Abstract: A dynamic ligament repair device includes a suture, a femoral side suture anchor and a threaded screw or housing implant. The screw is configured for placement in the tibia, or alternatively in the femur. A spring is housed inside an axial bore in the threaded screw. In some embodiments, the spring is a compression spring. A moveable spring button is positioned inside the axial bore adjacent a distal end of the spring. The spring button engages the spring directly in some embodiments. In alternative embodiments, an intermediate structure such as a spacer is positioned between the spring button and the spring. The suture extends between the spring button and the suture anchor. When the joint flexes or extends, the spring button travels inside the axial bore and dynamically compresses or relaxes the spring.

Abstract: A tissue anchor includes a central body extending between a first lengthwise end and a second lengthwise end. A first arm extends outwardly from the central body, and a second arm extends outwardly from the central body and spaced from the first arm. The tissue anchor is movable between a collapsed state and a deployed state. In the collapsed state, the central body extends linearly from the first lengthwise end to the second lengthwise end of the central body along an axis and the first and second arms extend parallel to the axis. In the deployed state, the central body extends non-linearly and the first and second arms extend radially outwardly from the central body.

Abstract: A suture assembly including a first suture having a generally O-shaped configuration having a first arm, a second arm, a first bridge connecting the first arm to the second arm, and a second bridge connecting the first arm to the second arm. The first bridge opposes the second bridge so that the first suture includes a closed loop. A second suture having a first arm, a second arm and a bridge connecting the first arm to the second arm. The first arm of the second suture is wrapped around the first arm of the first suture in a first direction, and the second arm of the second suture is wrapped around the second arm of the first suture in a second, opposite direction. The suture assembly is capable of assuming (i) a longitudinally-extended, radially-contracted first configuration, and (ii) a longitudinally-contracted, radially-expanded second configuration.

Abstract: Disclosed herein shock wave catheters comprising one or more shock wave electrodes for cracking calcifications located within blood vessels. In some variations, a shock wave catheter has first and second shock wave electrodes each circumferentially disposed over the outer surface of the catheter. In certain variations, the first electrode has a recess and the second electrode has a protrusion that is received by the recess and a spark gap is located along the separation between the recess and the protrusion. The second electrode can also have a recess that receives a protrusion from a third shock wave electrode, where the separation between the second and third electrodes along the separation between the recess and the protrusion forms a second spark gap. A shock wave can be initiated across these spark gaps when a voltage is applied over the electrodes.

Abstract: A method and apparatus for coupling a soft tissue implant into a looking cavity formed within a bone is disclosed. A bone engaging fastener is coupled to bone. A second fastener is coupled to a suture construction. The second fastener is coupled to the first fastener. Soft tissue is coupled to the suture construction.

Abstract: A hole closing material achieves less invasive treatment for atrial septal defect with no or little possibility of problems in the late post-treatment period. The hole closing material includes two tubular bodies (first tubular portion and second tubular portion) having a mesh structure formed of a bioabsorbable linear material, and includes: a proximal connecting part connected to a first end; and a distal connecting part connected to a second end and screwed to a delivery cable. The proximal connecting part and the distal connecting part are capable of selectively achieving: “locked” in which the proximal connecting part and the distal connecting part remain united; and “unlocked” in which the proximal connecting part and the distal connecting part do not remain united. The delivery cable passes through the substantially middle portion, is inserted into a hollow tube of the proximal connecting part, and passes out of the hole closing material in a direction from the second end to the first end.

Abstract: A closure system for closing an opening in tissue, the closure system including a closure device and a knot replacement device configured to position a suture lock on a suture. The closure device includes a housing, a needle actuation handle cooperating with the housing, a first hollow needle selectively movable by the needle actuation handle and operatively cooperating with a suture anchor frictionally engaged with a slot and a lumen of the first hollow needle and coupled to a suture. A portion of the suture anchor rests along an outer surface of the first hollow needle as the first hollow needle is advanced through tissue adjacent the opening.

Abstract: Methods and systems are provided for securing tissue to bone. A surgical system can include a driver device, an elongate shaft receivable within the driver device and having a dilator feature at its distal end, and a capture suture extending through the shaft such that the capture suture's terminal end portions extend to a more proximal position on the driver and the capture suture forms a loop that extends through an opening formed through a side of the shaft. The loop is configured to receive at least one retention suture therethrough and can be tightened by pulling the capture suture's terminal ends, thereby coupling the retention suture with the suture anchor. Once the shaft is inserted into bone and the loop with the retention suture is closed, the suture anchor is driven distally towards the dilator features and into the bone to secure the retaining suture in the bone.

Abstract: A slip knot suture construct system and method for securing multiple limbs of suture. The system includes a suture construct having a length of suture including a standing limb with a standing terminal end and a closing limb with a closing terminal end. The suture construct has three loops: a primary loop formed in the closing limb, the primary loop and closing limb extending to the standing limb, a secondary loop formed in the standing limb, and a locking loop formed in the length of suture between the primary loop and the secondary loop. A limb of suture extends through the primary loop. The limb of suture is secured in the suture construct by pulling the closing terminal end proximally, which pulls the primary loop holding the limb of suture through the locking loop and at least partially into the secondary loop.

Abstract: An apparatus comprises a body assembly, a shaft, an acoustic waveguide, an articulation section, an end effector, an articulation drive assembly, and a locking feature. The shaft extends distally from the body assembly. The waveguide comprises a flexible portion. The articulation drive assembly is operable to drive articulation of the articulation section to thereby deflect the end effector from the longitudinal axis of the shaft. The articulation drive assembly comprises an actuator. The actuator is movable relative to the body assembly to drive articulation of the articulation section. The locking feature is in communication with the actuator. The locking feature is movable between an unlocked state and a locked state. The locking feature is configured to permit movement of the actuator relative to the body assembly in the unlocked state. The locking feature is configured to prevent movement of the actuator relative to the body assembly in the locked state.

Abstract: A suture retention device includes a housing having one or more suture slots. The device also includes a plunger with suture slots. The plunger is slidably disposed in a channel in the housing and when the housing suture slots are aligned with the plunger suture slots, a suture filament may be disposed in the slots. When the plunger is actuated so that the housing suture slots are misaligned with the plunger suture slots, the suture filament is captured between the plunger and the housing preventing movement of the suture filament.

Abstract: A medical device may include a handle assembly having an actuator and a sheath. The sheath may extend between a proximal end and a distal end. The proximal end of the sheath may be coupled with the actuator. The medical device may further include an end-effector moveable relative to the sheath between an extended configuration and a retracted configuration. The end-effector may include a plurality of expandable legs. Each of the plurality of expandable legs may include a plurality of first indicia and a plurality of second indicia. A color of each of the first plurality of indicia may be different than a color of each of the second plurality of indicia.

Abstract: Systems and methods for delivering an implantable occluder device, e.g., an atrial septal defect occluder having a bioresorbable frame, to the atrial septum of a patient are provided. The system may include an outer shaft configured to be removably coupled to a proximal end of the occluder, an inner shaft slidably disposed within the outer shaft and configured to be removably coupled to a distal end of the occluder, and an outer sheath slidably disposed over the outer shaft and having an expandable distal region configured to transition between a collapsed delivery configuration defining an atraumatic tip, and an expanded configuration to facilitate passage of the occluder therethrough. The system may include a handle having slidable and rotatable actuators operatively coupled to the outer shaft, inner shaft, and outer sheath for deploying and releasing the occluder at the atrial septum.

Abstract: Occlusion crossing devices and systems. An inner shaft may be configured to rotate and extend within an outer shaft. The inner and outer shafts may include engagement regions to limit distal movement of the inner shaft within the outer shaft. The outer shaft may include a distal opening that is angled to form a tapered distal end. The inner shaft may include a distal end having a fluted tip with cutting edges that are configured to extend through the distal opening of the outer shaft. The inner shaft may include an imaging window. When the cutting edges are fully extended distally through the distal opening of the outer shaft, the tapered distal end of the outer shaft may be configured to occlude the imaging window at a defined rotational position as the inner shaft is rotated relative to the outer shaft to provide a registration mark for imaging.

Abstract: A compression device includes an adhesion sheet including an adhesion surface; and a compression member mounted on the adhesion sheet and configured to compress a biological surface. The compression member includes a fixing portion fixed to the adhesion sheet on a side of the sheet opposite the adhesion surface in a thickness direction, and a compression main body portion provided in a portion of the compression member, in a plan view seen along the thickness direction, that does not overlap the adhesion sheet. The compression main body is configured to protrude or be protrusible further toward one side in the thickness direction than the adhesion surface. The adhesion sheet includes a first portion to which the fixing portion is fixed and a second portion to which the fixing portion is not fixed. The second portion is provided on at least a compression main body portion side of the adhesion sheet.

Abstract: Disclosed herein is a kit for augmenting a primary repair construct in an articulating joint. The kit includes a flexible member, a first implant that fixes a first end of the flexible member in a first bone adjacent to the primary repair construct and a second implant that may selectively couple to the flexible member, and thereby fix a second end of the flexible member in a second bone adjacent to the primary repair construct. The kit also includes a tension adjusting construct that may operatively couple to the flexible member and controllable adjust a tension on the flexible member disposed between the first and second implant, the tension adjustable so as to define an angle of joint articulation at which the flexible member changes from being passive to augment the primary repair construct.

Abstract: A closure device (320) is provided for suturing a puncture. The closure device (320) includes a suture (322, 822), an elongate support (328), a suture-positioning support (330), and an elongate dilator (344). The suture-positioning support (330) is coupled to a distal end portion (332) of the elongate support (328), laterally extendable with respect to the distal end portion (332) of the elongate support (328), and configured to removably receive the suture (322, 822). The dilator (344) is configured to be inserted through the puncture, and has a proximal end (348) that is coupled to the distal end portion (332) of the elongate support (328). The closure device (320) is configured to allow movement of the distal end portion (332) of the elongate support (328) with respect to the proximal end (348) of the dilator (344) with at least two degrees of freedom. Other embodiments are also described.

Abstract: The present disclosure describes apparatuses and methods related to suture anchors. One such apparatus involves an inserter instrument for a suture anchor implant comprising a handle; a hollow outer barrel shaft extending from one end of the inserter instrument to an opposing end at an anchor screw attachment tip; and an inner barrel shaft extending along a length of the inserter instrument within a cavity of the hollow outer barrel shaft. The inserter instrument further includes a tension sensor coupled to an end of the inner barrel shaft, which can measure an amount of tension applied to an opposing end of the inner barrel shaft and output an electrical signal indicating a value of the measured tension, such that an electronic display communicatively coupled to the tension sensor can display the value of the measured tension indicated by the electrical signal.

Abstract: Described herein is a medical device for treating a target site, the medical device including, a proximal end including a disc and a distal end including a lobe. The disc and the lobe are connected by a connecting member. The lobe includes a proximal portion defining a proximal surface of the lobe, a distal portion defining a distal surface of the lobe, and a middle portion connecting and extending between the proximal portion and the distal portion. A first transition between the proximal portion and the middle portion is curved, and a second transition between the middle portion and the distal portion is curved. The medical device also includes a plurality of stabilizing wires coupled to the lobe at a radially outer surface of the middle portion, each stabilizing wire including a hook portion extending radially outward from the at least one lobe.

Abstract: Self-expanding plug embodiments may be used in conjunction with vascular closure device embodiments to promote hemostasis at surgical sites or any other suitable location. In some cases, vascular closure device embodiments may include self-expanding plug embodiments in order to promote hemostasis at a surgical site during a vascular closure procedure.