Abstract: A plaque scoring catheter comprises a catheter body having a balloon or other radially expansible shell at its distal end. A non-axial scoring structure is carried over the shell and scores a stenosed region in a blood vessel when the balloon is inflated therein. The non-axial scoring structure may be formed directly on the balloon or may alternatively be part of a cage structure which floats over the balloon. Exemplary configurations for the scoring structure include helical, serpentine, and irregular.

Abstract: A two-piece cut block for performing a minimally invasive partial or total knee arthroplasty. The present invention comprises a cut block that can be inserted into an incision in two parts then assembled in vivo.

Abstract: An anastomosis occlusion device having a low-profile shaft assembly configured for insertion into the lumen of a vessel and a distal perfusion system adapted to be connected to the shaft assembly. The device includes an expandable region at the shaft assembly distal end with a sealing membrane that spans the expandable region, and a corresponding clamping member moveable toward the expandable region. Once inserted into the vessel lumen the expandable region is deployed from a first low-profile position into a second expanded position, and positioned at the target site of the anastomosis. Movement of the distal end of the clamping member, which remains located outside the vessel, against the expanded region creates a seal at the target site allowing a blood-free, graft site.

Abstract: A patellar trial and drill guide for use during knee replacement surgery comprising an articular surface member and a fixation peg drill guide. The articular surface member is the exact geometry as the artificial patellar implant, and the drill guide aligns the holes for the fixation pegs of the artificial patellar implant. The patellar trial is placed on the resected patella in the desired position, a patellar clamp is used to temporary fix the patellar trial to the patella. The patella is then returned to its normal position and a trial reduction of the total knee replacement is completed. If the placement and/or size of the patellar trial is unacceptable, the patella is inverted, the patellar trial removed, and a different sized trial or new location is determined. The new patellar trial is secured to the resected patella, and another trial reduction of the total knee replacement is completed. This procedure can be repeated until the patellar trial is the correct size and in the proper location.

Abstract: A suture anchor system configured so as to facilitate implantation of a suture anchor within a bore formed in a bone, so as to secure a suture to the bone, is provided. Such a system comprises a suture anchor having a suture operably engaged therewith and an insertion tool having a tip and defining a first axis. The insertion tool is discrete with respect to the suture anchor and is capable of implanting the suture anchor within the bore such that the suture anchor is secured in the bone. The tip is engagable with the suture anchor and is configured to cooperate therewith so as to prevent the suture anchor from rotating about the first axis. Further, the insertion tool is configured with respect to the suture anchor such that a rotational force exerted on the insertion tool rotates the suture anchor about a second axis disposed perpendicularly with respect to the first axis. A predetermined axial seating force is then applied to the insertion tool, outwardly of the bore, to seat the suture anchor in the bore.

Abstract: A method and device for implanting an endoprosthesis within the lumen of a body passageway. A tubular, elongated endoprosthesis having a small outer diameter for intraluminal delivery of the selected body passageway, is capable of being progressively permanently deformed to an expanded diameter by application of outwardly acting force. The endoprosthesis is provided on a catheter having an inflatable, radially expandable balloon, the axial dimension of which is shorter than the axial dimension of the endoprosthesis. The elongated prothesis is inserted in unexpanded state into a desired location within the body passageway and with the catheter positioned so that its expandable portion registers inside a first portion of the endoprosthesis, the inflatable portion of the catheter is inflated to cause deformation of the first portion of the endoprosthesis to an expanded diameter.

Abstract: This is in the general field of surgical instruments and is specifically a delivery catheter with a flexible, proximally-manipulated hinge or joint region. The inventive catheter may have a balloon region. The catheter may have a shaft of varying flexibility which contains several lumen. The inner, or delivery, lumen generally may be used with a guidewire to access target sites within the body via the flexible, small diameter vessels of the body. The delivery lumen may be also used for placement of occlusive materials, e.g., in an aneurysm. Inflation of the micro-balloon, located near the distal tip of the catheter, is effected using the inflation lumen. The push/pull wire lumen contains a wire, which when manipulated, flexes the catheter's distal tip. The push/pull wire tubing may have a variable thickness to aid in adjusting the degree of flexibility. Moreover, the delivery catheter may be capable of twisting in a helical or corkscrew-like manner for traversing certain vasculature.

Abstract: A supported bioprosthetic heart valve is provided. The valve includes a stent and a bilogical valve member. The stent has an annular frame defined by a support rail. The support rail is formed to define a triad of axially-projecting circumferentially-spaced commissure posts, each post having an inverted U-shaped configuration and a pair of legs. Each of the pair of legs has an upper end and a lower end. The lower end of each leg merges smoothly with the lower end of a leg of an adjacent commissure post. A sleeve having an inflow end and an outflow end is fitted around the annular frame. The biological valve member is defined by a tubular wall and three leaflets, the three leaflets being attached to the tubular wall and axially converging along three commissures. The biological valve member has a shape which fits the contour of the support rail and is disposed under the support rail. The biological valve member is sutured to the support rail and the outflow end of the sleeve.

Abstract: The object of the invention is an implant not requiring major surgery for its insertion or for the partial replacement of any of its elements; said prosthesis can be applied for long-term placement. The implant disclosed replaces the entire urinary organs, thereby precluding any possible anastomosis, said implant comprising a double-layered (7, 8) structure for the artificial replacing elements: tubular elements (1, 3) for the renal ducts and urethra, a reservoir (2) for the bladder, and an artificial urethral sphincter (4). The aritificial tubular elements of renal ducts (1) are connected to the reservoir (2) by mechanical attachments (5), said elements (1 to 3) being constituted and formed so that they can pass from a flattened state when empty to an expanded state.

Abstract: A stent (1) is provided for having variable flexibility and stiffness along its length. The stent (1) comprises portions (5, 7, 9, 11, 13, 15) of the stent having different bending and durability characteristics, and may be fabricated, using any of a variety of methods out of any of a variety of materials.

Abstract: A biomaterial is provided which is suitable for use in surgery in a human patient. It comprises a coherent layer of non-human collagenous tissue which has been subjected to glutaraldehyde tanning so as to comprise cross-linked collagen fibrils, and a reinforcement of synthetic material embedded within the coherent layer. The synthetic material has structure features for promoting the embedding, the synthetic material having an average in situ more than 50 of the features per square centimeter. Improvements are also provided in a method of producing biomaterials by allowing collagenous tissue growth on mesh structures covering support surfaces implanted into host animals. In one aspect a tubular synthetic fibre mesh structure fits loosely over a support rod or tube, and in the other aspect a sheet support is used and the tissue growing around the sheet support is adapted to form a pocket, pouch or envelope of collagenous material.

Abstract: A delivery device for delivering an implantable, radially expandable medical device having a constricted region for occluding fluid flow to a desired location in a body lumen. The delivery device includes an outer sleeve, an inner tube terminating at its distal end in a plunger, and a tapered guide member. In one embodiment, the tapered guide member is attached to and extends away from the constricted region of the occlusion device, and is thus implanted in the body lumen along with the occlusion device upon deployment of the occlusion device at the desired treatment location. In a second embodiment, the tapered guide member is integrated into the constricted region of the occlusion device. In a third embodiment, an inflatable balloon is positioned distally of the medical device, and when inflated provides a tapered guide surface that eases the navigation of the delivery device through the body lumen.

Abstract: Medical articles can include biocompatible material with a deposit of anticalcific elemental metal. The biocompatible material can be tissue, fabric or the like. The biocompatible material can be configured on the medical article such that when the medical article is positioned for its intended use, the biocompatible material is substantially removed from blood flow or is in a low blood flow area effectively removed from vascular blood flow. Gas phase or solution phase methods can be used to deposit the anticalcific elemental metal.

Abstract: Humeral prosthesis having a rod for anchoring into a humeral canal of a humerus. The prosthesis has a hemispherical cup adapted to engage a shoulder socket and a connection which connects the rod to the hemispherical cup. The connection includes a spherical portion and the spherical portion includes a spherical engaging surface having at least one recess. At least one reference mark is disposed on at least one of the rod, the hemispherical cup, and the connection. The at least one reference mark corresponds to the at least one recess. The prosthesis also has a binding mechanism for engaging the at least one recess. The hemispherical cup is pivotal about the spherical portion and fixable in a finite number of combined angular positions which correspond to a number of recesses.

Abstract: A heart valve prosthesis having improved flow characteristics. A heart valve prosthesis includes a valve body and a pair of leaflet occluders. The valve body includes an interior surface that defines a central passage for blood flow. The pair of leaflet occluders are pivotably mounted in the passage via ears or tabs that are received in recesses formed in the interior surface that defines the central passage. The recesses are formed with sloped sidewalls to improve the blood flow therethrough. The recesses are also formed such that the leaflet occluder ears act against at least two surfaces that limit the motion of the leaflet occluder to provide a more stable movement that is less damaging to blood cells.

Abstract: An easy-to-produce and mechanically strong tube of an implantable submucosal tissue has been developed which is manufactured in any desired length, wall thickness, or diameter. The construct produced by the method of the invention may be used as grafts for arteries, veins, ureters, urethras, shunts, or in any application where a compliant, tissue-compatible tube is needed. The manufacture of the submucosal tissue prosthesis generally involves wrapping a first sheet of submucosal tissue (60) and a second sheet of submucosal tissue (70) around a mandrel (50), wherein the first end (74) and the second opposite end (76) of the second sheet of submucosal tissue (70) are sutured together with sutures (78). The submucosal tissue is compressed and dried on the mandrel (50) before removing the construct by pulling on a first end (54) and a second end (56) of a water permeable tape to unwind the tape and thus release the construct for eventual use.

Abstract: An implantable orthopedic prosthesis is provided that includes a shell having a substantially concave inner surface defining a cavity and a substantially annular groove formed therein. The prosthesis further includes a polymeric insert that is positionable within the cavity of the shell, and that has a substantially convex outer surface and a circumferential protrusion projecting therefrom. The protrusion has a substantially trapezoidal cross-section wherein at least one of the sides of the trapezoid is substantially parallel to the axis of symmetry of the insert. The cross-section of the protrusion is substantially congruent to the cross-section of the groove of the shell, and the inner surface of the shell is substantially congruent with a corresponding portion of the outer surface of the insert when the insert is properly positioned within the cavity of the shell.

Abstract: A nail for fixing the position and shape of broken long bones is provided. The nail has a shank having a central main body and longitudinal chamber-like expansion elements attached to the central main body which are expandable while in situ. The expansion elements run substantially the length of the shank and are preferably arranged substantially equiangularly around the central main body. When the expansion elements are expanded, a cross-section of the central main body is expanded. The central main body may be provided with channels into which the expansion elements may be disposed.

Abstract: An improved set screw, for use in an osteosynthesis apparatus to secure and fix the spinal rod in the bore of the head of a bone screw, hook, connector or the like from translational or rotational motion, which comprises a head of hexagonal external cross-section and a lower portion having a threaded outer surface. A point is centrally formed on a lower surface of the set screw for penetrating into the rod and the point is preferably surrounded by a spaced and sharpened ring. In some embodiments a peripheral notch is formed between the head and the lower threaded portion of the set screw. A cylindrical bore comprising an upper bore section and a lower bore section is formed in the set screw such that the upper bore section extends through the head and the lower bore section extends partially through the set screw lower portion.

Abstract: A bioprosthetic valve comprising a support ring having three spaced apart end stops projecting upwardly therefrom, a stent post ring having three spaced apart stent posts pivotally connected thereto and adapted to engage respective ones of the end stops so as to permit outward pivoting of the stent posts and to prevent inward pivoting thereof, a leaflet valve having three generally triangular leaflets defining respective cusps, the leaflets being joined at respective commissures, and a sewing ring for attaching the leaflet valve to the stent post ring and support ring.