Abstract: A medical procedure for positioning an embolic protection device effectively prevents material from entering with blood flow into side branch vessels of the aortic arch. The protection unit is permanently attached to a transvascular delivery unit at a connection point at a support frame that is at least partly arranged at a periphery of a selectively permeable unit. In an expanded state of the device, the connection point is enclosed by the support member or arranged at said support member.

Abstract: There are shown and described embodiments of a closure device for closing holes in tissue, for example in the right atrial appendage. The closure device in particular embodiments includes first and second mesh closure members and a tether or stem connecting them. Embodiments of a delivery device for the closure device are also described.

Abstract: A device for transcatheter insertion into the aortic root at the sinotubular junction by a wire guide and a catheter for protecting surrounding tissues, the device including an assembly serving as a valvular embolic filter, configured to slide in a guided manner inside the catheter, the assembly configured to form, in the aortic root of an aorta, a safety enclosure ensuring a valve function and a protective function against embolic accidents, wherein the assembly includes, a tubular body, and a filtration and valve part configured to deploy outside the catheter or retract inside the catheter, wherein the tubular body is secured, at one end, to the filtration and valve part, wherein the filtration and valve part forms the valvular embolic filter and a temporary valve, wherein the filtration and valve part is configured to prevent regurgitation of blood when deployed outside the catheter for covering a native aortic valve with a seat secured in the aortic root at sinuses of valsalva without obstructing a blood

Abstract: The present disclosure relates to the field of endovascular treatment. More particularly, the present invention uses a modified hydrogel intrasaccular occlusion device designed to implement an endovascular treatment to ameliorating or eliminating aneurysm recurrence, which hydrogel may optionally be impregnated with pharmaceutical compounds. The present invention also teaches the use of thin hydrogel coatings to ameliorate endovascular treatment related difficulties.

Abstract: Embolic material capture catheters and related devices and methods employ a staged deployment of an embolic material capture element. A method of deploying an embolic material capture element in a blood vessel includes advancing the embolic material capture element in an insertion configuration through the blood vessel. A middle portion of the embolic material capture element is expanded via distal advancement of an inner sheath toward a distal end portion of the embolic material capture element constrained by a dilator assembly. The dilator assembly is then reconfigured to release the distal end portion of the embolic material capture element from engagement with the dilator assembly. Upon release, the distal end portion of the embolic material capture element expands to complete deployment of the embolic material capture element in the blood vessel.

Abstract: A calculus removing device includes a cylinder, a screw, and a hand-operated unit. The cylinder includes a storage portion configured to store calculi and broken calculus pieces, and an opening communicating with the storage portion. The screw is helically-shaped, is arranged in the storage portion and is configured to move the calculi to a proximal end of the cylinder while drawing the calculi into the storage portion thereof via the opening in association with the rotation of the cylinder about an axial line along a longitudinal direction of the cylinder. The hand-operated unit includes an operating member for rotating the screw.

Abstract: A medical implant for a left atrial appendage may include a central member having an anchor at a distal end and a plurality of legs joined together at a joint coupled to the central member. The plurality of legs may be configured to expand from a delivery configuration to a deployed configuration. A medical implant may include a central shaft having an anchor at a distal end and a cup-shaped occluder fixed to a proximal end of the central shaft, the occluder being configured to expand from a delivery configuration to a deployed configuration and retard tissue ingrowth thereon. A medical implant system may include a delivery sheath, an implant having an expandable frame including a plurality of legs each having an anchor and a mesh having a plurality of openings therethrough attached to the frame, and a plurality of particles disposed within the delivery sheath.

Abstract: The present invention teaches the use of a disc shaped mesh intrasaccular occlusion structure with at least one hole in said disc, with optional supplemental hydrogel, which is designed to implement an endovascular treatment to facilitate saccular aneurysm treatment while ameliorating or eliminating aneurysm recurrence.

Abstract: A device for filtering emboli from blood flowing through a lumen defined by the walls of a vessel in a patient's body, comprising: a filter element being expandable from a collapsed configuration when the filter element is restrained to an expanded configuration when the filter element is unrestrained, and an elongate support member, the filter being carried on a portion of the elongate support member, wherein the filter element has proximal and distal portions and a central portion, the filter element having a shape in the expanded configuration which defines a cavity having a proximal facing opening, and wherein the proximal portion of the filter element comprises a radiopaque element in the form of a discontinuous loop extending around a portion of a perimeter of the proximal facing opening, the discontinuous loop having a gap and the gap being proximate to the elongate support member.

Abstract: A catheter compiling a housing portion defining an interior cavity and the housing portion comprising a housing member having an interior space dimensioned for housing an indwelling medical device. The elongated member comprises a lumen extending at least from an exit port to a distal port, the housing member is disposed within the lumen, and the lumen is dimensioned in the housing portion to receive a guidewire outside of the interior space of the housing member. A medical device for filtering emboli from blood flowing in a blood vessel of patient comprising an elongate support member and an elongate side branch member connected to the elongate support member. The filter element is attached to the elongate side branch member by a proximal filter element slider, and the elongate side branch member is adapted to maintain the filter element centered in the vessel.

Abstract: Systems and methods are provided for delivering and mechanically detaching embolic coils. The systems disclosed herein comprise a mechanical detachment mechanism to intravascularly release an embolic coil. The methods disclosed herein comprise a various triggering mechanisms to detach embolic coils.

Abstract: An apparatus and method of deploying a stent graft having a proximal anchor stent ring includes restraining proximal apexes of the proximal anchor stent ring between a spindle body of a spindle and a control release sleeve of a tapered tip. The control release sleeve is advanced relative to the spindle to release a first proximal apex through an opening in the control release sleeve while the remaining proximal apexes remain restrained by the control release sleeve. The control release sleeve is further advanced relative to the spindle to release the remaining proximal apexes from the control release sleeve. In another example, a stent capture fitting has variable length stent capture fitting arms. As the stent capture fitting is retracted, the proximal apexes of the proximal anchor stent ring are sequentially exposed from and released by the variable length stent capture fitting arms.

Abstract: The present invention relates generally to a method and apparatus for deploying and/or retrieving an object (e.g., a vena cava filter) in a cavity (e.g., a vena cava) using a system configured to: (i) maintain grip of the unsheathed object in the cavity until deliberately released, (ii) prevent premature release of the object in the cavity, and/or (iii) facilitate retrieval by first everting said object, then withdrawing the object through a guiding catheter (e.g., retrieval via eversion).

Abstract: Systems and methods for treating thrombosis and or emboli in a peripheral vasculature of a patient are disclosed herein. The method can include providing a thrombus extraction device including a proximal self-expanding coring portion formed of a unitary fenestrated structure and a distal expandable tubular portion formed of a braided filament mesh structure; advancing a catheter constraining the thrombus extraction device through a vascular thrombus in a vessel; deploying the thrombus extraction device from the catheter from a constrained configuration to an expanded configuration; retracting the thrombus extraction device proximally so that the coring portion cores and separates a portion of the vascular thrombus from the venous vessel wall while the mesh structure captures the vascular thrombus portion; and withdrawing the thrombus extraction device from the patient to remove the vascular thrombus portion from the vessel.

Abstract: A system for removing an undesirable material from within a vessel is provided. The system includes a cannula designed for maneuvering within a blood vessel to a site of interest and applying a suction force, such that the undesirable material can be captured and removed along the cannula away from the site. The system also may include a catheter having a balloon at its distal end. The balloon may be designed to be positioned adjacent to the undesirable material such that the undesirable material is situated between the balloon and the cannula. The catheter may also be designed to subsequently impart a force onto the undesirable material for removal of the undesirable material. A method for removing an undesirable material from within a vessel is also provided.

Abstract: A multi-basket clot capturing device that includes a distal basket connected to a wire. The distal basket may be positionable distal of the clot and operable to capture a distal portion of a clot. A proximal basket may be connected to a hypotube that is slidably axially connected to the wire. The proximal basket may be positionable proximal of the clot and operable to capture a proximal portion of the clot. A cage can form between the proximal and distal baskets around multiple portions of the clot for capturing the clot. Sliding the wire distally, or microcatheter proximally, relative to the clot causes the distal basket to move from a collapsed state to an expanded state. The cage may be around at least two portions of the clot that are opposed.

Abstract: Rolling tractor tube mechanical thrombectomy apparatuses that may be deployed from out of a catheter in situ are described herein. These apparatuses may be delivered out of a catheter from a collapsed delivery configuration within the catheter to a deployed configuration out of the catheter, in which the same catheter is re-inserted between a tubular tractor and an elongate puller. In particular, any of these methods and apparatuses may be adapted to work with a tractor tube having an open end that is biased open, including using an annular bias.

Abstract: Provided is a method of treating inguinal hernia, in which a burden applied to a patient during treatment can be reduced. There is provided a method of treating inguinal hernia, in which a bowel is prevented from being exposed to an outside through a fascia. The method of treating inguinal hernia includes an introduction step of introducing a member configuring a structural body which restricts deformation of the bowel, through an anus toward a hernial site by using a transportation member; and a configuration step of configuring the structural body with respect to the bowel which stays medial to the fascia.

Abstract: A collapsible embolic protection device prevents material from entering with blood flow into side branch vessels of the aortic arch. The device has a protection unit including a selectively permeable unit that prevents embolic material from passage with a blood flow into a plurality of aortic side branch vessels at the aortic arch.

Abstract: In general, the invention features an intra-vascular device for filtering or deflecting emboli or other large objects from entering a protected secondary vessel or vessels. The device of the invention may include a filter, an central member, additional supporting members, and a delivery cable and may serve to filter or deflect emboli or other large objects from entering protected secondary vessels. The device may be capable of collapse along its longitudinal axis for ease of delivery to the treatment site. The device may further be compatible with common delivery methods used in interventional cardiology (e.g., TAVI procedures). The device may be integrated into the delivery systems. In other embodiments the device may be detachable from the delivery system. Upon deployment, the device may be positioned so as to contact the orifice of one or more secondary blood vessels. Upon retrieval the device may be retracted in an orientation substantially similar to the original deployment orientation.

Abstract: Catheter-delivered endovascular medical devices are described. The devices may include a pull wire attached to a distal body. The distal body may be formed of a distal body outer body comprising a basket comprised of a plurality of cells defined by a plurality of basket strips and a distal body inner body located in the interior of the distal body outer body and comprising a plurality of distal braided mesh openings formed by a plurality of woven linear strands. The distal braided mesh openings may be smaller than the cells when the device is in the relaxed state. Methods of using and making the devices are also described.

Abstract: This invention relates to devices that are inserted in a blood vessel or other body lumen, and in particular to filter that may block particles from entering a blood vessel. Devices of this invention position and secure a filter in a vascular system to intercept particulates, including emboli.

Abstract: In one aspect, the present invention provides a device for occluding an aperture in a body, for example, a patent foramen ovale (PFO), including a first side adapted to be disposed on one side of the septum and a second side adapted to be disposed on the opposite side of the septum. The device has an elongated, low-profile delivery configuration and a shortened, radially expanded deployment configuration. The first and second sides are adapted to occlude the aperture upon deployment of the device at its intended delivery location. The device also includes a radially expandable center portion. In some embodiments, the center portion includes a plurality of ribs provided by slits in device. The ribs expand radially when the device is deployed. The expandable center portion facilitates the positioning of the device in the aperture. The device can be secured in the deployed configuration using a catch system.

Abstract: An attachment configuration for a vascular filter assembly including a self-expanding filter member attached to a catheter body and constrained from expansion in a first configuration by a constraining sheath is presented. The attachment configuration includes an outer tube of material that is overlaid over an end of the filter member and bonded to the catheter body through cutouts disposed through the end of the filter member.

Abstract: Clot engagement element comprising bundle of unwoven fibers can be assembled to form an acute stroke treatment device. The device has the capability of forming a three dimensional filtration matrix comprising effective pores with a distribution of sizes. The bundle of fiber design allows the device to be effectively delivered into circuitous cerebral arteries to remove clot that causes stroke. The fiber bundle based filtration matrix offers the advantages of conforming to the changing inner perimeter of a blood vessel during a clot removal process and thus the capability to effectively retain and remove a clot in the vessel. The filtration matrix offers the additional advantage to trap any break-off of the clot during the removal process. A plurality of fiber bundles can be combined to form an effective clot engagement element. Supplemental engagement structure as well as mechanical treatment structure can be integrated into the stroke treatment device.

Abstract: In one example, this disclosure is directed to a kit for intravascular implantation of an implantable medical device, the kit comprising an outer sheath, the outer sheath sized to traverse a vasculature of the patient, and an elongated inner sheath with a tapered distal end. The inner sheath is slidable within the inner lumen of the outer sheath and is selectably removable from the inner lumen of the outer sheath by sliding the inner sheath out of the proximal opening of the outer sheath. The kit includes an elongated deployment receptacle including a deployment bay slidable within the inner lumen of the outer sheath when the inner sheath is not within the inner lumen of the outer sheath. The deployment bay carries an implantable medical device through the inner lumen of the outer sheath and facilitates deployment of the implantable medical device from the distal end of the outer sheath.

Abstract: A snare instrument has a snare structure which is formed in one piece from a tube section, by the latter being slit and bent open, and which has a proximal base portion and, extending axially forward from the latter, a distal snaring portion, and which is movable between a snaring position, in which it is moved forward out of an enclosure with the snaring portion folded open, and a securing position, in which it is moved back at least partially into the enclosure with the snaring portion folded in and providing a securing action. The snaring portion, in the folded-open state, has a cup shape with a distal snare opening. For this purpose, a distal end area of the tube section is provided with open axial slits of suitable length introduced from the direction of the distal end of the tube section, and, lying between these, with associated closed axial slits which terminate at a distance in front of the distal end of the tube section and are of greater length than the open axial slits.

Abstract: Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, is directed toward an occlusion device that includes a proximal portion, a distal portion, and an intermediate portion extending between the proximal portion and the distal portion. The distal portion can include a directing region and a lead-in member that extends distally from the directing region. When the occlusion device is in a deployed configuration, the intermediate portion can form a preset bend in the occlusion device that positions the directing region at an angle with respect to the proximal portion. As a result, as the occlusion device is pushed distally out of a delivery catheter into the aneurysm, the directing region directs the distal portion away from exiting the aneurysm through the neck such that the proximal portion crosses the neck and generally remains within the aneurysm.

Abstract: A vascular filter device (1) comprises a plurality of filter elements (6) which are movable from a capturing position to an open position upon elapse of a predetermined period of time. In the capturing position the filter elements (6) are configured to capture thrombus passing through the inferior vena cava. In the open position the filter elements (6) are configured to facilitate unrestricted blood flow. The filter elements (6) are biased towards the open position. The filter (1) comprises a holder member (10) to temporarily hold the filter elements (6) in the capturing position until elapse of the predetermined period of time. The holder member (10) comprises a biostable wire element (12) which extends through an opening (13) in each filter element (6), and a biodegradable/bioabsorbable stop element (11). Upon biodegrading/bioabsorbing of the stop element (11), the filter elements (6) are free to move from the capturing position to the open position.

Abstract: A parent artery occlusion (PAO) device which provides for immediate occlusion of a cerebral artery to isolate a defect. The PAO device includes a self-expanding wire-frame prolate structure which is partially covered with an ePTFE membrane.

Abstract: Vascular treatment devices and methods include a woven structure including a plurality of bulbs that may be self-expanding, a hypotube, for example including interspersed patterns of longitudinally spaced rows of kerfs, and a bonding zone between the woven structure and the hypotube. The woven structure may include patterns of radiopaque filaments measurable under x-ray. Structures may be heat treated to include various shapes at different temperatures. The woven structure may be deployable to implant in a vessel. A catheter may include a hypotube including interspersed patterns of longitudinally spaced rows of kerfs and optionally a balloon. Laser cutting systems may include fluid flow systems.

Abstract: The present disclosure describes filter devices for deployment to body vessels where clots or emboli may need to be captured, particularly the vena cava. The filter device is of unitary construction, having been cut from a substantially planar sheet of a metal, in some instances a shape memory metal. The device has a construction including a plurality of petals, the petals containing an inner rib which curves in the deployed state. A method of making a filter device is also disclosed.

Abstract: Transcatheter guidewire delivery systems, catheter assemblies and associated methods for percutaneous guidewire delivery across heart valves are disclosed herein. A catheter assembly configured in accordance herewith includes an elongated tubular component and an alignment assembly at a distal portion of the tubular component and which is adapted to be located at a target location adjacent a heart valve of a patient. In one embodiment, the alignment assembly deploys to a shape set loop configuration with a side port in an open configuration positioned to allow advancement of a guidewire to exit the catheter in an aligned path with a leaflet coaptation region of the heart valve. In another embodiment, the alignment assembly has a plurality of spaced apart side ports that a guidewire may advance therethrough and toward the heart valve. In some embodiments, a wire guide is used to align the guidewire with a selected side port.

Abstract: A delivery system for percutaneously deploying a prosthetic heart valve. The system includes an inner shaft assembly, a delivery sheath capsule and a handle maintaining a first actuator and a second actuator. The capsule is configured to compressively retain the prosthetic heart valve over the inner shaft assembly. The first actuator is operated to proximally retract the delivery sheath capsule and expose the prosthetic heart valve relative to the capsule. The second actuator is operated to proximally retract the prosthetic heart valve by transmitting forces to the inner shaft assembly.

Abstract: Systems and methods can remove material of interest, including blood clots, from a body region, including but not limited to the circulatory system for the treatment of pulmonary embolism (PE), deep vein thrombosis (DVT), cerebrovascular embolism, and other vascular occlusions.

Abstract: Apparatus is provided that includes a tissue anchor, which (a) includes a helical tissue-coupling element which has a distal tissue-penetrating tip at a distal end of the tissue anchor, and which is configured to be advanced into soft tissue, and (b) is shaped so as to define a longitudinal channel extending to the distal end of the tissue anchor. The apparatus further includes a depth-finding tool, which includes a radiopaque bead that is axially moveable along the channel so as to serve as a marker indicating a depth of penetration of the tissue-coupling element into the soft tissue.

Abstract: An endoscopic stone-extraction device is provided comprising a support filament comprising an end portion, a sheath comprising a lumen, wherein the support filament is disposed in the lumen such that the sheath is slideable with respect to the support filament, and a handle comprising an actuator. Movement of the actuator in a first direction retracts the sheath and causes a shape to expand outside the lumen. Movement of the actuator in a second direction advances the sheath and causes the shape to at least partially collapse inside the lumen. Other embodiments are provided, and any of these embodiments can be used alone or in combination.

Abstract: The presently disclosed delivery systems utilize microtools, also referred to as theragrippers, to deliver a drug or other therapeutic agent to targeted tissue. More particularly, the drug delivery system and methods provide a delivery system that is capable of anchoring to a tissue site and then delivering a drug or therapeutic agent to the tissue directly to or in the vicinity of the site over an extended period of time. Any number of theragrippers may be deployed as desired to deliver different doses of a desired drug or therapeutic agent. The theragrippers also can be biodegradable such that they remain in place for an extended period of time and then degrade without adversely affecting the surrounding tissue.

Abstract: A medical device for blood flow restoration and/or for use as an implantable member in a human vessel includes a self-expanding member, a guidewire, and a connection mechanism. The self-expanding member includes a plurality of cells and filaments having specific ranges of thicknesses, widths, and heights. The self-expanding member can take on a volume-reduced coiled form with overlapped edges, and can generate optimal radial forces against a vessel wall and/or thrombus when deployed and expanded.

Abstract: An anchoring delivery system for use in an intracranial artery is provided including a tethering device having an elongated tether and an anchor coupled to a distal end of the tether. The anchor is deployable from a low profile configuration to a higher profile configuration to fix the distal end of the tether at an anchoring site in an anchoring vessel. The tethering device is configured to be used with a guide-sheath having a lumen configured to receive the tether. Related devices, systems, and methods are also described.

Abstract: There are described a variety of intravascular filters have wherein at least a portion of the filter has been modified to provide an enhanced echogenic characteristic of the filter.

Abstract: There is disclosed a porous emboli deflector for preventing cerebral emboli while maintaining cerebral blood flow during an endovascular or open surgical procedure. The device prevents the entrance of emboli of a size able to cause stroke (such as greater than 100 microns) from entering either the right or left common carotid arteries, and/or the right or left vertebral arteries by deflecting emboli downstream of these vessels. The device can be placed prior to any manipulation of the heart or aorta allowing maximal protection of the brain during the index procedure. The deflector has a low profile within the aorta which allows sheaths, catheters, or wires used in the index procedure to pass. Also disclosed are methods for insertion and removal of the deflector.

Abstract: A microcatheter deliverable implant is provided formed of an elongated wire of a diameter capable of delivery through the axial passage of such a microcatheter. A first portion of the formed implant forms a coiled first section larger in diameter than an anomaly to be blocked. A second portion formed by the coiled wire engages the implant between the first and second portions to block communication of fluid through the anomaly.

Abstract: A system can comprise a catheter and a device having an elongate member and an expandable member. The expandable member can be coupled to the elongate member. The elongate member can extend through the catheter. The expandable member can be positioned with a proximal member end proximal to a distal catheter end, a distal member end positioned distal to the distal catheter end, and at least a portion of the expandable member between the distal catheter end and the distal member end in an expanded state in which a maximum transverse dimension of the expandable member is larger than a maximum transverse dimension of the distal member end. The catheter can be advanced in a patient's body with the expandable structure, in the expanded state, at the distal end of the catheter.

Abstract: A profile altering tip is provided for a delivery system. The tip defines a first profile with a generally conical shape and a second profile with an expanded profile. During use of the delivery system, a tip profile control assembly can alter the tip from the first profile to the second profile.

Abstract: A method for reducing left ventricular volume, which comprises identifying infracted tissue during open chest surgery; reducing left ventricle volume while preserving the ventricular apex; and realigning the ventricular apex, such that the realigning step comprises closing the lower or apical portion of said ventricle to achieve appropriate functional contractile geometry of said ventricle in a dyskinetic ventricle of a heart.

Abstract: An absorbable vascular filter is disclosed for deployment within a vessel for temporary filtering of body fluids. A preferred embodiment is the placement of such absorbable vascular filter within the inferior vena cava (IVC) to filter emboli for the prevention of pulmonary embolism for a limited duration in time. Once protection from PE is complete, the filter is sequentially biodegraded according to a planned schedule determined by the absorption properties of the filter components. Hence the temporary absorbable vascular filter obviates the long term complications of permanent IVC filters such as increased deep vein thrombosis, while also circumventing the removal requirement of metal retrievable IVC filters.

Abstract: The medical device can comprise a manipulation member, a mechanical thrombectomy apparatus attached to a distal end of the manipulation member, and flow-restricting apparatus attached to the manipulation member to a location proximal to the mechanical thrombectomy apparatus. A method, for retrieving thrombus from a blood vessel, can comprise advancing a single elongate delivery member carrying a mechanical thrombectomy apparatus and a flow-restricting apparatus through a catheter to the blood vessel, expanding the thrombectomy apparatus and capturing the thrombus with the thrombectomy device, expanding the flow-restricting apparatus to at least partially occlude blood flow toward the thrombus, retracting at least a portion of the thrombectomy apparatus into the flow-restricting apparatus, and retracting the flow-restricting apparatus and the thrombectomy apparatus into the retrieval catheter.

Abstract: An assembly including a deployment device for deploying a stent device into an aorta of a patient is provided. The deployment device includes a rod translatable within an aorta of a patient and a first release wire configured for releasing one or more radially constraining members, wherein the radially constraining members are configured to constrain a diameter of the stent device. The stent device is at least partially permeable and engaged with the deployment device in an initial configuration, wherein a diameter and a length of the stent device in a deployed configuration can be altered by axial translation of the rod and releasing one or more of the radially constraining members by translation of the first release wire.

Abstract: A catheter includes a protective film covering an inner periphery of a proximal end side of a tubular mesh member, the tubular mesh member being expandable and contractible in a radial direction. The tubular mesh member including a first wire that is interwoven with a second wire. The protective film being joined only to any one of either the first wire or the second wire. The catheter has improved efficiency for removing a blockage in a blood vessel, and the catheter can prevent breakage of a retrograde guide wire. Additionally, the mesh member having the protective film is able to smoothly expand and contract.