Abstract: A stent delivery device having a pair of balloons at a proximal end of a catheter and having separate lumens for selectively inflating the respective balloons. The outer balloon is relatively compliant and the inner balloon is relatively non-compliant. A central lumen is provided for a guide wire. A stent is carried by the delivery device within an axially retractable sheath at the distal end of the catheter and is deployed by retraction of the sheath and inflation of the compliant balloon, and the stent is subsequently expanded by inflation of the non-compliant balloon.

Abstract: Improved earring alignment piercing systems. In a first embodiment, the invention comprises first and second cartridges axially alignable with one another that may be deployed utilizing conventional deployment mechanisms. In the first cartridge, there is housed therein a compression disk, guidance member, piercing earring having a piercing pin formed thereon, and an alignment member arranged in a generally linear configuration. The second cartridge houses a clasp that, in use, receives and secures the piercing pin as the latter is advanced through said tissue and into the clasp. The guidance member and alignment member cooperate to insure that the piercing pin forms a generally straight pathway as the same is penetrated through tissue. In a second embodiment, there is provided a piercing earring having an elongate shaft portion with a cannula member detachably mounted thereon.

Abstract: The present invention is a collapsible nasal-oropharyngeal tube and a method of its use. The collapsed tube is inserted via a patient's nostril, then expanded when properly located in the upper airway. Collapsing the tube prior to insertion, facilitates insertion, minimizes trauma to the nasal passage, and allows self insertion by the patient. The expanded tube's lumen defines an unobstructed airway, and thus maintains upper airway patency. The nasal-oropharyngeal tube can be used as a treatment of nasal-oropharyngeal obstructions, sleep apnea, and other related disorders.

Abstract: A stent for helping to hold open a lumen in a tubular body structure has at least one axial portion (preferably an axial end portion) that stents the surrounding portion of the tubular body structure to a lesser degree than another axial portion of the stent. For example, the stent portion that stents to a lesser degree may be circumferentially weaker than the other stent portion, or it may recoil more than the other stent portion after the stent is applied by being circumferentially expanded and then released.

Abstract: A dissector/retractor device comprising a balloon having a deflated state and an inflated state is described for performing minimally invasive surgical procedures by creating a tunnel alongside a target tissue in the body. The balloon in its inflated state forms an open space extending transversely through the balloon. The balloon is carried by an insertion assembly. The balloon may be an elongate torus shape with an elongate open area in its interior. The insertion assembly includes a blunt dissection device and a handle. In use, the dissector retractor is inserted through a small incision and bluntly tunneled through body tissue to a desired location. The balloon is inflated to create a space in the body tissue and may also dissect tissue as necessary away from the tissue to be treated. The balloon is left in place inflated to retract the space. Another incision may be made to provide more direct access to the target tissue than the original incision.

Abstract: A target tissue localization device (28) has outer and inner members (30, 32) which are longitudinally movable relative to one another. An anchor (42) is secured to the outer and inner members and is movable from a radially-contracted configuration to a radially-expanded configuration. The anchor may be a tubular mesh anchor. The anchor may have a sufficiently large cross-sectional area when in the radially-expanded configuration to substantially eliminate inadvertent dislodgment of the anchor once radially-expanded. In use, the location of the target tissue (56) is determined and the distal end of the localization device is passed through the patient's skin (58) and to the target tissue to create a tissue track (60) between the patient's skin and the target tissue. The target tissue includes near and far sides (62, 64). The anchor element, located at the target tissue is expanded to an expanded configuration. The method the anchor element may be located on the far side of the target tissue.

Abstract: What is disclosed is a stent delivery system comprising an inflation shaft having an expandable balloon sealingly mounted at the distal end thereof and a tubular sheath having the inflation shaft longitudinally running therethrough. The tubular sheath has an expandable sheath at the distal end thereof with the balloon longitudinally therethrough and an expandable stent mounted on the expandable sheath Also disclosed is a method of delivering a stent into a body lumen. The method comprises the steps of providing an inflation shaft having an expandable balloon sealingly mounted at the distal end thereof and providing a tubular sheath having the inflation shaft longitudinally running therethrough. The expandable sheath has the balloon longitudinally and slidingly running therethrough, and an expandable stent is mounted on the expandable sheath. The stent is positioned in the body lumen at the treatment site and the balloon is inflated simultaneously with the expandable sheath to deploy the stent.

Abstract: A filter device for temporary placement of a filter in an artery or vein is disclosed. The device includes an expandable filter mounted on a distal end of a catheter. The filter comprises a plurality of circumferentially adjacent porous segments which are arranged generally about the surface of a cone having an open base, and the segments are engaged to one another by means, such as a hook. The filter conforms to the interior of a vessel wall when expanded and contracts to a consistent diameter without bunching when stowed. Methods of using the filter device to entrap and remove embolic material from a vessel during endovascular procedures are also disclosed.

Abstract: A surgical extractor for removing objects from a body including, for example, calculi, such as kidney stones and gall stones. The extractor includes a handle at a proximal end with a slider for operation by a physician. At the distal end the extractor includes a plurality of wires with each wire comprising a first portion having an individual strand and a second portion comprising a plurality of filaments. When a retaining sheath is retracted, the wires, formed of a shape memory material such as stainless steel, expand such that each of strands assume a spaced relationship to define a first section of a basket and the plurality of the filaments assume a spaced relationship to define a second section of the basket.

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: This invention is a method and apparatus for implanting retinal tacks and retinal electrode element with spiked electrodes. In one aspect of the invention, a tack suitable for insertion into the retina is driven into the retina by the repeated minute blows from the rapid contractions and expansions of the piezoelectric crystal. In a different aspect of the invention, a retinal electrode element with spiked electrodes suitable for insertion into the retina is driven into the retina by the repeated minute blows from the rapid contractions and expansions of the piezoelectric crystal. In another aspect of the invention, a single, short impulse is used to drive the tack home. In a different aspect of the invention, a single, short impulse is used to drive the retinal electrode element with spiked electrodes home. With this mode of tack and electrode element implanting, a remotely placed driver couples its motion to the tack using a thin, elongated tube filled with a suitable hydraulic fluid.

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: 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: A perfusion-occlusion catheter provides an occluded region in a vessel to facilitate, for example, an anastomosis in the region, while providing a path for perfusing fluid (blood) through the path for delivery in the vessel downstream from the occluded region. According to one aspect of the invention, at least a portion of the catheter that effects vessel occlusion comprises a shield that when exposed to suture needles or like piercing instruments deflects or resists perforation.

Abstract: This is an implant for placement in the human body and an assembly for so placing that implant. Most desirably, it is an implant for use in the vasculature of the human body and is used to occlude some space in that vasculature as a portion of a treatment regimen. The implant itself is preferably a component of a deployment device using an electrolytically severable joint. The implant is electrically isolated from the electrolytically severable joint by a highly resistive or insulative layer. Such isolation and minimization of the conductive pathway from the placement apparatus to the body's fluids appears to enhance the susceptibility of the electrolytic joint to quick erosion and detachment of the implant from the deployment media. Although the implant itself is preferably a vaso-occlusive device, it may instead be a stent, a vena cava filter, or other implant which may be installed in this manner.

Abstract: With the advent of laparoscopic and endoscopic surgery, the patient is benefiting from shorter hospitalization, less pain, and generally better outcomes. However, the minimization of the size of incision a surgeon uses in these procedures has created some unique challenges. Large tissue masses, such as fibroid tissue masses, are traditionally excised during the surgical procedure and removed intact from the patient through the surgical incision. One common procedure for reducing the size of large tissue masses is generally referred to as morcellation. In the present invention, a method of morcellating tissue is described that includes the steps of: inserting a ballistic specimen bag through a cannula; opening the ballistic specimen bag; inserting tissue into the ballistic specimen bag; closing the ballistic specimen bag around a ultrasonic surgical instrument; and cutting or debulking the tissue with the ultrasonic surgical instrument.

Abstract: An automatic lens delivery device using a linear actuator which is specially adapted for low torque, low heat applications, and can be used to insert a lens into a user's eye. The linear actuator uses two semiconductor devices which are moved one relative to the other. The movable device pushes a push rod that delivers a lens.

Abstract: A device for removing undesirable material from a tubular structure within the human body features a cylindrical body with a lumen therethrough. The distal portion of the body is divided into a number of flexible members. An inflatable cuff is attached to the flexible members. When the cuff is inflated, the members flex radially outwardly so that the distal opening of the lumen is expanded. An inflation tube is used to inflate and deflate the cuff by means of a syringe. An elastomeric membrane sleeve surrounds the flexible members so that the latter are contracted towards their original position when the cuff is deflated. The sleeve also prevents material from escaping between the flexible members when the cuff is inflated.

Abstract: An assembly for delivery and deployment of an inflation expandable stent within a vessel is comprised of a catheter, an 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: The present invention relates to a combination device comprising two catheters, or a dual catheter assembly, for use in vascular procedures wherein the shaft of the first catheter functions as a guidewire for the second catheter. The dual catheter assembly comprises a first balloon catheter and a second balloon catheter wherein the second balloon catheter is slidably disposed on the shaft of the first balloon. In preferred embodiments, the first catheter is a low profile balloon on a wire catheter and the second catheter is a full size balloon catheter having a plurality of balloons mounted thereon. Optionally, a stent is carried by at least one of the balloons on the second catheter. In more preferred embodiments, the second catheter includes a manifold that may be used to inflate and deflate any combination of the plurality of balloons via a single port.