Abstract: A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body.

Abstract: A system, a closure, and method of use for sealing a percutaneous puncture in a blood vessel. The puncture includes an opening in the vessel wall and a tract leading to the opening. The system includes an introducer sheath and associated positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device enables the introducer sheath to be positioned at a desired position within the vessel. The deployment instrument includes a tubular carrier storing the closure. The closure comprises a rigid, e.g., radio-opaque, anchor, a compressed collagen plug, and a thin filament connecting the two in a pulley-like arrangement. The instrument and introducer are used to introduce the closure into the puncture, with the anchor located within the artery and with the collagen plug within the puncture tract. A locking member is provided to hold the closure in place at its operative position, whereupon hemostasis occurs rapidly, thereby sealling the puncture.

Abstract: A system and method of use for effecting the bypass or other anastomosis of a portion of a native blood vessel, duct, lumen or other tubular organ within the body of a living being. The system includes a connector assembly and a deployment instrument for carrying the device to the desired position within the vessel, duct, lumen or tubular organ. The system includes a piercer-dilator instrument to form an opening in the wall of the vessel, duct, lumen or tubular organ into which the connector assembly is deployed by the deployment instrument. The connector assembly is at least partially formed of a resorbable material and includes movable members for securing it to the tissue of the vessel, duct, lumen or tubular organ contiguous with the opening. Other components may be included in the device for expediting the anastomosis procedure, with or without the use of sutures.

Abstract: Occlusion assembly for sealing openings in blood vessels, consisting of an occlusion element and fixing element to be fitted through the openings in the blood vessel. The fixing element is firmly connected to a retaining element. A locking element engages on the retaining element. This locking element is fitted horizontally against the outside of the blood vessel.

Abstract: A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body.

Abstract: A system for sealing a percutaneous puncture in a blood vessel in a living being and method of use thereof. The system includes a hemostatic closure, a blood vessel locator device for determining the position of the blood vessel via the percutaneous puncture, and a deployment instrument for deploying the closure within the puncture to seal the puncture. The vessel locator includes means for enabling blood from the vessel to flow therethrough so that the position of the vessel can be rapidly determined. Once the vessel has been located the deployment instrument, which includes a tubular carrier storing the closure, is extended into the puncture to deploy the closure. The closure basically comprises a radiopaque rigid anchor for location within the blood vessel, a compressed collagen plug for location within the puncture tract leading to the vessel, and a thin filament connecting the two in a pulley-like arrangement.

Abstract: A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being's vascular system. The system comprises an instrument having a working head, e.g., a rotary impacting impeller located within an apertured shroud, and a debris extraction sub-system. The instrument is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced by the operation of the working head on the occlusive material. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head, e.g., through a opening in the shroud, and withdraws that liquid and some blood at a second and higher flow rate, e.g., through the guide catheter.

Abstract: Apparatus and methods of use for reducing bleeding from the situs of a percutaneous arterial puncture in a living being, with the opening in the arterial wall having been closed by a closure including at least one portion of a suture extending out of the puncture. The apparatus basically comprising a mass of material which inhibits the flow of blood therethrough, e.g., collagen, a carrier for carrying the suture portion through the mass of material, and means for holding the mass of material with respect to the suture portion so that it closely engages tissue contiguous with the puncture tract. The means for holding may comprise a knot in the suture portion, or can be a releasably securable member for location on the suture portion. In one embodiment the carrier comprises a piercing member, e.g., a needle, arranged for location within the interior of the artery for passage thereout through the wall of the artery and through the mass of material to carry the suture portion therethrough.

Abstract: A system, a closure, and method of use for sealing a percutaneous puncture in a blood vessel. The puncture includes an opening in the vessel wall and a tract leading to the opening. The system includes an introducer sheath and associated positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device enables the introducer sheath to be positioned at a desired position within the vessel. The deployment instrument includes a tubular carrier holding the closure. The closure comprises a rigid, e.g., radio-opaque, anchor, a compressed collagen plug, and a thin filament connecting the two in a-pulley-like arrangement. The instrument and introducer are used to introduce the closure into the puncture, with the anchor located within the artery and with the collagen plug within the puncture tract. A locking member is provided to hold the closure in place at its operative position, whereupon hemostasis occurs rapidly, thereby sealing the puncture.

Abstract: A hemostatic closure for sealing a percutaneous puncture in a blood vessel. The puncture includes a tract leading to it from the skin of the being. The closure comprises a rigid, resorbable material anchor having a reinforcement strip therein, a compressed collagen plug, a thin filament connecting the anchor and the plug in a pulley-like arrangement, and a locking mechanism, The plug is deployed so that the anchor is pulled against the tissue contiguous with the puncture inside the artery and with the plug and the locking member within the puncture tract. Pulling on the filament moves the plug toward the anchor member to a puncture sealing position. The locking mechanism is arranged to be actuated to engage the filament in such a manner that the plug is held in the puncture sealing position. In one embodiment the locking mechanism comprises a compressible disk mounted on the filament.

Abstract: Apparatus and methods of use for reducing bleeding from the situs of a percutaneous arterial puncture in a living being, with the opening in the arterial wall having been closed by a closure including at least one portion of a suture extending out of the puncture. The apparatus basically comprising a mass of material which inhibits the flow of blood therethrough, e.g., collagen, a carrier for carrying the suture portion through the mass of material, and means for holding the mass of material with respect to the suture portion so that it closely engages tissue contiguous with the puncture tract. The means for holding may comprise a knot in the suture portion, or can be a releasably securable member for location on the suture portion. In one embodiment the carrier comprises a piercing member, e.g., a needle, arranged for location within the interior of the artery for passage thereout through the wall of the artery and through the mass of material to carry the suture portion therethrough.

Abstract: A system for sealing a percutaneous puncture in a blood vessel in a living being and method of use thereof. The system includes a hemostatic closure, a blood vessel locator device for determining the position of the blood vessel via the percutaneous puncture, and a deployment instrument for deploying the closure within the puncture to seal the puncture. The vessel locator includes means for enabling blood from the vessel to flow therethrough so that the position of the vessel can be rapidly determined. Once the vessel has been located the deployment instrument, which includes a tubular carrier storing the closure, is extend into the puncture to deploy the closure. The closure basically comprises a radiopaque rigid anchor for location within the blood vessel, a compressed collagen plug for location within the puncture tract leading to the vessel, and a thin filament connecting the two in a pulley-like arrangement.

Abstract: A closure device for sealing a percutaneous puncture in the wall of a blood vessel, duct, or lumen of a living being. The puncture has opening in the wall of the blood vessel, duct, or lumen, and a tract contiguous therewith. The closure device is arranged to be inserted into the puncture by an introducing instrument and basically comprises an anchor, a collagen plug, a flexible filament, and locking disk. The anchor is arranged to be brought into engagement with the interior tissue of the vessel, duct, or lumen contiguous with the opening, while the plug and the locking disk are located within the tract. The filament is arranged to be pulled to apply tension thereto. While tension is applied to the filament the locking disk and the plug are moved in the tract toward the anchor. The filament comprises an engagement loop, a first extending portion, and a second extending portion. The engagement loop is coupled to the locking disk.

Abstract: Apparatus and methods of use for reducing bleeding from the situs of a percutaneous arterial puncture in a living being, with the opening in the arterial wall having been closed by a closure including at least one portion of a suture extending out of the puncture. The apparatus basically comprising a mass of material which inhibits the flow of blood therethrough, e.g., collagen, a carrier for carrying the suture portion through the mass of material, and means for holding the mass of material with respect to the suture portion so that it closely engages tissue contiguous with the puncture tract. The means for holding may comprise a knot in the suture portion, or can be a releasably securable member for location on the suture portion. In one embodiment the carrier comprises a piercing member, e.g., a needle, arranged for location within the interior of the artery for passage thereout through the wall of the artery and through the mass of material to carry the suture portion therethrough.

Abstract: A system and method for sealing a percutaneous puncture extending into internally located tissue, e.g., the peritoneum, of a living being. The system includes a sealing device and a deployment instrument. In one embodiment the sealing device comprises a substantially rigid anchor, a resorbable holding member, a collagen plug, and a resorbable thin filament connecting the anchor, holding member, and plug. The anchor or the plug or both may be formed of a resorbable material having a non-resorbable mesh reinforcement embedded therein. The deployment instrument is operated to place the anchor in the interior of the peritoneum and the plug and the holding member in the puncture tract, with both ends of the filament extending out of the puncture. The extending ends of the filament are formed into a knot, a portion of which extends through the skin contiguous with the puncture, to lock the closure in place. The reinforced mesh of the closure reinforces any scar tissue which forms at the opening.

Abstract: A system and method for sealing a percutaneous puncture extending into internally located tissue, e.g., the peritoneum, of a living being. The system includes a reinforcing device and a deployment instrument. The device comprises a substantially rigid anchor, a resorbable holding member, a collagen plug, and a resorbable thin filament connecting the anchor, holding member, and plug in a pulley-like arrangement. The anchor or the plug or both may be formed of a resorbable material having a non-resorbable mesh reinforcement embedded therein. The deployment instrument includes a tubular carrier in which the closure and a tamping member are located. The tamping member is operated to expel the closure so that the anchor is in the interior of the peritoneum and the plug and the holding member are in the puncture tract, with both ends of the filament extending out of the puncture and with the holding member fixedly secured to a portion of the filament adjacent one end.

Abstract: A system, a closure, and method of use for determining the position of a blood vessel via a percutaneous puncture and for sealing the percutaneous puncture in the blood vessel. The system includes an introducer sheath and associated positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device enables the introducer sheath to be positioned at a desired position within the vessel. The deployment instrument includes a tubular carrier storing the closure. The carrier has a distally located free end to be extended via an introducer through the puncture and its associated tract. The closure comprises a radiopaque rigid anchor, a compressed collagen plug, and a thin filament connecting the two in a pulley-like arrangement. The carrier ejects the anchor through the introducer and puncture and then draws it against the free end of the introducer.

Abstract: A system, a closure, and method for sealing a percutaneous puncture in a blood vessel. The puncture includes a tract leading to it from the skin of the being. The system includes an introducer sheath, a positioning device, a hemostatic puncture closure, and a deployment instrument. The positioning device positions the introducer sheath at a desired position within the vessel. The deployment instrument includes a tubular carrier having a distal end storing the closure. The carrier is extended via an introducer sheath through the tract and puncture into the blood vessel. The closure comprises a rigid anchor, a spacer member, a compressed collagen plug, and a thin filament connecting them in a pulley-like arrangement. The anchor has a centrally located domed projection. The carrier ejects the anchor through the introducer and puncture and then draws it against the free end of the introducer.

Abstract: An apparatus and method for reducing peak systolic blood pressure and the rate of change of velocity of the blood flow in a living being by passively absorbing a portion of the blood pressure during systole. The apparatus comprises an expandable/contractible chamber, e.g., a balloon, which is internally pressurized by a gas, e.g., carbon dioxide. The chamber has a surface portion which is moveable between first and second positions and vice versa when the chamber is contracted and expanded, respectively. The chamber is sufficiently small to be located at a desired situs, such as the aorta, so that the surface portion is subjected to blood pressure, whereupon it moves to the second position during systole to reduce the magnitude thereof while also reducing the rate of change of the velocity of the blood flow.

Abstract: Apparatus for disintegrating or otherwise destroying a stone, such as a gallstone, within the body of a living being. The apparatus comprises a small diameter catheter having a longitudinal axis and a working head located at the distal end thereof. The catheter is capable of being located at any position within the body so that the working head is adjacent the stone. The working head is arranged to be rotated at a high speed about the longitudinal axis of the catheter. The working head comprises at least one bladed member having an impacting surface thereon. The bladed member is arranged to move from a retracted position wherein its impacting surface is located adjacent the periphery of the catheter to an extended position wherein the impacting surface extend substantially beyond the periphery of the catheter when the working head is rotated. The impacting surface is arranged so that when it rotates in the extended position, it impacts the stone to disintegrate or otherwise destroy the stone.