Abstract: A trocar system including a cannula and an obturator assembly being at least partially insertable through the cannula. The obturator assembly including a housing, a penetrating tip disposed at a distal end, an elongated shield including a guard extending from a shaft are movable relative to the penetrating tip, and a latch mechanism disposed generally within the housing. The latch mechanism facilitates changing the configuration of the obturator assembly between a fixed-shield orientation, wherein at least a portion of the guard is maintained to extend at least partially distal of the penetrating tip to prevent puncturing of tissue by the penetrating tip, to a non-fixed shield orientation whereby upon application of force to the distal end of the obturator assembly, the guard and penetrating tip are permitted to move relative one another to facilitate puncturing of tissue by the penetrating tip.

Abstract: The present invention provides a new approach to reshaping of the cornea, e.g., for refraction change, using multiple, displaced planar cuts and a custom shaping template. Large refractive change and/or substantial tissue removal can be obtained by a two-cut approach to reshaping of the cornea to a desired shape using a template or applanator. The process begins with a planar template being applied to the cornea. The template includes one or more moveable sections or cams positioned to provide an overall flat contact surface with the cornea. Then, a first cut is made by a water microjet producing a hinged flap. The first cut is parallel to but displaced from the anterior cornea surface in contact with the template. Then the template cam or cams are repositioned to change the shape of the cornea surface in situ in preparation for the second cut. The hinged flap is not moved; it remains in contact with the stromal bed. The second cut is along the same path as the first cut.

Abstract: A rotary bur instrument includes an outer tube having an open distal end, and an inner member rotatably disposed in the outer tube. The inner member includes an inner tube having a distal end, a lumen therethrough and a bur tip at the distal end of the inner tube. The bur tip extends distally from the open distal end of the outer tube and has a passage extending longitudinally therethrough in communication with the lumen of the inner tube. The passage and the lumen define an aspiration passage through the inner member communicating with an aspiration port at a distal end of the bur tip.

Abstract: An atherectomy catheter is provided for excising and imaging material in a body lumen. In one embodiment, the catheter comprises a catheter body, a cutting blade, and an imaging device. The cutting blade is mounted on the catheter body and configured to move between a first position and a second position relative to an aperture or cutting window. When the cutting blade is in the second position, the blade substantially closes the aperture on the catheter body. The imaging device which is mounted on or otherwise coupled to the cutting blade is configured to be in an imaging position when the cutting blade substantially closes the aperture or cutter window. This allows the imaging device to survey material within the cutting zone of the atherectomy catheter. By allowing the imaging device to view materials within this cutting zone, material may be imaged and then removed from the body lumen without having to reposition the catheter between each step.

Abstract: In accordance with the present invention, there is provided a stent-graft for insertion into target site within a vessel of a patient. The graft has a crimped state for delivery to the target site, and an expanded state for implantation therein. The graft has a self-expanding outer stent, which is a tubular member made from an elastic material. The graft further includes a tubular flexible porous graft member extending along the interior of the outer stent. The graft member has front and back ends which are folded over and bonded to the front and back ends of the outer stent to form cuffs. In addition, the stent-graft has a self-expanding inner stent which also is a tubular member made from an elastic material. The inner stent is disposed within the interior of the graft member such that the inner stent, the graft member and the outer stent are all abutting.

Abstract: The present invention describes an inflatable intraluminal vascular stent which incorporates fine conduits of synthetic material in a meshwork like structure forming a tubular vascular prosthesis. The conduits provide for inflating and deflating the meshwork structure to deploy the stent, adjust its supporting force and for repositioning or removing the stent, if needed. Accordingly, the present invention includes a method for repairing a treatment zone in a vasculature and the like by positioning the inflatable intraluminal vascular stent bridging the treatment zone. Following insertion of the stent into the vasculature spanning the treatment zone, the meshwork structure is inflated to expand the stent against the vasculature wall. Importantly, the inflation pressure is controllable to regulate the supporting force of the stent as it conforms to the shape of the vasculature.

Abstract: A balloon having a predetermined maximum expandable size is combined with a stent having a predetermined maximum expandable size, which is equal to the maximum expandable size of the balloon. The stent is formed of a plurality of rows of cylindrical strut sections situated side by side in a longitudinal direction, and a plurality of connecting members for connecting two rows of the struts adjacent to each other. The strut section includes struts, and bending portions located at ends of the struts. A strut angle is defined by the strut and a line parallel to a central axis of the stent and extending through the bending portion. The strut angle is at least 75 degrees and less than 90 degrees when the stent is fully expanded. Thus, the stent fully expanded by the balloon is not easily collapsed.

Abstract: A surgical instrument (10) is provided for cutting tissue. The surgical instrument (10) includes a shaft (20) having proximal (84) and distal (40) ends, a cutter (12) coupled to the distal end (40), and a handle (16) coupled to the proximal end (84). The cutter (12) is formed to include a base (30) having two cutting edges (50) providing an opening (51), a slider (32), and a tip (34) coupled to both the base (30) and the slider (32). The cutter (12) is formed to move between a fully open position in which the cutting edges (50) of the tip (34) form an obtuse angle (124) relative to the shaft (20) and a fully closed position in which the tip (34) is received within the opening (51) of the base (30). The handle (16) is arranged to move the cutter (12) between the open and closed positions.

Abstract: A surgical instrument is configured to aid in performing a procedure of detaching an internal mammary artery (IMA) and the like, from the connecting tissues and side branch vessels which surround the artery in its native location, wherein the detaching procedure is preliminary to the performing of a coronary artery bypass grafting procedure and wherein the IMA is detached via a minimally invasive thoracotomy. To this end, an elongated slender rod includes a handle at its proximal end and an artery engaging loop, arc, fork configuration, or hook at its distal working end. Embodiments may incorporate electrosurgical capability or electrical insulation. A surgeon thus has means for harvesting an intact and undamaged graft vessel from its native location through a minimally invasive incision with enhanced speed, visibility, and freedom of motion.

Abstract: The invention provides a nested tubing cannula which comprises outer and inner elongate tubular members, both having a proximal end, a distal end, and a lumen therebetween. The inner tubular member is sealed at its distal end and is nested substantially coaxially within the lumen of the outer tubular member, so that the gap between the inner and the outer tubular member defines a second lumen whereas the first lumen is the lumen of the inner tubular member. A tubular sleeve is disposed coaxially between the inner and outer tubular members. A balloon is mounted on a distal region of the outer tubular member and is in communication with the first lumen. The cannula further comprises a port proximal or distal the balloon occluder and is in communication with the second lumen. Methods for making the devices herein are disclosed.

Abstract: A dilator/insert internally support the lateral nasal walls and securely stay in place without discomfort. It stays inserted by a pair of ledges (9a and 10a) and/or catches (7a and 8a), each resting behind a respective: limen nasi ridge (a somewhat vertical central protuberance on a lateral nasal wall); and/or a foot of the columella (the ‘meaty’ protuberance peripherally off the base of the columella). The insert is confined from shifting off those protuberances by being tall (distance between 1a and 2a); almost as tall near the entrances of the nose as the entrances themselves. When worn, the bridge (1a and 2a)/leg (3a, 4a an 5a, 6a) assemblies look like two central nose rings. The peripheral rigidity of the bridge/leg assemblies braces the lateral walls of the nose apart and keeps the ledges in position. Catches can position midway rearward on bottom legs; and they extend centrally enough to rest behind, without engaging, the feet of the columella.

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: A medical device for treating a body vessel with a radioactive source includes an elongated tubular catheter and an axially flexible support structure on a distal end of the catheter. The catheter has proximal and distal ends, and a lumen for receiving a radioactive source. The support structure is formed from a plurality of filaments which are helically wound and interwoven in a braided configuration and has a plurality of alternately spaced unconstricted and constricted regions. The unconstricted regions are radially compressible and self-expandable from a positioning diameter when the device is in a positioning state to a vessel-engaging, treatment diameter which is greater than the positioning diameter when the device is in the treatment state. The constricted regions are engaged with the catheter and concentric with the unconstricted regions.

Abstract: A vascular filter for temporary or permanent implantation within a body vessel to filter particulates or thrombus in the blood stream, is capable of being converted some time after initial implantation into a tubular stent. In this configuration, the stent tends to hold the vessel open without any significant filtering effect. The convertible filter/stent may have a tubular metal mesh structure. Also, the device may form one or more filter lattices when in the filter configuration.

Abstract: An apparatus and method is provided for stenting bifurcated vessels. A proximal angled stent is configured for implanting in a side-branch vessel wherein the proximal angled stent has an angulated portion that corresponds to the angle formed by the intersection of the side-branch vessel and the main vessel so that all portions of the side-branch vessel at the bifurcation are covered by the proximal angled stent. A main-vessel stent is provided for implanting in the main vessel, wherein the main-vessel stent has an aperture or stent cell that aligns with the opening to the side-branch vessel to permit unobstructed blood flow between the main vessel and the side-branch vessel. Side-branch and main-vessel catheter assemblies are advanced over a pair of guide wires for delivering, appropriately orienting, and implanting the proximal angled stent and the apertured stent.

Abstract: An improved balloon catheter which includes bumpers located adjacent to the proximal and distal ends of the catheter balloon. The bumpers form a recessed pocket into which a stent crimped onto the catheter balloon is mounted. The recessed pocket formed by the bumpers securely retains the stent on the balloon and minimizes undesired contact between the stent and arterial walls and lesions during advancement of the stent within a patient's vasculature.

Abstract: A radially expandable support structure is provided, for keeping open lumina within a body, in particular a blood vessel, having a tube-shaped body that has at least two partial structures, with a wall surface that extends between a first and a second end, which has several cut out areas, in particular, slits, which are essentially oriented parallel to the longitudinal axis of the tube-shaped structure. At least one partial structure (11) extends without interruption in the axial direction generally from the first end to the second end of the tube-shaped body. The first partial structure (1, 2) can be expanded at least in the radial direction and has at least one radial-expansion component. Individual radial expansion components (12, 13) are arranged as rings or in a ring shape, and the second partial structure (11) is almost rigid in the axial direction.

Abstract: A wire frame stent and stent delivery system for inserting the stent into the body.

Abstract: The present invention relates to a medical device for placing an intravascular stent at a preselected location within a vessel of the human body, and more particularly, relates to a catheter having a distal tip for retaining the stent in order to transport the stent to a preselected position within the vessel and a control mechanism for releasing the stent at the preselected position.

Abstract: A surgical knife blade of the type primarily intended for making incisions in the eye, though suitable for incising virtually any spherical surface, is disclosed. The blade is uniquely characterized by its construction to include cutting edge bevels of different transverse dimension on the anterior surface of the blade with respect to the transverse dimension of corresponding bevels on the posterior surface of the blade, such that the blade of this invention will incise a substantially straight, perpendicular cut into the eye or other spherical surface.