Abstract: Apparatus for delivering stents to body lumens include one or more tubular prostheses carried at the distal end of a catheter shaft, a sheath slidably disposed over the prostheses, and a guidewire tube extending from within the sheath to the exterior of the sheath through an exit port in a sidewall thereof. A guidewire extends slidably through the guidewire tube. The sheath can be moved relative to the catheter shaft and the guidewire tube to expose the prostheses for deployment. Methods of delivering stents are also provided.

Abstract: Apparatus for delivering stents to body lumens include one or more tubular prostheses carried at the distal end of a catheter shaft, a sheath slidably disposed over the prostheses, and a guidewire tube extending from within the sheath to the exterior of the sheath through an exit port in a sidewall thereof. A guidewire extends slidably through the guidewire tube. The sheath can be moved relative to the catheter shaft and the guidewire tube to expose the prostheses for deployment. Methods of delivering stents are also provided.

Abstract: Described here are methods for forming one or more tracts in tissue. The tracts may be formed in any suitable or desirable tissue, and may seal relatively quickly without the need for a supplemental closure device. In some variations, the methods comprise advancing a tissue-locating member adjacent to a tissue wall, deforming at least a portion of the tissue wall with the tissue-locating member, and advancing a tissue-piercing member through the deformed tissue to form the tract, where the tract provides access for one or more tools. Also described here are methods of forming tracts through rotated or tented tissue. Any of the methods described here may also be used with tissue having at least one irregular surface.

Abstract: Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture.

Abstract: Described here are methods, devices and kits for locating tissue and/or forming one or more tracts in tissue. In some variations, tissue may be located (e.g., using one or more optical sensors, ultrasound sensors, thermal sensors, or the like) and one or more tracts may be formed through the tissue after it has been located. In certain variations, the same device may be used both to locate tissue and to form one or more tracts in the tissue. In some variations, a tissue-piercing member for forming one or more tracts in tissue may comprise a first elongated portion and a second elongated portion, and an angle therebetween.

Abstract: Tissue tract-forming devices, methods, and kits are disclosed. In some variations, a method for forming a tract in a tissue wall having an interior surface and an exterior surface may comprise advancing an anchor member through the tissue wall and into a lumen defined by the tissue wall, the anchor member comprising a proximal portion, a distal portion, and an intermediate portion therebetween, wherein the proximal and intermediate portions are angled with respect to each other and the intermediate and distal portions are angled with respect to each other, positioning the anchor member so that the intermediate portion contacts the interior surface of the tissue wall and the distal portion is angled toward the interior surface of the tissue wall, and advancing a tissue-piercing member into the tissue wall while the intermediate portion is in contact with the interior surface of the tissue wall, to form a tract in the tissue wall.

Abstract: Described here are methods for forming one or more tracts in tissue. The tracts may be formed in any suitable or desirable tissue, and may seal relatively quickly without the need for a supplemental closure device. In some variations, the methods comprise advancing a tissue-locating member adjacent to a tissue wall, deforming at least a portion of the tissue wall with the tissue-locating member, and advancing a tissue-piercing member through the deformed tissue to form the tract, where the tract provides access for one or more tools. Also described here are methods of forming tracts through rotated or tented tissue. Any of the methods described here may also be used with tissue having at least one irregular surface.

Abstract: Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture.

Abstract: A hemostatic agent delivery system, comprising: a suture, pledget or introducer sheath coated or impregnated with a hemostatic agent. A hemostatic agent delivery system, comprising: an introducer sheath; a flow blocking system positioned at the distal end of a deployment device; and a hemostatic agent injection system. A hemostatic agent delivery system, comprising: an introducer sheath; and (a) a plug delivery shaft positionable within the introducer sheath, the plug delivery shaft dimensioned to push hemostatic material in the introducer sheath to a location adjacent to a vessel wall, or (b) a delivery sleeve receivable over the introducer sheath, delivery sheath dimensioned to push a cuff of hemostatic material to a location adjacent to a vessel wall. The hemostatic agent may comprises chitosan.

Abstract: Devices, systems, and methods for suturing of body lumens allow the suturing of vascular puncture sites located at the distal end of a percutaneous tissue tract. An elongated articulated foot near a distal end of a shaft is inserted through the penetration and actuated so that the foot extends along the lumenal axis. The foot carries suturing attachment cuffs, and needles are advanced from the shaft through the vessel wall outside of the penetration and into engagement with the needle cuffs after the foot has been drawn proximally up against the endothelial surface of the blood vessel. The cross-section of the shaft within the tissue tract can be minimized by laterally deflecting the needles as they leave the shaft, while tapered depressions within the foot can guide the advancing needles into engagement with the cuffs. The cuffs lockingly engage the needles and can be withdrawn proximally along the needle paths and through the tissue tract so as to form a loop of suture across the puncture.

Abstract: An apparatus for ablating biological tissue having a deflectable ablation area including an elongated catheter having a distal end, a proximal end, and an elongated body portion. A plurality of optical fibers extend between the proximal and distal ends of the catheter. The distal ends of all of the plurality of optical fibers define an ablation area at the distal end of the catheter. The catheter includes a device for selectively deflecting the distal ends of all of the optical fibers so that at least a portion of the ablation area extends beyond an area defined by the cross-sectional area of the catheter while the amount of light energy over the entire ablation area remains constant.

Abstract: A fiber optic catheter has a short guide wire lumen (less than 10 cm) extending in a proximal direction from its distal end and an intermediate portion reinforced with a tapered mandrel which provides optimal steerability and trackability characteristics. The distal end of the mandrel is coextensive with a proximal portion of the guide wire lumen. The intermediate portion of the catheter may have a marker for visual identification, and the tip of the catheter may include a radiopaque tip marker band for fluoroscopic identification. The short guide wire lumen catheter provides superior flexibility, a low profile, and low-friction engagement with the guide wire.

Abstract: The present invention is a catheter with a twistable tip. The catheter having a flexible wall for use in complex twisting anatomy contains a torque wire or a torquable guide wire lumen. The torque wire or torquable guide wire lumen extends through the length of the catheter and is attached to the catheter at or near the distal end thereof. The distal face of the catheter is angled to self align the catheter with an obstruction upon insertion. The proximal end of the torque wire protrudes from the proximal end of the catheter and is attached to a turn limiter. Rotation of the turn limiter imparts a torque to the torque wire or torquable guide wire lumen which is transmitted through the catheter to the distal end of the catheter where the applied torque twists the distal tip to manually align the tip with an obstruction.

Abstract: A catheter having an outer wall of tubular shape, a cylindrical marker attached to the distal end of the catheter. The marker band includes markings for identifying the axial, rotational and yaw position of the catheter distal end when it is located in a body and viewed fluoroscopically.

Abstract: The present invention is a turn limiter for a catheter with a twistable tip. The catheter having a flexible wall for use in complex twisting anatomy contains a torque wire or a torquable guide wire lumen. The torque wire or torquable guide wire lumen extends through the length of the catheter and is attached to the catheter at or near the distal end thereof. The proximal end of the torque wire protrudes from the proximal end of the catheter and is attached to a turn limiter. Rotation of the turn limiter imparts a torque to the torque wire or torquable guide wire lumen. The turn limiter allows limited rotation of the proximal end of the torque wire or torquable guide wire lumen without axial dislocation. The turn limiter may have a feature for indicating the amount of torque applied to the torque element.

Abstract: A device for terminating a surgical apparatus such as a fiber optic catheter is disclosed. A fiber optic catheter having an outer body, an inner body disposed within the outer body to form an outer lumen therebetween and an inner lumen within the inner body, and optical fibers within the outer lumen is terminated at its distal end with a two-piece tip. An outer band of the tip has one end between the outer body and the optical fibers, while an inner band contacts the ends of the inner body and the optical fibers. The terminal faces of the optical fibers may be angled to increase the surface area illuminated or ablated by the fiber optic catheter. The inner and outer bands may be flared outwardly to increase the surface area affected even more. The inner body may also be extended beyond the terminal face to aid tracking of the catheter. The inner body and inner band may be eccentric to the outer body and outer band so that the catheter may be rotated to ablate a larger vascular area.