Abstract: An expandable stent is implanted in a body lumen, such as a coronary artery, peripheral artery, or other body lumen for rupturing a fibrous cap to controllably release vulnerable plaque. The invention provides for a an intravascular stent having a plurality of cylindrical rings connected by links. The stent includes struts and links of varying strengths about the circumference of the stent. The weaker struts and links require less force to open and, hence, may apply more stress to rupture the fibrous cap while the stronger struts and links protect the healthy portions of the body lumen. In another embodiment, the stent may include stress concentrators positioned on outer surfaces of the links. The stress concentrators are aligned with the fibrous cap prior to stent expansion so that upon stent expansion, the stress concentrators induce stress to rupture the fibrous cap, thereby releasing the vulnerable plaque.

Abstract: Devices and methods for accessing and closing vascular sites are disclosed. Self-sealing closure devices and methods are disclosed. A device that can make both steeply sloping and flat access paths into a vascular lumen is disclosed. The device can also form arteriotomies with sections cleaved between a vessel's intima and adventitia. Methods for using the device are also disclosed.

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: Systems and methods introduce and deploy prosthesis into a blood vessel or hollow body organ by intra-vascular access. The prosthesis is secured in place by fasteners which are implanted by an applier that is also deployed by intra-vascular access. The applier is configured to permit controlled, selective release of the fastener in a step that is independent of the step of implantation.

Abstract: A surgical knotting device comprising a length of suture thread; a first portion located and held in place on the length of suture thread; a needle on the length of suture thread at a position spaced from where the first portion is located; a second portion attached to the first portion and having a groove therein adapted to receive the length of suture thread at a point between where the first portion is located and the needle, and to secure the length of suture thread in place; and an auxiliary thread on the length of suture thread at an end opposite the needle.

Abstract: An endovascular grafting device having a main body component and limb components. The device is contemplated to be assembled in-situ for the purpose of treating vascular defects or conditions.

Abstract: Disclosed herein are methods for joining one piece to tissue to another piece of tissue. In one embodiment, the method can include inserting an applier device having an actuation portion into a first body lumen through a natural body orifice, forming a first opening in a first piece of tissue within the first lumen and a second opening in a second piece of tissue defining a portion of a second lumen adjacent to the first piece of tissue, and inserting the applier device through the first and second openings such that the actuation portion is between the first and second piece of tissue. The method can further include deploying a fastener into the first and second pieces of tissue through the actuation portion of the applier device, thereby joining the first and second pieces of tissue to form an anastomosis between the first and second lumens.

Abstract: A biopsy device comprises a handpiece, a fluid collection system, and a power transmission source. The handpiece is configured for grasping by a single hand, and is independently manipulatable by hand for movement of the instrument toward and away from the patient. An elongated piercer extends from the distal end of the handpiece. The piercer has a sharpened distal end for entering the tissue and a port located proximal to the sharpened distal end for receiving a portion of tissue mass. An elongated cutter is disposed coaxially relative to a piercer lumen of the piercer. A distal blade of the cutter slides distally past the port of the piercer to sever the tissue portion drawn into the port by vacuum. The handpiece further comprises a holster for detachably connecting a cutter rotational transmission and a cutter axial transmission to the power transmission source.

Abstract: A catheter (100) having a catheter body (102) having a proximal end (106) and a distal end (104) and a proximal portion fixedly connected to the proximal end. A magnet (120,220,320) is disposed around the catheter body (112) distally of the proximal portion and may be contained within a hub (208, 308).

Abstract: A microsurgical instrument including a cutting member and a base with an actuating mechanism that provides more efficient cutting of tissue.

Abstract: The methods, devices, and systems are provided for performing endovascular repair of atrioventricular and other cardiac valves in the heart. Regurgitation of an atrioventricular valve, particularly a mitral valve, can be repaired by modifying a tissue structure selected from the valve leaflets, the valve annulus, the valve chordae, and the papillary muscles. These structures may be modified by suturing, stapling, snaring, or shortening, using interventional tools which are introduced to a heart chamber. Preferably, the tissue structures will be temporarily modified prior to permanent modification. For example, opposed valve leaflets may be temporarily grasped and held into position prior to permanent attachment.

Abstract: An endoscopic tissue apposition device that includes a vacuum chamber configured to securely hold a portion of tissue therein, the vacuum chamber being defined by a proximal wall and a distal wall opposite to the proximal wall. Working and vacuum channels are provided in communication with the vacuum chamber. A portion of tissue is held in the vacuum chamber when vacuum is applied in the vacuum chamber through the vacuum channel. A carrier needle is disposed on a proximal side of the vacuum chamber and is longitudinally advanceable into and across the vacuum chamber, while a punch needle is disposed on a distal side of the vacuum chamber and is configured to receive the carrier needle therein. A hold and release mechanism holds and releases the punch needle to facilitate joining portions of tissue together.

Abstract: Methods and devices are disclosed for minimally invasive procedures in the heart. In one application, a catheter is advanced from the left atrium through the mitral valve and along the left ventricular outflow tract to orient and stabilize the catheter and enable a procedure such as a “bow tie” repair of the mitral valve. Right heart procedures are also disclosed.

Abstract: The present invention concerns a flexible stapling device (1). More particularly, this invention concerns a flexible endovascular stapling device (1) for an intavascular procedure such as patent foramen ovale closure, which is designed to avoid open heart surgery by permitting the closure of the defect utilizing a stapling means (26) which is positioned by using a flexible shaft/guidewire system.

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 introduer 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: Bone anchors are provided having three suture attachment sites disposed within a bore. The bone anchors are suitable for use in rotator cuff repair procedures. The bone anchors comprise an anchor body having a bore that opens at a proximal end of the anchor body. At least three attachment sites are positioned within the bore. Each attachment site is capable of slidably receiving a respective suture thereon. The three attachment sites are spaced apart and configured such that the portions of the respective sutures that are in contact with the three attachment sites are maintained separated during use. In one embodiment, the three suture attachment sites are provided by two transverse pins placed within the bore. In another embodiment, the bore opens at a distal end and a longitudinal pin is inserted into the opening at the distal end. The at least three attachment sites are provided by the longitudinal pin disposed within the bore.

Abstract: The invention provides an apparatus having a tubular member for receiving an endocardial lead implanted within a patient's body. Disposed generally at a distal end of the tubular member is at least one blade or cutting surface. An adjustment mechanism moves the blade between retracted and extended positions to engage the cutting surface with the endocardial lead to cut the lead. Once severed, the cut portion of the lead remains within an inner channel of the tubular member and the apparatus and cut portion of the lead are removed from within the patient. Various embodiments include the blade pivotally connected to the distal end of the tubular member and activated by a wire adjustment mechanism. Others include a metallic wire for slicing through the lead. Still others include a pneumatically actuated adjustment mechanism that inflates to move the blade and engage the cutting surface with the lead.

Abstract: Devices and methods for accessing and closing vascular sites are disclosed. Self-sealing closure devices and methods are disclosed. A device that can make both steeply sloping and flat access paths into a vascular lumen is disclosed. The device can also form arteriotomies with sections cleaved between a vessel's intima and adventitia. Methods for using the device are also disclosed.

Abstract: Systems and method implant prostheses in the body. The systems and methods provide permanent attachment of the prosthesis in the body. The prosthesis can comprise, e.g., an endovascular graft, which can be deployed without damaging the native blood vessel in either an arterial or a venous system. The endovascular graft can comprise, e.g., a radially expanding vascular stent and/or a stent-graft. The graft can be placed in the vasculature, e.g., to exclude or bridge an aneurysm, for example, an abdominal aortic aneurysms. The graft desirably adapts to changes in aneurysm morphology and repairs the endovascular aneurysm. The fastening systems and methods can be deployed through the vasculature and manipulated from outside the body, to deliver a fastener to attach the graft to the vessel wall.

Abstract: A surgical needle includes an elongated needle body defining a longitudinal y-axis along which the needle body extends and transverse x and z-axes. The needle body includes a central shaft portion, a first suture end portion for attachment to a suture and a second needled end portion for penetrating tissue. The needled end portion has three sides which intersect to define three cutting edges and terminate at a needle point. At least one side includes a pair of planar surface portions arranged in oblique relation to define a general concave appearance to the one side. The needled end portion further defines an enlarged transition portion adjacent the central shaft portion with at least an x-dimension greater than a corresponding x-dimension of the central shaft portion.