Abstract: The discovery that by use of a spreader beam and pressure pad which has an adjustable strap secured to its ends, and then positioning the spreader beam with the pressure pad over the wound or puncture, will inhibit the bleeding and enhance coagulation is disclosed. As a result of the method, substantially less than 180.degree. radially of a limb or a body portion is subject to the pressure of the strap. Only a small portion of the radius of the skin is engaged by the pressure pad itself. The method of the invention derives from utilizing a spreader beam and pressure point with a strap at each end of the spreader beam in surrounding engagement with a limb or other body portion which has been punctured, and then positioning the pressure pad to apply pressure to the puncture point, and keeping the compress in place until the wound has ceased bleeding.

Abstract: A Safe Ear Wax Remover is composed of three parts; a wax extractor (26), a safety stopper (10), and an adjuster (30) whereby the three parts combine together making a functional unit. The unit is then placed into the ear canal with stopper resting outside. Once the unit is inserted into the canal, the handle (20) is rotated, wax is caught in the extractor and then the unit is removed from the canal. Wax is thereby safely extracted from the ear canal. Repetitious insertion done, moving the adjuster and stopper to allow increased depth of insertion of extractor, until all wax is extracted. Wax is thereby extracted without visualization of ear drums and thereby can be accomplished by oneself and/or by lay persons.

Abstract: A device for dissecting, grasping and/or cutting an object has at least two elongate elements at least a portion of at least one of the elements is formed from a pseudoelastic material, preferably a pseudoelastic shape memory alloy. End portions of the elements can be moved away from one another and then toward one another to dissect, grasp and/or cut an object with the elements. In certain embodiments, the device further comprises an actuating means and at least a portion of the elements and/or the actuating means is formed from a pseudoelastic material. The device is particularly useful in dissecting, grasping and/or cutting objects located in difficult to reach areas, for example within the body during surgery.

Abstract: A method of endoluminally bypassing blood flow through an aneurysm in the vicinity of a branched blood vessel is provided. The method comprises the steps of advancing a graftstent complex through each branch of the branched blood vessel, aligning the cephalic stents of each of the graftstent complexes relative to each other in a common vessel above the aneurysm, and deploying each of the aligned cephalic stents in the common vessel.The invention also provides an expanded vascular stent having a non-circular cross-section and an apparatus for expanding the stent in this manner. Preferably, the expanded stent is generally "D" shaped for collateral deployment within a common body lumen. A curved edge of the stent engages a body lumen while an alignment edge engages a collaterally deployed stent.

Abstract: Disclosed herein is a cutter capable of removing soft and hard tissue when used with an atherectomy catheter of the type having a cutter housing attached to the distal end of a catheter having a torque cable. A circular cutting blade is disposed within the housing and is secured to the distal end of a rotatable torque cable. An elongated aperture formed along one side of the hosing allows the intrusion of stenotic material which may then be severed by rotating and axially translating the cutting blade. The cutting blade may be made from a cemented tungsten carbide compound of 90 percent tungsten carbide (WC) and 10 percent cobalt (Co) which is heated, injection molded and sintered to produce a hard, durable cutting edge. The cutting edge is coated with titanium carbonitride using a physical vapor deposition process to further increase durability. Cutting edge hardness is further increased by application of an ion implantation of nitrogen using an ion-beam assisted deposition process.

Abstract: A jaw assembly is provided with a pair of jaws which are closed with a flexible, tension member that is pulled by the operator of the instrument. In a preferred embodiment, one of the jaws is pivotally mounted in a slot to the other jaw. A cord, having a loop configuration, is attached to the pivoting jaw and can be pulled to pivot the jaw closed. A second cord can be provided to initially hold the proximal end of the pivoting jaw away from the other jaw until the distal ends of the jaws are closer together. In another embodiment, jaws can be closed in a parallel orientation by rotating two pulleys with threaded shafts engaged with the jaws.

Abstract: An improved carpal tunnel tome for performing carpal tunnel release surgery is provided. In a first embodiment, a carpal tunnel tome including a slender handle with a blade at one end is provided. The blade is bounded on both sides by a pair of relatively blunt protuberances that extend distally beyond the cutting edge of the blade. In another embodiment, a carpal tunnel tome having a stem is provided. A cutting head, including a blade, is connected to the stem. One portion of the stem is angled so as to facilitate the use of the device in a small wound. The blade is bounded on one side by a short beveled protuberance, and on the other side by a longer blunted protuberance. In one embodiment, a disposable carpal tunnel tome is provided. The surgical procedure utilizing the tome requires only a single small incision in the palm of the patient's hand adjacent the distal end of the transverse carpal ligament.

Abstract: A self-expanding endovascular stent formed of stainless steel wire which is bent into an elongated zigzag pattern. The zigzag pattern has a plurality of substantially straight wire sections of various lengths separating a plurality of bends. The zigzag pattern is helically wound about a central axis to define a tubular shape such that a majority of the bends are disposed in a helix. Adjacent bends in the helix are interconnected with a filament. The stent is capable of being radially compressed such that the straight wire sections and the bends are tightly packed around a central axis. The stent resiliently self-expands to assume a tubular shape when released from the compressed state. Depending on the pattern of the lengths of the straight wire sections in the zigzag pattern, the final tubular shape can be made irregular to match a patient's vascular system. In other words, the diameter of the tube which is defined by the stent can be made to vary along the length of the stent.

Abstract: The invention provides devices and method for performing extremely small-scale, minimally-invasive microsurgery such as thoracoscopic coronary artery bypass grafting. The instruments of the invention utilize a symmetrical, forcep-like actuator which provides extremely precise actuation and control of the instrument and which mimics the feel of instruments used in conventional open surgical procedures. The instruments generally include a pair of coaxially arranged shafts, an end-effector at the distal ends of the shafts, and an actuator at the proximal ends of the shafts. The actuator includes a pair of arms pivotally coupled to one of either the outer or inner shaft, and a pair of links pivotally coupled at one end to the arms, and at a second end to the other of the shafts. The links are coupled to a proximal portion of the arms to maximize mechanical advantage and reduce interference.

Abstract: A removeably attachable wrist band device for use in helping an addicted cigarette smoker permanently quit smoking. The device comprises an elastic section, a hook fastener section, a loop fastener section, and an acupressure stimulator. The device is placed on a user's wrist such that the acupressure stimulator is positioned proximal to the L-7 acupuncture point and the elastic section of the wrist band is positioned on top of the user's wrist. The elastic section of the wrist band is designed to limit the maximal energy that the user can transfer to a unit area of skin when the band is snapped against the wrist. This is so that snapping the wrist band will not be perceived as aversive to the user. The disclosed wrist band has the dual functions of providing a non-aversive behavioral modification device together with providing continuous and differential stimulation of the L-7 acupuncture point, which has therapeutic value in treatment of smoking addiction.

Abstract: An improved expandable removal element for an atherectomy device wherein the expandable removal element is movable between an expanded position and a contracted position. In one embodiment of the present invention, a drive shaft is operatively connected to the distal end of the expandable removal element for rotating the removal element. A catheter surrounds a portion of the drive shaft. The catheter is shiftable with respect to the drive shaft for moving the material removal element between the expanded position and the contracted position. In another embodiment of the present invention, dual coaxial drive shafts are employed. The inner drive shaft and the outer drive are shiftable with respect to one another for moving the removal element between the expanded position and the contracted position. The present invention also describes several embodiments of a removal element for increasing the durability and effectiveness of the removal element.

Abstract: A surgical instrument comprising a handle assembly with a detachable tool assembly is disclosed. The tool assembly comprises rotatable jaws having arc defining portions near their proximal ends which define arcs having arc centers displaced from the jaws. The jaws are coupled to the distal end of an inner rod which is longitudinally translatable within an outer sleeve. When the inner rod is translated, a guide member at the distal end of the outer sleeve contacts the arc defining portion of the jaws such that each jaw rotates about the center of its arc. The handle assembly comprises a trigger which engages a translation member on the inner rod. As the trigger is rotated, the translation member carries the inner rod back and forth to actuate the jaws. The translation member is coupled to the inner rod via a coupler having a spring which limits the closing force applied to the jaws.

Abstract: An ear piercing apparatus is disclosed which comprises a pistol (1) and a disposable cassette (20) mounted on said pistol, the pistol (1) having a body portion (10), a handgrip (11), a spring biased plunger (12) and means for releasing said plunger from a cocked state, with said disposable cassette (20) comprising a stud housing (22) positioned adjacent said body portion (10) for cooperation with said plunger (12) and a back clasp housing (23) cooperating with the stud housing (22) via a guide member (33) extending from the back clasp housing (23) and passing into the stud housing (22) for cooperation with positioning means controlled by a positioning lever (38) on said pistol (1) for relative axial displacement of the stud housing (22) and the back clasp housing (23).

Abstract: A reusable endoscopic surgical instrument includes a tool assembly and a detachable handle. The tool assembly consists of an outer sleeve to which a surgical jaw assembly such as scissors or graspers is mounted. An inner extension is mounted inside the sleeve and is longitudinally translatable with respect to the sleeve. When the distal end of the extension is in engagement with the jaws of the jaw assembly, translation of the extension causes the jaws to open and close. The extension can be translated out of engagement with the jaws to permit disassembly of the instrument for cleaning and changing jaw assemblies. The tool assembly is retained within the handle assembly. The sleeve is retained within the handle in a longitudinally stationary position with respect to the handle, while the extension is permitted to move longitudinally within the sleeve.

Abstract: Balloon dilatation catheter adapted to be utilized in connection with a guiding catheter and a guide wire. The catheter comprises a flexible elongate tubular member having proximal and distal extremities and having a lumen extending therethrough. An inflatable balloon is mounted on the distal extremity of the tubular member. The interior of the inflatable balloon is in communication with the lumen. A sleeve extends through the balloon and extends rearwardly from the balloon and alongside the lumen. The sleeve has a guidewire lumen extending therethrough. The guidewire lumen is adapted to receive a guide wire extending therethrough and extending rearwardly of the flexible elongate element into a region adjacent the proximal extremity of the proximal elongate element. The sleeve has a slit extending longitudinally of the same from the proximal extremity of the sleeve to a region adjacent the balloon permitting the guide wire to be removed therethrough.

Abstract: A surgical instrument for treatment in the body cavity, in which an open-close member for treatment is rockably mounted by of a pivot pin on the distal end portion of a sheath to be inserted into the body cavity, and is connected to the distal end of a rod passed through the sheath, by a cam mechanism including a cam groove and a cam pin in engagement therewith. As the rod is moved by an operating handle, the cam mechanism is activated to open and close the open-close member for treatment. The component members of the cam mechanism have external shapes such that those portions on the proximal end side of the position near the pivot pin do not project from the sheath in every operating state.

Abstract: A combination guarded surgical scalpel and blade stripper (200, 300) uses the sliding guard (202, 301) in cooperation with an ejector button (238, 311) to strip a (used) blade (224, 314) from the scalpel (200, 300) thereby avoiding manual contact with the blade (224, 314) and the problems associated therewith.

Abstract: An intravascular occlusion material removal device for removing vascular occlusion material in a vascular lumen comprises an expandable material removal element movable between an expanded position and a contracted position. The material removal element has a distal end and a proximal end. A drive shaft is operatively connected to the distal end of the expandable material removal element for rotating the removal element. A catheter surrounds a portion of the drive shaft. The catheter has a distal end for operatively variably contacting the proximal end of the material removal element such that the removal element is rotatable with respect to the catheter. The catheter is shiftable with respect to the drive shaft for moving the material removal element between the expanded position and the contracted position. A number of novel methods for removing vascular occlusion material are also provided.

Abstract: An end effector assembly for use with an endoscopic instrument includes a clevis and first and second end effectors. The clevis has curved channels extending from a distal portion of the clevis towards the proximal portion of the clevis means. Each channel has first and second inner curved walls. The end effectors each have proximally extending tangs with first and second curved surfaces. The tangs of the end effectors are respectively disposed in the channels of the clevis, and are guided by the channels such that when they are moved forward by a control member of the endoscopic instrument first curved surfaces of the tangs engage said first inner curved walls of the clevis to cause the end effectors to open. When the control member moves the end effectors back, the second curved surfaces of the tang engage the second inner curved walls of the clevis which cause the end effector to close.

Abstract: Self-venting balloon dilatation catheter having a flexible tubular member with first and second lumens extending therethrough. An inflatable balloon is carried by the distal extremity of the tubular member in such a manner so that the first lumen extends through the balloon and is out of communication with the interior of the balloon and the second lumen is in communication with the interior of the balloon. A venting device is disposed between the balloon and the tubular member for venting air from the interior of the balloon but inhibiting the escape of liquid from the balloon.