Abstract: A medical instrument for removing deposits on the walls of arteries and/or veins having at least one partially hollow body that can be introduced into the arteries and/or veins and a plurality of cutting bodies with cutting edges for removal of the deposits. A base body protrudes at least partially into the partially hollow body and the cutting bodies and fixedly connected to the base body.

Abstract: An intraocular lens injection system having an injecting device and cartridge. The cartridge includes a lens holding portion and an outer sleeve portion. The invention includes a method of pre-loading the injecting system, particularly the cartridge, to reduce the amount of packaging, prevent damage to the intraocular lens during packaging and shipping, allow the pre-loaded injecting cartridge to be autoclaved as a unit, and eliminate the step of loading the cartridge with the intraocular lens by the end user to prevent potential damage during this step.

Abstract: The improved medical instrument is adapted to remove obstructions from ear canals, nostrils and endotracheal tube airways. It includes an elongated handle with an elongated hollow tube connected to the front end thereof and an elongated flexible wire extending from the front end of the tube. The front end of the wire is curved to form a scoop for removing obstructions from a lumen. In one embodiment the wire and tube are removable as a replaceable unit from the front end of the handle. In another embodiment the handle has a central cavity therein communicating with the cavity in the tube and through both of which the wire extends. The wire is connected to a spring which extends out of the handle. The spring biases the wire into the tube. When the wire is manually depressed the front end of the wire extends out of tube and curves into the desired scoop configuration. The instrument can include a light which is switched on when the wire extends out of the tube and which is used to light the lumen.

Abstract: Methods and devices for harvesting blood vessels using balloons to hold the blood vessel and to dissect and mobilize the blood vessel from surrounding tissue. A small balloon catheter is inserted into the blood vessel lumen to and inflated in order to hold the blood vessel, and an everting balloon dissector is everted over the blood vessel. Eversion of the balloon dissector over the blood vessel pushing surrounding body tissue away from the blood vessel.

Abstract: A tool and method for continuous elastomeric band ligation type castration of larger sexually mature animals with an elastic band that must be enlarged by stretching for placement provides an elongate body having a handle at a first rearward end to aid manipulation and an elastic band supporting yoke at a second forward end. The band supporting yoke provides spaced forwardly extending legs for releasable support of the elastic band at two spaced points. Band stretching mechanism carried by the body provides an elongate stretching rod that releasably interconnects one course of the elastic band carried by the yoke at a third point between the two yoke support points to stretch the band rearwardly responsive to motion of an associated compound lever mechanism to enlarge the medial orifice defined by the elastic band sufficiently to allow the band to pass over the scrotal pouch and contained testicular structure of a large animal.

Abstract: Apparatus and method for reducing a fractured long bone includes a cannula having a transparent tapered tip for facilitating visualization of the cannula being advanced along the bone from an initial incision remote from the fracture. The cannula includes a selectively inflatable balloon near the tip to expand a working cavity adjacent the bone. An arched, elongated positioning fixture is inserted into the working cavity with lower edges including facing grooves therein disposed against the bone. A support gate is slid into position across the fracture along the groove in the fixture, and holes in the support plate are referenced by the fixture from above the overlying skin. Small incisions are formed with reference to holes in the support plate for insertion of bone screws through the incisions and the fixture to secure the support plate to the bone across the fracture under visualization of an endoscope positioned within the arched space of the fixture.

Abstract: A surgical cutting tool having a "stepped" or "funneled" axial passageway for the evacuation of tissue plugs. The tool is made of a length of cylindrical surgical steel having an axial bore therethrough. The proximal end of the tool terminates in a cutting tip which has a cutting edge sufficient to cut tissue plugs of a desired diameter. The distal end is adapted for connection to a vacuum source. The axial bore has a first inside diameter at the cutting edge, a second inside diameter greater than the first inside diameter forming a first relief near the cutting edge, and a third inside diameter greater than the second inside diameter forming a second relief upstream of the first relief. This funnel configuration from the proximal end to the distal end of the tool allows tissue plugs to be easily evacuated from the tool.

Abstract: Balloon loaded dissection devices with elongate balloons and a pushing member are described for creating a tunnel alongside an elongate vessel in the body. The devices may utilize an elongate balloon of any suitable length which may be formed of an elastic or non-elastic material. The balloon may be of double walled construction and may be provided with a central lumen which may receive a guide rod, scope or other surgical instrument. The device may have a support tube secured to the inner wall of the balloon to provide columnar support. The support tube may have a transparent shroud attached to its distal end. There is an open space between the distal end of the support tube and the end of the shroud allowing access to adjacent tissue. The shroud may perform blunt dissection and/or retraction to clear an open space for viewing or for performing surgical procedures. The support tube receives a scope or other surgical instrument.

Abstract: A medical instrument includes an elongated shaft, a plurality of implements mounted to the shaft, and an actuator coupled to produce relative movement between the implements. At least one of the implements is detachable from the shaft and the actuator and from another one of the implements. The actuator includes a distal portion with an inclined slot. One of the implements is detachably coupled to the slot such that movement of the actuator causes the relative movement between the implements. A coupler including an opening for receiving the actuator is mounted to a handle for rotation relative to the handle.

Abstract: A method for endoluminally isolating a pathological defect in a body passageway. The method includes the steps of advancing a graft through the body passageway and attaching a distal portion of the graft to the interior surface of the body passageway. A proximal portion of the graft is sized within the body passageway. The method sizes the graft by moving an intraluminal cutting device through the body passageway relative to the graft and actuating the cutting device within the body passageway at a predetermined position relative to the graft. The foregoing steps result in a graft being cut to a desired length within the body passageway. Contrast may be injected in the vicinity of the graft to facilitate the method. Graft cutting while the graft is contained in a guide sheath. Also, the graft may be attached to a stent for attaching it within the body passageway. A device for performing the method is also disclosed.

Abstract: An ultrasonic energy amplifier. The amplifier comprises a delivery horn having a solid proximal portion and a hollow distal portion. The hollow distal portion has substantially less cross-sectional area than the solid proximal portion. Ultrasonic energy is transmitted sequentially through the proximal and distal portions and its velocity is amplified because of the lower cross-sectional area of the distal portion.

Abstract: A system and method for opening a lumen in an occluded blood vessel, e.g., a coronary bypass graft, of a living being. The system comprises an atherectomy catheter having a working head, e.g., a rotary impacting impeller, and a debris extraction sub-system. The atherectomy catheter is located within a guide catheter. The working head is arranged to operate on, e.g., impact, the occlusive material in the occluded vessel to open a lumen therein, whereupon some debris may be produced. The debris extraction sub-system introduces an infusate liquid at a first flow rate adjacent the working head and withdraws that liquid and some blood at a second and higher flow rate, through the guide catheter to create a differential flow adjacent the working head, whereupon the debris is withdrawn in the infusate liquid and blood for collection outside the being's body.

Abstract: A stent for insertion into a heart wall for Trans Myocardial Revascularization (TMR) thereof. The TMR stent provides for the delivery of blood nutrients from a heart chamber into the heart wall and has an elongated body which may contain a cavity and openings through the elongated body from the cavity. The elongated body should be in fluid communication with the heart chamber. If a cavity and openings are provided, the openings are in fluid communication with the heart chamber, the cavity and the heart wall. The TMR stent may include an anchoring element integrally formed thereon for securing the TMR stent in the heart wall.

Abstract: The catheter connected to a rotary drive mechanism has, at its front end, a cutting tool which consists of a stator and rotor. Cutting edges arranged on the circumference of the rotor and stator interact in a shearing action. The detached deposits are conveyed through a tubular sheath and into a collection container via a discharge chamber. A drive shaft which is arranged inside the tubular sheath, and which connects the rotary drive mechanism to the rotor, is designed as a conveyor screw and is used for the conveying. A rotary catheter of this kind is used for carefully removing and withdrawing blood clots and stenoses from narrowed blood.

Abstract: An improved medical instrument with a releasable lock interposed between the handles of the medical instrument to hold the jaws in closed position to grip an object. The lock has at least one flexible finger and a plurality of movable sleeves that allow one hand operation to selectively lock and release the jaws without substantial lateral displacement of the object. A plurality of locking stops is provided so that the jaws may be held closed at a variety to tensions, to accommodate a variety of objects.

Abstract: Methods and devices for harvesting veins or other elongate structures from the body are disclosed. The disclosed methods and devices allow vein harvesting using endoscopic procedures. A working space is created over a vein using standard endoscopic procedures and a side-hooked wire is inserted into the working space and twisted to insert the side-hook under the vein. The wire is then pulled or drawn along the vein to separate the vein from the surrounding tissue. In an alternative embodiment, vein separation is accomplished by threading a soft rubber tube under the vein, and then pulling the tube along the vein. In other embodiments, the working space is created with everting balloons.

Abstract: A method of implanting small diameter conductive leads for an artificial cardiac pacemaker or other body-implantable medical device includes inserting the lead to be implanted into a predetermined path within the patient's body with the assistance of a stylet for guiding the lead along the path. At least a portion of the stylet which is to traverse the path has an enhanced radiopaque characteristic attributable to the application or addition to the material of which the stylet is composed, of a substance having such radiopaque characteristic. When viewed under fluoroscopy external to the patient's body as the lead is maneuvered along the path, although the thin lead itself may be difficult to see, the stylet is readily discernible by virtue of its enhanced radiopacity, thereby enabling the physician to position the lead at a desired location within the patient's body. For various reasons, the thin lead itself may not be amenable to similar enhancement, which makes the stylet a suitable solution.

Abstract: Apparatus for inserting intraocular lenses (IOLs) into eyes comprises a tube, a rod having a distal end portion, and a tip carried by the distal end portion. The tip is softer than the distal end portion of the rod. Methods for inserting an IOL into an eye using such apparatus are within the scope of the present invention.

Abstract: The multi-plane corneal incision form of this invention includes a frame member in the shape of a segment of a hollow sphere that fits over a patient's cornea. The inner surface of the frame member includes a protuberance that distorts the cornea when the frame member is placed against the patient's cornea. The frame member also includes an aperture adjacent to the protuberance to allow a surgical blade to pass therethrough. By carefully configuring the protuberance and aligning the aperture, a physician can insert a surgical blade into the aperture and through the distorted cornea in a planar fashion that results in a multi-plane incision in the cornea once the frame member is removed from contact with the patient's cornea.

Abstract: A polymeric heat shrinkable tubular sheath for mounting about a balloon on a dilatation catheter by heat treating at a temperature which does not detrimentally effect the properties of the balloon to shrink the sheath onto the balloon. The tubular sheath is preferably heated to a temperature above body temperature, e.g. 40<100.degree. C., preferably less than 85.degree. C., to heat shrink the sheath onto the balloon. A presently preferred polymeric material is a copolymer of ethylene(75%) and methyl acrylate (25%). The heat shrinkable sheath has an inner lumen with minimum dimensions large enough to facilitate the advancement of the sheath over the exterior of a dilatation balloon without the need for a great deal of manual manipulation by the physician or other operator prior to heat shrinking.