Abstract: A manipulating handle for a successive clipping device comprises: a cylindrical handle main body connected to a sheath with a manipulating wire extending from the sheath being arranged in an interior thereof; a slider engaged with the manipulating wire for moving the manipulating wire in the axial direction of the handle main body; and a slider-movement-amount regulating member attached onto the outer circumferential surface of the handle main body so as to be rotatable in a circumferential direction of the handle main body, for regulating, according to a rotational position in a circumferential direction thereof, an amount of movement of the slider in the axial direction of the handle main body to one of a plurality of different amounts of movement required for respective clipping manipulations using a plurality of clips connected to the manipulating wire.

Abstract: Endolumenally sealing a zone around the puncture and dilation area of a stent-graft fenestration or sealing the juncture between two lumens with an expandable sealant delivery device. In exemplary embodiments, an expandable sealant delivery device includes a catheter mounted balloon, which has a microporous membrane or a plurality of pores suitable for delivering a surgical sealant.

Abstract: A holder for a flexible leaflet prosthetic aortic heart valve that is less bulky than earlier holders and minimizes obstructions to vision and working space around the valve to facilitate implantation thereof. The holder may have a central hub and three outwardly extending legs that connect directly and exclusively to tips of the commissures of the aortic heart valve for better tactile feedback when parachuting and seating the valve in the annulus. The legs are sized so that they do not overlap the commissure tips and therefore afford a better view of the sewing ring adjacent the commissures. The legs may be narrow in the midsection or split into two rails to increase visibility of the valve leaflets. The hub may be vaulted axially upward relative to the outer ends of the legs to further increase visibility of the valve.

Abstract: A surgical instrument having an anchor and a plug is capable of anchoring a suture. The suture anchor has an anchor body having a top surface, a bottom surface distal to the top surface, a transverse bore and a well, the well having an outer surface, an inner surface, and an inner bottom surface. The plug has a post, a head, and a bottom face. The anchor body and the anchor plus form a suture anchor. The suture anchor may be used during surgical procedures and can be used in the re-tensioning of a suture.

Abstract: An assembly for joining two vessel segments of a patient comprises a coupler formed of adjoining coupler halves, and a cuff having a large diameter portion and a small diameter portion. Each of the coupler halves includes an aperture for receiving an end of one of the vessel segments. One of the coupler halves comprises a connector element sized and shaped for connection to the other coupler half. The vessel segments are alignable in the respective coupler halves such that a path for fluid flow is formed therebetween upon connection of the coupler halves. The large diameter portion of the cuff is positioned over at least a portion of the coupler, and the small diameter portion of the cuff is positioned over one of the vessel segments. The cuff further includes a probe positioned at the small diameter portion. The probe is positioned within the cuff in a manner such that a signal is receivable therein corresponding to fluid flow through the vessel segment.

Abstract: A surgical fastening apparatus including at least one self-closing clip and a deployment device. The self-closing clip comprises a wire defining an intermediate portion interconnecting opposing, first and second side portions having a memory set loop shape. The deployment device includes a clip holding assembly and an actuator. The clip holding assembly includes first and second containment arms and a transfer rod. The containment arms have a distal segment defining a lumen extending from an open, distal end. The transfer rod is associated with at least one of the containment arms in an axially movable fashion and forms an engagement feature. The actuator is connected to the transfer rod for controlling movement of the rod. Upon final assembly in a pre-deployment state, the engagement feature of the transfer rod engages the intermediate portion of the clip, and the side portions are captured by the containment arms.

Abstract: A device for repairing a tear in a portion of tissue comprises a proximal actuator portion, a transfer needle extending distally from the proximal actuator portion and a catch needle extending distally from the proximal actuator portion. A suture needle is disposed in the transfer needle, and is extendable from the transfer needle toward the catch needle and retractable from the catch needle toward the transfer needle. An extendable catch plunger is disposed in the catch needle for capturing suture therein when it is transferred from the transfer needle. A retractable insertion sheath is provided for covering the transfer needle and the catch needle when the device is inserted into a procedural site. A depth limiting apparatus limits the depth of insertion of the needle into the procedural site.

Abstract: A surgical staple remover apparatus is disclosed. The surgical staple remover apparatus comprises a first elongated element having a handle on one end and a downward facing protrusion on the other end and a second elongated element having a handle on one end and an upwards sloped planar element on the other end, wherein the first and second elongated elements are pivotally connected. The apparatus further includes a cutout located at a midpoint of a tip of the upwards sloped planar element and a housing running a length of the second elongated element, beginning at the upwards sloped planar element and including an opening facing the planar element, such that surgical staples removed with the apparatus are drawn into the housing. The apparatus further includes a spring loaded element within the housing, wherein the spring loaded element grabs removed surgical staples and draws them into the housing.

Abstract: A closure device for closing a puncture wound has a distal section that can be placed against the interior wall of a vessel and a proximal section that bunches in the tissue tract to close the wound.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a cannulated suture anchor is provided and it includes a suture-engaging member formed therein and configured to receive a suture therearound such that trailing ends of the suture can extend through the suture anchor. The present invention also provides exemplary sutures and drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: A tissue clipping apparatus comprises a clip including a proximal end received within a capsule. The clip includes a clip locking member biased to engage a first locking structure of the capsule to lock the clip in the capsule in a closed configuration. The apparatus also comprises a tension member releasably coupling the clip to a proximal end of the device which, during use, remains accessible to a user. The tension member is coupled to the clip by a joint designed to release when subject to a predetermined load to separate the clip from the device, release of the joint releasing the locking member to engage the first locking structure.

Abstract: An embolic protection device includes a foam body attached to a plurality of flexible struts. The foam body has a generally conical geometry and the bottom of the conical geometry having a generally conical recess. The filter portion has pores sized such that blood cells can pass through the foam body, but larger material such as objects would be trapped in the recess. Each strut is attached along the periphery of the foam body and extend from the first end of the foam body to a connection point located proximate the first end.

Abstract: An automatic atherectomy system uses a rotary burr at the tip of a catheter as a sensing device, in order to measure both electrical conductivity and permittivity of surrounding tissue at multiple frequencies. From these parameters it is determined which tissue lies in different directions around the tip. A servo system steers the catheter tip in the direction of the tissue to be removed. In non-atherectomy applications the rotary burr can be replaced with any desired tool and the system can be used to automatically steer the catheter to the desired position. The steering may be done hydraulically, by pressurizing miniature bellows located near the catheter tip.

Abstract: A knotless bone anchor and method for securing soft tissue, such as tendons, to bone, includes a plurality of discrete components. In one variation of the invention, the bone anchor includes a proximal toggle component, an intermediate plug component, and a distal sleeve component. Suture is looped around the plug component and once the anchor is actuated, the suture is compressed between the plug and the sleeve components. Advantageously, one or more of the components may be made of a biocompatible polymer. The polymeric components may be detachably joined to a drive shaft using a plurality of sacrificial fills. The sacrificial fills are broken or severed during deployment of the anchor. Related instruments and methods are also described.

Abstract: A clamp has two arms with gripping jaws for supporting and positioning a superelastic osteosynthesis clip, The osteosynthesis clip comprising a web from which two flanges to be inserted into two portions of bone emerge. The clamp also has a component for preventing the jaws from being opened beyond a point at which the angle between the flanges of a clamp supported clip is greater than 90°; and a second component for preventing the jaws from being closed beyond a point at which the angle between the flanges and the web is substantially 90°.

Abstract: An innovative bone anchor and methods for securing soft tissue, such as tendons, to bone are described herein Such devices and methods permit a suture attachment that lies beneath the cortical bone surface and does not require tying of knots in the suture.

Abstract: A suture securement apparatus for selectively securing one or more ends of a suture while allowing adjustments in the tension or a full release of the sutures intermittently after a prolonged period of time. The suture securement apparatus can be particularly adapted for use with a purse-string suture to close a percutaneous catheter puncture site without causing puckering or distortion of the skin at the purse string suture site. The suture securement apparatus permits a practitioner to subsequently modify the amount of tensioning or full release of the sutures at the catheter insertion site. A threading assembly for use with the suture securement apparatus and being adapted to facilitate threading of sutures along the length of the suture securement apparatus.

Abstract: Methods and devices are provided for anchoring suture to bone. In one exemplary embodiment, a cannulated suture anchor is provided and it includes a suture-engaging member formed therein and configured to receive a suture therearound such that trailing ends of the suture can extend through the suture anchor. The present invention also provides exemplary sutures and drivers that can be used with the various methods and devices disclosed herein, or with other methods and devices known in the art.

Abstract: Devices, delivery systems and techniques for an occlusion device for the closure of physical anomalies, such as an atrial septal defect, a patent foramen ovale (PFO), and other septal and vascular defects are described. The devices, delivery systems and techniques relate to, but are not limited to, a patent foramen ovale (PFO) occluder made from a substantially cylindrical form. An occluder having a distal side and a proximal side, with a catch system for securing the deployed configuration, is introduced into the treatment site by a delivery sheath. In one aspect, the occluder has an adjustable length center joint that allows the device to fit a particular septal defect. In some embodiments, the occluder includes a catch member that holds the occluder in the deployed, expanded profile configuration. In one aspect, the catch member also has an adjustable length.

Abstract: Provided are systems and methods for suture anchor deployment. A system according to the present invention is a trocar system that includes a cannula assembly and an obturator assembly, the cannula assembly providing a needle assembly and the obturator assembly providing a needle actuation mechanism. The obturator assembly may be at least partially inserted into the cannula assembly and arranged to operatively couple the needle actuation mechanism to the needle assembly. The needle assembly includes at least one needle, each needle having disposed near its distal tip a suture anchor. A method according to the present invention includes steps for deploying and/or depositing at least one suture anchor in or through an organ of the human body.