Abstract: An arterial catheter system for removing plaque from the aorta and other arteries is disclosed. The system typically includes an elongate catheter member, a filtration apparatus disposed within the distal region, and an atherectomy assembly which includes a mechanism for trapping and holding mobile or fixed plaque and an excising mechanism for removing the plaque. In use, the catheter is positioned so that the atherectomy assembly lies within a region of interest, the filtration apparatus is deployed downstream of the region of interest, the plaque is trapped and held by a snare, vacuum, or other trapping means, and then the excising mechanism is activated to remove the plaque. Methods are also disclosed for removing plaque from the aorta and other arteries.

Abstract: A laparoscopic instrument for manipulating an internal organ during surgery comprising an elongated cannula and a plurality of elongated, individually movable finger prongs operatively associated with the cannula, for engaging and manipulating an internal organ. The finger prong elements are incrementally movable from an open configuration wherein the finger prong elements are substantially spaced, to a closed configuration wherein the finger prong elements are substantially adjacent. A handle is connected to the proximal end of the cannula and includes a finger prong actuating lever for allowing the user to open and close the finger prong elements.

Abstract: A trocar assembly for use in minimally invasive surgery including a housing having an opening formed therethrough and adapted to receive a selected surgical instrument therein. Positioned within the housing is a split seal having a slit extending therethrough. The split seal maintains a seal through the opening of the housing when a surgical instrument is not inserted through the bore of the sleeve. Also positioned within the housing is a seal assembly having a plurality of sealing structures effective to maintain a seal between the housing and a surgical instrument inserted through the bore of the sleeve, such that the plurality of seals accommodate and seal against surgical instruments having different diameters.

Abstract: Device for pinpointing lesions detected in a breast comprisingan anchoring means comprising one or more flexible and elastic elements which are capable of assuming a linear form during positioning and of deforming once in place, andat least one wire of a length which is at least equal to a depth of implantation of the anchoring means within the breast.

Abstract: A device including an elongate body (15) with anti-rotation projections on the peripheral side surface thereof and a generally flat side bearing surface (20) for engaging one side of a bone rod (5) forming the end of a ligament (4). The body (15) comprises an axial hole having a tapered internal seat and being engaged by a screw. Slots (24) enable the body (15) to be expanded by the axial screw. When the body (15) is expanded (13, 14), the bone rod (5) is locked in place in a hole (7) formed in the bone (2). Reliable and easily performed and adjusted ligament anchoring may thus be achieved.

Abstract: A thrombus filter configured for placement within a blood vessel lumen. The filter having a longitudinal axis. The filter includes first and second units, each unit including a plurality of elongated struts. Each strut has a joining end where the respective struts of each unit are joined together. Each strut also has a free end opposite the joining end. The struts have at least two curves such that in a longitudinal planar projection of the filter, each strut has a first direction of curvature proximate the joining end and an opposite direction of curvature closer to the free end. In a transverse planar projection of the filter, the strut has a first direction of curvature proximate the joining and an opposite direction of curvature closer to the free end.

Abstract: An introducer for introducing an expandable implantable device into a catheter includes an outer tube and an inner core which slides in the outer tube. A first end of the core has a tubular configuration with a slit which allows it to expand radially to grip an end of the device. The first end of the core holding the device is pulled into a first end of the outer tube which further tightens the grip on the device. The second end of the core, which extends beyond the second end of the outer tube, may have a handle attached or be bent to prevent the core from moving and releasing the device. The core preferably has a metal wire inside of it. The device remains in its relaxed condition attached to the introducer at the first end of the outer tube and mostly outside of it until use. The outer tube may have a rigid transparent cup-shaped shield member attached at its first end and extending beyond it to protect the device and allow the device to be viewed on the introducer.

Abstract: A vascular hemostasis device comprises a shaft coaially received within a hollow tube, and having a distal end formed with an opposed pair of resilient grasping prongs. The tube has an open distal end that may be situated percutaneously adjacent a vascular puncture site. The shaft and the tube are axially movable with respect to one another, so that the distal end of the shaft may be selectively extended from and partially retracted into the distal end of the tube by means of an actuation member attached to the shaft. When the distal shaft end is in its extended position, the prongs are exposed from the distal end of the tube, and they resiliently expand to an open position. When the distal shaft end is moved to its retracted position, the prongs are partially retracted into the distal end of the tube, radially contracting them to a closed position. In contracting, the prongs grasp and gather tissue adjacent the puncture site to obstruct bleeding therefrom.

Abstract: A wax container and applicator kit including a cylindrical container having an open top portion. Included is a first applicator member that is sized for positioning through the open top portion of the container. The first applicator member has a handle portion and a body portion. A second applicator member is provided and is elongated and linear. Finally, a third applicator member is included. The third applicator member is elongated, linear and having a size being 2/3 that of the second applicator member.

Abstract: A tissue everting apparatus includes at least one elongated frame, at least one actuator slidably mounted to the frame and longitudinally movable between proximal and distal positions, a tissue everting bulbous tip, and at least two prongs which are laterally movable between open and closed positions. The bulbous tissue everting tip is positioned, for example, in the lumen of a vascular segment to evert the edge and the prong is closed to capture the everted edge of the vascular segment. The edge of a second vascular segment is everted and captured in a similar manner with the edges being brought together to form a flange-like structure to which one or more surgical clips may be applied to fasten the segments together.

Abstract: A lateral connector assembly for connecting a bone engaging fastener to an elongated member, such as a spinal rod includes a lateral connector having an elongated opening for receiving a portion of the bone engaging fastener therethrough. The lateral connector includes a plate portion and an integral yoke portion, which yoke portion is attached to the elongated member by way of a clamp. The lateral connector assembly can include variable angle means between the clamp and the yoke portion of the lateral connector that permits rotation of the lateral connector about an axis projecting outward from the spinal rod. The plate portion and the yoke portion of the lateral connector are oriented at non-perpendicular angles, preferably an angle greater than 100 degrees.

Abstract: Connectors are provided for making connections between tubular conduits in medical procedures such as those involving treatment of a patient's circulatory system. The connectors are variously configured for making end-to-side or end-to-end connections of tubular conduits. One of the tubular conduits may be a graft conduit, which can be artificial conduit, natural conduit, or a combination of both. The connectors for making end-to-side connections can be generally T-shaped or L-shaped. Various portions of the connectors can attach to the inside or outside of the associated conduit, depending on the connector configuration that is selected.

Abstract: Wire fasteners having legs with lengths that can be one hundred times the width of the fastener are used to secure items, such as prosthesis valves to a patient during minimally invasive surgery. The fasteners are manipulated into position and then are immobilized by means of the legs thereof for tensioning, cutting and forming in situ. The fasteners are manipulated, tensioned and formed from the leg end of the fasteners. Tools for initially placing the fasteners and for immobilizing, tensioning, cutting and bending the fastener legs are disclosed. Once the fasteners are initially placed, the prosthesis is placed on the long legs of the placed fasteners and is guided into position on the legs. Once the prosthesis is in position, the legs of the fasteners are immobilized, tensioned, cut and bent into staple-like shapes to secure the prosthesis to the patient. A method for carrying out the procedure using the long fastener is also disclosed.

Abstract: A device for machining of workpieces or objects, comprises an elongated tool which rotates about its longitudinal axis and is provided with a shaft which can be coupled to a drive unit and with a chip-removing head connected to the shaft. In order to ensure that even a very long tool can be used in deep hollows in the workpiece in a stable and vibration-free way, a sleeve positioned between the shaft and the chip-removing head is connected at one end to the chip-removing head so that it cannot slide or rotate. The tool can be clamped in the chuck of a hand-held drive unit, preferably with a suction and flushing device connected in series, and used to suck away chips through the cavity in the sleeve and to pump cooling fluid onto the cutting site.

Abstract: A system/assembly for delivery and deployment of an inflation expandable stent within a vessel, comprising a catheter having proximal and distal ends; a stent, inflation expandable from a delivery diameter to a deployment diameter, such that the delivery diameter is reduced from the deployment diameter for conforming the stent to the catheter, such that the stent, in its delivery diameter, is coaxially mounted on the catheter near the catheter distal end; an expandable inflation means coaxially mounted on the catheter axially within the stent, for expansion of the stent from the delivery diameter to the deployment diameter upon application of fluid deployment pressure to the inflation means; and a securement component coaxially mounted on the catheter, axially within the expandable inflation means, the securement component designed and adapted to provide a securement pressure to the stent in the delivery diameter to maintain the stent in position on the catheter during delivery to the deployment site.

Abstract: A sternotomy suture comprises a loop which passes around a split sternum and is twisted until double cabling begins at which point the suture is fastened to itself. The loop preferably comprises a single strand of wire with one end welded to an intermediate point of said strand leaving a portion available for connection to the needle. A curved needle having a cutting tapered point is swaged to the free end of the single strand. Initially the wire is passed around the split sternum and the needle then removed with a pair of diagonal cutting pliers. A twisting tool, having a handle and a hooked portion, passes through the two free loops on opposite sides of the sternum. Twisting force is applied to the tool and transmitted through the hook to the suture causing it to twist and cable. The suture reaches its critical length L.sub.crit when the loop is fully cabled but before double cabling begins. At the onset of double cabling the loop reaches its maximum tension T.sub.crit.

Abstract: A removably lined adhesive strip for foreshortening a nose and dilating the nasal passages of the nose. The strip is an external strip with two end portions. One end portion is fixed to a position on or beyond the tip of the nose, such as immediately beyond the tip of the nose and the other end portion is fixed to a position on the bridge of the nose. The strip may be integrally formed with or separate from a spring nasal dilator applied across the bridge of the nose and to the nostril of the nose. The strip may be used with or without such a spring nasal dilator. One preferred embodiment of the strip includes an end portion which is generally the shape of a diamond or arrowhead with rounded tips so as to generally reflect the shape of the tip of the nose or the shape of the nose immediately beyond the tip of the nose. A method for applying the strip includes first applying one end portion to a position on or beyond the tip of the nose and then applying the other end portion to the bridge of the nose.

Abstract: In order to make it possible, in a surgical instrument comprising a tubular shaft with two tools pivotable towards one another at its distal end, these tools being pivotable relative to one another by means of a grip section at the proximal end of the tubular shaft via a transfer member arranged in the tubular shaft, to use the tools in a region arranged laterally of the instrument even with a simple construction it is suggested that the pivot axis of the tools extend concentrically to the longitudinal axis of the tubular shaft, that one tool be securely connected to the tubular shaft and the other securely connected to the transfer member, that the transfer member be a core mounted in the tubular shaft for rotation about its longitudinal axis, and that the grip section comprise two grip elements pivotable towards one another, one of these elements being connected to the tubular shaft and the other to the transfer member.

Abstract: A tool for installing a suture anchor which supports first and second suture segments having free ends, the tool including an installation end adapted to accommodate the suture anchor and to transmit mechanical power for driving the suture anchor, and a guiding arrangement adapted to guide and support the first and second suture segments in a non-parallel configuration at the installation end. The guiding arrangement may include at least one suture guide adapted to support the first and second suture segments, respectively, at least at a first and a second support points, which are spaced laterally with respect to a direction of installation of the suture anchor.

Abstract: An instrument assembly for performing anatomical tissue ligation includes a passage defining member having a distal end for being disposed at an internal operative site, a proximal end for being disposed externally of the internal operative site and a passage between the distal and proximal ends. A grasping member is disposed at the distal end of the passage defining member for grasping anatomical tissue at the internal operative site. A contractible ligature loop of filamentous ligature material is carried by the passage defining member and is disposed externally of the distal end thereof for positioning around the anatomical tissue grasped by the grasping member. The ligature loop is contractible, from externally of the internal operative site, around the anatomical tissue to form a ligature allowing a complete anatomical tissue ligation to be performed with a single instrument assembly.