Abstract: A device for fracturing calcifications in heart valves including an expandable stabilizer (14) and expandable impactor arms (20) assembled on and deployed by a delivery system (10), wherein the delivery system (10) is operable to move the impactor arms (20), while in an expanded position, with respect to the stabilizer (14) with sufficient energy so as to fracture a calcification located in tissure which is sandwiched between the stabilizer (14) and the impactor arms (20).

Abstract: A surgical instrument which both incises and splits the nucleus of a lens has a pair of spring steel segments slidably received in a metallic tube. Each segment terminates in a tip. As the spring steel segments are drawn into the tube the tips come together to form a cutting edge useful for incising the lens. When the segments are extended from the tube the tips separate, forcing the incision open until the lens is split.

Abstract: An angioplasty catheter includes an elongated carrier, and an angioplasty balloon about the carrier in sealed relation thereto. The balloon is arranged to receive a fluid therein that inflates the balloon. The catheter further includes a shock wave generator within the balloon that forms a rapidly expanding and collapsing bubble within the balloon to form mechanical shock waves within the balloon. The expanding bubble forms a first shock and the collapsing balloon forms a second shock wave. The shock wave generator is arranged such that the energy of the first shock wave is greater than the energy of the second shock wave.

Abstract: Clot disruption and dissolution are achieved using a catheter having the ability to infuse a thrombolytic agent, aspirate clot and fluid, and allow passage of a guidewire. Optionally, the catheter may also include a mechanical agitator for further disrupt clot in the presence of the thrombolytic agent. A flow resistor in the catheter provides for infusion and/or aspiration to be concentrated primarily at a clot treatment area in a blood vessel while also providing optional infusion and/or aspiration distal to the treatment area. In some embodiments, infusion, aspiration and guidewire passage occur through a common lumen. The thrombolytic agent, such as tPA, streptokinase, or urokinase, is directly released into the clot at the point where the agitator is engaging the clot. In this way, the thrombolytic activity of the agent is enhanced and the dissolution of the clot is improved.

Abstract: A surgical instrument featuring a combination cauterizing and surgical capture component. The instrument is deployable from a distal end of a lumen to a first position partially exposing a cauterizing loop and restrained radially deployable members wherein a plurality of cauterizations may be performed. The instrument is deployable to a second position fully translated from the lumen wherein the plurality of radially positionable members may be released by activation of a release member to allow the biased members to deploy radially around an axis running through the loop.

Abstract: Invasive side-firing electrohydraulic lithotripsy probes that creates a substantially annular shockwave to break up concretions are disclosed. Generally, the side-firing electrohydraulic lithotripsy probe includes a lithotripter tip including a first electrode and a second electrode. The first electrode is positioned at a distal end of the lithotripter tip and the second electrode is positioned in the lithotripter tip such that an end of the second electrode is coaxially aligned with an end of the first electrode. An electric arc between the first and second electrodes causes a shockwave to radiate radially from the lithotripter tip.

Abstract: An ultrasound catheter has an elongate flexible catheter body having a lumen extending longitudinally therethrough, and an ultrasound transmission member extending longitudinally through the lumen of the catheter body. The ultrasound transmission member has a proximal end that is coupled to a separate ultrasound generating device, and a distal end that terminates at the distal end of the catheter body, with at least a portion of the distal end of the ultrasound transmission member extending outside the lumen of the catheter body and beyond the distal end of the catheter body, and with the ultrasound transmission member directly attached to the catheter body via an attachment device.

Abstract: An apparatus includes a crushing part which rotates and crushes the calculus, wherein a radius of rotation of the crushing part with respect to a rotation axis thereof increases or decreases in accordance with a rotation speed of the crushing part.

Abstract: An intravascular filter assembly is disclosed for fragmenting a thrombotic or atherosclerotic occlusion and capturing thrombotic or atherosclerotic debris within a blood vessel. The intravascular filter assembly includes an elongate shaft and an expandable filter coupled to the distal region of the elongate shaft. One or more piezoelectric elements are secured to the elongate shaft at a location proximal of the expandable filter. A conducting wire is attached to the one or more piezoelectric elements and extends toward the proximal end of the elongate shaft. The one or more piezoelectric elements are configured to generate ultrasonic waves when subjected to an electrical voltage to fragment a thrombotic or atherosclerotic occlusion within a blood vessel.

Abstract: The present invention discloses calculi breakup method and apparatus. The method comprises: inserting a combination of an endoscope with a driving assembly and a milling assembly, or a combination of an endoscope and a sleeve with a driving assembly and a milling assembly into the urinary intracavity; starting up a driving unit to drive the milling assembly so as to mill the calculi in the intracavity into powder; and, discharging the milled calculi powder out of the body. Compared to the other calculi breakup method, the calculi breakup apparatus according to the present invention has the advantages of high calculi breakup speed, high efficiency, no heat during the calculi breakup, no hurt to the urinary mucous membrane, painless, short time for the treatment, low calculi residual rate, simple operation, and easy maintenance.

Abstract: An obstruction removal system for percutaneous removal of clots or obstructions within the vascular system is disclosed. The obstruction removal system includes a multi-lumen catheter with a plurality of circulating capture devices attached to or integral with a drive belt. The circulating capture or interference devices affect removal of the clot or obstruction bit-by-bit through a series of passes. The obstruction removal system may include one or more drive mechanisms, such as a pulley system and/or a vacuum source and/or a pressurization source, on its proximal end for driving the drive belt and capture devices through the catheter in a circulating manner. The obstruction removal system may also include one or more cleaning mechanisms, such as a vacuum chamber and/or a fluid rinse chamber, for removing the captured clot pieces from the capture devices.

Abstract: An obstruction removal system for percutaneous removal of clots or obstructions within the vascular system is disclosed. The obstruction removal system includes a multi-lumen catheter with a plurality of circulating capture devices occurring along a drive belt. The plurality of capture devices may be basket-like devices attached to the drive belt, or may be formed by integral coiled or protuberant sections of the drive belt. The circulating capture or interference devices affect removal of the clot or obstruction bit-by-bit through a series of passes.

Abstract: Improvements in intra-abdominal surgery include a method for removing large chunks of organic or inorganic material from the abdomen through a natural body opening such as the urethra. The technique may be supplemented by laparoscopic procedures.

Abstract: A device for fragmenting substances comprises a probe having an elongate probe shaft on the distal end of which a probe head is arranged, said probe head comprising an electro-hydraulic converter with which electrical energy, delivered via the probe shaft from the proximal direction, is converted in shock-like manner into mechanical kinetic energy, said converter comprising a housing which accommodates a liquid chamber and a shock-transmitting element which is designed as a piston and which can be moved in the longitudinal direction of the housing from a proximal end position to a distal end position, the distal end position being defined by an abutment on the housing, which abutment is struck by a counter-abutment arranged on the shock-transmitting element.

Abstract: A method and a system for destruction of an undesirable formation in a mammalian body are described. The invention is based on inserting a probe into mammalian body; said probe is electrically connectable to a control unit and upon bringing the probe in physical contact with the formation supplying pulses of energy from the control unit to the probe in order to destroy the formation. The invention further comprises counting amount of pulses being supplied to the probe and establishing a remaining service life of the probe by subtracting the amount of pulses being supplied to the probe from an amount of pulses corresponding to initial service life of the probe. The treatment session is automatically terminates as soon as amount of pulses being supplied to the probe approaches at least a fraction of the established remaining service life of the probe. The established remaining service life of the probe is stored for new treatment session.

Abstract: A method for maintaining patency in a duct or hollow vessel located within the body of a patient is described wherein the duct includes one or more obstructions. The method comprises the steps of introducing a device into the duct, the device comprising a catheter having a distal and a proximal end, wherein the distal end includes a distal tip portion and wherein the distal tip portion comprises at least one energy delivery member; locating the device within the duct at a position proximal to the obstruction; delivering energy to the duct and any surrounding tissue via the at least one energy delivery member for a specified time period, so that the obstruction is removed from the duct; and withdrawing the device from the duct. It is optional to subsequently place a device such as a stent at the therapy site in order to further maintain long term patency of the duct. It is also optional to apply a dilation force to the duct or hollow vessel after the energy delivery phase.

Abstract: An apparatus, system and method for re-canalization or opening a passage through an occlusion in a blood vessel is provided. The apparatus and method, which are appropriate for both cardiovascular as well as peripheral vessels, use a pulling member and a spring element, for example a compression spring, to oscillate a vibratable member, and the system of the invention includes the apparatus and a control unit to permit the frequency or amplitude of oscillation of the vibratable member to be adjusted. Also provided is a method for oscillating a vibratable member using a pulling member and a spring element. The apparatus and system are useful not only for penetrating a total or partial occlusion, but also to improve deliverability of a catheter through a partially occluded vessel or a tortuous vessel.

Abstract: An ERCP catheter having a removable handle for a lithotriptor compatible basket is disclosed. The removable handle allows the catheter and handle assembly to be removed, leaving the basket in place within the duct and facilitates the use of a lithotriptor for mechanically crushing stone captured in the basket.

Abstract: A system for breaking obstructions in body lumens includes a catheter including an elongated carrier, a balloon about the carrier in sealed relation thereto, the balloon being arranged to receive a fluid therein that inflates the balloon, and an arc generator including at least one electrode within the balloon that forms a mechanical shock wave within the balloon. The system further includes a power source that provides electrical energy to the arc generator.

Abstract: A medical retrieval device for retrieving foreign objects from a patient and the method of constructing the device are disclosed. The device incorporates a wire cable composed of a precursor alloy to a superelastic material to improve durability of the device. Because precursor alloys exhibit a linear stress-strain relationship and a yield point associated with a relatively high stress level, the device transfers greater stresses before experiencing deformation. Thus, greater crushing forces can be achieved using a device of this type. These crushing forces may be needed when the foreign object is too large to remove intact. This property also facilitates the device in dilating ducts to retrieve foreign objects. Using the precursor alloy additionally eliminates the need for heat treatment of the cables used in constructing the device. A retrieval device made of precursor alloy cable also is less susceptible to permanent deformation and unwinding during use.

Abstract: A variety of electrical ablation apparatuses and methods are disclosed. In one embodiment, an ablation apparatus includes an injector catheter electrode having a proximal end configured to couple to an energy source and a fluid source. A distal end of the injector catheter defines an injection needle and defines an electrically conductive hollow channel for communicating a fluid from the fluid source to a treatment site. A balloon electrode is in fluid communication with a balloon catheter. The balloon catheter has a proximal end configured to couple to the energy source and the fluid source and a distal end configured to inflate the balloon electrode.

Abstract: Stabilizing an object in the body of a patient involves the injection of a lower critical solution temperature (LCST) material or other flowable material into the body of the patient so that the material contacts the object. The LCST material or other flowable material then forms a gel in the body such that the object is contained at least partially within the gel and thereby stabilized by the gel such that the object can then be easily fragmented within the body and/or retrieved from the body.

Abstract: A method and apparatus for treating gland dysfunction caused by gland obstruction in order to restore the natural flow of secretion from the gland comprises the application of a combination of energy, suction, vibration, heat, aspiration, chemical agents and pharmacological agents to loosen and thereafter remove the obstructive material.

Abstract: Ultrasound catheter devices and methods provide enhanced disruption of blood vessel obstructions. Generally, an ultrasound catheter device includes an elongate flexible catheter body with one or more lumens, an ultrasound transmission member extending longitudinally through the catheter body lumen and a distal head coupled with the transmission member and positioned adjacent the distal end of the catheter body for disrupting occlusions. A proximal housing of the catheter device may include one or more features for dissipating heat from the ultrasound transmission wire, such as a fluid inlet aperture for passage of fluid, use of heat conductive materials in the proximal housing, surface features to increase the housing's surface area, heat conductive members disposed adjacent the transmission member and the like. Various irrigation fluids may be used, such as cooled, oxygen supersaturated or lubricious fluids.

Abstract: A method for performing computer-assisted orthopaedic surgery includes the steps of: (1) producing and displaying three-dimensional geometrical models of first and second bones, the first and second bones forming a joint; (2) identifying a zone of impingement between the first bone and the second bone on at least one of the bones; and (3) generating and displaying a color map of at least one surface of at least one bone, the at least one surface being within the zone of impingement, the color map including different colors representing different depths of bone to be removed in order to achieve an increased range of motion between the first and second bones.

Abstract: The device for mechanical lithotripsy and removal of stones that form in the bile duct or urinary system has a stone collection basket at a distal end of a tube and two actuators at the proximal end of the tube. A cable runs through the tube and connects each actuator to the basket. The actuators are screw drives and form a common structural unit that is concentric to the tube and the cable. One actuator controls the opening and closing of the basket while the other actuator controls the force transmitted through the cable to the basket to allow for crushing of the stone in the basket.

Abstract: Methods and devices are disclosed that enable safe, rapid and relatively short and straight access to the cerebral arteries for the introduction of interventional devices to treat acute ischemic stroke. In addition, the disclosed methods and devices provide means to securely close the access site to the cerebral arteries to avoid the potentially devastating consequences of a transcervical hematoma.

Abstract: A medical device configured to be inserted into a patient's body to retrieve material from the patient's body includes a basket assembly. The basket assembly is configured to transition between various states including an expanded state and a collapsed state. The basket assembly may be substantially covered in a flexible sheet except for a side-facing opening when the basket assembly is in the expanded state. When the basket assembly is in the collapsed state, the side-facing opening may be substantially closed. The device may be inserted into the patient's body while the basket assembly is in the collapsed state. While in the patient's body, the basket assembly may be transitioned to the expanded state. Then, a physician may maneuver material to be removed from the patient's body into the basket assembly via the side-facing opening. Next, the basket assembly may be transitioned into the collapsed state or a partially collapsed state so that the basket assembly can be removed from the patient's body.

Abstract: Clot disruption and dissolution are achieved using a catheter having the ability to infuse a thrombolytic agent, aspirate clot and fluid, and allow passage of a guidewire. Optionally, the catheter may also include a mechanical agitator for further disrupt clot in the presence of the thrombolytic agent. A flow resistor in the catheter provides for infusion and/or aspiration to be concentrated primarily at a clot treatment area in a blood vessel while also providing optional infusion and/or aspiration distal to the treatment area. In some embodiments, infusion, aspiration and guidewire passage occur through a common lumen. The thrombolytic agent, such as tPA, streptokinase, or urokinase, is directly released into the clot at the point where the agitator is engaging the clot. In this way, the thrombolytic activity of the agent is enhanced and the dissolution of the clot is improved.

Abstract: Occluding structures may be created within a body lumen by advancing a length of material distally through the body lumen. By drawing a distal location on the advanced length of material in a proximal direction, the material may be compacted into a structure which at least partially occludes the lumen. The occluding structure may be used to remove kidney stones from the ureter in conjunction with lithotripsy and irrigation.

Abstract: A medical retrieval device for retrieving foreign objects from a patient and the method of constructing the device are disclosed. The device incorporates a wire cable composed of a precursor alloy to a superelastic material to improve durability of the device. Because precursor alloys exhibit, a linear stress-strain relationship and a yield point associated with a relatively high stress level, the device transfers greater stresses before experiencing deformation. Thus, greater crushing forces can be achieved using a device of this type. These crushing forces may be needed when the foreign object is too large to remove intact. This property also facilitates the device in dilating ducts to retrieve foreign objects. Using the precursor alloy additionally eliminates the need for heat treatment of the cables used in constructing the device. A retrieval device made of precursor alloy cable also is less susceptible to permanent deformation and unwinding during use.

Abstract: In a method for re-entry from extraluminal space into the central lumen of a vessel, a guidewire is advanced into the extraluminal space of the vessel, and then a directional catheter is advanced over the guidewire through the extraluminal space. Thereafter, the guidewire is removed from the directional catheter, an ultrasound device is placed through the directional catheter, and the ultrasound device is advanced through the extraluminal space into the central lumen and then activated.

Abstract: A method and systems for treating chronic total occlusions (CTOs), particularly those that are difficult to treat. CTO recanalization is achieved using radiofrequency ablation directed at the occlusion between antegrade and retrograde guidewires placed on either side of the occlusion.

Abstract: A medical device and method for breaking a concretion in a body into smaller pieces and removing the pieces from the body are described. The device comprises a dilator sheath, a lithotripsy probe, a tubular member, and a retrieval basket. The dilator sheath adapted to penetrate into a passage of the body to reach the location where the concretion is located. The lithotripsy probe is configured for shattering the concretion into smaller pieces. The tubular member is mounted within the dilator sheath adapted to permit the lithotripsy probe to be inserted into the tubular member. The retrieval basket is coupled to the tubular member, and configured for entrapping the concretion and the smaller pieces for their extraction from the body.

Abstract: Embodiments of the invention are directed to a medical device and methods for immobilizing and retrieving material from a patient's body. The device may include a sheath having a lumen, a distal end, and a proximal end. An elongate member is provided including an expansible member connected to a distal portion of the elongate member. The elongate member and expansible member are movable relative to the sheath to achieve a first state of the expansible member when the expansible member is within the lumen of the sheath and an expanded state when the expansible member extends from the distal end of the sheath. The expansible member comprises a material that expands to the expanded state due to the presence of fluid.

Abstract: A treatment assembly is positioned along an AV-fistula and couples therapeutic energy to an adjacent area due to a material response to an applied energy field from a remotely located energy source. The treatment assembly may be delivered into the fistula through a hemodialysis needle, or may be secured to the fistula graft itself and implanted therewith in a patient. A cover provides a shield between an anastomosis area and blood flow. Another AV-fistula includes a valved reservoir that receives a fluid agent from a hemodialysis needle while moving the needle into or from the fistula; the agent leaks from the reservoir into the fistula lumen. Another valved fistula is adjustable between an open condition and closed conditions during and between hemodialysis treatments, respectively. Another AV-fistula has a bladder reservoir coupled to a second refillable fluid reservoir and is adapted to locally deliver a therapeutic agent into the fistula lumen.

Abstract: The present invention provides devices and methods for decalcifying an aortic valve. The methods and devices of the present invention break up or obliterate calcific deposits in and around the aortic valve through application or removal of heat energy from the calcific deposits.

Abstract: The present invention relates generally to perfusion catheters and distal protection devices. According to an embodiment, the present invention includes a distal protection filter comprising an elongate shaft having a proximal end and a distal end, a distal protection device disposed at the distal end, a coupling member that couples the elongate shaft to the distal protection device, and a first space between the coupling member and the elongate shaft. A method of filtering debris from a blood vessel is also disclosed.

Abstract: A system and method for a lithotripter is provided. The system can include a shockwave generator and an ultrasonic transmitting/receiving unit, which are in communication with an evaluating unit. The transmitting/receiving unit can include an ultrasonic transducer that emits ultrasonic pulses and receives ultrasonic waves reflected from a target area of the shockwave generator. The evaluating unit can determine a correlation coefficient of the time correlation between the ultrasonic waves and the ultrasonic pulses and provide a signal related to the coefficient. The method can include emitting ultrasonic pulses from the transducer into a body, receiving the ultrasonic waves reflected from a target object in the body, evaluating the received ultrasonic waves with the evaluating unit to determine the correlation coefficient, and providing a signal related to the correlation coefficient.

Abstract: Harmonic motion is produced in a subject using vibro-acoustography. An ultrasonic imaging system repetitively interrogates the subject and the Doppler shift in the reflected echo signals is analyzed to measure the phase and amplitude of harmonic motion produced in the subject at different prescribed frequencies. Shear wave propagation through the subject is determined from this information and mechanical properties related to “stiffness” of the subject are determined. A Kalman filter is employed in the phase and amplitude measurement to extract the harmonic motion information from background noise.

Abstract: Methods and devices are disclosed that enable safe, rapid and relatively short and straight access to the cerebral arteries for the introduction of interventional devices to treat acute ischemic stroke. In addition, the disclosed methods and devices provide means to securely close the access site to the cerebral arteries to avoid the potentially devastating consequences of a transcervical hematoma.

Abstract: The invention relates to the field of minimal invasive catheterization, in particular to an apparatus for opening and/or removing obstructions occluding body internal passages by means of an active guidewire comprising a coil to which an alternating voltage can be applied. In that way the guidewire can vibrate if an external magnetic field is applied.

Abstract: The present invention relates to neurovascular thrombectomy devices that include an occlusion microcatheter and fluid-assisted microcatheter fitted within the occlusion microcatheter. Also provided are systems and methods for neurovascular thrombectomy using the devices of the invention.

Abstract: A surgical instrument for fragmenting and extracting stones includes an outer sheath having a proximal end and a distal end and an inner core longitudinally extending through the core and longitudinally movable relative to the core. The outer sheath has a basket sized for entrapping the stones and located near the distal end of the outer sheath. The distal end of the inner core is longitudinally moveable from a retracted position within the basket to an extended position past the distal end of the outer sheath. The distal end of the inner core is also adapted to engage and fragment the stones. Longitudinal movement of the inner core relative to the outer sheath transforms the basket from an expanded condition to a collapsed condition to entrap stones within the basket and provide a small profile for insertion and withdrawal.

Abstract: A method of capturing and macerating particles in a blood vessel is provided. A vascular filter device is implanted in the blood vessel at a treatment site. The vascular filter device comprises a filter body and an agitation member disposed within the filter body. Movement of the agitation member acts on particles trapped within the filter body for enhancing the dissolution of the particles, thereby reducing the likelihood of filter occlusion and improving the flow of blood through the vessel. The vascular filter device is preferably collapsible for percutaneous delivery to a treatment site. The agitation member is preferably rotatably coupled to the filter body. A power source is provided for moving the agitation member. In various examples, the power source may take the form of an energy storage device, a drive catheter, or a magnetic field.

Abstract: A process and instruments for diminishing an undesired endoluminal structure present at a treatment site in a mammalian treatment subject. The endoluminal can be or include a vascular occlusion, a biofilm or another undesired biological structure. The process can include applying mechanical shockwaves to the endoluminal structure and the endoluminal structure absorbing the applied mechanical shockwaves and becoming diminished, dispersed or weakened. The shockwaves can be generated by pulsed laser energy delivered to an ionizable target via an optical fiber.

Abstract: A two-step mammalian biofilm treatment process can have a first step of disrupting or dispersing an undesired biofilm present at a treatment site in or on a mammalian host by suitable mechanical action for example, by applying irrigation fluid, sonic or other vibration, a mechanical instrument or laser-generated mechanical shockwaves to the biofilm. The treatment can also have a second step comprising applying an antimicrobial treatment to the mammalian host to control possible infection related to biofilm dispersed in the first step or to residual biofilm at the treatment site. Usefully, the second step can be performed within a limited time period after the first step. The process can also include additional steps The antimicrobial treatment can employ light or an antibiotic material. Included are implants cleaned of biofilm by a described process.

Abstract: The invention relates to a direct reading endoscopic measuring instrument and, more specifically, to a manually operated measuring instrument that is placed in close proximity to an internal anatomical feature and a related method for operation of the measuring instrument. The direct reading endoscopic measuring instrument includes a distal reticule that is passed through an endoscope in a folded position. When extended past the distal end of the endoscope proximate to an anatomical structure to be measured, a remote actuator unfolds the reticule along an axis perpendicular to the endoscope. Graduations on the reticule can be observed to directly measure the size of the anatomical structure.

Abstract: A retrieval device is provided for capturing and retrieving stones, calculi, and other objects from a body. The retrieval device includes an irrigation orifice to irrigate a passageway. Irrigating the passageway helps to keep the viewing area free from debris and particulate matter.

Abstract: A stone capture device comprises a shaft with a deployable sweeping structure at its distal end. The shaft is adapted to be removably placed over and connected to a conventional ureteroscope. The combination of the stone capture device and ureteroscope can be introduced into the urinary tract to capture, fragment, and remove stones from the bladder and kidney.