Abstract: A deployment device for anchoring a suture to a suture anchoring device, which is made from a helically coiled member, includes a winding tube for winding a suture around the coiled member in a helical path such that the suture is attached to at least one turn of the coiled member. A support mechanism is also provided for supporting the suture anchoring device during the winding of the suture around the coiled member. The deployment device can be used for anchoring a string and the like to any helically coiled member.

Abstract: A steerable guidewire apparatus for use during percutaneous catheter interventions such as angioplasty or stent deployment. A protection element comprising a filter or an occluder is mounted near the distal end of the steerable guidewire, which guides a therapeutic catheter. The guidewire comprises a hollow shaft movably disposed about a core wire. The shaft and core wire control separation of the ends of the protection element, causing transformation of the protection element from a deployed configuration to a collapsed configuration. Farther separation of the ends of the protection element, after it has been collapsed, causes deflection in a distal region of the apparatus.

Abstract: Actuator for an inhaler for delivering medicament by inhalation. The actuator includes a main body having a tubular member for receiving a canister containing medicament and having a valve stem extending therefrom, and an outlet assembly, as a part formed separately of the main body, having a mouthpiece for guiding medicament to the mouth of a user and a nozzle block for receiving the valve stem of the canister and delivering medicament from the canister into the mouthpiece. At least a part of the outlet assembly is configured so as to deform and optionally break on withdrawal of the outlet assembly from the main body so as to prevent re-use of the outlet assembly.

Abstract: A fresh donor tissue valve isolation annulus size comprising a handle and trigger or crank knob manipulated by the user moves a movable probe into proximity with a stationary probe so that the probes can be inserted into the tissue valve lumen. The user releases the trigger or crank, and a biasing mechanism urges the movable probe away from the stationary probe until the resistance presented by the valve annulus equals the biasing force. A gage coupled to the movable probe displays a measure of the valve annulus diameter as a function of the distance that the movable probe moves away from the stationary probe until restrained from further movement by the fresh tissue valve annulus.

Abstract: An endoscopic or laparoscopic instrument includes a distal tool, a rigid or flexible elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via bendable motion members. The tool and the tool motion member are coupled to the handle and the handle motion member via cables and a push rod in such a way that the movement of the handle with respect to the elongated shaft in any direction is replicated by the tool at the distal end of the shaft. The magnitude of the tool motion with respect to the handle motion may be scaled depending on the size of the handle motion member with respect to that of the tool motion member.

Abstract: A blood vessel occluding device including a plug and an insertion device to temporarily occlude a blood vessel. In one embodiment, the plug has an axially symmetric shape and is made of a biocompatible material such as Silicone. The plug is inserted axially into the blood vessel and is gripped firmly by the walls of the blood vessel. A filament is attached to an inner surface of the plug. Pulling the filament exerts compressive force on the plug, causing the plug to collapse and facilitating the removal of the plug. The blood vessel occluding device allows the blood vessel to be occluded quickly and effectively. The insertion device is a spring loaded device that has a spring activated needle; this insertion device provides the axial force to insert the plug into the blood vessel.

Abstract: Apparatus and methods for creating anastomoses are provided. An incision tool for creating an incision having a controlled length in a side wall of a patient's body tissue conduit is provided. A delivery device for inserting a hollow annular connector into an incision in a side wall of a patient's body tissue conduit is provided. The delivery device may include first and second anvil structures around which the connector may be disposed. By moving the first anvil structure away from the second anvil structure, the connector may expand to a desired configuration (e.g., non-round) within the aperture. In one example, the connector may be inserted into the aperture to hold the aperture open prior to attachment of a graft conduit to the aperture, thereby allowing a physician to inspect the aperture and the surrounding tissue.

Abstract: This invention relates to apparatus and methods for use in sealing a vascular puncture site and to apparatus and methods for properly locating and deploying a sealing device. The locating apparatus includes a lumen which extends from an opening in the distal region of the apparatus but located proximally of the sealing device, which lumen extends to another opening in the proximal region of the device. When the distal opening is in communication with blood in a blood vessel, blood flow through the lumen and out of the proximal opening signifies such location to the user. When the sealing device is withdrawn such that the sealing device is deployed such that it blocks the blood flow into the distal port, the user will know the location of the sealing device. In a preferred embodiment, the sealing device is then withdrawn proximally a predetermined distance to assure that no part of the sealing device extends into the blood vessel lumen. The sealing device is then detached from the delivery device.

Abstract: A system for dispensing a medium includes at least a first container to hold the medium, a pressurizing device, such as a pump, in fluid connection with the container for pressurizing the medium, and an agitation mechanism or device to maintain the components of the medium in a mixed state. The container and the pressurizing device can be separate units, as in the case of an bag or bottle in fluid connection with a peristaltic or other type of pump. The container and the pump can also be combined in a single unit, as in the case of a syringe, wherein the syringe barrel of the syringe acts to contain the medium and the syringe plunger pressurizes the medium within the syringe barrel. A method of injecting a multi-component medium includes the step of agitating the medium (for example, as described above) before or during an injection procedure to maintain the components of the medium in a mixed state.

Abstract: A stent includes a conduit defining a lumen; a first malecot adjacent the conduit, where the first malecot includes at least two members having at least one slit therebetween and where the at least one slit is in fluid communication with the lumen; and a second malecot including an annular structure surrounding and protruding from the conduit. A method for placing a stent includes inserting into a patient a stent and a stylet disposed within the stent, where the stylet includes an expandable member, expanding the expandable member, seating the stent, and removing the expandable member.

Abstract: Apparatus and method are provided for treatment of a bifurcation of a body lumen. The apparatus includes an elongated catheter body having a proximal end and a distal end. A balloon is associated with the distal end of the balloon catheter. The balloon includes a main vessel balloon for treating a main vessel of the bifurcation, and a branch vessel balloon for treating a branch vessel of the bifurcation. The branch vessel balloon includes an accordion configuration capable of being expanded from an unexpanded collapsed accordion configuration to an expanded accordion configuration extending into the branch vessel.

Abstract: Intralumenal material removal systems are provided using an advanceable and rotatable cutter assembly designed for differential cutting. The intralumenal material removal system includes a cutter assembly positionable in the body cavity of a mammalian subject. One embodiment of the cutter assembly includes a cutter with blades that are designed and arranged to form an acute blade angle of attack with the matter-to-be-removed. The cutter assembly is axially advanceable by translating the drive shaft and rotatable by rotating the drive shaft. The occlusive material is scraped by the cutter assembly and may be aspirated to remove the material from the body cavity. The cutter assembly may provide aspiration ports positioned between facing surfaces of the blades.

Abstract: An endoscopic biopsy device having an outer sheath that is transparent, at least along a portion thereof, to allow visualization of at least a portion of the inside of the device. A distal portion of the outer sheath may be relatively more opaque or relatively less reflective to avoid glare that may otherwise result due to the sheath reflecting light from the endoscopic light source.

Abstract: An angled tissue cutting instrument comprises an angled outer tubular member rotatably receiving a flexible inner tubular member. The inner member has a flexible region in correspondence with an angle of the outer member. The flexible region comprises a helically cut length portion of an elongate tubular body of the inner member and a continuous solid flexible surface secured to an outer surface of the body along the helically cut length portion. A method of fabricating a flexible inner tubular member involves forming a helical cut through the solid wall of a length portion of a tubular body and securing a continuous solid flexible surface to the outer surface of the body along the helically cut length portion to form a flexible region.

Abstract: A vessel filter comprising a first region and a second region wherein the filter is movable between a collapsed position for delivery to the vessel and an expanded position for placement within the vessel. A first region has a filter portion having a converging region at a first end portion to direct particles toward the center of the filter and the second region is flared in the expanded position to have a transverse dimension increasing toward a second end portion opposite the first end portion. The second region includes a vessel engaging portion at the second end portion. The second region includes a plurality of spaced apart struts with adjacent struts being joined.

Abstract: The surgical instrument includes a distal tool, a rigid or flexible elongated shaft that supports the distal tool, and a proximal handle or control member, where the tool and the handle are coupled to the respective distal and proximal ends of the elongated shaft via distal and proximal bendable motion members. Actuation means extends between said distal and proximal members whereby any deflection of said control handle with respect to said elongated instrument shaft causes a corresponding bending of said distal motion member for control of said working member. A manually rotatable member is arranged adjacent to the control handle for manually rotating the instrument shaft and working member relative to the control handle.

Abstract: A suture anchoring device is made from a coiled member having a helical configuration with a multiplicity of turns. When used in connection with a surgical procedure, the device is positioned adjacent to a wound site and a suture is attached to at least two of the turns so as to anchor the suture to the coiled member.

Abstract: An anchoring device for incorporation into an endoluminal prosthesis to prevent migration thereof in a reliable way without the problems associated with intraluminal delivery of the prosthesis. The anchoring device allows smooth, efficient delivery of the prosthesis by providing an anchoring system that does not engage the delivery catheter or sheath upon deployment of the prosthesis within a body lumen.

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: Apparatus for pulling and positioning an apparatus, e.g., a stent, in the target area of a lumen. In one embodiment, a cylindrically shaped motor has a longitudinal bore, a friction area within the longitudinal bore, and a guide wire disposed within the longitudinal bore. The guide wire and friction area of the motor are sized and adapted to contact each other and impart friction between the friction area and the guide wire to permit the motor to pull a catheter to the target arcs by crawling against the guide wire. In another embodiment, a cylindrical motor having a friction area on its outer surface is disposed within a guide tube.