Abstract: Embolic protection elements are integrated with a catheter or access sheath for any catheter. A catheter with an integrated embolic protection element comprises a catheter shaft, an embolic filter slidably mounted on a distal portion of the shaft, a proximal stop for limiting the proximal movement of the embolic filter, and a distal stop for limiting the distal movement of the embolic filter. The filter comprises a porous mesh material defining a collection chamber for captured emboli and has a collapsed and a deployed configuration. The filter may be collapsed by an access sheath used with the catheter. An access sheath may comprise a tubular main body and an embolic filter mounted on the distal portion of the tubular main body. The embolic filter may evert into the central lumen of the sheath or may be constrained on the exterior of the sheath with a larger diameter outer tube.

Abstract: Scar formation is inhibited by simultaneously applying a vertical force and a lateral compression to the wound site during the healing process. Apparatus for applying such simultaneous forces can include a backing and a tissue displacement device. The backing holds the tissue displacement device over the wound. The tissue displacement device may be expanded to both apply the vertical force against the wound and to draw the backing radially or laterally inward to apply the desired compression forces to the wound.

Abstract: Devices, methods, and systems for treating an ulcer or skin defect are disclosed. First and second base panels of a closure device are adhered to first and second sides of the ulcer or skin defect, respectively. Lateral ties couple the first and second base panels together and provide a predetermined separation distance or lateral gap between the inner edges of the panel. The predetermined separation distance or lateral gap is sufficient to treat the most common sized ulcers or skin defects, for example, accommodating an ulcer or skin defect with a minor axis of at most 50 mm. The lateral ties have their ends fixed to one panel and their opposite ends adjustably and reversibly attached to the other panel so that the separation distance can be reduced or adjusted to provide a lateral compressive force to the ulcer or skin defect, thereby promoting healing.

Abstract: A system for controlling movement of a remotely controlled steerable instrument may comprise a flexible instrument comprising a steerable portion configured to articulate to change a shape of the steerable portion. The system may also comprise a shape sensing device comprising a first resistance-changing flexible sensor. The first resistance-changing flexible sensor may be configured to generate a signal indicative of a first bend change in the steerable portion. The system may also comprise a controller in signal communication with the first resistance-changing flexible sensor. The controller may be logically coupled to the flexible instrument and is configured to output a control signal to articulate the steerable portion of the flexible instrument in response to receiving at least the signal from the first resistance-changing flexible sensor.

Abstract: Intravenous access is achieved by introducing a catheter over an access needle which is initially present in the catheter. A tapered dilating element is positioned over the needle and provides a transition between the needle and a larger catheter lumen.

Abstract: A wound dressing for use with a closure device is disclosed. The first and second base panels of the closure device are positioned on opposite lateral sides of a wound or incision. The base panels are coupled together to maintain wound or incision closure. A release liner is removed from a bottom surface of the wound dressing. The wound dressing is positioned over the closure device and the wound or incision. Exudate is absorbed by an absorbent material of the wound dressing through a porous strip of the wound dressing. The wound dressing is slightly larger than the closure device so that its perimeter area is adhered to the skin area around the closure device. Alternatively or in combination, the wound dressing is lightly adhered to the closure device and wound or incision area so that it can be removed without harming the underlying device and tissues.

Abstract: Methods and apparatus for accessing and treating regions of the body are disclosed herein. Using an endoscopic device having an automatically controllable proximal portion and a selectively steerable distal portion, the device generally may be advanced into the body through an opening. The distal portion is selectively steered to assume a selected curve along a desired path within the body which avoids contact with tissue while the proximal portion is automatically controlled to assume the selected curve of the distal portion. The endoscopic device can then be used for accessing various regions of the body which are typically difficult to access and treat through conventional surgical techniques because the device is unconstrained by “straight-line” requirements. Various applications can include accessing regions of the brain, thoracic cavity, including regions within the heart, peritoneal cavity, etc., which are difficult to reach using conventional surgical procedures.

Abstract: The embolic protection device (10) has an expandable tubular structure supporting a filter mesh material (12). The embolic protection device is compressed to a small diameter for insertion into a patient's aorta, then expanded within the aorta with the filter mesh material positioned to allow blood to enter sidebranch vessels connected to the aorta and to prevent embolic material from entering the sidebranch vessels. The filter mesh material may be configured with waves or undulations (26) for increased surface area and/or with two layers of mesh material to provide additional protection against embolization and to prevent inadvertent occlusion of the sidebranch vessels.

Abstract: A method for treating a patient using a catheter insertion device. The catheter insertion device includes a housing, a needle, a catheter, a guidewire, and an actuator mechanism. The needle is attached to a needle carrier, the catheter is positioned coaxially around the needle such that a distal end of the needle extends distal of a distal end of the catheter, and the guidewire has a distal end positioned in a lumen of the needle. The method includes holding the catheter insertion device, inserting the distal end of the needle and catheter into a blood vessel, advancing the distal end of the guidewire out of the lumen of the needle into the blood vessel, moving the catheter over the guidewire in the blood vessel, and activating the actuator mechanism to simultaneously retract the distal end of the needle and the distal end of the guidewire into the housing.

Abstract: A treatment system delivers a breathing gas and frozen ice or other particles (FSP) to a bronchus of a lung of a patient in order to induce hypothermia. The breathing gas and the FSP are usually delivered through separate lumens. Clogging of an FSP lumen can be inhibited by heating and/or cooling of the lumen. The temperature of exhaled gases or a body temperature may be measured, and a controller can adjust the duration or rate at which the ice particles are delivered in order to control the patient's core temperature based on the measured temperature.

Abstract: A catheter insertion device includes a housing, a needle, a guide wire, and a catheter disposed coaxially over the needle. The needle has a proximal end in the housing and a distal end extending from a distal end of the housing in an insertion position. The guide wire has a distal portion disposed in a lumen of the needle in a withdrawn position. The guide wire may include a safety tip having a non-coiled configuration in the withdrawn position and a coiled configuration in an advanced position. The catheter insertion device may include a sliding member attached to the guide wire, wherein movement of the sliding member translates the guide wire from the withdrawn position to the advanced position.

Abstract: Apparatuses (devices, systems) and methods for shielding (protecting) surroundings around periphery of regions of interest located inside objects (e.g., patients) from radiation emitted by X-ray systems towards the objects. Apparatus includes: at least one radiation shield assembly including a support base connectable to an X-ray system radiation source or detector, and a plurality of radiation shield segments sequentially positioned relative to the support base, thereby forming a contiguous radiopaque screen configured for spanning around the region of interest periphery with a radiopaque screen edge opposing the object. Radiation shield segments are individually, actively controllable to extend or contract to selected lengths with respective free ends in directions away from or towards the support base(s), for locally changing contour of the radiopaque screen edge.

Abstract: A treatment system delivers a breathing gas and frozen ice or other particles (FSP) to a bronchus of a lung of a patient in order to induce hypothermia. The breathing gas and the FSP are usually delivered through separate lumens. Clogging of an FSP lumen can be inhibited by heating and/or cooling of the lumen. The temperature of exhaled gases or a body temperature may be measured, and a controller can adjust the duration or rate at which the ice particles are delivered in order to control the patient's core temperature based on the measured temperature.

Abstract: Systems, devices, and methods for post-surgical joint range of motion measurement, activity monitoring, as well as monitoring compliance with post-operative extremity elevation and cooling recommendations are provided. The system comprises sensor(s) to be attached adjacent a joint of the patient, with limb attachment element(s), applications running on a computing device of the patient and medical practitioner, and a cloud-based backend system.

Abstract: A wound or incision closure apparatus comprises a first and second panel. Each of the panels comprises a bottom adhesive layer, a medial substrate layer, and an upper load distribution layer which connect the two panels. A sensory or therapeutic element is disposed adjacent, within, or between two or more of the layers. The sensory or therapeutic element can provide sensing and/or therapy for the incision and/or monitor the incision so that the therapy can be customized and updated.

Abstract: A system may comprise an instrument with an elongate body portion to be moved along a path, one or more datums, and a plurality of sense elements disposed at positions spaced along a length of the elongate body portion. Each sense element may sense or be sensed by one of the datums when in proximity to the datum. The system may also include a processor configured to compare signals transmitted from the datums or from the sense elements, including a first signal and a second signal, and identify, based on the comparison, a state of motion of the elongate body chosen from a state of motion in a forward direction (insertion) along a path and a state of motion in a rearward direction (withdrawal) along the path. The processor may identify the state of motion of the elongate body based on whether the first signal is lower than or higher than the second signal and whether the first and second signals are both increasing or decreasing.

Abstract: An embolic protection device for use in a patient's blood vessel, such as the aorta, has an approximately cylindrical outer structure made of a filter mesh material and an approximately conical inner structure also made of a filter mesh material. On the downstream end of the embolic protection device, the wider end of the conical inner structure is joined to the cylindrical outer structure. The upstream end of the embolic protection device is open for blood to flow between the conical inner structure and the cylindrical outer structure. The space between the conical inner structure and the cylindrical outer structure defines a collection chamber for captured emboli. The narrow upstream end of the conical inner structure has a catheter port with a resilient seal that is sized for passage of a catheter shaft. The filter mesh material may be self-supporting or it may be supported on a resilient-framework or an inflatable framework.

Abstract: Systems, devices, and methods for post-surgical joint range of motion measurement, activity monitoring, as well as monitoring compliance with post-operative extremity elevation and cooling recommendations are provided. The system comprises sensor(s) to be attached adjacent a joint of the patient, with limb attachment element(s), applications running on a computing device of the patient and medical practitioner, and a cloud-based backend system.

Abstract: A method may comprise storing a first waypoint corresponding to a first position of a tip of a steerable medical device including an articulatable segment. The controller may perform a motion pause check operation to determine that an insertion motion of the articulatable segment into a patient anatomy has been paused, while the tip is at a second position. The controller may determine that the articulatable segment has resumed the insertion motion into the patient anatomy. After determining that the articulatable segment has resumed the insertion motion, a second waypoint corresponding to the second position of the tip of the steerable medical device, may be stored. A boundary region may be defined to form a three-dimensional volume enclosing the positions of the stored waypoints. The articulatable segment may be constrained to remain within the boundary region as the articulatable segment is inserted in the patient anatomy.

Abstract: A catheter insertion device includes a housing, a needle, a guide wire, and a catheter disposed coaxially over the needle. The needle has a proximal end in the housing and a distal end extending from a distal end of the housing in an insertion position. The guide wire has a distal portion disposed in a lumen of the needle in a withdrawn position. The guide wire may include a safety tip having a non-coiled configuration in the withdrawn position and a coiled configuration in an advanced position. The catheter insertion device may include a sliding member attached to the guide wire, wherein movement of the sliding member translates the guide wire from the withdrawn position to the advanced position.