Abstract: A knotless suture anchor provides a method for securing soft tissue to a rigid structure such as bone. The anchor has an inner member that receives suture thread and rotates within an outer tubular member. As the inner member rotates, the suture thread is wrapped onto the inner member thereby increasing contact with the outer tubular member which applies pressure to the wrapped suture thread to retain it in position on the inner member while simultaneously and adjustably tensioning the suture thread. A ratchet prevents undesirable counter-rotation, although the ratchet can be released to permit loosening of the suture thread. Also described is a suture bridge and suture platform for providing further stabilization of a tendon. A method for repairing rotator cuff tears is also described.

Abstract: A method for minimally invasive tendon sheath release is presented herein. The method enables a surgeon to cut (“open”) a pulley that is obstructing a nodule and keeping a tendon from sliding smoothly. A guide probe of the device is inserted through a small incision and is used to find the edge of the pulley. Once found, the probe is guided to an end of the pulley. Proper placement of the device may be confirmed through the use of ultrasound. After proper position is assured, a hemi-cannula is moved over the guide probe to isolate the pulley from the surrounding tissue. A cutting blade is then used to sever the pulley. A dilation device may be inserted prior to the insertion of the spherical tipped guide probe to dilate the area.

Abstract: A device for minimally invasive tendon sheath release is presented. The device enables a surgeon to cut (“open”) a pulley that is obstructing a nodule and keeping a tendon from sliding smoothly. The device is generally comprised of a sheath having a guide probe and a dorsal outrigger guide between which a cutting blade is positioned. The device is inserted through a small incision and the guide probe is used to find the edge of the pulley. Once found, the probe is guided to an end of the pulley. After proper position is assured, a cutting blade is deployed The entire device is then pushed or pulled using the device handle along the pulley until the pulley is completely released or where resistance is no longer felt.

Abstract: The present embodiments provide systems and methods for deploying at least one clip during a medical procedure. In one embodiment, the system comprises a clip having first and second arms. A locking pin is coupled to the clip and disposed for incremental movement relative to the clip. Further, a tether is coupled to the locking pin, wherein a first tether segment is secured to a distal region of the second arm, and a second tether segment is secured to a distal region of the first arm. In use, proximal retraction of the locking pin causes a proximal retraction of the first and second tether segments to move the clip between open and closed states. Incremental retraction of the locking pin incrementally advances the clip between the open and closed states.

Abstract: A delivery system and method for delivering a prosthetic heart valve to the aortic valve annulus. The system includes a balloon catheter having a steering mechanism thereon for delivering a balloon-expandable prosthetic heart valve through an introducer in an antegrade fashion to the aortic annulus. The balloon catheter passes through an introducer that accesses the left ventricle through its apex and a small incision in the chest wall. The balloon catheter includes a deflecting segment just proximal to the distal balloon to facilitate positioning of the prosthetic heart valve in the proper orientation within the aortic annulus. A slider in a deflection handle may be coupled to a deflection wire that actuates the deflecting segment. The method includes using two concentric rings of purse-string sutures around the puncture in the left ventricular apex to maintain a good seal around instruments passed therethrough.

Abstract: The invention relates to a lancet magazine with a plurality of lancets for generating a puncture wound for collecting a sample of body fluid. According to the invention, the lancets in the lancet magazine are each coupled to a drive mechanism which, for each lancet, comprises at least one pretensioned drive element which, when the drive mechanism is triggered, releases mechanical energy to accelerate the lancet coupled thereto for a puncturing movement.

Abstract: A precision depth guided instrument, such as a Jamshidi needle, is provided for use in various surgeries related to the vertebrae. The instrument includes an outer cannula, an inner cannula and a stylet. After the cortical bone of a vertebra is penetrated by the outer cannula of the instrument, the depth of penetration of the inner cannula is adjusted by rotation of a stop mounted to the outer cannula. The inner cannula is then moved further into the vertebrae, and a stop mounted on the outer cannula controls the depth of penetration of the inner cannula. The correct depth of penetration is determined by radiography prior to the procedure.

Abstract: Embodiments of the present invention comprise a fiber optic guidewire having a hypotube with a plurality of openings that provide variable stiffness and tracking characteristics between at least one proximal segment and one distal segment of the guidewire. In some embodiments, the guidewire further comprises a mandrel disposed within the hypotube, the mandrel cooperating with the optical fibers to permit the distal end of the hypotube to be shaped as desired by a user. Methods of manufacturing and using the guidewire are also disclosed.

Abstract: A percutaneous transluminal angioplasty device having an embolic filter mounted to the catheter shaft at a location distal to the angioplasty balloon and downstream from the blockage to capture embolic particles that may be set loose into the blood stream as the angioplasty procedure is performed. The embolic filter is normally collapsed against the catheter shaft to facilitate introduction and withdrawal of the device to and from the operative site. Once the angioplasty balloon is properly positioned, however, means operatively associated with the embolic filter are actuated to erect the filter to operatively position a filter mesh across the lumen of the vessel.

Abstract: Dilators and sheaths for use in minimally invasive vascular therapy are disclosed. In some embodiments, the dilators include a slot that accesses a guidewire lumen within the dilator. These slots facilitate rapid exchange of one dilator for another. In another embodiment, a dilator is sufficiently stiff to facilitate entry, but also designed to facilitate placement of the dilator along a tortuous path.

Abstract: A device for occluding septal defects or other bodily passageways including PFOs, includes an occluding body formed from a plurality of flexible outwardly radiating occluding wires connected to one or more biocompatible sheet materials. The occluding wires are joined together at proximal wire ends. Linking members connectively link the occluding body to a flexible, substantially linear anchor formed from at least one tube, coil, or bar. The anchor is configured for placement on one side of bodily passageway, whereby the longitudinal axis of at least one anchor extends across a transverse cross-section of the bodily passageway, anchoring the occluding body in place against the other side of a bodily passageway to close, occlude, or fill at least a lumenal portion of a bodily passageway. The anchor may include one or more grasping member(s) integrally formed or connected to the tube, coil, or bar for releasable attachment to an anchor engaging member, such as a biopsy forceps.

Abstract: A system for a controlled insertion and withdrawal of at least one electrode in the anatomy. The system can include a guide device and at least one electrode located within the guide device to at least one of record or stimulate an anatomy. The system can also include an indicator coupled to the electrode to indicate a position of a distal end of an electrode relative to the guide device.

Abstract: An apparatus for sealing a puncture through a vessel wall including a positioning assembly, a sheath releasably engaged with the positioning assembly, and a support member axially advanceable through the sheath. The positioning assembly includes a positioning element positioned at a distal portion of the positioning assembly and a sealant disposed at a distal portion of the positioning assembly. The sheath guides the sealant and positioning assembly to the puncture in the vessel wall.

Abstract: A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: A knotless suture system formed from two lengths of suture joined at a suture junction point, with at least four suture limbs extending from the suture junction. The knotless suture system provides the ability to construct a suture bridge for soft tissue repair and fixation across a medial and lateral row bone fixation anchor configuration while passing the suture system in a simplified method of suture management.

Abstract: A distal protection device comprising a catheter having a first strut movable from a collapsed configuration to an expanded configuration having a first dimension and a second strut movable from a collapsed configuration to an expanded configuration having a second dimension larger than the first dimension. Movement of the first strut deploys filter material to a first position having a first deployed dimension and movement of the second strut to a first position deploys filter material to a second deployed dimension larger than the first expanded dimension.

Abstract: The invention pertains to a method, apparatus, and system for cutting anatomic members, such as ligaments, in surgical procedures such as carpal tunnel release, plantar fasciotomy, gastroc release, cubital tunnel release, and tarsal tunnel release. The apparatus includes a retrograde knife and a guide tool for guiding the knife and a scope during surgery. Relevant features include a knife stop for preventing the knife from inadvertently raising out of the knife channel, indicators showing the proper orientation for the guide tool, a self dilating tip and channel design on the guide tool, a cover piece and/or pivotable panel system for preventing ligaments and other anatomy from getting caught in the guide tool, a pivot pin and groove system for stabilizing the knife and also assuring that the knife blade is not inadvertently raised out of the channel, and a use indicator for preventing re-use of a single use device.

Abstract: A stent for implantation in a blood vessel is disclosed, especially in the region of the aortic arch. The stent is comprising rings which are disposed successively in the stent's longitudinal direction and which are made up of meandering circumferential supports. The stent further comprises a prosthesis material which is fixed to the rings and which connects them, thereby forming a hollow cylindrical body with a jacket which is substantially closed on the circumference thereof. At least one connecting support is provided between the last ring and the penultimate ring at the proximal end of the stent and connects these two rings to one another.

Abstract: A morcellator (1) for morcellating tissue within a body cavity of a patient is provided in combination with first (17) and second (18) tissue-pulling devices, and an insert (19). The morcellator (1) comprises a handle portion (2) having a lumen (6) passing therethrough, and an aperture (10) communicating with the proximal end of the lumen. A tube (3) extends from the handle portion and has a tissue cutting device (7) located at the distal end of the tube. The handle includes first (11) and second (12) valves associated with the lumen of the handle portion, and the first and second tissue-pulling devices have shafts of a first diameter and second diameter respectively. The insert (19) comprises a stem (21) and a body portion (20), the stem being received in the aperture (10) to form a substantially gas-tight seal in combination with the first valve (11).

Abstract: The invention provides a rotational atherectomy system, device and method comprising a flexible, elongated, rotatable drive shaft with an abrasive section within a pre-curved section of the drive shaft. The device may further comprise a concentric or eccentric enlarged diameter section that is at least partially covered with abrasive material to comprise the abrasive section. The abrasive section may further comprise an abrasive crown or burr mounted to the drive shaft. The pre-curved drive shaft allows smaller diameter and/or massive abrasive regions to be used while sweeping larger diameters during high-speed rotation. The pre-curved region is substantially straightened for insertion into vasculature and placement adjacent stenosis by insertion of the guide wire. Removal of guide wire proximally from the pre-curved region allows the drive shaft to return to its pre-curved form for ablation. Reinsertion of the guide wire beyond the pre-curved region straightens the drive shaft for ease of removal.