Abstract: This disclosure is directed to a device for facilitating treatment via a vascular wall defining a vascular lumen containing an occlusion therein. The device includes an intravascular device including a shaft having a distal end and a proximal end. The device includes a handle assembly fixed about the proximal end of the shaft, the handle assembly including a first portion. Rotation of the first portion in a first direction about a longitudinal axis of the shaft causes rotation of the shaft in the first direction when a torque applied by the first portion to the shaft is below a first maximum torque. Further rotation of the first portion in the first direction about a longitudinal axis of the shaft does not cause rotation of the shaft in the first direction when the torque applied by the first portion to the shaft is equal to or above the first maximum torque.

Abstract: A suture anchor includes two clamping surfaces that secure one or more suture strands between them. Cooperating engaging structures, such as recesses and a projection enable the clamping surfaces to be incrementally moved closer together such that the force applied between the clamping surfaces is increased in predetermined increments to secure the suture strands. If the applied force is too high, the clamping surfaces can be released from a fixed position, and the force applied by the clamping surfaces can again be incrementally increased to the desired clamping force. A guide is provided to mark the location of the hole that has been drilled in the bone. A suture anchor delivery tool is provided to insert and secure the suture anchor in the hole in the bone. The suture anchor delivery tool enables the surgeon to move the clamping surfaces of the suture anchor towards each other.

Abstract: Systems and techniques for explanting implantable devices are described. In one aspect, a device includes an explant tool configured to explant an implantable device from a body. The explant tool includes an elongate shank comprising a forward portion defining a longitudinal passage and a front tip attached to the forward portion and defining an opening to the longitudinal passage defined by the forward portion. The front tip comprises a slanted surface that slopes in a direction so as to spread tissue during forward penetration of the front tip into the body.

Abstract: An intravascular filter configured for retrieval through a patient's femoral vein and a method for retrieving the filter through the patient's femoral vein. The filter includes a plurality of struts having connected ends attached together along a longitudinal axis, a shaft disposed along the longitudinal axis and having a first end disposed with the connected ends of the struts, a first cuff slidably disposed on the shaft, and a second cuff disposed over the struts and connected to the first cuff.

Abstract: An apparatus for moving an object disposed within a body lumen. The apparatus includes a first sheath, a coupling member and at least one contraction member for engaging at least a portion of the object. The coupling member is movable relative to the first sheath between a retracted position and a capture position. In the retracted position, a distal portion of the coupling member is disposed within the first sheath. In the capture position, the coupling member distal portion is disposed outside the first sheath. The coupling member is also selectively attachable to the object in at least the capture position. When the coupling member is attached to the object and the contraction member is directly engaged with the object, a predetermined coupling member movement relative to the contraction member radially contracts at least a portion of the object thereby facilitating movement of the object within the body lumen.

Abstract: The invention provides a rotational atherectomy device having, in various embodiments, a flexible, elongated, rotatable drive shaft with at least one asymmetric and at least partially spherical abrading element attached thereto, which comprises an abrasive surface. The abrading element comprises more mass above the drive shaft than below and comprises a flattened side or transverse surface which creates hard cutting edges and spaces the center of mass radially from the rotational axis of the drive shaft. Thus the center of mass is moved vertically and transversely by the structure of the abrading element, conferring geometric and mass eccentricity upon the element. When placed against stenotic tissue and rotated at high speed, the eccentric nature of the abrading element moves along an orbital path, opening the lesion to a diameter larger than the resting diameter of the abrading element.

Abstract: Device useful for implanting an implantable device within the vasculature of a patient. The device includes a deployment line, a control component for actuating the deployment line, and an actuation mechanism for translating constant-rate actuation of the control component into variable rate retraction of the deployment line from a remotely deployable implantable device. Suitable implantable devices include, for example, stents and stent grafts.

Abstract: A suture needle driving instrument comprises a shaft, an end effector, and a grasping actuation assembly. The end effector is located at the distal end of the shaft and includes a pair of grasping arms. Each grasping arm comprises a respective pair of jaws. Each pair of jaws is operable to cooperate to grasp and release a suture needle. The grasping actuation assembly is operable to drive one jaw of each pair in one direction while simultaneously driving the other jaw of the pair in an opposite direction, to selectively grasp or release the suture needle. The actuation assembly may include a drive shaft having separate threaded regions with opposing pitch. The end effector is further operable to pass the needle from one arm to the other arm during a suturing procedure. The instrument may be used through a trocar during minimally invasive surgery.

Abstract: Systems and methods for treating a patient having a head with a first ear and a second ear, function by aligning a first device with a tympanic membrane of the first ear; inputting a command to an input device operatively coupled to the first device to generate a signal; and actuating the first device in response to the signal so as to drive a penetrator of the device through the tympanic membrane.

Abstract: An extensible polyp retrieval apparatus designed to be slidably disposed along the outer surface of an endoscope that is fully or partially inserted in the lumen of a patient using a “connect and push” polyp retrieval apparatus to reach the distal end of the inserted endoscope. The polyp retrieval apparatus comprises: a flexible cylindrical polymeric tube capable of being deployed from a few centimeters in mounted length on an endoscope to over 210 centimeters in total length when partially deployed or fully extended, respectively; a multiplicity of clamping fasteners permanently mounted to the flexible cylindrical polymeric tube; a movable snare like device that is designed as an cooperating component of the polyp retrieval system to enable the grasping and storage of polyps therein so as to avoid the complete removal of the endoscope from the lumen as is normal to remove a large polyp after cauterization or after a piecemeal polypectomy.

Abstract: A guidewire loaded stent for delivery through a catheter is described herein. The stent delivery assembly can deliver and place a stent within tortuous regions of the body which are accessible to guidewires but inaccessible to stenting catheters. The assembly comprises a guidewire covered in part by a retractable sheath and a radially expandable stent near or at the distal end of the guidewire. The whole assembly is advanced through conventional catheters or it may be used alone. In either case, when the stent is adjacent to a treatment site within the body, the sheath is retracted proximally to expose the stent for radial expansion into contact with the vessel wall. Radio-opaque marker bands are optionally located on either side or both sides of the stent on the guidewire body to aid in visual placement. The assembly can optionally include an expandable balloon on the guidewire for different treatment modalities.

Abstract: A tissue cutting device is disclosed, which is structured and arranged to be inserted through the vascular system into a body vessel adjacent to the heart and/or into the heart, and to be subsequently subjected to a change of shape in order to penetrate into the heart tissue. The tissue cutting device may thus be used for treating disorders to the heart rhythm regulation system. A kit of devices provides a plurality of devices for creating a lesion pattern for treating such disorders.

Abstract: Tools and methods of use for removing biological units from a body surface utilizing a removal tool are disclosed. The tool incorporates a retention member configured to impede movement of the biological unit in the direction of a distal end of the tool and to improve retention of the biological unit in the tool. The retention member is radially movable within the lumen of the biological unit removal tool. The distal tips of the tools are desirably configured to reduce the chance of transection of a biological unit.

Abstract: A method is provided including coupling a tissue-engaging element to a first portion of cardiac tissue of a heart of a patient and advancing toward the tissue-engaging element an adjustment mechanism along at least one guide member that is removably coupled to the tissue-engaging element. The adjustment mechanism engages a first portion of a first flexible longitudinal member. A second portion of the first flexible longitudinal member is coupled to a second portion of cardiac tissue. Following the coupling of the second portion of the first flexible longitudinal member to the second portion of cardiac tissue, the adjustment mechanism is slid further along the guide member and coupled to the tissue-engaging element. Using the adjustment mechanism, a length of the first flexible longitudinal member is adjusted between the first and second portions of cardiac tissue. Other applications are also described.

Abstract: A cutting balloon catheter and method of making and using the same. The cutting balloon catheter may include a catheter shaft having a balloon coupled thereto. One or more cutting members or blades may be coupled to the balloon. The cutting members may configured to be more flexible.

Abstract: Vascular treatment and methods include a plurality of self-expanding bulbs and a hypotube including interspersed patterns of longitudinally spaced rows of kerfs. Joints between woven structures and hypotubes include solder. Woven structures include patterns of radiopaque filaments measurable under x-ray. Structures are heat treated to include at least shapes at different temperatures. A catheter includes a hypotube including interspersed patterns of longitudinally spaced rows of kerfs. Heat treating systems include a detachable flange. Laser cutting systems include a fluid flow system.

Abstract: A knotless suture system formed from two lengths of suture joined at a suture junction point, with at least four suture limbs extending from the suture junction. The knotless suture system provides the ability to construct a suture bridge for soft tissue repair and fixation across a medial and lateral row bone fixation anchor configuration while passing the suture system in a simplified method of suture management.

Abstract: A surgical staple remover apparatus includes a handle located at a rear of the apparatus, an upward sloped jaw element comprising a pair of jaws, an arm having a hook element on a distal end, wherein the arm is positioned such that the hook element is disposed over the jaw element, a housing, a spring that couples the housing to the arm, a lever mechanically coupled to the arm, wherein moving the lever closer to the handle results in the hook element pressing against a crown of a surgical staple, deforming the surgical staple for removal and moving the surgical staple proximally, and a strip element located on top of the jaw element, such that when the hook element deforms and moves the surgical staple proximally, the surgical staple is moved under the strip element and held in place by same.

Abstract: An automated system for harvesting or implanting follicular units, including a moveable arm; a harvesting and/or implantation tool mounted on the moveable arm; one or more cameras mounted on the moveable arm; a processor configured to receive and process images acquired by the one or more cameras; and a controller operatively associated with the processor and configured to position the moveable arm based, at least in part, on processed images acquired by the one or more cameras, wherein the moveable arm is positionable such that the tool may be positioned at a desired orientation relative to an adjacent body surface.

Abstract: An apparatus for joining organ wall portions of first and second hollow organs, including first and second connectors, wherein the first and second connectors are magnetically attracted to one another. A device for delivering and deploying the first and second connectors to portions of the first and second hollow organs can be provided, wherein the device is configured and dimensioned to axially align the first and second connectors for performing circular anastomosis of the first and second hollow organs.