Abstract: A cross stream thrombectomy catheter with a flexible and expandable cage preferably formed of nitinol for removal of hardened and aged thrombotic material stubbornly attached to the interior of a blood vessel. The cage, which can be mesh or of straight or spiral filament design, is located close to inflow and outflow orifices at the distal portion of a catheter tube and is deployed and extended at a thrombus site for intimate contact therewith and for action of a positionable assembly and subsequent rotation and lineal actuation to abrade, grate, scrape, or otherwise loosen and dislodge difficult to remove thrombus which can interact with cross stream flows to exhaust free and loosened thrombotic particulate through the catheter tube. An alternative embodiment discloses a mechanism involving a threaded tube in rotatable engagement with an internally threaded sleeve to incrementally control the deployment and expansion of the flexible and expandable cages.

Abstract: An inventive method for performing gastric bypass surgery and a gastric bypass band that is used in conjunction with the surgical method is disclosed. The inventive method involves separating a top portion of the stomach along with the esophagus from the remainder of the stomach, and re-connecting the separated portion to the small intestine to form a gastric pouch of about 20-30 cc in size. The inventive gastric band is placed midway along the gastric pouch to act as a restrictor valve to limit the amount of food passing through the valve. The band also retains food within the gastric pouch to give the patient a feeling of satiety. The band is comprised of an expansion-resistant section combined with a one-way latch mechanism. The latch has a curved orientation so that the band is formed into a radial profile when placed around the gastric pouch.

Abstract: The subject invention is a surgical scalpel, scalpel instrument and/or scalpel system (collectively, scalpel), particularly designed for use in a transverse carpal ligament surgical procedure, that evaluates an incision path with respect to a nerve in the incision path, and is used to perform the incision if appropriate. The scalpel emits an evaluation signal through a potential incision path through tissue captured by the scalpel. The scalpel utilizes the emitted evaluation signal to determine the presence of a nerve in the incision path. The dissection and evaluation (surgical) instrument includes a blade that is retractable relative to a target tissue capture area thereof. Evaluation may include determining the presence of a nerve before incision and/or the evaluating whether the target tissue has been appropriately captured.

Abstract: An apparatus for application of surgical clips to body tissue is provided and includes a handle assembly; a shaft assembly including a housing extending distally from the handle assembly and defining a longitudinal axis; a plurality of surgical clips disposed within the shaft assembly; a jaw mounted adjacent a distal end portion of the shaft assembly, the jaw being movable between an open spaced-apart condition and a closed approximated condition; and a pusher bar reciprocally disposed within the housing of the shaft assembly and being detachably connectable to the housing of the shaft assembly, the pusher bar being configured to load a distal-most surgical clip into the jaws during distal movement and remain connected to the housing of the shaft assembly and in a distally advanced position during an approximation of the jaws.

Abstract: A spinal device for stabilizing adjacent vertebral bodies of the human spine. The device includes a combination of a screw and a member having a screw hole and a length sufficient to span a disc space between the adjacent vertebral bodies. The member has a portion that is bendable or deformable to prevent the outward excursion of the screw from the screw hole of the member.

Abstract: A tissue fastener assembly delivers a fastener for deployment. The assembly includes a fastener including a first member, a second member, the first and second members having first and second ends, and a flexible connecting member fixed to each of the first and second members intermediate the first and second ends and extending between the first and second members. The first member has a longitudinal axis and a through channel along the axis. The assembly further includes a deployment wire slidingly received within the through channel of the first member that pierces into the tissue and guides the first member through the tissue, a guide structure defining a lumen that receives the fastener and deployment wire and guides the deployment wire and fastener to the tissue, and a fastener configuration structure that orientates the second member in a predetermined position relative to the first member within the lumen for dependable deployment.

Abstract: A device for expansion within a blood vessel having a wall defining a lumen in the body. The device comprises an elongated tubular member having proximal and distal extremities and having a longitudinal axis. An expansile member is carried by the distal extremity of the elongated tubular member and is movable between contracted and expanded configurations. A deformable membrane having proximal and distal outer surfaces at least partially covers the expansile member in the expanded configuration. The proximal and distal outer surfaces have substantially different configurations when the expansile member is in the expanded configuration. Deployment means is carried by the proximal extremity of the elongated tubular member and is coupled to the expansile member for moving the expansile member between the contracted and expanded configurations. A handle assembly is carried by the proximal extremity of the elongated tubular member and coupled to said deployment means.

Abstract: Medical devices, and in particular implantable medical devices, may be coated to minimize or substantially eliminate a biological organism's reaction to the introduction of the medical device to the organism. The medical devices may be coated with any number of biocompatible materials. Therapeutic drugs, agents or compounds may be mixed with the biocompatible materials and affixed to at least a portion of the medical device. These therapeutic drugs, agents or compounds may also further reduce a biological organism's reaction to the introduction of the medical device to the organism. Various materials and coating methodologies may be utilized to maintain the drugs, agents or compounds on the medical device until delivered and positioned.

Abstract: A medical ligating apparatus includes a medical ligating device having a member which is made of a flexible line and ligates living tissues, and a fixing member which is movably provided at the ligating member and fixes the living tissues in a ligated state, a manipulating device having a flexible sheath and a proximal manipulating section, and a cutting member for cutting the ligating member. The cutting member is provided on the manipulating device and is movably provided on the ligating member.

Abstract: A medical ligating apparatus includes a medical ligating device having a member which is made of a flexible line and ligates living tissues, and a fixing member which is movably provided at the ligating member and fixes the living tissues in a ligated state, a manipulating device having a flexible sheath and a proximal manipulating section, and a cutting member for cutting the ligating member. The cutting member is provided on the manipulating device and is movably provided on the ligating member.

Abstract: A medical ligating apparatus includes a medical ligating device having a member which is made of a flexible line and ligates living tissues, and a fixing member which is movably provided at the ligating member and fixes the living tissues in a ligated state, a manipulating device having a flexible sheath and a proximal manipulating section, and a cutting member for cutting the ligating member. The cutting member is provided on the manipulating device and is movably provided on the ligating member.

Abstract: Devices and methods for removing an obstruction from a blood vessel are described. The devices are deployed in a collapsed condition and are then expanded within the body. The devices are then manipulated to engage and remove the obstruction.

Abstract: A method for passing suture through tissue and a suture passing instrument having a first jaw coupled to an end of an elongated shaft, a second jaw coupled to the first jaw, and formed with a holder for supporting a suture, and a needle slidably disposed within the first jaw, having a hook on a side for releasably capturing a portion of a suture, is provided. The first jaw defines a channel for receiving the needle and a ramp for deflecting the needle transversely of the shaft when advanced to an extended position.

Abstract: A suture anchor includes an outer sleeve having a longitudinal throughbore and defining leading and trailing ends and an insert positionable within the longitudinal throughbore of the outer sleeve. The insert defines at least one suture track for slidably supporting a suture whereby opposed free ends of the suture extend from the at least one suture track through the longitudinal throughbore to extend beyond the trailing end of the outer sleeve to be tensioned and secured relative to the tissue. The outer sleeve may include an external thread for threaded rotation and advancement into the tissue.

Abstract: A surgical wound closure device comprising multiple layers joined at only one edge of each layer in a book-like arrangement and having opposite unjoined edges, including a substrate having a proximal surface and a distal surface; a drape having a proximal surface and a distal surface, and being disposed proximally to said substrate; and an adhesive layer having a proximal surface and a distal surface; said drape being disposed releasably adherently to said distal surface of said adhesive layer. Also provided is a surgical procedure employing a surgical wound closure device.

Abstract: A vaso-occlusive device is provided for reducing blood flow in a patient. The device can include a coil, a stretch resistant member, and a plurality of fibers. The coil can define a lumen and be sized for insertion to a point of use in a vascular network of the patient. The stretch resistant member can have a first end fixedly attached to the first end of the coil. Further, the plurality of fibers can be configured with each of the fibers in direct contact with the stretch resistant member.

Abstract: Devices and methods for removing an obstruction from a blood vessel are described. The devices are deployed in a collapsed condition and are then expanded within the body. The devices are then manipulated to engage and remove the obstruction.

Abstract: A system and method for deploying an occluding device that can be used to remodel an aneurysm within the vessel by, for example, neck reconstruction or balloon remodeling. The system comprises an introducer sheath and an assembly for carrying the occluding device. The assembly includes an elongated flexible member having an occluding device retaining member for receiving a first end of the occluding device, a proximally positioned retaining member for engaging a second end of the occluding device and a support surrounding a portion of the elongated flexible member over which the occluding device can be positioned.

Abstract: A system and method for deploying an occluding device that can be used to remodel an aneurysm within the vessel by, for example, neck reconstruction or balloon remodeling. The system comprises an introducer sheath and an assembly for carrying the occluding device. The assembly includes an elongated flexible member having an occluding device retaining member for receiving a first end of the occluding device, a proximally positioned retaining member for engaging a second end of the occluding device and a support surrounding a portion of the elongated flexible member over which the occluding device can be positioned.

Abstract: A method of delivering a replacement prosthetic valve to a previously implanted prosthetic valve including the steps of compressing a replacement prosthetic valve having an expandable stent within a sheath of a delivery system, wherein the delivery system comprises a proximal end, a distal end, and a centering structure positioned between the proximal and distal ends, advancing the delivery system and compressed replacement prosthetic valve into a vessel of a patient until the distal end of the delivery system is positioned adjacent to a second side of a previously implanted prosthetic valve, deploying the centering structure to radially reposition the distal end of the delivery system, further advancing the delivery system toward the previously implanted prosthetic valve, and deploying the replacement prosthetic valve.