Abstract: Endoscopic devices and methods used for fastening multiple tissue layers, such as, for example, an endoscopic fundoplication procedure, are disclosed. The endoluminal device includes a tissue fastener, a flexible needle having means for grasping and releasing a portion of the tissue fastener, and a deflector for deflecting and guiding the needle toward the multiple tissue layers.

Abstract: A method for forming a valve-like mechanism in a body of a mammal having an esophagus extending through a lower esophageal sphincter to a stomach and formed by a wall having a muscle layer and a mucosal layer. The method comprises the step of forming at least one implant in the muscle layer of the wall in the vicinity of the lower esophageal sphincter. The at least one implant inhibits opening of esophagus at the lower esophageal sphincter and causes the mucosal layer to appose in the vicinity of the implants.

Abstract: Guidewire with an improved distal end. A guidewire with an improved distal end may include a core wire, a solder tip disposed at a distal end of the core wire, a radiopaque inner coil coupled to the distal end of the core wire, an outer coil disposed along the length of the core wire, and a distal hub coupled to the core wire and disposed proximate a distal end of the inner coil.

Abstract: A self-expanding endoluminal device comprising at least one tubular filamentary member having a hollow core for receiving a guidewire, the tubular member having a straightened configuration with the guidewire in the hollow core and a shape memory configuration without the guidewire in the hollow core. A delivery system includes the guidewire. The hollow core may contain a substance that is adapted to be eluted from the tubular member or permanently contained inside. The device may further comprise a graft. The device may also comprise a plurality of filamentary members, more than one of which may comprise tubular members. The device may also have a severable extension that extends outside of the body through which the substance may be periodically injected.

Abstract: An intravascular guidewire having an articulating distal section for improved maneuverability beyond a lesion or other protrusion within a body lumen. An elongated core wire having an actuatable stop disposed thereon is adapted to have a reduced profile in a first position, and an enlarged profile in a second position. The actuatable stop can be adapted to expand by any number of means, including a spring coil, a polymeric tube or a mesh sleeve. In one particular embodiment, the actuatable stop comprises a distal section of a tubular member having a plurality of circumferentially disposed openings adapted to permit a plurality of struts disposed therebetween to expand in an outward direction when compressed axially.

Abstract: The present invention relates to methodology of and apparatus for accurately positioning devices for performing endoscopic cannulation, papillotomy and sphincterotomy and similar procedures. The sphincterotome with a steerable or adjustable distal segment of the present invention allows the physician to control the position of the distal tip of the device independently of the endoscope and adjust for inconsistencies in the device and the anatomy. According to one embodiment of the present invention, a threaded portion of a cable assembly cooperates with a torque transmission element and a cog to enable the operator to rotate a cutting wire into a desired position relative to the catheter. Alternate embodiments allow the operator to fix the depth of a needle knife while allowing, if desired, accurate rotational positioning of the associated catheter. Threaded stabilizing elements, pivot elements and a steering wire may be used together or individually to accomplish these features.

Abstract: A spiral cut transition member is disclosed for controlling the transition in stiffness of a catheter from a stiffer more pushable proximal section to a more flexible and trackable distal section and increasing kink resistance. The transition member has a spiral cut provided therein to vary the flexibility of the transition member over its length. The pitch of the spiral cut can be varied to facilitate a gradual transition in flexibility along the catheter. The transition member may be used in conjunction with any type of catheter including single-operator-exchange type catheters, over-the wire type catheters, and/or fixed-wire type catheters.

Abstract: A guide wire including a lubricous distal portion and a less lubricous intermediate portion proximal of said distal portion. One guide wire provides a highly lubricous distal portion with a hydrophilic layer and a less lubricous intermediate portion with a hydrophobic layer. Another guide wire provides a lubricous distal portion with a polymer tip that is itself hydrophilic. Yet another guide wire provides a less lubricous intermediate portion using a stainless steel coil helically wound around the tapering intermediate portion. The coil is preferably coated with a hydrophobic coating such as PTFE or silicone. The coil can either abut the distal portion proximal end or extend into the distal portion interior.

Abstract: A rapid exchange stent delivery catheter includes an inner tubular member having a proximal portion, a distal portion, a stent holding portion located adjacent the distal portion of the inner member, and a guide wire lumen extending from a proximal guide wire opening disposed distal of the proximal portion of the inner member to a distal guide wire opening disposed at a distal end of the inner member. The proximal guide wire opening has a first length. An outer tubular member is slidably disposed about the inner member. The outer member has a proximal portion, a distal portion, and a guide wire opening disposed distal of the proximal portion of the outer member. The guide wire opening of the outer member has a second length that is shorter than the first length and a guide wire ramp extends into, and is movable along the first length.

Abstract: A catheter having a flexible outer tube and a lubricious inner tube bonded within the flexible outer tube. One catheter has a distal outer tube formed of a substantial portion of a first, flexible material, an inner tube having a lubricious inside wall surface formed of a second, lubricious material, and an outer tube wall surface compatible with heat bonding the inner tube outside wall surface to the outer tube wall surface. A preferred flexible material is polyether block amide (PEBA) and a preferred lubricious material is polyethylene. One catheter utilizing the invention includes a flexible distal outer tube having an orifice through the tube wall and an inner tube inserted through the orifice having a lubricious inner layer surrounded by a tie-layer, surrounded in turn by the same flexible material forming the outer tube.

Abstract: A medical device, such as a catheter shaft, having an inner lumen defined by a layer of polymer coating, and a method for forming such a medical device. In some embodiments, the method generally includes the steps of applying a polymer coating to an elongated mandrel, and constructing the remainder of the catheter shaft body around the polymer coated mandrel. In some embodiments, the polymer coating layer is made from water dispersible polymer or water soluble polymer.

Abstract: Crosslinked compositions formed from water-insoluble copolymers are disclosed. These compositions are copolymers having a bioresorbable region, a hydrophilic region and at least two cross-linkable functional groups per polymer chain. Crosslinking of these polymers can be effected in solution in organic solvents or in solvent-free systems. If crosslinking occurs in a humid environment, a hydrogel will form. If crosslinking occurs in a non-humid environment, a xerogel will form which will form a hydrogel when exposed to a humid environment and the resulting crosslinked materials form hydrogels when exposed to humid environments. These hydrogels are useful as components in medical devices such as implantable prostheses. In addition, such hydrogels are useful as delivery vehicles for therapeutic agents and as scaffolding for tissue engineering applications.

Abstract: The present invention provides an implantable prosthesis and more specifically, an implantable tubular textile prosthesis comprising a biocompatible fabric having inner and outer surfaces and first and second ends; the fabric having a textile construction comprising cold drawn PTFE yarns having a substantially uniform denier and high molecular orientation. Use of cold drawn PTFE yarns result in implantable prostheses that have excellent abrasion resistance, strength and lubricity properties. Useful textile constructions include weaves, knits, braids, filament windings, spun windings and combinations thereof. The prostheses of the present invention are lubricious and have characteristics that closely resemble the properties of a natural body lumen.

Abstract: A tissue ablation system comprises an ablation source, such as an RF ablation source, configured for generating a common power signal, and a power multiplexor configured for splitting the power signal into first and second power signals, substantially attenuating the second power signal relative to the first power signal to create nominal and attenuated power signals, and sequentially delivering the nominal power signal to each tissue ablation probe, while delivering the attenuated power signal to the remaining ablation probes to which the nominal power signal is currently not delivered.

Abstract: A medical assembly and method are provided to effectively treat abnormal tissue, such as, a tumor. The target tissue is thermally ablated using a suitable source, such as RF or laser energy. A cooling shield is placed in contact with non-target tissue adjacent the target tissue, and actively cooled to conduct thermal energy away from the non-target tissue. In one method, the cooling shield can be placed between two organs, in which case, one of the two organs can comprise the target tissue, and the other of the two organs can comprise the non-target tissue. In this case, the cooling shield may comprise an actively cooled inflatable balloon, which can be disposed between the two organs when deflated, and then inflated. The inflatable balloon can be actively cooled by pumping a cooling medium through it. In another method, the cooling shield can be embedded within the non-target tissue. In this case, the cooling shield can comprise one or more needles.

Abstract: An apparatus is provided for deploying an endograft that maintains a fluid channel throughout deployment. A method for deploying an endograft maintaining a fluid channel through the deployment is also provided.

Abstract: The present invention pertains generally to the field of cryo balloon therapy and the use of cryo balloon therapy catheters to generate cold-induced lesions. The present invention includes a cryo balloon therapy apparatus, comprising a catheter having a proximal and a distal end, a cooling member disposed at the distal end of the catheter, a pull cord coupled to the cooling member, and a sheath that couples the pull cord and the catheter. A method for causing cold-induced necrosis is also disclosed.

Abstract: The present invention relates generally to perfusion catheters and distal protection devices. According to an embodiment, the present invention includes a distal protection filter comprising an elongate shaft having a proximal end and a distal end, a distal protection device disposed at the distal end, a coupling member that couples the elongate shaft to the distal protection device, and a first space between the coupling member and the elongate shaft. A method of filtering debris from a blood vessel is also disclosed.

Abstract: A guide wire having a coil disposed over the guide wire, wherein the coil is integrally formed of a single wire and has regions of differing properties over its length. Some wire embodiments have longitudinally alternating layer segments having differing properties including radiopacity, lubricity, hydrophilicity, hemo-compatibility, flexibility, malleability, stiffness, and shape memory properties. A coil may have numerous distinct property segments, while being formed from only a single wire and requiring only two points for affixation to the guide wire.

Abstract: Medical devices for removing gasses, such as gas bubbles and/or dissolved gasses, from a liquid to be delivered to a patient, and methods of use and making of such devices. In at least some embodiments, a gas permeable membrane material is used in the construction of the gas removal devices. In some embodiments, layers of gas permeable membrane material are used to construct a filter structure for removing gas from the liquid. In other embodiments, hollow tubes and/or fibers of the gas permeable membrane material are used to construct a filter structure for removing gas from the liquid. The gas removal devices may be used in any of a broad variety of liquid delivery systems and/or configurations.