Abstract: A laparoscopic suturing device is provided. The suturing device can pass a suturing needle back and forth between jaws of a jaw assembly to suture tissue at a surgical site in a minimally invasive procedure. The jaw assembly can have a pivotable jaw member in each jaw to position the jaw assembly and needle in a low-profile stowed configuration for insertion through a low diameter surgical port. The jaw assembly can be actuated by a handle assembly that provides simultaneous needle passing from a driving jaw to a receiving jaw and latching the needle within the receiving jaw in a single trigger cycle.

Abstract: An apparatus and method for connecting two tubular vessels together in a side-by-side or tangential manner is disclosed. The apparatus has an annulus and at least one series of fingers connected to and extending away from the annulus. Each finger is preferably heat-formed into an arcuate shape. In use, a deployment apparatus is used to constrain the fingers of the apparatus to be in a relatively planar configuration. The deployment apparatus containing the apparatus is placed between and in contact with the two tubular vessels so that one tubular vessel is above the device and one tubular vessel is below the device and so that the fingers of the device come into contact with the tissue of the vessels. As the fingers penetrate the vessels the constraint on the fingers is removed so that the fingers can assume their unbiased, heat-formed arcuate shape. In this way, the fingers penetrate and grasp the tissue of the vessels so that the apparatus grasps the vessels and pulls the vessels toward each other.

Abstract: A rotatable cutter for a tissue-removing catheter includes a central hub, flutes spaced apart from one another around the circumference of the central hub, and arcuate cutting members. Each cutting member includes an arcuate cutting edge extending along an arc length of the cutting member for cutting tissue as the cutter is rotated. A raised element of each cutting member has a leading cutting edge at a leading end of the distal cutting member for cutting tissue as the cutter is rotated. A clearance portion of each cutting member is recessed, relative to the longitudinal axis of the cutter, from the raised element and extends from the raised element to a trailing end of the cutting member to provide clearance for the leading cutting edge of an adjacent and opposing distal cutting member.

Abstract: Vascular closure devices and methods for closing a blood vessel puncture site disposed at a distal end of a tissue tract are described. A combination of the body's own natural mechanism with chemical and/or biological agents is relied upon to accelerate the hemostatic process. Included are steps of introducing a closure device through the tissue tract and deploying an expansible member at a distal end of the device within the blood vessel to occlude the puncture site. A sealing member disposed proximal the expansible member is then displaced by retracting and tensioning a coil spring so as to expose a chemical and/or biological region or release region of the device. The retraction and tensioning of the coil spring is limited by a coupling member. Exposure of blood and tissue to the chemical and/or biological sealing member promotes the clotting processing to accelerate the occlusion process in the tract.

Abstract: A blood flow reducing assembly includes a catheter shaft and an expandable occlusion member assembled with the catheter shaft. The expandable occlusion member includes foldable protrusions. One or more manipulation members are connected to the foldable protrusions and operative to move the foldable protrusions closer to or further away from one other. Movement of the foldable protrusions modifies occlusion ability of the foldable protrusions.

Abstract: An endoscopic treatment tool includes: a needle tube in which a needle tube insertion passage extending from a distal end to a proximal end of the needle tube is formed; a stylet which is disposed to move freely in the needle tube insertion passage; a main manipulation part which is connected to a proximal end side of the needle tube, the main manipulation part supporting the stylet such that the stylet advances while rotating, and the main manipulation part operating the stylet; a manipulation transmission member which has flexibility and the manipulation transmission member is connected to the stylet; and an auxiliary manipulation part which includes a handle fixed to a proximal end portion of the manipulation transmission member and the auxiliary manipulation part is configured such that the manipulation transmission member advances while rotating in accordance with a manipulation of the handle.

Abstract: A device and method for dilating a Eustachian tube of a patient is disclosed. The device includes a guide catheter and a balloon dilation catheter. The balloon dilation catheter has an actuator that prevents injury to the middle ear. The balloon dilation catheter is slidably coupled with the guide catheter through the guide catheter lumen and is fully inserted into the guide catheter lumen when the distal side of the actuator is adjacent to the proximal end of the guide catheter. The method involves advancing the guide catheter and balloon dilation catheter through a nasal passage of the patient to dilate a portion of the Eustachian tube.

Abstract: A handle assembly for a prosthesis delivery device is disclosed. The handle assembly comprises a stationary main handle having a proximal end and a distal end and an outer surface extending therebetween. A first helical groove is formed in at least a portion of the outer surface of the main handle and a first trigger wire actuation mechanism disposed about the main handle and rotatably moveable relative to the main handle. A first trigger wire is operatively connected to the first trigger wire actuation mechanism, the first trigger wire having a prosthesis capture condition and a prosthesis release condition. Movement of the first trigger wire actuation mechanism causes movement of the first trigger wire thereby moving the first trigger wire from the prosthesis capture condition to the prosthesis release condition. Additional trigger wire actuation mechanisms operatively connected to one or more additional trigger wires may also be disposed about the main handle.

Abstract: A delivery device for percutaneously delivering a stented prosthetic heart includes a sheath, a handle, and adjustment device including a fine adjustment mechanism, and an outer stability shaft. The sheath defines a lumen and is configured to compressively constrain the stented prosthetic heart valve. The handle is coupled to the proximal portion of the sheath and includes an actuator mechanism coupled to a proximal portion of the sheath that is configured to selectively move the sheath relative to the housing to release the stented prosthetic heat valve. The adjustment device is coupled to the handle and includes an adjustment lumen through which the sheath and the handle slidably extend. The outer stability shaft is coupled to the adjustment device. The fine adjustment mechanism is configured to selectively move the handle and the sheath relative to the adjustment device and the outer stability shaft.

Abstract: A vascular plug has a frame or skeleton which includes a ring of spring material and, attached to the frame, a cover of impervious or porous material. The plug is able to open a cup configuration when in a deployed condition, so as to provide an occlusion barrier to blood flow. The frame can be radially contracted by twisting into a multi-coiled configuration for deployment through an introducer. The vascular plug has a very short deployment length, making it suitable for deployment in precise locations and is also able to expand to a variety of operating diameters, thereby being suitable for a range of vessel sizes.

Abstract: A device and a method of manufacturing an implantable medical device, such as a stent, are described herein. The device includes a metallic region composed of a bioerodable metal and a polymer region composed of a biodegradable polymer contacting the metallic region. The metallic region may erode at a different rate when exposed to bodily fluids than the polymer region when exposed to bodily fluids. In certain embodiments, the polymer region is an outer layer and the metallic region is an inner layer of the device. A further aspect of the invention includes device and a method of manufacturing the device that includes a mixture of a biodegradable polymer and bioerodable metallic particles. The mixture may be used to fabricate an implantable medical device or to coat an implantable medical device. In some embodiments, the metallic particles are metallic nanoparticles.

Abstract: An introduction arrangement for a fenestrated or branched stent graft (13) intended for deployment into the lumen of a vessel having a blind vessel extending from it. The introducer (1) has a distal end intended to remain outside a patient in use and a proximal end with a nose cone dilator (11) and an arrangement to retain the branched stent graft distally of the nose cone dilator. A sheath (15) on the introducer extends over the branched stent graft to the nose cone dilator. An indwelling catheter (22) extends from the distal end of the introducer and enters the fenestration or side arm and through to the nose cone dilator, the indwelling catheter has a guide wire (29) extending through it. The guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft so that it can be snared from the contra-lateral artery.

Abstract: The present invention involves an automatic suture locking device useable with vascular closure device. The suture locking device includes a housing and a locking mechanism. The locking mechanism has locked and unlocked positions. In the locked position, a suture pathway through the mechanism is sufficiently tortuous to prevent free suture movement.

Abstract: An introduction arrangement for a fenestrated or branched stent graft (13) intended for deployment into the lumen of a vessel having a blind vessel extending from it. The introducer (1) has a distal end intended to remain outside a patient in use and a proximal end with a nose cone dilator (11) and an arrangement to retain the branched stent graft distally of the nose cone dilator. A sheath (15) on the introducer extends over the branched stent graft to the nose cone dilator. An indwelling catheter (21) extends from the distal end of the introducer and enters the fenestration or side arm and through to the nose cone dilator, the indwelling catheter has a guide wire (29) extending through it. The guide wire can be extended beyond the nose cone dilator in use before the sheath is withdrawn from the branched stent graft so that it can be snared from the contra-lateral artery.

Abstract: The present invention generally relates to surgical clips. A surgical clip comprises a first piece comprising a first base and a first projection extending from the first base, a second piece comprising a second base, a second projection extending from the second base wherein the second projection further comprises a top surface, at least one side surface and a bottom surface, the surfaces defining a reservoir therein, and the first and the second piece are detachably connectable. In a preferred embodiment, the reservoir is self-releasing to deliver therapeutic materials when the first piece and second piece are connected.

Abstract: A linear surgical needle is provided having a body portion including a proximal end section; a central section; and a distal end section. The distal end section has a substantially parabolic configuration for producing a substantially uniform stress profile along a length thereof.

Abstract: The present invention provides apparatuses, systems, methods and kits for fastening sutures or similar devices used in medical surgical procedures. In particular, the present invention is suitable for use with percutaneous or minimally invasive procedures in which sutures are placed with catheter-based devices wherein the tying of knots is particularly challenging. Suture fasteners of the present invention provide for fastening the sutures together in a fixed position at any location along the suture strands. In addition, the fasteners are adjustable to allow repositioning of the fastener after placement to a new desired location along the suture strands. Similarly, such fasteners may be used to hold a single suture strand for various applications.

Abstract: Apparatus is provided for sealing a vascular puncture by causing a reduction in the circumference of the puncture tract through delivery of a closure agent into tissue surrounding the puncture tract. A resultant inflammatory response and volumetric increase cause the tissue to swell into the puncture tract, thereby sealing it.

Abstract: Forming a proximal anastomosis on an aortic wall includes method and instrumentation and apparatus for forming an aortic puncture and inserting into the vessel through the puncture a fluid-impervious sealing element with a protruding retainer. An anastomosis of a graft vessel over the puncture is partially completed with the retainer of the sealing element protruding through the partial anastomosis. The retainer facilitates removal of the sealing element from the partial anastomosis prior to completion of the procedure.

Abstract: Systems, apparatuses and methods for securing tissue to bone using a bone anchoring system are described. Methods and apparatuses may allow transformation between locked and unlocked states, thereby allowing adjustment of the tension in the suture. The apparatus and/or methods may allow unidirectional movement of a suture, while preventing slippage or movement of the suture and tissue in the opposite direction. Ends of a suture may be individually tensioned to adjust positioning of a tissue with respect to a bone.