Abstract: Methods of implanting a device in the lumen of a blood vessel are described. The method includes providing a microcatheter and a device. The device includes a first hub, a second hub, a support structure including a plurality of struts disposed between the first hub and the second hub, and a layer of material disposed over the plurality of struts. The support structure has a low profile, radially constrained state with an elongated tubular configuration suitable for delivery from a microcatheter. The support structure also has an expanded state, a smooth outer surface, and has an axially shortened configuration relative to the radially constrained state. The microcatheter is advanced to a region of interest within the blood vessel. The support structure is advanced through the lumen of and out the distal end of the microcatheter where it expands to the expanded state.

Abstract: An endoluminal prosthesis system for being deployed in a patient's aorta near the heart includes a graft having a tubular body with a lumen extending from proximal end configured to be deployed near a patient's heart to a distal end configured to be deployed away from the patient's heart. A collar around the graft is sized and configured to be sutured to a patient's aorta. Passageways in the middle portion of the graft permit fluid communication from the lumen of the graft to an exterior of the graft. A respective bridging branch is disposed at each of the passageways, each of the bridging branches having an inner opening and an outer opening so that the bridging branches provide fluid communication from the lumen of the graft to the exterior of the graft. A respective bridging graft is sized and arranged to mate with each of the bridging branches.

Abstract: A method is used to reduce a volume of a stomach of a patient. The method includes inverting a portion of a stomach wall to thereby create an inverted portion. An expandable member is positioned adjacent to the outer surface of the inverted portion. The expandable member is expanded to thereby expand the inverted portion. The expanded expandable member has a first outer diameter. A base region of the inverted portion is cinched to thereby capture the expanded expandable member in the expanded inverted portion. The expanded expandable member has a first outer diameter. Expanding and cinching provide a cinch diameter to first outer diameter ratio from approximately 0.5:1 to approximately 0.9:1.

Abstract: A medical securing device for securing an object with a securing member into a tissue comprises an elongated sheath with proximal and distal ends, and a securing member introduction device having proximal and distal ends. The securing member comprises first and second ends. The distal end of the securing member introduction device is configured to extend the second end of the securing member from the sheath and introduce it to or through the tissue via an introduction movement so to secure the portion of the securing member to the object and/or to the tissue. This is advantageously configured to happen without extending the securing member introduction device through the tissue whereupon no extra hole is made to the tissue by the securing member introduction device.

Abstract: Apparatus (20) is provided for use with a guidewire (12). The apparatus includes a guide tube (22) having a guidewire-engaging portion (122) and a slit (28) extending proximally along a wall of the guide tube, from a distal end (32) of the tube, a proximal end (29) of the slit being located distally to a proximal end (30) of the tube. A first stent (52) surrounds the tube and is advanceable together with the tube into a lumen of a subject, the first stent being slidably advanceable off the distal end of the tube; and a second stent (54), proximal to the first stent, surrounding a proximal portion of the tube, and advanceable off the distal end of the tube into the lumen, and placed alongside the first stent subsequently to advancement of the first stent off the distal end of the tube. Other applications are also described.

Abstract: An occlusion device suitable for endovascular treatment of an aneurysm in a blood vessel in a patient, including a substantially tubular structure having a proximal end region and a distal end region, having a first, expanded condition and a second, collapsed condition. The device has dimensions in the second, collapsed condition suitable for insertion through vasculature of the patient and through a neck of the aneurysm. The device further includes a control ring having a substantially annular body disposed on the proximal end region of the structure and at least substantially circumscribing the proximal end region to prevent radial expansion of the proximal end region and to provide an engagement feature during manipulation of the occlusion device.

Abstract: An ultrasonic surgical instrument includes a waveguide defining a blade at a distal end thereof and a lumen extending through a portion of the blade. The blade is configured to receive ultrasonic energy for treating tissue. The instrument further includes first and second conduits each defining a proximal end and a distal end. The second conduit is coaxially disposed about the first conduit. The distal ends of the first and second conduits extend into the lumen. The distal end of the first conduit extends further distally into the lumen than the distal end of the second conduit.

Abstract: A clot retrieval device for removing occlusive clot from a blood vessel. The device comprises an inner elongate body having a collapsed delivery configuration and an expanded deployed configuration. An outer elongate body is at least partially overlying the inner elongate body. The outer elongate body is expandable to a radial extent which is greater than the radial extent of the inner body in the deployed configuration to define a clot reception space. The outer elongate body has a plurality of clot receiving openings and a plurality of clot engaging regions. The clot engaging regions are adapted, on engagement with clot, to urge clot towards the clot receiving openings and into the reception space between the outer elongate body and the inner elongate body, wherein the radial force profile of the device varies along the length of the device.

Abstract: Devices and methods for tissue and graft procedures are provided that are designed to fail under a certain amount of force, providing sensory feedback that a particular activity may be providing too much stress on a surgical implant. For example, a surgical implant can include a sacrificial element in the form of a filament designed to break when a certain threshold value of force is met or exceeded, while a second filament that has the ability to withstand higher values of force, is able to maintain the repair after the first filament fails. In other embodiments, the sacrificial element includes a filament engagement mechanism associated with a suture anchor configured to fail at a threshold value of force, and a second filament engagement mechanism of the anchor can maintain the repair after the first one fails. Many implants configurations are provided, as are various surgical methods incorporating sacrificial elements.

Abstract: In a sheath device for inserting a catheter into a patient's body, comprising a first sheath having a proximal end and a distal end, wherein when used as intended the distal end of the first sheath is provided for arrangement in the patient's body and the proximal end of the first sheath is provided for arrangement outside the patient's body, and wherein the first sheath comprises a tubular section and a sheath housing, which is disposed at the proximal end of the section and comprises a receiving channel for a catheter, according to the invention the tubular section is detachably held in a clamping element of the sheath housing in a non-positive manner so as to be able to easily shorten the tubular section.

Abstract: A surgical knife safety device having a handle, a blade connected to the handle, and a guard carried by the handle for sliding movement between a retracted position in which the blade is exposed for use, and an extended position for covering the sharp cutting edge of the blade. In the retracted position, an enlarged guard radius is provided at the distal end of the handle to allow improved handle control and blade orientation. The enlarged guard radius is positioned to allow the user to firmly grip a large distal handle portion which is preferably molded as a single piece with the blade holder, preventing unwanted blade or handle movement due to guard mechanism tolerances.

Abstract: A device for treating tissue including a capsule including a channel extending therethrough; clip arms extending from a proximal end to a distal end, proximal ends received within the channel to be moved between a tissue receiving configuration, in which distal ends of the arms are separated, and a tissue clipping configuration, in which distal ends of the arms are moved toward one another, the arms including proximal and distal portions, the proximal portion including longitudinal legs extending from the proximal end to the distal portion, a plane of the legs being rotated about a longitudinal axis of the arms from a plane including the distal portion; and a yoke including proximal and distal portions, the distal portion being releasably coupled to the clip legs via a pin, the pin is inserted through the distal portion.

Abstract: Devices, systems, and methods for treating vascular defects are disclosed herein. One aspect of the present technology, for example, includes an occlusive device comprising a mesh having a low-profile state for intravascular delivery to the aneurysm and a deployed state, the mesh comprising a first end portion, a second end portion, and a length extending between the first and second end portions, and a first lateral edge, a second lateral edge, and a width extending between the first and second lateral edges. The mesh may have a predetermined shape in the deployed state in which (a) the mesh is curved along its width, (b) the mesh is curved along its length, and (c) the mesh has an undulating contour across at least a portion of one or both of its length or its width. The mesh is configured to be positioned within the aneurysm in the deployed state such that the mesh extends over the neck of the aneurysm.

Abstract: Surgical instruments having a rotary drive that can selectively actuate multiple end effector functions are described herein. In at least one embodiment, a surgical instrument includes a shaft, an end effector coupled to the shaft, a rotatable drive shaft coaxially disposed within an inner lumen of the shaft, and a plurality of selectively engageable clutches configured to transfer torque from the rotatable drive shaft to the end effector. Each of the clutches is configured to convert the rotation of the drive shaft into one of a plurality of movements of the end effector relative to the outer shaft.

Abstract: An end effector assembly of a tissue resecting device includes a cutting member and an elongated outer shaft. The cutting member includes a core defining a passage and a plurality of blades extending radially outward from the core. Adjacent blades define a gap therebetween. The plurality of blades defines at least one window in communication with the passage of the core. The elongated outer shaft includes a tool portion rotatably receiving the plurality of blades of the cutting member therein. The tool portion defines a lateral opening such that the plurality of blades of the cutting member rotatably received in the tool portion is in registration with the lateral opening. The cutting member is transitionable between a neutral position, in which, the cutting member defines a longitudinal axis, and an articulated position, in which, at least a portion of the cutting member is offset from the longitudinal axis.

Abstract: Embodiments of the present disclosure provide an introducer device and method for introducing a delivery apparatus into a patient's vasculature. Disclosed methods can include positioning a sleeve of an introducer sheath in a blood vessel of a patient, the sleeve having a lattice layer with a lumen therethrough, inserting a distal end portion of the delivery apparatus and a prosthetic heart valve into the lumen, and advancing the distal end portion of the delivery apparatus through the lumen from the proximal end to the distal end. The method can then include expanding the lumen from a first diameter smaller to a second diameter at least equal to the diameter of the prosthetic heart valve to allow passage of the prosthetic heart valve through the lumen, and returning the lumen of the sleeve to a diameter smaller than the second diameter after advancing the prosthetic heart valve through the lumen.

Abstract: A suture passer includes a handle assembly, a shaft extending distally from the handle assembly, an end effector assembly coupled to a distal end portion of the shaft, and an overstroke assembly. The overstroke assembly effects an opening and a closing of the end effector assembly while also preventing an overstroke of the handle assembly from damaging components of the suture passer.

Abstract: The present disclosure relates to heart valve prostheses, delivery devices, actuation handles, and other improved devices and methods that facilitate delivery of a heart valve prosthesis to a defective native valve structure in a patient, such as the aortic valve.

Abstract: New methods for implanting a cardiac therapy system include implanting a lead of the system substernally anterior of the heart without attaching to the myocardium or pericardium. An illustration includes placement of an anchor beneath the sternum in the vicinity of one of the sternal angle, a location superior of the ventricles, the area bounded by the 2nd or 3rd ribs, and level with the aortic arch. A tension element or tether is attached to the anchor and a lead is introduced over the tension element or tether and secured in a desired position relative to the anchor. Other examples also include implantation, substernally, of a lead without the use of a pre-tunneling tool or sheath over the lead itself, for example by using an advancing tool for pushing the lead into position.

Abstract: Disclosed is an atrial appendage clip delivery system, which includes a handle shell, a push rod, a connection pipe and a support base; a passage is provided in the handle shell along a length direction; one end of the push rod is slidably disposed in the passage; the support base is provided with a mounting window for mounting an atrial appendage clip; the atrial appendage clip includes a first clip arm and a second clip arm capable of opening in parallel or closing; the handle shell, the connection pipe and the support base are sequentially connected and communicate; the first clip arm or the second clip arm is fixedly connected with an upper side or a lower side of the mounting window; the second clip arm or the first clip arm is movably connected with the lower side or the upper side of the mounting window.