Abstract: A system, apparatus, and method of using the same are disclosed for carrying out a transvascular procedure such as a Transjugular Intrahepatic Portosystemic Shunt (TIPS) procedure using energy to create a tract between the hepatic vein and the portal vein. The present invention provides a flexible puncturing solution to effectively perform a transvascular procedure such as a TIPS procedure while minimizing damage to the liver and surrounding soft tissues or organs.

Abstract: A method and apparatus are disclosed for providing forward fluid delivery through an electrosurgical device, while avoiding coring when energy is delivered to the electrosurgical device. The device has a distal face defining an opening, with the distal face including at least one cutting portion and at least one non-cutting portion. An embodiment of the electrosurgical device for puncturing tissue includes an elongate member defining a lumen for receiving a fluid; a distal face defining at least one aperture; and the distal face including at least one cutting portion and at least one non-cutting portion cooperating to produce an elongated cut in a tissue when electrical energy is delivered to the distal face while avoiding coring of the tissue.

Abstract: An electrosurgical device and methods are disclosed for creating a channel through a region of tissue. The device comprises an elongate member for receiving the energy from an electrical energy source. An electrical insulation layer surrounds the elongate member along the device proximal region. An electrode tip is coupled to the distal end of the elongate member for delivering the energy, the electrode tip being configured and sized for delivering the energy in a manner such that electrical arcing is generated in the region of tissue in order to create a channel through at least a portion of the region of tissue. An electrically insulative thermal shield is disposed between the electrode tip and the device proximal region for preventing arcing therebetween during the delivery of the energy and for thermally protecting the device proximal region from heat produced by the delivery of the energy through the electrode tip.

Abstract: A steerable catheter control handle and method are provided for bi-directional control of a steerable catheter, the catheter including at least two control wires, a distal end of each of the control wires being coupled to the catheter at a distal region thereof. The control system comprises a housing. A wire actuation mechanism is disposed within the housing and is operably coupled to at least two control wires for enabling actuation of the at least two control wires. The steerable catheter control handle additionally comprises a proximal control knob that is operably coupled to the wire actuation mechanism to enable actuation of the at least two control wires. The control knob is positioned proximal to the wire actuation mechanism to enhance ease of use of the steerable catheter control handle. The rotation of the proximal knob causes movement of the wire actuation mechanism within the housing for tensioning one of the at least two control wires for causing a distal end deflection of the steerable catheter.

Abstract: A method and apparatus are disclosed for a catheter having a side-port through which a wire may be advanced. The catheter comprises a catheter body, the catheter body defining at least a primary catheter lumen and at least one side-port in communication with the primary catheter lumen, and a distal portion of the catheter extending distal to the at least one side-port, the side-port being configured to allow travel of a wire or other component therethrough, wherein the distal portion of the catheter is radially collapsible.

Abstract: A processing system includes a program processor for executing a program, and a dedicated processor for executing operations of a particular type (e.g. vector processing operations). The program processor uses an interfacing module and a group of two or more register banks to offload operations of the particular type to the dedicated processor for execution thereon. Whilst the dedicated processor is accessing one register bank for executing a current operation, the interfacing module can concurrently load data for a subsequent operation into a different one of the register banks. The use of multiple register banks allows the dedicated processor to spend a greater proportion of its time executing operations.

Abstract: A logging unit is used to log entries for events in a computer system. Each entry includes an n-bit timestamp field and a payload. The payload includes information about the event and the timestamp field includes the n least significant bits of an N-bit timestamp for the event, where N>n. If the n least significant bits of the timestamp have wrapped compared to the corresponding n bits of the timestamp of the preceding entry then a timing entry is logged which includes other bits of the timestamp. Therefore, an N-bit timestamp can be determined for an event, but only the n least significant bits of the timestamp are stored in the timestamp field of an entry for the event. Therefore, the time flow of events in the store is better maintained (by having a larger timestamp) without increasing the number of bits (n) in the timestamp field of each entry.

Abstract: A SIMD processing module is provided, comprising multiple vector processing units (“VUs”), which can be used to execute an instruction on respective parts (or “subvectors”) within a vector. A control unit determines a vector position indication for each of the VUs to indicate which part of the vector that VU is to execute the instruction on. Therefore, the vector is conceptually divided into subvectors with the respective VUs executing the instruction on the respective subvectors in parallel. Each VU can then execute the instruction as intended, but only on a subsection of the whole vector. This allows an instruction that is written for execution on an n-way VU to be executed by multiple n-way VUs, each starting at different points of the vector, such that the instruction can be executed on more than n of the data items of the vector in parallel.

Abstract: Methods and apparatus are disclosed for a needle comprising a distal shaft and a proximal shaft joined at a junction, the needle having a distal tip which includes an electrode for delivering energy to puncture a tissue, wherein the distal shaft is comprised of a superelastic material. In typical embodiments, the needle includes a lumen for delivering and withdrawing fluids from a treatment site. In some embodiments the junction is comprised of a superelastic material.

Abstract: Novel and unique medical devices and associated methods are disclosed, for facilitating efficient and repeatable puncture of a tissue site while allowing vascular access from various access sites of a patient's body. Disclosed medical devices include dilators and wires usable alone or in combination and configured to facilitate tissue access and puncture at various anatomical locations from desired access sites. The medical devices each include one or more sections having sufficient flexibility for accessing the tissue site from the access site while retaining sufficient stiffness to perform one or more additional functions.

Abstract: Devices and methods are disclosed for widening a channel in a treatment site, the channel containing a guide-wire. The channel is widened by advancing an elongated dilation device, which is configured to fit tightly over the guide-wire at the distal tip of the dilation device and to provide a distal dilating surface, over the guide-wire and at least partially through the treatment site. The dilation device comprises a tubular metallic shaft, typically a metal inner tube, for providing sufficient stiffness and column strength for the dilator to be advanced at least partially through the channel, and a flexible sleeve providing a tapered distal tip. The distal end of the dilator defines a leading surface that is shaped to force away portions of a lesion surrounding the guide-wire away from the guide-wire as the distal end is advanced over the guide-wire through the lesion, whereby a channel through the lesion is at least partially dilated.

Abstract: In some embodiments, an electrosurgical device comprises an electrically conductive elongate member for traversing body vasculature defining a hollow lumen with one or more apertures at or near its distal end, wherein electrical energy can flow through the wall of the elongate member; and an energy delivery device in electrical communication with the elongate member located at or about the distal end of the elongate member. The energy delivery device includes an electrode for delivering energy, and a thermal shield positioned between the electrode and the elongate member.

Abstract: Devices and methods for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes advancing a distal end of a puncture device towards the heart from a subxiphoid region of a patient wherein the distal end of the puncture device is atraumatic and comprises an energy delivery device; positioning the energy delivery device at a target site on a pericardium of the heart using ultrasound for imaging; and delivering energy from the energy delivery device to a tissue of the target site to create a channel to the pericardial cavity. The method may include repeating one or more of the above steps until the energy delivery device is located within the pericardial cavity. Some embodiments of the method include using supplemental means of monitoring, including medical imaging and using contrast fluid.

Abstract: Embodiments of medical devices and methods are disclosed. The medical devices typically comprise a flexible elongate member defining a lumen, and a support spine affixed to the distal end and extending proximally therefrom within the elongate member lumen. In some embodiments, the support spine is configured to support at least a portion of the elongate member when the elongate member is bent or curved. Some embodiments include apertures at or near the distal end for enabling fluid communication between the lumen and the outside environment. In some embodiments, the support wire extends proximally from the distal end within a distal portion of the lumen such that a proximal portion of the lumen is substantially unobstructed, thereby reducing turbulence of fluid flowing through the lumen.

Abstract: Described herein is a method for creating a channel through a foreign material located in a body of a patient. The foreign material defines a material first surface and a substantially opposed material second surface and the channel extends through the foreign material between the material first and second surfaces. The method uses an apparatus including an electrode, and includes the steps of: positioning the electrode substantially adjacent to the material first surface; energizing the electrode with a radiofrequency current; and using the electrode energized with the radiofrequency current to deliver energy into the foreign material to create the channel. In some embodiments, the patient's body includes a heart defining a septum, the septum defines an aperture extending there-through and the foreign material extends across the aperture to cover the aperture.

Abstract: A method and apparatus are disclosed for providing forward fluid delivery through an energy delivery device that avoids coring when it delivers energy to a tissue. The device has a distal face defining an opening, with the distal face including at least one electrically exposed portion and at least one electrically insulated portion. An embodiment of the energy delivery device includes an elongate member defining a lumen structured to receive a fluid, and a distal face defining an aperture in communication with the lumen. The distal face includes an electrically exposed conductive portion and an electrically insulated portion. The electrically exposed conductive portion is configured such that the energy it delivers while the energy delivery device is advanced into a tissue punctures the tissue without the tissue substantially occluding the lumen and without creating embolic particles.

Abstract: Devices and methods are disclosed for providing access to the pericardial cavity while reducing risk of myocardial damage. One method includes advancing a puncture device towards a heart, the puncture device including an energy delivery device; measuring an electrical impedance at the energy delivery device; delivering energy from the energy delivery device to at least partially puncture a pericardium; and repeating one or more of the above steps, if necessary, until the energy delivery device is located at least partially within the pericardial cavity. Some embodiments of the method include using supplemental means of monitoring, including measuring voltage to plot an ECG, medical imaging and using contrast fluid, using tactile feedback, and aspirating fluid.

Abstract: A control system and method are provided for control of a steerable catheter, the catheter including at least two control wires, a distal end of each of the control wires being coupled to the catheter at a distal region thereof, the control system comprising: a housing coupled to the catheter; a slide assembly positioned within the housing and operable to translate linearly therein; a proximal portion of each of the at least two control wires being positioned through the slide assembly; and a control knob rotatably coupled to the housing for linearly translating the slide assembly, thereby enabling the slide assembly to separately manipulate each of said at least two control wires to effect a change in a deflection of said catheter.