Abstract: A fastener for attaching a sheet-like implant to tissue or bone may be provided with a first arm having a proximal end and a distal end, a second arm having a proximal end and a distal end, and a bridge extending therebetween. Each of the first and second arms include a trunk portion defining at least a portion thereof, the trunk portion having a lateral extent larger than a lateral extent of the bridge or non-trunk portion of the arm adjacent thereto and can be mounted eccentrically to the bridge or non-trunk portion of the arm adjacent thereto such that the staple includes a first change in lateral stiffness disposed proximate the bridge or non-trunk portion of the arm abutment with the trunk. Fastener delivery devices and methods are also disclosed.

Abstract: An implantable tendon protection system includes a body adapted to be implanted within a bursa overlying a tendon of a patient to protect the tendon. The body may be fixed to the tendon with adhesive, sutures, staples, and/or anchors. A surgical kit is provided with such a tendon protection system and an insertion cannula. Methods of protecting a tendon of a patient are also disclosed.

Abstract: Devices for attaching a sheet-like implant to a target tissue include a sheath and a staple push rod. The sheath has a distal end configured to be pressed against the target tissue. The staple push rod is disposed within at least a portion of the sheath and is slidable relative thereto. The staple push rod includes a pair of stakes. Each stake is dimensioned to abut a surface of a staple to apply pushing forces thereto. The stakes are biased to assume a bow-like shape such that an intermediate portion of a staple extends tautly between the first stake and the second stake when the stakes are extending beyond the distal end of the tubular member. Methods for attaching a sheet-like implant to a target tissue are also disclosed.

Abstract: Implant delivery systems for delivering sheet-like implants include a delivery shaft, an implant expander, a sheath, and a sheet-like implant. In some embodiments, the delivery shaft has a proximal end and a distal end. The implant expander is mounted to the distal end of the delivery shaft. The implant expander includes a central portion and a plurality of leg portions radiating from the central portion. The implant expander is evertable between an unstressed configuration in which a distal surface of the implant expander defines a concave surface, and a first compact configuration in which the distal surface of the implant expander defines a convex surface. The implant expander has a first lateral extent when the implant expander is free to assume the unstressed configuration. The sheath defines a lumen having a lumen diameter. At least a portion of the delivery shaft is slidably disposed in the lumen.

Abstract: A device for attaching a sheet-like implant to a target tissue includes a pilot member and a staple push rod. In some embodiments, the pilot member has a distal end and at least a pair of prongs extending from the distal end. The prongs are configured to form pilot holes when the distal end of the pilot member is pressed against the target tissue. The staple push rod is disposed within at least a portion of the pilot member and slidable relative thereto. The staple push rod includes at least a pair of stakes. Each stake is dimensioned to engage a surface of a staple to apply pushing forces thereto. Each stake is positioned relative to a prong along an inner surface of the pilot member so that the stakes advance into the pilot holes when the stakes are moved in a distal direction.

Abstract: A staple for attaching a sheet-like implant to tissue or bone may, include first and second arms, and first and second flukes. In some embodiments, the first arm has a proximal end and a distal end, and the second arm has a proximal end and a distal end. A bridge extends from the proximal end of the first arm to the proximal end of the second arm. The first fluke has a proximal end abutting the distal end of the first arm, and the first fluke extends distally from the first arm. The first fluke has a lateral extent larger than a lateral extent of the first arm and is mounted eccentrically thereto. The first fluke includes a proximal surface projecting at an outward angle in a proximal direction away from the distal end of the first arm to engage the tissue or bone when inserted therein. The second fluke has similar features. This arrangement causes the first and second flukes to rotate in response to a pullout force on the bridge.

Abstract: A tendon repair implant delivery system and methods incorporating a guide member having a temporary fixation member on or adjacent to the distal end. The point of fixation defines a target site for placement of the tendon repair implant which is subsequently affixed to the tendon.

Abstract: An implantable tendon protection system includes a body adapted to be implanted within a bursa overlying a tendon of a patient to protect the tendon. The body may be fixed to the tendon with adhesive, sutures, staples, and/or anchors. A surgical kit is provided with such a tendon protection system and an insertion cannula. Methods of protecting a tendon of a patient are also disclosed.

Abstract: A method of inserting an ocular implant into a patient's eye, the ocular implant being mounted on a carrier, the method comprising: inserting a cannula into an anterior chamber of the eye; moving a distal exit port of the cannula into communication with Schlemm's canal; and advancing the ocular implant and carrier through an exit port of the cannula into Schlemm's canal. The invention also provides an ocular implant and delivery system comprising: a cannula comprising a distal exit port adapted to be inserted into a Schlemm's canal portion of an eye; an ocular implant; a carrier disposed within the implant and movable with the implant within the cannula; and a proximal control adapted to be operated from exterior to an eye to move at least one of the carrier and the implant when the distal exit port of the cannula is within the eye.

Abstract: A catheter system and method for intracranial infusion of therapeutic substances to a patient. An anchor formed of generally flexible, elastomeric material is used to mount the catheter to the outer surface of the skull of the patient. The anchor has a through hole for receiving the catheter, a channel, extending substantially from the through hole, into which a portion of the catheter may be inserted to retain the portion substantially parallel to the surface of the skull, and at least one flange for engaging the outer surface of the skull. An anchor clip may be provided to engage the anchor adjacent the through hole to further stabilize the catheter.

Abstract: Catheters for introducing fluids into a bodily lumen of a patient are disclosed. The fluids may include medicinal, imaging or other compounds. The catheters include a proximal tube, a core wire and a distal tube. The first end of the core wire is secured to the second end of the proximal tube. The core wire extends through the distal tube. A proximal lumen of the proximal tube is in communication with the distal lumen of the distal tube. A bridge tube may be provided between the proximal lumen and the distal lumen to facilitate communication of the proximal lumen and the distal lumen. The catheter may be configured with a relatively small diameter and low overall profile using aspects of the present inventions. The catheters may include a balloon at a distal end to receive the fluid. The fluid provided through the catheter may inflate the balloon. The catheter may include a distal outlet release a fluid into the patient.

Abstract: Occluding guidewires to access bodily lumen of a patient are disclosed. The occluding guidewires include a slotted tube and a balloon secured to a distal end of the slotted tube. The slotted tube includes a plurality of slots. The slots are in fluid communication with a lumen defined by the slotted tube. The balloon is secured about the slotted tube over one or more slots to permit inflation media to be communicated through one or more slots from the lumen into the inflation chamber of the balloon. The occluding guidewire may also include a proximal tube. A proximal lumen of the proximal tube is in communication with the lumen of the slotted tube. The occluding guidewire may be configured with a relatively small diameter using aspects of the present inventions.

Abstract: Balloon apparatus to access bodily lumen of a patient are disclosed. The balloon apparatus include an inflation tube, a core wire and a balloon. The balloon is secured to a distal end of the inflation tube and a core wire extending from the distal end of the inflation tube passes through a sleeve in the balloon. A proximal tube may be provided at the proximal end of the inflation tube. The balloon apparatus may be configured with a relatively small diameter using aspects of the present inventions.

Abstract: A catheter system and method for intracranial infusion of therapeutic substances to a patient. An anchor formed of generally flexible, elastomeric material is used to mount the catheter to the outer surface of the skull of the patient. The anchor has a through hole for receiving the catheter, a channel, extending substantially from the through hole, into which a portion of the catheter may be inserted to retain the portion substantially parallel to the surface of the skull, and at least one flange for engaging the outer surface of the skull. An anchor clip may be provided to engage the anchor adjacent the through hole to further stabilize the catheter.

Abstract: A catheter system and method for intracranial infusion of therapeutic substances to a patient. An anchor formed of generally flexible, elastomeric material is used to mount the catheter to the outer surface of the skull of the patient. The anchor has a through hole for receiving the catheter, a channel, extending substantially from the through hole, into which a portion of the catheter may be inserted to retain the portion substantially parallel to the surface of the skull, and at least one flange for engaging the outer surface of the skull. An anchor clip may be provided to engage the anchor adjacent the through hole to further stabilize the catheter.