Abstract: In some aspects, the present disclosure pertains to multi-arm polymers that comprise a core and a plurality of polymer segments having a first end that is covalently attached to the core and (a) a second end comprising a moiety that comprises a reactive end group, wherein the polymer segments comprise one or more hydrophilic aprotic NMP-polymerizable monomers, and wherein the reactive multi-arm polymer comprises nitroxide radicals or (b) a second end comprising a moiety that comprises an alkoxyamine group, wherein the core is a polyol residue, and wherein the polymer segments comprise one or more NMP-polymerizable monomers. In some aspects, the present disclosure pertains to a multifunctional alkoxyamine molecule comprising a core and a plurality of alkoxyamine groups covalently attached to the core, wherein the core is a polyol residue.

Abstract: An apposition device having a first elongate element movably coupled with a second elongate element. The second elongate element is deployable distal to the structures to be apposed, in a position transverse to the first elongate element. The first elongate element may be pulled to pull the second elongate element to move the structures into apposition. A third element may be positioned proximal to the structures to hold the structures in apposition. The third element may be a ratcheting element fixable in place with respect to the first elongate element. The apposition device may be deployed with a fine gauge needle. The second elongate element may be deployed from a side port in the needle facilitating deployment, and/or movement of the second elongate element with respect to the first elongate element and into a deployment configuration. Such arrangement may allow control of the first elongate element independent of the needle.

Abstract: The present disclosure relates generally to the field of medical devices. In particular, the present disclosure relates to a tissue traction device for endoscopic procedures such as tissue dissection. For example, a tissue traction device may include first and second attachment members pivotably attached by first and second swivels to opposite ends of a stretchable traction band comprising a compliant or semi-compliant material.

Abstract: A device for permanent placement across an atrial appendage ostium in a patient includes a support structure having a contracted delivery configuration and an expanded deployed configuration defining a radially enlarged portion to permanently engage an interior wall of the atrial appendage, a membrane attached to the support structure and configured to extend across the ostium of the atrial appendage when the support structure is in the expanded deployed configuration, and a polymer coating disposed on at least one of the support structure and the membrane, the polymer coating including a direct oral anticoagulant (DOAC) dispersed in a polymer.

Abstract: Techniques are provided for controlling an output laser pulse signal of a medical device. A control device defines a time duration of capacitive discharge to a laser device. The time duration corresponds to an intended energy of the output laser pulse signal. The control device generates a plurality of sub-pulse control signals. The sub-pulse control signals define a series of capacitive discharge events of the capacitor bank. The control device modulates one or more of a sub-pulse control signal period or a sub-pulse time duration of the sub-pulse control signals to modify the capacitive discharge of the capacitor bank to the laser device during the time duration.

Abstract: An endoscopic system includes an endoscopic imager configured to capture image frames of a target site within a living body and a processor configured to apply a spatial transform to a preliminary set of image frames, the spatial transform converting the image frames into cylindrical coordinates; calculate a map image from the spatially transformed image frames, each pixel position in the map image being defined with a vector of fixed dimension; align a current image frame with the map image and apply the spatial transform to the current image frame; fuse the spatially transformed current image frame to the map image to generate a fused image; and apply an inverse spatial transform to the fused image to generate an enhanced current image frame having a greater spatial resolution than the current image frame. The system also includes a display displaying the enhanced current image frame.

Abstract: An atherectomy system includes a handle having a handle housing, with a drive member extending through the handle housing and operably coupled to an atherectomy burr. A drive mechanism is disposed within the handle housing and is adapted to rotatably engage the drive member. The drive mechanism may include an electric drive motor, a drive gear that is rotatably engaged with the electric drive motor and a driven gear that is coupled with the drive member and is engaged with the drive gear such that rotation of the driven gear causes rotation of the drive member. The drive mechanism may be configured to enable a rotation speed of the atherectomy burr of up to at least about 200,000 revolutions per minute (rpm).

Abstract: Embodiments herein relate to systems and methods for intravascular lesion disruption. In an embodiment, a catheter system for imparting pressure to induce fractures upon a vascular lesion within or adjacent a blood vessel wall is included. The system includes a catheter configured to advance to a vascular lesion, the catheter including an elongate shaft that defines at least a first orifice for fluid flow; a balloon, coupled to the elongate shaft, that surrounds the first orifice where the balloon can expand from a collapsed configuration suitable for advancing the catheter through a patient's vasculature to a first expanded configuration suitable for anchoring the catheter in position relative to a treatment site; and a propulsion system configured to propel a fluid from the first orifice toward the balloon wall to create an inertial impulse in a vessel wall to transfer momentum to the vascular lesion. Other embodiments are also included herein.

Abstract: Devices and methods for acquiring and fastening tissues folds within an internal organ, such as the stomach, and for applying the methods and devices to producing reductions in organ volume or repair of bariatric procedures, are disclosed. An exemplary method for forming a continuous laterally extending tissue fold involves forming a succession of laterally extending folds having adjacent overlapping fold portions. One exemplary tissue-acquisition device has an open-end roller-and-arm structure that allows individual tissue folds to be formed and fastened, then advanced to an adjacent region within the stomach, for capture of a new fold that will form an extension of the existing fold(s).

Abstract: A cutting balloon catheter including a balloon mounted on a distal portion of a catheter shaft. The balloon includes a cutting member mounted on an exterior surface of the balloon which includes one or more features for providing the cutting member with enhanced flexibility for navigating tortuous anatomy and more closely conforms to the expansion characteristics of the balloon to which the cutting member is mounted.

Abstract: Thrombectomy catheter and pump assemblies for controlling a flow of effluent from a thrombectomy catheter. An illustrative assembly may a thrombectomy catheter, a pump, a connection manifold assembly positioned between the thrombectomy catheter and the pump, an effluent return tube fluidly coupled to the thrombectomy catheter and the connection manifold assembly, an effluent collection bag, an effluent waste tube fluidly coupled to the connection manifold assembly and the effluent waste bag, and a spool valve positioned in line with the effluent waste tube.

Abstract: In accordance with some aspects, the present disclosure is directed to medical compositions that comprises (a) a first hydrophilic polymer functionalized with a plurality of first functional groups and (b) a second hydrophilic polymer functionalized with a plurality of second functional groups, wherein the first and second functional groups are selected to react and form covalent bonds upon a change in conditions such that the first and second hydrophilic polymers crosslink with one another. In other aspects the present disclosure is directed to kits that comprise such medical compositions and to medical procedures that utilize such medical compositions.

Abstract: A medical device system may include an occlusive implant including a central hub and a plurality of elongate members configured to shift between extended and radially expanded configurations. The central hub includes a plurality of conduits extending from a proximal end to a radially outward facing surface. The plurality of elongate members is configured to extend through the conduits in the radially expanded configuration. An implant remodeling tool may include an elongate sheath having at least one lumen, a plunger guide, and a plurality of plunger shafts extending from the at least one lumen through the plunger guide. The plunger guide is configured to direct the plunger shafts radially outward as the plunger shafts are advanced distally. The plunger shafts are configured to engage a medical implant and urge at least a portion of the implant radially outward.

Abstract: A medical device includes an electrode shaft and an insulation tip. The electrode shaft is configured to deliver energy to a target site and includes an electrode shaft lumen configured to deliver fluid to the target site. The insulation tip is coupled to a distal tip of the electrode shaft. The insulation tip includes an insulation tip lumen fluidly connected to the electrode shaft lumen and configured to deliver fluid to the target site. The insulation tip covers an entirety of the distal tip of the electrode shaft.

Abstract: Irrigation devices, methods, and systems are disclosed. The system comprises a catheter with one or more lumens and an expandable portion. One or more pumps are used to supply a mixture of contrasting and dilating agents in an interior kidney volume and flush a portion of the mixture out of the interior kidney volume. The method comprises placing a catheter into the interior kidney volume through a ureter, occluding a portion of the ureter with a distal end of the catheter, forming an exit port through an exterior kidney surface, flowing the contrasting and dilating agents through the one or more lumens to supply the mixture in the interior kidney volume, and flushing a portion of the mixture out of the exit port.

Abstract: The present disclosure relates generally to systems, medical devices, and methods for closing an opening in a target tissue using hydraulics and/or pneumatics. In some embodiments, a medical device may include an endoscopic device operable to close an opening in a target tissue, and an actuator operable with the endoscopic device, wherein the actuator includes a piston within a chamber. The piston may include a piston head engaged with an interior surface of the chamber, and a piston rod coupled to a tissue engagement component of the endoscopic device, wherein pressure from a fluid within the chamber actuates the tissue engagement component.

Abstract: An endoprosthesis may include an expandable framework configured to shift between a delivery configuration and a deployed configuration, and a covering including a plurality of polymeric cover segments disposed about at least a portion of the expandable framework. A portion of each of the plurality of polymeric cover segments may be fixedly attached to the expandable framework. The plurality of polymeric cover segments is longitudinally spaced apart from each other in the delivery configuration. The plurality of polymeric cover segments longitudinally overlaps each other in the deployed configuration.

Abstract: An implantable inflatable penile prosthesis cylinder includes an outer tube member having a longitudinal axis, an inner tube member contained within the outer tube member, and one or more tensile support members within the inner tube member. The inner tube member includes at least one inflatable chamber section, at least a portion of which is defined by a wall of the inner tube member. The one or more tensile support members extend between interior surfaces of the wall and are placed in tension when the at least one chamber section is in an inflated state.

Abstract: One general aspect includes a system for ablation including a catheter including a sheath defining a sheath lumen and a distal end, and an elongate electrode assembly axially moveable within the sheath lumen. The electrode assembly includes a shaft defining a central channel and a distal central channel opening. The electrode assembly also includes an expandable electrode array including two or more electrode elements positioned at the distal portion of the electrode assembly, where the electrode array is moveable between a retracted position contained within the sheath lumen and an expanded position protruding from the sheath.

Abstract: Embodiments of the disclosure include methods and systems for attaching an articulation section. In an embodiment, a medical instrument includes a first tubular member including a first end. The medical instrument also includes a second tubular member including a first end. The second tubular member includes a plurality of layers including an inner layer and a first layer including a fluorinated material. The inner layer includes a first section disposed under the first layer and a second section extending out from under the first layer. A portion of the first tubular member overlaps and is bonded to at least a portion of the second section of the inner layer of the second tubular member.