Abstract: Thrombectomy and other treatments are achieved using a catheter having a positioning cage and a macerator within the positioning cage. The catheter is introduced to a target body lumen, typically a blood vessel, and a positioning cage deployed at a treatment site. The macerator is then operated to disrupt thrombus, clot, or other occlusive materials at the treatment site, and the catheter is used to collect and remove the disruptive materials from the body lumen. In particular examples, the macerator may be radially expansible and optionally rotated and/or axially translated within the positioning cage to effect disruption of the occlusive material.

Abstract: A device for treating material in a body of a patient includes an expandable basket having a projection for securing material within the basket. The projection has a distal end joined to a distal tip of the basket and a proximal end extending within a lumen of the basket.

Abstract: An ultrasound delivery catheter equipped and configured for concurrent delivery of drugs or therapeutic agents. The catheter comprises an elongate pliable catheter body having an ultrasound delivery member or wire extending longitudinally therethrough. A drug/therapeutic agent infusion lumen also extends longitudinally through the body of the catheter and opens distally through one or more outflow apertures at or near the distal end of the catheter body. The drug/therapeutic agent outflow apertures are preferably positioned and configured to cause the drug or therapeutic agent to flow in direction(s) non-parallel to the longitudinal axis of the catheter. The delivery of ultrasound through the catheter, concurrent with infusion of drug or therapeutic agent therethrough, will cause the drug or therapeutic agent to be disseminated or dispersed by the ultrasonic vibration or movement at the distal end of the catheter.

Abstract: A calculus treatment apparatus includes first and second probe which transmit first and second mechanical energy to a distal end side thereof and pulverize a calculus by the first and second mechanical energy, and first and second mechanical energy generating devices which are arranged on a proximal end side of the first and second probes and generate the first and second mechanical energy. A probe arrangement structure is provided in which the first probe and the second probe are arranged substantially coaxially or concentrically.

Abstract: A medical retrieval device is used to retrieve and/or fragment stones (and/or other objects) from the body of a patient. The device has a retrieval basket with a releasable tip. The tip release is designed to release in a controlled pre-determined manner and under a predetermined force before any other component of the device fails due to a force exerted on the basket.

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: Thrombectomy and other treatments are achieved using a catheter having a positioning cage and a macerator within the positioning cage. The catheter is introduced to a target body lumen, typically a blood vessel, and a positioning cage deployed at a treatment site. The macerator is then operated to disrupt thrombus, clot, or other occlusive materials at the treatment site, and the catheter is used to collect and remove the disruptive materials from the body lumen. In particular examples, the macerator may be radially expansible and optionally rotated and/or axially translated within the positioning cage to effect disruption of the occlusive material.

Abstract: A method and apparatus for removing plaque, fatty deposits, and other occlusions from blood vessels using ultrasonic energy. The method and apparatus has particular application in removing plaque from the carotid artery in a non-thermal manner. The apparatus is designed to have as small a cross-sectional profile as possible, therefore allowing the apparatus to be used in a minimally-invasive manner. As a result, the apparatus can be used in both surgical and outpatient treatment with minimal post-operative complications and minimal damage to areas other than the area of treatment. An ultrasonic probe may include aspiration channels on its outer surface. An aspiration sheath may surround the ultrasonic probe, such that the location of an aspiration port may be varied axially relative to the ultrasonic tip.

Abstract: A medical device for entraining biological stones during medical procedures for the fragmentation of urinary, biliary, pancreatic, and other biological calculi and safely removing them from the body. The device includes a guidewire having a longitudinally-extending wire core. A portion of the wire core more adjacent the distal end thereof than the proximal end thereof is wound to form a helical coil which tapers in diameter from a larger diameter end at the proximal end thereof to a smaller diameter end at the distal end thereof. At least a portion of the core forming said helical coil is made of a super-elastic deformable material which collapses upon retraction into a tubular sheath and which reforms into a coil upon deployment from the sheath.

Abstract: An ultrasonic probe assembly is provided. The probe assembly includes a cannula and an ultrasonic probe disposed within the cannula. The probe assembly further includes a low-friction bushing disposed within the cannula and adapted to maintain the cannula and ultrasonic probe in a relatively fixed longitudinal relationship.

Abstract: The ultrasonic angioplasty transmission wire for use in an ultrasonic angioplasty device comprises an inner layer of a first ultrasound transmitting material, and at least one outer coaxial shell or tube of a second ultrasound transmitting material different from the first ultrasound transmitting material. The first inner layer and one or more of the outer coaxial shells or tubes can be formed of ultrasound transmitting metal compositions such as stainless steel, nickel-titanium, or aluminum, or other similar suitable ultrasound transmitting metals. In one embodiment, the first inner layer is formed of a nickel-titanium alloy, and at least one outer coaxial shell or tube is formed of stainless steel. In another embodiment, the first inner layer is formed of nickel-titanium alloy, a first outer coaxial shell or tube is formed of stainless steel, and a second outer coaxial shell or tube is formed of the nickel-titanium alloy.

Abstract: An improved rigid catheter is provided for lithotripsy. The catheter includes a rigid tube adapted to engage a lithotripsy transducer and power supply, with a restriction in an internal diameter of the rigid tube proximate a power delivery end of the rigid tube. The catheter may also include an enlargement on an external diameter of the tip. The tip may also be fabricated of a material considered to be very hard. The probe may also be solid with an enlarged tip.

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: Stabilizing an object in the body of a patient involves the injection of a lower critical solution temperature (LCST) material in a flowable form into the body of the patient so that the material contacts the object. The LCST material then forms a gel in the body due to a temperature inside 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 device for removing calculi by using an intracorporeal lithotripter comprises a single metallic probe or sonotrode which for the fragmentation of calculi is connected with an electrically controlled ultrasonic transducer for generating longitudinal oscillations which alternatively may be switched to the generation of shock or pressure waves by either a pulse wave stimulated oscillation of the metallic probe or sonotrode or by a reversibly driven impact member or projectile which is accommodated by the hollow of a backward tubular extension of the sonotrode.

Abstract: A method of and apparatus for removing a thrombus deposit from the cardiovascular system of a patient without the need to surgically access the location of the thrombus deposit via a cut-down or other surgical procedure. A catheter is inserted percutaneously into the patient at a convenient location either directly or over a previously positioned guide wire. The distal end of the catheter is advanced under fluoroscopy to the site of the thrombus deposit. A balloon is inflated to stabilize the position of the distal end of the catheter within the center of the vessel lumen. A flexible metal tube conveys an extremely high pressure stream of sterile saline solution to at least one jet at the distal end of the catheter. At least one jet positions the thrombus deposit for emulsification by at least one other jet. By directing the jets toward the orifice of the large evacuation lumen of the catheter, a stagnation pressure is induced which propels the emulsion proximally for disposal.

Abstract: A rotational angioplasty device having a handle housing and an exchangeable drive shaft cartridge. The handle housing includes a rotatable prime mover carried by a prime mover carriage which is longitudinally movable with respect to the handle housing. The exchangeable drive shaft cartridge includes a tubular core element, a longitudinally extendible tube, a catheter and a rotatable drive shaft which, near its distal end, has an abrasive tissue removal implement. The cartridge is detachable from the handle housing, the longitudinally extendible tube is detachable from the prime mover carriage, and the drive shaft together with its tissue removal implement may be attached to and detached from the prime mover, thereby permitting the exchangeable drive shaft cartridge to be selectively attached to and detached from the handle housing.

Abstract: A burst generator includes a structure for placing at least a portion of a liquid into a tension state, the tension state being below a cavitation threshold of the liquid. The tension state imparts stored mechanical energy into the liquid portion. A structure for cavitating provides energy to the liquid portion sufficient to bubble nucleate at least one bubble having a bubble radius greater than a critical bubble radius of the liquid, formation of the bubble releasing at least a portion of the energy which is stored in the tension state.

Abstract: Methods and apparatus for creating fluid flow from one location to another are disclosed. The fluid flow is created via the absorption of repetitive pulses of radiation in a fluid to generate bubbles that expand and collapse repetitively. This fluid mechanism, or pumping phenomenon, can be used to aid removal of a total or partial occlusion in a body passage by disrupting a surface of the occlusion with acoustic shock and pressure waves and/or by causing mechanical disruption of the occlusive material. Appropriate selection of materials and particular constructions improve apparatus flexibility.

Abstract: A method and apparatus for removing plaque, fatty deposits, and other occlusions from blood vessels using ultrasonic energy. The method and apparatus has particular application in removing plaque from the carotid artery in a non-thermal manner. The apparatus is designed to have as small a cross-sectional profile as possible, therefore allowing the apparatus to be used in a minimally-invasive manner. As a result, the apparatus can be used in both surgical and outpatient treatment with minimal post-operative complications and minimal damage to areas other than the area of treatment. An ultrasonic probe may include aspiration channels on its outer surface. An aspiration sheath may surround the ultrasonic probe, such that the location of an aspiration port may be varied axially relative to the ultrasonic tip.

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 device for removing calculi by using an intracorporeal lithotripter comprises a single metallic probe or sonotrode which for the fragmentation of calculi is connected with an electrically controlled ultrasonic transducer for generating longitudinal oscillations which alternatively may be switched to the generation of shock or pressure waves by a pulse wave stimulated oscillation of the metallic probe or sonotrode.

Abstract: An ultrasonic calculus treatment apparatus includes a longitudinal-vibration piezoelectric oscillator for vibrating in the axial direction of an ultrasonic transmitting member and a torsional-vibration piezoelectric oscillator for vibrating about the axial direction, and further includes driving circuits for driving the piezoelectric oscillators at respective resonance frequencies and a mode selection switch for permitting the oscillators to vibrate independently or in combination, so that lithotripsy can be performed effectively in accordance with the size of a calculus or a function of an operating tool.

Abstract: Device for removal of calculi by using an intracorporeal lithotripter comprises a metallic probe or sonotrode which is excited by an electrically controlled ultrasonic transducer for generating longitudinal oscillations for the fragmentation of calculi via the distal end of the sonotrode, the sonotrode accommodating a coaxially arranged impact probe which for an alternative fragmentation of calculi transfers shock or pressure forces that are generated by the impact energy of a reversibly driven impact member or projectile which periodically hits against a mass body on the proximal end of the impact probe when its drive is alternatively switched-on.

Abstract: A device for destroying formations in a body has a tubular element introducible into a body to an area of a formation, a gripping element extended through the tubular element and having a front end provided with gripping means for grasping a formation, and a formation destroying element also extending through the tubular element and having a front end provided with a working part, the formation destroying element being rotatable so that during rotation of the formation destroying element with the working part the part in contact with the formation destroys the formation.

Abstract: The invention provides a surgical instrument for inserting an elongate element into a human patient. In the preferred form of the invention the instrument has a curved hollow shaft defining an arc corresponding to the general curvature of a passage between the anterior vaginal wall and the abdomen of a female patient and having a cutting tip at one end and a handle at the other end. An elongate threading element is used draw a filamentary element through the shaft. Once the filamentary element is in position the shaft is removed from the patient, leaving the element in position. The instrument is preferably used to insert a U-shaped loop of filamentary material into the patient which passes around the patient's urethra and helps the patient improve her urinary control.

Abstract: An acoustic focusing device whose acoustic waves are generated by laser radiation through an optical fiber. The acoustic energy is capable of efficient destruction of renal and biliary calculi and deliverable to the site of the calculi via an endoscopic procedure. The device includes a transducer tip attached to the distal end of an optical fiber through which laser energy is directed. The transducer tip encapsulates an exogenous absorbing dye. Under proper irradiation conditions (high absorbed energy density, short pulse duration) a stress wave is produced via thermoelastic expansion of the absorber for the destruction of the calculi. The transducer tip can be configured into an acoustic lens such that the transmitted acoustic wave is shaped or focused.

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 metal probe for intracorporeal shock wave lithotripsy has a point at its distal end with one or several lateral notches next to the probe end. These notches secure a calculus laterally against an adjacent duct wall and thus prevent it from bursting when it is crushed.

Abstract: A medical device for fragmenting objects and aspirating remaining debris enables a physician or other medical personnel quickly and easily remove objects, such as kidney stones, from a patient. The medical device can include a dual-lumen elongated member and a handle coupled to the elongated member. A first one of the lumens provides a suction passageway, and a second one of the lumens receives a laser fiber for delivering laser energy to an object, such as a kidney stone, within the patient. The handle can include a positioning mechanism to enable the physician by manual manipulation to move and hold in place the laser fiber longitudinally within the second lumen.

Abstract: Thrombectomy and other treatments are achieved using a catheter having a positioning cage and a macerator within the positioning cage. The catheter is introduced to a target body lumen, typically a blood vessel, and a positioning cage deployed at a treatment site. The macerator is then operated to disrupt thrombus, clot, or other occlusive materials at the treatment site, and the catheter is used to collect and remove the disruptive materials from the body lumen. In particular examples, the macerator may be radially expansible and optionally rotated and/or axially translated within the positioning cage to effect disruption of the occlusive material.

Abstract: Thrombectomy and other treatments are achieved using a catheter having a positioning cage and a macerator within the positioning cage. The catheter is introduced to a target body lumen, typically a blood vessel, and a positioning cage deployed at a treatment site. The macerator is then operated to disrupt thrombus, clot, or other occlusive materials at the treatment site, and the catheter is used to collect and remove the disruptive materials from the body lumen. In particular examples, the macerator may be radially expansible and optionally rotated and/or axially translated within the positioning cage to effect disruption of the occlusive material.

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 metal probe for intracorporeal shock wave lithotripsy has a point at its distal end with one or several lateral notches next to the probe end, These notches secure a calculus laterally against an adjacent duct wall and thus prevent it from bursting when it is crushed.

Abstract: A medical retrieval device for retrieving foreign objects from a patient, the method of constructing the device, and the method of using 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 catheter for insertion into an artery having deposits of plaque and/or thrombus includes, at its distal end an ultrasonic transducer and a dilatation balloon surrounding the transducer such that when the balloon is positioned in the artery adjacent the deposits and inflated, energizing of the ultrasonic transducer will focus the ultrasonic energy against the deposits to cause dissolution of the thrombus into microscopic particles and cause cracking and softening of the plaque. Other embodiments include the provision of a second ultrasonic transducer as a means for viewing the treatment site, and a second balloon to cooperate with the first balloon to define a chamber between the balloons and with a lumen and a port connected to the chamber to remove any debris of larger than microscopic size which might otherwise tend to move downstream and cause further obstructions. Also described is the use of an expandable filtering device distal of the dilatation balloon for trapping such particles.

Abstract: A medical device includes a handle, a sheath, and an object-engaging unit. The distal end portion of the sheath is strong enough to resist being deformed by the object-engaging unit, yet another portion of the sheath is flexible enough to bend sufficiently.

Abstract: A method for inhibiting hyperplasia at an anastomotic junction of a vascular fistula or vascular graft comprises exposing the anastomotic junction to vibrational energy at a mechanical index and for a time sufficient to inhibit hyperplasia. Kits are described comprising the catheter or a probe suitable for performing the methods together with instructions for use setting forth the methods. The methods and kits are particularly suitable for treating anastomotic junctions formed to provide vascular access for hemodialysis, hemofiltration, and the like. The methods and kits are also suitable for treating other vascular grafts, such as those formed during cardiac bypass graft surgery, vascular repair, and the like.

Abstract: A method for suppression and prevention of the gag reflex, particularly during dental procedures, utilizing a non-invasive nerve stimulation device applied to the wrist.

Abstract: A method for destructing, reducing or removing mammalian tissue with an ultrasonic device IS disclosed, comprising contacting the tissue with a transverse mode ultrasonic probe, and transmitting ultrasonic energy to the probe, until the tissue is fragmented by emulsification. The probe can be used with acoustic and/or aspirations sheaths to enhance destruction and removal of an occlusion and in combination with an imaging device to effect remodeling of human tissue in medical and cosmetic surgical procedures.

Abstract: The invention relates to an electrode arrangement for generating shock waves by electrical discharging between electrode tips (12, 13), which arrangement is particularly suitable for use as an ESWL (Extracorporal Shock Wave Lithotripsy) electrode in a shock wave source for the pulverization of kidney stones or as an electrode in an apparatus for Extracorporal Shock Wave Therapy (ESWT). The electrode arrangement is characterized notably in that at least one of the electrode tips (12, 13) can be replaceable arranged in an associated electrode holder (14, 15), the electrode tip and the electrode holder being provided with corresponding fitting contours so as to achieve mutual locking. This enables very economical replacement of spent electrode tips by the user.

Abstract: A device for removing calculi by using an intracorporeal lithotripter comprises a single metallic probe or sonotrode which for the fragmentation of calculi is connected with an electrically controlled ultrasonic transducer for generating longitudinal oscillations which alternatively may be switched to the generation of shock or pressure waves by either a pulse wave stimulated oscillation of the metallic probe or sonotrode or by a reversibly driven impact member or projectile which is accommodated by the hollow of a backward tubular extension of the sonotrode.

Abstract: A device for removing calculi by using an intracorporeal lithotripter comprises a single metallic probe or sonotrode which for the fragmentation of calculi is connected with an electrically controlled ultrasonic transducer for generating longitudinal oscillations which alternatively may be switched to the generation of shock or pressure waves by a pulse wave stimulated oscillation of the metallic probe or sonotrode.

Abstract: There is provided a manually actuable ultrasonic disintegrator for the removal of human or animal tissue, which includes a sonotrode for the transmission of sound waves at its distal end to the tissue, an ultrasonic transducer which can be coupled to the sonotrode and a passage which extends lengthwise of the sonotrode for flushing and/or sucking away disintegrated or ablated tissue. In order to provide for the most effective possible application of ultrasonic waves into the tissue to be treated, the distal end of the sonotrode is in the form of a full surface outside which the flushing or suction removal passage extends.

Abstract: A medical device is provided which comprises a suction conduit and an energy-transmitting conduit wherein at least some of the transmitted energy is directed to the distal region of the suction conduit. The device may include an optical apparatus for directing the energy. The device has applications in lithotripsy and tissue-removal in a patient.

Abstract: A medical device includes a handle, a sheath, and an object-engaging unit. The distal end portion of the sheath is strong enough to resist being deformed by the object-engaging unit, yet another portion of the sheath is flexible enough to bend sufficiently.

Abstract: The present invention is directed to a device for producing a shock wave to impact an object that includes a transfer member. The device has a voice coil assembly including a permanent magnet and a bobbin member, wherein the permanent magnet provides a first magnetic field. A hammer is attached with the bobbin member; and a coil is operatively attached to the bobbin member, wherein when a voltage is applied to the coil a second magnetic field is generated that opposes the first magnetic field and thereby propels the hammer to contact the transfer member to cause a shock wave to travel along the transfer member.

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: Surgical basket instruments according to the invention generally include a sheath (catheter), a shaft extending through and axially movable relative to the sheath, a basket assembly coupled to a distal end of the shaft, and a handle coupled to a proximal end of the shaft and adapted for facilitating movement of the shaft relative to the sheath such that the basket assembly may be moved out of and into the distal end of the sheath. The basket assembly is formed from a plurality of circumferentially spaced flexible wires or cables which facilitate entrapping of urological and gastrointestinal calculi. The shaft is made of a hollow compacted cable formed from a flexible yet strong shape memory material such as a nickel-titanium alloy. The hollow (channel) in the shaft receives at least one fiber optic couplable to a laser beam for destroying calculi.

Abstract: A device for concrement destruction or crushing is disclosed which comprises an elongate probe adapted to be introduced into the human body, a drive unit that accelerates an impact body and a lever unit comprising at least one single-arm lever which is supported for rotation about an axis of rotation in such a way that it bears, in its home position, on the proximal end surface of the probe in particular, and which is rotated by the hitting impact body such that the lever accelerates the probe, which bears expediently against it, and the probe performs a translational movement causing the destruction or crushing of the concrement by the distal end surface of the probe hitting thereon.