Abstract: A surgical instrument configured to be coupled to an ultrasonic oscillation mechanism for resection of tissue under suction. A tip extends from a shaft and includes teeth formed by slots. Each of the teeth includes a distal end, a distal cutting edge, and a side cutting edge. The distal cutting edge and the side cutting edge are configured to slice the tissue with the tip moving in a first direction of combined longitudinal and torsional vibration and pull the tissue with the tip moving in the second direction opposite the first direction. An intersection of an outer edge, the distal cutting edge, and the side cutting edge defines a sharp cutting point at the distal end. A sloped surface defining the slot maintains coupling of the tip with the tissue with suction during resection of the tissue with the distal cutting edge and the side cutting edge.

Abstract: Devices and methods are described for occluding the left atrial appendage (LAA) to exclude the LAA from blood flow to prevent blood from clotting within the LAA and subsequently embolizing, particularly in patients with atrial fibrillation. An implant is delivered via transcatheter delivery into the LAA. The implant includes a conformable structure comprising a foam body and internal support. The support includes anchors that penetrate the foam body and anchor the implant to the walls of the LAA. The implant provides compliance such that it conforms to the native configuration of the LAA.

Abstract: The present disclosure describes treatment of the vasculature of a patient with an expandable implant. The implant is constrained to a reduced delivery diameter for delivery within the vasculature by at least one sleeve. The implant can be constrained to other diameters, such as an intermediate diameter. The sleeves can be expanded, allowing for expansion of the diameter of the expandable implant, by disengaging a coupling member from the sleeve or sleeves from outside of the body of the patient. The expandable implant can comprise a steering line or lines which facilitate bending and steering of the expandable implant through the vasculature of a patient.

Abstract: Described herein are systems, devices, and methods for aspiration and mechanical thrombectomy. In some embodiments, a thrombectomy device for removing a thrombus from a vessel can include a handle assembly, a vacuum source, an aspiration catheter with an expandable distal portion, and a flexible shaft configured to rotate within the aspiration catheter.

Abstract: A device for treating hemorrhoids includes a first ligating member which moves between a first position in which the first member is tightened to a degree required to maintain a desired position of the first member around the first portion without significantly cutting off blood flow and a second configuration in which the first member is cinched down around the first portion to substantially cut off blood flow to the encircled first portion. Also, the device includes a first applicator having a proximal lumen and first and second opposed distal lumens open to the proximal lumen. The first member is extending from a proximal end distally through the proximal lumen into the first lumen to exit a distal end of the first lumen, loop around and enter the distal end of the second lumen. The first member is passing through the second lumen into the proximal lumen.

Abstract: The apparatus and method for hemostasis that informs the provider as to whether the appropriate magnitude of pressure is being applied to a puncture site on a patient. A visual pulse indicator can visually convey whether or not there is proper blood flow at the puncture site based on the pulsing motion encountered by the visual pulse indicator on the puncture site. The visual pulse indicator can potentially factor in a variety of different input parameters in displaying information that is useful to providers.

Abstract: A clot removal device has an expandable treatment member having a distal tip and a proximal end, a delivery wire having a distal end coupled to the proximal end of the expandable treatment member, and a flow restrictor carried along the delivery wire at a location that is separate and proximal from the expandable treatment member. The flow restrictor has a body with a distal section and a proximal section, the distal section being covered and the proximal section being uncovered. The expandable treatment member is moveable relative to the flow restrictor, and can be retracted into the distal section.

Abstract: A suture passer device for passing a length of suture through an object. The suture passer device includes a hollow tube having a proximal end and a curved distal tube portion extending to a distal end. The suture passer device also includes a handle attached to the proximal end of the hollow tube, an actuator on the handle movable between first, second, and third positions, and an internal arm within the curved distal tube portion and connected to the actuator. The internal arm is movable between first, second, and third configurations. When the actuator is in the first position, the internal arm extends out from the distal tube portion at an angle from the distal tube portion in the first configuration. When the actuator is in the second position, the internal arm is retracted within the distal tube portion in the second configuration.

Abstract: An occlusion device formed of a microcoil having a three-dimensional relaxed state employing open looped portions interposed between closed loop portions. Planes defined by sequentially formed open looped and closed loop portions are neither coincident nor parallel to one another.

Abstract: In one embodiment of the present disclosure, an apparatus for securing a first object to a second object, including a deformable anchor body, a working suture connected to the anchor body, the working suture including a pre-formed knot, and a repair suture connected to the first object, wherein, with the anchor body connected to the second object and at least one of the anchor body and the working suture connected to the repair suture, the anchor body is adapted to secure within the second object and the working suture and repair suture are adapted to secure to the anchor body to secure the first object to the second object.

Abstract: A clot removal device can include a caged portion which can include a distal end; a proximal end; an inner cage having a network of inner struts; and an outer cage having a network of outer struts. The inner cage and the outer cage can include a delivery configuration within a microcatheter and a deployed configuration distal of the microcatheter operable to retrieve at least a portion of the clot. The device can include a distal pinching portion located proximate the distal end of the caged portion, and a proximal pinching portion located proximate the proximal end of the caged portion, each pinching portion can include at least one pinching cell can include a collapsed state and an expanded state distal of the microcatheter operable to tweeze at least a portion of the clot.

Abstract: In some examples, a tissue compression device includes a base including a major surface configured to engage a dorsal surface of a hand of a patient, a flexible backing adjustably mechanically connected to the base and configured to engage a palmar surface of the hand when the dorsal surface of the hand is engaged with the base, and an expandable member mechanically connected to the flexible backing. The expandable member is configured to be positioned over an ulnar region of the patient when the palmar surface of the hand is engaged with the flexible backing and the dorsal surface of the hand is engaged with the base, such that inflation of the expandable member may apply pressure to tissue near the ulnar artery of the patient.

Abstract: A surgical robotic tool used with a surgical robotic system can include cables that effect movement in the surgical robotic tool. A brake in any of these cables can be detected by checking a plurality of conditions. A process can compare a) a tension error against a first threshold, b) a rate of change of the sensed tension of the cable against a second threshold, and c) a rate of change of a cable extension error against a third threshold. If all thresholds are exceeded, the process can disable the respective actuator.

Abstract: Disclosed herein are systems, devices, and methods for the removal of objects from the body. The device may be a urethral catheter configured to aspirate kidney stones from the urinary tract through one or more aspiration ports at the distal face or along a lateral side of the catheter. The catheter may include one or more irrigation ports at the distal face or along the lateral side of the catheter for dislodging kidney stones. The device may be steerable. The spatial arrangement of the one or more irrigation ports with respect to the one or more aspiration ports may vary. The device may include an irrigation tube and/or a shield member configured to spatially confine the kidney stones adjacent the catheter. Various temporal patterns of aspiration and irrigation are disclosed for optimizing removal of kidney stones.

Abstract: Devices, systems and methods are described for implantation of a prosthesis within a lumen or body cavity and delivery systems for delivering the prosthesis to a location for implantation. A delivery system can include a tether connected to a single directional handle knob for release of the prosthesis within the lumen or body cavity and retraction of the tether towards the handle.

Abstract: Medical devices for applying a cinch to one or more suture and cutting the suture, and methods for making and using such devices are disclosed. An example medical device may include an elongated shaft, a connection sleeve, a cinch sleeve coupled to the connection sleeve, and a cinch member. An elongated inner shaft may extend through and be longitudinally movable within the elongated shaft, connection sleeve, cinch sleeve, and cinch member.

Abstract: Devices described herein include a stentriever for removing an occlusive clot. The stentriever can include a membrane cover on the proximal end which can be sized to form a seal with the tip of an intermediate catheter. Clot engagement sections and/or a distal engagement section of the stentriever can also include a full or partial membrane covering to control the direction of aspiration and/or areas where the aspiration applies suction to the thrombus or clot. The membranes can be used to direct the aspiration so as to pull the clot deeper into the clot engagement sections of the stentriever, thereby improving grip on the clot. The design can also increase the effectiveness of clot fragment protection for friable clots by providing pores and/or clot cells in a distal engagement section.

Abstract: Retrieval of material from vessel lumens can be improved by use of a distal element comprising an expandable mesh. a treatment device includes an elongated member having a proximal portion and a distal portion configured to be positioned within a blood vessel at a treatment site at or near a thrombus. A distal element comprising an expandable mesh is coupled to the distal portion of the elongated member via a connection assembly. In an expanded state, at least a portion of the mesh is configured to be in apposition with the blood vessel wall at the treatment site to anchor or stabilize the elongated member with respect to the blood vessel. The distal element can be electrically coupled to an extracorporeal current generator.

Abstract: A thrombosis macerating device for macerating blood clots and blockages in a blood vessel is disclosed. The macerating device comprises an expandable basket that is rotated to macerate the clot or blockage. The expandable basket is disposed at the distal end of the tubular shaft. The expandable basket comprises a plurality of struts that form a braiding pattern. The braiding pattern of the expandable basket comprises a pick per inch that ranges from 2 to 5.

Abstract: A manipulator, including an elongated chassis containing a U-shaped channel defining a distal direction and a proximal direction. The manipulator also includes an adjuster that is configured to slide in the U-shaped channel. The adjuster includes a first wheel which on rotation translates a guidewire positioned in the adjuster along an axis of the guidewire, and a second wheel which on rotation rotates the guidewire positioned in the adjuster about the axis of the guidewire. The adjuster also includes a port, distal to the first and the second wheel, that is configured to accept a tubular balloon and the guidewire.