Abstract: The instant invention is directed toward an ablation catheter and sheath incorporating wire rail system. The catheter may have a combination of rigid and flexible components to orient an ablation electrode at the distal tip toward the target tissue. The wire rail acts to guide an ablation tip along the tissue to aid in the formation of spot or continuous linear lesions on a trabecular surface, e.g., in the right atrium along the isthmus between the ostium of the inferior vena cava and the tricuspid valve.

Abstract: A curved ablation catheter imparts ablative energy to target tissue, for example, along a trabecular slope, e.g., in the right atrium along the isthmus between the ostium of the inferior vena cava and the tricuspid valve. The catheter is formed with a preset curvature that, when deployed, both translates linearly and increases in radius to aid in the formation of spot or continuous linear lesions. A method of treating atrial flutter employs the curved ablation catheter.

Abstract: An introducer sheath has multiple distal slots allowing for translation of a catheter within a cardiac cavity. A pair of longitudinal slots are provided on opposite sides of the sheath near the distal end. A portion of the catheter may deploy from one of the slots while the ablation tip deploys from the opposing slot. The sheath design provides greater maneuverability for the catheter in a direction orthogonal to the tissue to be ablated, while restricting lateral movement of the catheter. The longitudinal direction of the slots further aids in the formation of linear lesions using the catheter.

Abstract: A bipolar conforming electrode catheter has a plurality of flexible filaments or bristles forming a brush electrode for applying therapeutic energy (e.g., RF energy) to target tissue to form spot or continuous linear lesions. Interstitial spaces are defined among the filaments of the brush electrode. The interstitial spaces are adapted to direct conductive or nonconductive fluid, when present, toward the distal ends of the filaments. The brush electrode facilitates electrode-tissue contact in target tissue having flat or contoured surfaces. The flexible filaments may be selectively trimmed to give a desired tip configuration or a desired standoff distance between the tissue and the conductive filaments in the brush electrode. The filaments may be grouped into clusters. The catheter includes a dispersive return electrode for bipolar function.

Abstract: A spring-tip, flexible electrode, and a method for using that electrode for tissue ablation, are disclosed. The spring-tip, flexible electrode comprises an enshrouded flexible electrode (e.g., an enshrouded plurality of flexible brush filaments or bristles) for applying ablative energy (e.g., RF energy) to target tissue during the formation of spot or continuous linear lesions. The spring of the spring tip may comprise compressible coils, compressible mesh, or compressible bellows, among other things. The spring provides axial suspension and is capable of axial compression and extension, and is flexible enough for deflection and bending. The axial suspension of the spring tip facilitates the desired contact between the electrode and the tissue surface. A shielded, spring-tip, flexible electrode is also disclosed, and includes a flexible nipple or shield. The spring-tip, flexible electrode facilitates enhanced tissue contact in difficult environments (e.g.

Abstract: Side-port sheaths for catheter placement and translation are disclosed. The sheaths include a side-port opening through which a gliding catheter may be deployed during diagnosis or treatment of tissue. The side-port sheath may include a suspension ribbon used to deploy, or that aids in the deployment of, the embedded gliding catheter. The suspension ribbon may be slideably or fixably engaged with an outer surface of the sheath of the gliding catheter.

Abstract: The present invention relates to a three-needle type vascular closure system. The closure system utilizes three needles in the form of a guiding device, an expandable needle, and a hooking device. The guiding device is used to make the initial opening in the vessel, where the opening provides access for a sheath through which a medical procedure is to be performed. The expandable needle is inserted into the vessel in which it expands radially from the needle to form a target. The hooking device is also inserted into the vessel and is used to hook the expandable needle so as to form an internal union between the hooking device and the expandable needle. The needles can then be retracted thereby extending a suture from the hooking device and forming an internal suture pass that can be used to approximate the tissue surrounding the initial opening in the vessel. In one embodiment, the suture is passed across the vessel opening prior to dilation of the vessel opening.

Abstract: A brush electrode and a method for using the brush electrode for tissue ablation are disclosed. The brush electrode comprises a plurality of flexible filaments or bristles for applying ablative energy (e.g., RF energy) to target tissue during the formation of spot or continuous linear lesions. Interstitial spaces are defined among the filaments of the brush electrode, and the interstitial spaces are adapted to direct conductive or nonconductive fluid, when present, toward the distal ends of the brush filaments. The brush electrode facilitates electrode-tissue contact in target tissue having flat or contoured surfaces. The flexible filaments may be selectively trimmed to give a desired tip configuration or a desired standoff distance between the tissue and the conductive filaments in the brush electrode. Also, the filaments may be grouped into clusters. A shielded-tip brush electrode, including a flexible boot, is also disclosed.

Abstract: A brush electrode catheter and a method for using the brush electrode catheter for tissue ablation are disclosed. The brush electrode catheter comprises a plurality of flexible filaments or bristles for applying ablative energy (e.g., RF energy) to target tissue during the formation of spot or continuous linear lesions. Interstitial spaces are defined among the filaments of the brush electrode, and the interstitial spaces are adapted to direct conductive or nonconductive fluid, when present, toward the distal ends of the brush filaments. The brush electrode facilitates electrode-tissue contact in target tissue having flat or contoured surfaces. The flexible filaments may be selectively trimmed to give a desired tip configuration or a desired standoff distance between the tissue and the conductive filaments in the brush electrode. Also, the filaments may be grouped into clusters. A shielded-tip brush electrode, including a flexible boot, is also disclosed.

Abstract: A surgical device incorporates a brush electrode for tissue ablation and other forms of electrosurgical treatment. A plurality of flexible filaments compose the brush electrode, through which therapeutic energy (e.g., RF energy) is applied to target tissue for the formation of spot or continuous linear lesions, cauterization, incision, and desiccation. A fluid delivery system is used in conjunction with the brush electrode to apply fluid to the filaments and surgical site.

Abstract: A pre-tied knot is used in conjunction with a vascular closure device to approximate tissue surrounding an opening in a corporeal vessel. The pre-tied knot is positioned on a proximal end of the suture such that a distal end of the suture can be inserted through the pre-tied knot to complete the knot. A typical medical procedure as contemplated by the present invention is performed through a sheath inserted through an opening in the vessel wall to access the inside of the vessel. The device used to perform the medical procedure is then removed from the sheath and a vascular closure device is inserted through the sheath to position a suture across the vessel opening. The pre-tied knot assists in approximating tissue surrounding the vessel opening.

Abstract: An internal tissue puncture closure method and apparatus. The method and apparatus provide a folded sealing plug that provides more surface area than conventional plugs to more fully cover and seal an external situs of an internal tissue puncture. The folded sealing plug may have a weave pattern that tends to cause the sealing plug to corkscrew into the internal tissue puncture as it is compressed toward an anchor placed inside of the tissue puncture.