Abstract: This invention is a device (210) for sealing a hole (100) in a blood vessel (102), comprising a blood vessel engager (217) having at least one spike (214), for engaging a portion of a blood vessel (102) adjacent a hole in the blood vessel, and a body (216) coupled to the blood vessel engager (217). The device (210) has at least two configurations, a first configuration in which the device does not seal the hole, and a second configuration to which the device can be changed so that the second configuration of the device seals the hole.

Abstract: A portal device maintains an opening in the skin of a patient to allow for the passage of surgical device therethrough. Tabs disposed at one end of the portal device may be used to resist removal of the device, retract soft tissue from the operative site, and seal the opening to prevent the escape of gases or liquids.

Abstract: A high-speed pneumatic cutting system having a cutter and an actuator. The cutter is a guillotine-type, pneumatic cutter that receives a train of pressure pulses from the actuator. The actuator is designed to capture pressure pulses it receives from a pneumatic energy source in a surgical machine, such as a vitrectomy machine, or to generate its own pneumatic energy. The actuator has an accumulator coupled to the outlet of the pneumatic energy and a pressure transducer that senses the pressure level inside the accumulator. A control and display unit with a plurality of input mechanisms receives inputs from a user who selects a desired cutting rate or frequency for the cutter. The control and display unit produces an output signal based on the inputs received. The outputs from the control and display unit and the pressure transducer are sent to a waveform shaping circuit. The waveform shaping circuit produces a command signal based on the inputs that it receives.

Abstract: These and other objects of the present invention are achieved in a body fluid sampling system for use on a tissue site that includes an electrically powered drive force generator. A penetrating member is operatively coupled to the force generator. The force generator moves the member along a path out of a housing having a penetrating member exit, into the tissue site, stops in the tissue site, and withdraws out of the tissue site. A cartridge houses the penetrating member. The cartridge has first and second seals coupled to the penetrating member to maintain a sterile environment around a portion of the penetration member prior to penetrating member actuation. A user interface is configured to relay at least one of, penetrating member performance or a penetrating member setting.

Abstract: An angioplasty device and particle trap for use in removal of a particle from a small diameter vessel or vessel-like structure is disclosed. One embodiment includes a catheter for insertion into a vessel-like structure, the catheter having a catheter wall and a movable member, a trap operably connected to the catheter wall and to the movable member, wherein relative motion between the catheter wall and the movable member actuates the trap. In one embodiment, the expanded trap is formed from struts in a spiral-shaped configuration. In one embodiment, the contracted trap forms a waist to creates a pinch-point to trap particles. In one embodiment, the contracted trap forms a cocoon-like structure to further trap particles. In one embodiment, the angioplasty device includes a handle to actuate the trap from a contracted position to an expanded position and return to a contracted position. The handle provides rotational or longitudinal or both types of movement to actuate the trap.

Abstract: An emboli extraction catheter and vascular filter system comprising a guidewire, a vascular filter attached near the distal end of the guidewire, and an emboli extraction catheter. The vascular filter has a smaller first diameter for insertion into the lumen of a vessel, and a second larger diameter for expanding to substantially equal the diameter of the lumen and to be placed in generally sealing relationship with the lumen. The emboli extraction catheter is a flexible catheter comprising a hub attached to the proximal end of the catheter. The hub further comprises a sideport and means for maintaining a seal on the guidewire. The emboli extraction catheter can be used to aspirate embolic particulates, so as to avoid their accidental release after they are captured in a vascular filter, and can also be used to empty full vascular filters of embolic particulates which may block distal flow.

Abstract: The apparatus includes at least two skin-contacting elements, the elements having narrow end faces and a mounting assembly for holding the elements closely adjacent to each other. A driving assembly reciprocally moves one element relative to the adjacent element(s) at a frequency that produces an action on the pores of the skin to loosen sebaceous plugs present in the pores, by permitting their ready removal from the skin.

Abstract: The present invention is directed to a tool having a wrist mechanism that provides pitch and yaw rotation in such a way that the tool has no singularity in roll, pitch, and yaw. In one embodiment, a minimally invasive surgical instrument comprises an elongate shaft having a working end, a proximal end, and a shaft axis between the working end and the proximal end; and an end effector. A wrist member has a flexible tube including an axis extending through an interior surrounded by a wall. The wall of the flexible tube includes a plurality of lumens oriented generally parallel to the axis of the flexible tube. The wrist member has a proximal portion connected to the working end of the elongate shaft and a distal portion connected to the end effector.

Abstract: A method and device are disclosed directed at harvesting of vessels, such as arteries and veins, especially as required in vessel grafting procedures. The device and method discloses a cannula-like device that provides, identification, capture, manipulation, hemostasis and cleavage of branch vessels from the harvested vessel without need for further devices. In certain preferred embodiments of the disclosed method and device, the disclosed harvesting device achieves branch vessel cleavage and hemostasis without the use of heat producing means such as cautery. In addition, certain embodiments utilize a clip/coil magazine technology so as to enable severance and hemostasis of multiple branch vessels without need for removal of the device from the surgical site.

Abstract: A dilatation system preferably including a dilator and a detachable handle for achieving step dilatation of a bodily opening is provided. The dilator preferably is steerable and can be visually guided using a fiber optic scope positioned in a lumen formed in a shaft of the dilator. Fluid can be delivered through the lumen with the scope positioned therein so as to distend, irrigate, or insufflate a space within the body. A kit and related methods also are provided that can include elements desired to facilitate step dilatation of a body opening.

Abstract: Various obesity treatment tools and methods are described herein, as well as treatments for other gastric-related diseases, e.g., GERD. Treatment includes reducing the size of the stomach pouch to limit the caloric intake as well as to provide an earlier feeling of satiety. This may be done by creating a smaller gastric pouch within the stomach directly from the interior of the stomach itself. The smaller pouches may be made through the use of individual anchoring devices, rotating probes, or volume reduction devices. A pyloroplasty procedure may also be performed to render the pyloric sphincter incompetent. A gastric bypass procedure may additionally be performed using atraumatic magnetic anastomoses devices so that sugars and fats are passed directly to the bowel while bypassing the stomach. Many of these procedures may be done in a variety of combinations. Treatment may create enforced behavioral modifications by discouraging the ingestion of high-caloric foods.

Abstract: An expandable frame for an embolic filtering device used to capture embolic debris in a body vessel includes a first half frame having a first control arm connected to a second control arm by a partial loop and a second half frame having a first control arm connected to a second control arm by a partial loop. The partial loops cooperatively form a composite loop for attachment of a filtering element which will expand in the body vessel to capture embolic debris entrained in the fluid of the vessel. The lengths and positioning of the first and second control arms of each half frame can be varied to create an expandable frame which conforms to the size and shape of the body vessel in which the filtering device is deployed. Additionally, the radius of the partial loops, along with the length of the arc of the partial loops, can be varied on each of the frames to create a composite filtering assembly that can easily adapt to the size and shape of the body vessel.

Abstract: Disclosed is a single-use surgical scalpel having two molded plastic elements, and a surgical blade. The first molded plastic element is a housing. The housing has an upper and a lower radiused edge, and ribbed interior wall surfaces. The ribbed interior wall surfaces of the molded plastic housing define a channel for slidable engagement of the second molded plastic element which is referred to as a blade carrier. The channel has one open end through which a surgical blade is extended during use, a slot through the lower radiused edge for slidable engagement of an actuator/locking fin, a single-use indicator window, and a retaining element for engaging a distal end of a leaf spring. The molded plastic blade carrier has a first end adapted for engaging the surgical blade, a second end having a leaf spring to assist in blade retraction, the leaf spring having a proximal and a distal end, and a central portion having the actuator/locking fin and a single-use indicator. A single-mold embodiment is also disclosed.

Abstract: An apparatus and system for removing an obstruction from a body lumen simultaneously mechanically dislodges the obstruction, macerates the obstruction, and aspirates the effluent caused thereby. The maceration is effected by directing pressurized fluid to the obstruction, while the obstruction is dislodged by a tip portion formed on the end of a guidewire. The apparatus includes a flexible catheter having at least two channels individually accommodating fluid flow paths towards and away from the obstruction. The guidewire may be disposed in either of the channels or a third channel formed in the flexible catheter. The apparatus also includes a drive unit for rotating the guidewire. The drive unit may be an external drive unit, such as an electrical motor, or may include drive elements formed on the guidewire within a drive chamber, across which the fluid flows and imparts energy against the drive elements to cause rotation of the guidewire.

Abstract: An improved method is provided to enhance skin appearance and health, in which skin is cleaned (or exfoliated) and conditioned by use of microelements affixed to a base element or hand-held patch. For the microstructure used in the improved method, the dimensions of the microelements are controlled so as to remove a certain number of layers of skin cells and to accumulate and retain those skin cells, along with other foreign substances, into areas between the microelements. In another embodiment of the improved method, a conditioning compound or therapeutic active can be applied to the exfoliated skin to enhance the skin. Moreover, the amount of skin cells accumulated using the improved method represents a self-limiting maximum quantity that cannot be substantially exceeded regardless of the number of attempts by a user to re-use the microstructure apparatus associated with the improved method.

Abstract: An improved method and apparatus is provided as a system to deliver a composition, preferably a medical or pharmaceutical composition or active, through the stratum corneum of skin, without introducing bleeding or damage to tissue, and absent pain or other trauma. The dimensions and shapes of the microelements are controlled so as to control the penetration depth into the skin. The microelements can be “hollow” such that passageways are created therethrough to allow the composition to flow from a chamber, through the microelements, and into the skin. Alternatively, the microelements can be “solid,” and the composition is applied directly to the skin just before or just after the microelements are applied to the skin surface to create the openings in the stratum corneum.

Abstract: Medical devices or components thereof, and particularly intracorporeal devices for therapeutic or diagnostic uses, which are formed at least in part of a polymeric material and a ferromagnetic or paramagnetic material, so that the medical device or component thereof is visible on magnetic resonance imaging (MRI) scans. In one embodiment, the medical device is a balloon catheter having an MRI visible balloon. In a presently preferred embodiment, there is an insufficient amount of the ferromagnetic or paramagnetic material within a wall of the balloon or coated onto a wall of the balloon to make the balloon radiopaque.

Abstract: A system for treating stenosis in a target blood vessel, such as the common carotid artery, comprising a graft portion having a main portion and a branch portion extending therefrom. The branch portion extends from the intermediate portion of the main portion at an angle thereto and is in fluid communication with the main portion. A first stent is associated with the main portion and is expandable from a first configuration to a second configuration to retain the main portion in position within the target vessel. A second stent is associated with the branch portion and is expandable from a first configuration to a second configuration to retain the branch portion in position within a branching vessel. In one embodiment, the branch portion is integral with the main portion. In an alternate embodiment the branch portion is connected to the main portion.

Abstract: Methods for bypassing total or near-total obstructions in arteries or other anatomical conduits. A guidewire is advanced through the lumen of the artery or anatomical conduit upstream of the obstruction and past the obstruction. In navigating past the obstruction, this guidewire may advance through tissue that is located within the wall of the artery or anatomical conduit and/or through tissue that is located outside of the wall of the artery or anatomical conduit. After this guidewire has been advanced past the obstruction, a penetrating catheter that is equipped with an orientation element is advanced over that guidewire. The orientation element is then used to aim a penetrator back into the lumen of the obstructed artery or conduit, downstream of the obstruction. The penetrator is then advanced into the lumen of the obstructed artery or conduit, downstream of the obstruction, and a final guidewire is advanced through the penetrator and into the lumen of the artery or conduit downstream of the obstruction.

Abstract: A surgical instrument (10) includes a handle (12) and a member (30) for acting on tissue of a patient. A flexible stem (20) extends between the member (30) and the handle (12). The flexible stem (20) includes a tubular member (60) having a longitudinal axis (70) and radially inner and outer cylindrical surfaces (62 and 64) extending generally parallel to each other. The tubular member (60) has wedge-shaped slots (80 and 90) extending through the inner and outer cylindrical surfaces (62 and 64). Each of the wedge-shaped slots (80 and 90) is defined by first and second ring portions (92 and 94) extending at an angle to each other and transverse to the longitudinal axis (70). An actuator mechanism (14) connected with the handle (12) bends the flexible stem (20).