Abstract: A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.

Abstract: An apparatus for providing hemostasis within a puncture through tissue includes an elongate member having a lumen extending between proximal and distal ends thereof, an expandable member carried on the distal end and a housing on the proximal end, the housing including an interior communicating with the lumen, and further including a valve assembly with a one-way valve allowing access into the housing interior upon application of a pressure differential across the valve, and a movable plunger for overriding and opening the valve.

Abstract: A method for locating neural tissue in a patient body may involve: advancing a probe along a natural tissue interface between the neural tissue and another tissue in the body, the probe having a first surface oriented toward the neural tissue and a second surface oriented away from the neural tissue; delivering a first electrical current to a first electrode along the first surface of the probe; delivering a second electrical current to a second electrode along the second surface of the probe; and verifying that the first surface of the advanced probe remains oriented toward the neural tissue and the second surface remains oriented away from the neural tissue by monitoring neural response to the first and second electrical currents.

Abstract: A method in which a probe is advanced between a neural tissue structure and a non-neural tissue structure such as the intervertebral foramen. The probe includes electrodes on opposite surfaces. Threshold currents required to stimulate action potentials for each electrode are determined. A ratio of the threshold currents are calculated. Tissue is removed from the non-neural tissue structure when the ratio is greater than a predetermined threshold.

Abstract: Described herein are method, systems and devices for measuring the region adjacent to or around a nerve root, such as the space within an intervertebral foramen before, during and/or after a spinal decompression procedure. Measurement devices may be advanced by pulling on them using a guidewire passing through the intervertebral foramen and out of the subject. The measurement device may include sounds for determining one or more dimensions of the space around a nerve root within an intervertebral space, lateral recess or central canal. Various embodiments of sounds, including calibrated, inflatable, expandable, moldable, and tapered sounds (or combinations of these) are described.

Abstract: Guidewire exchange systems, devices and methods, for positioning and actuating surgical devices in a desired position between two tissues in a patient's body are described. A guidewire may be coupled to a surgical device for positioning and actuating (e.g., urging against a target tissue). The guidewire may be exchanged between different surgical devices during the same procedure, and the guidewire and surgical devices may be releaseably or permanently coupled. The surgical device generally includes one or more guidewire coupling members. A system may include a guidewire and a surgical device having a guidewire coupling member. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures.

Abstract: A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.

Abstract: A method and system for guiding at least a portion of a surgical device to a desired position between two tissues in a patient's body involves coupling a guidewire to the device and pulling the distal end of the guidewire to guide at least a portion of the surgical device to a desired position between the two tissues. The surgical device generally includes one or more guidewire coupling members and may comprise a tissue access device. A system may include a guidewire and a surgical device. In some embodiments, a guidewire, a tissue access device, and one or more additional devices to use with the access device may be provided. Methods, devices and systems may be used in open, less-invasive or percutaneous surgical procedures, in various embodiments.

Abstract: A device for cutting tissue in a human body may include an elongate, hollow shaft having a proximal portion and a distal portion, a bundle of flexible wires slidably disposed within at least a portion of the shaft and having a proximal end and a distal end, and an actuator coupled with the proximal portion of the shaft and the proximal end of the bundle of wires. The distal end of the bundle may be configured to facilitate cutting of tissue, and the wires of the bundle may be at least partially free to move, relative to one another, to allow a cross-sectional shape of the bundle to differ along a length from the proximal to the distal end. The actuator may be configured to move the wires back and forth through the hollow shaft to cause the distal ends of the wires to cut tissue.

Abstract: An apparatus for providing hemostasis within a puncture through tissue includes an elongate member having a lumen extending between proximal and distal ends thereof, an expandable member carried on the distal end and a housing on the proximal end, the housing including an interior communicating with the lumen, and further including a valve assembly with a one-way valve allowing access into the housing interior upon application of a pressure differential across the valve, and a movable plunger for overriding and opening the valve.

Abstract: A device for modifying tissue in a patient may include: an elongate body having a rigid proximal portion and a flexible distal portion having first and second major surfaces; a proximal handle coupled with the proximal portion of the body; one or more tissue modifying members disposed along the first major surface of the distal portion of the body; a guidewire coupled with and extending from the distal portion of the body; and a distal handle removably couplable with the guidewire outside the patient.

Abstract: A device for modifying tissue in a patient may include: an elongate body having a rigid proximal portion and a flexible distal portion having first and second major surfaces; a proximal handle coupled with the proximal portion of the body; one or more tissue modifying members disposed along the first major surface of the distal portion of the body; a guidewire coupled with and extending from the distal portion of the body; and a distal handle removably couplable with the guidewire outside the patient.

Abstract: A method for locating neural tissue in a patient body may involve: advancing a probe along a natural tissue interface between the neural tissue and another tissue in the body, the probe having a first surface oriented toward the neural tissue and a second surface oriented away from the neural tissue; delivering a first electrical current to a first electrode along the first surface of the probe; delivering a second electrical current to a second electrode along the second surface of the probe; and verifying that the first surface of the advanced probe remains oriented toward the neural tissue and the second surface remains oriented away from the neural tissue by monitoring neural response to the first and second electrical currents.

Abstract: A connector assembly for catheters having closed loop flow circuits, such as some balloon catheters and heat exchange catheters. The connector assembly comprises first and second connector bodies that may be connected and disconnected from one another. When the connector bodies are disconnected, a syringe or negative pressure source may be attached to withdraw residual fluid from the catheter's closed loop circuit and to deflate any expandable portion of the closed loop circuit (e.g., balloon or expandable heat exchanger). A one way flow valve prevents make up air or other fluid from entering the catheter while the negative pressure is being applied. Also disclosed are sterility barrier assemblies for all types of catheters.

Abstract: A balloon catheter having improved flexibility in and about its distal end is provided. The flexibility of the catheter is determined in part by improving the properties of a wire or catheter located within the area where the balloon is mounted. In one aspect of the present invention, connecting wires extend through the balloon from the distal end of a catheter body to the proximal end of a core wire. The core wire extends distally away from the connecting wires and the catheter body. In another aspect of the present invention, a core wire is provided having a proximal end extending within the balloon into the catheter tubular body but is not mounted therein. This allows the proximal end of the core wire to “float” within the tubular body, such that when the catheter is advanced through the vasculature of a patient, the core wire may move longitudinally within the tubular body.

Abstract: A dilation catheter and expandable balloon. The catheter includes a catheter tube, a proximal end, a distal end and an axis which extends between the proximal and distal ends. A balloon has two ends, at least one end mounts on the distal end of the catheter. The balloon inflates and deflates between a collapsed configuration and an expanded configuration. The balloon has a tapered portion and a working length. The tapered portion extends from the catheter tube at an angle &agr; within the range of 7° to 20° and attaches the working length of the balloon to the catheter tube. Accordingly, the angle &agr; between the tapered portion and the catheter tube is optimized to enable the balloon to slide when the balloon is in the collapsed configuration.

Abstract: A dilation catheter and expandable balloon. The catheter includes a catheter tube, a proximal end, a distal end and an axis which extends between the proximal and distal ends. A balloon has two ends, at least one end mounts on the distal end of the catheter. The balloon inflates and deflates between a collapsed configuration and an expanded configuration. The balloon has a tapered portion and a working length. The tapered portion extends from the catheter tube at an angle .alpha. within the range of 7.degree. to 20.degree. and attaches the working length of the balloon to the catheter tube. Accordingly, the angle .alpha. between the tapered portion and the catheter tube is optimized to enable the balloon to slide when the balloon is in the collapsed configuration.