state and the contracted state upon being subjected to an external stimuli. Methods of assembling junction assemblies are also provided.

Abstract: The present disclosure relates generally to stents, systems, and methods for anchoring devices within a body lumen by cooperation between the device and the body musculature. A device comprising an elongate tubular member may be deployed within a body lumen, where the body lumen includes a sphincter that regulates flow through the body lumen. The elongate tubular member includes a sleeve formed from a flexible membrane and one or more stents disposed at either or both ends of the sleeve. In some embodiments, the stents may be treatment stents configured to treat a portion of the body lumen. The elongate tubular member may be deployed within the body lumen such that the flexible membrane aligns with and moves in coordination with the sphincter, thereby increasing retention forces acting upon the elongate tubular member when the sphincter is closed to minimize treatment stent migration.

Abstract: Disclosed are devices and methods for delivering a sheet of tissue into the eye in such a way that damage to the tissue is minimized, damage to the eye during insertion and manipulation of the tissue is minimized, and the tissue is released and delivered in a precise and controlled fashion.

Abstract: A stent is disclosed that has an elongated body composed of a bioabsorbable polymer having a proximal end, a distal end, two open spiral channels formed on the exterior surface of the body to provide fluid communication between the proximal end and the distal end. The stent also has a central lumen open at the proximal and distal ends of the stent for the passage of a guide wire. A method for using the stent and a kit containing the stent are also disclosed.

Abstract: A disposable device for treating a condition of a ureter or kidney having a cylindrical body about 1-2 mm in diameter by about 5 to 10 mm in length and having a top and bottom end. The body is made of absorbent material that expands upon contact with pharmaceutical agent and bodily fluids and includes a string connected to the bottom end of the body for removing the device. The device can be used to treat a condition of the ureter or kidney by inserting into the ureter or kidney, delivering a pharmaceutical agent, and removing the device after it has been impregnated with fluid. The device can be included in a kit with an insertion device and/or appropriate pharmaceutical agents.

Abstract: The embodiments disclosed herein relate to a ureteral stent having two stent bodies and a tether. The stent can minimize or prevent migration of the device out of the bladder of the patient while also reducing patient discomfort associated with such stents.

Abstract: A surgical instrument comprising a first jaw, a second jaw rotatable relative to the first jaw, and a closure system for closing the second jaw is disclosed. The closure system comprises a multi-stage closure system. In at least one instance, the closure system comprises a first closure member which closes the second jaw quickly, but with low force, and a second closure member which closes the second jaw more slowly, but with a higher force.

Abstract: Methods and devices that prevent stasis in the LAA by either increasing the flow through the LAA or by closing off or sealing the LAA. Increasing the flow is accomplished through shunts, flow diverters, agitators, or by increasing the size of the ostium. Closing off the LAA is accomplished using seals or by cinching the LAA.

Abstract: Glaucoma treatment systems are disclosed. In various example, the glaucoma treatment systems include a body and a fluid conduit configured to facilitate an evacuation of fluid, such as aqueous humor, from a fluid-filled body cavity, such as an anterior chamber of an eye. In some examples, the fluid conduit is soft and compliant, and the glaucoma treatment system includes one or more stiffening members coupled with the fluid conduit to temporarily stiffen the fluid conduit and help aid in the delivery of the glaucoma treatment device. In some examples, the stiffening members are removable from the fluid conduit after the glaucoma treatment system has been implanted.

Abstract: Delivery devices, systems and methods are provided for inserting an implant into an eye. The delivery or inserter devices or systems can be used to dispose or implant an ocular stent or implant, such as a shunt, in communication with a suprachoroidal space of the eye. The implant can drain fluid from an anterior chamber of the eye to a physiologic outflow path of the eye, such as, the suprachoroidal space or other portion of the uveoscleral outflow path. The delivery or inserter devices or systems can be used in conjunction with other ocular surgery, for example, but not limited to, cataract surgery through a preformed corneal incision, or independently with the inserter configured to make a corneal incision. The implant can be preloaded with or within the inserter to advantageously provide a sterile, easy-to-use package for use by an operator.

Abstract: In general, medical sheath systems that include a curved support sheath are described. In one embodiment, the support sheath includes a curved tube includes a distal portion fixed in an orientation perpendicular to the proximal end during advancement of an interventional tool through the support sheath.

Abstract: An adjustable length medical device, such as a drainage stent, and delivery device for placing within the body, having an elongate tube and retention members at each end portion for anchoring the device in the body. The proximal portion of the device including the proximal retention member may be segmented in incremental portions so that the length of the device can be adjusted for placement.

Abstract: A method may include positioning a first device within an internal carotid artery of a subject and impeding antegrade blood flow in the internal carotid artery. Additionally, the method may include delivering a pharmaceutical agent through an external carotid artery for passage into an ophthalmic artery of the subject.

Abstract: Described here are systems and methods for accessing Schlemm's canal and for delivering an ocular device or fluid composition therein. The ocular devices may maintain the patency of Schlemm's canal without substantially interfering with transmural fluid flow across the canal. The fluid composition may be a viscoelastic fluid that is delivered into the canal to facilitate drainage of aqueous humor by disrupting the canal and surrounding trabeculocanalicular tissues. Tools for disrupting these tissues and minimally invasive methods for treating medical conditions associated with elevated intraocular pressure, including glaucoma, are also described.

Abstract: A shunt system used to treat excess cerebrospinal fluid (CSF) accumulation is described. In some embodiments, the system utilizes various mechanical, electrical, or electromechanical concepts designed to either clean a portion of the shunt system, or customize CSF drainage.

Abstract: Apparatus and associated methods relate to a lead that includes metallic traces sandwiched between layers of polymers to form a ribbon (e.g., similar to a flex circuit). In an illustrative example, areas on both ends of the traces may be exposed, forming stimulation electrodes on one end and electrical contacts on the other. The ribbon may be formed such that it fits down a small diameter needle. When the needle is removed, the formed ribbon may relax and engage the tissue providing a means of retention. The lead may advantageously: (1) be minimally invasive to implant, (2) be inexpensive, (3) stay in place a temporary/trial medical procedure setting, and (4) be easy to remove.

Abstract: The present disclosure discloses a nephrostomy tube and a nephrostomy tube with curved drainage. The nephrostomy tube with curved drainage includes a bending head, a balloon element, and an elongated main body integrally connected with each other, wherein the nephrostomy tube with curved drainage has an guiding channel adapted for a guiding member to penetrate through, wherein the bending head has a first inner channel and at least two drainage bending channels located on the outer side of the first inner channel, wherein the balloon element has an air chamber and a second inner channel, wherein the at least two drainage bending channels are communicated with the second inner channel, wherein the elongated main body has a third inner channel communicated with the second inner channel of the balloon element, wherein the first inner channel, the second inner channel and the third inner channel from the guiding channel.

Abstract: The present invention provides materials and methods for using electrical stimulation to treat a mammal having a proteinopathy (e.g., neurodegenerative diseases) or at risk of developing a proteinopathy are provided. For example, the present invention provides materials and methods for modulating glymphatic clearance (e.g., enhancing glymphatic clearance) of pathogenic proteins.

Abstract: The present invention provides for a deformable, insertable device for relieving intraocular pressure comprising a body portion composed of a biocompatible porous material with pores throughout to permit drainage of fluid from the anterior chamber to the scleral tissue without collapse of the anterior chamber. The invention also includes a method for inserting the device into the eye and for using ultrasound intraoperatively to determine the position of surgical tools and devices within the sclera. The invention also includes a device excising sclera in an eye to create a chamber for insertion of the insertable device into the eye.

Abstract: A hemodynamic flow assist device includes a miniature pump, a basket-like cage enclosing and supporting the pump, and a motor to drive the pump. The device is implanted and retrieved in a minimally invasive manner via percutaneous access to a patient's artery. The device has a first, collapsed configuration to assist in implantation and a second, expanded configuration once deployed and active. The device is deployed within a patient's aorta and is secured in place via a self-expanding cage which engages the inner wall of the aorta. The device includes a helical screw pump with self-expanding blades, sensors, and anchoring structures. Also disclosed is a retrieval device to remove the hemodynamic flow assist device once it is no longer needed by the patient and an arterial closure device to close the artery access point after implantation and removal of the hemodynamic flow assist device.

Abstract: A stent (100) comprising a stent wall (102), the stent wall (102) having a plurality of side holes (110) extending therethrough, each side hole (110) having an upstream end (116) and a downstream end (118). The stent wall (102) tapers in thickness in a direction towards the side hole (110) at the upstream (116) and/or downstream (118) end of at least one of the side holes (110). Also disclosed are methods for making side holes (110) in stents (100) by milling and making stents (100) having side holes (110) by injection moulding.

Abstract: An apparatus comprises a sleeve, a seal, and an anchor assembly. The sleeve is flexible and non-permeable and is configured to fit in a duodenum. The seal is positioned at the proximal end of the sleeve and is configured to seal the proximal end of the sleeve against the stomach mucosa, the pylorus, or the duodenum mucosa. The anchor assembly comprises a pair of atraumatic anchor ends and a resilient member positioned between the anchor ends. At least a portion of the resilient member extends along at least a portion of the length of the sleeve. The resilient member is configured to bias the anchor ends generally toward each other, to thereby substantially anchor the sleeve in the duodenum. The sleeve is configured to prevent chyme from contacting the mucosa of the duodenum; and to prevent enzymes excreted in the duodenum from mixing with chyme in the duodenum.

Abstract: An everting balloon system is disclosed that can be used for the placement of an IUD within the uterine cavity of a female patient. The everting balloon system with IUD can be used to access a uterine cavity at specific locations in the fundus. A one-handed IUD delivery system for placement with an everting catheter is disclosed. An IUD loading system for placement within an everting catheter is disclosed. The everting catheter with an IUD can simplify the process of IUD placement within the uterine cavity.

Abstract: An ocular implant configured for implantation into the eye of a subject comprising an elongate outer shell (54), an internal plug (210) including a hydrogel and a drug reservoir including a drug (62) wherein the drug is configured to pass through at least a portion of the internal plug to control elution of the drug through the outer shell. The implant is made of biodegradable materials.

Abstract: The invention relates to a cannula comprising a tip and an outlet, the cannula having a reduction in the internal diameter, which reduction is designed as a conically tapering tip the end of which has a length that is shorter than the internal diameter of the adjoining portion of the cannula.

Abstract: An asymmetric device for regulating blood volume distribution across a patient's atrial septum having a first expandable end region and a second expandable end region. The first expandable end region is transitionable from a contracted delivery state to an expanded deployed state in which the first expandable end region extends into the patient's left atrium and an inlet end of the first expandable end region is in a first plane. The second expandable end region is transitionable from a contracted delivery state to an expanded deployed state in which the second expandable end region extends into the patient's right atrium and an outlet end of the second expandable end region is in a second plane, such that the first plane intersects the second plane. The device further includes a neck region joining the first expandable end region to the second expandable end region, wherein the neck region is sized and shaped for placement in the patient's atrial septum.

Abstract: Implantable shunt devices and methods for draining cerebrospinal fluid from a patient's subarachnoid space include a shunt having opposed first and second ends, the second end being constructed to penetrate a wall of a sigmoid, transverse, straight, or sagittal sinus of the patient, a one-way valve, a hollow passageway extending between the second end and the one-way valve such that cerebrospinal fluid can be drained through the second end and out through the valve, and a mechanism coupled to the shunt and configured to anchor the shunt at a desired location proximal to the subarachnoid space.

Abstract: An endovascular anastomotic connector and method of using the same. The endovascular anastomotic connector includes a vascular conduit and a supply conduit. The vascular conduit has proximal and distal ends that reside within a vascular structure. The supply conduit extends at an angle from the vascular conduit. The proximal end of the supply conduit is configured to be attached to an auxiliary device.

Abstract: A cochlear implant device is disclosed, comprising an inductive antenna, a stimulation unit, an electrode array, and an energy harvesting apparatus. The inductive antenna is configured to receive energy to operate the cochlear implant and to receive signals for a stimulation of a cochlea via an electrode array comprising a plurality of electrodes. The stimulation unit is configured to process the signals received by the inductive antenna to be usable for the electrodes of the electrode array. The electrode array is configured to apply the signals processed by the stimulation unit to the cochlea for the stimulation thereof. The energy harvesting apparatus is connected to the stimulation unit or to the electrode array, and is configured to harvest energy based on at least one of thermal, biochemical, biophysical, and mechanical processes/phenomena pertaining to the cochlea, and is configured to provide harvested energy to the stimulation unit or the electrode array, respectively.

Abstract: A shunt rivet for implantation between a first body space and a second body space in a patient, such as to treat chronic obstructive pulmonary disease.

Abstract: A lacrimal drug delivery device includes a reservoir configured to hold a drug. The reservoir is moveable between a relaxed state and an expanded state. A connector is fluidly coupled to the reservoir and a lumen is formed in the connector wherein the drug is configured to flow from the reservoir to an delivery site through the lumen. A hydrogel is within the lumen and configured to absorb the drug from the reservoir and deliver the drug from the lumen at the delivery site. The hydrogel includes a first section which absorbs the drug at a first rate of absorption. A delivery guide is detachably coupled to the reservoir to deliver the reservoir into a lacrimal sac of a patient.

Abstract: An implantable prosthesis is provided for repairing a fistula, such as an anal fistula. The prosthesis or fistula repair device may include a body with a shape configured for placement in the fistula. The prosthesis may also include an anchor or base that is located at one or both ends of the body to facilitate anchoring the prosthesis in position. The prosthesis may include one or more channels to create one or more pathways for drainage and/or irrigation of the fistula. The channel may have a relatively uniform dimension along its length or a tapered shape that increases along its length. The prosthesis may have an adjustable length for accommodating fistula tracts of varying lengths. The prosthesis may include elongated body segments that provide a wicking or capillary function to facilitate drainage of the fistula tract.

Abstract: An implantable body fluid drainage system includes a metering shunt having a housing with an internal chamber. A movable barrier divides the chamber into a first section and a second section, and the barrier can be displaced by a differential pressure. A first powered inlet valve providing a fill path to the first section of the chamber, and a first powered drain valve providing a drain path from the first section of the chamber. A CSF inlet conduit connects a CSF space to the first powered inlet valve. A CSF outlet conduit connects the first powered outlet valve to a discharge location. A controller opens the first powered inlet valve and close the first powered drain valve to fill the first section to a volume defined by the barrier and chamber geometry and closes the first powered inlet valve and opens the first powered drain valve to discharge the filled volume from the first section through the outlet conduit.

Abstract: An implantable intracardiac device to prevent systolic anterior motion of the anterior mitral valve leaflet into the left ventricular outflow tract is described. The device comprises a blocking member configured for implantation within the left ventricle of the heart and in-situ blocking of systolic anterior motion of the mitral valve into the left ventricular outflow tract when anchored into the left ventricle of the heart. The device may be configured for radial expansion from a contracted orientation suitable for transluminal delivery to the left ventricle of the heart within a suitable delivery vehicle and an expanded orientation suitable for deployment within the left ventricle of the heart. The device comprises anchors configured for anchoring the device in-situ within the left ventricle to a wall of the left ventricle.

Abstract: A bypass device may include an elongate member extending from a proximal end toward a distal end, and a proximal opening and a distal opening coupled to one another by a lumen disposed through the elongate member. The bypass device also may include at least one port extending through a side surface of the elongate tubular member, wherein at least a portion of the bypass device may be bioabsorbable.