Abstract: A controlled advancement laser ablation device is provided for precise ablation of body matter. The laser ablation device includes a laser energy transmission mechanism such as, e.g. a fiber optic fiber mounted for controlled translational longitudinal movement relative to a housing structure. A laser energy generator is optically connected to the laser energy transmission mechanism. A controlled advancement mechanism is provided in engagement with the laser energy transmission mechanism for advancing the mechanism through the housing structure at a controlled rated coordinated with the laser energy generator output to ablate body tissue. Controlled advancement mechanisms include constant and/or variable rate springs, motors, and other mechanisms which can be coordinated with the laser energy generator to advance the laser energy transmission mechanism as the targeted substance is ablated. The device is particularly suitable for use in transmyocardial revascularization (TMR) and angioplasty procedures.

Abstract: A graft forming apparatus and method including a plurality of mandrels for receiving tubular grafts thereon and an adjacent cutting instrument for forming regular and repeated patterns of small holes therein and for severing the ends of the graft. The cutting instrument is preferably a low-powered laser to form clean and non-frayed holes and lines in fabric grafts. The mandrel are mounted for rotation about an axis underneath the cutting instrument which is movable along the axis. By computer control, the motion of the cutting instrument and mandrel can be accurately and precisely choreographed. The mandrel may be a straight cylinder for forming straight grafts, or may be a bifurcated mandrel formed of several components. The bifurcated mandrel includes a trunk portion and pair of detachable leg portions. Adapter disks are provided so that the bifurcated mandrel can be rotated either about the axis of the trunk portion, or about the axis of one of the leg portions.

Abstract: A method for improving the radial enlargeability and other properties of tape-reinforced tubular vascular graft formed of sintered fluoropolymer(s), such as expanded, sintered PTFE. Broadly, the method comprises the step of radially shrinking the reinforcement tape layer of the graft, or the entire tape-reinforced graft, after sintering thereof. Such radial shrinkage of the reinforcement tape layer, or of the entire graft, renders the graft subsequently radially enlargeable by more than 5%, without tearing or breaking of the reinforcement tape layer of the graft. Radially enlargeable grafts of the present invention may be combined with various types of stents or anchoring systems, to form endovascular graft devices which are transluminally insertable and implantable within the lumen of a host blood vessel.

Abstract: A system for sensing a characteristic of fluid flowing to or from the body of a human or a comprising a conduit having a first end adapted to be outside the body, a second end adapted to be received within the body, and a flow passage through which fluid can flow between the first and second ends and a probe including a sensor for sensing a characteristic of the fluid. The probe is mounted on the conduit with the sensor in the flow passage. The sensor is isolated from the fluid flowing in the flow passage.

Abstract: A catheter-based material removal device includes an elongated tube having a distal material removal tip thereon. The material removal tip includes a one- or two-piece housing affixed to the tube, and a rotating member therein. The rotating member includes a screw thread for coarsely chopping material received within the housing and an outwardly projecting flange for finely chopping the material. The housing includes at least one shearing member located axially adjacent the outwardly projecting flange. The shearing member has a relatively small circumferential size and a shearing edge that removes any material buildup on the axially-facing surface of the flange. Two shearing members may be provided, one each on both the proximal and distal sides of the flange. There may be three flanges restrained within a groove formed with the housing.

Abstract: A method for inserting and maintaining an intracranial pressure monitoring catheter within a skull of a patient using a flexible catheter having a stylet insertion aperture formed in the side wall thereof opening to a stylet lumen extending to a closed distal end of the catheter. Two incisions are made in the scalp at a spaced distance apart. A bore hole through the patient's skull is then formed beneath a first of the incisions, and the catheter is inserted underneath the scalp from the second incision and out of the first incision until the stylet insertion aperture is exposed. A stylet is then inserted into the stylet insertion aperture and into the stylet lumen to impart stiffness to a distal portion of the catheter. The stylet-containing portion of the catheter is then inserted through the bore hole and advanced such that a pressure sensing/transmitting component on the distal end of the catheter is located intracranially.

Abstract: Methods for utilizing a device for blocking (e.g., embolizing) the side branches of an anatomical passageway under endoscopic guidance. The device comprises an elongate catheter body having a side branch blocking apparatus, such as an embolization catheter, disposed therein and further incorporating an endoscope (e.g., an angioscope). The incorporated endoscope is useable to a) visually locate side branches which emanate from the anatomical passageway and b) visually observe the operation of the side branch blocking apparatus. Disclosed are methods for performing in situ embolization of the side branches of a vein, under angioscopic visualization. The endoscopic component of the device may also be utilized to visually observe the use and/or effect of one or more separate device, such as valvulotome(s) used for cutting venous valves located within the lumen of a vein.

Abstract: A method for positioning an intraluminal graft within a branching vessel in a patient's body is described. The method is particularly applicable to the appropriate positioning of a trouser graft so that it bridges an aneurism which extends from a single vessel, such as the aorta, into one or more divergent vessels, for example, an iliac artery. The method can comprise the steps a of placing a first graft (10), that bifurcates in a pair of tubular sections (19a, 19b) into the pre-branching portion of a vessel (11) through one of the post-branching portions of the vessel (12, 13), positioning a second tubular graft (10b) into one of the post-branching portions (12) and connecting it to one of the tubular sections of the first graft (19a), and positioning a third tubular graft (10a) into the other of the post-branching portions (11) and connecting it to the other of the tubular sections of the first graft (19b).