Abstract: A soft tip guiding catheter for atraumatic insertion into delicate, tortuous coronary vessels and introduction of an angioplasty balloon catheter therethrough. The guiding catheter includes a main tubular portion and a soft tubular tip with cooperating bonding surfaces for increasing the contact area and strength of the thermal bond therebetween. The cooperating bonding surfaces each include a proximal ground taper portion with a braid material included therein and a distal longitudinal portion without the braiding material. The main portion preferably includes an inner layer of lubricous material, an outer layer of a polyether block amide, and a reinforcing braid positioned therebetween. The main tubular portion also includes distal and proximal segments heat shrink bonded together to provide changes in durometer along the length of the catheter. The layers of the main portion provide a thin catheter wall with pushability, torquability, and kink resistance.

Abstract: A transluminal grafting system for grafting a prosthesis to the wall of a lumen includes a tubular graft provided with spring assemblies and anchoring barbs. The prosthesis is mounted on an apertured tubular carrier and a central control means is inserted into the bore of the apertured carrier. Mooring loops are attached to the prosthesis, pass through the apertures of the tubular carrier, and engage the central control means. An introducer sheath covers the system for smooth insertion into a lumen. When the graft has been positioned, the central control means maintains the axial position of the prosthesis. When the introducer sheath is pulled, the prosthesis is exposed and the spring assemblies return to an expanded state and anchor the graft against the internal wall of the lumen.

Abstract: A grommet positioning device 10 includes a positioning member 16, such as a sheath 28, carrying an elastic anchor, fastener or grommet 14 thereon. The grommet 14 is preferably composed of silicone and has a predefined, unstressed interior diameter. The positioning member 16 includes a portion 25 in contact with the grommet, the portion 25 having an outer diameter at least equal to the predefined, unstressed interior diameter of the grommet 14. The positioning member 16 is capable of being split or torn apart along at least the portion 25, so as to release the grommet 14 from the member 16 and allow it to be fixed in position along an object such as a catheter 12. The interior diameter of the grommet 14 is chosen to preclude closure or blockage of the catheter 12 when the grommet 14 is positioned on it. The positioning member 16 is preferably configured as a sheath 28 composed of molecular oriented PTFE, capable of being split along its entire length, and includes pull tabs 46 for causing such splitting.

Abstract: A needle inserted into body tissue is rendered visible to a Doppler ultrasound imager by generating a longitudinal oscillation of the fluid column in the needle barrel by means of a transducer which is energised by a signal of frequency 100 Hz to 2 kHz, for example. An image of the needle tip is displayed on a screen.

Abstract: An assembly for positioning an embolization coil (4) in the vascular system. The assembly includes a guidewire having a relatively flexible distal section (6), which has a central core (7) and a threading coil (10), the distal turns (11) of which are arranged with such mutual spacing (12) that the embolization coil can be threaded in and out of the threading coil. The distal end section of the guidewire is manufactured with an elongated, rotationally symmetrical member, such as cylindrical member (13), and the peripheral surface of the member is provided with a bonding layer (25). Then the distal turns of the threading coil are positioned in the desired helical shape on the external side of the member, and the bonding layer is activated so that the distal turns are fixed to the member in this shape.

Abstract: An improved prosthesis assembly for placement at an aneurysm in the bifurcated lumen of the aorta and the common iliac arteries extending therefrom. The prosthesis assembly includes a single lumen graft or a bifurcated lumen graft having a main body and ipsilateral and contralateral limbs extending therefrom. The main body and ipsilateral and contralateral limbs each have a spring assembly about their orifices for conforming that portion of the graft to the wall of the vessel lumen. The main body spring assembly has an improved barb with first and second attachment arms for securely anchoring the spring assembly to the vessel wall. The improved barb includes two forms of mechanical attachment such as, for example, a helical coil body positioned around a spring assembly arm and, secondly, a bonding material such as, for example, solder for fixedly attaching the coil and spring assembly arm.

Abstract: A tracheal guide (10) for positioning a medical device (11) such as an endotracheal or intubation tube in the trachea (12) of a human patient (13). The tracheal guide includes an elongated member (14) with a generally U-shaped passage (17) extending therethrough. Ears (18, 33) are disposed laterally about the passage and, in particular, the distal end (15) thereof. These ears are shaped for conformance with and placement in the piriform fossa (19, 34), which are located in the vicinity of the glottic opening (39) of the trachea. A tongue (25) extends distally from the distal end of the elongated member and into the esophagus (32) of the patient when the ears of the guide are positioned in the piriform fossa. The passage of the elongated member includes first and second surfaces (20, 24) that form an edge (26) that extends anterior to the cricoid cartilage and, in particular, the transverse arytenoid when the edge and ears are properly positioned in the patient's airway.

Abstract: A uterine endometrial tissue sample brush 10 includes a flexible core 12 having a distal core end 16 and a cylindrical brush member 18 carried adjacent the distal core end 16. The core 12 is formed from a spirally wrapped pair of wires 22 and includes an atraumatic tip 26. The brush member 18 is about 3 to 5 cm long and has a free outside diameter, preferably about 5.08 to 7.62 mm (0.2 to 0.3 in.), suited to maintain patient comfort yet comprehensively contact the undilated uterine canal 38. The brush member 18 includes a plurality of resilient bristles 20 axially spaced about 0.5 to 1.5 mm apart. The bristles 20 have a stiffness equivalent to that possessed by nylon-6,12 at a diameter of about 0.076 to 0.152 mm (0.003 to 0.006 in.). This stiffness is critical and unexpectedly gives the brush 10 good exfoliating and collecting abilities simultaneously, in contrast to prior devices which may possess either good exfoliating or good collecting abilities, but not both abilities at the same time.

Abstract: An introducer (10) method of percutaneously deploying a self-expanding stent (14) in a body vessel or duct (43). The stent introducer includes an outer elongated member tube (11) having a passage (12) extending longitudinally therein and operable in a first direction (13) for deploying the self-expanding stent in a collapsed condition from the outer member passage. An inner elongated member (15) is positioned in the outer member passage and is operable in a second direction (16) for deploying the stent from the outer member passage. An interconnection mechanism (17) is connected to the outer and inner members for operation thereof, whereby a stent in a collapsed condition is deployed from the outer member passage to an expanded condition. When deployed, the expanded portion of the stent remains fixedly positioned longitudinally in the body vessel or duct as the remaining portion is deployed from the outer member passage.

Abstract: A flexible, kink-resistant, introducer sheath for percutaneous vascular access. The introducer sheath includes a flat wire coil with uniform spacing between the turns, which is compression fitted about an inner, lubricous material polytetrafluoroethylene tube. The introducer sheath further includes an outer tube of a heat formable polyamide material which is heat formed and compressed through the spaces between the turns of the wire coil to mechanically connect to the roughened outer surface of the inner tube. The distal end of the outer tube is tapered in a mold with additional polyamide outer tube material. The proximal end of the sheath is flared for connection to a connector fitting. In another aspect of the introducer sheath, the flat wire coil has an inner diameter less than the outer diameter of the inner tube. The coil is then expanded and wrapped around the inner tube to form a compression fit.

Abstract: A device (10) for removing from a patient (12) a previously implanted elongated structure (14), such as a catheter, sheath, defibrillator lead, pacemaker lead (15) or the like. The device (10) includes a snare (24) which encircles and reversibly grasps either the proximal end (16) or the distal end (20) of the elongated structure (14), as well as a sheath member (22) for delivering the snare (24) to the particular end (16 or 20) of the structure (14) to be grasped.

Abstract: A transluminal arrangement for positioning a prosthesis assembly at an aneurysm in the bifurcated lumen of the aorta and the common iliac arteries extending therefrom. The prosthesis assembly includes a bifurcated endovascular graft having a main body and ipsilateral and contralateral limbs extending therefrom. The assembly also includes main, ipsilateral, and contralateral spring assemblies each having a compressed state. When released from its compressed state, each spring expands a portion of the graft to substantially conform that portion of the graft to the wall of the bifurcated lumen. The transluminal arrangement comprises an elongated member extending through the main and ipsilateral bores of the graft and includes attachment sutures and an inner catheter extending therethrough for temporarily attaching the main and ipsilateral spring assemblies to the elongated member.

Abstract: A medical article for implantation into the vascular system of a patient comprises a self expanding body shaped substantially into the form of a body (1; 2) of revolution, at least part of the surface of which is defined by wire members (3) forming cells of a generally polygonal shape. The body of revolution has a diameter increasing continuously in an axial direction of the body from one end forming an apex (4) towards the opposite end forming a base (5). In a preferred embodiment, the body (1; 2) of revolution is defined by a generatrix forming n-th order curve. The article may comprise two bodies (1; 2) of revolution joined at their apices (4). The article may be used, in particular as an intravenous filter for the capture of thrombi or in combination with an elastic blood impermeable membrane flexibly linked to the apex of the body of revolution as an occlusion device for closing a vessel lumen or defects such as ASD or PDA in vascular walls.

Abstract: A kink-resistant catheter, such as a balloon dilation catheter (10) useful in endoscopic or other surgical procedures, includes a flexible nitinol wire (24) having a transition temperature well above the temperature of the body. The catheter (10) remains essentially unkinked through acute bends and turns which would unacceptably kink comparable catheters having wires of stainless steel or other materials. The potential for patient injury from the catheter is thereby reduced. The catheter (10) includes a tubular catheter shaft (12) having a fluid flow lumen (14) defined therein, an expandable but nondistending balloon (18) connected to a distal end (16) of the shaft (12) in fluid communication with the lumen (14), and a flexible catheter tip (22) on the balloon (18) opposite the catheter shaft (12).

Abstract: A method and device 10 for providing an ostomy 102 through the wall 100 of the trachea are particularly advantageous in allowing the ostomy 102 to be formed atraumatically and to be enlarged without risk of perforating the rear of the trachea. The method employs a balloon catheter 16 including an inflatable balloon 18 and entails: positioning the catheter 16 over a percutaneously inserted wire guide 54; advancing the catheter 16 along the wire guide 54 until the balloon 18 lies across the tracheal wall 100; and inflating the balloon 18 to dilate a portion of the tracheal wall 100 and form an ostomy 102. The method desirably includes the further steps of deflating the balloon 18 and inserting a tracheal tube 20 into the ostomy 102. The method is preferably carried out with a device 10 which includes a dilator tube 12 carrying the catheter 16 and tracheal tube 20 on it. Such a construction allows the dilator tube 12, the balloon catheter 16 and the tracheal tube 20 to be advanced on the wire guide 54 together.

Abstract: Ureteral stents are tubes which are placed in the ureter between the bladder and kidney to maintain patency when otherwise due to stone burden, invasive tumor, scarring, or whenever the ureter has become obstructed in order to provide drainage of urine from the kidney to the bladder. In the past, stents of this nature are open ended tubes and may allow for the reflux of urine back into the kidney when there is sufficient buildup of pressure within the bladder. Since urine is generally considered to be sterile when within the body, this is generally not a problem. However, if the patient has a bladder infection and/or pyrogens are present, then urine refluxed into the ureter and kidney may result in the development of sepsis in the patient and cause serious illness and even death. The stent of the present invention has a very specific design and avoids this problem by providing a stent having a closed section, i.e.

Abstract: A prosthetic device for sustaining a vessel or hollow organ lumen (a stent) has a tubular wire frame (1) with rows of elongate cells (2) having a larger axis and a smaller axis. The cells are arranged with the larger axis in the circumferential direction of the frame (2) and the smaller axis parallel to the axial direction thereof. Each cell is formed by two U-shaped wire sections, and in a plane perpendicular to the longitudinal axis one of the branches of the U-shaped wire sections in one row form together a closed ring-shape (4) which provides the frame (1) with large radial stiffness. In the axial direction the frame (1) has only low stiffness so that it easily conforms to the vascular wall even if this deforms due to external loads. The interconnection between the cells (2) may be flexible.