Abstract: Distal catheter assemblies, catheters, and methods for minimizing damage to heat and/or magnetically sensitive components are provided. A distal catheter assembly comprises a housing having a cavity and a proximal mounting member. The sensitive component, e.g., a magnetic sensor, is mounted within the cavity of the housing, and another component, e.g., a steering assembly or RF wire, is mounted to the proximal mounting member. If the proximal mounting member is hollow, it may have a window to provide access to the inner surface of the proximal mounting member to facilitate mounting of the other component. The proximal mounting member extends proximally from the sensitive component, thereby minimizing any adverse effects on the sensitive component that may otherwise result from mounting the other component in close proximity to the sensitive component. In the preferred embodiment, the housing forms a cap-shaped head and a cylindrical neck section, with the head forming an ablation electrode.

Abstract: An atherectomy burr includes a number of cutting blades having a less aggressive cutting action when rotated in a first direction and a more aggressive cutting action when rotated in a second direction. In accordance with one embodiment of the invention, each cutting blade includes an abrasive surface that is substantially parallel to the outer surface of the cutting burr. Each blade further includes a second cutting surface that is substantially perpendicular to the outer surface of the burr. By selectively rotating the burr in either direction, a physician can cause the less aggressive or more aggressive cutting surface to engage deposits in a patient's vessel.

Abstract: An improved guide wire brake that is particularly suited to ablative rotational atherectomy devices is disclosed. The guide wire brake ensures that a guide wire is prevented from rotating or moving axially prior to activation of a primary mover such as a turbine. In one embodiment a pressure relief valve delays the activation of the prime mover on start up, and a check valve delays the release of the guide wire brake on shut down. In a second embodiment the guide wire brake is serially connected to the prime mover such that the prime mover is not connected to the pressurized gas source until after the guide wire brake is engaged. In a third embodiment a guide wire is disposed through a flexible tube within a rigid cylinder that is serially connected to the prime mover, such that when pressurized gas is provided to the prime mover the flexible tube will collapse on the guide wire, to prevent guide wire movement.

Abstract: A tubing assembly for manufacture for a catheter of the type having an inner tubular member defining a lumen, an outer tubular member surrounding said inner member, and a support member mounted between the tubular members to provide rigidity to the flexible catheter. The support member comprises a high tensile strength wire braid, and in the preferred embodiment comprises a stainless steel wire braid which has been tempered or hardened. This higher tensile strength affords significantly greater kink resistance to the flexible catheter. One wire braid has a tensile strength in the range of 300 to 425 kpsi and a braid density of approximately 40 pic. The high tensile strength wire braid has the disadvantage of tending to flare out at its free ends. Therefore, means are provided for preventing the flaring of the wire braid during manufacture of the tubing assembly. One means includes adhesive applied over the free ends. Another means includes a restraining sleeve applied over the free ends.

Abstract: A balloon catheter having a perfusion lumen communicating with a blood vessel, and a magnetically driven impeller disposed in the perfusion lumen to increase blood flow through the catheter and the arteries.

Abstract: Various catheter designs with irrigated tip electrodes are provided for reducing the heating of the tip resulting from RF biasing. The electrode tip of the catheter may be comprised of a highly thermal conductivity layer covered by a biologically compatible material and having irrigation or irrigation channels for removing excess thermal energy from the catheter tip and the surrounding area of the catheter tip. The catheter tip may be designed with multiple irrigation channels, multiple channel pathways, and/or exterior shapes to improve the cooling of the tip. These approaches may be used individually or in combination to produce a catheter tip with improved heat dissipation characteristics.

Abstract: An endoscopic instrument has a portion having an outer surface with a non-circular cross-sectional shape. The non-circular cross-sectional shape may be provided to the instrument by providing peripheral projections or fins along the length of the portion or by providing the periphery of the portion with a polygonal shape. Where fins are used, the fins are preferably quite small and only have a minimal effect on the fluid flow cross sectional area between the interior of the working channel and the endoscopic instrument. The resulting instrument has significantly reduced backlash while maintaining adequate fluid flow in the working channel. According to a second embodiment of the invention, a portion of the interior of the working channel of the endoscope has an interior surface having a non-circular cross sectional shape by the inclusion of a plurality of radially spaced and inwardly directed ribs or by being polygonally shaped.

Abstract: An implantable microporous ePTFE tubular vascular graft exhibits long term patency, superior radial tensile strength and suture hole elongation resistance. The graft includes a first ePTFE tube and a second ePTFE tube circumferentially disposed over the first tube. The first ePTFE tube exhibits a porosity sufficient to promote cell endothelization, tissue ingrowth and healing. The second ePTFE tube exhibits enhanced radial strength in excess of the radial tensile strength of the first tube.

Abstract: A method of bonding a first tubular member to a second tubular member to form a catheter shaft. The method comprising the step of providing a first tubular member including a distal end, a proximal end, and a lumen extending between the distal end and the proximal end thereof. The method further including the step of providing a second tubular member including a distal end, a proximal end, and a lumen extending between the distal end and the proximal end thereof. The method further including the steps of inserting a joining portion of the first tubular member into a joining portion of the second tubular member and applying heat the joining portions.

Abstract: A dynamically configurable ultrasound transducer element and related circuits and methods. The transducer may comprise an array of capacitive transducer elements, a row decoder coupled to said array of capacitive transducer elements, a column decoder coupled to said array of capacitive transducer elements, a bias voltage source coupled to said row decoder, and a driving signal source coupled to said column decoder. Preferably, a master clock also is provided to allow for a synchronization of signals between the row decoder and column decoder.

Abstract: A steerable guide wire and associated methods are disclosed. A guidewire in accordance with the present invention includes a shaft assembly including a lumen defined by a coil and an elongate shaft disposed within the lumen defined by the coil, a distal end of the coil being fixed to the elongate shaft proximate a distal end thereof, the elongate shaft including a curved portion proximate the distal end thereof, wherein the curved portion of the elongate shaft is biased to assume a substantially curved shape.

Abstract: A center support including a steering member and a mounting member integral with the steering member. The center support may be mounted on an internal support member within a catheter without the use of a ferrule.

Abstract: The surgical treatment of stress urinary incontinence includes: 1) a technique of probe passage to avoid injuring the bladder and to provide a more accurate and reproducible capture of the pubocervical fascia lateral to the bladder neck and urethra, 2) anchor fixation of the suspending sutures to the pubic bone to decrease the risk of suture pull through from above and to decrease post-operative pain and 3) a simple and reproducible technique to set a limited tension of the suspending sutures. A description of these methods and results of procedures with some of these methods are disclosed. Novel drill guides, suture passers, suture tensioners, and various related tools and devices for use in the surgical method are also disclosed.

Abstract: A system for removing matter from a partially or totally occluded stent includes a cutter that is urged radially outward toward the inner surface of the stent. Preferably, the cutter has a hardness that is less than or equal to the hardness of the material used to make the stent. Aspiration may be provided to remove portions of the occluding material from the vessel.

Abstract: A medical system for performing a tissue ablation procedure comprises a guide sheath and an ablation catheter disposed within an internal lumen of the catheter. The guide sheath has a distal end that includes irrigation exit ports that are configured to perfuse irrigation fluid in a distal direction over the ablation electrode of the catheter when the distal end of the catheter protrudes from the guide sheath. In this manner, the ablation electrode can be advantageously cooled during the tissue ablation process, thereby maximizing the size and depth of the ablation lesion and reducing the duration of the ablation process.

Abstract: A method and related device for performing sterile medical procedures are disclosed. The method and related device are capable of accessing a sterile environment from a non-sterile environment to perform a medical procedure within the sterile environment. The method and related device can achieve a sterile technique during endoluminal procedures and in uncontrolled and unsterile environments. The device includes an inner hollow member moveably disposed within an outer hollow member. The outer hollow member is adapted to penetrate a boundary separating non-sterile and sterile environments and the inner hollow member is adapted to extend past the outer hollow member and into the sterile environment. A fluid compartment is adapted to be in selective fluid communication with the outer tube such that when the inner member extends past the outer member and into the sterile environment, fluid enters the outer member and the boundary.

Abstract: An atherectomy device having the ability to create variably sized lumens in a vessel. An ablation burr rotated by a drive shaft is routed through a control shaft having a bend in its distal end. The control shaft is in turn routed through a surrounding guide catheter. By extending or retracting the bend of the control shaft into the distal end of the guide catheter, the lateral displacement of the ablation burr is varied. A lumen in a vessel is created by rotating the control shaft within the surrounding guide catheter. In addition, the atherectomy device may include an integrated imaging sensor contained within a separate lumen of the catheter surrounding the drive shaft. The imaging sensor provides images of the interior of the vessel wall to determine if an occlusion has been removed by operation of the ablation burr. The catheter may include a self-expanding stent at its distal end to force the ablation burr against a vessel wall in order to create various sized lumens in a patient's vasculature.

Abstract: A catheter assembly includes an elongate catheter body having a proximal end and a distal end with a drive cable disposed therein, the drive cable having a proximal end and a distal end, and rotatable relative to the catheter body. A first electromagnetic element is disposed proximate the distal end of the catheter, and a second electro-magnetic element disposed proximate the distal end of the drive cable and in electrical communication with an operative element mounted at the end of the drive cable, the first and second electromagnetic elements forming an inductive coupler. The catheter assembly can include various other distal operative elements, which are in communication with corresponding proximal operative elements via transmission lines embedded within the wall of the catheter body.

Abstract: A catheter with a distal end having a member formed from a hydrophilic composition is provided. The hydrophilic composition expands upon contact with an aqueous fluid to move the member from a quiescent state to an expanded state. The member may provide an open passageway in the quiescent state and be capable for forming a fluid tight seal by action of expansion of the hydrophilic composition. In such a case the member acts as a valve for permitting or preventing fluid flow through the catheter.

Abstract: A coated wire for medical applications including a length of biocompatible wire material. The wire material can be coated along a portion of the perimeter of the wire. The deposition of the coating can cover less than the total circumference of the wire.