Abstract: A steerable device, such as a catheter or a guidewire, adapted for insertion into a patient is provided with a means for controllably varying the curvature at the distal end of the device. The arrangement includes a conduit, at least a portion of which is formed from a material that contracts when contacted by a first liquid and expands when contacted with a second liquid. The liquids preferably are immiscible and are disposed in the conduit. Means are provided for shifting the position of the liquid column in the conduit. The portion of the conduit formed from said material is formed into a configuration that will cause that portion of the conduit to change shape depending on the position of the liquid column in the conduit.

Abstract: A balloon catheter for dilating an obstructed lumen in the human body has a specially shaped balloon which, when inflated, has a proximal end cone having a relatively small cone angle and a distal end cone with a relatively large cone angle. The catheter is used in a procedure in which it is inserted into the obstructed lumen, with the ballon in the deflated condition and with the balloon advanced through and past the obstructed region. The balloon then is inflated and then is drawn back through the constricted region to dilate it progressively by the proximal cone of the balloon. Also disclosed are improved techniques relating to use of balloon catheters in the treatment of fallopian tube disorders including procedures for treating hydrosalpinx, for tubal manipulation and for GIFT procedures.

Abstract: A micro-injection port having a low profile is provided. The micro-injection port has a septum and an injection chamber located side-by-side. When implanted, the puncture surface of the septum lines substantially perpendicular to the surface of the the micro-injection port also has a filter systems skin. The filter is formed from an opening in the side wall of the injection port and a shaft secured within the opening.

Abstract: A system for introducing a stent into a patient at a site of stenosis is disclosed. The system comprises a balloon catheter having a stent surrounding the balloon portion of the catheter. At least one stent-retaining means is located adjacent to at least one end of the balloon to retain the stent in position on the catheter until the balloon is inflated. Upon inflation of the balloon, the stent is expanded and the retention means releases the stent. The balloon is then deflated and the catheter is removed from the patient, leaving the expanded stent in place.

Abstract: Probe-like catheter has a small diameter and can be steered to and passed through narrow stenoses. The probe has a balloon at its distal end which is collapsible to a low profile to enable it to be passed through the stenosis. The probe may include a distal tip which can hold a preset curve. The probe is sufficiently rigid to enable the transmission of torque to the distal end to permit steering of the probe by controllably rotating the proximal end of the probe.In use, a stenosis which cannot be crossed by a more conventional sized dilatation catheter may permit passage of the dilatation probe.

Abstract: A device and method for accessing the uterus to manipulate it or to introduce fluids or other devices into it. The device includes a shaft having a first, expandable distal member which is inserted into the uterus and a second, inflatable proximal member which is inserted partially into the cervical canal. The proximal member automatically adjusts to the length of the cervical canal upon inflation because only the proximal portion of the proximal member which is outside of the cervical canal expands. During use of the device, the distal member is expanded within the uterus and the shaft is withdrawn proximally until the expanded distal device contacts the internal os of the cervix. The proximal member is then inflated proximal to the exterior os of the cervix. The distal portion of the proximal member lies within and is obstructed by the cervical canal. The distal and proximal members thereby cooperate to securely couple the shaft to the uterus by automatically adjusting to the length of the cervical canal.

Abstract: A balloon angioplasty system includes a balloon dilatation catheter having an inflation and deflation lumen for the balloon and a main lumen extending the full length of the catheter to provide fluid communication from the proximal to the distal end of the catheter. A microdilatation probe has a small diameter and can be passed through the main lumen of the dilatation catheter. The microdilatation probe has a balloon at its distal end which is collapsible to enable it to be passed through the main lumen of the dilatation catheter so that it can be projected distally beyond the distal tip of the dilatation catheter. The probe balloon is inflatable to a diameter no smaller than the diameter of the uninflated dilatation catheter.

Abstract: An uncured or partially cured, collagen-based material is delivered to a selected site in a blood vessel and is crosslinked in the blood vessel by laser energy or other suitable energy to form an endovascular stent. The collagen-based material can be delivered to the blood vessel as a coating on an inflatable balloon mounted on the distal end of a catheter. The collagen-based material can also be delivered to the blood vessel in liquid form and forced through a porous balloon to form a tubular configuration. The collagen-based material is preferably crosslinked by laser radiation carried through an optical fiber to a diffusing tip located within the balloon. In another embodiment, an endovascular stent is formed by rolling a flexible sheet of biologically-compatible material onto an outside surface of an inflatable balloon.

Abstract: A balloon dilatation catheter having a guidewire lumen that extends to the distal tip of the catheter, a balloon mounted on the distal end of the catheter and an inflation lumen extending through the shaft and communicating with the interior of the balloon is provided with an improved arrangement for filling the inflation lumen and balloon with liquid while purging air from the system. The device includes a one-way valve means carried by the catheter shaft within the balloon which permits fluid flow from the guidewire lumen into the balloon under a predetermined pressure greater than about one atmosphere. The system is used by first plugging the distal end of the guidewire lumen and then pressurizing the guidewire lumen with inflation liquid sufficiently to open the one-way valve means to permit inflation liquid to fill the balloon. As the balloon fills, air is forced out of the balloon through the inflation lumen and is vented through the open proximal end of the inflation lumen.

Abstract: A method and catheter for use in practicing the method are provided by which a highly concentrated medication or chemotherapeutic agent can be applied locally under sufficient pressure to cause the medication or agent to penetrate into the localized tissue. The total volume of medication or agent is quite small, well below levels that might cause an adverse reaction in other parts of the body. The catheter includes a thin walled flexible balloon having a plurality of minute holes through which medication may flow at a low flow rate. The balloon is inflated with the medication under pressure and the flow rate of the order of a few ccs per minute is controlled by the minute holes in the balloon. In practicing the method of the invention, the balloon is selected such that its inflated diameter will correspond to or be slightly greater than the diameter of the lumen into which it is to be placed so that when the balloon is inflated, it will contact intimately the surface of the lumen.

Abstract: A balloon dilatation catheter is provided with a fluted balloon defining at least three wings. When the balloon collapses, it tends to assume the fluted configuration which defines a lower profile better adapted to pass through narrow channels, such as in endoscopes and guide catheters. The balloon is formed from a polymeric material in a method that involves the steps of tensioning the balloon to cause it to form flutes while maintaining its interior under vacuum and subjecting the balloon, while so held, to heat and, thereafter, cooling the balloon while maintaining it in its tensioned, fluted configuration.

Abstract: A surgical gripping instrument comprises a support assembly, a slide mounted on the support assembly for relative movement with respect thereto, a wire movable with the slide relative to the support assembly, gripping means at the distal end of the wire, and a sheath enveloping the wire. Movement of the wire a predetermined distance relative to the sheath causes the gripping means to be actuated. A belt or gear arrangement is provided to enable the slide to be moved a distance relative to the support assembly less than the predetermined distance causing sufficient displacement of said sheath relative to the gripping means to actuate the latter.

Abstract: A balloon catheter for dilating an obstructed lumen in the human body has a specially shaped balloon which, when inflated, has a proximal end cone having a relatively small cone angle and a distal end cone with a relatively large cone angle. The catheter is used in a procedure in which it is inserted into the obstructed lumen, with the balloon in the deflated condition and with the balloon advanced through and past the obstructed region. The balloon then is inflated and then is drawn back through the constricted region to dilate it progressively by the proximal cone of the balloon. Also disclosed are improved techniques relating to use of balloon catheters in the treatment of fallopian tube disorders including procedures for treating hydrosalpinx, for tubal manipulation and for GIFT procedures.

Abstract: A flexible, lubricious organic polymeric coating is formed by applying a mixture of an isocyanate, a polyol, poly(ethylene oxide), and carrier liquid to a surface to be coated. The carrier liquid is removed and the mixture reacted to form a polyurethane coating with associated poly(ethylene oxide) giving a highly lubricious, abrasion resistant, flexible coating particularly suitable for use as a protective lubricious coating on devices introduced into the body.

Abstract: A guidewire for use with a catheter has varying radiopacity at its distal end. The guidewire includes a shaft having an outer helical coil attached to the distal region of the shaft, the coil extending distally beyond the distal end of the shaft and terminating in a tip weld. The outer coil is formed from a small diameter highly radiopaque wire. A smaller diameter inner helical coil, formed from a larger diameter highly radiopaque wire is disposed within the outer coil and is attached at its proximal end to the distal end of the shaft and at its distal end to the tip weld. The guidewire thus defines an arrangement which when viewed fluoroscopically will have a highly radiopaque distal portion and a moderately radiopaque proximal portion.

Abstract: A small diameter steerable guidewire for cardiovascular catheterization procedures is provided with a means by which the curvature at the distal tip of the guidewire can be adjustable by control applied at the proximal end of the guidewire whereby the curve at the distal end of the guidewire can be adjusted without requiring removal of the guidewire from the patient. The proximal end of the guidewire is configured so that it can be attached to a guidewire extension so as to facilitate catheter exchanges.

Abstract: A urethral stent is disclosed for the nonsurgical management of bladder outlet obstruction caused by an enlarged prostate. The stent is sufficiently rigid to provide support to assure patency of an intact but contracted urethral lumen but is sufficiently flexible to accommodate the natural anatomical bend of the prostatic urethra. The stent further includes means for frictionally engaging the urethral walls to anchor the device within the protstatic urethra and to prevent migration back into the bladder or down the urethra. When the need arises, the stent is easily and nonsurgically removed from the prostatic urethra.

Abstract: A vascular dilator has a truncated tip adapted to reduce the risk of trauma to a blood vessel into which the dilator is to be inserted. The vascular dilator comprises an elongate tube having a guide member lumen of uniform diameter in which a guide member may pass. The thickness of the walls of the elongate tube decreases at the distal portion to create a tapered configuration. The distal portion terminates in an outlet defined by first and second arcuate segments. The first arcaute segment lies generally in a plane perpendicular to the longitudinal axis of the tube, whereas the second segment lies so as to meet the first segment at angle in the range of 30.degree. to 60.degree..

Abstract: A disposable biopsy forceps includes an elongate tubular member having proximal and distal ends. Manually operated actuating means is mounted to the proximal end of the flexible tubular member. A biopsy jaw assembly is mounted to the distal end of the tubular member and is operatively connected to the actuating means by a control wire extending through the tubular member. Several embodiments of jaw arrangements are disclosed. At least the cups and cutting rim portion of the cutting jaws is formed from an injection molded plastic capable of holding and retaining an edge sufficiently sharp to cut tissue.

Abstract: A low profile, steerable balloon dilatation catheter for dilating obstructions in blood vessels is provided which also enables catheter exchanges to be performed without losing guidewire position. The system includes a guidewire and catheter that can be locked together to be operated in a manner as that of an integral wire catheter, or alternatively, they can be unlocked to allow the guidewire to be operated independently in a manner similar to that of an over-the wire catheter system. In the latter mode of operation, the length of the guidewire, at its proximal end, can be extended and the catheter can be withdrawn from the patient without causing a loss of guidewire position. With the guidewire position so maintained, a succeeding catheter can be advanced over the guidewire to the vascular location being treated.