Abstract: Treatment methods and devices are provided for percutaneously accessing a patient's thoracic region via a controlled opening in the aorta, so that cardiac procedures, such as a coronary bypass procedure, can be performed in a minimally invasive manner. Advantageously, it may be possible to perform the procedure without placing the patient on cardiopulmonary bypass. The method may include percutaneously delivering at least one catheter into an aorta of a heart, forming a controlled opening in the aorta and pericardium via the at least one catheter to access a thoracic region within the patient's chest, and performing at least one coronary bypass graft procedure through the controlled opening.

Abstract: A method of treating a sinus cavity of a subject includes advancing a distal portion of a light source through a drainage pathway of a sinus cavity and into the sinus cavity and visually observing a transdermal light emitted from the light source. A distal portion of a substantially rigid inner guide member of a balloon dilation catheter is advanced into the drainage pathway, the balloon dilation catheter including a movable shaft including a balloon that is slidably mounted on the substantially rigid inner guide member. The movable shaft and balloon are advanced distally over the substantially rigid inner guide member to place a portion of the balloon in the drainage pathway whereby the balloon is inflated.

Abstract: A catheter system and method are described for stenting a vessel at a bifurcation or sidebranch of the vessel. The catheter system includes a first balloon catheter, a second balloon catheter and a releasable linking device for holding the first and second balloon catheters arranged in a side-by-side configuration and aligned with one another along a longitudinal axis so that the catheter system can be advanced as a unit. The catheter system is combined with drug eluting technology to prevent restenosis, inflammation and/or thrombosis and/or to promote reendothelialization in the vessel bifurcation. The main vessel stent and/or the sidebranch stent may be coated or impregnated with one or more drugs or bioactive substances. Alternatively or in addition, the first balloon and/or the second balloon may be coated with or include a mechanism for delivering one or more drugs or bioactive substances to the vessel wall.

Abstract: A pressure relief apparatus for a balloon dilation catheter having a shaft with a dilation balloon attached to the distal end of the shaft and an inflation/deflation lumen for inflating and deflating the balloon includes a pressure relief port formed through the wall of the inflation/deflation lumen with a pressure relief member secured across the pressure relief port to form a fluid tight seal such that the fluid tight seal formed by the pressure relief member fails at a predetermined pressure to release pressure from the inflation/deflation lumen through the pressure relief port. A splash guard is positioned across the pressure relief port, the splash guard being formed from a fluid permeable body defining a plurality of flow passages therethrough, whereby the splash guard partially obstructs fluid flow through the pressure relief port to prevent a direct uncontrolled release of the fluid from the pressure relief port.

Abstract: A system for stabilizing the heart via a helical needle, providing access to the interior of the heart via an introducer sheath, and forming a purse string suture using suture delivered by the helical needle. A helical needle projects distally from the device and terminates in a sharp distal tip. The helical needle is advanced into the heart wall, and is used to stabilize the heart and to pass a purse string suture through the heart tissue. An access port provides access to the interior of the heart via an opening passing through the heart wall in an area circumscribed by the helical needle. The helical needle may have a deflection segment adjacent the distal tip that is more flexible than the rest of the helical distal portion of the helical needle.

Abstract: Surgical devices are disclosed herein that generally include an intracorporeal elbow joint to facilitate translational movement of an end effector while allowing a body portion of the surgical device and a trocar or working channel through which the device is inserted to be maintained in a fixed angular orientation relative to the patient. This allows a plurality of such devices to be used effectively with a single incision or access device. Such devices also generally provide end effector movement with six degrees of freedom, while maintaining a mechanical linkage between the user and the end effector and while mimicking and/or mirroring natural user movement. Various methods related to such devices are also disclosed.

Abstract: The invention relates to a device for the implantation of microcoils into body cavities and blood vessels, in particular aneurysms, with said microcoils comprising wires forming a plurality of windings, at least one microcoil serving as occlusion helix for the occlusion of the body cavity or blood vessel, and the device consisting of a catheter, one or several microcoils movably arranged in longitudinal direction within the catheter and at least one securing means passing at least partially through the lumen of the occlusion helix, with said securing means being fixed in its end areas inside the microcoils. Such a fixation of the securing means is achieved in at least one end area by providing a frictional connection with the microcoil in such a manner that this connection is detachable from the microcoil when a certain tensile force acting on the securing means is exceeded.

Abstract: The present disclosure relates to an apparatus for endoscopic application of surgical clips to body tissue. The apparatus includes a handle portion, an elongated tubular member, one or more surgical clips, a jaw assembly and a locking cam driver. The elongated tubular member extends distally from the handle portion and defines a longitudinal axis. The surgical clips are disposed within the tubular member. The locking cam driver includes a bifurcated distal end portion that has a pair of angled camming surfaces to facilitate closure of the jaw assembly.

Abstract: An occluding device is provided for occluding fluid flow through a lumen of a body vessel. The occluding device includes an expandable tubular body having a tubular wall defining a lumen formed therethrough. The tubular wall has a proximal end extending to a distal end along a longitudinal axis of the tubular body. A plurality of longitudinal slits is formed through the tubular wall to define a plurality of flexible strips bound by a proximal non-slit portion and a distal non-slit portion. A plurality of barbs is disposed on the flexible strips. The tubular body is configured to open radially to engage the barbs with the vessel wall defining an expanded state and to collapse along the longitudinal axis to draw the vessel wall radially inward defining a collapsed state. Occluding material is housed within the lumen of the tubular body and the occluding material is configured to move between a collapsed state and an expanded state with the tubular body.

Abstract: An expandable and retrievable device for treatment of a stenotic lesion in a body vessel is disclosed. The device comprises a tubular portion including a proximal end and a distal end extending from the proximal end. The tubular portion has a lumen formed therethrough between the proximal and distal ends. The device further comprises an expandable member formed helically about the tubular portion. The expandable member is configured to helically close, defining a collapsed state for delivery of the device. The expandable member is configured to helically open, defining an expanded state for treatment of the stenotic lesion in the body vessel. The expandable member has at least one filter portion that helically extends from the tubular portion at a predetermined angle. This defines a proximally faced opening when the expandable member is in the expanded state.

Abstract: Devices and methods for controlling blood perfusion pressure. In an exemplary device for controlling blood perfusion pressure within a vessel of the present disclosure, the device comprises an elongated body having a lumen, a proximal end configured for placement in a first area having a first blood pressure, and a distal end configured for placement in a second area having a second blood pressure, partial occluder positioned within the lumen of the elongated body between the proximal end and the distal end, the partial occluder configured so not to fully occlude a blood vessel, wherein the partial occluder is configured to equalize the first blood pressure at the first area with the second blood pressure at the second area.

Abstract: A surgical needle includes a pair of ends, a mid-region extending between the ends, and at least one grasping feature configured for grasping by a suturing instrument. An end of a suture is secured to the mid-region of the needle in a manner such that the end of the suture defines an oblique angle with at least part of the centerline defined by the mid-region of the needle. The end of the suture may be disposed in a hollow portion of the needle. The grasping feature may include a notch such as a scallop. The suture may be pivotally coupled with the needle via a ball or pin. The needle may have one or more sharp points. The sharp point may include three converging cutting edges, at least two planar surfaces bounded by the three cutting edges, and a rounded surface bounded by two of the three cutting edges.

Abstract: A combined multi-lumen central access catheter and an embolic filter including ports proximal and distal the filter for fluid infusion and/or pressure sensing and infusion ports in the catheter to permit infusion of bioactive agents, flushing agents and/or contrast agents. The embolic filter may be removably coupled to the multi-lumen catheter for temporary placement and retrieval under recommended indications.

Abstract: A hand-held actuator device for releasing into the body from a delivery system a medical prosthesis, like a stent, comprising a frame (10) that acts as a housing, a reel (30) for receiving a wire (8), a manually operable slider (34) mounted to the frame and a one-way connection between the slider and the reel. Actuating the slider causes the reel to wind up the wire and release the medical prosthesis.

Abstract: An implantable medical electrode system for intramuscular use that is readily removable is provided, as well as methods for its use. The system includes an electrode, an electrical lead mechanically and electrically connected to the electrode and extending proximally, and a tether bonded to the electrode and extending proximally. A conductor with an insulated portion enwraps the electrical lead; an uninsulated portion enwraps the electrode. Some embodiments may include a tissue-piercing guide such as a needle. In some embodiments, the electrode includes a barb, although in some of these embodiments the tether does not extend through the barb. The method of using the system includes inserting the through a target tissue, pulling the electrode with the needle into the target tissue, and extending the electrical lead and tether proximally to an electrical connection. Methods are further provided for removing the electrode which take advantage of structural features of the system.

Abstract: A stent graft (1) including a tubular wall (3) with at least one fenestration (40) including a peripheral (37) reinforcement around at least part of the fenestration. There can also be a tubular extension (15). The side arm includes a stent (19) and a cover (17) and extends from and is in fluid communication with the fenestration and the stent graft. The stent may be a self expanding stent. The ring and/or tubular extension provides better support and sealing for an extension arm. The fenestration (40) can be circular or if towards the ends of the stent graft may be in the form of a U-shape (50) with an open end.

Abstract: A device for positioning a catheter at an ostium. The device includes an attachment mechanism for direct attachment to the catheter at a location proximal to a treatment device positioned on the catheter, the attachment mechanism having a proximal end, a distal end, and a longitudinal axis extending from the proximal end to the distal end. The device also including a stopper element extending from the distal end of the attachment mechanism and projecting away from the longitudinal axis, the stopper element being bendable in a direction toward the proximal end of the attachment mechanism.

Abstract: The invention relates to a medical implant in the form of an elongated helix wherein at least one part of the helix is preformed in such a manner that it has a secondary structure of identically sized loops which it assumes during implantation at the placement site, with said structure in turn forming at the placement site during implantation a polyhedral tertiary structure, and the polyhedron being provided with at least one additional loop.

Abstract: An implant delivery system has one or more interlock assemblies which connect the implant delivery catheter to the implant, an improved inner tubular member and an outer tubular member. The interlock assemblies, improved inner tubular member and outer tubular member cooperate to place the implant in tension during deployment, thereby reducing implant deployment force.

Abstract: Braid-balls suitable for aneurysm occlusion and/or parent vessel occlusion/sacrifice (e.g., in treating neurovascular defects) are disclosed. Especially for aneurysm treatment, but also for either one of the aforementioned treatments, the form of the ball is very important. In particular, the density of the device is paramount in applications where braid itself is intended to moderate or stop blood flow—allowing thrombosis within a volume formed by the ball.