Abstract: The present invention provides for therapeutic treatment methods, devices, and systems for the partial or complete closure or occlusion of a patent foramen ovale (“PFO”). In particular, various methods, devices, and systems for joining or welding tissues, in order to therapeutically close a PFO are described. In yet another aspect of the invention, various methods, devices, and systems for the penetration of the interatrial septum enabling left atrial access are also provided.

Abstract: The intralumenal material removal system includes a cutter assembly positionable in the lumen of a mammalian subject and operably connected to system controls. The cutter assembly is axially advanceable by translating the drive shaft and rotatable by rotating the drive shaft. One cutter assembly comprises an adjustable cutter that is adjustable between a smaller diameter condition and a larger diameter condition by rotation of the drive shaft in opposite directions. The cutter may thus be introduced to and withdrawn from the material removal site in a retracted, smaller diameter condition that facilitates translation and navigation of the device through various lumens. The adjustable cutting assembly may be selectively expanded at the material removal site to facilitate cutting, removal and aspiration of the occlusive material. One composite cutter assembly comprises both a distal, fixed diameter cutter and a proximal adjustable diameter cutter.

Abstract: Intralumenal material removal systems are provided. The intralumenal material removal system includes a cutter assembly positionable in the lumen of a mammalian subject and operably connected to system controls. One composite cutter assembly comprises a distal, fixed diameter cutter and a proximal, adjustable diameter cutter, the cutter assembly being axially advanceable by translating the drive shaft and rotatable by rotating the drive shaft. The adjustable cutting assembly is adjustable between a smaller diameter condition and a larger diameter condition by rotation of the drive shaft in opposite directions. The cutter may thus be introduced to and withdrawn from the material removal site in a retracted, smaller diameter condition that facilitates translation and navigation of the device through various lumens. The adjustable cutting assembly may be selectively expanded at the material removal site to facilitate cutting, removal and aspiration of the occlusive material.

Abstract: An RF activated catheter apparatus for performing transmyocardial revascularization. The catheter apparatus including an elongate catheter shaft having proximal and distal ends, the distal end including an RF emitter which is coupled to an RF generator for cutting channels into the myocardium of a patient's heart.

Abstract: An improved system for removing thrombus from blood vessels comprising a catheter shaft having proximal and distal ends, designed to be advanced through a hemostasis valve and guide catheter and over a guidewire for placement of its distal end at a point proximal to a thrombus, the catheter shaft defining at least one longitudinally-extending lumen, the catheter having a guidewire retainer which retains the guidewire within the catheter in a peripheral or non-centered part of the catheter cross-section, the distal tip of the catheter being angled back from the guidewire retainer to allow the catheter to follow the guidewire around tight bends and across restrictions easily; a suction device in fluid communication with the proximal end of the catheter for providing vacuum down the catheter lumen to the distal tip, for drawing thrombus into the lumen; and the lumen terminating in an angled tip at the distal end, the angled tip improving the removal of thrombus adhering to the vessel wall and reducing clogging o

Abstract: An apparatus and method for use in performing ablation of organs and other tissue includes an electrode carrying member which is substantially absorbent and/or permeable to moisture. The electrode carrying member is mounted to the distal end of an elongate shaft, and an array of electrodes is mounted to the surface of the electrode carrying member. Following placement of the ablation device into contact with the tissue to be ablated, an RF generator is used to deliver RF energy to the electrodes and to thereby induce current flow from the electrodes to tissue to be ablated. As the current heats the tissue, moisture (such as water vapor or liquid) leaves the tissue causing the tissue to dehydrate. The moisture permeability and/or absorbency of the electrode carrying member allows the moisture to leave the ablation site so as to prevent the moisture from providing a path of conductivity for the current.

Abstract: The invention is an apparatus for breaking up a thrombus by introducing a tating core wire into the thrombus whereby the fibrin of the thrombus will be withdrawn from the thrombus into the rotating core wire, thereby breaking up the network of the thrombus which prevents blood flow. The apparatus includes a drive shaft housing which can be used to withdraw fluid from the area of the thrombus or to introduce medicines, such as streptokinase which will further break up the thrombus or other chemicals such as contrast agents for visualizing the vascular anatomy. The apparatus also includes a shaft housing which is provided with an expanded catheter funnel at the distal end and a venturi insert immediately proximal to the distal end. The apparatus further includes a prime mover which, in addition to rotating the drive shaft, allows for axial motion of the drive shaft relative to the drive shaft housing.

Abstract: A rotational ablation device for use in medical applications which are designed to reduce lesions, particularly vein-graft lesions, within blood vessels, the device includes a distal balloon located at the end of a guide wire, a proximal balloon having a cuff surrounding a guide catheter, an inflation lumen for use in inflating a distal balloon on the guide catheter, one or more rotating burrs used in conjunction with a helical drive system surrounding the guidewire; a suction system to remove ablated lesion material; and a control console to provide for the necessary control of the various systems of the device.

Abstract: The invention relates to an RF-activated guidewire to electrosurgically pass through occlusive material to allow the use of other vescular therapeutic devices to traverse the guidewire through the occlusive material. More particularly, the invention relates to a catheter system for penetrating occulsive tissue in an arterial lumen, comprising:a substantially tubular sheath means;an electrically conductive guidewire, said guidewire having an electrosurgical tip and passing through said sheath means; anda voltage generating means electrically connected to said electrically conductive guidewire to activate said electrosurgical tip.

Abstract: The present invention is a clinically practical, rotational angioplasty system which employs a unique rotary ablative device for mechanically abrading, and thereby removing, lesions from within a patient's vessels. The device has a gas driven prime mover connected, via a hollow helical drive assembly, to an ellipsoidal, rotating, ablative burr which is used for the actual recanalization of the patient's vessel. The burr is provided with a central opening therethrough, which, together with the hollow drive assembly, permits the burr and drive assembly to be threaded over a guide wire similar to the type conventionally used in a catheterization procedure. The drive assembly is located within a hollow sheath which prevents the rotating drive assembly from contacting the inner walls of a patient's vessel.

Abstract: An abrasive tipped rotating cutting tool for use in removing abnormal deposits within a patient's vessels is described. The tip is preferably covered with a material such as diamond grit, and rotated at high speed to pulverize any abnormal deposits contained within the vessel.In a preferred embodiment of the invention, the tip is ellipsoidal in shape, and the coarseness of the abrasive material on the tip is varied from most coarse adjacent the distal end of the tip to finest adjacent the portion of the tip which has the widest diameter. Preferably, there is no abrasive on the widest part of the tip in order to prevent the tip from injuring a patient's vessel in the event that the tip is allowed to remain in one place for an extended period of time. In addition, there may be radial openings formed in the tip which permit water to be pumped therethrough in order to act as a lubricant for assisting in the cutting action of the tip.

Abstract: The guidewire gripping device is usable in connection with guidewires of the type used in medical application, i.e., for guiding catheters. The guidewire gripping device is constructed from a spring loaded, slitted cylindrical body.

Abstract: A thermal cautery system having an endoscopically deliverable probe connected to a power supply and display unit. The power supply and display unit, when triggered by a footswitch, energizes a voltage regulator having a current limited output that supplies power to the probe. The current limiting function of the voltage regulator is disabled for a predetermined period that power is initially applied to said probe to minimize the heating time of said probe. The current through said probe is sensed and used to increase the voltage at the output of the voltage regulator as the current increases to compensate for the voltage drop in the conductors connecting the probe to the power supply. A manually selected portion of the sensed current through the probe is also integrated and used to terminate the flow of current through the probe when the integral of the current with respect to time has reached a predetermined value.

Abstract: The invention is an apparatus for breaking up a thrombus by introducing a rotating drive shaft into the thrombus whereby the fibrin of the thrombus will be withdrawn from the thrombus onto the rotating drive shaft, thereby breaking up the network of the thrombus which prevents blood flow. The apparatus includes a drive shaft housing which can be used to withdraw fluid from the area of the thrombus or to introduce medicines, such as streptokinase which will further break up the thrombus or other chemicals such as contrast agents for visualizing the vascular anatomy.

Abstract: A miniaturized, endoscopically deliverable thermal cautery probe for cauterizing internal vessels. The probe is applied to tissues cold, and a large number of electric heating pulses of equal energy are then applied to an internal heating element in the probe. The probe has an internal heating element in direct thermal contact with an active heat-transfer portion that has a low heat capacity to insure quick heating and subsequent cooling, thereby adequately coagulating tissue while minimizing heat penetration and resulting tissue damage. The electrical power applied to the probe is continuously measured and is terminated when the energy delivered reaches a preset value. The number of such pulses applied to the probe (and hence the total energy delivered) may be preset while the duration of the period during which the pulses were applied is displayed.

Abstract: The present invention is a pump apparatus which is adapted to move liquids which contain debris. The apparatus is adapted to operate by alternating suction and pressure, whereby any debris which becomes lodged in any orifices or conduits in the system is effectively dislodged as a consequence of the normal operation of the system.The push-pull material transport system of the present invention includes a conduit to transport fluid from a first location to another location. The invention includes a peristaltic pump which has two heads. The first head pumps fluid from the first location to the second location, and the second head intermittently and periodically pumps fluid in the reverse direction in order to keep the conduit clear of debris.

Abstract: A multipolar electrosurgical device is described for use in neurosurgery or through the channel of an endoscope or other precision surgery procedures. The device is formed with an insulative probe body, which, in the described embodiment, is sized to pass through a channel of an endoscope to enable the electrocoagulation of blood vessels such as may be needed in the treatment of a gastrointestinal ulcer. The probe body is provided with electrically separate conductors which are formed of a plurality of electrodes distributed over the peripheral surface of the probe body. The electrically separate conductors are so sized in width W and spaced from each other by a distance S as to establish a ratio of W:S which enables effective bipolar treatment of tissue independent of probe body orientation relative to the tissue and without sticking of the probe body to coagulated material.

Abstract: A non-sticking electrocautery system having bipolar electrocautery forceps connected to an RF signal generator. The forceps includes a pair of electrically conductive arms movable toward and away from each other. The arms terminate in respective jaws which are adapted to grasp tissue to be cauterized. The arms have a thermal conductivity sufficiently high to remove heat from the jaws at a rapid rate. As a result, the surfaces of the jaws that are in contact with the tissue are maintained at a temperature sufficiently low to prevent the tissue from sticking to the jaws. The forceps also include an insulating stop for preventing the jaws from contacting each other. The forceps also include an internal switch which causes the RF signal generator to apply RF power to the forceps when the arms of the forceps are closed. The RF signal from the signal generator has a relatively low voltage so that sparking does not occur from the jaws to either each other or to the tissue.

Abstract: A miniaturized, endoscopically deliverable thermal cautery probe for cauterizing internal vessels. The probe is applied to tissues cold, and a large number of electric heating pulses of equal energy are then applied to an internal heating element in the probe. The probe has an internal heating element in direct thermal contact with an active heat-transfer portion that has a low heat capacity to insure quick heating and subsequent cooling, thereby adequately coagulating tissue while minimizing heat penetration and resulting tissue damage. The electrical power applied to the probe is continuously measured and is terminated when the energy delivered reaches a preset value. The number of such pulses applied to the probe (and hence the total energy delivered) may be preset while the duration of the period during which the pulses were applied is displayed.

Abstract: A device for safe removal of abnormal deposits, primarily in the human body, where differential cutting properties provide for fracture of hard matter while safely preserving soft tissue. The device includes a rotating cutting tool having spirally shaped cutting flutes having hardness-differential cutting properties. The tool is driven from outside the body by means of a flexible drive shaft at greater than 2000 revolutions per minute. A channel is incorporated in the drive shaft for adding or removing chemical matter from the internal body space to provide systematic removal of cutting debris from abnormal deposits. The cutting tool has fluid ports which communicate with the drive shaft channel. The fluid ports may be at the nose of the tool as well as around its cicumference. In the latter instance, the ports extend from in front of a cutting flute into a center cavity with a circumferential component so that rotation tends to force blood into these ports.