Abstract: Improved medical guide elements for use with dilators to be inserted into an organ or body structure of a patient, such as the kidney. The guide element includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the guide element is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment. The relative dimensions of the dilator tip and the discrete stepped transition of the guide element provides full shielding or over shielding of the dilator tip, thereby facilitating passage of the dilator tip along the tissue track, through the puncture hole and into the orifice.

Abstract: Improved methods for percutaneously creating, entering and/or dilating an opening in the wall of a blood vessel or other anatomic structure. The improvement comprises deploying a guide element having a proximal segment and a distal segment, the diameter of said distal segment being greater than the diameter of said proximal segment at their juncture, and which at said juncture forms an abrupt circumferential step comprising a proximally-facing surface. Said proximally-facing surface abuts the catheter's tip and shields said tip, thereby facilitating passage of said catheter as it enters and passes through said opening in said wall of a blood vessel or other anatomic structure.

Abstract: Improved methods for percutaneously creating, entering and/or dilating an opening in the wall of a blood vessel or other anatomic structure. The improvement comprises deploying a guide element having a proximal segment and a distal segment, the diameter of said distal segment being greater than the diameter of said proximal segment at their juncture, and which at said juncture forms an abrupt circumferential step comprising a proximally-facing surface. Said proximally-facing surface abuts the catheter's tip and shields said tip, thereby facilitating passage of said catheter as it enters and passes through said opening in said wall of a blood vessel or other anatomic structure.

Abstract: A stiffened balloon apparatus for use in angioplasty. Elongate stiffening members disposed longitudinally on the expandable balloon stiffen the membrane of said balloon. The stiffening members possess sufficient rigidity to resist local deformation of the wall of said expandable balloon upon expansion of said balloon and upon contact of said stiffening member with a local deformation within an anatomical passage or target lumen. Projections and/or raised surfaces on a stiffening member may engage, incise, crush, fracture, or pierce occlusions and/or the inner surface of the passage or target lumen in which it is being operated. Associated method for use to incise the inner surface of a target lumen or incise the stenosis that may be located therein.

Abstract: A physical configuration of cables and a wireless communication system for connecting a monitoring apparatus to a human patient, where said patient and his immediate surroundings define a potentially infectious contaminated zone. The configuration provides for the monitoring apparatus and a wireless receiver to lie outside of the contamination zone, and one or more serial cables to interface with said patient within said infectious zone. A wireless transmitter is connected to said serial cable proximal end and configured to wirelessly transmit patient information to said wireless receiver which is connected to the monitoring apparatus. This physical configuration prevents contamination of the monitoring apparatus and wireless receiver, so they may be reused on successive patients, and prevents the transfer of infective agents to a subsequent patient in a series of patients. The serial cable(s) used to contact the patient within his contamination zone may be disposable.

Abstract: Improved methods for percutaneously creating, entering and/or dilating an opening in the wall of a blood vessel or other anatomic structure. The improvement comprises deploying a guide element having a proximal segment and a distal segment, the diameter of said distal segment being greater than the diameter of said proximal segment at their juncture, and which at said juncture forms an abrupt circumferential step comprising a proximally-facing surface. Said proximally-facing surface abuts the catheter's tip and shields said tip, thereby facilitating passage of said catheter as it enters and passes through said opening in said wall of a blood vessel or other anatomic structure.

Abstract: Improved medical filaments for use with dilators to be inserted into a patient, for example into the vascular lumen, are provided, as well as combinations of filaments and dilators. Methods for use of such filaments and filament-dilator combinations are also described. The filament includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the filament is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment.

Abstract: A physical configuration of cables connecting a monitoring apparatus to a human patient, where said patient and his immediate surroundings define a potentially infectious contaminated zone. The configuration provides for the monitor and main trunk cable to lie outside of the contamination zone, and one or more serial cables connect to the trunk cable and enter the contamination zone to provide contact with the patient. This physical configuration prevents contamination of the monitor and trunk cable, so they may be reused on successive patients, while lightweight and inexpensive serial cables contacting the patient and his contamination zone may be disposable. Examples of monitoring various physiological variables are provided to exemplify the universal concept of such physical configuration. Adaptation for wireless transmission is also described.

Abstract: Improved medical filaments for use with dilators to be inserted into a patient, for example into the vascular lumen, are provided, as well as combinations of filaments and dilators. Methods for use of such filaments and filament-dilator combinations are also described. The filament includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the filament is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment.

Abstract: A tubular conduit is used to access blood vessels or other structures in the human body. The conduit has a distal tip angled to match the angle of entry into the body and an end contour adapted for the surface of the target vessel or organ. The contour may be curved to match the curve on the outer surface of the vessel or organ. The conduit's angled and contoured distal end may be adapted to engage, and align the conduit with, the surface of the vessel or organ. The conduit bears a longitudinal groove along its lower, inner surface. When the conduit is appropriately aligned, the groove may be used to guide a needle tip to the desired location, for example, the mid-line of the vessel or organ.

Abstract: An instrument for engaging an underlying blood vessel or body structure. The instrument comprises a pair of instrument arms, and an instrument finger extends at an angle from each arm. The distal end of each instrument finger comprises a bottom surface at an angle to the axis of the instrument finger such that it is adapted to rest upon the underlying blood vessel or body structure. In certain embodiments the bottom surfaces are in a plane that is substantially parallel to the plane of the instrument arms.

Abstract: The present invention pertains to a stiffened balloon which can be used in angioplasty, endovascular, and valvuloplasty procedures or as a delivery balloon to deliver a stent or a stent-graft. Longitudinally discontinuous stiffening members connected to the expandable balloon stiffen the balloon but allow it to be navigated through curved passages. Projections on the stiffening members may engage, incise, crush, fracture, or pierce occlusions or retain a stent or stent-graft. Radio-opaque portions may be referenced to determine orientation. Longitudinally continuous stiffening members bearing projections and connected to the balloon perform in a similar manner.

Abstract: Improved medical filaments for use with dilators to be inserted into a patient, for example into the vascular lumen, are provided, as well as combinations of filaments and dilators. Methods for use of such filaments and filament-dilator combinations are also described. The filament includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the filament is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment.

Abstract: A physical configuration of cables connecting a monitoring apparatus to a human patient, where said patient and his immediate surroundings define a potentially infectious contaminated zone. The configuration provides for the monitor and main trunk cable to lie outside of the contamination zone, and one or more serial cables connect to the trunk cable and enter the contamination zone to provide contact with the patient. This physical configuration prevents contamination of the monitor and trunk cable, so they may be reused on successive patients, while lightweight and inexpensive serial cables contacting the patient and his contamination zone may be disposable. Examples of monitoring various physiological variables are provided to exemplify the universal concept of such physical configuration. Adaptation for wireless transmission is also described.

Abstract: An ergonomic hand instrument with a finger grip loop and a thumb grip loop also has a forefinger control surface on at least one of the instrument arms. The control surface may include a proximally facing curved wall surface to receive the distal end of the tip of the user's forefinger. Forward and downward pressure can be applied with the forefinger with improved control and stability.

Abstract: The present invention pertains to a stiffened balloon which can be used in angioplasty, endovascular, and valvuloplasty procedures or as a delivery balloon to deliver a stent or a stent-graft. Longitudinally discontinuous stiffening members connected to the expandable balloon stiffen the balloon but allow it to be navigated through curved passages. Projections on the stiffening members may engage, incise, crush, fracture, or pierce occlusions or retain a stent or stent-graft. Radio-opaque portions may be referenced to determine orientation. Longitudinally continuous stiffening members bearing projections and connected to the balloon perform in a similar manner.

Abstract: The present invention pertains to a stiffened balloon which can be used in angioplasty, endovascular, and valvuloplasty procedures or as a delivery balloon to deliver a stent or a stent-graft. Longitudinally discontinuous stiffening members connected to the expandable balloon stiffen the balloon but allow it to be navigated through curved passages. Projections on the stiffening members may engage, incise, crush, fracture, or pierce occlusions or retain a stent or stent-graft. Radio-opaque portions may be referenced to determine orientation. Longitudinally continuous stiffening members bearing projections and connected to the balloon perform in a similar manner.

Abstract: A balloon having one or more stiffeners is used to configure an expandable device. Methods of configuring and reconfiguring an expandable device with a balloon having a stiffener attached at its perimeter by orienting the stiffener with the expandable device and expanding the balloon to cause the stiffener to exert radial force against the expandable device are provided. Methods of delivering an expandable device carried on a balloon having a stiffener attached are also provided. Reference to radio-opaque portions of the stiffener facilitate orientation of the stiffener with the expandable device.

Abstract: Improved medical filaments for use with dilators to be inserted into a patient, for example into the vascular lumen, are provided, as well as combinations of filaments and dilators. Methods for use of such filaments and filament-dilator combinations are also described. The filament includes a proximal segment and a distal segment. The diameter of the distal segment is greater than the diameter of the proximal segment. The change in diameter is abrupt, providing a discrete step transition at a point along the filament which presents a proximally-facing surface on the distal segment. When the proximal segment of the filament is fully inserted into a dilator having a distal tip adapted for insertion into a patient, the dilator distal tip firmly abuts the proximally-facing end surface of the distal segment.

Abstract: A spreading instrument includes instrument fingers which can be spread to partially define a cylindrical passage between the instrument fingers. A rounded groove on the interior surface of each instrument finger is tapered lengthwise, becoming shallower towards the distal end of the finger. When the fingers are spread, the opposing grooves partly define a cylindrical passage adapted to receive a tubular structure.