Abstract: A system is provided having a catheter, a torque member extending longitudinally through a lumen of the catheter, a removal mechanism secured to a distal end of the torque member, and a guidewire having a guide section that extends through a lumen of the removal mechanism. The guide section defines a curved profile that is diametrically larger than the dimension of the removal mechanism. The guide section of the guidewire is adapted to be positioned inside a passageway of the occluding material, and provides a curved path along which the removal mechanism can be advanced inside the passageway of the occluding material to separate and remove occluding material.

Abstract: A stent and a method for fabricating the stent are disclosed. The stent has an originally flat pattern and connection points where the sides of the flat pattern are joined. The method includes the steps of a) cutting a stent pattern into a flat piece of metal thereby to produce a metal pattern, b) deforming the metal pattern so as to cause two opposing sides to meet, and c) joining the two opposing sides at least at one point. Substantially no portion of the stent projects into the lumen of the stent when the stent is expanded against the internal wall of a blood vessel.

Abstract: An atherectomy device that may reduce the risk of damage to a vessel wall. One rotatable atherectomy burr has a recessed material removal portion lying between less abrasive proximal and distal shoulders. The shoulders can have a straight, rounded or elliptical taper. The shoulders can perform a cam action when the burr is canted is a vessel, as when passing the burr and guide wire through a tortuous, stenosed vessel path. The shoulders act to align the burr with the path through the vessel, presenting the less abrasive shoulders to the vessel wall while presenting the abrasive portion to a stenosis.

Abstract: An introducer for retaining an implant placed within an implant delivery device having a pusher for displacing the implant includes a tube and a clamp. The interior of the tube defines a passage for guiding the movement of the pusher. The clamp is made of a shape memory material disposed in the passage about the pusher. The clamp is normally operative to grip the pusher to hold it in position relative to the tube and further operative in response to an elevated temperature to release the pusher for movement relative to the tube. The clamp may be formed integrally with the tube and may comprise at least one crimp or an annular ring surrounding the tube. The tube is tapered to be narrower at its distal end and may be formed of a shaped memory polymer material.

Abstract: A stent having varying outward radial force along its length. In use, the stent can provide greater force in vessel regions requiring greater force and less force in regions requiring less. In particular, more force is provided in the narrowed, center of a stenosis, while not applying too much force to the adjoining healthy tissue area. Greater stent expansion is provided in wider vessel geometries and less stent expansion in narrower regions. Varying force is achieved varying the number of elements, the density of elements, and the thickness of the elements.

Abstract: A method and apparatus for defining the location of a medical instrument relative to features of a medical workspace including a patient's body region are described. Pairs of two-dimensional images are obtained, preferably by means of two video cameras making images of the workspace along different sightlines which intersect. A fiducial structure is positioned in the workspace for defining a three dimensional coordinate framework, and a calibration image pair is made. The calibration image pair comprises two 2D projections from different locations of the fiducial structure. After the calibration image pair is made, the fiducial structure is removed. A standard projection algorithm is used to reconstruct the 3D framework of the fiducial structure from the calibration image pair. Appropriate image pairs can then be used to locate and track any other feature such as a medical instrument, in the workspace, so long as the cameras remain fixed in their positions relative to the workspace.

Abstract: A trocar introducer system having a trocar slideably inserted into a lumen of a cannula. The trocar has an elongate member which comprises a proximal end and a distal end. An actuating mechanism is mounted at the proximal end of the trocar and operates a surgical blade which is mounted on the distal end of the trocar. The cannula may have a suture flange, drainage ports, a balloon occluder, and/or threads to facilitate delivery of medical therapies to a body tissue. Methods of using the devices herein are also disclosed.

Abstract: For repeat localization and immobilization of the head, neck and/or torso of a patient's body, immobilizing structures are used to secure the head and the neck and torso in a relative orientation in the position and relative orientation. A reference structure determines the relative position of the head and neck or torso so that the same configuration of these portions of the body can be achieved on a scanner couch or treatment machine couch repeatedly. Several forms of head and neck or torso immobilizers accommodate specific objectives and several forms of reference structures accomplish repositioning and patient position orientation.

Abstract: A rotary flexible-agitator system for removing an obstruction from within a patient's vessel that is comprised of a tubular-housing with suction connected to its proximal end, and a motor-driven, rotary, flexible agitator-shaft with an offset distal-agitator disposed in the housing and the offset distal-agitator extending out of the open distal end of the housing. The offset distal-agitator is adapted to break the obstruction in the vessel to pieces while the suction draws the pieces into the housing, where the relative motion between the flexible-agitator and the housing reduces the longitudinal frictional forces between the pieces, the rotary flexible agitator-shaft and the tubular-housing, and where the relative motion between the rotary flexible agitator-shaft and the tubular-housing further breaks the pieces as they pass through the tubular-housing.

Abstract: A hand-piece comprises an arm main body which moves relative to a grip section, and an arm section having a clamp member openable and closable with respect to a probe section. As a result of movement of the arm main body relative to the grip section, the clamp member is shifted between a closure position in which the clamp member cooperates with the probe section to hold living tissue between the clamp member and the probe section, and an open position in which the clamp member is separated from the probe section to release the living tissue.

Abstract: An apparatus and method of making a guidewire with a preformed three dimensional profile is described. The Apparatus comprises a mandrel having a screw thread for receiving a core wire and at least one securing means for holding the core wire onto the mandrel. The core wire must be retained under tension in order to properly impart the desired shape into the core wire. A system and method of using the apparatus is disclosed comprising the steps of loading the core wire onto the mandrel, securing the core wire and mandrel and then heating the assembly until the wire takes the desired shape.

Abstract: The present invention provides an artificial blood vessel provided with collagen layer composed of ultra-fine fibers on at least the outside of a tube composed of a supporting framework material, and a method for producing the same. The present invention offers advantages such that its materials are easily acquired, it causes very little rejection after being transplanted into the body, it allows sutures to be maintained for a long time after transplant, and all or a portion is absorbed and degraded in the body after a predetermined period of time.

Abstract: Devices and methods for filtering blood. The devices generally comprise: a mesh for filtering blood flowing within a blood vessel, particularly within an artery such as the aorta; a structure adapted to open and close the mesh within the blood vessel; and a means to actuate the structure. The methods generally include the following steps: introducing a mesh into a blood vessel to entrap embolic material; adjusting the mesh, if necessary, during the course of filtration; and removing the mesh and the entrapped foreign matter from the blood vessel. Additionally, visualization techniques are used to ensure effective filtration.

Abstract: A device for sampling blood from the skin of a patient by puncture. The device includes one or more lancets for lancing the skin and a fluid-conducting plate unit for transporting blood from the lancing wound. The plate unit has one or more channels for conducting fluid to one or more target locations. Preferably there is a first channel for conducting away a first portion of fluid that contains more of a fluid that is emitted initially (initial fluid) from the puncture wound and a second channel for conducting a second portion of fluid that contains less of the initial fluid from the puncture wound. Blood is drawn into the channels by capillary force. The device can be used to lance the skin and obtain a representative sample of blood with relatively simple procedures.

Abstract: Devices for insertion into an atrial appendage of stasis reducing components such as mesh members, chemical bonding agents or expandable anchors are disclosed.

Abstract: The present invention relates to an expansible tunneling apparatus suitable for tissue dissection. The apparatus is provided with a cannula-loading shaft at its proximal end such that a cannula chosen from a range of different cannulas may be loaded over the cannula-loading shaft and installed in an anatomic space created by the expansible tunneling apparatus. The apparatus is also provided with an inflatable member such as a balloon to accomplish the dissection and a sleeve covering the balloon which are removed from the apparatus before the cannula is loaded on the cannula-loading shaft.

Abstract: A nipple is provided for use with an apparatus for dispensing medicine and liquid to infants. The nipple includes a medicine tube disposed therein which is in communication with one of the discharge openings in the nipple and which allows medicine and other liquids such as formula, juice, etc. to be dispensed separately or simultaneously to an infant. The nipple is preferably comprised of silicone and is formed integrally with the medicine tube. The nipple further includes a webbed membrane which connects the medicine tube to the body portion of the nipple.

Abstract: An assembly for delivery and deployment of an inflation expandable stent within a vessel is comprised of a catheter, and inflation expandable stent, an expandable balloon, and a securement means such as a corrugated tube component or an expandable tube component. The tube component is mounted on the inner shaft beneath the balloon and provides increased securement to the stent in a reduced delivery diameter to maintain the stent on the catheter during delivery to the deployment site. The tube component is adhered to the inner shaft and has a plurality of ribs or is fluid expandable to no more than the delivery diameter, and may be comprised of more than one separately inflatable pouch expandable to provide the stent with a substrate seat with increased friction and to decrease the slack in stent recoil crimping. The assembly is used in a method for delivering and deploying a stent, and also adds safety when loading/crimping the stent onto a balloon.

Abstract: A safety-shielded trocar having an obturator with a linear cutting edge surface defining a base width substantially less than the diameter of the safety shield is disclosed. When the trocar is inserted through tissue, the tissue dilates from the width of the linear incision to accommodate the size of the safety shield of the trocar, thus making it possible to provide an access opening greater than the incisional width made by the linear cutting edge surface of the obturator. In a preferred embodiment, the safety shield has a shield tip region which is asymmetric to facilitate the dilation of the tissue as the trocar is inserted.

Abstract: A patch that is deployed inside an artery and the like to close a puncture in the artery, is described. The patch includes an enclosing support having a sheet of microporous material secured to a perimeter thereof and at least two protrusions extending from the support. The patch is deployed inside the artery and then pulled up against the artery wall by strings connected to the patch to thereby seal the puncture.