Abstract: Exemplary embodiments are directed to providing a method of preparing an anatomical vessel contained within a tissue bundle for ligation, including positioning a cannula adjacent to the tissue bundle, wherein the positioning is non-penetrating, the cannula including a first extendable member, a second extendable member, a Doppler wand, and a distal end, transmitting ultrasound signals toward the vessel through the tissue bundle with the Doppler wand, receiving ultrasound signals reflected by the vessel through the tissue bundle with the Doppler wand, invaginating the tissue bundle with the first extendable member on a first side of the tissue bundle, invaginating the tissue bundle with the second extendable member on a second side of the bundle opposite the first side, and interpenetrating a length of ligation material between the first and second extendable members on a side of the vessel opposite the cannula distal end.

Abstract: A system is provided for compressing one or both of the uterine arteries of a patient which is at least in part shaped to complement the shape of the exterior of the cervix, which allows the system to be self-positioning. One or more Doppler chips can be mounted or incorporated into the system which permit the practitioner to better identify the uterine artery and monitor blood flow therein. The system includes a pair of pivotally joined elements which can be moved toward and away from the cervix to compress a uterine artery.

Abstract: A treatment procedure is disclosed which involves the short term, non-permanent occlusion of the patient's blood vessels by depositing a bioabsorbable embolic mass within the patient's blood vessel. The procedure is particularly suitable for treating uterine disorders by occluding a patient's uterine arteries. A therapeutically effective time period for occlusion of a uterine artery is from about 0.5 to about 48 hours, preferably about 1 to about 24 hours, with occlusion times of about 1 to about 8 hours being suitable in many instances. The embolic mass may bioabsorbable particulate with minimum transverse dimensions of about 100 to about 2000 micrometers, preferably about 300 to about 1000 micrometers. The particulate may be a polymeric material formed of polylactic acid, polyglycolic acid or copolymers thereof, or a swellable copolymer of lactic acid and polyethylene glycol.

Abstract: The invention provides a devices, methods and systems to measure and record uterine tissue environment components such as pH during the course of uterine artery occlusion. The uterus becomes ischemic due to the occlusion thereof, and its pH drops sharply within minutes of uterine artery occlusion and remains relatively low for a period of time. The return of normal pH is an indicator of return of blood to the ischemic tissue. In use, a catheter with a pH measuring tip is advanced through the patient's vaginal canal and into the patient's uterine cavity until the pH measuring active electrode on the distal end of the catheter contacts or penetrates the uterine fundus. The active electrode detects the pH and a signal representing pH is transmitted to a pH recording and monitoring device which preferably displays the pH. The signal may be transmitted through a conductor or by a radio transmitter. Components other than pH may be monitored such a pCO2, and pO2.

Abstract: The invention is directed to tenaculum-like devices and systems for the intravaginal delivery of therapeutic or diagnostic devices and particularly for occluding a female patient's uterine arteries in order to treat uterine disorders. Included are methods for grasping, manipulating and retaining tissue. The tenaculum-type device has a distal portion with a sound configured to enter a cervical os without causing undue trauma or discomfort to the patient, and a retention or tissue grasping mechanism with a grasping element such as a spike configured to engage and retain a patient's cervix. The tenaculum-type devices embodying features of the invention may have an expandable distal tip to more securely be engaged within the patient's uterine cervical canal.

Abstract: The invention is directed to instruments and procedures using such instruments for temporarily reducing or terminating blood flow through a female patient's uterine artery to treat post partum hemorrhage (PPH). The uterine artery is occluded by a clamping device which includes a pair of pivotally connected clamping members, with each of the clamping members having a handle and a clamping element at the distal end of the handle. The clamping elements are inclined with respect to the longitudinal axes of the handles at an included obtuse angle between about 120° and about 170°, preferably between about 130° and 160°. An artery locating sensor is provided on the distal end of at least one of the clamping elements. Preferably, the artery locating sensor is a Doppler ultrasound blood flow sensor.

Abstract: The invention is directed to a uterine artery clamp and the relatively non-invasive treatment procedure utilizing this clamp. The uterine clamp includes a clamping member having a jaw with tissue-contacting surfaces for applying pressure to target tissue and a stabilizing member which is configured to be inserted into the patient's uterine cervical canal. The clamp may be provided with elongated handles to manually adjust the spacing between the jaw and stabilizer and thereby apply pressure to a uterine artery beneath a bundle of tissue held between the jaw and stabilizer. Uterine clamps embodying features of the invention by be used in procedures for treating uterine disorders such as fibroids, DUB, PPH and the like.

Abstract: Devices and methods are disclosed for treating a uterine disorder which receive its blood supply from a uterine artery. In particular, uterine fibroids are effectively treated by occluding the uterine arteries using trans-vaginal, trans-uterine, transrectal, or retroperitoneal approaches. The devices and methods are advantageous because the inventive procedures may be performed by a patient's gynecologist in the course of treatment, avoiding the need for referrals to specialist practitioners and for more radical treatments, such as hysterectomies. The methods include both temporary and permanent occlusion of the arteries. A cannula carries an imaging device and a member which will easily penetrate tissue, the member including a device which partially or completely, and temporarily or permanently, occludes a uterine artery.

Abstract: Exemplary embodiments are directed to providing a method of preparing an anatomical vessel contained within a tissue bundle for ligation, including positioning a cannula adjacent to the tissue bundle, wherein the positioning is non-penetrating, the cannula including a first extendable member, a second extendable member, a Doppler wand, and a distal end, transmitting ultrasound signals toward the vessel through the tissue bundle with the Doppler wand, receiving ultrasound signals reflected by the vessel through the tissue bundle with the Doppler wand, invaginating the tissue bundle with the first extendable member on a first side of the tissue bundle, invaginating the tissue bundle with the second extendable member on a second side of the bundle opposite the first side, and interpenetrating a length of ligation material between the first and second extendable members on a side of the vessel opposite the cannula distal end.

Abstract: Devices and methods are disclosed for treating a uterine disorder which receive its blood supply from a uterine arteries. In particular, uterine fibroids are effectively treated by occluding the uterine arteries using trans-vaginal, trans-uterine, transrectal, or retroperitoneal approaches. The devices and methods are advantageous because the inventive procedures may be performed by a patient's gynecologist in the course of treatment, avoiding the need for referrals to specialist practitioners and for more radical treatments, such as hysterectomies. The methods include both temporary and permanent occlusion of the arteries. A cannula carries an imaging device and a member which will easily penetrate tissue, the member including a device which partially or completely, and temporarily or permanently, occludes a uterine artery.

Abstract: A ligation device includes a cannula having first and second extendable members and a Doppler wand. The Doppler wand permits an anatomical vessel, such as a blood vessel, to be located in close proximity to the distal end of the cannula. The extendable members are extendable on two opposite sides of the vessel. A length of ligation material, such as suture material, extends through the first extendable member, and is attached to a detachable element mounted to the distalmost end of the extendable member. The second extendable member includes a snare. The first extendable member includes curved portions which, when the member is extended distally, extend the detachable element into position for the snare so that the snare can grab the loop. Once ensnared, the detachable element is released from the first extendable member, which pulls the ligation material around the vessel. The ligation device does not require prior visualization or dissection of the area around the vessel.

Abstract: Exemplary embodiments are directed to providing a method of preparing an anatomical vessel contained within a tissue bundle for ligation, including positioning a cannula adjacent to the tissue bundle, wherein the positioning is non-penetrating, the cannula including a first extendable member, a second extendable member, a Doppler wand, and a distal end, transmitting ultrasound signals toward the vessel through the tissue bundle with the Doppler wand, receiving ultrasound signals reflected by the vessel through the tissue bundle with the Doppler wand, invaginating the tissue bundle with the first extendable member on a first side of the tissue bundle, invaginating the tissue bundle with the second extendable member on a second side of the bundle opposite the first side, and interpenetrating a length of ligation material between the first and second extendable members on a side of the vessel opposite the cannula distal end.

Abstract: Devices and methods are disclosed for treating a uterine disorder which receive its blood supply from a uterine artery. In particular, uterine fibroids are effectively treated by occluding the uterine arteries using trans-vaginal, trans-uterine, transrectal, or retroperitoneal approaches. The devices and methods are advantageous because the inventive procedures may be performed by a patient's gynecologist in the course of treatment, avoiding the need for referrals to specialist practitioners and for more radical treatments, such as hysterectomies. The methods include both temporary and permanent occlusion of the arteries. A cannula carries an imaging device and a member which will easily penetrate tissue, the member including a device which partially or completely, and temporarily or permanently, occludes a uterine artery.

Abstract: Non-permanent occlusion of the uterine arteries is sufficient to cause the demise of uterine myomata without unnecessarily exposing other tissues and anatomical structures to hypoxia attendant to prior permanent occlusion techniques. A therapeutically effective transient time of occlusion of a uterine artery to treat uterine fibroid tumors is from 1 hours to 24 hours, and preferably is at least about 4 hours. A therapeutically effective temporary time of occlusion of a uterine artery to treat uterine fibroid tumors is from 1 day (24 hours) to 7 days (168 hours), and preferably is about 4 days (96 hours).

Abstract: Medical devices that are coated with an echogenic material that includes an electrically insulative base layer and an echogenic layer demonstrate both improved ultrasonic imaging and protection against RF electrical breakdown. The echogenic layer includes a polymeric matrix that (i) defines a plurality of void spaces, (ii) includes glass microsphere particles, or (iii) both defines a plurality of void spaces and includes glass microsphere particles. Medical instruments exhibit enhanced ultrasonic imaging even when viewed along their lengths.

Abstract: The invention provides devices, systems and methods for occluding arteries without puncturing skin or vessel walls. The devices, systems and methods for occluding arteries are configured to be applied to arteries externally of the arteries. Occlusion may be temporary or permanent, and may be partial or complete. Clamping a device to tissue near to an artery is effective to compress tissue around the artery and to indirectly compress the artery. The methods, devices and systems of the invention find use in, for example, treatment of uterine disorders and conditions which may be treated by occlusion of the uterine arteries. A uterine artery may be accessed via a patient's vagina by compressing a portion of the vaginal wall around a portion of a uterine artery to occlude a uterine artery. Clamping of an artery may also be performed by clamping a device directly onto an artery.