Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: An access tube is used for accessing an anatomic space, such as a pericardial space between the parietal and visceral pericardia. The access tube is advanced against the parietal pericardium and an anchor structure thereon embedded into the parietal pericardium. The access tube can then be used to separate the parietal and visceral pericardia and enlarge the pericardial space. After such enlargement, a needle or other access device can be introduced through the access tube into the pericardial space to provide access for a wide variety of purposes, including aspiration, infusion, and guidewire placement.

Abstract: An access tube is used for accessing an anatomic space, such as a pericardial space between the parietal and visceral pericardia. The access tube is advanced against the parietal pericardium and an anchor structure thereon embedded into the parietal pericardium. The access tube can then be used to separate the parietal and visceral pericardia and enlarge the pericardial space. After such enlargement, a needle or other access device can be introduced through the access tube into the pericardial space to provide access for a wide variety of purposes, including aspiration, infusion, and guidewire placement.

Abstract: Methods and apparatus for closing a left atrial appendage are described. The methods rely on introducing a closure tool from a location beneath the rib cage, over an epicardial surface, and to the exterior of the left atrial appendage. The closure device may then be used to close the left atrial appendage, preferably at its base, by any one of a variety of techniques. A specific technique using graspers and a closing loop is illustrated.

Abstract: Implantable systems for controlling flow through body lumens comprise a control module and an actuator. The actuator is implanted at least partially over the body lumen to selectively constrict the lumen and control flow therethrough. The control module includes at least a power source for operating the actuator and a remotely operated switch for controlling the power source. Usually, the control module will have programmable circuitry for adjusting on/off time, degree of closure, and the like. The switch of the control module is remotely actuated by a magnetic or other signal. The control circuitry may be remotely programmed using a hand-held programmer.

Abstract: Angiogenesis in cardiac and other tissues is promoted by the transmural delivery of angiogenic factors such as VEGF, FGF, EGF, and PDGF, through blood vessels and other body lumens into the surrounding tissue. Usually, the angiogenic factor is delivered using a catheter having infusion parts at its distal end. Optionally, the distal end of the catheter is radially expanded to engage the infusion parts directly against the blood vessel wall.

Abstract: Sleeve catheters having an interactive device near their distal ends are provided for introduction while disposed over conventional interventional and imaging catheters. Exemplary interactive devices on the sleeve catheters include ultrasonic imaging arrays, drug delivery lumens, and the like. The sleeve catheters are most commonly used with angioplasty catheters, stent placement catheters, atherectomy catheters, and the like.

Abstract: The invention provides methods and devices for delivering low level radiation to inhibit neointimal hyperplasia following angioplasty or other intravascular procedures. In an exemplary method, a balloon is inflated within a stenosed region of a blood vessel to produce a treated region. The balloon is then deflated and a radioactive source within a sleeve is aligned over the deflated balloon. The balloon is again inflated at the treated region to engage the sleeve having the radioactive source against the blood vessel within the treated region for from 1 to 40 minutes to deliver a sufficient dosage of radiation to inhibit neointimal hyperplasia.

Abstract: The catheter system comprises a balloon catheter having a removable hub. The hub is removed to permit loading of a sleeve catheter over the proximal end of the balloon catheter. The removable hub includes both a circumferential seal for preventing leakage of inflation medium from the hub and a mechanical interlock for axially securing the hub to the balloon catheter.

Abstract: A catheter for use in combination with a balloon angioplasty catheter for delivering stents and other intraluminal prostheses comprises a tubular catheter body having a radially expansible portion. The stent is disposed over the radially expansible portion, and structure is provided for retaining the stent on the tubular body prior to deployment. The retaining structure may be active, i.e., requiring the user to retract retaining elements, such as axial members, sheaths, or the like. Alternatively, the retaining structure may be passive, wherein balloon expansion results in release of the prosthesis from the retaining structure. Particular methods for fluoroscopically positioning stents using such delivery catheters, for delivering two or more stents using such delivery catheters, and for overexpanding the ends of the stents for anchoring them in place, are also described.

Abstract: Restenosis in recanalized blood vessels is inhibited by delivering tissue factor pathway inhibitor (TFPI) intramurally at a target site within the blood vessel. Usually, TFPI is delivered using a catheter having infusion ports at its distal end. Optionally at the distal end of the catheter is radially expanded to engage the infusion ports directly against the blood vessel wall.

Abstract: An intravascular catheter provides means for infusing an agent into a treatment site in a body lumen and means for deploying the infusing means adjacent the treatment site which operate independently of one another. In a first embodiment, a flexible catheter body has an expansion member attached to its distal end in communication with an inflation passage, and an infusion array disposed about the expansion member in communication with one or more delivery passages. In a second embodiment, the infusion array is a separate component and slidably received over the expansion member, which may be a balloon dilatation catheter. In both embodiments, the infusion array includes a plurality of delivery conduits having laterally oriented orifices. The delivery conduits may be extended radially from the catheter body to contact a treatment site by expanding the expansion member with an inflation fluid.

Abstract: Type-A (operational) and type-B (non-operational) syringes (2A, 2B), used for double-blind clinical tests, are constructed so the type-B syringe mimics the operation of the type-A syringe while avoiding the delivery of anything into the patient. Each syringe includes an injector (4), a fluid connector (12) coupling the exit port (10) of the injector to a discharge port (14) to which a catheter or needle cannula is connected, a valve (18) positioned along the fluid connector, and a dumping reservoir (24) mounted to the valve. The type-A valve fluidly couples the exit port to the discharge port in both purging and infusion positions. The type-B valve couples the exit port to the discharge port in the purging position, but couples the exit port to the dumping reservoir in the infusion position. The infusate is directed through the catheter and into the patient when in the infusion position with the type-A valve but is directed into the dumping reservoir with the type-B valve.

Abstract: An intravascular catheter provides means for infusing an agent into a treatment site in a body lumen and means for deploying the infusing means adjacent the treatment site which operate independently of one another. In a first embodiment, a flexible catheter body has an expansion member attached to its distal end in communication with an inflation passage, and an infusion array disposed about the expansion member in communication with one or more delivery passages. In a second embodiment, the infusion array is a separate component and slidably received over the expansion member, which may be a balloon dilatation catheter. In both embodiments, the infusion array includes a plurality of delivery conduits having laterally oriented orifices. The delivery conduits may be extended radially from the catheter body to contact a treatment site by expanding the expansion member with an inflation fluid.

Abstract: A catheter sleeve includes a radially expansible distal region having a plurality of axial blood perfusion lumens or channels formed thereon. The catheter sleeve may be introduced over a conventional angioplasty balloon catheter with the expansible region lying over the balloon. When the balloon of the angioplasty catheter is expanded, the perfusion lumens will provide a flow path for blood around the expanded balloon. Optionally, the catheter sleeve may further include drug infusion lumens over the radially expansible region. In this way, drugs can be delivered over prolonged periods while the underlying angioplasty balloon is inflated and blood flows through the lumens or channels to perfuse the distal myocardium.

Abstract: Sleeve catheters having an interactive device near their distal ends are provided for introduction while disposed over conventional interventional and imaging catheters. Exemplary interactive devices on the sleeve catheters include ultrasonic imaging arrays, drug delivery lumens, and the like. The sleeve catheters are most commonly used with angioplasty catheters, stent placement catheters, atherectomy catheters, and the like.

Abstract: A multi-function proximal end adapter (70, 86, 100) for a catheter (22) includes a hollow body (6) defining an axial lumen (8) extending between its proximal and distal ends (12, 10). An annular radially compressible seal (48) is positioned within the body along the axial lumen. A seal driver (58) is threadably mounted to the body and has a hollow extension (60) with a distal end adapted to axially compress the seal causing a radially inward deflection of the seal when the seal driver is threaded onto the body thereby providing a good seal against and securement for an object (such as a catheter or guide wire) passing through the axial lumen of the body. At least a portion of the proximal end of the axial lumen is defined by an internal tapered surface (36) sized to matingly and sealingly engage an external tapered surface (44) of a Luer lock connector (40) after the seal driver has been removed from the proximal end of the body.

Abstract: The present invention relates generally to stents having delivery matrices which provide for the controlled release of bioactive substances. The delivery matrices comprise porous and erodible filaments, and multiple filaments may be employed in order to release different bioactive substances and/or the same bioactive substance at different delivery rates. The stents are particularly useful for preventing restenosis of dilated body lumens, such as blood vessels. Methods for preventing stenosis of dilated body lumens or locally delivering bioactive compounds to tissue are also provided.