Abstract: A medical tool comprises an elongated tubular section comprising a body wall. The body wall includes a plurality of slits. The tool further comprises a rigid needle tip coupled to a distal end of the elongated tubular section. The tool further comprises a flexible jacket covering at least a portion of the elongated tubular section. The tool further comprises an elongated flexible member coupled to a proximal end of the elongated tubular section. A distal portion of the elongated flexible member covers a proximal portion of the flexible jacket, and a proximal portion of the elongated flexible member extends into at least a portion of the plurality of slits.

Abstract: An axial support structure for a flexible elongate device includes a plurality of rigid links coupled by pin joints. Each of the plurality of rigid links comprises a shaft, a pair of male joint connectors extending axially from a first end of the shaft, and a pair of female joint connectors extending axially from a second end of the shaft opposite the first end. The female joint connectors are complementary to the male joint connectors and are rotated by 90 degrees relative to the male joint connectors. Each of the plurality of rigid links is rotated by 90 degrees with respect to neighboring links among the plurality of rigid links, thereby aligning each pair of male joint connectors with a neighboring pair of female joint connectors to form the pin joints.

Abstract: A method comprises deploying a tool to a passageway exit site through a lumen of a flexible elongate device. The flexible elongate device comprises a proximal end, a distal end, and the lumen therebetween, and the tool comprises a needle. The method further comprises puncturing a passageway wall at the passageway exit site with the needle. The method further comprises deploying the needle through the passageway wall and through target tissue at a target location beyond the passageway wall. The method further comprises deploying an instrument to perform treatment on the target tissue at the target location. The instrument is deployed within the tool and through a perforation created in the target tissue by the needle.

Abstract: An axial support structure for a flexible elongate device may comprise a plurality of rigid links coupled by pin joints. Each of the plurality of rigid links may comprise a shaft, a pair of male joint connectors, and a pair of female joint connectors. Each male joint connector may comprise a male tab including an inner surface coplanar with an inner surface of the shaft and extending axially from a first end of the shaft. Each of the male joint connectors may include a pin extending radially. Each female joint connector may comprise a female tab having an outer surface coplanar with an outer surface of the shaft and extending axially from a second end of the shaft. The pair of female joint connectors may be rotated by 90 degrees relative to the pair of male joint connectors. Each female tab may define an aperture.

Abstract: Apparatus for endovascularly replacing a patient's heart valve, including: a replacement valve adapted to be delivered endovascularly to a vicinity of the heart valve; an expandable anchor adapted to be delivered endovascularly to the vicinity of the heart valve; and a lock mechanism configured to maintain a minimum amount of anchor expansion. The invention also includes a method for endovascularly replacing a patient's heart valve. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve; expanding the anchor to a deployed configuration; and locking the anchor in the deployed configuration.

Abstract: The present invention provides apparatus for endovascularly replacing a patient's heart valve. The apparatus includes a replacement valve and an expandable anchor configured for endovascular delivery to a vicinity of the patient's heart valve. In some embodiments, the replacement valve is adapted to wrap about the anchor, for example, by everting during endovascular deployment. In some embodiments, the replacement valve is not connected to expandable portions of the anchor. In some embodiments, the anchor is configured for active foreshortening during endovascular deployment. In some embodiments, the anchor includes expandable lip and skirt regions for engaging the patient's heart valve during deployment. In some embodiments, the anchor comprises a braid fabricated from a single strand of wire. In some embodiments, the apparatus includes a lock configured to maintain anchor expansion.

Abstract: The invention includes methods of and apparatus for endovascularly replacing a heart valve of a patient. One aspect of the invention provides a method including the steps of endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve in an unexpanded configuration; and applying an external non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to change the shape of the anchor, such as by applying proximally and/or distally directed force on the anchor using a releasable deployment tool to expand and contract the anchor or parts of the anchor. Another aspect of the invention provides an apparatus including a replacement valve; an anchor; and a deployment tool comprising a plurality of anchor actuation elements adapted to apply a non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to reshape the anchor.

Abstract: Configurations are described for conducting minimally invasive medical interventions utilizing elongate instruments and assemblies thereof to stabilize and/or fixate a sacro-iliac joint. In one embodiment, a tool assembly may be advanced from a posterior approach into the SI junction and configured to create a defect defined at least in part by portions of both the sacrum and the ilium, the defect having a three dimensional shape defined in part by at least one noncircular cross sectional shape in a plane substantially perpendicular to the longitudinal axis of the tool assembly. After a defect is created, the tool assembly may be retracted and a prosthesis deployed into the defect.

Abstract: Configurations are described for conducting minimally invasive medical interventions utilizing elongate instruments and assemblies thereof to stabilize and/or fixate a sacro-iliac joint. In one embodiment, a tool assembly may be advanced from a posterior approach into the SI junction and configured to create a defect defined at least in part by portions of both the sacrum and the ilium, the defect having a three dimensional shape defined in part by at least one noncircular cross sectional shape in a plane substantially perpendicular to the longitudinal axis of the tool assembly. After a defect is created, the tool assembly may be retracted and a prosthesis deployed into the defect.

Abstract: A medical tool may comprise sheath and a needle extendable from and retractable into the sheath. The sheath may comprise a tubular shaft member and a guard member attached to the tubular shaft member. The needle may comprise a flexible jacket. One or more of these components may be configured to prevent interference between the flexible jacket and a portion of the guard member as the need is extended or retracted.

Abstract: Apparatus for endovascularly replacing a patient's heart valve, including: a replacement valve adapted to be delivered endovascularly to a vicinity of the heart valve; an expandable anchor adapted to be delivered endovascularly to the vicinity of the heart valve; and a lock mechanism configured to maintain a minimum amount of anchor expansion. The invention also includes a method for endovascularly replacing a patient's heart valve. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve; expanding the anchor to a deployed configuration; and locking the anchor in the deployed configuration.

Abstract: An axial support structure for a flexible elongate device may comprise a plurality of rigid links coupled by pin joints. Each of the plurality of rigid links may comprise a shaft, a pair of male joint connectors, and a pair of female joint connectors. Each male joint connector may comprise a male tab including an inner surface coplanar with an inner surface of the shaft and extending axially from a first end of the shaft. Each of the male joint connectors may include a pin extending radially. Each female joint connector may comprise a female tab having an outer surface coplanar with an outer surface of the shaft and extending axially from a second end of the shaft. The pair of female joint connectors may be rotated by 90 degrees relative to the pair of male joint connectors. Each female tab may define an aperture.

Abstract: An axial support structure for a flexible elongate device includes a plurality of rigid links. each link comprises a shaft, a pair of male joint connectors comprising a male tab coplanar with the shaft extending from a first end, and a pair of female joint connectors comprising a female tab coplanar with the shaft extending from a second end. Each of the male joint connectors includes a pin extending from the male tab in a direction perpendicular to an axial direction of the shaft and each female tab defines an aperture. Each of the plurality of rigid links is rotated by 90 degrees with respect to neighboring links among the plurality of rigid links, thereby aligning each pair of male joint connectors with a neighboring pair of female joint connectors to form pin joints in which each aperture encircles a corresponding pin.

Abstract: Flexible elongate device systems and methods include a flexible elongate device having a flexible body and an axial support structure. The axial support structure includes at least one groove extending along a length of the axial support structure. The flexible elongate device further includes a plurality of control elements for actuating the flexible elongate device. Each of the plurality of control elements extends through one of the at least one groove of the axial support structure. In some embodiments, the at least one groove includes a plurality of grooves spaced circumferentially around the axial support structure. In some embodiments, the flexible body includes lumens that extend through the at least one of the grooves. The control elements are disposed in the lumens. In some embodiments, the flexible body includes a main lumen that extends centrally through the flexible body. The main lumen provides a channel for a medical tool.

Abstract: A medical tool comprises an elongated tubular section having a body wall including a plurality of slits and a rigid needle tip coupled to a distal end of the tubular section. The tool further includes a flexible jacket coupled with the elongated tubular section by extending into the plurality of slits to block a fluid passageway through the plurality of slits.

Abstract: Systems and methods for minimally invasive treatment of target tissue among one or more passageways include a flexible elongate device, a tool including a first tubular member, and an instrument to perform treatment on target tissue around the target location. The flexible elongate device includes a proximal end, a distal end, and a lumen therebetween. The tool is configured for deployment within the lumen to a passageway exit site, puncturing a passageway wall at the passageway exit site, and deployment to a target location. The instrument is sized to be deployed within the tool. In some embodiments, the systems and methods further include an anchor configured to stabilize the tool. In some embodiments, the first tubular member is a first hollow sheath configured to be deployed past the distal end of the flexible elongate device to the passageway exit site.

Abstract: The invention includes methods of and apparatus for endovascularly replacing a heart valve of a patient. One aspect of the invention provides a method including the steps of endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve in an unexpanded configuration; and applying an external non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to change the shape of the anchor, such as by applying proximally and/or distally directed force on the anchor using a releasable deployment tool to expand and contract the anchor or parts of the anchor. Another aspect of the invention provides an apparatus including a replacement valve; an anchor; and a deployment tool comprising a plurality of anchor actuation elements adapted to apply a non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to reshape the anchor.

Abstract: Apparatus for endovascularly replacing a patient's heart valve, including: a replacement valve adapted to be delivered endovascularly to a vicinity of the heart valve; an expandable anchor adapted to be delivered endovascularly to the vicinity of the heart valve; and a lock mechanism configured to maintain a minimum amount of anchor expansion. The invention also includes a method for endovascularly replacing a patient's heart valve. In some embodiments the method includes the steps of: endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve; expanding the anchor to a deployed configuration; and locking the anchor in the deployed configuration.

Abstract: A replacement heart valve assembly including an expandable anchor having a skirt region, a lip region, and a groove region therebetween and a replacement valve disposed within the expandable anchor and engaged with the groove region of the expandable anchor.

Abstract: The invention includes methods of and apparatus for endovascularly replacing a heart valve of a patient. One aspect of the invention provides a method including the steps of endovascularly delivering a replacement valve and an expandable anchor to a vicinity of the heart valve in an unexpanded configuration; and applying an external non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to change the shape of the anchor, such as by applying proximally and/or distally directed force on the anchor using a releasable deployment tool to expand and contract the anchor or parts of the anchor. Another aspect of the invention provides an apparatus including a replacement valve; an anchor; and a deployment tool comprising a plurality of anchor actuation elements adapted to apply a non-hydraulically expanding or non-pneumatically expanding actuation force on the anchor to reshape the anchor.